Workers' Compensation Claim and 'Idiopathic Cause'

by James M. Hoffmann on Nov. 07, 2014

Employment Workers' Compensation Employment  Employee Rights Accident & Injury 

Summary: Many employees assume that all workplace injuries are covered by Missouri workers' compensation.

When an accident occurs at a workplace, the injured employee may or may not receive compensation under Kansas City Missouri workers’ compensation law. For an injury to be compensable, it has to meet the definition of "injury" under the statute. An "injury" under the Missouri Revised Statutes is defined as “an injury which has arisen out of and in the course of employment”. Injuries which result from an accident at a workplace are the only ones which can a basis for seeking compensation. The accident in this case is the prevailing factor which caused the injury and the resulting medical condition or disability. The prevailing factor is the primary cause as compared to any other factor which caused the accident and the resultant medical condition or disability.

Workers' Compensation Claim Denied

The doctor treating the injured person can certify whether the accident has been a cause of the injury and the resultant medical condition or not. Hence, as per the above definition and the doctors’ certification, many claims for workers' compensation may be denied as the medical condition or disability has not been a result of the accident. The statute further states that “an injury resulting directly or indirectly from idiopathic cause is not compensable”.

What Are ‘Idiopathic Causes’?

To understand this let us consider when someone is injured after a fall, a car accident, or any other event for seemingly no reason and the defense is raised against the compensation claim. For example, an employee is injured while at work after falling off a ladder due to fainting; in such a circumstance, the employer will raise the defense that the injury or the resulting medical condition has been caused by the employee fainting while working on the ladder. The act of fainting is an idiopathic cause and a compensation claim may be denied.

Missouri workers' compensation law defines an idiopathic cause for an accident as those conditions which are peculiar to the individual injured in the accident. The case requires evidentiary support to prove that the cause for the accident is completely idiopathic and no other cause exists, such as the individual had a physical defect or disease which was a cause of the accident.

Workplace Injuries Not Caused by Negligence

There are workplace injuries which are caused not due to negligence or any other systematic failure, but due to idiopathic causes resulting from the workers’ condition. A worker at a construction site may get injured by a heavy load that he had been shifting, a wood craft worker may get his hand severely cut on the wood saw, or a worker may fall from a height. All these injuries may result due to idiopathic causes of a medical event like a heart attack, seizure, or loosing consciousness.

It is essential that an experienced Kansas City workers' compensation attorney is consulted; since cases involving idiopathic causes are generally hard-fought and go for trial. Contact The Law Office of James M. Hoffmann at (816) 399-3706.


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