THE STATE OF SOUTH CAROLINA 

In The Supreme Court 

Judy Marie Barnes, Employee, Petitioner, 

v. 

Charter 1 Realty, Employer, and Technology Insurance 

Co. Amtrust South, Carrier, Respondents. 

Appellate Case No. 2012-212389 

ON WRIT OF CERTIORARI TO THE COURT OF APPEALS 

Appeal from The Workers' Compensation Commission 

Opinion No. 27479 

Heard September 24, 2014 – Filed January 14, 2015 

REVERSED AND REMANDED 

James K. Holmes and David T. Pearlman, both of the 

Steinberg Law Firm, LLP, of Charleston, and Michael J. 

Jordan, of The Steinberg Law Firm, LLP, of Goose 

Creek, for Petitioner. 

Natalie B. Fisher, of Fisher Law Firm, LLC, of Mount 

Pleasant, for Respondents. 

 JUSTICE HEARN: This case requires us to clarify the idiopathic exception 

to workers' compensation. Judy Barnes tripped and fell at work while walking 
 

 

down the hallway to check e-mail for another employee. Although there was no 

evidence that her fall was precipitated by an internal condition—such as her legs 

giving out or her fainting—the single commissioner and appellate panel found that 

her fall was idiopathic and therefore noncompensable. The court of appeals 

affirmed. We now reverse. 

FACTUAL/PROCEDURAL HISTORY 

Barnes was employed as an administrative assistant at Charter 1 Realty. On 

the day of her injury, Barnes was asked to check the e-mail of one of the realtors 

before noon. Around 11:30 a.m., Barnes left her desk and walked toward the 

realtor's office. However, she stumbled, fell, and sustained serious injuries: a 

broken left femur, broken left humerus and a torn rotator cuff. 

Barnes subsequently filed a claim for workers' compensation. At the 

hearing, Barnes testified she was hurrying to the realtor's office to check her e-mail 

and that caused her to fall. Evidence was also introduced that her husband did not 

like the shoes she wore, and he had told her she needed to pick up her feet when 

she walked. 

The single commissioner denied her claim, finding there was no explanation 

for the fall and it was not caused by some hazard at work or a deficiency in the 

carpet. Based upon these findings, the commissioner concluded Barnes' fall was 

idiopathic. The commissioner also concluded no competent evidence was 

presented that her employment contributed to her fall. 

The appellate panel affirmed, adopting the order of the single commissioner 

in its entirety. Barnes appealed and the court of appeals affirmed in a 

memorandum decision. Barnes v. Charter 1 Realty, Op. No 2012-UP-025 (S.C. 

Ct. App. filed Jan. 25, 2012). We granted a writ of certiorari. 

ISSUES PRESENTED 

I.	 Did the court of appeals err in affirming the appellate panel's finding that 

Barnes' fall was idiopathic? 

II.	 Did the court of appeals err in affirming the appellate panel's finding that 

Barnes' fall did not arise out of her employment? 
 

 

 

STANDARD OF REVIEW 

Workers' compensation law is to be liberally construed in favor of coverage 

to serve the beneficent purpose of the Workers' Compensation Act; therefore, only 

exceptions and restrictions on coverage are to be strictly construed. James v. 

Anne's Inc., 390 S.C. 188, 198, 701 S.E.2d 730, 735 (2010). On appeal from an 

appellate panel of the Workers' Compensation Commission, this Court can reverse 

or modify the decision if it is affected by an error of law or is clearly erroneous in 

view of the reliable, probative, and substantial evidence in the whole record. 

Pierre v. Seaside Farms, Inc., 386 S.C. 534, 540, 689 S.E.2d 615, 618 (2010). 

"The claimant has the burden of proving facts that will bring the injury within the 

workers' compensation law, and such award must not be based on surmise, 

conjecture or speculation." Crisp v. SouthCo., 401 S.C. 627, 641, 738 S.E.2d 835, 

842 (2013). In a workers' compensation case, the appellate panel is the ultimate 

fact-finder. Pratt v. Morris Roofing, Inc., 357 S.C. 619, 622, 594 S.E.2d 272, 273 

(2004). However, where there are no disputed facts, the question of whether an 

accident is compensable is a question of law. Grant v. Grant Textiles, 372 S.C. 

