Source: https://lawyertampa.wordpress.com/2008/11/27/understanding-florida-statute-11218-the-heartlung-bill/
Timestamp: 2019-04-22 18:03:22+00:00

Document:
Florida Statute 112.18, commonly referred to as the Heart/Lung Bill, is a public policy piece of legislation designed to offer added legal protection for police, fireman and correctional officers who suffer with heart disease, high blood pressure or tuberculosis. The heart/lung bill should not be confused with F.S. 112.181, which creates a separate presumption for the transmittal of communicable diseases.
(1) Any condition or impairment of health of any Florida state, municipal, county, port authority, special tax district, or fire control district firefighter or any law enforcement officer or correctional officer as defined in s. 943.10(1), (2), or (3) caused by tuberculosis, heart disease, or hypertension resulting in total or partial disability or death shall be presumed to have been accidental and to have been suffered in the line of duty unless the contrary be shown by competent evidence. However, any such firefighter or law enforcement officer shall have successfully passed a physical examination upon entering into any such service as a firefighter or law enforcement officer, which examination failed to reveal any evidence of any such condition. Such presumption shall not apply to benefits payable under or granted in a policy of life insurance or disability insurance, unless the insurer and insured have negotiated for such additional benefits to be included in the policy contract.
In short, the statute gives police, firefighters and corrections officers a rebuttable presumption that their heart, blood pressure or TB condition was caused by their employment. In a workers’ compensation setting, it eliminated the usual need for the employee to prove up the required elements found in Florida Statute 440.151 pertaining to “occupational diseases.” Once you gain the presumption, more often than not, your employer will have to cover your condition under workers’ compensation. This means the cost of your medical care may be covered by workers’ compensation and you will be eligible for impairment and lost wage benefits through workers’ compensation as well.
The presumption in favor of the employee may be overcome by evidence to the contrary. The standard of proof to rebut the presumption will generally be competent evidence, unless you offer proof of a work related cause for your hypertension or heart disease. If a work related cause is offered into evidence, the employer must rebut the presumption with clear and convincing evidence of a non-work related cause. An unknown cause doesn’t help the employer, they must offer a specific non-work related cause, typically obesity or smoking. The most important thing to understand initially are the elements necessary to make the claim in the first place.
4) You have to be disabled, totally or partially.
For claims filed after July 1, 2010 the statute was amended to state that the presumption is lost if the you departed in a material fashion from the prescribed course of treatment from your personal physician and as a result, there was a significant aggravation in your covered condition. You could also lose the presumption if you had previously filed and received benefits on a workers’ compensation claim for a covered condition and departed from the prescribed treatment of an authorized physician’s recommendations. It also limited the time for filing claims to 180 days after leaving employment.
This amendment does some unwelcome things from a litigant’s point of view. First, it opens up a can of worms in terms of your prior medical records. It is one thing to fail to take medicine your personal physician may have given you for high cholesterol and quite another to fail to follow the doctors’ advice to lose weight, or stop smoking. The failure to take medicine might be a valid defense, but you can bet your employer might also argue you failed to lose weight or to quit smoking when your doctor told you to. Beware of your prior medical records. They can create a problem for you by creating a defense to your claim.
First however, let’s discuss the 4 element’s necessary to make the claim, as this creates the bulk of the questions I receive. The first category, which conditions are covered, creates the most litigation and is developing almost on a case by case basis. The following cases create generalities and should not be used, in and of themselves, to decide whether to file a claim for compensation.
Viral gastroenteritis was determined to be the ultimate cause of the claimant’s heart diesease, which was a combination of myopericarditis and cardiomyopathy. Because the cardiologist testified gastroenteritis was the cause, and seemingly unrealted to the heart and lung system, the carrier appeared to have rebutted the presumption. On appeal,the 1st DCA awarded benefits to the claimant, finding the carrier had not established the viral gastroenteritis was not work related. So unless the cardiologist can state the heart disease was caused by a specific, non-work related condition, if the other 3 elements are met, the condition is compensable. Walters v. State, opinion dated 10/16/12 (Fla. 1st DCA 2012).
Peripheral vascular disease (PVD) is covered if it was caused by hypertension. Butler v. City of Jacksonville, 980 So.2d 1250 (Fla 1stDCA 2008).
Strokes may be covered if the are caused by heart disease or hypertension. Lucunar strokes are generally covered.
