Virginia Court Clarifies “Sudden Mechanical or Structural Change” Requirement

A Virginia appellate court, affirming a decision by the state’s Workers’ Compensation Commission, held that a claimant need only prove her accident caused one “sudden mechanical or structural change” to her body to collect compensation for any injury caused by that accident; she need not demonstrate a sudden mechanical or structural change to each part of the body in which the claimant is experiencing pain for the injury to be compensable [Alexandria City Pub. Schs. v. Handel, 2019 Va. App. LEXIS 114 (May 14, 2019)]. Claimant had suffered a work-related fall and complained of ongoing pain in her shoulder. After imaging tests failed to show any abnormality in her shoulder, the employer contested that part of her claim.


Claimant slipped on a puddle of hand sanitizer on her classroom floor and fell on her right side. She was then taken by ambulance to a hospital for treatment of her injuries. In claimant’s notice of injury report, she indicated that she had injured her right ankle, knee, hip, shoulder, neck, and back in the fall. Although claimant complained of pain throughout her right side, including her shoulder area, imaging tests showed no abnormalities. One examining physician did conclude, however, that claimant suffered from a neurological condition in her shoulder and referred her to physical therapy.

At a hearing on the claim, the employer stipulated to a compensable injury by accident to the claimant’s right hip, neck, back, right ankle, and right knee but disputed claims for the right shoulder and a head injury. The deputy commissioner found that claimant had demonstrated the necessary causal nexus between the accident and her right shoulder complaints and that she had, therefore, sustained an injury by accident to both her shoulder and head. The Commission affirmed and the employer appealed.

Employer’s Primary Contention

As it had before the Commission, on appeal the employer argued claimant had failed to demonstrate a structural or mechanical change in the shoulder. The court, citing Hoffman v. Carter, 50 Va. App. 199, 212, 648 S.E.2d 318 (2007), stressed that in Virginia, the claimant must show that her injury was the result of an accident, which the claimant may establish by proving:

  1. An identifiable incident;
  2. That occurs at some reasonably definite time;
  3. An obvious sudden mechanical or structural change in the body; and
  4. A causal connection between the incident and bodily change.

The court noted that the employer only challenged the third prong, claiming that there was no structural or mechanical change to the claimant’s shoulder and that the shoulder pain she complains of was not caused by the structural or mechanical changes elsewhere in her body. The employer contended that this fact alone made claimant’s shoulder injury non-compensable under the Act.

Sudden Versus Gradual Change Over Time

The court observed that it had never directly addressed the issue before, but it did not find the employer’s argument persuasive. According to the court, the requirement that a claimant prove she suffered a “sudden mechanical or structural change” existed only to establish that the injury was accidental and not the result of a gradual change over time. The Court of Appeals and the Supreme Court of Virginia have applied the “sudden mechanical or structural change” requirement in three general circumstances:

  1. A claimant suffers an “injury by accident” when she suffers a “sudden mechanical or structural change” in the body, even if the claimant’s injury is caused by the usual exertions of her job—even when there is no “accident” within the ordinary sense of that word.
  2. A claimant has not suffered an “injury by accident” when the injury is gradually occurring. Suffering a “mechanical or structural change to the body” is insufficient. Rather it must be a “sudden mechanical or structural change.”
  3. A claimant may prove a purely psychological injury to be an “injury by accident” without proving she suffered a “sudden mechanical or structural change” to her body. Rather, she can prove she suffered an “injury by accident” by demonstrating an “obvious sudden shock or fright” caused her purely psychological injury, such as post-traumatic stress disorder.

The court stressed that in each circumstance, the two courts had ultimately used the requirement to establish that a claimant’s injuries were accidental. The requirement had not been used to establish that the injuries are “injuries” within the meaning of Workers’ Compensation statute.

Core of Test: Suddenness of Injury

The court stressed further that core of the test was the suddenness of the injury. Thus, when a claimant was involved in an obvious accident, a single “sudden mechanical or structural change” was sufficient to demonstrate she suffered an “injury by accident.” All injuries causally connected to the accident, even if not directly attributable to one particular “sudden mechanical or structural change,” were compensable.

The court concluded that here, by stipulating that several of claimant’s injuries, sustained in the slip and fall, were compensable, employer conceded claimant suffered at least one “sudden mechanical or structural change to her body.” That is all that is required. As long as her shoulder injury was causally connected to her fall, that injury was compensable.

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