RENDERED: OCTOBER 23, 2020; 10:00 A.M.

NOT TO BE PUBLISHED

Commonwealth of Kentucky

Court of Appeals

NO. 2020-CA-0855-WC

REYNOLDS CONSUMER PRODUCTS APPELLANT

PETITION FOR REVIEW OF A DECISION

v. OF THE WORKERS’ COMPENSATION BOARD

ACTION NO. WC-19-80527

WILLIAM BELL III; HONORABLE JOHN

MCCRACKEN, ADMINISTRATIVE LAW JUDGE;

and WORKERS’ COMPENSATION BOARD APPELLEES

OPINION

AFFIRMING

**   **  **

BEFORE: CLAYTON, CHIEF JUDGE; KRAMER AND MCNEILL, JUDGES.

KRAMER, JUDGE: William Bell III sought workers’ compensation benefits from 

his employer, Reynolds Consumer Products, claiming he had sustained a 

compensable injury to his right eye after suffering a fall on his employer’s 

premises on April 6, 2019. The Administrative Law Judge (ALJ) dismissed Bell’s 
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claim after determining Bell had failed to prove his fall qualified as a work-related

injurious event under Kentucky workers’ compensation law or that his fall had 

been the proximate cause of his eye injury. Bell then appealed to the Workers’ 

Compensation Board (Board). Upon review, the Board reversed and remanded, 

explaining Bell’s eye injury was indeed work-related because Bell’s fall was

“unexplained” and because the evidence overwhelmingly demonstrated Bell’s fall 

had caused his injury. Reynolds now appeals. We affirm.

The evidence adduced in this case is as follows. Bell testified that he 

passed out while at work for Reynolds on April 6, 2019. He had never passed out 

before and had felt “normal” when he arrived at work that day. At the time of his 

fall, he was standing near a transfer cart. Bell testified he has no idea what he hit 

when he fell. He blacked out and the next thing he remembers is Jermaine 

Campbell standing over him. Bell stated he did not have loss of vision in his right 

eye until after the fall. When he awoke, he did not initially realize he could not see 

out of his right eye. Just prior to passing out, he did not feel well and was 

sweating. He suddenly became disoriented and fell. At the time of his fall, the 

transfer cart was near him and he held a wireless crane remote in his hand. The 

crane remote was approximately ten to eleven inches long and five inches wide and 

was beside him when he awoke.
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Jermaine Campbell testified by deposition on November 19, 2019. He 

was working approximately twenty to twenty-five feet away from Bell 

immediately prior to the fall. Campbell testified he had spoken with Bell earlier in 

the shift; they had been “talking on and off” during their shift and Bell seemed 

“okay.” About two hours into their shift, though, Campbell glanced in Bell’s 

direction and noticed he was standing and “just staring.” Campbell yelled to Bell, 

who did not respond. Campbell walked toward Bell, who started walking toward 

him. Bell was wearing a hard hat, safety shield, and safety glasses. He was also 

carrying a remote control for a crane. Campbell saw Bell fall and stated Bell’s 

body rolled while he was falling. Campbell was not sure if Bell struck anything as 

he fell. Bell’s hardhat, face shield, and safety glasses came off when he hit the 

floor. When Campbell reached Bell, Bell was approximately twelve inches from 

the transfer cart, a permanent immovable structure. Bell was face down with his 

hardhat and safety glasses a few feet away. The face shield was still attached to 

the hardhat, but it was bent. Campbell helped Bell to a seated position and 

observed blood coming out of his right eye.

Campbell, with the assistance of another Reynolds employee (William 

Cole Duley), escorted Bell to the supervisor’s office. Regarding that time frame, 

Campbell further testified:
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Q: As he walked to the office, did [Bell] complain of any 

particular complaints, particularly with regard to his right 

eye?

CAMPBELL: No.

Q: Did he tell you whether or not he could or could not 

see out of the right eye?

CAMPBELL: Well, he didn’t – at the time he didn’t. I 

noticed it, but he didn’t tell me that he couldn’t see until I 

guess he came to the guard office and they checked him 

out and he came back to get his stuff because he was 

going home. At that time I noticed that his eye was 

swollen shut. I asked him about his eye and he told me 

he could not see out of his eye.