Likewise “essential hypertension” may be covered if the doctor specifically states the hypertension is arterial or cardiovascular. Bivins v. City of Lakeland, 993 So.2d 1100 (Fla. 1st DCA 2008).
Pulmonary hypertension is not covered as it is not heart disease or arterial hypertension. Bond v. City of Boca Raton, 992 So.2d 252 (Fla. 1st DCA 2008).
A renal condition was covered because it was caused by hypertension. O’Dwyer, Jr. v. City of Jacksonville Fire and Rescue, 41 So3d 897 (Fla. 1stDCA 2010).
Palpitations were not covered because they were not caused by heart disease. Shamp v. Flagler Beach Police Department, 48 So.3d 58 (Fla. 1stDCA 2010).
Thoracic aortic disease is a form of heart disease and covered by the presumption. City of Venice v. Michael Van Dyke, 46 So.3d 115 (Fla 1stDCA 2010).
The disability prong of the test means you must have work related restrictions which impacts your ability to perform your job. Just being diagnosed with a health condition alone doesn’t qualify you. The condition must disable you, either fully or partially, and result in a loss of earnings. Effective October 1, 2003, Section 440.02(13) defines disability as the incapacity because of injury to earn in the same or any other employment, the wages which the employee was earning at the time of the injury. Having a permanent injury, and therefore an impairment rating, does not satisfy the definition of disability. Nor does missing time from work for diagnostic tests. You must demonstrate the protected condition prevented performance of your job, even if just for a few hours.
Presumptive disability cases are considered “occupational disease” cases and therefore the procedural rules relating to occupational disease cases apply. One such rule is that the date of accident is the date of disability. So for instance, if a person has a heart attack on June 1st, but doesn’t start missing work until June 6th, the date of accident is June 6th, the date of disablement.
The section 112.18 presumption does not apply a paramedic, who was certified as a firefighter. Lansford v. Broward County Board of County Commissioners, 485 So.2d 845 (Fla 1st DCA 1986).
A retired fireman was not protected because he did not meet the definition contained in Section 112.191 which provides that a “fireman” meant a duly employed uniformed fireman employed by an employer. Smith v. City of Miami, 552 So.2d 245 (Fla 1st DCA 1989).
Invoking the presumption requires the protected employee to have passed a pre-employment physical. The physical must show no evidence of heart disease, high blood pressure or TB. If the employer did not offer a pre-employment physical, then the presumption can not be invoked. Likewise a Section 633 pre-certification physical, which is mandatory, is not the same thing as a pre-employment physical, which is optional for the employer. The results of one cannot be substituted for the other.
In addition, you must have passed a pre-employment examination with your current employer. Passing a pre-employment physical with a former employer will not allow the presumption to be invoked.
1) When does my claim start?
The 2 year statute of limitations for filing a formal claim for workers compensation begins to run beginning with the date of disability or death. Not the date of exposure, not the date of diagnosis, not the date you miss time from work to go to the doctor. The date of your “accident” in the case of a heart/lung claim, is the date you receive permanent work restrictions from a doctor that cause you to lose income. From that date, you have 90 days to report your claim to your supervisor, and if it is denied for any reason, you have 2 years from your accident date to file suit.
2) Does my condition have to start at work?
No. You must be an active employee, but a diagnosis is all that is required. If you suffer a heart attack while off duty, but it is because of heart disease, you are entitled to the presumption.
3) What is meant by a rebuttable presumption?
The presumption that your condition is work related can be “rebutted” or overcome, with competent medical evidence to the contrary. So even though you may have been diagnosed with heart disease or high blood pressure, if there is testimony from a physician that your condition has a specific, non-occupational cause, you may still lose your claim. For instance, in a recent court ruling, the court found a firefighter with “essential hypertension,”a term referring to high blood pressure with no specific cause, was not entitled to the presumption. In order for high blood pressure to be compensable under this statute, it must be caused by a problem in the cardiovascular system. The standards of proof necessary to rebut the presumption vary from competent to clear and convincing.
4) What can I do to protect myself?
Get regular check ups with a primary care physician and eliminate your risk factors. The most common defenses to a claim under the heart/lung bill are obesity, smoking, and high cholesterol. All three are preventable and can be eliminated by you as possible defenses to a claim. Speak with your primary care doctor about the broad term “heart disease” and whether you have any condition which could be construed as heart disease.
Follow any prescribed course of treatment suggested by your doctor. Remember, under the 2010 amendments to the statute, failing to follow a prescribed course of treatment can be a defense to a claim.
5) What will likely happen in the future?
