Adams v. Prestressed Systems Industries, 91-3830
| Decision Date | 12 October 1993 |
| Docket Number | No. 91-3830,91-3830 |
| Citation | 625 So.2d 895 |
| Parties | 18 Fla. L. Weekly D2226 William ADAMS, Appellant, v. PRESTRESSED SYSTEMS INDUSTRIES and Liberty Mutual Insurance Company, Appellees. |
| Court | Florida District Court of Appeals |
James D. DiLorenzo of Sims & DiLorenzo, Ocala, Joseph C. Segor, Miami, for appellant.
Mark A. Massey of Daniel L. Hightower, P.A., Ocala, for appellees.
Claimant, William Adams, appeals an order of the judge of compensation claims (JCC) denying his claim for workers' compensation benefits under the bar established in Martin Co. v. Carpenter, 132 So.2d 400 (Fla.1961). We reverse and remand for further proceedings.
In 1985, the 32-year-old claimant injured his lower back while working for a previous employer. He received workers' compensation benefits for two and one-half years, and then settled his claim for $19,500. He was hospitalized three different times for low back strain between January 26, 1987 and July 23, 1989.
On September 29, 1989, Adams applied for work as a carpenter with the employer, Prestressed Systems Industries (PSI), and was given an employment application. Because Adams could barely read or write, he was assisted by a PSI employee who read the questions to him and set down his answers. The pertinent questions, answered or unanswered by Adams, were as follows:
Have you ever injured or sprained your back? Yes No
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If yes, did it happen on the job? Yes No
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off the job? Yes No
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Did you receive treatment from a doctor? Yes No
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If yes, give the physician's name and address: ________________________________
_______________________________________________________________________________
Do you presently suffer from any aches or pains of the Yes No x
back
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Do you have any physical disabilities or handicaps? Yes No x
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Are you fully recovered from previous injuries or Yes No x
sickness you may have had
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Have you ever received any benefits or a disability Yes No
under the Workers' Compensation Act of Florida
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Any other state? Yes No
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Louise Jackson, an insurance clerk for PSI, testified that if an applicant indicates a prior injury on an application form, the company has a policy of inquiring further, particularly in the case of back injuries, because construction work requires a certain amount of heavy labor. Without inquiring about the omissions in the application, the foreman immediately put Adams to work as a carpenter. On October 2, 1989, while he was working on a ladder during a rainstorm, claimant fell, landing on the right side of his neck and head. He was treated first by Dr. R. Patrick Jacob, a neurosurgeon in Ocala, and then by Dr. E. Jacob, another neurologist, when Adams moved to Marianna.
In his final order, the JCC held that the claim was barred under Martin v. Carpenter, finding that Adams knowingly misrepresented his physical condition to the employer when he was hired; and that the employer detrimentally relied on the misrepresentation, based on Louise Jackson's testimony that the employer would have investigated further had claimant affirmatively answered the questions about back injuries in the application, and, upon ascertaining accurate information regarding claimant's condition, would not have hired him. The JCC further found that claimant's neck injury was causally related to the prior back injury, using the following reasoning: That Dr. E. Jacob, after diagnosing claimant as suffering from muscle-tension headaches with vascular features and anxiety state, assigned claimant a four percent permanent impairment (PI) rating as a result of his neck injury and related it to the October 2, 1989 accident. Because Adams sustained PIs to his neck and his lower back caused by the injuries in 1985 and 1989, respectively, claimant had a greater overall impairment and disability after the 1989 neck injury than he had suffered from the 1985 injury alone. The JCC reasoned that if the employer had known of the 1985 back injury, it could have applied to the Special Disability Trust Fund for reimbursement of excess benefits paid. Therefore, because the causal connection was established for Trust Fund purposes, a medical causal connection was also established under Martin v. Carpenter.
Although it is questionable whether appellant's failure to answer some of the inquiries on the application constituted affirmative misrepresentations, we do not decide that question because there clearly was no competent, substantial evidence (CSE) supporting the JCC's findings of employer reliance and medical causation.
Turning first to the reliance finding, it is axiomatic that the conclusion of a JCC will not be disturbed if the evidence it is based upon "is competent and substantial and comports with reason and logic." Crowell v. Messana Contractors, 180 So.2d 329 (Fla.1965). The JCC's finding of reliance based...
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