Prior posts have stated that a workers’ comp claimant has the burden of showing four things in order to obtain an award of compensation: (a) employment; (b) injury; (c) the injury arises out of employment; (d) the injury occurred in the course of employment.  These last two elements are considered the “core” of workers’ compensation law in all states.  Again, this is a system that doesn’t (usually) ask who is to blame for an injured body part—this is a “no fault” system of compensation for injury, if the injury is sufficiently connected with work.  The idea behind this law, which was pioneered by Otto von Bismarck in Germany in the 1880s, prior to being adopted by all of the American states in the early 1900s, is that the human cost of producing what we consume, should be put into the products produced.  That way, the consumers of goods and other products indirectly pay the human cost suffered in producing what consumers demanded.  But for that to be a meaningful reflection of the cost of production, the injuries must be connected with the work.

But how to articulate in words the connection necessary?  It seemed most logical that compensation should cover injury that happens at work.  Therefore, all states have a way to compensate injury that “occurs in the course of employment.”

But, should anything that happens to you when you are “on the clock” get compensated?  Even if you have a heart attack at work because you are a smoker?  That seemed over-broad to legislators drafting the law 100 years ago.  Therefore, they added one more concept—that the injury should also “arise out of” the employment.  Thus, all state WC laws contain these two requirements that almost always overlap, yet are distinct.  These two key elements are discussed below.

“Arising out of Employment” Part I

The classic injury that occurs in the course of employment and yet does not qualify for compensation as a work-related injury, is the heart attack.  Heart attacks occurring during a person’s work hours, are often claimed not to “arise out of” the employment.  That element of a workers’ compensation case is meant to capture the concept that there must be some connection between the physical demands of your job, and the nature of the injury your body suffered, for the injury to be compensated.

And there are cases where compensation is denied because the Iowa agency finds that an injury did not arise out of employment, even if it happened at work.

But the key to understanding this element is that those cases really are the rare exception.  Agency and case law in Iowa have narrowed those cases to an extreme rarity such that any injury occurring at work is very likely to be awarded compensation despite the “arising out of” requirement.  Here are the most notable of the few cases denying compensation as not arising out of employment.

In Karkosh v. Fisher Controls, file 1029281 (11/29/94), the Commissioner ruled that a worker injured upon tripping over his own feet at work had suffered an injury that did not arise out of employment and would get no compensation.  There are other agency cases that deny compensation for falling down at work with no explanation (known as an idiopathic fall).

One of the more notable zero compensation cases on this point of law was Miedema v. Dial Corp., 551 N.W.2d 309 (Iowa 1996).  In Miedema, the Iowa Supreme Court ruled that a worker claiming work injury during his work hours nonetheless should not get compensation for his low back injury (herniated disc), because it did not arise out of the employment.  The worker’s painful onset had occurred when he was in the act of standing up from using the restroom toilet and turning to flush.  That act had no connection with employment, and he did not receive compensation.

Again, these zero compensation cases for failure to arise out of employment are vanishingly rare.  Part II demonstrates the ease of fulfilling this element in the worker’s burden of proof.

Arising out of Employment” Part II 

Part I described this element of the worker’s burden of proof—to show that the injury “arose out of” the employment, and noted some cases where the worker failed to make the showing.  But there are many more cases that demonstrate the ease of making this showing.  For example, while some cases deny compensation for idiopathic fall at work, there are many more others like Kohler v. Wills, 608 N.W.1 (Iowa 2000), where the worker suffered an unexplained fall at work, but was several steps up on a ladder at the time of the fall.  He argued that the effect of the fall was made worse by work—his work had, after all, put him up on the ladder (a “positional risk”).  While the fall itself may have not been an incident that arose out of employment, the worsened impact due to his work-related height, did arise out of employment.  He was awarded compensation.  This means that even if you faint at work for personal health reasons, or trip over your own feet—if some piece of machinery with sharp edges that is close by is what you land on, and that causes your injury, then your injury arises out of employment.  Certainly, any fall caused by slipping on water or grease on the floor (a “hazard” in the workplace) arises out of employment. 

Another notable case showing the propensity of Iowa’s workers’ compensation court to be forgiving regarding the “arising out of” element of the case concerned a worker who asserted that he sat on a hardwood chair for several hours in an airport terminal while traveling for work and had back pain upon getting up.  That worker, too, was held to have suffered an injury arising out of the employment.  (One element in that case of note was that the injured worker was himself a judge of the division of workers’ comp, whose case was being decided by a fellow judge). 

And finally, while the classic injury intended to be deemed non-compensable by the “arising out of” element is the simple heart attack, the agency and Iowa’s courts have built in many exceptions here too, most notably two cases from 1984.  In Briar Cliff College v. Campolo, 360 N.W.2d 91, the Court dealt with the case of a faculty member who unfortunately died from heart attack while engaging in a faculty-student basketball game.  His death was held to arise out of employment, because he was engaging in demanding exertion, out of character for his regular duties.  In Varied Enterprises v. Sumner, 353 N.W.2d 407, the worker (an OTR trucker) suffered a heart attack, but kept driving for several hours, because of certain time demands on his load.  When he got care hours later, the medical evidence showed that the effect of his heart attack was much worse due to the delay in seeking care.  Because a portion of his injury (that portion caused by the work-related delay) did arise out of the employment, the heart attack was compensated.  These two cases, among others, have largely led to heart attack at work being compensated, despite the requirement that a work injury arise out of employment. 

Ellis Law Offices can obtain compensation for your injury by demonstrating how it arises from your employment.  We have knowledge of this rule and its exceptions, and the skill to establish a new exception not yet conceived, due to the circumstances of your specific case.   


This information does not develop an attorney-client relationship and is not legal advice.  You should consult with an attorney for advice on any worker’s compensation matter. 

Author: Peter M. Sand

Ashley Allen