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Bluml v. Dee Jay's Inc.

Supreme Court of Iowa

November 16, 2018

JASON BLUML, Appellant,
v.
DEE JAY'S INC. d/b/a LONG JOHN SILVERS and COMMERCE & INDUSTRY INSURANCE COMPANY, Appellees.

          Appeal from the Iowa District Court for Pottawattamie County, Jeffrey L. Larson, Judge.

         A workers' compensation claimant appeals a district court ruling affirming the commissioner's denial of benefits. REVERSED AND REMANDED.

          Douglas R. Novotny of Novotny Law, LLC, Omaha, NE, for appellant.

          Jean Z. Dickson and Paul M. Powers of Betty, Neuman & McMahon, P.L.C., Davenport, for appellees.

          MANSFIELD, Justice.

         In this case, we return to the question of when an idiopathic workplace fall is compensable. We last addressed this issue nearly two decades ago.

         A fast-food employee who was handling a customer order had a seizure and fell backwards directly to a ceramic tile floor. He suffered serious head injuries. The workers' compensation commissioner declined to award benefits, reasoning that idiopathic falls from a standing or walking position to a level floor do not arise out of employment under our workers' compensation law. The employee petitioned for judicial review, and the district court affirmed the commissioner for the same reasons.

         On appeal, we reverse. We conclude there is no blanket rule rendering certain categories of workplace idiopathic falls noncompensable, so long as the employees proves that a "condition of his [or her] employment increased the risk of injury." Koehler Elec. v. Wills, 608 N.W.2d 1, 5 (Iowa 2000). Because the commissioner incorrectly treated a factual issue as a legal matter, we remand for further agency proceedings.

         I. Facts and Procedural History.

         Jason Bluml is a high school graduate who has worked a number of supervisor jobs in fast-food restaurants. In approximately 2007, Bluml began to have seizures. In one instance, Bluml experienced a seizure while driving, which resulted in a crash into a house. Bluml was prescribed antiseizure medicine. In the months leading up to February 2012, Bluml had not been taking his antiseizure medication regularly and also had some issues with alcohol abuse.

         On February 15, 2012, Bluml-then 38 years old-was working at a Long John Silver's in Council Bluffs as shift manager. Bluml had called in late for work that evening because he was not feeling well. About two hours into his shift, Bluml was working behind the customer counter. According to witnesses, Bluml experienced a full-body seizure. He fell straight backward onto the ceramic tile floor of the restaurant, striking the back of his head. Witnesses heard Bluml's head hit the tile floor. In addition to seeing blood on the floor, they saw nearby a paper bag containing a customer order that Bluml apparently had in his hand when he fell. Bluml was taken to the emergency room where he was found to have an acute subarachnoid hemorrhage and required intubation.

         Bluml was transferred to the University of Nebraska Medical Center for further care. On February 18, doctors performed a left decompressive craniectomy. On March 12, Bluml began a course of rehabilitation for his brain injuries. On June 6, he underwent a left-sided cranioplasty. Following his release, Bluml went to work in the fast-food business again, although he still has significant cognitive impairments, especially with reading, memory, and judgment. Bluml presently works as a cook rather than as a manager. He continues to suffer from seizures and to struggle with alcohol abuse.

         On February 7, 2014, Bluml filed a petition for arbitration before the Iowa Workers' Compensation Commission, seeking workers compensation benefits from Dee Jays Inc. d/b/a Long John Silvers, the employer, and Commerce & Industry Insurance Company, the carrier, relating to the February 15, 2012 incident. The case went to hearing, and on January 13, 2016, the deputy commissioner issued his arbitration decision.

         In that decision, the deputy ruled that Bluml had failed to carry his burden of proof that he had sustained an injury that arose out of and in the course of employment. The deputy noted that Bluml had suffered an idiopathic fall, i.e., a fall due to a personal condition, and concluded, "[T]he law appears clear that idiopathic falls to level surfaces are not compensable under Iowa law."