Q: Do you remember what the timeframe was between 

the point that he was at the guard shack waiting to be 

picked up, I believe, by his girlfriend? Do you know 

what time that would have been?

CAMPBELL: I’d say somewhere between forty-five 

minutes and maybe an hour.

William Cole Duley testified at the hearing. Duley works in security 

and loss prevention. He did not witness the accident but provided first aid 

afterward. When Duley first saw Bell, he was in a seated position with a paper 

towel over his right eye. Duley observed redness in the white part of the eye but 

stated nothing was coming out of the eye. He gave Bell some wet rags “because it 

was hot back there” but provided no other care. He noted Bell was taken from the 

premises by his fiancée.
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Bell’s fiancée, Kristin Lucas, testified at the hearing. She took Bell 

directly to the Baptist East emergency room. Lucas testified as follows concerning 

Bell’s condition when she arrived at Reynolds:

Q: And when you picked up Mr. Bell can you tell us 

what you saw as in relation to his eye?

A: Well, when he came out he had like a wet paper 

towel on his eye and it was like a rust color I’m assuming 

from where he was wiping or oozing something that was 

coming out of his eye. And I asked him to open up his 

eye because it was like closed, like stuck closed, and he 

kind of pulled it open and it was just like – it was very 

gruesome. It was almost like smooshed.

Q: What was smooshed, the white part?

A: His eye – his entire eyeball, like the whole thing.

Q: So was it one side smooshed more than the other side 

or just –

A: It looked – honestly, just the whole thing was just like 

a big glob.

Q: Did it look bloody as well?

A: Yes. It was very red and had oozing stuff coming out 

of it.

Records from Baptist Health Louisville on April 6, 2019, the day of 

the accident, reflect Bell sustained a ruptured globe of the right eye. Bell had a 

dilated, non-reactive right pupil with blood in the anterior chamber, and “[l]arge 

amounts of tearing and drainage” were observed. A CT of the head was read as 
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showing an abnormal appearance of the right globe, likely related to a prior corneal 

transplant. Bell was transferred to the University of Louisville for surgery.

Bell filed the October 18, 2019 report of Dr. Richard A. Eiferman. He 

opined as follows:

In my opinion, Mr. Bell’s eye injury was a result of direct 

trauma to the right eye. Given the severity of his injury 

(traumatic wound dehiscence with a prolapse of the 

intraocular contents and ultimate loss of vision) and the 

unaffected left eye (which also had a pre-existing corneal 

transplant) it is highly unlikely that it was caused by a 

blunt force trauma to the skull. In addition, Mr. Bell’s 

injury could not have been caused by any other nontraumatic event such as hypertension.

The opinions above are based on over 40 years of clinical 

experience and are expressed within a reasonable degree 

of medical probability.

Bell’s claim was bifurcated on the issue of work-relatedness of the 

eye injury. The ALJ’s findings relevant to this appeal were as follows:

An employee has the burden of proof and the risk of nonpersuasion to convince the trier of fact of every element 

of his workers’ compensation claim. Snawder v. Stice, 

576 S.W.2d 276 (Ky. App. 1979). Injury is statutorily 

defined in KRS 342.0011(1) as a work-related traumatic 

event or series of traumatic events, including cumulative 

trauma, arising out of and in the course of employment, 

which proximately causes a harmful change in the human 

organism evidenced by objective medical findings.

When the causal relationship between an injury and a 

medical condition is not apparent to a lay person, the 

issue of causation is solely within the province of a 

medical expert. Elizabethtown Sportswear v. Stice, 720 
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S.W.2d 732, 733 (Ky. App. 1986); Mengel v. HawaiianTropic Northwest and Central Distributors, Inc., 618 

S.W.2d 184 (Ky. [App.] 1981).

Whether a workplace injury arises out of employment 

requires considering three risk categories: 1) risks 

distinctly associated with employment; 2) risks that are 

idiopathic or personal to the worker; and 3) risks that are 

neutral. Vacuum Depositing, Inc. v. Dever, 285 S.W.3d 

730, 733 (Ky. 2009). Bell’s fall does not fit into category 

one. “Unexplained falls begin with a completely neutral 

origin of the mishap, while idiopathic falls begin with an 

origin which is admittedly personal.” Id.