As a matter of public policy it’s unlikely the Governor will gut the law in it’s entirety. But there will likely be limits placed on the extent of coverage. There may be age limits, or employment term limits, wellness programs put in place, or exemptions from coverage. The local municipalities just can’t afford to cover the costs of heart disease for all the retirees. It’s going to be a budget battle.
This entry was posted on November 27, 2008 at 1:56 am and is filed under Heart/Lung Bill.	You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
Thank you for this interesting article. One question I have is in regards to the rebuttable presumption section. What if the injury did in fact result from a job-related duty, however the employer vehemently denies such a possibility? Is this a common result for a worker looking to obtain compensation for a work-related injury. Also, what are the chances of that individual actually standing up and fighting back against a larger, more financially capable corporate entity? Thank you in advance and any information relating to my questions would be much, much appreciated. Keep the interesting material coming.
Actually the ability to respond is pretty even. This is because the court system only allows for each side to select one doctor to testify in a case. So it’s not a situation where money makes a big difference. Where it does create a problem is in the selection of an Independent medical evaluator. If you file a workers’ compensation claim and your employer immediately denies the claim then you must prove up your case through the use of an IME. These physicians cannot be treating physicians. They are doctors that see you once and render a legal opinion on causation. In a heart/lung case this means either a pulmonologist or cardiologist; and these exams can run $1,000 to $2,000 dollars, and the worker must pay for the evaluation. This is just cost preclusive for many workers, and can grind the case to a halt before it gets started.
I have been an active law enforcement officer for 27 years, I am enrolled in the State of Florida Investment plan and I have suffered from two heat attacks and would like information on how the heart bill will work in conjuction with my pension, any information will be helpful.
If you were receiving benefits through workers compensation for permanent, total disability, the sum of you workers compensation, social security disability and state disability (in line of duty) pension could not total more than 100% of your pre-injury wages. They offset so you don’t end up making more on disability than you were when you were working. But you have to be receiving the categories of benefits listed above.
If I am a firefighter and get the heart and lung bill awarded, am i still able to function in the same dept under a new role. S o I would be collecting the heart and lung bill per yr. and a new salary for new role in the dept?
That’s a difficult question. If you were awarded wc benefits for an injury under the heart/lung bill, once you reached maximum medical improvement your doctor would assign a numerical rating for the impairment, say 8%, and certain restrictions. Let’s say the restrcitions were no exposure to fumes, due to lung damage. Under wc these restrictions would not prevent you from working, so you would not be permanently and totally disabiled which would warrant continuing wc payments for lost wages. So you would get paid for the 8% rating (2 x 8 = 16 weeks of benefits) and your medical care would remain open. If your employer could accomodate your restrictions and provide you other work in the office, you could continue working. The problem with most of these cases are police and firefighters are often subject to termination for any condition which causes restrictions. Rarely does the employer accomodate restrictions, because what they have to do for one, they have to do for all.
Sorry for the delay in responding. There was no link telling me people were asking questions. Tell me what information you would like or call me at my office in Tampa, 813-229-2667. I will be happy to answer any questions. I also moderate the Florida Workers’ Compensation website at http://www.lawyers.com. So if you have questions you can post them there and get an instant reply.
I am a full time Battalion Chief for EMS for a Fire Service Company that does not require me to be a firefighter as an EMS employee. Because of our “seperate service” none of the EMS providers for my department are covered by the Heart/Lung bill in Virginia. My question for you is; is this the same for EMS providers in your state?
I have tried to find an answer for that question and cannot. The term firefighter is not defined by Florida Statutes. I tried looking for a case that might involve Firefighter/EMS workers, and there are about 12 cases in total in Florida that construe this statute and none of them involve firefighter paramedics. Obviously if paramedics are employed by the fire department I would argue they are covered, but maybe someone can chime in and let us know if EMS workers are also considered a separate service here in Florida.
I JUST RETIRED FROM EMS AFTER 29 YEARS. I WAS DIAGNOSED WITH HEART DISEASE IN APRIL OF 08 WHILE STILL EMPLOYED. I DIDN’T KNOW ABOUT THE HEART/LUNG BILL. I ALSO WAS DIAGNOSED WITH HYPERTENSION. MY EKG IS IRREGULAR WITH UNIFOCAL PVCS. WHAT CHANCES DO I HAVE IN FILING A CLAIM AND HOW DO I PROCEED.
