The Mystery of the Disappearing Chair: The Commission Finds an Explanation for an Unexplained Accident
In every case, a claimant is required to prove two things by a preponderance of the evidence: (1) that their accident occurred in the course of their employment and (2) that their injury was caused by some condition of the employment that put them at greater risk of injury than the general public. In Virginia Workers’ Compensation 101, employers, attorneys, adjusters, and claims administrators learned that simple acts of walking, bending, and standing – without more – were not compensable and should be denied. Similarly, if an injured worker could not explain what caused their accident, their claim should be denied not compensable because they failed to meet their burden of establishing a relationship between work and their injury.
In the recent case of Dawit v. SP Plus Corporation, VA00001708797 (Mar. 17, 2021), the Commission called into question these foundational principles of Virginia workers’ compensation law. In Dawit, an employee was injured when she fell while trying to sit down in a chair at her desk. The injured worker described standing up to greet her supervisor immediately prior to the incident. As she went to sit back down, the chair was not where she thought it was and she fell on her buttocks. The record established that the claimant was not sure if the chair had moved and, if it did, she was not certain what had caused the chair to move. After a hearing, the Deputy Commissioner held that the claimant “failed to prove that the accident was caused by any work-related risk or significant work-related exertion.”
On appeal, the Deputy Commissioner’s Opinion was reversed and remanded in a 2-1 split decision. In reversing the Deputy Commissioner’s Opinion, the majority seemed to rely upon philosophical musings rather than decades of case law precent. They wrote “[n]ot every fact in human transactions can be corralled within the boundaries of observation and perception.” They then went on to quote Albert Einstein’s thoughts about the intersection between quantum physics and reality before concluding that they could infer from the facts and their own “common sense” that the claimant’s injury arose out of the employment.
The majority said that they relied upon the undisputed evidence that the claimant stood up, but the chair was not there anymore when she sat down. Thus, they could readily infer that the chair moved and the only reason the chair could have moved is if the claimant bumped it. (Even though the opinion also noted that the chair “moved easily because it was on a hard surface.”)
The case was remanded to the Deputy Commissioner for a determination as to causation of the nature and scope of injuries. A ruling on those issues must be rendered before the defendants can appeal to the Full Commission.
How can employers and carriers evaluate the compensability of a claim when the claimant doesn’t even know how it occurred?
The employer and carrier in Dawit appear to have done everything correctly. Specifically, they obtained a statement from the claimant in which she said that she did not know why, how, or if, the chair moved. Yet, the Commission inferred that the chair moving was related to work. In his dissenting opinion, Commission Rapaport summed up the problem with the majority’s opinion in one sentence “[w]e cannot presume to know what must have happened rather than relying upon what the presented evidence established – or did not establish.”
It is yet to be determined whether Dawit will have long term ramifications on whether an employee has to provide an explanation for their accident. It is possible that this was a unique case because the Full Commission found that there was only one possible explanation. While Dawit makes its way through the courts, we recommend sticking to principle that, if the claimant does not know how their accident happened, then it is an unexplained accident and is, therefore, not compensable.
In each and every case please continue to:
- Ask the injured worker if they know what caused their accident. Unexplained accidents are not compensable – for now.
- Ask the injured worker if there was more than one thing that could have caused their accident. If there are multiple potential explanations for what caused the accident, Dawit leaves the door open for denial.
- Ask the injured worker if they are aware of any defect, substance, or awkward position that distinguished their accident from things that the general public is exposed to.
- Identify and speak with as many witnesses to the accident as possible to determine whether the claimant provided an explanation for his/her accident at the time it occurred. We all know that an injured workers’ explanation may change over time.
Click here for the full opinion on Dawit v. SP Plus Corporation.
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