Kentucky has adopted a presumption that unexplained 

workplace falls arise out of the employment unless the 

employer presents substantial evidence to show 

otherwise. Id. “The employer cannot prevail in such a 

case unless it shows affirmatively that the fall was not 

work-related.” Id.

Idiopathic falls may be compensable if work places the 

injured worker in a position that increases its dangerous 

effects. Id.; see also Indian Leasing Company v. 

Turbyfill, 577 S.W.2d 24 (Ky. App. 1979). This 

increased dangerous effect may be a fall from a height, 

near machinery or sharp corners, or in a moving vehicle. 

Turbyfill at 24. The Court in Turbyfill stated the issue in 

idiopathic falls must be carefully distinguished from the 

medical question whether the final injury was in fact the 

result of the fall itself, rather than the idiopathic 

condition. Id.

In the present case, Bell stated that he passed out. He 

does not know what happened from the time he passed 

out until he came to with Campbell standing over him. 

Bell stated that just prior to the fall he felt ill and sweaty. 

There is no proof in the record to indicate that his work 

caused his feeling ill and sweaty just prior to his fall, 

differentiating him from a person whose work-related
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physical exertion may cause a heart attack who falls to 

the ground. While it may appear as though Bell’s fall is 

unexplained, the evidence points to the fact that he 

fainted. He admitted that he passed out. Campbell saw 

him pass out and fall. The ALJ understands an 

“unexplained” fall to be one that has no explanation. 

Bell has an explanation for his fall in that he passed out. 

The ALJ relies on Bell and Baptist Hospital East records 

to find that he suffered a syncope episode and collapsed. 

Therefore, the fall is explained. The only remaining 

question is whether the syncope was caused by some 

condition of his work. There is no proof that his work 

caused the syncope episode. The ALJ relies on Bell and 

the medical records to find that Bell’s fall fits the 

category of falls related to idiopathic and not 

“unexplained.”

The second step in determining whether an idiopathic fall 

is compensable is to determine whether Bell’s work 

placed him in a position of increasing the dangerous 

effects of such a fall, such as on a height, near machinery 

or sharp corners, or in a moving vehicle. Bell asserts that 

wearing his safety glasses and hardhat with face shield 

placed him at a greater risk of injury. He also asserts that 

his proximity to the platform and the handheld remote 

increased his risk in a fall.

Bell testified that he does not know if he fell on anything. 

The only eyewitness, Campbell, testified that he does not 

know if Bell fell onto anything as he fell. Campbell 

found him face down on the ground. Campbell 

remembers seeing Bell’s hardhat, shield and safety 

glasses coming off Bell when he struck the floor. He 

described the plastic shield as being a little “cockeyed.” 

No one knows if Bell’s hearing protection came off his 

head. Additionally, there is no proof that Bell struck the 

platform with his body when he fell, or that the handheld 

wireless remote device he held struck his eye. There is 

simply no proof that his safety gear, or anything near 

him, increased his risk of this injury. No one testified 
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that his safety glasses were broken or had blood on them. 

It is the same for the other gear Bell was using at the time 

of his fall.

Dr. Eiferman, Bell’s eye doctor, stated that Bell’s eye 

injury was the result of direct trauma to the right eye, not 

blunt force trauma to the skull from the fall. There is no 

proof that Bell sustained direct trauma to the right eye 

when he fell. There is speculation as to what may have 

happened, but no proof. The Baptist Health Louisville 

records do not help on the issue of causation. The CT of 

the head was interpreted to show the right eye had an 

abnormal appearance of the right globe, likely related to 

the prior corneal transplant. There is no other 

explanation as to how this interpretation relates to the 

cause of Bell’s eye condition.

The ALJ relies on Bell, Campbell, Dr. Eiferman and the 

Baptist Health Louisville records to find that Bell’s job 

did not place him at a greater risk of injury. There is 

simply no proof that Bell struck, or was poked by, 

anything causing direct trauma to his right eye.

The ALJ finds that Bell has not met his burden of proof 

that his April 6, 2019 fall produced an injury in the 

course and scope of his work.