The first issue is whether you have heart disease. Irregular heart beats are not considered heart disease, nor is hypertension necessarily. Ask you cardiologist is you have a condition which falls under the broad defenition of heart disease.
I have been retired since July 2010 un an in line of duty injury. It was back/shoulder related. I still have an open workers comp claim and I’m still being treated for these injurues. I’ve had high blood pressure for well over ten years and have been on meds for most of that time. When I retired under a medical retirement, I had no idea of this bill. Can I still file for any benefits or have I missed them due to not being informed of the bill? I’ve also been deemed disable by Social Security.
No, there is a 2 year statute of limitations. Just like the previous post, workers comp benefits and medical retirement are mutually excluside remedies. We have to compare benefit packages and see which puts you ahead.
I just recently retired under a medical. Have high blood pressure and high blood sugar. Had 23 years in with dept’. Still have open w/c claim from on the job injury. It wasn’t related to two above listed ones. Can I still file under the bill and if so, who could handle it. Thanks.
If you retired because of high blood pressure with an in line of duty disability you could file for wc benefits as long as 2 years from date of retirement hasn’t lapsed. We would also have to compare benefit packages under wc and retirement to see which pays more, the tax consequences, and where your health coverage is funded. Remember, in order to maintain the wc claim I need a doctor, preferably a cardiologist, indicating no know cause for your high blood pressure and that you can no longer work because of it. We also need documentation that you passed a pre-employment physical.
I handle these cases. I am a board certified wc lawyer.
I am a Lieutenant-Firefighter-Paramedic and have worked for the same dept for 14 yrs. I have recently been diagnosed with symptomatic PVC’s and am taking medication for them. There is no family hx of this, as far as I know. I have also recently began having near syncope, while on-duty at night when we get a call. One time I was not doing anything physical and the second time I had just finished bringing down a pt from a flight of stairs. The only “risk factor” I have is obesity. I have gradually over the years been gaining weight, even though I have tried practically every diet out there. I this something that would fall under the heart/lung bill?
PVC’s can be brought on by a number of factors. Most often people with premature contractions, don’t even know they have them, but obviously you are nearly passing out, so we need to get to the root of the problem. You cardiologist may do halter testing or other studies to determine the cause of the electrical malfunction. Sometimes it can be due to underlying heart disease, or other intrinsic problems with the heart like ischemia, myocarditis, cardiomyopathy, myocardial contusion, hypoxia, CO2 poisoning, mitral valve prolapse or prior heart attack. It can also be caused by increased levels of adrenaline, lack of sleep/exhaustion and stress.
If your attacks are coming when you get a call, I would be inclined to ask for a 24 hour monitor to see if the events coincide with calls. Although the heart/lung bill was worded in such a way to mention only hypertension and heart disease, something directly correlated to the stress or adrenaline ought to be covered. It must be debilitating though. So, if the condition progresses to the point where you have to stop work and your cardiologist thinks it could be adrenaline related, boy I’d argue that case.
I first started having near-syncope around the same time as I started having a lot of PVC’s. I was overweight at that time and my blood pressure was normal. I have since had gastric bypass surgery to lose weight. I am now at the weight I was when I got hired. My blood pressure when I got hired ran on the low side but with no symptoms and no near-syncope. I now again have low blood pressure, but I was also getting very dizzy. I am now taking medication to increase my blood pressure and the dizziness has gone away. I have had 2 more near syncope episodes, both on duty. One after a training exercise and another after a fire. The one after the training exercise I was not taking any medication yet and the second was after I started taking medication for the low blood pressure. I have been unofficially diagnosed with neurocardiogenic syncope. I only have near-syncope while I am on duty. My chief has told me that either I voluntarily go on light-duty until the problem is fixed or he will force me to go on light-duty. Does this sound like something to pursue?
The cause of neurocardiogenic syncope is not well understood. While the symptoms can certainly be triggered by stress, there is no direct correlation to either high blood pressure or heart disease. Rather the heart is misinterpreting your actual pressure levels and overcompensating. My gut reaction would be this condition is not covered.
But as always, I recommend asking your doctor if there is any correlation to heart disease or hypertension, then talking to a lawyer about your situation.
I am a police officer and have been working for the same department for over 20 years. About 5 years ago I noticed that when I ran I became fatigue easily and had a sharp pain in my chest. I learned this year that I have Sarcoidosis, which is a lung diseases. I applied for a medical disability but was denied, because the doctor don’t believe the enviorment as a police officer cause me condition. From doing research I have learned that my condition is cause by a viruses, dust, bacteria or chemicals. There were a lots of details that was not mentioned at the first hearing. Is this case worth hiring a lawyer to fight this case.
