Injuries that occur while performing work are eligible for workers’ compensation benefits, regardless of location. However, some injuries that occur at a work location are not automatically eligible for benefits. Among the ineligible injuries for workers’ compensation claims are idiopathic injuries, which, if you are not familiar with the term, are probably not what you might think they are. An idiopathic injury refers to any injury that occurs spontaneously and does not have an immediately known cause. In general, insurance companies may consider any injuries that are not caused by working or by the work environment to be idiopathic, even if the injury took place in a work environment.
Many conditions and diseases, whether previously diagnosed or not, could lead to an idiopathic injury denial of workers’ compensation benefits. Common types of injuries that could occur physically at work but not caused by working that may be considered idiopathic could include:
- Heart attack, stroke, or other cardiovascular event
- Fainting spell
- Diabetic event
- Bone fracture without trauma
Every workers’ compensation claim is unique, so it is difficult to know whether or not an insurance company will deny a claim using an idiopathic injury argument. And even if the idiopathic injury itself is not compensable, injuries that occurred because of the idiopathic injury may be. For example, if a worker experiences a seizure and hits his head on a desk, the seizure itself may not be eligible for benefits, but the head injury might be eligible.
Insurance companies will use any reason to deny a claim, including idiopathic injuries. The Law Offices of Scott Warmuth fights to ensure our clients receive all of the benefits they are entitled to. Our dedicated workers’ compensation attorneys examine every case in detail to prove that your work injury receives medical treatment and disability benefits. For a free work injury consultation, call us today at 888-517-9888.