In sum, the ALJ found Bell had failed to prove it was more likely that 

not that his fall had caused the trauma to his right eye. Moreover, the ALJ held, 

even if the fall had proximately caused Bell’s injury, it was still non-compensable 

because the fall was “idiopathic”; in other words, Reynolds was not responsible 

because Bell had admitted he had “passed out” after feeling ill and weak; and 

because Bell had failed to prove – as is necessary regarding idiopathic falls – that 
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his “work placed him in a position of increasing the dangerous effects of such a 

fall[.]” 

In a petition for reconsideration before the ALJ, and in his subsequent 

appeal before the Board, Bell contested these findings. As to causation – which we 

will address in this appeal first – Bell asserted that the evidence overwhelmingly 

demonstrated his fall had caused the direct trauma that had undisputedly caused his 

right eye injury. The ALJ denied Bell’s petition for reconsideration regarding 

causation. However, the Board reversed on this point, explaining “there is no 

question that the eye injury occurred while Bell was at work at Reynolds,” and that 

“before Bell fell on April 6, 2019, his eyes were functioning and the fall resulted in 

significant damage to Bell’s right eye.” 

Reynolds now appeals, arguing nothing of record directly proved 

Bell’s fall caused him to sustain the trauma necessary to cause his right eye injury, 

and that the Board accordingly erred in reversing the ALJ. We disagree. As stated 

in Kroger v. Ligon, 338 S.W.3d 269, 273 (Ky. 2011):

A party who fails to meet its burden before the ALJ must 

show on appeal that the unfavorable finding was clearly 

erroneous because overwhelming evidence compelled a 

favorable finding, i.e., that no reasonable person could 

have failed to be persuaded by the favorable evidence.

Evidence that would have supported but not compelled a 

different decision is an inadequate basis for reversal on 

appeal.

(Footnotes and citations omitted.)
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With that said, while it is true that no evidence directly proved Bell’s 

fall sustained the trauma necessary to cause his right eye injury, the circumstantial

evidence was overwhelming. To review, it reflected the following:

• Bell testified he had arrived at work on April 6, 2019, feeling normal. For 

two hours, he had been working in his usual location. No evidence suggests 

he sustained any injury to his right eye prior to arriving at work that day. He 

testified that prior to his fall, he was able to see out of his right eye.

• Prior to his fall, Campbell, who had been talking with him earlier in his shift, 

had noticed nothing wrong with Bell – he seemed “okay.”

• When he fell, Bell was either holding equipment or was in an area capable

of causing trauma to his right eye, depending upon how he fell.

• Campbell was the only individual who witnessed Bell fall. He could not 

recall if Bell struck anything during the fall. After the fall, however, 

Campbell noticed, for the first time, there were signs that Bell had recently 

sustained trauma to his right eye. Specifically, Bell had blood coming out of 

his right eye; approximately forty-five minutes later, he noticed Bell’s right 

eye was “swollen shut,” and Bell complained to Campbell for the first time 

that he could not see out of his right eye.

• Bell testified that the first time he lost vision in his right eye was after he had 

passed out.
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• Lucas testified that after Bell’s fall, when she picked Bell up from work, she 

also noticed signs of recent trauma to Bell’s eye (i.e., a “rust-colored” 

substance had soaked into the paper towel Bell had been using to wipe his 

right eye; and Bell’s right eye appeared “smooshed”).

• Nothing of record demonstrates Bell sustained trauma to his right eye 

between when Campbell assisted him after the fall, and when Bell was 

treated at the hospital.

Considering that evidence, we agree with the Board that the ALJ erred 

in this respect.

Moving on, the next issue presented on appeal is the type of fall Bell 

sustained on April 6, 2019. As indicated, Reynolds argued and the ALJ found 

Bell’s fall was “idiopathic,” and thus not work-related, because Bell had admitted 

to passing out; because the hospital’s documentation indicated his fall had been 

due to a “syncope episode”; and because “[t]here is no proof in the record to 

indicate that his work caused his feeling ill and sweaty just prior to his fall.” 