The only condition for which the presumption of Florida Statute 112.18 applies is TB. In all other cases you treat the injury like an exposure case, with the burden on you to show the disease was contracted as a result of employment. Since Sarcoidosis does not have a higher incidence among law enforcement officers and there are so many reasons why pople can contract it, I would not elect to pursue it. Not unless a pulmonologist could tie the condition to work. So by all means ask, but if the doctor can’t tell you, I see no viable means of pursuing the case.
Your statute of limitations begins to run from the date you become disabled, which is defined as an inability to perform your job as a police officer. If you are still performing your regular job, your claim hasn’t matured yet. If you should become disabled, you have 2 years from the date you leave the force or are placed in a different job to file your claim.
I am 45 years old and have been a deputy sheriff for 24 years. In september 2009 I suffered a heart attack in Colorado while hunting. I subsequently filed a wc claim. I do not hhave high blood pressure, Iam in good shape, non-smoker and my cholestrol was 90 at the time of the heart attack. I do have a family history of heart disease. I was denied based on family history, jurisdiction issues (out-of-state), not being engaged in my duties at the time of the event and pre-existing conditions. The pre-existing conditions was a diagnosis of “tachycardia” in May 1985 in my pre-employment physical. My cardiologist has dismissed this pre-existing diagnosis as “ridicuolous”. I have returned to full duty but want to protect myself after retirement. What is my best course of action? I really don’t want to retire, but may consider it if it is my best option for protection in the future.
Once you voluntarily retire there is no protection afforded by the presumption. Your prior claim was denied, so you don’t have an open claim, so to speak, that would afford you coverage for further heart problems. In order to gain coverage you would have to pursue a claim, while employed. The statute requires the heart condition disable you from your regular job. If you retire voluntarily, you can’t then claim you became disabled as a result of your heart condition. The only way you are getting coverage for your condition in retirement, is if you have to leave your job because of your heart condition and you successfully pursue a claim.
It’s not a question of reducing benefits, it’s a question of whether a smokers claim will even be deemed compensable. When you make a claim for heart disease or high blood pressure under the heart/lung bill a rebuttable presumption is created. The condition is presumed work related if you have passed a pre-employment physicial UNLESS the workers’ compensation carrier can rebut the presumption by proving a cause for the condition. Smoking is a common cause for high blood pressure, heart and lung disease. If someone is a heavy smoker, their claim may be denied altogether if a physician concludes it is the cause of the problem.
In short, a municipal employee cannot receive a combination of workers’ compensation, social security disability and in line of duty pension benefits that exceeds 100% of their average weekly wage. The court considered getting more than 100% of your salary while out on disability a windfall.
Take a look at your weekly gross salary when you became disabled, subtract your weekly disability pension, subtract any weekly social security disability payments (if you were receiving them) and the result is what workers’ compensation owes you per week.
I work as a firefighter and during my pre employment physical they did not perform a ekg or stress test. I “passed ” the physical and was hired. By reading your entry, does that me if I developed are presumptive condition ie Heart Attack, would i not be covered due to the incomplete nature of the physical. I came from a different that gave annual physicals, with stress tests, would that be usable?
I have a co worker out right now with a cardiac problem and from what I have heard work comp refused his claim in the first week because he did not a physical on file. I am trying look out for myself.
Looking at how to correct my problem before I have a problem.
That’s a good question. The statute simply says passed a pre-employment physical with the employer, meaning your current employer. It doesn’t say EKG’s or stress tests must be performed. Just that the exam fails to reveal evidence of heart disease, high blood pressure, etc.
I think you are just fine.
My wife is currently employed with a large Sheriffs Office in Florida. She holds the rank of Lieutenant. She has had yearly physicals which are required by the agency. Last year she was diagnosed with High Blood Pressure. A few weeks ago she was diagnosed with stage 3 kidney disease, there are only 5 stages. Her doctor stated that the kidney issues were a direct result of the high blood pressure, which we are convinced is from the high level of stress from her job. What alternative’s are available to us/her in regards to the heart bill?
I’m not sure what you mean by what alternatives are available. File a claim under the heart/lung bill if she passed a pre-employment physical. There is no alternative. If she has to take off from work, also look to short/long term disability, in-line of duty pensions and Social Security.
If she has any problem filing the claim, or it is denied. Get to a board certified comp lawyer ASAP. They are listed under attorney’s, workers’ compensation, board certified in the yellow pages.
