A Utah appellate court sent a case back to the Utah Labor Commission for consideration of how an injured employee’s physical work environment may or may not have made her injuries worse. The case is Ackley v. Lab. Comm'n, 557 P.3d 234 (Utah Ct. App. 2024).
The Injury
Lillian Ackley was labelling products as part of her job at Lowe’s. As she was placing a label on a hammer, she tightened her grip to avoid dropping it; the adjusted position of her fingers on the handle ruptured a ganglion cyst on her right hand. The pain was so extreme that Ackley collapsed, unconscious, on the concrete floor, suffering multiple severe injuries.
As she had been working when she was injured, Ackley sought benefits with the Utah Labor Commission (Commission). Though the Commission did not dispute that Ackley was injured on the job, they determined her injuries were not compensable because the fall “was caused by a preexisting condition,” not her work activities.
The First Debate and Appeal
Ackley requested a hearing before an administrative law judge (ALJ), who said it was Ackley’s burden to show that her work activities were both the legal and the medical cause of the injuries “for which she sought workers' compensation benefits.” The ALJ ultimately determined that Ackley had successfully drawn the connection between her work activities and medical causation, but her claim failed nonetheless because she did not show adequate legal causation. Maintaining her grip on the hammer was an ordinary activity that required neither special skills nor special training to perform. Ackley’s petition for benefits was rejected, and she appealed to the Commission.
Ackley argued that the ALJ had taken too narrow a view of her fall. The hammer was only one part of the whole accident. The Commission instead determined that the ALJ had been correct: the injuries were noncompensable because she did not establish “a legal causal connection between” her work duties and her injuries. Ackley also asserted that her claim was payable under the “idiopathic fall” doctrine because her fall had been occasioned by a “preexisting internal weakness or disease.” The Commission disagreed, noting that the doctrine Ackley cited contemplated falls that occurred “‘because of strictly idiopathic factors.’” Ackley’s fall, on the other hand, had been caused by “a pre-existing condition aggravated by a work activity.’”
Ackley sought judicial review of her case. The Court of Appeals of Utah found that Ackley’s fall had actually been idiopathic, and that the Commission had focused on the wrong aspect of the fall, namely “whether gripping the hammer was an unusual or extraordinary exertion.” Instead, the analysis should have centered on “whether employment conditions increased or aggravated an employee's risk of injury from a fall to level ground.” The judges reversed the Commission’s decision and sent it back for consistent proceedings.
Take Two
The second time around, the Commission denied Ackley’s request for benefits, but for a different reason. This time, the Commission found that Ackley’s specific position at Lowe’s did not place her in an area that increased her risk of injury should she fall. The Court of Appeals, the Commission said, should outline a specific standard for determining the compensability of fall-related injuries if the judges “believe[d] a fall similar to the one suffered by [Ackley] should be considered compensable due to the hardness of the floor” (italics omitted, bold added) and how it was similar to or different from someone hitting their head “against a comparably hard object such as a metal cabinet or shelf” (italics omitted, bold added). Or, if the court had agreed with Ackley that “the mere presence of increased risk is sufficient to causally connect her idiopathic fall to her employment even if she does not come in contact with the hazards that pose the increased risk,” it should have stated so more clearly, because the remand order did not specify what path the Commission should take.
Ackley appealed to the Court of Appeals of Utah for a second time, and the judges again accepted the case.
A Clearer Standard
An injured employee is not entitled to workers compensation benefits simply because the injuries happened to occur while the employee was on the clock. Injured employees like Ackley, said the court, needed to “show a causal connection between the injury and the employment” (emphasis added) in order to receive benefits for work-related injuries.
However, in the appellate judges’ first Ackley opinion, the “causal connection” analysis shifted just a bit. An “idiopathic fall,” as Ackley claimed her fall had been, was the result of “an internal or personal weakness or condition of the employee.” The judges acknowledged, and Utah workers compensation law implicitly accepted, that employees do not attend work from or in a vacuum. They “routinely bring with them…myriad idiosyncratic physiological conditions…that…pose risks that could interact with employment conditions to prompt accidents or injuries” (emphasis added). Those idiosyncrasies must be considered when determining workers compensation benefits. The inquiry must focus “on whether employment conditions increased the dangerous effects of the fall” (emphasis added).
In Ackley’s case, she had been standing on a concrete floor in the middle of Lowes. As the Commission had put it, “though the cabinet, post, key-cutting machine, and counter all represented a potential for increased risk and injury from [Ackley’s] workplace, that potential was not actually realized” (italics original, bold added) because Ackley fell straight to the floor and did not hit anything else as she did. But the Commission felt that “the mere presence of an increased risk” was not enough to draw the necessary causal connection required for Ackley’s workplace injuries to be compensable.
The court agreed with the Commission that “a per se rule that requires the payment of benefits based simply on the possibility of an increased risk of injury from a fall to level ground at a workplace” (emphasis added) went a step too far. But the causal connection between an employee’s injuries and their employment needed something more than the existence of an increased risk; the “increased risk” must somehow be realized. The hazards that increase the risk of injury “must actually result in increased or aggravated injuries.”
The Commission had determined that Ackley’s injuries weren’t compensable under workers compensation because the risk of falling and landing on concrete “[was] not particular to a workplace, retail space, public setting, or even one’s own private residence…” The fall was “just ‘one of those accepted and expected risks inherent to countless modes of modern life.’” The appellate judges, however, stated that it was possible to compensate an injured employee for an idiopathic fall “on a hard floor, …but only if the employee can show, as a factual matter, that the hardness of the floor made the resulting injuries worse” (emphasis added).
Conclusion
The court noted that “‘a significant minority’ of jurisdictions” had determined idiopathic falls were compensable under certain circumstances, and declared that Utah was “join[ing] that 'significant minority’ of jurisdictions." The Commission’s decision was reversed again, and the case was sent back to the Commission with specific instructions to determine “whether the condition of Lowe’s concrete floor aggravated the effects or severity of Ackley’s injuries.”
Editor’s Note: It is important to note that the judges did not order the Commission to pay workers compensation benefits to Ackley. They only ordered that the Commission reconsider its second dismissal of Ackley’s claim, and give her a chance to show how the concrete floor made her injuries worse than they may have been otherwise.
If Ackley succeeds in showing that the concrete floor “made [her] resulting injuries worse,” her claim, according to the judges’ ruling in this case, should be compensable. If she does not make such a showing, the claims will likely not be compensable.