However, the Board opined Bell’s fall had been “unexplained,” and thus 

presumptively work-related, because substantial evidence did not demonstrate that 

any internal weakness or medical condition on Bell’s part had caused his feeling ill 

and sweaty just prior to his fall, either – or otherwise explain why Reynolds had 

passed out. Reversing the ALJ, the Board determined Bell’s fall was properly 
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categorized as “unexplained”; Reynolds consequently had the burden below to 

present substantial evidence to rebut that presumption with substantial evidence; 

and because Reynolds had produced no such substantial evidence, the injuries Bell 

sustained due to the fall were compensable. Upon review, we agree with the Board 

in this respect, as well. We adopt the Board’s reasoning as follows:

A review of Kentucky law on the issue begins with the 

case of Workman v. Wesley Manor Methodist Home, 

462 S.W.2d 898 (Ky. 1971), where benefits were denied 

to an employee who fell and broke her hip in the course 

of her employment. The facts indicated that the 

employee did not slip or stumble but fell after her back 

gave way due to an injury previously suffered in one or 

possibly two automobile accidents. The Court held that 

“an injury from a fall resulting during the course of the 

employment but solely from a cause or causes to which 

the work is not a contributing factor is not compensable.” 

Id. at 901. The Court further noted that, under the 

“positional risk theory,” benefits may be allowed for 

injuries sustained in a fall “if the employment places the 

employee in a position increasing the dangerous effects 

of such a fall, such as on a height, near machinery or 

sharp corners, or in a moving vehicle.” Id. (quoting 

Larson, Workmen’s Compensation Law, § 12.11).

The Workman Court acknowledged there is a rebuttable 

presumption that an unexplained fall during the course of 

employment is work-related. However, the Court found 

that the rebuttable presumption had been reduced to a 

permissible inference by evidence that the employee’s 

fall was not unexplained but, rather, resulted solely from 

a prior, non-work-related back condition. Consequently, 

the “old” Board was not compelled to find that the 

employment was a causative factor in the employee’s 

injuries.
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The continuing viability of the Workman decision was 

addressed in Jefferson County Public Schools/Jefferson 

County Board of Education v. Stephens, 208 S.W.3d 862 

(Ky. 2006), in which the Supreme Court upheld a 

determination by the ALJ that the claimant sustained a 

work-related injury when she fell walking from a 

carpeted surface to a tile floor. There was evidence 

introduced the claimant might have experienced 

dizziness prior to her fall. However, the ALJ believed 

the claimant’s testimony that she did not experience any 

such dizziness. The Court stated as follows:

The burden is on an injured worker to prove 

every element of her claim, including that a 

workplace injury arose out of the 

employment. See Workman v. Wesley 

Manor Methodist Home, 462 S.W.2d 898 

(Ky. 1971); Stasel v. American Radiator & 

Standard Sanitary Corp., 278 S.W.2d 721 

(Ky. 1955). As explained in Arthur Larson 

and Lex K. Larson, Larson’s Workers’ 

Compensation Law, § 4 (2006), an analysis 

of whether a work-related injury arises out 

of employment begins with a consideration 

of three categories of risk: 1.) risks 

distinctly associated with employment (e.g., 

machinery breaking, objects falling, 

explosives exploding, fingers getting caught 

in machinery, exposure to toxic substances); 

2.) risks that are idiopathic or personal to the 

claimant (e.g., a disease, internal weakness, 

personal behavior, or personal mortal enemy 

that would have resulted in harm regardless 

of the employment); and 3.) neutral risks 

(e.g., a stray bullet, a mad dog, a running 

amuck, lightning). Where an employment 

and personal cause combine to produce 

harm, the law does not weigh the importance 

of the two causes but considers whether the 

employment was a contributing factor.
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Although one naturally infers that a fall in 

the workplace has something to do with the 

employment, proving that it arose out of the 

employment can be problematic when the 

reason that it occurred is unexplained. 

Workman v. Wesley Manor Methodist 

Home, supra, stands for the principle that an 

unexplained workplace fall is presumed to 

arise out of the employment unless the 

presumption is rebutted. The court 

determined subsequently in Indian Leasing 

Company v. Turbyfill, 577 S.W.2d 24 (Ky.

App. 1978), that even an idiopathic fall may 

be compensable if work placed the 

individual in a position that increased its 

dangerous effects.

