Try Walking in Her Shoes

Can a nurse receive benefits for her walking too much? You be the judge.

A supervising nurse was attending to a patient who requested more medicine. The nurse moved quickly from the patient's room, turned the corner, stumbled, and turned her ankle and foot. She did not fall, but she regained her balance and continued to the medicine storage area. After the incident, her foot hurt and swelled, and she limped slightly. But she continued working.

After a few days, she consulted a doctor, who determined that she sustained a number of small fractures to her foot. She was diagnosed with chronic tendinitis, which was caused in part by calcifications in the tendons of her feet. A doctor determined that walking caused her tendinitis and that because the nurse had calcium on her tendon, walking could cause the bone to break. She underwent surgery.

The nurse testified that she was on her feet 80 percent of the time while working, and 50 percent of the time she spent outside of work. The nurse normally worked 12-hour shifts three or four times a week.

The Missouri Labor and Industrial Relations Commission denied compensation to the nurse.

Was the commission correct in denying benefits to the nurse?

A. Yes. The nurse did not show that her employment exposed her to a risk that she would otherwise not be exposed to in everyday life.

B. Yes. The nurse was merely walking when she was injured.

C. No. The injury arose out of and in the course of her employment. She faced an increased risk of injury at work given that she walked more at work than outside of work.

How the court ruled: C.

The court ruled that the nurse was entitled to benefits because her injury arose out of and in the course of her employment. Pile v. Lake Regional Health System, No. SD30153 (Mo. Ct. App. 09/01/10).

The court stated that there was a clear nexus between the risk of injury and her employment because the development of calcifications was due to tendinitis, which was caused by the prolonged walking required by her job. She was injured while dispensing medication to a patient. The court explained that the commission should have ended its analysis at that point and it was not necessary to consider whether she would have been equally exposed to the risk in her normal nonemployment life.

A is incorrect. The court noted that the commission applied the incorrect standard in its analysis. The injury must not come from a hazard or risk that the claimant would have been "equally exposed" to in everyday life. Here, 80 percent exposure to the risk of injury at work is not equal to the 50 percent risk at home. The court noted that requiring a worker to show that her employment exposed her to a risk she was not exposed to in everyday life would eviscerate almost any workers' compensation claim. The court stated that the legislature could not have intended such a result.

B is incorrect. The court noted that the nurse's risk was not mere walking but the risk of tendinitis from prolonged walking. The more the nurse was on her feet, the more likely it was that she would get injured.

CHRISTINA DIFONTE is the legal editor of the WorkersComp Forum.

This feature is not intended as instructional material or to replace legal advice.

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