Rebutting the presumption - Walters v. State of Florida Division of Risk Management

CASE LAW UPDATE

This update is regarding a recent decision from the First District Court of Appeal that addresses the standard applicable to rebutting the presumption of Section 112.18, Florida Statutes, more commonly known as the Heart/Lung Bill.

The opinion is titled Walters v. State of Florida Division of Risk Management.  In Walters, the Claimant contracted cardiomyopathy as a result of a gastrointestinal virus.  It was undisputed that Claimant’s cardiomyopathy was heart disease and his stomach virus caused the heart disease.  It was also undisputed that the cause of the virus was unknown. The dispute regarding the compensability of Claimant’s heart disease came down to whether the Employer/Servicing Agent could rebut the presumption. 

At a final hearing, the E/SA argued that the presumption could be rebutted because the cause of the cardiomyopathy was Claimant’s stomach virus.  The E/SA further argued that there was no evidence indicating that Claimant contracted the stomach virus at work.  The Claimant, in contrast, argued that in order to rebut the presumption, the E/SA was required to prove that the cause of the virus was something other than Claimant’s employment.  Ultimately, the JCC determined that because the E/SA proved the cause of the cardiomyopathy was Claimant’s virus, and there was no evidence the virus was work-related, the presumption was rebutted.

On appeal, the First District Court of Appeals reversed the JCC.  In doing so, the Court indicated that the State had the burden to prove Claimant did not get the virus at work.  Because the cause of the virus was unknown, the Court held the State failed to carry its burden.  The Court further held that in shifting the burden to the Claimant to prove that the offending virus was work-related, the JCC failed to give proper effect to the section 112.18 presumption.
Based on the holding, an Employer/Servicing Agent will not be able to rebut the presumption applicable to viral heart disease (such a cardiomyopathy) unless they can point to the cause of the virus that caused the heart disease.  This decision does not mean, however, that every case involving viral heart disease will be compensable.  Unfortunately though, in cases involving viral heart disease the E/SA will not only have to prove the cause of the heart disease, but also the cause of the agent that caused the heart disease.  Thus, if an E/SA can show by medical testimony that a Claimant contracted the virus from his ill child, for example, and the JCC accepts that testimony as evidence of a non-work-related-cause for the virus, the E/SA will still be able to successfully rebut the presumption. 
In sum, the Walters decision provides another hurdle for the E/SA to rebut the presumption applicable to viral heart disease.  Even so, it will still be important to analyze such cases to determine whether the virus and a non-occupational cause for the virus can be identified.  As always, please contact our office if you would like to discuss this case or a specific factual scenario further.
Meredith Barrios