An idiopathic injury is defined as an injury that has “an unknown cause or is peculiar.” Pursuant to the Workers’ Compensation law in Florida, this type of an injury is not compensable. However, it is a common misconception that the Claimant has to prove that he/she suffered an injury if there is no explanation for what caused the accident.
Lebron’s Tractor Injury
For example, let’s say that Lebron James injured his back while exiting a tractor. Mr. James did not know what caused his injury, however he did report the injury and indicated that he hurt his back while performing his job on the tractor. If the Employer disputes the injury, it is the Employer/Carrier’s duty to prove that Mr. James was suffering from a pre-existing injury, which in turn caused his back injury. Florida Workers’ Compensation Law places the burden of proving an idiopathic injury on the Employer/Carrier. The Employer/Carrier must prove that the Claimant has a pre- existing injury, disease or ailment that caused that worker to be injured. If the Employer/Carrier cannot prove that the Claimant has a pre-existing injury or disease, than the Judge of Compensation Claims will award the Claimant the benefits he/she is requesting.
The Employer has to Prove
A recent case in the 1st District Court of Appeals was decided on this very issue of idiopathic injuries. The Court in Caputo held that where an unexplained fall occurs in the workplace while the Claimant is engaged in his normal duties of employment, and there is no other reason established for the fall, then the Claimant is entitled to medical/lost-wage benefits if requested. It follows that the Employer/Carrier has the burden to prove that because of a pre-existing injury/disease, the Injured Worker was suffering from a condition that caused his/her injury. The Employer/Carrier would have to prove that Mr. James was suffering from a previous back injury, and that the previous condition was the cause of his injuries, not the fall he took from exiting the tractor.
Injured Workers should be Compensated
An injured worker is entitled to medical treatment and lost wage benefits pursuant to Florida law. An individual injured at the workplace should not be discouraged because he/she cannot state the specific reason for an injury. So long as there was a fall, or some type of injury while a Claimant performed his/her job duties, it is up to the Employer/Carrier to prove that there was a pre-existing injury or disease that caused the injury. The Employee need not prove the specific reason for an injury in the workplace.