Case Conclusion Date: 11.12.2008
Practice Area: Workers compensation
Outcome: Resolved By Agreement
Description: D.L. was on a break in the outside break area on her employer's premises. For unknown reasons, she fell and landed on the cement in the break area. An ambulance was called and she was taken to the Hospital where she was found to have sustained multiple injuries due to an episode of "syncope." The workers' compensation insurance carrier denied liability alleging that the injury was not sustained in the course and scope of employment. However, in Texas, injuries during breaks while on the employers premises are covered under workers compensation. Even if an employee falls for non work-related reasons (like fainting or passing out that is just random or due to other health issues), the fact that the employee is injured on the employer's premises and strikes the premises of the employer allows for a recovery. In this instance, a state-appointed designated doctor had determined that D.L. did in fact sustain injuries when she fell. The parties were able to reach an agreement to resolve this case. The agreement was that D.L. did injure her neck, shoulder, knees, elbow and wrist. The agreement also stated that D.L. did not injure her low or mid back, ankles, opposite elbow and shoulder, and that the carrier was not responsible for vertigo, syncope, and a cardiac dysrhythmia, none of which the claimant was alleging to be the result of her work injury. Additionally, the carrier agreed to pay temporary income benefits from June 5, 2008, through the date of the agreement. Those benefits will continue until the claimant no longer has disability or reaches maximum medical improvement.