In an August 7, 2008 posting below, Jim Edmunson discussed cases that dealt with whether certain accidents were work-related. The Court of Appeals has issued another decision on this topic, SAIF Corp. v. Uptegrove (February 18, 2009). Jennifer Uptegrove sprained her ankle while walking down a flight of stairs at work. Her co-worker noticed after the accident that Ms. Uptegrove’s high heel had come off her shoe. The insurer denied her workers’ compensation claim and argued she did not prove that her injury was work-related. The insurer argued that, if the accident was caused because the heel came off, then it was caused by a personal matter and was not work-related.
The insurer relied on a statute that says, “The burden of proving that an injury or occupational disease is compensable and of proving the nature and extent of any disability resulting therefrom is upon the worker. The worker cannot carry the burden of proving that an injury or occupational disease is compensable merely by disproving other possible explanations of how the injury or disease occurred.”
The court noted that the administrative judge and the Workers’ Compensation Board had found that “[i]t is unknown why claimant fell at work.” The Court then stated, “[t]he board adopted that finding in its order, and we conclude that that finding is supported by substantial evidence. Also, it is clear that claimant’s fall occurred in the course of employment. The stairway was part of employer’s premises provided for the use of its employees, and the fall occurred during a time and under circumstances related to the risks of employment.”
The court rejected the insurer’s argument that the injured worker must disprove other personal causes when the facts did not show that there was an explanation for the accident. The court stated, “We disagree. Claimant was walking down stairs when she fell. The stairs presented a risk inherent to her work environment. Under the circumstances, there exists a reasonable inference that the stairs caused her fall.” The insurer was therefore ordered to accept the claim.
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