City of Jacksonville v. Ratliff
| Decision Date | 13 April 2017 |
| Docket Number | CASE NO. 1D15–5844 |
| Citation | 217 So.3d 183 |
| Parties | CITY OF JACKSONVILLE/City of Jacksonville Risk Management, Appellants, v. Robert RATLIFF, Appellee. |
| Court | Florida District Court of Appeals |
Thomas G. Portuallo of Eraclides, Gelman, Hall, Indek, Goodman & Waters, Jacksonville, for Appellants.
John J. Schickel of Coker, Schickel, Sorenson, Posgay, Camerlengo & Iracki, Jacksonville, and Bryan S. Gowdy and Meredith A. Ross of Creed & Gowdy, P.A., Jacksonville, for Appellee.
In this workers' compensation appeal, the Employer/Carrier (E/C) challenges an order awarding the Claimant, a firefighter, entitlement to compensability of his heart condition and related medical treatment under the "heart-lung" statute, section 112.18, Florida Statutes (2014). The Claimant did not appeal the JCC's denial of compensability of an alleged hypertension
condition. We affirm in result because we find the E/C failed to sustain its burden of proof in one respect, but write to clarify application of section 112.18(1) regarding the shifting burdens of proof and required quantum of evidence. As the Claimant asserted a presumption-only claim, the E/C's burden on rebuttal is competent evidence. Major contributing cause (MCC) is not a component of the E/C's rebuttal threshold. However, under these facts, the E/C must also rebut, by competent evidence, the presumption of the "triggering event." We find the E/C failed to rebut this second aspect of the presumption.
The Claimant, a firefighter for twenty-six years, suffered an anterior wall myocardial infarction
while at work on November 17, 2014. On that day, he attended a meeting in which a disagreement arose as to building code requirements. The Claimant characterized the atmosphere as "back and forth" and extremely stressful, but noted he did not consider the discussion a heated argument. During the meeting, the Claimant began to experience discomfort and chest pain. After the meeting, he sought medical care and was admitted to the hospital. The Claimant was ultimately diagnosed with coronary artery disease (CAD) and acute anterior wall myocardial infarction. The E/C accepted compensability under the "120 day rule" and authorized continued medical care with Dr. Dietzius upon Claimant's release from the hospital. See § 440.20(4), Fla. Stat. However, the E/C later denied compensability of the "accident" and cardiac conditions.
The Claimant qualified for the "heart-lung" presumption under section 112.18(1), having no evidence of heart disease
on his pre-employment physical, among other prerequisites. The Claimant asserted compensability of the heart condition on a "presumption only" basis; or in other words, the Claimant had no medical evidence of occupational causation and relied solely on the presumption of the "heart-lung" statute.
The Claimant's IME cardiologist, Dr. Schimmel, and the E/C's expert cardiologist, Dr. Dietzius, both testified via deposition. The record supports that Drs. Dietzius and Schimmel noted the Claimant's pre-existing history of diabetes
, high cholesterol, prior history of smoking, and a family history of early onset CAD, among other pre-existing factors. Dr. Dietzius testified the Claimant suffered from multiple risk factors for development of CAD. In his opinion, these factors had risen, within a reasonable degree of medical certainty, to the level of causative factors for the Claimant's CAD and were not related to work.1 He testified, "... given his risk factors of hyperlipidemia and diabetes, which I do not believe are related to his work, I believe that his risk factors contribute to his coronary artery disease over his work."
Medical testimony established the Claimant suffered from blocked arteries
(CAD) caused by the build-up of plaque. The myocardial infarction resulted from the rupture of the plaque. Dr. Dietzius admitted there was no medical test to determine the "trigger" or cause of the plaque rupture. He identified possible "triggers" of the plaque rupture to be high blood pressure, stress, or non-work-related factors, among others.