196, 201, 641 S.E.2d 869, 872 (2007). 

LAW/ANALYSIS 

Barnes argues the court of appeals erred in affirming the finding that her fall 

was idiopathic and that it did not arise out of her employment. We agree. 

I. IDIOPATHIC INJURIES 

Based on the finding that there was no irregularity in the carpeting and 

Barnes could not otherwise explain her fall, the appellate panel held the fall was 

idiopathic and the court of appeals affirmed based on substantial evidence. 

However, we conclude the panel's holding is a departure from settled jurisprudence 

regarding idiopathic falls, and endeavor to clarify the scope of this doctrine. 

Because we hold the appellate panel committed an error of law, we do not believe 

the substantial evidence rule controls our decision. 

Idiopathic falls are excepted from the general rule that a work-related injury 

is compensable. As an exception to workers' compensation coverage, the 

idiopathic doctrine should be strictly construed. See Anne's Inc., 390 S.C. at 198, 

701 S.E.2d at 735. An idiopathic fall is one that is "brought on by a purely 

personal condition unrelated to the employment, such as heart attack or seizure." 2 

Modern Workers Compensation § 110:8. Idiopathic injuries are generally 
 

noncompensable absent evidence the workplace contributed to the severity of the 

injury. Bagwell v. Ernest Burwell, Inc., 227 S.C. 444, 452, 88 S.E.2d 611, 614 

(1955). The idiopathic fall doctrine is based on the notion that an idiopathic injury 

does not stem from an accident, but is brought on by a condition particular to the 

employee that could have manifested itself anywhere. See Ellis v. Spartan Mills, 

276 S.C. 216, 219, 277 S.E.2d 590, 592 (1981) ("'The adjective 'accidental' 

qualifies and described the injuries contemplated by the statute as having the 

quality or condition of happening or coming by chance or without design, taking 

place unexpectedly or unintentionally. If one becomes ill while at work from 

natural causes, the state or condition is not accidental since it is a natural result or 

consequence and might be termed normal and to be expected.'" (quoting Hiers v. 

Brunson Constr. Co., 221 S.C. 212, 230, 70 S.E.2d 211, 219–220 (1952)). 

In finding the unexplained nature of Barnes' fall rendered it idiopathic, the 

appellate panel relied on the court of appeals' opinion in Crosby v. Wal-Mart Store, 

Inc., 330 S.C. 489, 499 S.E.2d 253 (Ct. App. 1998). In Crosby, the court affirmed 

the finding that the claimant's fall was idiopathic, basing its conclusion on the fact 

the fall was a result of an internal failure or breakdown in the knee. Id. at 494– 

495, 499 S.E.2d at 256. The court specifically referenced testimony of another 

employee that Crosby had indicated her leg "gave out" to support this finding. Id. 

at 494, 499 S.E.2d at 256. Thus, in Crosby the court did not find the cause of the 

fall was unknown, but found it was in fact occasioned by an internal and personal 

condition specific to Crosby, and was therefore idiopathic in nature. 

The holding in Crosby is in harmony with how our courts have consistently 

applied the idiopathic exception—the circumstances of the fall were not simply 

unexplained, but indicated the cause was internal. See, e.g., Bagwell, 227 S.C. at 

450, 88 S.E.2d at 613 (finding fall was idiopathic where employee was standing at 

a desk and suddenly fell rigidly backward without crying out or making any 

attempt to catch himself); Miller v. Springs Cotton Mills, 225 S.C. 326, 330, 82 

S.E.2d 458, 459 (1954) (denying compensation finding the claimant's knee failed 

to function normally and concluding the fall was caused by "some internal failure 

or breakdown in the knee which might have happened at any time"): c.f. Shatto v. 

