NOTICE: NOT FOR OFFICIAL PUBLICATION.

UNDER ARIZONA RULE OF THE SUPREME COURT 111(c), THIS DECISION IS NOT PRECEDENTIAL

AND MAY BE CITED ONLY AS AUTHORIZED BY RULE.

IN THE

ARIZONA COURT OF APPEALS

DIVISION ONE

KEVIN TRIMBLE, Petitioner Employee,

v.

THE INDUSTRIAL COMMISSION OF ARIZONA, Respondent,

CAPITAL GRILLE HOLDINGS, Respondent Employer,

XL INSURANCE AMERICA, Respondent Carrier.

No. 1 CA-IC 21-0022

Special Action - Industrial Commission

ICA Claim No. 20200-670001

Carrier Claim No. 006829-487189-WC-01

The Honorable Rachel C. Morgan, Administrative Law Judge

AFFIRMED

COUNSEL

Crossman Law Offices, PC, Phoenix

By Avery N. Crossman

Counsel for Petitioner Employee

Industrial Commission of Arizona, Phoenix

By Gaetano J. Testini 

Counsel for Respondent

FILED 2-1-2022
2

Lundmark Barberich LaMont & Slavin PC, Phoenix

By Lisa M. LaMont

Counsel for Respondent Employer and Carrier

MEMORANDUM DECISION

Judge Jennifer M. Perkins delivered the decision of the Court, in which 

Presiding Judge Cynthia J. Bailey and Judge Maria Elena Cruz joined.

P E R K I N S, Judge:

¶1 Kevin Trimble asks us to set aside an Industrial Commission 

of Arizona (“ICA”) Award that finds his injury non-compensable. We

affirm.

FACTUAL AND PROCEDURAL BACKGROUND

¶2 Trimble worked as a restaurant server for Capital Grille 

Holdings in February 2020. On a busy Saturday night, and after working a 

double shift, Trimble collapsed and struck his head on the kitchen floor. 

Several co-workers were nearby, but no one saw Trimble’s fall. One of them 

heard Trimble hit the floor behind her, immediately turned toward him, 

and saw him “seizing” on the floor with blood under his head. Others 

rushed in and witnessed the same thing. Trimble’s coworker drove him to 

a hospital, where he underwent brain surgery for a “rapidly enlarging 

hematoma.” The surgery was successful, and Trimble left the hospital a few 

days later.

¶3 XL Insurance America denied Trimble’s worker’s 

compensation claim. Trimble challenged the denial of his claim, and the 

ICA held a hearing. Trimble, four of his co-workers, and two medical 

experts testified. Trimble testified he did not remember falling to the floor, 

although he remembered feeling lightheaded within the hour before he fell.

He believed he may have briefly lost consciousness. Trimble did not take 

any significant breaks and he ate only a few french fries during his shifts.

He testified he suffered a single seizure about eight years before his fall but

had received no subsequent treatment for seizures. 

¶4 Trimble’s co-workers each testified that they did not see

Trimble fall but had observed him appear to have a seizure while on the 
TRIMBLE v. CAPITAL/XL

Decision of the Court

3

floor. One of his co-workers testified Trimble rubbing his eyes and saying 

he was tired before the fall. There is no record evidence of any tripping or 

slipping hazards on the floor. None of the witnesses testified that Trimble 

hit his head on anything other than the floor.

¶5 Dr. Abhishiek Sharma, the neurosurgeon who performed 

Trimble’s emergency craniotomy, testified the surgery was necessitated by 

a “rapidly expanding hematoma on [Trimble’s] brain” caused by recent 

head trauma. A pre-operation CT scan showed no sign of an aneurysm.

Sharma could not say with certainty whether Trimble’s employment

caused him to fall, though Sharma acknowledged it was possible. 

¶6 Dr. Leo Kahn, a neurologist, also testified after reviewing

Trimble’s medical records. Kahn assumed Trimble fell without tripping, 

slipping, or being pushed. Kahn agreed with Sharma that Trimble’s head 

hitting the floor caused Trimble’s head trauma. Kahn identified five 

possible medical reasons to explain Trimble’s collapse: (1) dehydration; (2) 

low blood pressure; (3) irregular heartbeat; (4) seizure; and (5) an unknown 

reason that caused Trimble to faint. Kahn ruled out the first two possibilities 

because Trimble’s lab results showed he was not dehydrated or suffering 

from low blood pressure. Kahn ruled out a heart problem because Trimble 

did not have low blood pressure or a history of heart disease. Kahn did not 

know whether the seizure resulted from Trimble’s head hitting the floor or 

whether the seizure occurred while he was standing and caused him to fall.

But Kahn concluded a seizure was the most likely explanation for Trimble’s 

fall given Trimble’s prior seizure. Kahn admitted he could not rule out that 

Trimble had slipped and then fell, and he agreed he did not “know” what 

caused Trimble’s fall.

¶7 The administrative law judge (“ALJ”) found the lay witnesses 

credible and Kahn’s opinion “more probably correct.” The ALJ thus found 

Trimble’s claim non-compensable. Trimble now brings this special action 

review. 

