Ackley v. Labor Commission

2024 UT App 119

THE UTAH COURT OF APPEALS

LILLIAN ACKLEY,
Petitioner,
v.
LABOR COMMISSION AND LOWE’S,
Respondents.

Opinion
No. 20220966-CA
Filed August 22, 2024

Original Proceeding in this Court

Stony V. Olsen and Michael Gary Belnap,
Attorneys for Petitioner
Mark D. Dean and Kristy L. Bertelsen,
Attorneys for Respondent Lowe’s

JUDGE MICHELE M. CHRISTIANSEN FORSTER authored this Opinion,
in which JUDGES DAVID N. MORTENSEN and RYAN M. HARRIS
concurred.

CHRISTIANSEN FORSTER, Judge:

¶1 Lillian Ackley once again challenges the Utah Labor
Commission’s (the Commission) denial of her claim for workers’
compensation benefits and asserts that the Commission erred in
its application of the idiopathic fall doctrine to her workplace
accident. On remand from this court, the Commission determined
that the conditions of Ackley’s employment at Lowe’s did not
increase her risk of being injured in a fall. We clarify our holding
in our previous opinion and again set aside the Commission’s
decision with instructions for further proceedings.
Ackley v. Labor Commission

BACKGROUND

¶2 The facts supporting Ackley’s claim for benefits have
already been recounted in this court’s decision in Ackley’s first
petition for judicial review. See Ackley v. Labor Comm’n, 2021 UT
App 42, ¶¶ 2–6, 487 P.3d 882. We therefore repeat only those facts
most pertinent to the issues raised in this current case.

¶3 In December 2014, Ackley fell to a concrete floor while she
was working at Lowe’s. See id. ¶ 2. Ackley had been in the process
of labeling a hammer when it began to slip, and she “grasped it
more tightly” with her right hand. Id. The act of exerting greater
force on the hammer aggravated a ganglion cyst on Ackley’s third
finger of her right hand, causing it to burst. Id. The ruptured cyst
caused Ackley extreme pain and loss of consciousness, leading
Ackley to fall to the concrete floor. Id. Ackley suffered multiple
serious injuries as a result of her workplace accident, including “a
closed head injury, a torn rotator cuff in her right shoulder, a non-
healing scalp lesion, hearing loss, and left-shoulder pain.” Id.
“Ackley had surgery to repair her torn rotator cuff, and the injury
to her ear eventually prompted the need for a hearing aid. Doctors
who evaluated Ackley agreed that the fall led to the injuries
identified above.” Id.

¶4 To pay for her injuries, Ackley filed a claim for benefits
with the Commission, alleging that her work activities led to her
injuries. Lowe’s did not dispute that Ackley fell and was injured
while at work but argued that Ackley’s fall was caused by a
preexisting condition, which rendered her injuries
noncompensable. See id. ¶ 3.

¶5 Ackley’s claim proceeded to a hearing before an
administrative law judge (the ALJ). See id. ¶ 4. The ALJ “found
that Ackley was injured when she gripped the hammer and
experienced intense pain associated with irritation to the ganglion
cyst, causing her to black out and fall,” but determined that
“Ackley bore the burden of demonstrating that her workplace

20220966-CA 2 2024 UT App 119
Ackley v. Labor Commission

activities both medically and legally caused the injuries for which
she sought workers’ compensation benefits.” See id. “The ALJ
concluded that although Ackley had shown medical causation,
she failed to demonstrate legal causation because the exertion of
gripping a hammer is ‘both usual and ordinary’ and ‘comparable
to the exertion associated with typical nonemployment
activities’” and thus denied Ackley’s claim for benefits. Id.

¶6 Ackley appealed this denial to the Commission, where she
argued that “the ALJ erred in focusing only on the act of gripping
the hammer as the cause of her injuries rather than the entirety of
the accident,” such as the presence of a concrete floor. See id. ¶ 5.
“The Commission rejected Ackley’s arguments and affirmed the
ALJ’s decision, stating that ‘the absence of a legal causal
connection between [Ackley’s] employment and the intense right-
hand pain she cited as the reason for losing consciousness and
falling to the floor severs any causal connection between her work
activity of gripping the hammer and her subsequent injuries from
falling.’” Id. “The Commission also rejected the applicability of the
idiopathic[1] fall doctrine to Ackley’s claim, noting that the
doctrine requires a worker to fall ‘because of strictly idiopathic
factors rather than a pre-existing condition aggravated by a work
activity.’” Id. (quoting 1 Lex K. Larson, Larson’s Workers’
Compensation Law § 7.04[1][b] (2020) (explaining that an idiopathic
fall is one caused by an employee’s preexisting internal weakness
or disease)).