         Bluml appealed to the commissioner. On July 20, 2017, the commissioner affirmed the deputy. The commissioner observed, "There is no real dispute that the injuries sustained by claimant were rendered more serious because claimant's fall occurred on a ceramic tile floor inside defendant-employer's restaurant." He commented that a minority rule "hold[s] that idiopathic falls on a level floor are compensable when the hardness of the floor affects the severity of the injury," whereas a majority of jurisdictions

hold that idiopathic falls on a level floor are not compensable regardless of the hardness of the floor on the theory that a floor presents a risk or a hazard encountered everywhere and that such risks and hazards presented by a level floor are the same risks which confront all members of the public.

         The commissioner acknowledged that the issue appears to be one of "first impression" in Iowa. Ultimately, the commissioner found "the authority and the arguments presented by defendants in support of the majority rule on this issue are more persuasive."

         On August 16, Bluml petitioned for judicial review in the Iowa District Court for Pottawattamie County. On January 25, 2015, the district court affirmed the commissioner's decision, after discussing much of the same caselaw cited by the commissioner and agreeing with the commissioner's "interpretation of the applicable law." Bluml appealed, and we retained the appeal.

         II. Standard of Review.

         The question here is whether an idiopathic fall is compensable because it "aris[es] out of . . . employment." Iowa Code § 85.3(1) (2011). We will review the commissioner's legal interpretation of this section for errors at law. See Iowa Code § 17A.19(10)(c). "In recent years, we have repeatedly declined to give deference to the commissioner's interpretations of various provisions of chapter 85." Iowa Ins. Inst. v. Core Group of Iowa Ass'n for Justice, 867 N.W.2d 58, 65 (Iowa 2015). The language at issue is not technical or within the special expertise of the commissioner. See Renda v. Iowa Civil Rights Comm'n 784 N.W.2d 8, 13-14 (Iowa 2010). Indeed, we have previously held that this phrase should be interpreted de novo by our court on administrative review. Xenia Rural Water Dist. v. Vegors, 786 N.W.2d 250, 253 (Iowa 2010). However, we accept the commissioner's factual findings when supported by substantial evidence. See Iowa Code § 17A.19(10)(f).

         III. Analysis.

         It is not disputed that this case involves an idiopathic fall. Bluml fell on February 15, 2012, because he had a seizure. The seizure was unrelated to Bluml's work. In fact, Bluml had a history of seizures, and it was happenstance that this seizure occurred while Bluml was working.

         A. Idiopathic Falls and the Increased-Risk Standard.

         Although the parties and the commissioner devote considerable attention to nonprecedential, unpublished opinions of the court of appeals, we will focus on the published opinions. The only published precedent in Iowa on idiopathic falls is Koehler Electric, 608 N.W.2d 1. There the claimant fell from a ladder to a cement floor while wiring a customer's air conditioning unit. Id. at 2. The claimant sustained serious head and shoulder injuries. Id. Yet, the claimant appeared to be unconscious when he fell, and it was determined that the cause of the fall was alcohol withdrawal. Id. The commissioner nonetheless awarded workers' compensation benefits, reasoning that the claimant's "employment or working environment placed him in a position that increased the effects of his fall." Id. at 2-3.

         On appeal, we sustained the award. Id. at 5. First, we noted that we had not previously addressed the compensability of idiopathic falls. Id. at 4. We acknowledged that "[g]enerally injuries resulting from risks personal to the claimant are not compensable." Id. Yet we noted an exception to this rule, where "an employee . . . is placed in a position that aggravates the effects of an idiopathic fall, such as a height." Id.

         We then invoked what is known as the increased-risk rule. We held that to recover for an idiopathic fall, the claimant needed only prove "that a condition of his employment increased the risk of injury." Id. at 5. In other words, the claimant did not need to prove "the precise injuries that were caused by the workplace condition, such as the elevation from which the claimant fell." Id.

         Additionally, we found that no expert testimony was needed in the particular case "because the fact finder could conclude based on common experience that the risk of injury is greater when one falls from a height of four to five feet onto a concrete floor than when one falls on level ground." Id.

         The ultimate question, of course, is whether the claimant has suffered an injury "arising out of and in the course of the employment." Iowa Code § 85.3(1). The increased-risk test that we relied upon in Koehler Electric is an interpretation of that phrase. 1 Arthur Larson et al., Larson's Workers Compensation Law ยง 3.01, at 3-4 (2018) [hereafter ...


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