McLeod Reg'l Med. Ctr., 408 S.C. 595, 600, 759 S.E.2d 443, 445–46 (Ct. App. 

2014) (affirming award of compensation and concluding fall was not idiopathic 

where claimant did not "directly and unequivocally testify to what specifically 

caused her fall" but "identified specific, non-internal reasons for tripping"). 

By contrast, the appellate panel here concluded Barnes' fall was idiopathic 
 

 

simply because she could not point to any cause of the fall. Specifically, it found: 

There was no substance, no object, no item, no debris, or anything 

else over which the Claimant tripped. The surface she walked on in 

the hallway was level without any bubbling or alterations in the 

carpet. There was no evidence her fall was caused by any hazards of 

her work. Therefore, the greater weight of the evidence, including the 

Claimant's own testimony, indicates that the Claimant's injuries were 

caused by an idiopathic fall. 

This reasoning does not comport with our jurisprudence of idiopathy. As 

discussed supra, an idiopathic fall arises from an internal breakdown personal to 

the employee, thus negating any causal connection. A finding that a fall is 

idiopathic is not warranted simply because the claimant is unable to point to a 

specific cause of her fall. 

We therefore find the appellate panel's conclusion that Barnes' fall was 

idiopathic is an error of law and contrary to the very foundation of the idiopathic 

exception. There is no evidence that her leg gave out or she suffered some other 

internal breakdown or failure. She did not faint or have a seizure. It is irrelevant 

that the carpet or hallway was not defective. Whether she tripped because she was 

hurrying or she tripped over her own feet, neither is an internal breakdown or 

weakness that falls within the ambit of idiopathy. Accordingly, we find the court 

of appeals erred in affirming the finding that Barnes' fall was idiopathic.1 

II. ARISING OUT OF EMPLOYMENT 

The respondents also argue there is substantial evidence in the record to 

1 We soundly reject the respondents' assertion that there is substantial evidence in 

the record to support the finding that Barnes suffered an idiopathic fall. In support 

of this argument, the respondents point only to the evidence that Barnes tripped 

over her own feet, asserting that this could have happened anywhere. We have no 

quarrel with that characterization of the facts; however, as discussed supra, they 

fail to establish an idiopathic fall. Additionally, our review of the record contains 

no suggestion that Barnes suffered any internal breakdown which caused this fall. 

Although she fell previously in a grocery store parking lot, that fall was also 

apparently due to her tripping, not a personal health defect. We find no legal 

authority indicating clumsiness is an exception to workers' compensation. 
 

 

 

support the finding Barnes' injury did not arise out of her employment. We 

disagree. 

For an accidental injury to be compensable, it must "aris[e] out of and in the 

course of the employment." S.C. Code Ann. § 42-1-160(A) (Supp. 2013). Arising 

out of refers to the injury's origin and cause, whereas in the course of refers to the 

injury's time, place, and circumstances. Osteen v. Greenville Cnty. Sch. Dist., 333 

S.C. 43, 50, 508 S.E.2d 21, 24 (1998). An injury arises out of employment if it is 

proximately caused by the employment. Douglas v. Spartan Mills, Startex Div., 

245 S.C. 265, 269, 140 S.E.2d 173, 175 (1965). For an injury to arise out of 

employment, there must be a causal connection between the conditions under 

which the work is required to be performed and the resulting injury. Grant 

Textiles, 372 S.C. at 201, 641 S.E.2d at 871. 

Because we find the material facts are not in dispute, we decide this issue as 

a matter of law. In holding Barnes' injury was noncompensable, the appellate 

panel found: 

Although the Claimant undoubtedly fell while in the work place this 

fact alone does not make her claim compensable. The Claimant was 

at work and she testified she was going to check e-mails when she fell 

in the hallway, but there is no competent evidence that her 

employment contributed to her fall or its effect on her. 

In our view, the appellate panel's finding does not support its ultimate conclusion. 

