Opinion
W.C. No. 4-725-754.
February 15, 2008.
FINAL ORDER
The claimant seeks review of an order of Administrative Law Judge Walsh (ALJ) dated November 6, 2007, that denied and dismissed the claimant's claim for workers' compensation benefits. We affirm.
The ALJ's pertinent findings of fact are as follows. The claimant was working at Penrose Hospital for the employer and went into an emergency room to assess a patient. The room was small with a number of objects in it. The claimant was walking around the patient's bed at which time she thinks she may have stepped on something. She twisted around and felt pain in her back and ankle. The claimant cannot state with certainty that she stepped on anything. The claimant did not trip or fall forward and she did not slip on anything. The clamant did not check the floor afterwards to ascertain if there were any objects that might have caused her to twist her ankle. The claimant's twisting of her ankle was unexplained and was not combined with any special hazard of the claimant's employment.
The ALJ noted that the claimant had the burden of proof to establish compensability; however, she was unable to pinpoint any mechanism in the room that caused her to twist her ankle. The ALJ concluded that the claimant failed to carry her burden of showing a compensable injury and denied and dismissed the claimant's claim for workers' compensation benefits.
On appeal, the claimant argues that, contrary to the ALJ's order, the claimant's fall was explained and her injury is therefore compensable. The claimant argues that the uncontested evidence is that the claimant was not watching where she was going because she was observing her patient as required by her job duties and regardless of whether she actually stepped on something or simply made a misstep, the injury would not have occurred but for her duty to observe the patient. The claimant further argues that there is sufficient circumstantial evidence in the record to support the conclusion that she stepped on something that caused her ankle to twist, given that the room was very small and crowded.
This issue is largely factual in nature and we must uphold the ALJ's resolution if supported by substantial evidence in the record. Section 8-43-301(8), C.R.S. 2007. This standard of review requires that we consider the evidence in a light most favorable to the prevailing party, and defer to the ALJ's credibility determinations, resolution of conflicts in the evidence and plausible inferences drawn from the record. Wilson v. Industrial Claim Appeals Office, 81 P.3d 1117 (Colo.App. 2003). We perceive no basis upon which to set aside the ALJ's finding that the fall was unexplained.
Contrary to the claimant's argument, the ALJ was not compelled to conclude from the record that the explanation for the claimant's fall was that she was not watching where she was going because she was observing her patient and stepped on something which caused her ankle to twist. The evidence does not compel the conclusion that the incident arose out of the employment. In our view, it was a reasonable inference from the claimant's testimony that the cause of the accident remained unexplained.
Colorado law supports the ALJ's determination that a truly "unexplained fall," in the present case the twisting incident, is not compensable simply because it occurred in the course of employment. In the present case, the ALJ found that the claimant was unable to pinpoint any mechanism in the room as causing her to twist her ankle. The ALJ found that the claimant's twisting of her ankle was unexplained. The ALJ further found that no special hazards of employment were implicated in the claimant's injury. The ALJ simply found that the preponderance of the evidence showed that the claimant was injured while walking into the room. These findings are supported in the record by the claimant's testimony. Tr. at 14, 16, 25, 27, 31. The findings are also supported by the testimony of Dr. Wallace. Tr. at 37-38; Exhibit J at 2.
In our view, given his factual findings and the record, the ALJ did not err in relying upon Rice v. Dayton Hudson Corporation W. C. No. 4-386-678 (July 29, 1999) to deny the claim. In Rice, the ALJ found the claimant was unable to provide any explanation for her fall. Consequently, it was held that the claimant's unexplained fall was not compensable, because it could not be associated with the circumstances of the claimant's employment nor any preexisting idiopathic condition. The Panel noted in Rice that Colorado law does not create a presumption that injuries which occur in the course of employment necessarily arise out of employment. See Finn v. Industrial Commission, 165 Colo. 106, 437 P.2d 542 (1968).
Similarly, in Finn v. Industrial Commission, supra the claimant was found lying on the floor at his place of employment suffering from a fractured skull and numerous bruises and abrasions. The claimant "surmised that he had been struck by a forklift," but he did not know what happened and could not produce evidence of what occurred. The referee concluded that the claimant failed to prove his injuries arose out of employment, and expressed his belief the claimant's injuries were triggered by a "mysterious inner-body malfunction." The claimant appealed arguing that a "presumption exists that an injury arises out of the employment where there is an unexplained injury which occurred during the course of the employment." 437 P.2d at 543. However, the court in Finn ruled that no such presumption exists, and that the burden is on the claimant to prove a causal relationship between his employment and his injury. See also Industrial Commission v. London Lancashire Indemnity Co., 135 Colo. 372, 311 P.2d 705 (1957) (mere fact that the decedent fell to his death on the employer's premises did not give rise to presumption that the fall arose out of and in course of employment).
We acknowledge that circumstantial evidence can be considered by the ALJ in determining causation. However, we are not persuaded by the claimant's argument that Brandt v. Bill's Tool Rental, W.C. No. 4-511-128 (August 21, 2003) compels a finding of compensability under the present circumstances. In Brandt the decedent was found unconscious with a hoist chain wrapped around his neck. The decedent's feet were touching the ground and his knees were suspended approximately 6 inches above the ground. The panel affirmed the ALJ's order, which determined that the decedent died of injuries arising out of his employment. The Panel particularly noted that "unexplained fall" cases were inapposite because of the ALJ's inference from circumstantial evidence that the claimant sustained an accident while using a piece of work-related equipment. In contrast, in the present case the ALJ determined that the claimant's twisting of her ankle was unexplained. Findings of Fact, Conclusions of Law, and Order at 3, § 8.
The claimant's reliance on Wood v. Wal-Mart Stores Inc., W.C. No. 4-481-581 (November 30, 2001) is also misplaced. That case is distinguishable because in Wood the Panel again particularly noted that the ALJ did not find that the fall was "unexplained." Instead, in Wood the ALJ reasonably inferred from circumstantial evidence that the claimant fell because she slipped on an oily substance on the asphalt. Here the ALJ made no such inference on causation, but instead found that the incident was unexplained.
In our opinion, the finding of the ALJ that the incident was unexplained was a reasonable inference from the record. Because this dispositive finding is supported by substantial evidence, we have no authority to disturb the finding. Consequently, the ALJ's order denying benefits must be affirmed.
IT IS THEREFORE ORDERED that the ALJ's order issued November 6, 2007, is affirmed.
INDUSTRIAL CLAIM APPEALS PANEL
_______________________
Curt Kriksciun
_______________________
Thomas Schrant
REBECCA BLUNT, COLORADO SPRINGS, CO, (Claimant).
NURSECORE MANAGEMENT SERVICES, Attn: KAREN WALLACE, ARLINGTON, TX, (Employer).
COMMERCE INDUSTRY INSURANCE CO, Attn: AIG CLAIM SERVICES, INC., C/O: RONICA REXROAT (PHOENIX OFFICE), SHAWNEE MISSION, KS, (Insurer).
SHAKESHAFT LAW FIRM, Attn: CHARLOTTE VEAUX, ESQ., COLORADO SPRINGS, CO, (For Claimant).
SENTER GOLDFARB RICE, L.L.C., Attn: J. J. FRASER, III, ESQ., DENVER, CO, (For Respondents).
NURSECORE OF COLORADO SPRINGS, Attn: ROBIN FRASER, COLORADO SPRINGS, CO, (Other Party).