We explained in Magic Coal Co. v. Fox, 19 

S.W.3d 88, 95 (Ky. 2000), that rebuttable 

presumptions are governed by KRE[1] 301. 

Such a presumption shifts the burden of 

going forward with evidence to rebut or 

meet it to the party against whom it is 

directed, but it does not shift the burden of 

proof (i.e., the risk of nonpersuasion) from 

the party upon whom it was originally cast. 

If a presumption is not rebutted, the party 

with the burden of proof prevails on that 

issue by virtue of the presumption. If a 

presumption is rebutted, it is reduced to a 

permissible inference. The ALJ must then 

weigh the conflicting evidence to decide 

which is most persuasive.

Because a fact must be proved with 

substantial evidence, a rebuttable 

presumption must be met with substantial 

 

1 Kentucky Rule of Evidence.
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evidence. Therefore, an employer asserting 

that a workplace fall was idiopathic must 

meet the presumption with substantial 

evidence to that effect. If the employer does 

so, the ALJ must weigh the conflicting 

evidence, including the permissible

inference that a workplace fall arises out of 

the employment. The burden of persuasion 

remains on the worker.

Id. at 866-867.

As an aside, in Jefferson County Public Schools, the employer was 

deemed to have produced substantial evidence capable of meeting the presumption 

of work-relatedness relative to the claimant’s “unexplained” fall, and to have thus 

reduced the presumption of work-relatedness to a permissible inference. As to the 

nature of that substantial evidence, the Court indicated that while nothing indicated 

“that the claimant developed syncope, fainted, or lost consciousness immediately 

before the fall,” some evidence had indicated the claimant had a medical 

predisposition and history of suffering from blackout spells. Id. at 867.

And that, in turn, leads to the crux of the Board’s analysis in this 

matter. “Fainting,” “passing out,” or “blacking out” can be caused by any number

of conditions, personal or otherwise. Thus, without more, simply noting that a 
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claimant suffered a fall due to “fainting” merely begs the question of whether the 

claimant’s fall was idiopathic or unexplained.2

Keeping that in mind, the Board’s analysis continued in relevant part 

as follows:

Bell testified he had corneal implants approximately 

twenty years prior to the date of his fall. After 

undergoing a follow up from the surgeries, Bell had not 

received any further treatment of his eyes. As noted by 

the ALJ, Bell began taking blood pressure medication 

after the subject fall. Bell did not know why he passed 

out at work. In fact, he went to see Dr. Katherine Dunbar 

to find out why he passed out. She ran tests which 

provided no explanation. He denied being treated for any 

other chronic conditions or being prescribed medication 

until he took blood pressure medication following this 

incident. Bell denied ever being prescribed blood 

pressure medication prior to his April 2019 fall. Notably, 

there is no evidence linking potential blood pressure 

problems to the fall at work. Bell testified he passed out 

and such an episode had never happened before. Bell 

explained:

Q: What’s the last thing you remember

before you passed out?

A: Not feeling well at the moment, 

sweating. Like I said, I just got disoriented 

just all of a sudden. I’ve never had that 

experience before in my life. We was only 

 

2 Underscoring this point in its appellate brief, Reynolds hypothesizes (without proof) that 

perhaps Bell had arrived at work on April 6, 2019, with an already-traumatized right eye and 

that his already-traumatized right eye had, perhaps, caused him to pass out two hours later into 

his shift. However, engaging in that base level of speculation could just as easily lead to the 

proposition that, perhaps, Bell may also have passed out due to heatstroke owing to his working 

conditions; as noted, Bell had been exerting himself, and Duley testified he gave Bell some wet 

rags after Bell passed out “because it was hot back there.”
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going to get four coils ready. And then after 

we got two coils ready I started sweating 

and feeling bad and like I said after that I 

passed out. That’s all I remember.

Q: When you got to work that day, were 

you feeling like your normal self?

A: Uh-huh.

Q: Is that a yes?

A: Yes. I’m sorry.

Q: . . . but are you telling me then that the 

symptoms that you had of feeling 

disoriented and getting a little sweaty, did 

those come on suddenly?

A: Yes.

