Florida Court Says Cardiac Presumption Favoring Corrections Officer Was Rebutted
In a case that provides guidance for employers and carriers who seek to rebut the special presumption of compensability provided to firefighters and certain other “covered officers” (including corrections officers) who contract tuberculosis, heart disease, or hypertension [see § 112.18(1)(a), Fla. Stat.], as well as to covered officers who desire to utilize it, a Florida appellate court held the JCC erred in failing to find that the E/C had rebutted the presumption [City of Jacksonville v. O’Neal, 2020 Fla. App. LEXIS 5471 (1st DCA, Apr. 23, 2020)] in a claim filed by a corrections officer for his atrial fibrillation condition. The Court said the undisputed evidence showed the officer’s cardiac condition was “triggered” by non-occupational exercise. An obvious question existed, therefore, as to whether the corrections officer would have prevailed in his claim without the aid of the presumption, and the case was remanded for further consideration consistent with the appellate court’s ruling.
Background
Claimant was a 29-year-old corrections office in 2002, when he experienced heart problems. At the time, claimant was training to compete in Olympic-type competitions in track and flag football. He noticed that when he exercised, his heart would flutter and cause lightheadedness. He was diagnosed with atrial tachycardia and atrial fibrillation. On June 26, 2002, Claimant underwent a cardiac catheterization. As part of this procedure, his doctor intentionally induced the troublesome arrhythmias. Based on these arrhythmias, Claimant filed a workers’ compensation claim, which specified June 26th as the date of accident.
First Round of Hearings and Appeal
After a hearing in 2016 (the appellate court opinion offers no explanation for the delay), the JCC determined the claim was compensable in view of the occupational causation presumption applicable to correctional officers in § 112.18(1)(a), Fla. Stat. Acknowledging that claimant’s atrial tachycardia was congenital, the JCC concluded that he had a compensable injury that could have been “triggered” by job — related stress. The E/C appealed, and the appellate court reversed and remanded for additional findings related to the JCC’s “trigger-theory-based” decision [see City of Jacksonville v. O’Neal (O’Neal I), 240 So. 3d 861 (Fla. 1st DCA 2018). On remand, the court asked the JCC to identify the underlying condition and resulting diagnosis so that it could evaluate the scope of the E/C’s potential liability on the 2002 claim.
Those findings were subsequently made. The JCC recognized the diagnosis as atrial tachycardia that degenerated into atrial fibrillation and concluded that it was compensable under the occupational presumption because job stress could have been a trigger. The E/C again appealed.
The Cardiac Presumption
In Florida, when a covered officer or firefighter passes a physical examination upon entering into service, and is later disabled or killed by tuberculosis, heart disease, or hypertension, § 112.18(1)(a) presumes that the condition was contracted accidentally and in the line of duty. The injury is compensable even if the claimant presents no evidence, other than the presumption, to support a work-related cause, so long as the E/C doesn’t rebut the presumption. An E/C’s case to overcome the presumption essentially requires a demonstration that the accident arose from a non-work-related cause or causes.
The “Trigger” Theory
The court observed that where, as here, a covered employee had a congenital heart problem, the underlying condition could still lead to a compensable injury if a work-related cause “triggered” the ultimate diagnosed injury, or if an unknown cause triggered the injury.
Citing O’Neal I, the court noted that the “trigger theory” of compensability required three things:
- An underlying condition,
- A so—called “trigger,” and
- Resulting heart disease.
Job Stress as a Trigger
At the remand hearing, the JCC looked to Dr. Mathias’s medical testimony in identifying job stress as an occupational trigger, noting that the doctor testified broadly that job stress could play a role in causing arrhythmias. The appellate court stressed, however, that the doctor dismissed this cause in claimant’s particular case. Dr. Mathias could not implicate job stress in the development of claimant’s atrial fibrillation, nor could the doctor isolate it as the cause of claimant’s condition. Instead, he understood Claimant’s arrhythmias to be triggered by exercise.
The Court concluded that the E/C had rebutted the presumption. It said the evidence consistently conflicted with the application of the statutory presumption in this case. That evidence showed that claimant’s peak exercise workouts in 2002 triggered the degeneration of his congenital heart condition into atrial fibrillation. The JCC did not evaluate the evidence as a non-occupational cause that would overcome the presumption found in § 112.18(1)(a), Fla. Stat. The JCC’s decision had to be reversed again and remanded for further consideration.