To be entitled to workers’ compensation benefits in North Carolina for an arm injury, an injured worker needs to show that the injury was caused by an “accident”. If an employee injures his arm because of something that is an ordinary event, part of life for everyone, he is ordinarily not entitled to benefits.
Sometimes, however, people are injured, for example in a fall, and despite an investigation, no one can say for sure exactly what happened. In those situations, our courts have developed the “unexplained fall”” doctrine. The doctrine says that if an employee falls and gets hurt, and no one can testify with necessary certainty why they fell, the worker is entitled to workers’ compensation benefits. In essence, the court say, where no one can say for sure exactly what happened, it’s the employer who should bear the burden of paying for the injury, rather than the worker. The reason is that the Workers’ Compensation Act was set up as a system where industry pays for its damage. The system takes away an injured worker’s right to sue the employer, in exchange for giving the employer the burden of providing benefits in most situations where workers are injured.
In Philbeck v. University of Michigan, decided last week, the Court of Appeals applied the “unexplained fall” doctrine in a case where a 67-year old woman who traveled as part of her job fell while walking to her car, and broke her arm. The woman didn’t know what had caused her to fall, and although several doctors testified that she could have been dehydrated, they could not say to a reasonable degree of medical certainty that dehydration had caused the fall. As a result of the opinion the employer is responsible for paying the woman’s medical bills and for paying her weekly workers’ compensation benefits while she heals from the injury.