Arkansas Court Stresses Difference Between “Idiopathic” and “Unexplained”

An Arkansas appellate court affirmed the denial of workers’ compensation benefits to an employee who suffered mysterious GI bleeding while completing workers’ compensation claims forms at his employer’s facility, and then, when he went to a restroom on site, fainted, striking his knee and head on a bathroom fixture [Nolen v. Walmart Assocs., 2021 Ark. App. 68 (Feb. 10, 2021)]. Agreeing with the ALJ that the employee’s GI bleeding was idiopathic—not “unexplained”—the appellate court agreed that the employee had failed to tie his bleeding condition to any specific incident of his employment. Stressing that “idiopathic” and “unexplained” were not the same, the court found substantial evidence supported the ALJ’s denial of the claim.

Background

Nolen, employed as a night stocker at Walmart, experienced blood in his stool on June 16, 2018—while he was at home—after what he later testified was an “unusually heavy” workday stacking 50-to-55-pound bags of dog food. He was scheduled to work the night shift from June 16 to 17, but because he experienced the instances of blood in his stool, he went into work around 8:30 p.m. to complete paperwork alleging that the blood in his stools was the result of a work-related injury. While he was completing the workers’ compensation paperwork at Walmart, he felt the urge to use the restroom, so he did. While doing so, he passed more blood and fainted. He fell and hit his right leg above his kneecap and cut his head above his right eyebrow.

A co-employee transported Nolen to a hospital where he received stitches for his forehead cut and was admitted to the intensive care unit due to iron-deficient anemia related to his blood loss. The hospital released him on June 18, directing him to stay off work for two days. Upon his return to work, he was restricted to lifting no more than twenty-five pounds until he followed up with a gastroenterologist. When Nolen returned home, he experienced more blood in his stool. Physicians performed several tests upon Nolen, including a colonoscopy, but no specific findings ever revealed the cause and nature of his GI bleeding.

Workers’ Compensation Claim: ALJ Finds No Compensable Injury

Nolen sought workers’ compensation benefits, alleging that he sustained a compensable injury of an intestinal bleed that resulted in additional compensable injuries to his forehead and right knee. He sought TTD benefits from the date of the incident until he returned to work (June 22 to October 22, 2018) and additional medical care associated with his knee, with which he claimed to have continuing issues.

The ALJ denied Nolen’s claims determining that Nolen failed to meet his burden of proof that he sustained compensable injuries. The ALJ specifically found that the preponderance of the evidence revealed the claimant’s episodes of GI bleeding were idiopathic in nature. The ALJ indicated there was no medical or other credible evidence establishing the bleeding was in any way caused by or related to Nolen’s work duties at Walmart. Nor were the knee injury and eyebrow injuries compensable.

Appellate Court Affirms

The court acknowledged that Nolen claimed that his GI bleed and subsequent fall due to blood loss from the GI bleed were caused by the conditions of his employment—that being heavy lifting and twisting in a confined space. The court stressed, however, that a compensable injury was an accidental injury causing internal or physical harm to the body, arising out of and in the course of the employment that required medical services[Ark. Code Ann. § 11-9-102(4)(A)].

Idiopathic and “Unexplained” Are Not the Same

The court also stressed that “idiopathic” and “unexplained” were not the same. While it was true that when an employee suffered an unexplained injury at work, it was generally compensable. But an idiopathic injury was personal to the claimant; it was not related to the employment. Idiopathic injuries generally are not compensable in Arkansas.

No Specific Injury

The court pointed out that, unlike the situation in cases cited by Nolen in his appeal, his claim lacked evidence of a specific-incident injury. He could not point to one specific instance while working on his shift where he felt or experienced a physical manifestation of sustaining an injury while he was at work. His testimony generally attributed his injury due to lifting excessive weight over the two shifts on June 14 through June 16, but he first noted something was wrong and experienced the symptom of bleeding while at home. Moreover, as the ALJ noted, none of Nolen’s treating physicians related the GI bleed to his work duties.

Other Injuries in the Walmart Bathroom

As to Nolen’s injuries that resulted from passing out in the bathroom, the court indicated Nolen had incorrectly analyzed them as a separate injury from the GI bleed. But the ALJ found that Nolen fell due to syncope, which was caused by the GI bleed. These injuries occurred because of the noncompensable GI bleed, not as a result of the conditions of his employment. Consequently, for the same reasons the GI bleed was considered noncompensable, so were the injuries he sustained to his forehead and knee. The court concluded substantial evidence supported the Commission’s decision.