Idiopathic Injuries

Idiopathic injuries, which arise from factors outside of the victim’s job, may be compensable in SC if the job amplified the injury risk significantly.

Many people in the Columbia, Greenville & Orangeburg areas know that workers’ compensation insurance covers sudden traumatic injuries that occur while an employee is working, as long as the injury is due to the nature of the employee’s job and it does not fall into one of the exceptions. Many people believe this provision excludes workplace injuries that are partly caused by other factors, such as personal health conditions. However, under certain circumstances, these idiopathic injuries may be compensable under South Carolina law especially when the idiopathic condition then leads to other injuries.

Idiopathic injuries in the workplace

Idiopathic injuries arise spontaneously, either from an unknown cause or due to an individual’s pre-existing health condition. Common idiopathic injuries and idiopathic conditions that may lead to injury include heart attack, stroke, epilepsy, seizures, fainting and diabetes.

These injuries affect many individuals each year. The CDC reports that, annually, over 700,000 Americans have heart attacks; about 800,000 people experience strokes; about 2.3 million adults live with epilepsy; and almost 10 percent of Americans live with diabetes. Not surprisingly, these conditions or their related health effects may lead to many injuries in the workplace.

Obtaining compensation for these injuries can be difficult, since the injury arises in part due to factors outside of the employee’s job duties and work environment. South Carolina law requires that compensable injuries arise during work and due to the nature of the work. However, in some cases, idiopathic injuries may qualify for compensation.

Direct and indirect injuries

Some idiopathic injuries are directly compensable. Someone who has experienced one of the following injuries may qualify for workers’ compensation benefits, if the injury occurs in tandem with a physical injury:

Stroke.
Embolism.
Aneurysm.
Heart attack.

These injuries may also be compensable if working conditions raise the risk of the injury; for example, physical labor can raise the risk of a heart attack. However, if one of these injuries occurs during normal interactions between employers and employees – for example, evaluations, transfers or terminations – the interaction would have to be exceptionally stressful or otherwise out of line for the injury to be compensable.

In other cases, injuries that result from idiopathic conditions may be compensable. For instance, after experiencing a stroke during work, an employee may fall and sustain a serious injury. However, the employee is only entitled to compensation if the nature of the employee’s job contributed to the injury in some way. The activity the employee was engaged in at the time of the injury usually matters significantly.

As an example, if an on-site construction worker suffers a stroke and falls while doing something that is not unique to the job, such as standing or walking, any resulting injury would likely not be compensable. Although the injury could technically be considered a construction site injury, the worker’s job duties did not create a heightened risk for the injury.

However, if the same construction worker experiences a stroke and subsequent fall while performing a specialized duty, such as working on a ladder, the claim could be found compensable. This is because the work-related task significantly raised the risk of injury from the fall.

Protecting personal rights after an injury

Determining whether a workplace injury involving an idiopathic condition is compensable can be difficult, as can obtaining appropriate compensation.

Anyone who has experienced one of these injuries should consider speaking with a Columbia workers’ compensation attorney about state laws and potential next steps.