Opinion
W.C. No. 4-842-436.
October 20, 2011.
FINAL ORDER
The respondent seeks review of an order of Administrative Law Judge (ALJ) Martin D. Stuber dated April 27, 2011, that determined the claimant sustained a compensable injury and awarded medical benefits. We affirm the ALJ's Order.
A hearing was held on the issues of compensability and medical benefits. The ALJ entered findings which, for purposes of review, are summarized as follows. On December 3, 2010, the claimant attended a work-related holiday brunch at the home of Ms. Carlsen, the Executive Director of the Human Resources department. The ALJ found, and the respondent does not now dispute, that Ms. Carlsen's home became a temporary work site. The claimant's supervisor offered to drive the claimant back to the office after the brunch. As the claimant was exiting the home, she stepped down over the threshold and then walked to the next step down. The claimant attempted to step down on the next step, but "she lost her balance" or "misstepped" and fell to the left, injuring her left knee and left shoulder. The ALJ found that the claimant did not actually miss a step but that she simply fell while making her way down the steps when she "misstepped" or "lost her balance." There was no evidence of snow, ice or other debris at the time of the accident. Based on these findings the ALJ concluded that the claimant's injuries arose out of participation in the employment meeting as she attempted to exit the home.
On appeal, the respondent does not dispute that the injuries occurred in the course and scope of employment. Rather, the respondent contends that the claimant's injuries did not arise out of her employment because the injury was the result of an "unexplained fall." We are not persuaded that the ALJ committed reversible error.
To establish that an injury arose out of employment, "the claimant must show a causal connection between the employment and injury such that the injury has its origins in the employee's work-related functions and is sufficiently related to those functions to be considered part of the employment contract." Madden v. Mountain West Fabricators, 977 P.2d 861, 863 (Colo. 1999). It is well settled that there is no presumption that an employee injured at her place of employment sustains an injury arising out of that employment. When a claimant does not prove the cause of an injury, the claim fails. Finn v. Industrial Comm'n, 165 Colo. 106, 437 P.2d 542 (1968).
The determination of whether there is a sufficient causal relationship between the claimant's employment and the injury is generally one of fact, which the ALJ must determine based on the totality of the circumstances. Section 8-43-301(8), C.R.S.; Moorhead Machinery Boiler Co. v. Del Valle, 934 P.2d 861 (Colo. App. 1996); Lori's Family Dining, Inc. v. Industrial Claim Appeals Office, 907 P.2d 715 (Colo. App. 1995). This standard of review requires us to defer to the ALJ's credibility determinations, resolution of conflicts in the evidence, and plausible inferences drawn from the record. Cordova v. Industrial Claim Appeals Office, 55 P.3d 186 (Colo. App. 2002).
Here, the ALJ reasonably determined from the evidence presented that the claimant's injuries were the result of an accidental fall as the claimant proceeded down the stairs to exit the temporary work site. The ALJ's findings in this regard are supported by the testimony of the claimant and a co-employee and witness to the event, Ms. Barr. The claimant testified that she took the first step down out of the door and missed the next step, causing her to fall to the ground. Tr. at 23, 24 and 38. Ms. Barr testified that she saw the claimant lose her balance and fall but she could not see the claimant's feet. Tr. at 73. From this evidence, the ALJ logically inferred that the claimant did not actually "miss a step" but rather that the most likely cause of the accident was the claimant "misstepped" or "lost her balance." ALJ Order at 4 ¶ 14 Where the ALJ's findings are supported by substantial evidence and plausible inferences drawn from the record, we may not substitute our judgment for that of the ALJ concerning the proper inference. Section 8-43-301(8), C.R.S.; Arenas v. Industrial Claim Appeals Office, 8 P.3d 558 (Colo. App. 2000); Metro Moving Storage Co. v. Gussert, 914 P.2d 411 (Colo. App. 1995).
The respondent argues that by finding that the claimant either "misstepped" or "lost her balance," the ALJ, by definition, found that the fall was unexplained and, therefore, not compensable. Respondent's Brief at 9. However, the present case can be distinguished from the unexplained fall cases where Colorado appellate courts have determined that the resulting injury is not compensable.
