Matteini v. Birth-Related Neurological

• Decision Date: 08 December 2006
• Docket Number: No. 5D05-3704.,5D05-3704.
• Citation: 946 So.2d 1092
• Parties: Michelle MATTEINI and Russell Matteini, etc., Appellant, v. FLORIDA BIRTH-RELATED NEUROLOGICAL, etc., Appellee.
• Court: Florida District Court of Appeals

946 So.2d 1092

Michelle MATTEINI and Russell Matteini, etc., Appellant, v. FLORIDA BIRTH-RELATED NEUROLOGICAL, etc., Appellee.

No. 5D05-3704.

District Court of Appeal of Florida, Fifth District.

December 8, 2006.

Elihu H. Berman, Elihu H. Berman, P.A., Clearwater, for Appellant.

Wilbur E. Brewton and Kelly B. Plante, of Roetzel and Andress, L.P.A., Tallahassee, for Appellee.

ORFINGER, J.

Michelle and Russell Matteini, on behalf of and as parents and natural guardians of Sierra Matteini, a minor, appeal a final administrative order denying their petition for benefits under the Florida Birth-Related Neurological Injury Compensation Plan ("the Plan"), sections 766.301-.316, Florida Statutes (2005). In a final order, the administrative law judge ("ALJ") determined that Sierra had not suffered a "birth-related neurological injury," as the proof failed to "support the conclusion that, more likely than not, Sierra's neurological impairment was the result of a brain or spinal cord injury occurring in the course of labor, delivery or resuscitation in the immediate postdelivery period in the hospital, or that Sierra was permanently and substantially impaired." On appeal, the Matteinis dispute the ALJ's findings, contending that they are not supported by competent, substantial evidence. Having carefully reviewed the record, we affirm.

The physician providing obstetrical services at Sierra's birth was a "participating physician" in the Plan, as defined by section 776.302(7), Florida Statutes. Believing that Sierra had been injured during delivery, the Matteinis filed a petition with the Division of Administrative Hearings ("DOAH") for compensation under the Plan, alleging that Sierra had suffered brain damage as the result of a traumatic delivery. The Matteinis requested relief according to the provisions of the Plan as well as reasonable attorney's fees.

DOAH served Florida Birth-Related Neurological Injury Compensation Association ("NICA") with a copy of the petition. NICA responded, reporting that it had retained two medical experts to opine whether Sierra's claim was compensable under the Plan. Based on its experts' opinions, NICA "determined that the instant claim [was] not compensable as the injury [did] not meet the definition of a `birth-related neurological injury' as defined in Section 766.302(2), Florida Statutes, which specifically requires that the injury render `the infant permanently and substantially mentally and physically impaired.'" A hearing was then held to determine whether the Matteinis' claim was compensable. The question before the ALJ was whether it was a "birth-related neurological injury," as defined by the Plan.

The Plan was established by the Legislature to provide no-fault compensation for birth-related neurological injuries to infants. See §§ 766.301-.316, Fla. Stat. (2005); Fla. Birth-Related Neurological Injury Comp. Ass'n v. McKaughan, 668 So.2d 974, 978 (Fla.1996). Under the Plan, a "birth-related neurological injury" is an injury to the brain or spinal cord of an infant caused by oxygen deprivation or mechanical injury during labor or delivery, which renders the infant both "permanently and substantially mentally and physically impaired." § 766.302(2), Fla. Stat. (2005). If the infant's injury satisfies this statutory definition, then the infant qualifies for financial benefits. Id.; see §§ 766.309, 766.31, Fla. Stat. (2005).

As required by the statutory scheme, the ALJ was required to determine whether Sierra's brain injury was the likely cause of her current impairments and whether Sierra is substantially and permanently physically and mentally impaired. On this issue, NICA argued below and on appeal that Sierra's impairments were not based on the injury that she sustained at birth, and, regardless of the cause of her impairments, Sierra is not permanently and substantially mentally and physically impaired. The Matteinis take a contrary view, arguing that Sierra's brain injury caused her current impairments and renders her permanently and substantially mentally and physically impaired.

After the hearing, the ALJ issued a detailed final order, explaining his evaluation of the evidence and denying the Matteinis' claim for compensation under the Plan. The ALJ concluded that the Matteinis' claim was not compensable because Sierra had not suffered a "birth-related neurological injury." In rendering this finding, the ALJ resolved the conflicting evidence against the Matteinis.

This Court's review of the ALJ's final order is governed by section 120.68, Florida Statutes (2005). See Legal Envtl. Assistance Found., Inc. v. Clark, 668 So.2d 982, 986 (Fla.1996). "A determination of the administrative law judge as to the qualification of the claim for purposes of compensability under s. 766.309 ... shall be conclusive and binding as to all questions of fact." § 766.311(1), Fla. Stat. (2005). An ALJ's findings of fact are reversible on appeal when they are not supported by competent, substantial evidence in the record or where the agency's interpretation of the law is clearly erroneous. See § 120.68(7) & (10), Fla. Stat. (2005); Carreras v. Fla. Birth-Related Neurological Injury Comp. Ass'n, 665 So.2d 1082, 1084 (Fla. 3d DCA 1995). Conversely, an ALJ's interpretation of the law is reviewed de novo. See Schur v. Fla. Birth-Related Neurological, 832 So.2d 188, 191 (Fla. 1st DCA 2002); Nagy v. Fla. Birth-Related Neurological Injury Comp. Ass'n, 813 So.2d 155, 159 (Fla. 4th DCA 2002); Fluet v. Fla. Birth-Related Neurological Injury Comp. Ass'n, 788 So.2d 1010 (Fla. 2d DCA 2001).

To grant the Matteinis relief, we would be required to reweigh the evidence considered by the ALJ, who determined that Sierra did not suffer a "birth-related neurological injury." Although the Matteinis' expert, Dr. Trumble, testified that the contusion to Sierra's left temporal lobe of her brain was the cause of her speech delay, and that it was permanent, he was unable to opine whether this injury was "substantial," stating that "`substantial' gets into the subjective realm that I would defer to...