Younkman v. Waste Collection Services, 90-1411

• Decision Date: 11 March 1991
• Docket Number: No. 90-1411,90-1411
• Citation: 576 So.2d 801,16 Fla. L. Weekly 662
• Court: Florida District Court of Appeals
• Parties: 16 Fla. L. Weekly 662 Mary Ruth YOUNKMAN, Appellant, v. WASTE COLLECTION SERVICES and The Claims Center, Appellees.

Page 801

576 So.2d 801

16 Fla. L. Weekly 662

Mary Ruth YOUNKMAN, Appellant, v. WASTE COLLECTION SERVICES and The Claims Center, Appellees.

No. 90-1411.

District Court of Appeal of Florida,

First District.

March 11, 1991.

Rehearing Denied April 22, 1991.

Capp P. Taylor, St. Petersburg, for appellant.

Kathleen R. Hudson, St. Petersburg, for appellees.

ALLEN, Judge.

The appellant/claimant in this workers' compensation appeal alleges several points of error in the judge of compensation claims' order denying benefits based upon findings that the appellant's lost wages and psychiatric care expenses were not the result of an injury arising out of and in the course of her employment. We determine that competent substantial evidence supports the conclusion reached by the judge of compensation claims, and we affirm the order under review.

On July 31, 1988, while working for appellee, Waste Collection Services, the appellant was pulled into a bathroom by one of her employer's male customers. He told her that he was going to have sexual relations with her and attempted to pull up her skirt. The appellant was able to push the man away from her, and the incident then ended. She quit her job a few days later. Several months thereafter, the claimant sought temporary total, temporary partial, and wage loss benefits, as well as payment of various bills for psychological and psychiatric care. She claimed that the benefits were due because she had suffered a psychiatric disability as a result of the incident at work. One of the defenses raised by the appellees was that her disability was due to a preexisting psychiatric condition.

Testimony and medical records presented at the hearing indicated that the appellant was hospitalized with psychiatric problems on three occasions during the months following the incident at work. Record evidence also indicated that the appellant's post-incident hospitalizations were only the latest in a series of psychiatric hospitalizations over a period of several years. The only medical testimony relating to whether the appellant's psychiatric condition after July 31, 1988, was caused by the incident at work was given by Dr. Cohen. Dr. Cohen did not begin to treat the appellant until June of 1989, several months after the appellant made claims for workers' compensation benefits. Other medical evidence consisted of the medical records and correspondence of Dr. Schwab, who treated the appellant from August of 1988 until his death in June of 1989.

The history that Dr. Schwab took from the appellant included information as to a long-standing psychiatric condition, which had involved several hospitalizations. Dr. Schwab, characterized by Dr. Cohen as a "quite complete" record-keeper, made notes from his early visits with the appellant about various "stressors" which she reported to him. These included a recent job change, a recent move, the recent loss of a friend due to suicide, persistent low back pain, jaw pain due to TMJ, and having been the victim of a rape in May of 1988 and the victim of sexual abuse in earlier years. Although Dr. Schwab attended the appellant through several office visits and three hospitalizations during the six months following the date of the incident at work, his notes for that period contain no indication that the appellant ever mentioned the incident. The first mention of the incident appears in Dr. Schwab's office notes of February 24, 1989, in conjunction with the doctor's indication that the appellant was considering filing for workers' compensation benefits. Then, on March 23, 1989, Dr. Schwab sent a report to the appellant's attorney, in which he described his understanding of the incident, and discussed the appellant's psychiatric condition and her prognosis for recovery.

From Dr. Cohen's testimony, it appeared that the appellant's reports to him regarding the source of her depression had been limited to telling him about the incident at work. Dr. Cohen's testimony upon direct examination came close to indicating that the appellant's psychiatric problems were caused by the work incident. He testified as follows:

Obviously, apparently, according to her, the precipitant factor was this sexual attack that she had had, I think, in '88. She had just been unable to function at all, it seems, with any consistency after that episode.

(Emphasis supplied). However, after he learned, during cross-examination, of the stressors previously revealed to Dr. Schwab, Dr. Cohen testified that a rape would be a stressor of 10, whereas an incident like the incident which occurred on July 31, 1988, would be a 7 or 8 on a scale of 10. After learning of the additional stressors, Dr. Cohen offered the opinion that the appellant's experience at work was merely "a factor in her very depressed state." The testimony upon redirect examination was as follows:

Q. Do you feel that this major depression is linked to this sexual attack of July or August of '88 we have talked about?

. . . . .

