Opinion ID: 6497
Heading Depth: 3
Heading Rank: 1

Heading: Idiopathic Falls

Text: An injured employee in Texas may recover workers' compensation benefits if the injury was sustained in the course of employment. 1 National Union also argues that the district court made additional procedural mistakes in conducting the trial. Having reviewed the record and the merits of these contentions, we find no reason to reverse the trial court's decision based on these points of error. 3 Tex.Rev.Civ.Stat.Ann. art. 8309, § 1(4), (Vernon 1967) (repealed 1991).2 The statute defines injury sustained in the course of employment, to include: injuries of every kind and character having to do with and originating in the work, business, trade or profession of the employer received by an employee while engaged in or about the furtherance of the affairs or business of his employer. Id. Texas courts have culled two essential requirements out of this statutory definition: the injury (1) must have occurred while the claimant was engaged in the business of his or her employer; and (2) must originate in and have to do with the employer's business. Texas Employers Insurance Association v. Page, 553 S.W.2d 98, 99 (Tex.1977). National Union concedes that Pansegrau meets the first requirement; she was on duty and engaged in her employer's business at the time she suffered her injuries. The controversy in this case concerns the interpretation of the requirement that the injury originated in the employer's work, trade, business or profession. Id. National Union argues that Pansegrau's injury did not originate in the hospital's business or in her profession as a nurse. The evidence shows that she was standing up and talking when she lost consciousness, fell down, and hit her head on the floor. The doctors who testified to Pansegrau's injuries could not identify a particular reason for the original loss of 2 The statute in effect at the time of Pansegrau's injury in 1990 was the old workers' compensation law, Tex.Rev.Civ.Stat.Ann. art. 8306, et seq. (Vernon 1967) (repealed 1991, now Art. 8308- 1.01, et seq. (Vernon Supp.1992)). Although it has no effect on this case, the definition of this term was reworded in the new statute but was not substantively changed. 4 consciousness. They did testify, however, that her current disabilities are a direct result of her head hitting the hard tile floor. National Union argues that Texas requires a causal connection between the employee's work conditions and the injury. The injury, it asserts, must result from a risk or hazard which is necessarily or ordinarily or reasonably inherent in or incident to the conduct of such work or business. American General Ins. Co. v. Williams, 149 Tex. 1, 227 S.W.2d 788, 790 (1950); see also City of Garland v. Vasquez, 734 S.W.2d 92, 96 (Tex.App.—Dallas 1987, writ ref'd n.r.e.). Because there was no evidence linking Pansegrau's loss of consciousness to any particular risk or condition inherent to her position as a nurse at St. Paul Hospital, National Union claims that Pansegrau's injuries did not arise out of her employment. Based upon the causal connection requirement, National Union contends that the district court made two separate errors in the conduct of the trial below. First, it argues that there was insufficient evidence to support the jury's finding that Pansegrau's injury occurred in the course of her employment. Next, National Union contends that the trial court should have issued a jury instruction which embodied National Union's interpretation of the causal connection requirement. We conclude that National Union's interpretation of the causality requirement is jurisprudentially incorrect and therefore find no merit to its allegations of error. The case law interpreting and implementing the Texas worker's 5 compensation statute has provided compensation to employees who fall on the job for unknown reasons and are injured as a result. See Garcia v. Texas Indemnity Ins. Co., 146 Tex. 413, 209 S.W.2d 333, 336 (1948) (granting workers' compensation benefits following an idiopathic fall3); Page, 553 S.W.2d at 102 (same).4 This line of cases extends the principle that a pre-disposing bodily infirmity will not preclude compensation. INA of Texas v. Howeth, 755 S.W.2d 534, 536 (Tex.App.—Houston [1st Dist.] 1988, no writ). In idiopathic fall cases, although the condition which caused the fall is unknown, if the worker was injured by the fall itself, he or she can claim compensation for injuries sustained as a result. Our decision in this case follows a series of Texas decisions in which the employee was allowed to collect for injuries that occurred after an unexplained fall. The principle found its earliest incarnation in Garcia where the Texas Supreme Court allowed an injured employee to recover workers' compensation benefits after he suffered what the court assumed was an epileptic attack and fell and hit his head on a steel post. 209 S.W.2d at 336. The court held that even if the fall was precipitated by some underlying idiopathic condition and even if [t]he risk may be no different in degree or kind than those to which he may be exposed 3 An idiopathic fall is one for which there is no known cause. 4 This result is consistent with the intention of Texas courts to liberally construe the workers' compensation statute in favor of employees. Yeldell v. Holiday Hills Retirement & Nursing Center, Inc., 701 S.W.2d 243, 245 (Tex.1985); Montgomery County v. Grounds, 862 S.W.2d 35, 43 (Tex.App.—Beaumont 1993, writ denied). 6 outside of his employment[, t]he injury is compensable, not because of the extent or particular character of the hazard, but because it exists as one of the conditions of the employment. Id. at 337. While it seemed the court considered the presence of a steel post as a key factor in this case, later decisions interpreting Garcia have not emphasized this element in their analysis of idiopathic falls. Following Garcia, a Texas court of appeals allowed recovery when an employee's idiopathic condition caused him to lose consciousness and fall to the floor where he received a fatal head injury. General Ins. Corp. v. Wickersham, 235 S.W.2d 215, 219 (Tex.Civ.App.—1950, writ ref'd n.r.e.). The Wickersham court held that [w]e can find no sound reason for denying a recovery where the fall is to the floor, when recovery is allowed where the fall is from a ladder, or platform or similar place. Id.; see also American General Ins. Co. v. Barrett, 300 S.W.2d 358, 363 (Tex.Civ.App.1957, writ ref'd n.r.e.) (idiopathic fall case holding that a hard-surfaced road was an instrumentality essential to the work of the employer and falling against it was a hazard to which Barrett was exposed because of his employment). In Page the Texas Supreme Court faced a situation where a bank guard walking across a level parking lot fell when his right knee buckled. The court made clear that where an employee falls to the ground due to some unidentified cause, there remains a question of fact as to whether the injury originated out of Page's employment, that is whether there was a sufficient causal 7 connection between the conditions under which his work was required to be performed and his resulting injury. Page, 553 S.W.2d at 102. The crux of this holding is that where an employee has an idiopathic condition which precipitates a fall onto level ground, the employee can still assert a causal connection between the injury and a condition of employment despite the fact that no one has been able to identify the cause of the fall. For this reason, in an idiopathic fall case such as this, summary judgment (or directed verdict) against the employee on this basis is inappropriate. Id. A fair reading of the case law compels the conclusion that as long as the employee traces the cause of her injuries to the fall itself rather than the underlying condition, the injuries are compensable. Pansegrau demonstrated that an idiopathic condition caused her to fall while on the job. She showed that her injuries were a result of that fall and not the underlying condition which triggered the fall. She has therefore provided sufficient evidence for a jury to find that the injuries arose out of her employment. In sum, the case law supports Pansegrau's theory of recovery and demonstrates no reasonable basis for reversing the judgment in her favor.