As the panel acknowledged, Barnes was performing a work task when she tripped 

and fell. Those facts alone clearly establish a causal connection between her 

employment and the injuries she sustained.2 See Nicholson v. S.C. Dep't of Social 

2

 As the respondents' attorney admitted during oral arguments, had Barnes been on 

the way to the bathroom or to get a cup of coffee, her injuries would be 

compensable under the personal comfort doctrine. See Mack v. Branch No. 12, 

Post Exch., Fort Jackson, 207 S.C. 258, 264, 35 S.E.2d 838, 840 (1945) ("Such 

acts as are necessary to the life, comfort, and convenience of the servant while at 

work, though strictly personal to himself, and not acts of service, are incidental to 

the service, and injury sustained in the performance thereof is deemed to have 

arisen out of the employment."). We reject any interpretation of workers' 

compensation law which would permit recovery when an employee falls while 

attending to her personal needs but denies recovery when she falls while actually 

working. 
 

Servs., Op. No. 27478 (S.C. Sup. Ct. filed Jan. 14, 2015) (finding claimant who 

tripped and fell on the way to a meeting was entitled to compensation because 

"[t]he circumstances of her employment required her to walk down the hallway to 

perform her responsibilities and in the course of those duties she sustained an 

injury; these facts establish a causal connection between her employment and her 

injuries"). Barnes clearly established that she was performing her job when she 

sustained an accidental injury; we therefore hold her injuries arose out of her 

employment as a matter of law. 

CONCLUSION 

Based on the foregoing, we reverse the court of appeals' opinion affirming 

the appellate panel's denial of compensation and remand for a determination of the 

appropriate award. 

TOAL, C.J., BEATTY, and KITTREDGE, JJ., concur. PLEICONES, 

J., dissenting in a separate opinion. 
 

JUSTICE PLEICONES: I respectfully dissent. In my opinion, this case 

presents a question of substantial evidence and not one of law, and the Court 

of Appeals was correct to affirm the Workers' Compensation Commission's 

decision to deny compensation. I would therefore dismiss the writ of 

certiorari as improvidently granted. 

An accident is compensable only where it both "arises out" of employment 

and occurs "in the course of employment." These two requirements are not 

synonymous, and the claimant must prove both. An injury "arises out" of 

employment when there is a causal connection between the conditions under 

which the work is required to be performed and the injury. "In the course of 

employment" requirement is met by proof that the accident happened within 

the period of employment, at a place the employee reasonably may be in the 

performance of her duties, and while fulfilling those duties or engaging in 

something incidental to those duties. See, e.g., Ardis v. Combined Ins. Co., 

380 S.C. 313, 669 S.E.2d 628 (Ct. App. 2008). In my opinion, the majority 

erroneously equates these two requirements when it concludes petitioner's fall 

"arose out" of her employment because she was performing her job when she 

fell. 

South Carolina is among the minority of jurisdictions that deny compensation 

for unexplained falls. Crosby v. Wal-Mart Store, Inc., 330 S.C. 489, 499 

S.E.2d 253 (1998), citing 1 Arthur Larson & Lex K. Larson, Workers' 

Compensation Law § 10.31(a) (1977). Absent special conditions or 

circumstances, a level floor cannot cause an accident. Bagwell v. Ernest 

Burwell, Inc., 227 S.C. 444, 88 S.E.2d 611 (1955). Where the claimant 

presents no evidence as to what caused the fall, it is wholly conjectural to say 

that "employment was a contributing cause of [petitioner's] injury." Id. 

Here, since petitioner presented no evidence that her employment was a 

proximate cause of her fall, she did not meet the "arises out of employment" 

component required to prove a compensable injury. 

In my opinion, substantial evidence supports the Commission's decision that 

petitioner failed to meet her burden of showing her fall was compensable. 

Further, to the extent the Commission erred in equating 'idiopathic' falls with 

'unexplained' falls, the record nonetheless reflects petitioner presented no 

evidence that her fall arose out of her employment, that is, that her fall on a 
level surface was the result of a special condition or circumstance. Bagwell, 

supra. 

I respectfully dissent and would dismiss the writ of certiorari as 

improvidently granted.