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The idiopathic defense is not an easy one for employers to prevail on in New Jersey. The basic concept is that the injury is not a result of any particular work effort and could happen anywhere, such as walking along a work corridor and suddenly feeling pain in one’s knee without falling or tripping. But if work circumstances make the injury more likely, the defense is not available. That was the holding in Quiles v. County of Warren, A-3938-17T3 (App. Div. February 13, 2019).
Officer James Quiles worked as a corrections officer for the County of Warren. On March 14, 2014, he was climbing stairs at the County corrections facility to perform an inmate count when he felt a “pop and sharp pain” in his left knee. The County physician sent petitioner to an orthopedist following the incident, but the county denied the case. So petitioner made an appointment with his own personal physician, Dr. Frank Capecci, who examined petitioner’s knee in April 2014. Two days after seeing Dr. Capecci, petitioner went to the ER at Saint Clare’s Hospital with knee pain. There was an entry in the record to the effect that petitioner had been running approximately 100 yards a few days earlier and suffered knee pain.
Petitioner continued to work for months, but in the Fall of 2014, Dr. Capecci recommended arthroscopic surgery to repair a left knee meniscal tear. Three months later Dr. Capecci reconstructed petitioner’s ACL due to an incomplete ACL tear.
Petitioner filed a motion for medical and temporary disability benefits. A video was shown at trial exhibiting petitioner climbing metal stairs while wearing heavy equipment and combat boots. The equipment weighed about 25 pounds. Petitioner denied that he ever told the hospital that he had been running 100 yards. Dr. Capecci also testified at trial, stating that in his view it was the stair climbing that caused the knee pathology.
The County’s medical expert, Dr. Richard Rosa, testified that there was no clear link between a torn ACL and just walking up steps. There was some evidence that petitioner had complained of knee pain in 2008, but there was no evidence of any significant treatment.
The Judge of Compensation ruled in favor of petitioner on the ground that petitioner’s job required him to climb stairs while wearing 25 pounds of equipment. As such he was performing a task that was stressful to his knees. Further, the Judge did not credit the random entry in April 2014 to the effect that petitioner had been running 100 yards. The Judge awarded medical treatment and temporary disability benefits to petitioner. The County then appealed.
The Appellate Division noted that when an injury is due to a personal risk, such an injury is not compensable because there is no connection with employment. Rather, it is idiopathic and not related to work. The Court agreed with the Judge of Compensation that a key distinguishing feature in this case was that petitioner was wearing 25 pounds of equipment, making it harder to climb steps. The Court gave more weight to the opinion of the treating physician, Dr. Capecci, because he was more familiar with the case. The Court further discounted the one reference to running 100 yards, noting that petitioner exercised and participated in recreational activities until the March 14, 2014 stair climbing incident. Those facts indicated that petitioner did not have a pre-existing knee problem.
The case is interesting because it underscores what employers need to win idiopathic claims. In this case, the employer was at a huge disadvantage to begin with because petitioner was wearing 25 pounds while climbing stairs. This was not someone who was just walking up or down stairs in light clothing. The 25 pounds of weight removed the case from being an event that could have occurred anywhere. The County also could not produce solid evidence of preexisting disability in 2008.
John H. Geaney, Esq., is an Executive Committee Member and a Shareholder in Capehart Scatchard's Workers’ Compensation Group. Mr. Geaney concentrates his practice in the representation of employers, self-insured companies, third-party administrators, and insurance carriers in workers’ compensation, the Americans with Disabilities Act and Family and Medical Leave Act. Should you have any questions or would like more information, please contact Mr. Geaney at 856.914.2063 or by e‑mail at email@example.com.