Utah Rule Heightened Standard Regarding Preexisting Conditions Dooms Claim
Under Utah’s Allen standard, where the claimant suffers from a preexisting condition that contributes to the injury, the claimant is required to show an unusual or extraordinary exertion in order to prove legal causation. A state appellate court recently affirmed the denial of a claim for a worker who had a preexisting knee condition and who sustained a meniscus tear while walking backward as he inspected a steel beam for his employer [White v. Labor Comm’n, 2020 UT App 128, 2020 Utah App. LEXIS 130 (Sept. 11, 2020). The appellate court held that the activity was similar to that sort of action performed in ordinary life; it entailed nothing unusual or extraordinary that could be presumed to have contributed something substantial to increase the risk of injury.
Background
White contended that he injured his knee while working for the employer when, while walking backwards during the inspection of a steel beam, his foot hit a block of wood, causing his foot and knee to twist, resulting in multiple tears in the meniscus in his left knee. As part of discovery, the employer scheduled a medical evaluation (ME) of White. Following an evidentiary hearing on his claim, the ALJ referred the case to a medical panel. Noting that there was a medical dispute about whether White had a preexisting disease in his left knee that contributed to his left knee injury, the ALJ instructed the medical panel to answer whether the work accident aggravated or contributed to any preexisting condition. The medical panel opined that before the accident, White had been suffering from “chronic degenerative joint disease of the left knee,” which had been “symptomatic prior to the work accident,” and that the accident “likely aggravated his chronic pre-existing left knee” condition.
The Allen Standard
On the issue of legal causation, the ALJ determined that a heightened standard applied under the ruling in Allen v. Industrial Comm’n, 729 P.2d 15 (Utah 1986), because White suffered from a preexisting knee condition that contributed to the injury. In essence, the Allen rule is that where the claimant suffers from a preexisting condition which contributes to the injury, an unusual or extraordinary exertion is required to prove legal causation [emphasis added]. The ALJ determined that White’s tripping and stumbling was not an unusual or extraordinary exertion above that encountered in everyday life. On that basis, the ALJ concluded that White had not satisfied the higher standard of legal causation under Allen and dismissed White’s application. The Board adopted and affirmed the ALJ’s findings.
Appellate Court Decision
Initially, the appellate court stressed that because the ultimate question was the legal effect of the facts with respect to whether the activity was objectively unusual or extraordinary, the court was in a better position to analyze the issue than the Board, and the court’s review was accordingly non-deferential. The court noted that when the employee did not have a preexisting condition that causally contributed to the workplace injury, the medical and legal causation requirements were one and the same. But when, as here, the employee had a contributing preexisting condition, the employee must satisfy a heightened legal causation standard.
Citing Murray v. Labor Comm’n, 2013 UT 38, 308 P.3d 462 (2013), the court said evaluating legal causation under this heightened standard was a two-step process:
- The court was required to characterize the employment-related activity that precipitated the employees’ injury, taking into account the totality of the circumstances; and
- The court must determine whether this activity was objectively unusual or extraordinary.
The court added that it was to undertake both steps mindful that the heightened standard was not meant to prevent workers with preexisting conditions from recovering benefits. The court concluded that White’s work activities at issue were typical nonemployment activities generally expected of people in today’s society. The court observed:
People in everyday life are generally expected to multitask while walking and to steady themselves when stumbling on something unexpected in their path. Indeed, it is not unusual for persons undertaking simple home improvement or gardening projects to encounter circumstances similar to those surrounding White’s injury—those involving measuring-like tasks, inadvertent stumbling on objects in the way, and a need to steady themselves before continuing on [Opinion p. 14-15].
In short, the court concluded that, given the totality of the circumstances present in this case, the whole of White’s accident entailed nothing unusual or extraordinary that could be presumed to have contributed something substantial to increase the risk of injury. Accordingly, the court declined to disturb the Board’s order affirming the ALJ’s decision and denying benefits.