In North Carolina, it is well established that when an idiopathic condition is the sole cause of the injury, the injury does not arise out of the employment and is not compensable. An idiopathic condition is defined as “one arising spontaneously from the mental or physical condition of the particular employee.” Mills v. City of New Bern, 122 N.C. App. 283, 285, 468 S.E.2d 587, 589 (1996). Examples of idiopathic conditions include unknown physical infirmities (such as a leg “giving way”), as well as conditions including, but not limited to, epilepsy/seizures, heart disease/conditions, and diabetes. For more general guidance on analyzing idiopathic conditions, see this article.

However, if the idiopathic condition combines with the risks attributable to employment to cause the injury, these injuries are generally compensable. For example, if an employee blacks out while working near machinery and injures himself by falling onto machinery, this injury by accident would be compensable. 

What happens if an employee suffers an idiopathic condition while the employee is driving for work? Can these claims be defended by arguing the idiopathic condition and motor vehicle accident could have happened at any time while the employee was driving, either during the performance of work or on the employee’s personal time?  

When a job requires constant road travel, the hazards of the journey are risks of the employment. To illustrate, we look at two cases. 

In Chavis v. TLC Home Health Care, 172 N.C. App. 366, 616 S.E.2d 403 (2005), the North Carolina Court of Appeals found compensability when the plaintiff CNA blacked out while driving her car and crashed into the side of a church.  Plaintiff had driven to the homes of multiple patients during the day and was on her way to another patient when this accident occurred.  In addressing Defendants’ idiopathic condition defense, the Court noted that where a Plaintiff’s job requires him or her to travel from his or her place of work to various places in the community, the job exposes the plaintiff to the risk of travel inherent to the employment.  Chavis, 172 N.C. App at 372, 616 S.E. 2d at 409-410.    

Similarly, in Billings v. General Parts, Inc., 187 N.C. App. 580, 587, 654 S.E.2d 254, 259 (2007), the plaintiff suffered a “syncopal episode (i.e., blackout) while operating the defendant-employer’s truck, after which time the truck ran off the road, hit a light pole, and flipped over. The Billings Court found compensability, holding that when an employee’s duties require him to travel, the hazards of the journey are the risks of the employment.  Thus, Plaintiff’s idiopathic condition combined with the travel risks attributable to the employment make the claim compensable.   

It appears, therefore, an employee whose job requires regular and consistent travel is at a heightened risk of being in a motor vehicle accident and, when combined with an idiopathic condition, the injuries resulting from the motor vehicle accident are likely compensable.  Nonetheless, a claim’s compensability is based on the specific facts and must be analyzed on a case-by-case basis. If you have any questions, please do not hesitate to contact Nick Valaoras at or Jordan Bernstein at