Safety and OSHA News

Passed out, fell while smoking first e-cig and applies for workers’ comp

This employee was on a break and had just stepped out of his employer’s vehicle when he passed out and fell to the ground. Was this work-related and eligible for workers’ comp benefits? 

Larry Brooks worked for the City of Winston-Salem as a senior crew coordinator in the Utilities Department. He supervised a team of four employees who made water and sewer line repairs.

On Oct. 22, 2015, Brooks and his crew took their lunch break at a gas station near where they had been working. Brooks ate his lunch in the City’s truck and afterward, went into the gas station to purchase cigarettes.

Brooks bought an e-cigarette – something he’d never smoked before. He returned to the truck and began smoking the e-cigarette inside the vehicle and started to cough uncontrollably. To get some fresh air, he stepped out of the truck while continuing to cough. After he’d stepped out of the truck and while he was standing, still coughing uncontrollably, Brooks passed out and fell to the ground.

EMS was called to the scene. Brooks’ blood pressure was 194/120, and his blood sugar was 312 – both extremely high.

Brooks declined to go to the ER, but he did go to an urgent care center. There, his blood pressure was still 182/112.

Brooks told the doctor he’d been out of his diabetes medication for about six months.

An orthopedist diagnosed Brooks with L3 and L4 transverse process fractures and assigned him to light duty. This prohibited Brooks from returning to his previous position, so he was out of work.

Brooks filed a workers’ comp claim, and the City denied it. A deputy workers’ comp commissioner held a hearing and decided Brooks’ injuries weren’t the result of an injury arising out of and in the course of employment. On appeal, the North Carolina Workers’ Compensation Commission affirmed the deputy commissioner’s ruling.

The Commission noted:

  • Extremely elevated blood sugar levels and blood pressure, such as those Brooks had at the time of his injury, can cause someone to pass out, and
  • When someone coughs so much that they become light-headed, they can pass out.

Brooks’ fall was caused by idiopathic conditions (something that arises spontaneously from the physical condition of the employee), according to the Commission.

Brooks took his case to a state appeals court. He argued the Commission should have concluded that his fall arose out of his employment.

Why did Brooks think his injuries arose out of employment? Because previously, North Carolina courts had upheld workers’ comp benefits for employees who suffered injuries from an idiopathic condition while operating a vehicle for work purposes.

However, the appeals court said Brooks’ case was different. He was on his lunch break and had stepped out of his truck when he fell. While Brooks wouldn’t have been at the gas station but for his job, “his fall wasn’t traceable to the conditions of his employment.”

Brooks also argued the Commission should have applied the “unexplained fall” doctrine to his case. Brooks said it was unknown whether his injury was actually caused by his idiopathic condition or whether it was attributable to his employment.

But the appeals court said the Commission did expressly find that Brooks’ idiopathic conditions was the only cause of his fall, therefore the unexplained fall doctrine couldn’t apply.

The appeals court agreed with the previous rulings: Brooks shouldn’t get workers’ comp benefits for the injuries that resulted from his fall.

(Larry Brooks v. City of Winston-Salem, Court of Appeals of North Carolina, No. COA17-1208, 5/15/18)

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