Simply because an accident occurs at work does not mean that the injury is compensable under Missouri Workers' Compensation law. In order to be compensable, the injury must meet the definition of "injury" under the statute. Section 287.020.3 of the Missouri Revised Statutes defines an "injury" as "an injury which has arisen out of and in the course of employment. An injury by accident is compensable only if the accident was the prevailing factor in causing both the resulting medical condition and disability. 'The prevailing factor' is defined to be the primary factor, in relation to any other factor, causing both the resulting medical condition and disability. "
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As a result of this definition, many cases are deemed not compensable because the treating doctor says that work is not the prevailing factor in causing someone's injury. To further complicate matters, the statute goes further to say: "(3) An injury resulting directly or indirectly from idiopathic causes is not compensable. " Section 287.020(3) RSMo.
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So what does that mean, "an injury resulting directly or indirectly from idiopathic causes?" Generally, the defense is raised when someone is injured after a fall, car accident or other event that occurs for seemingly no reason. For instance, if a person falls off a ladder at work because he or she fainted and is thereafter injured, the employer might raise the defense that the injury was due to the "idiopathic cause" of the fainting. An "idiopathic cause" for an accident has been defined in the Missouri caselaw as follows: "Idiopathic conditions are those 'peculiar to the individual: innate.' Evidentiary support is required to successfully claim an event is entirely idiopathic, i.e., the event results from some cause personal to the individual, such as a physical defect or disease." Huffmaster v. American Recreation Products 180 S.W.3d 525, 529 (Mo.App. E.D.,2006).
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This defense is most often raised when a person is injured at work after suffering some medical event, such as a heart attack, asthma attack, seizure, or loss of consciousness. A skilled workers' compensation lawyer should be consulted if this issue is raised in your case, as cases defended by an employer based on an alleged idiopathic cause are usually hard-fought and headed for trial. Don't try to handle one of these cases without at least consulting a Missouri Workers' Compensation attorney.
