Work comp update: Benefits denied for knee injury while walking
By: Brad Young, Harris Dowell Fisher & Young L.C.
January 31, 2022 - The Missouri Court of Appeals, Southern District, issued a decision last week, affirming a denial of benefits for a knee injury that occurred while walking. Specifically, the Court of Appeals stated that the injury occurred as follows: “He planted his foot to turn right, turned around to retrieve his card, heard a "pop" and felt tearing in his left knee.” In addition to alleging that his knee popped while changing direction, he also testified that he was walking "downhill" or "across a decline" or a "slope" when his knee popped.
In years past, changing direction while walking was sufficient to make a claim compensable. Here, though, we are hopefully seeing the Courts’ “change direction” on the compensability of these questionable claims.
The Administrative Law Judge, in the decision that was upheld, found:
“(Claimant) did not prove that he suffered a compensable injury arising out of and in the course of his employment because his risk source—walking on asphalt and changing directions—was a risk to which Overstreet was exposed equally outside of employment.”
The Court of Appeals upheld the denial of benefits, stating:
“It is not enough that a claimant's injury occur at work or even while engaged in a work-related activity. To show a causal connection between the injury and work, the risk involved must be one to which the worker would not have been equally exposed in his non-employment life. Overstreet fails to meet this requirement.”
Early Investigation. This case demonstrates the benefits of an early investigation into a claim. We don’t know if a recorded statement was obtained, but the initial testimony from the claimant was secured in some fashion, demonstrating the absence of any real connection to work.
Also, surveillance video of the “incident” demonstrated that claimant wasn’t doing anything out of the ordinary at the time he felt pain in his knee. The Industrial Commission noted:
“Initially, the employee testified that he thought he had been walking at a slightly faster than normal pace when he changed directions. However, after watching the video of the incident, Overstreet retracted that testimony and stated that he was only walking at a normal pace.”
Evidence to secure. When investigating an alleged fall at work, the Court of Appeals gives us a road map for the investigation as the Court noted that the claimant failed to identify any of the following factors that would have made this claim potentially compensable:
No defect in the asphalt where claimant fell.
The asphalt lot at his work was not dissimilar from numerous other asphalt lots in his community which had similar surfaces, cracks, unevenness and slopes.
No evidence that the conditions of the employment, such as wearing steel-toed boots, low lighting, or cracks in the asphalt - - led to or worsened the claimant’s injury.
When investigating a fall injury, ensure that you focus on the exact cause of the fall. Ask the claimant multiple questions in different ways to develop a pattern of evidence as to the exact cause of the fall. Focus on whether any conditions of employment led to the fall, such as the condition of the floor, the lighting conditions, whether there are any defects in the surface, whether the claimant was carrying anything at the time of the fall, and whether the surface of the floor is any different than floors the claimant would walk on outside of his employment.
In years past, an allegation that claimant changed direction while walking was sufficient to make a claim compensable. Now that the Industrial Commission is more business friendly, the Court of Appeals is affirming decisions of non-compensability even in situations where the claimant alleges a change of direction as the cause of the injury.
If you have any questions about this decision from the Missouri Court of Appeals or how to implement the suggested practice points, please feel free to call or email Brad Young, firstname.lastname@example.org, (636) 532-0300.