Accidents happens. And they can happen all too easily in the workplace. Sometimes the cause of your on-the-job injury might be very clear. For example, if you fell down the stairs because of a broken guardrail, then your injuries obviously ‘work-related,’ and covered by workers’ compsensation.
But in some cases, your injuries might just to happen out of the blue, with no clear cause. In this case, it is harder to prove your have workers’ compensation claim, but it is not impossible.
What Are Idiopathic Injuries?
Injuries that happen without any clear cause are called idiopathic injuries. This simply means they happened because of an unknown or obscure cause.
Idiopathic injuries can happen spontaneously, or they can be caused by a personal health condition that you may or may not you’re aware of. Examples of these conditions include:
- Heart attacks
- Strokes
- Seizures
- Diabetic episodes
- Blackouts
Does Workers Compensation Cover Idiopathic Injuries?
In very specific conditions (and often with the help of a lawyer) workers’ compensation will cover these injuries.
To qualify for workers’ compensation, your injury or disease must arise out ofand in the course of your employment.
This means passing a two-prong test:
- To arise out of your employment, there has to be a causal link between your work duties and your health problem. For instance: if you are a factory worker and you have a seizure on the job, your employer can try to say there is no connection to your work, and that the same thing would have happened to you at home. But if you can prove that your seizure was because of high stress at work or exposure to dangerous chemicals, then you could have a claim.
- To happen in the course of your employment, your injury must have happened while you were on the job. That usually means you were on the clock, not commuting or on your lunch break.
The difficulty with idiopathic health conditions is that they may not have one cause that you can pinpoint. This makes it hard to prove they have anything to do with your job. This in turn means employers and insurance companies can try to deny your claims.
However, you shouldn’t assume you don’t have a case.
Why Details Matter
Every little detail will be important in determining whether you have a case. For example, if you were hurt doing something you have to do for work, but wouldn’t necessarily do in your day-to-day life, then your claim will be more likely to be successful.
Let’s just say you have a heart condition and suffer a heart attack while putting on your jacket to go home from the office. It is unlikely you will be successful trying to claim workers’ compensation with this case.
However, if you have a heart condition and your job contributes to you having a heart attack in someway, you could have a successful claim. This is what happened with a previous client.
What If Your Claim Is Denied?
Under workers’ compensation law, many claims for idiopathic injuries are denied. Why? Because it is hard to prove these injuries are work-related, even if they occur while you are at work.
Each case is unique, but these are some general guidelines that can help your case:
- Talk to a lawyer. An experienced lawyer can help you and will be able to advise you on your case. They will ask you for specific details that make your injuries unique and advise you on the best steps to take.
- Don?t talk directly to insurance companies. The insurance company will always try to do what is best for them. They are always going to try to to prove your accident wasn’t work-related or get you to settle for less than you deserve. This is why you should make sure you know your rights and have a great lawyer fighting for you.
Disclaimer: For informational purposes only. This is not a substitute for legal advice. If you need legal advice please contact us.
