A woman whose hand cyst burst while tagging tools at work, causing her to fall and sustain injuries, has a second chance to show that her injuries are compensable, an appellate court held Thursday.

In Ackley v. Labor Commission, the Utah Court of Appeals ordered the Utah Labor Commission to consider the compensability of the retail worker’s injuries under the idiopathic fall doctrine.

Lillian Ackley worked in the paint department at a Lowe’s Home Improvement store. She suffered from a ganglion cyst on her right hand, a condition she was diagnosed with in 2010. In 2014, while placing stickers on hammers, she gripped the tool tightly in her right hand when it began to slip, which caused her cyst to burst and she lost consciousness. She hit her head and shoulders on the concrete floor in the fall and was diagnosed with a closed head injury, a torn rotator cuff, a scalp lesion and hearing loss.

In 2018, she filed a claim for workers compensation benefits, alleging that work activities contributed to her idiopathic fall, which is a fall caused by an unknown condition. Lowe’s argued that the fall was caused by her preexisting condition — the rupture of her ganglion cyst — and a medical consultant said that medications Ms. Ackley was on may have caused her dizziness.

An administrative law judge held that Ms. Ackley failed to show that the exertion required by her job led to her injuries, but rather held that her act of gripping the hammer was “both usual and ordinary” and denied her claim for benefits.

Ms. Ackley appealed to the Utah Labor Commission, which affirmed the ALJ’s decision. Ms. Ackley appealed again, and the appellate court reversed the commission’s decision.

The appellate court held that the commission erred in failing to consider whether her conditions of employment “increased the dangerous effects of the fall.”

Since Ms. Ackley’s fall was caused by gripping the hammer, which burst her cyst — the idiopathic condition — and created “immense” pain, the commission should have analyzed whether her injuries from the fall were compensable using the idiopathic fall doctrine, the court said.

As a result, the appellate court held that the question of whether Ms. Ackley’s employment conditions increased or aggravated her risk of injury from idiopathic falls must be decided by the commission, and remanded the case for further consideration.