Explaining the Unexplained Fall Doctrine

Generally, under the North Carolina Workers’ Compensation Act, an injury is compensable if the injured worker can show: (1) an injury by accident, (2) in the course of employment, and (3) the injury arose out of the employment.[1] Typically, the burden of showing these three elements falls on the plaintiff/employee. However, what happens if the cause of a fall is unknown and unexplained by any of the evidence? Enter the “unexplained fall doctrine.”

The unexplained fall doctrine says that “[w]hen a fall is unexplained, and the [Industrial] Commission has made no finding that any force or condition independent of the employment caused the fall, then an inference arises that the fall arose out of the employment.”[2] This means that if a reason for the fall cannot be shown, the plaintiff is entitled to a presumption that it is employment related, satisfying the third element above.

However, the unexplained fall doctrine is not applicable when the fall is attributable to some “mental or physical condition of the particular employee.”[2] North Carolina courts refer to this as an “idiopathic” condition. Essentially, when it is clear that a plaintiff’s mental or physical condition was the sole cause of the fall, it is no longer “unexplained.” For example, if an employee simply “blacked out” without explanation, the “blackout” is the explanation for the fall, thereby avoiding the unexplained fall doctrine (an explanation for the blackout is not needed).[3] [4]

However, even if employers can avoid the unexplained fall doctrine, they can still be liable if the “injury is associated with any risk attributable to the employment…even though the employee may have suffered from an idiopathic condition which precipitated or contributed to the injury.”[5] In other words, if the plaintiff suffers from some mental or physical condition that precipitated the fall, if the employment in any way exacerbated or triggered that condition, the injury still “arises out of the employment.” The specific facts of each case will be significant. For example, in an unexplained blackout case, it would help to show facts supporting the employer’s argument that the blackout was unrelated to the employment–evidence that the employee was on level ground, had adequate breaks, had access to food and water, and was in an air conditioned environment.[3]

While the unexplained fall doctrine entitles plaintiff to an inference that the injury arose out of employment, do not be too quick to admit compensability. Even though the blackout may be unexplained, the blackout suffices as an explanation for the fall, taking us out of the realm of the unexplained fall doctrine. The plaintiff will still need to show that the risk of blackout is in some way attributable to the employment. Facts and conditions of employment at the time of the accident will be important, so be sure to take note of the surrounding circumstances.

If you have any questions or concerns, please contact one of our employment attorneys:


[1] Hedges v. Wake Cty. Pub. Sch. Sys., 206 N.C. App. 732, 734, 699 S.E.2d 124, 126 (2010)
[2] Hodges v. Equity Grp., 164 N.C. App. 339, 343, 596 S.E.2d 31, 35 (2004)
[3] Crowder v. Baldor Electric, No. COA16-403 (N.C. App. 2016) (unpublished)
[4] Hollar v. Montclair Furniture Company, 48 N.C. App. 489, 269 S.E.2d 667 (1998)
[5] Philbeck, 235 N.C. App. 124, 128-29, 761 S.E.2d 668, 672 (2014)

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