The medical records of Baptist Health Louisville reflect 

the reason for the visit was “syncope” and Bell provided

the following: “I got dizzy and sweaty today while at 

work and passed out hitting my head on the ground and 

busting my right eye.” Under “Review of Systems,” is 

the following: “Neurological: Positive for syncope. 

Negative for weakness, numbness and headaches.” The 

final diagnosis was “Syncope and collapse. Ruptured 

globe of right eye, initial encounter.” Baptist Health’s 

records contain no explanation for how or why the 

alleged syncope occurred. Consequently, the cause of 

the alleged syncopal episode was and is unknown.

After having carefully considered the facts, the law, and 

arguments of counsel, we agree with Bell that the ALJ 

erroneously determined his fall was idiopathic and not 

work-related. Reynolds put forth no evidence supporting 

the theory that something personal to Bell caused his fall. 

Further, it submitted no evidence Bell possessed some 
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physical or medical condition that caused him to fall. 

Reynolds may have persuaded the ALJ that nothing it did 

caused the fall. That alone, however, does not shift the 

inference from a rebuttable presumption of workrelatedness to the permissible inference. As the 

Kentucky Supreme Court pointed out in Jefferson County 

Public Schools, supra,

It was the employer’s burden to go forward 

with substantial evidence of a non-workrelated cause for the claimant’s fall in order 

to rebut the Workman presumption.

Id. at 867.

Even though the hospital records contain a diagnosis of 

syncope as the chief complaint, those records do not 

explain the cause of the syncope. The medical records 

and Bell’s testimony do not link the workplace fall to a 

prior condition of Bell’s. Thus, we believe the ALJ 

erroneously concluded the fact that there was a diagnosis 

of syncope caused the fall to be idiopathic. That is not 

the test. Rather, Reynolds must come forward with some 

explanation as to why the syncopal episode occurred. 

Applying that standard, Reynolds did not meet the abovedescribed burden. The Court of Appeals (now Supreme 

Court) phrased it best in Workman:

In blunt terms this means that without such 

rebutting evidence the Board [now ALJ] 

cannot find against him on the issue of 

whether the accident arose out of the 

employment.

Id. at 900.

Unlike in Workman, Reynolds did not demonstrate the 

cause of the fall. In Workman, Wesley Manor introduced 

evidence that Workman had the following problems:
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Prior to the time of the hip injury Mrs. 

Workman had suffered injuries to her back 

in two separate automobile accidents, one on 

February 14, 1964, and the other on 

November 3, 1965, following each of which 

she had brought suit against other parties for 

her damages. The second of these two 

damage suits was pending at the time she 

broke her hip, and on March 8, 1967, in that 

action, she testified in a deposition as 

follows.

Id. at 899.

The 1967 deposition in the damage suit was introduced 

as evidence against Workman during the course of the 

workers’ compensation proceeding. The Board 

concluded Workman’s fall was idiopathic due to her preexisting back problems and dismissed her claim. The 

Court of Appeals (now Supreme Court) explained the 

importance of Workman’s previous testimony in the 

personal injury action involving an injury to the same 

area of the back:

Mrs. Workman’s testimony in this 

proceeding would have entitled her as a 

matter of law to a favorable finding had 

there been no rebutting or countervailing 

evidence on the issue of causation, but the 

subsequently introduced content of what she 

had said while testifying in the damage suit 

constituted enough evidence that the 

accident resulted solely from the weakened 

condition of her back, and not in any respect 

from the performance of her work, to reduce 

the rebuttable presumption in her favor to a 

permissible inference, leaving the board free 

either to decide in her favor or to remain 

unpersuaded, as it did, that her work was a 

causative factor in precipitating the injury. 
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That being the case, the circuit court was 

correct in not disturbing the action of the 

board.

Id. at 901.

Our holding is also consistent with Vacuum Depositing, 

Inc. v. Dever, 285 S.W.3d 730, 733-734 (Ky. 2009), in 

which the Supreme Court stated as follows:

Kentucky has adopted a presumption that an 

unexplained workplace fall arises out of the 

employment unless the employer presents 

substantial evidence to show otherwise. 

