“Injury by Accident” versus “Specific Traumatic Incident”

Here in NC, if you are injured at work in a specific one-time incident, in order to be covered under workers’ comp it must be either an “injury by accident” or a “specific traumatic incident.”

An “injury by accident” is an injury caused by anything out of the ordinary that is interjected into your regular work routine. It can be a “slip, trip or fall” or it can be something much more subtle, like a new job task that you have not performed before. But, if you are doing your regular job in the regular way, and you get hurt, then you have not suffered an “injury by accident” and you may not be able to get that injury covered. An injury by accident (also known as “an interruption of the regular job routine”) is needed to get most injuries covered by comp. The only exceptions are back injuries, hernias and ruptures.

Back injuries, which include injuries to any part of your spine from the bottom of your spine all the way up to your skull, are covered even without an accident if you have a “specific traumatic incident of the work assigned” which we sometimes refer to as an “STI.” An STI is something that hurts you but it does not quite rise to the level of an “accident.” This means that if you hurt your back or neck when lifting something heavy, or pushing on a dolly, or picking up something off the floor, then your back or neck injury is covered in workers comp. You can look up and rupture a disk in your neck–a brick mason client of mine did that– and that can be covered. Another client of mine bent over to pick up a piece of paper from the floor one day and ruptured a disk in his lower back. We got that covered using the STI rule.

The same STI rule applies to hernias, but the hernia must be new and it must appear suddenly following either an accident or an STI. If it develops over time, it is not covered. If it is pre-existing, it is not covered.

That STI rule also applies to “ruptures” which one generally associates with a hernia, but I am looking forward to handling a case for someone who “ruptured” a biceps tendon while doing his or her regular job in the regular way. I have talked to several people who ruptured or tore their biceps tendon when engaged in heavy lifting or carrying, but that task was a normal part of the job, so they did not have an “injury by accident” and therefore were not covered for that industrial injury. Generally, arm and shoulder injuries require an “injury by accident” to be covered, but the “rupture” statute is written in such a way that a ruptured biceps tendon that did not occur “by accident” might be covered under the STI theory. I do not know whether anyone has successfully attempted that approach before now, but I am willing to pursue that in court for the right client.

We also have an “occupational disease” statute that allows medical conditions that develop over time due to hazards at work to be covered under workers’ compensation. This area includes chemical exposures, carpal tunnel, and many diseases such as anthrax and asbestosis. But “occupational disease” is a complicated discussion best left to another post.