DISCUSSION

¶8 We defer to the ALJ’s factual findings, but we review 

questions of law de novo. Young v. Indus. Comm’n, 204 Ariz. 267, 270, ¶ 14 

(App. 2003). Claimants must prove all elements of a compensable claim.

Toto v. Indus. Comm’n, 144 Ariz. 508, 512 (App. 1985). Compensability 

requires both legal and medical causation. Grammatico v. Indus. Comm’n, 211 

Ariz. 67, 71, ¶ 19 (2005). A claimant establishes legal causation by 

demonstrating the accident arose out of and in the course of employment.
TRIMBLE v. CAPITAL/XL

Decision of the Court

4

Id. A claimant proves medical causation by establishing that the accident 

caused the injury. Id. at ¶ 20. Here, the parties agree Trimble’s injury 

occurred within in the course of his employment and was caused by his 

head hitting the floor. 

¶9 The parties only dispute whether Trimble suffered an 

unexplained or idiopathic fall. An unexplained fall is one where no 

explanation whatsoever is offered for the injury. Circle K Store No. 1131 v. 

Indus. Comm’n, 165 Ariz. 91, 95 (1990). An idiopathic fall is one which results 

from a pre-existing infirmity and is non-compensable. Id. at 93.

¶10 There are three types of injury risks from employment: 

employment-related risks; personal risks; and neutral risks. Id. at 95 n.4. As 

relevant here, an unexplained fall is considered a neutral risk, “one neither 

distinctly associated with the employment nor personal to claimant.” Id. In 

Circle K, a worker fell in the parking lot while taking out trash. While the 

worker remembered falling there were no witnesses and neither party 

could explain why the worker fell. Id. at 92-93, 96. Our Supreme Court 

adopted the positional-risk doctrine for cases involving neutral risks. Id. at 

96. “An injury arises out of the employment if it would not have occurred 

but for the fact that . . . the employment placed claimant in the position 

where he was injured.” Id. (cleaned up). In the case of an unexplained fall,

the injured worker is entitled to a rebuttable presumption that the injuries 

from the fall arose out of the employment. Id. at 96. This presumption shifts 

the burden from the injured worker to the employer to prove an injury

cause unrelated to employment.

¶11 In Hypl v. Indus. Comm’n, we reached the same conclusion by 

a different route. 210 Ariz. 381 (App. 2005). There, New Mexico police

stopped an erratic driver transporting goods from Nogales to El Paso. Id. at 

383, ¶ 2. Police discovered the driver was injured and rushed him to a 

hospital with a fractured skull, which required emergency surgery. Id. at 

¶¶ 2–3. When the driver awoke from an eight-hour post-surgery coma, he 

could not remember what caused his injury. Id. at ¶ 3. The ICA found his 

claim non-compensable because he had not shown that the injury was 

connected to his employment. Id. at ¶¶ 2–4. We concluded when there are 

no witnesses, and a worker is found injured on the job, he was in the course 

and scope of employment and entitled to the “unexplained death 

presumption.” Id. at 386, ¶ 13. “[T]he unexplained death presumption 

softens both the in the course of employment element and the arising out of

employment element.” Id. (emphasis added). We applied the presumption 

to cases in which the worker is not killed but the injury removed the only 

possible witness, the worker himself, holding:
TRIMBLE v. CAPITAL/XL

Decision of the Court

5

if [the injured worker] can provide a sufficient 

factual basis to allow an inference that he was 

injured in the time and space limitations of his 

employment, he is entitled to a presumption 

that his injury occurred in the course of and 

arose out of his employment.

Id. at 388, ¶ 21.

¶12 Trimble’s only allegation of error is that the ALJ failed to 

apply the unexplained fall presumption when it analyzed whether the 

injury arose out of his employment. While it may be true the ALJ evaluated 

whether Trimble’s fall was idiopathic referencing Circle K., when it should 

have relied on Hypl because of the lack of witnesses and Trimble’s memory 

loss, we find no error. Although the ALJ’s decision is not a model of clarity, 

the ALJ nonetheless correctly analyzed whether Respondents rebutted the 

presumption, despite its citations to Circle K. The ALJ properly identified

the issue as “whether this injury arose out of the employment.” The ALJ

then noted an unexplained fall “is rebuttably presumed to ‘arise out of’

employment if the fall occurred ‘in the course of’ employment,” citing Circle 

K. Finally, the ALJ found Respondents “demonstrated sufficient evidence 

to rebut the presumption under Circle K.” The ALJ then described Trimble’s 

fall as “idiopathic,” but we do not believe this caused any legal harm to 

Trimble. Whether the fall was idiopathic, and thus not compensable, see 

Circle K., 165 Ariz. at 93, or Respondents rebutted the presumption that the 

injury arose out of employment, the record supports the ALJ’s conclusion 

that the employment did not contribute to Trimble’s injury. Kahn’s 

unrebutted testimony indicated a seizure most likely caused Trimble’s fall.

The ALJ thus properly found that Respondents rebutted the Hypl 

presumption.

CONCLUSION

¶13 We affirm the Award.