In Finn v. Industrial Commission, 165 Colo. 106, 437 P.2d 542 (Colo. 1968), for example, the claimant was found unconscious and injured, lying on the floor of his workplace. There was blood running from his ears, his skull was fractured, he had head abrasions and bruises, his eyes were blackened, and his forearms were bruised. The claimant did not know what had happened to him, and there were no witnesses to the circumstances of his unconsciousness or injuries. Although the claimant believed he had been struck by a forklift, the circumstantial evidence was not sufficient to determine what had caused his injuries, and the ALJ found that the "onset" of the injury was triggered by a "mysterious inner body malfunction," not by a work-related function of his employment. Id. at 108, 437 P.2d at 543. The supreme court affirmed, explaining that the claimant had failed to show how or when he received the fracture and the Industrial Commission did not draw any inference to supply a causal connection. Similarly, in Irwin v. Industrial Commission, 695 P.2d 763 (Colo. App. 1984), the claimant fainted and fell to the floor at her workplace. The panel concluded, and the Court of Appeals agreed, that there was not sufficient evidence to prove that the fall arose out of and in the course of employment.
Here, in contrast, the ALJ found a causal connection by drawing plausible inferences from the evidence presented. The evidence indicated that the claimant accidentally fell while making her way down the steps in order to exit the premises on her way back to the office. Under the circumstances presented here, the accidental fall arose out of the claimant's employment duties of having to exit the premises. It is not necessary, as the respondent contends, that the ALJ make findings to show exactly what caused the claimant to misstep or lose her balance. Schaffhauser v. National Jewish Medical Center, W.C. No. 4-815-335 (August 29, 2011). Rather, the causal connection is sufficiently established by the fact that the ALJ reasonably determined that the accident would not have occurred and the injury would not have been received if the claimant had not misstepped or lost her balance when she was required to be walking down the stairs to exit the premises of the temporary worksite in order to return to her office. See 1 A. Larson, Workers' Compensation Law § 7.04(1)(a)(2010).
In the Brief in Support the respondent makes a general statement that it appears "the ALJ misapplied the positional risk doctrine to the facts of this case." Respondent's Brief at 12. We do not read the ALJ's Order as applying the positional risk doctrine to the facts of this case.
The positional risk analysis applies when the cause of an event is neither personal to the claimant nor distinctly associated with employment. In re Question Submitted by U.S. Court of Appeals, 759 P.2d 17 (Colo. 1988) (injury arises out of employment if it would not have occurred but for the fact that the conditions and obligations of employment placed claimant in position where she was injured; compensation supported in cases of stray bullets, roving lunatics). Under such circumstances, the only connection between the claimant's injury and the claimant's employment is that the obligations of work placed the employee in a particular place at a particular time when the claimant was injured by a neutral force. Id. When a force truly is neutral, it follows that the injury would have occurred to anyone else present at the same time and place.
Here, the ALJ found a direct employment cause for the claimant's injury. The ALJ found, with record support, that the claimant's injury was caused because of a misstep or loss of balance when she attempted to exit an employment meeting and return to her office. Contrary to respondent's contention, the ALJ did not find that the claimant was injured as the result of a neutral force or apply the positional risk doctrine to the facts of this case.
Alternatively, the respondent suggests that the claimant's fall was attributable to her pre-exiting morbidity or arthritis and, therefore, the claimant was required to prove that her injury resulted from a special hazard of employment. However, the ALJ was not persuaded by this argument and found that the fall was not caused by any pre-existing condition or weakness. As detailed above, there is record support for ALJ's findings that the claimant's fall was due to a misstep or loss of balance as she was exiting the premises to return to the office. Consequently, the special hazard rule has no application to the present case. See H H Warehouse v. Vicory, 805 P.2d 1167 (Colo. App. 1990) (proof of a "special hazard" is not required where the injury is precipitated by the employment and not the pre-existing condition).
IT IS THEREFORE ORDERED that the ALJ's order issued April 27, 2011, is affirmed.
INDUSTRIAL CLAIM APPEALS PANEL
______________________________ Brandee DeFalco-Galvin
______________________________ Kris Sanko BARBARA LEMAY, 2534 CACTUS DRIVE, COLORADO SPRINGS, CO, (Claimant).
COLORADO SPRINGS SCHOOL DISTRICT #11, Attn: HANK HAHNE, COLORADO SPRINGS, CO, (Employer).
SCHIFF SCHIFF, P.C., Attn: SCOTT H. SCHIFF, ESQ., PUEBLO, CO, (For Claimant).
CLIFTON, MUELLER BOVARNICK, P.C., Attn: RICHARD A. BOVARNICK, ESQ., DENVER, CO, (For Respondents).