Dr. Schimmel, the Claimant's IME expert, also testified the Claimant suffered from underlying blockage. He also recognized the list of multiple pre-existing risk factors. He opined that he could not identify, within any degree of medical certainty, which risk factors caused the CAD. Further, he advised that stress or increase in blood pressure from the business meeting could have "triggered" the plaque rupture on the day of this alleged "accident." However, he also agreed the cause or "trigger" of the rupture/thrombosis
is unknown.2
Section 112.18(1), also known as the "firefighter's presumption" or the "heart-lung" statute, creates a rebuttable presumption of occupational causation for disabling heart disease
suffered by firefighters, among other protected classes, who meet certain prerequisites. At the time of the enactment of the "heart-lung" bill in 1965, workers' compensation law provided for an occupational diseases cause of action pursuant to section 440.151, Florida Statutes. Under section 440.151, a claimant was under the obligation to produce medical testimony to support the ultimate conclusion that the disease was related to employment, and could not prevail on an argument based on facts or inference alone. The enactment of section 112.18 offered a claim option that allowed qualifying employees to bridge this causation gap.3
Prior to enactment of the "heart-lung" statute, an occupational disease claim under section 440.151 enjoyed no presumption in favor of the claimant, and the statute was silent with respect to an evidentiary burden of persuasion.4 However, in the late 1960s, Chapter 440, Florida Statutes, established a presumption in favor of a claimant in "any proceeding for the enforcement of a claim for compensation."5 See § 440.26, Fla. Stat. (1965) ; Deahl v. Uni–Pak Corp. , 550 So.2d 122 (Fla. 1st DCA 1989) ; Hacker v. St. Petersburg Kennel Club , 396 So.2d 161 (Fla. 1981). Section 440.26 provided that, in the "absence of substantial evidence to the contrary ," claims filed would be presumed to have occurred within the course and scope of employment. (Emphasis added.) Thus, section 440.26 provided an evidentiary standard equivalent to that of "clear and convincing evidence" to rebut its presumption.6 Of interest, section 440.151 specifically excluded the presumption of section 440.26 from application in occupational disease cases. The evidentiary standard set by the Legislature for the presumption of section 440.26 was likely influential in later assignment of the quantum of proof required under section 112.18.
In 1979, the Florida Supreme Court in Caldwell v. Division of Retirement, Florida Department of Administration , 372 So.2d 438 (Fla. 1979), addressed for the first time the presumption of sections 112.18 (firefighters) and 185.34 (police officers) and application of the presumptions in "disability in-line-of-duty benefit" claims. Two issues were addressed: 1) whether the State Retirement Commission erred in refusing to apply the "heart-lung presumption" of section 112.18(1) in evaluating firefighter Caldwell's claim for disability in-line-of-duty benefits; and 2) if the presumption of section 112.18(1) applied, whether the E/C met the burden of proof with respect to its rebuttal threshold. Caldwell , 372 So.2d at 439. The Florida Supreme Court interpreted the burdens of proof and quantum of evidence required of the section 112.18 presumption. Id. at 440–42.
Caldwell argued that the presumption of section 112.18 required a high rebuttal standard, typically required of social policy presumptions, to maintain the legislative intent of the statute. Id. at 439. Furthermore, he asserted that a high burden should be placed on those litigants who claim no work-relatedness when a prima facia case of causal relationship has been made. Id. Caldwell proclaimed that the "heart-lung" statute was one of critical social policy affecting the burden of proof or persuasion and was not a "vanishing presumption." Id. at 440–41. In accepting Caldwell's arguments, the court explained, "the [section 112.18 ] presumption would be meaningless if the only evidence necessary to overcome it is evidence that there has been no specific occupational-related event that caused the disease."7 Id. at 440.
The Florida Supreme Court further detailed how the presumption may be rebutted:
Id. at 440–41 (emphasis added).
Section 112.18 did not explicitly recognize that it was a public policy measure and did not articulate the burden of persuasion applied to all possible levels of rebuttal. Where the Legislature does not articulate the rebuttal thresholds within a presumption statute, the courts are tasked with analyzing the substantive law of the case to determine whether the presumption was one of burden of proof or a "vanishing" or "bursting bubble" presumption. Universal Ins. Co. of N.A. v. Warfel , 82 So.3d 47, 58 (Fla. 2012). After determination that section 112.18 embodied strong public policy, the court assigned to the E/C the higher burden of...
To continue reading
Request your trial
-
McDonald v. City of Jacksonville
...attack and, if so, whether that trigger was occupational or non-occupational; as authority, the JCC cited City of Jacksonville v. Ratliff , 217 So. 3d 183 (Fla. 1st DCA 2017). For the reasons explained below, the JCC erred by placing this trigger burden on Claimant.II. For proof of occupati......
-
City of Jacksonville v. O'Neal, No. 1D19-597
...essentially requires a demonstration that the accident arose from a non-work-related cause or causes. See City of Jacksonville v. Ratliff , 217 So. 3d 183, 190 (Fla. 1st DCA 2017). Here, we review whether the JCC properly applied the trigger theory in view of the evidence put forth by the E......