¶7 Then, Ackley filed a motion for reconsideration before the
Commission. Id. ¶ 6. Citing Tavey v. Industrial Commission, 150

1. This court recognized in our previous opinion that while the
Workers’ Compensation Act does not define “idiopathic,” the
dictionary defines it as “‘arising spontaneously or from an
obscure or unknown cause’ or as ‘peculiar to the individual.’”
Ackley v. Labor Comm’n, 2021 UT App 42, ¶ 5 n.4, 487 P.3d 882
(quoting Idiopathic, Webster’s Third Int’l Dictionary (2002)).

20220966-CA 3 2024 UT App 119
Ackley v. Labor Commission

P.2d 379 (1944), “the seminal Utah case for the idiopathic fall
doctrine,” Ackley “urged the Commission to reconsider its
decision ‘because Utah courts have stated that a fall, regardless of
the cause of the fall, is an accident by itself.’” Ackley, 2021 UT App
42, ¶ 6. The Commission agreed that Ackley’s fall was idiopathic
in nature but went on to analyze Ackley’s injury based on
“whether it was caused by work-related exertion.” Id.
“Ultimately, the Commission determined that any increased risk
of injury Ackley faced was because of her ganglion cyst and not
because of any workplace requirement,” and thus denied her
motion for reconsideration. Id.

¶8 Ackley then sought judicial review of her claim by this
court. This court determined that Ackley’s fall was idiopathic and
that the Commission incorrectly focused on the question of
whether gripping the hammer was an unusual or extraordinary
exertion. See id. ¶ 28. We recognized that the determination of
whether employment conditions increased or aggravated an
employee’s risk of injury from a fall to level ground is factual and
should be decided on a case-by-case basis. See id. We therefore set
aside the Commission’s denial of benefits and remanded the
matter for the Commission to determine whether the work
conditions at Lowe’s placed Ackley at an increased risk of
suffering injury from her fall. See id. ¶¶ 21, 25.

¶9 Following remand and further evidentiary hearing, the
Commission once again denied Ackley workers’ compensation
benefits based on the presumption that “[g]enerally, idiopathic
conditions . . . that manifest in the work setting are not
compensable.” Though it recognized that the inquiry before it was
“whether the conditions of the floor and [Ackley’s] surrounding
work area contributed to the hazard of her fall and increased her
risk of injury,” the Commission determined that “the evidence in
the record does not support the conclusion that [Ackley’s]
employment placed her in a position increasing the dangerous
effects of her idiopathic fall.” The Commission stated as follows:

20220966-CA 4 2024 UT App 119
Ackley v. Labor Commission

If the court [of appeals] believes a fall similar to the
one suffered by [Ackley] should be considered
compensable due to the hardness of the floor and what
the court perceives as similar effects between
striking one’s head against a concrete floor and
against a comparably hard object such as a metal cabinet
or shelf, it is the court’s prerogative and its place to
clearly implement such a standard. It is also possible
that the court—as suggested by [Ackley]—
determines that the mere presence of increased risk
is sufficient to causally connect her idiopathic fall to
her employment even if she does not come in
contact with the hazards that pose the increased
risk. The Commission does not read the court’s
order of remand as clearly implementing either one
of those scenarios, however.

(Emphasis added.)

ISSUE AND STANDARD OF REVIEW

¶10 Ackley seeks judicial review of the Commission’s latest
decision denying her claim for workers’ compensation benefits.
On review, we consider again whether the Commission erred
when it denied Ackley’s claim for benefits related to her injuries
resulting from an idiopathic fall at her workplace. In this context,
we review the legal determinations of the Commission under a
correction-of-error standard. “In the context of a legal-cause
analysis in fall cases, the legal effect of a given set of facts depends
on whether the injury was caused by an employee’s employment
and employs an objective legal standard that we are in a better
position to analyze than the Commission. Thus, our review is non-
deferential.” Ackley v. Labor Comm’n, 2021 UT App 42, ¶ 7, 487 P.3d
882 (quotation simplified).

20220966-CA 5 2024 UT App 119
Ackley v. Labor Commission

ANALYSIS

¶11 We take responsibility for previously returning this matter
to the Commission with less than clear instructions on how to
proceed. As discussed below, we now determine that
compensation can be awarded in idiopathic fall cases like
Ackley’s if an employee can demonstrate that the hardness of the
workplace floor increased the severity of the injuries caused by an
idiopathic fall.