[footnote omitted] The employer cannot 

prevail in such a case unless it shows 

affirmatively that the fall was not workrelated. The employer in Workman did so 

by showing that Ms. Workman’s testimony 

in the workers’ compensation claim 

conflicted with her testimony in an unrelated 

civil suit that her back had been 

symptomatic and caused her to fall before 

the incident at work. The court determined 

that the employer offered sufficient evidence 

that the fall was idiopathic to negate the 

presumption that it was not.

The court explained subsequently in 

Turbyfill that an idiopathic fall may be 

compensable if work places the injured 

worker in a position that increases its 

dangerous effects. [footnote omitted]

Turbyfill’s employer negated the Workman

presumption by showing that his fall 

resulted from a non-work-related heart 

attack. The court found the fall to be 

compensable, however, because the fact that 

he was working 12 feet off the ground 

increased the fall’s effects.
-22-

To summarize, a work-related fall occurs if 

the worker slips, trips, or falls due to causes 

such as a substance or obstacle on the floor 

of the workplace or an irregularity in the 

floor. When the cause of a workplace fall is 

unexplained, the fall is presumed to be 

work-related under Workman. Unexplained 

falls divide ultimately into two categories: 

1.) those the employer has shown to result 

from a personal or idiopathic cause but 

which may be compensable under the 

positional risk doctrine; and 2.) those that 

remain unexplained and entitled to a 

presumption of work-relatedness. 

(emphasis added.)

The claimant alleged an unexplained fall 

but, as in Workman, the ALJ found that the 

employer rebutted the presumption of workrelatedness and showed the fall to be 

personal or idiopathic. The employer asserts 

that the Board erred by substituting its 

judgment for the ALJ’s and, thus, that the 

Court of Appeals erred by affirming the 

Board. We disagree.

In the case sub judice, the medical records reflect a 

diagnosis of syncope but do not show its cause or, more 

importantly, relate it to a non-work-related cause. Thus, 

the employer as required in Dever did not show the fall 

resulted from a personal or idiopathic cause. The 

following language from Dever is directly applicable to 

this case:

The ALJ characterized the claimant as “not 

an entirely credible witness” but determined 

that a workplace fall occurred although its 

cause was idiopathic. The fact that the 

claimant’s work did nothing to cause her fall 

was immaterial under Workman. The record 
-23-

contained no evidence that she suffered from 

a pre-existing disease or physical 

weakness that caused her to fall and no 

evidence that she was engaged in conduct 

when she fell that would take the injury 

outside Chapter 342. Nor did the record 

contain evidence that her footwear was 

inherently dangerous and inappropriate for 

work in the employer’s officers. Like the 

Board and the Court of Appeals, we are 

convinced that evidence the claimant was 

clumsy and wearing high heels was not 

sufficient to prove that the cause of her fall 

was idiopathic. The evidence did not 

overcome the presumption that the fall was 

unexplained and, thus, that it was workrelated. 

Id. at 734. (emphasis added.)

The record contains no evidence, as mandated by Dever, 

Bell suffered from a pre-existing disease or physical 

weakness causing his fall. There is no evidence he was 

predisposed to a syncopal episode when he fell, thereby 

removing the fall and injury from the work-related realm. 

In the case sub judice, there is no such evidence 

establishing, as mandated by Dever, that Bell suffered 

from a pre-existing disease or condition rendering him 

likely to suffer a syncopal episode resulting in a fall. 

That being the case, Bell’s fall was unexplained. 

In light of the foregoing, we agree with the Board’s decision to 

reverse the ALJ, due to Reynolds’ failure to adduce substantial evidence 

demonstrating Bell’s fall was idiopathic; its decision to remand for a finding that 

the fall was unexplained and that the physical effects of the fall are compensable; 

and its directions for the ALJ, in light of the overwhelming evidence of causation 
-24-

discussed above, to accordingly find Bell’s injury to his right eye compensable, 

and to hold any other proceedings not inconsistent therewith. Accordingly, we 

AFFIRM.

ALL CONCUR.

BRIEF FOR APPELLANT:

Lyn Douglas Powers

Louisville, Kentucky

BRIEF FOR APPELLEE WILLIAM 

BELL III:

Mark B. Wallace

Louisville, Kentucky