A. Well, I surely feel it was a factor.

Q. Nobody's asking you whether it was the cause?

A. Definitely a factor. I don't think we can minimize that one. It's a factor in her very severe depressed state.

Q. Even assuming her friend committed suicide and assuming she was raped by a stranger, assuming she was abused as a child, whatever, had a bad marriage, is it still a factor?

A. I definitely think so (Emphasis supplied). In his testimony, Dr. Cohen repeatedly indicated that he could offer no explanation for why Dr. Schwab would not have mentioned the July 31, 1988 incident in his notes prior to February of 1989, unless the claimant, who he described as being "pretty verbal," had simply not told Dr. Schwab about the incident until February of 1989.

The judge of compensation claims found that the claimant's psychiatric condition after July 31, 1988, was a continuation of her preexisting psychiatric condition. He further found that the appellant's testimony as to the source of her depression after July 31, 1988, was not credible, and that Dr. Cohen's testimony indicated that the work incident was merely one of many stress factors contributing to the claimant's psychiatric condition after that date. Accordingly, the judge concluded that the appellant's condition was not the direct and proximate result of an injury arising out of and in the course of her employment, and was therefore not covered by the workers' compensation law. See Section 440.09, Florida Statutes.

Even where a claimant has suffered a history of psychiatric problems, an aggravation of a psychiatric condition may be compensable if it is the direct and proximate result of an industrial accident. Deneault v. Alachua County School Bd., 555 So.2d 909, 914 (Fla. 1st DCA 1990); Franklin Manor Apartments v. Jordan, 417 So.2d 1159 (Fla. 1st DCA 1982), review denied, 426 So.2d 26 (Fla.1983). We have held that the question of causation of medical problems is peculiarly within the knowledge of medical experts and, accordingly, where the only medical testimony presented indicates that the industrial accident is the cause of the medical problem, it should be accepted unless the judge of compensation claims can offer a "sufficient reason" for rejecting it. Calleyro v. Mt. Sinai Hosp., 504 So.2d 1336 (Fla. 1st DCA 1987), review denied, 513 So.2d 1062 (Fla.1987); Jackson v. Dade County School Bd., 454 So.2d 765 (Fla. 1st DCA 1984); Allman v. Meredith Corp., 451 So.2d 957 (Fla. 1st DCA 1984). Therefore, if the unrefuted medical testimony presented in the present case indicated that the appellant's psychiatric condition after July 31, 1988, was caused by the incident which occurred on that date, the judge was required to either accept the testimony or offer a sufficient reason for rejecting it.

From our review of the record, we are satisfied that the medical testimony did not clearly indicate that the appellant's psychiatric condition was caused by the work incident. The only medical testimony offered on the question of causation was the testimony of Dr. Cohen. After he learned of the numerous stressors affecting the appellant in mid-1988, he testified that the work incident was just "a factor in her very depressed state." We believe it significant that the appellant's counsel was very careful when questioning Dr. Cohen, to let him know that he was not being asked to give an opinion as to "the cause" of the appellant's condition. This situation is very different from that which exists where the unrefuted medical testimony is that the industrial accident has caused the ensuing medical condition. Calleyro, Jackson, and Allman each involved testimony which indicated that an industrial accident had caused a medical condition. The medical testimony presented here was competent evidence going to the issue of causation, but it was not sufficiently definitive to require the judge, absent articulated "sufficient reason" for rejection, to find that the appellant's condition was the direct and proximate result of the work incident.

The evidence presented in this case was adequate for the judge to have decided the causation question in favor of the appellant. It appeared from the evidence presented that the appellant's psychiatric condition probably worsened in the months following the work incident. This, together with the appellant's testimony as to causation and Dr. Cohen's expert testimony that the work incident was a factor in her condition, would have been competent substantial evidence to support a finding that the work incident was the proximate cause of the appellant's psychiatric condition thereafter. But, this was not the conclusion reached by the judge, and, as we have said many times, the issue is not whether there is competent...