¶12 Under the Utah Workers’ Compensation Act, “[a]n injured
employee is entitled to benefits if the employee is ‘injured . . . by
accident arising out of and in the course of the employee’s
employment.’” Ackley v. Labor Comm’n, 2021 UT App 42, ¶ 8, 487
P.3d 882 (quoting Utah Code § 34A-2-401(1)). To succeed on a
claim for benefits then, first “the employee bears the burden of
proving he or she was injured ‘by accident.’” Id. (quoting Utah
Code § 34A-2-401(1)). And second, the employee must prove that
the accident “aris[es] out of and in the course of the employee’s
employment.” Utah Code § 34A-2-401(1). That is, “the employee
[must] show a causal connection between the injury and the
employment.” Ackley, 2021 UT App 42, ¶ 8 (quotation simplified).

¶13 Utah’s appellate courts have long recognized the general
rule “that an employee cannot recover for a physiological
malfunction which is not job-induced and which could have
happened as easily away from work as at work.” Kennecott Corp.
v. Industrial Comm’n, 675 P.2d 1187, 1191 (Utah 1983); see also JBS
Carriers v. Utah Labor Comm’n, 2022 UT 31, ¶ 10, 513 P.3d 715
(explaining that in Allen v. Industrial Commission, 729 P.2d 15 (Utah
1986), the Utah Supreme Court adopted a test to distinguish
between injuries resulting from a pre-existing condition that only
coincidentally occur while an individual is working and injuries
that were precipitated by an employment activity that increased
the risk of injury normally faced by the worker in nonwork life).

20220966-CA 6 2024 UT App 119
Ackley v. Labor Commission

¶14 But as this court previously recognized, a different rule
applies when an idiopathic condition causes an employee to fall
at work and sustain injury from that fall.

A fall originating from an internal or personal
weakness or condition of the employee is deemed
“idiopathic,” and the compensability of injuries
resulting from such a fall depends on whether
employment conditions increased the dangerous
effects of the fall. If the employment does not
increase the severity of the injuries resulting from
the fall, then there is no causal link between
employment and the injury, and the injuries are not
compensable.

Ackley, 2021 UT App 42, ¶ 18 (citations omitted). In other words,
causation is not shown based on the mere fact that the accident or
fall happened while the employee was on the clock. Our workers’
compensation system implicitly acknowledges that employees
routinely bring with them to their jobs myriad idiosyncratic
physiological conditions and that these conditions pose risks that
could interact with employment conditions to prompt accidents
or injuries. But employers bear responsibility to pay benefits only
for industrial accidents and injuries. 2 Therefore, “the inquiry”
central to determining whether an injury resulting from an

2. While Utah’s workers’ compensation system provides benefits
to injured employees for losses resulting from workplace injuries
and accidents without regard to proof of fault, see JBS Carriers v.
Utah Labor Comm’n, 2022 UT 31, ¶ 35, 513 P.3d 715, an employer is
not a general insurer, see Allen v. Industrial Comm’n, 729 P.2d 15,
27 (Utah 1986); see also Utah Tax Comm’n v. Industrial Comm’n, 685
P.2d 1051, 1053 (Utah 1984) (“The purpose of the Workers’
Compensation Act is to protect employees who sustain injuries
arising out of [and in the course of] their employment by affording
financial security during the resulting period of disability.”).

20220966-CA 7 2024 UT App 119
Ackley v. Labor Commission

idiopathic fall is compensable is whether a workplace or
employment condition aggravates “the dangerous effects of [a]
fall,” which is just another way of referencing “the injuries
resulting from the fall.” Id. Because causation requires that the
injury have some connection to employment, an idiopathic
condition that causes a fall resulting in injury to an employee does
not arise out of employment unless the employment in some way
contributes to or aggravates the injury.

¶15 When it concluded that idiopathic falls to level ground are
generally not compensable in Utah and denied Ackley’s claim for
benefits, the Commission was making a good-faith effort to
interpret our previous opinion. We take responsibility for
returning this case to the Commission with instructions that were
perhaps not as clear as they could have been regarding
compensability of injuries sustained in an idiopathic fall to level
ground. In our previous opinion, we stated that compensability
for idiopathic workplace falls depends on “whether a condition of
employment increased the risk of injury.” Id. ¶ 22. We opined that
“the Commission should have examined whether the conditions
of the floor and [Ackley’s] surrounding work area contributed to
the hazard of her fall and increased her risk of injury.” Id. ¶ 29.
These potential workplace hazards included “shelving,” “a key-
making machine,” and a “merchandise display.” Id. ¶ 27. We thus
remanded the matter to the Commission to examine the
conditions of Ackley’s surrounding work area, including the
floor. Id. ¶ 29.

