Natural Physical Condition

If the natural physical condition of the employee is the sole cause of the injury, it is not compensable.

 

EXAMPLE: a person has a heart attack, falls and hits their head on the floor. The floor itself presented no particular hazard incidental to employment. Consequently, the claim would not be compensable.

 

However, if there is an intervening hazard of employment, a natural physical condition is compensable.

 

EXAMPLE: a person has a heart attack, falls and hits their head on a machine while falling to the floor. Since the person hit their head on the machine, the injury to the head would be compensable, and treatment for heart attack would be compensable for the immediate medical emergency treatment of the injury. The presence of that machine created a hazard greater than that incurred by the general public and thus made the injury sustained in the fall compensable.

 

Consider the following circumstances when determining if the injury is related to employment:

 

         If a physical injury is caused by stress it is not compensable unless the injury resulted from greater emotional strain or tension than that to which all workers are occasionally subjected. Refer to Case Notes on stress-related injuries underRC 4123.01.

 

         If the injury is because of horseplay,an investigation of the facts of the incident is required to determine compensability. It is important to determine whether both (all) parties were involved in the horseplay, or if only one person instigated the horseplay. Injuries to the instigator will not be compensable and injuries to an innocent victim of the horseplay will be compensable.

 

         Acts of God or Nature such as a tornado or lightning are not compensable. If the act of God occurred alone to cause the injury, it is not compensable. However, if the act of God activated a hazard of the employment and the hazard caused the injury, such injury will be compensable.

 

         If an injury is a result of a fight or altercation,it is necessary to investigate and determine the facts of the accident. The general rule is that if the altercation was personal in nature, the injury is not compensable. If the fight was over a work-related matter then the injury is compensable. Witnesses can often be very helpful in these cases. Refer to the Assault Injury Claims Guide in the Initial Investigation section.