¶16 On remand however, the Commission aptly recognized
that most of the potential workplace hazards we had identified in
our first opinion did not contribute to Ackley’s injury because she
fell to level ground and did not hit anything on her way to the
floor. The Commission found that “even though the cabinet, post,
key-cutting machine, and counter all represented a potential for
increased risk and injury from [Ackley’s] workplace, that
potential was not actually realized” because—fortunately—she did

20220966-CA 8 2024 UT App 119
Ackley v. Labor Commission

not strike any of these items during her fall. (Emphasis added.)
And the Commission noted that while this court could possibly
“determine[] that the mere presence of increased risk is sufficient
to causally connect [Ackley’s] idiopathic fall to her employment
even if she does not come in contact with the hazards that pose
the increased risk,” the Commission declined to adopt a per se
rule to that effect. We agree with the Commission that a per se
rule that requires the payment of benefits based simply on the
possibility of an increased risk of injury from a fall to level ground
at a workplace does not accurately describe the law in Utah.
Instead, the potential workplace hazards must actually contribute
to the injuries sustained. Stated another way, increased risk alone
is not enough; the risk must actually result in increased or
aggravated injuries. Indeed, there is no hard-and-fast rule that
idiopathic falls onto level floors are never compensable. Nor does
our appellate precedent stand for the proposition that idiopathic
falls to hard floors are always compensable. Rather, as our
supreme court discussed forty years ago, an injured employee
may recover for injuries caused by a level-ground idiopathic fall
if the “employment places the employee in a position increasing
the dangerous effects of such a fall.” Kennecott Corp., 675 P.2d at
1191–92 (quotation simplified). We take this opportunity to clarify
that, by referencing “increased risk” in our previous opinion, we
did not intend to indicate that the mere presence of unactualized
risk means that all injuries from an idiopathic fall are
compensable.

¶17 But even though Ackley did not hit any of the surrounding
hazards on her way to the floor, she did strike her head on the
concrete floor of her work area, an event that caused Ackley to
suffer injuries. The Commission concluded, however, that those
injuries were not compensable because “the presence of a hard
flooring surface, by itself,” did not “contribut[e] to the hazard of
a fall” and was not “a condition of [Ackley’s] employment that
increased her risk of injury because such risk is ever-present in a
given day.” The Commission also stated that “[t]he danger of

20220966-CA 9 2024 UT App 119
Ackley v. Labor Commission

falling due to personal factors and striking one’s head on concrete
is not particular to a workplace, retail space, public setting, or
even one’s own private residence,” and concluded that Ackley’s
fall to the concrete floor was just “one of those accepted and
expected risks inherent to countless modes of modern life.” The
Commission also explicitly acknowledged that this court might
disagree with this sentiment and went so far as to put the onus on
us to implement a clear standard “[i]f the [appellate] court
believes [idiopathic falls] should be considered compensable due
to the hardness of the floor.”

¶18 Here, we clarify that, in appropriate cases, idiopathic falls
to level ground on a hard floor might be compensable, but only if
the employee can show, as a factual matter, that the hardness of
the floor made the resulting injuries worse. We noted in our
previous opinion that “a significant minority” of jurisdictions
allow “awards for idiopathic level-floor falls” in appropriate
cases. Ackley, 2021 UT App 42, ¶ 28 n.12 (quotation simplified). In
case it was not clear from our previous opinion, we join that
“significant minority” of jurisdictions. But we caution that in
order to recover, employees must satisfy the burden of
demonstrating that the environment in which they were required
to work—including, potentially, the hardness of the floor to which
they fell—made their injuries worse than if they had fallen in a
different work environment. The fact that hard surfaces are
relatively common should not be disqualifying when the question
to be answered is whether a concrete floor at a particular
workplace increased the effect of the employee’s injuries. To be
sure, Ackley was required by the terms of her employment to
work on this specific floor. Accordingly, whether the condition of
Lowe’s concrete floor aggravated the effects or severity of
Ackley’s injuries presents a factual question that has not yet been
answered by the Commission. We therefore remand the matter
for consideration of that question.

20220966-CA 10 2024 UT App 119
Ackley v. Labor Commission

CONCLUSION

¶19 We acknowledge that our first opinion in this matter was
less than clear, and on further review we determine that Ackley’s
injuries are not compensable merely because there existed
increased risk of harm. Instead, Ackley must demonstrate that the
injuries she sustained from her idiopathic fall while she was
working were actually made more severe by the environment in
which she was required to work. But we clarify that the hardness
of the floor to which she fell—which is part of her workplace
environment—can potentially qualify as an aggravating factor,
and to succeed on such a claim, Ackley will need to meet her
burden of demonstrating that the hardness of the floor actually
increased the severity of her injuries. Accordingly, we set aside
the Commission’s decision and remand the matter with
instructions for the Commission to reconsider Ackley’s claim in a
manner consistent with this opinion.

20220966-CA 11 2024 UT App 119