If you can get the high blood pressure treated as compensable, it might be possible to get the kidneys treated under comp as well.
thank you for your advice. I (alternatives) meant legal options, and can the agency “fire or dismiss” her for filing the claim?
I’ve been a firefighter for 22 years, exercise regularly and in good physical condition. My employer provides a thorough physical and a stress test every year. During my last stress test, I developed several short periods of Ventricular Tachycardia. I was immediately admitted to the hospital. A heart cath showed no signs of coronary blockage or heart damage. An electrophysiology study revealed the condition was a result of how my heart reacted to adrenaline. Since the incident, I have been put on light duty assignment. I’m taking medication and awaiting further consultation regarding the implantation of an internal defibrillator. Although I have no known family history and have never shown signs or had symptoms of this condition before, it is believed there is a possibility that the condition is genetic. Would this be covered?
In my opinion, tachycardia would not be covered, because it would not likely be considered heart “disease.” It is an electrical malfunction, not related to stress or diet.
Do I need to subscribe to this site?
You can, and you will probably be notified everytime I post. I don’t know if that happens or not, or you can just check back periodically. I am posting today about a new case and Florida Senate Bill which affects the heart/lung bill.
I am an Engineer Firefighter for over 10 years now. Can you tell me how much weight if any does the National Fire Protection Agency (NFPA) 1582 carry in a court of law? I have been diagnosed with “essential hypertension” which has been uncontrolled for over 1 year now. According to NFPA 1582, it states that if my hypertension is uncontrolled by approved medications then I am precluded from working as an active firefighter. I recently had a “pension” hearing based on the Heart and Lung statute and it was denied even though my pre-employment physical bp was 104/73. I have been placed on “light duty” and the doctor says it’s a permanent condition. Essential hypertension is an unknown cause. However, the City’s IME states that it’s not work related? If there is no known cause, then how can he say thats it’s NOT work related? My pre-employment physical refutes that claim. The board ignored the Heart and Lung bill, my pre-employment physical, and the NFPA. I do not have a history of smoking, diabetes, I’m not obese, and I dot have a family history of heart disease. I feel like I’m being “railroaded” by the City. Do you think I have a case for an appellate court?
The fly in the ointment of hypertension cases is the case of Bivens v. City of Lakeland. That case distinguishes “essential hypertension” from other forms of hypertension. “Essential hypertension” was excluded from coverage by workers’ comp because is was not considered cardiac in origin, therefore not covered under the heart bill. This is really splitting hairs if you ask me, as the statute itself makes no such distinction, but part of the decision is cited below. You should read the whole case, which is available online, and speak to a pension attorney, which differs from a workers’ comp attorney.
I am not sure procedurally whether you can request a re-hearing, get your own IME, or what remedies are available following a pension hearing. I will e-mail you privately with the name of a pension attorney.
In City of Miami v. Thomas, 657 So.2d 927, 928 (Fla. 1st DCA 1995), we clarified the types of “hypertension” covered by section 112.18(1). In that case, we overruled a JCC’s finding that “the term ‘hypertension,’ as used in section 112.18(1), was meant to include ‘any kind of hypertension,’ i.e., hypertensive conditions other than arterial or cardiovascular hypertension.” Id. Therefore, based on our previous decision, the presumption applies only to arterial or cardiovascular hypertension.
Take a look at my other post today on hypertension. Disability is also a required element for comp benefits. Disability may be partial or total, but it must take you away from firefighting. Losing time for a short period, while the condition is DIAGNOSED, is NOT considered disability. Losing time from work for TREATMENT for the condition is considered compensable, i.e. you can receive comp for your lost time. The courts have made this fine line distinction on the term “disabled” recently.
As far as your case, if you become disabled, you can apply for benefits. If you have “essential hypertension” you can run into problems. See my post on hypertension.
Can you please privately send me the name of a “pension” attorney? My email is jrt_ofd@yahoo.com Time is of the essence in this case. I did have an IME and he stated it was “arterial hypertension.” Is that recognized under the bill and by the courts? According to the case cited above, I believe it is. I was hospitalized and did miss addtional days from work due to complications from hypertension (not doctor’s appts.). My disability is partial. It’s been uncontrolled for over a year now. Work Comp denied my claim after the 120 day rule and we are going to trial. I beleived it was based on the original diagnoses of “essential” hypertension.
I am a State Law Enforcement Investigator with 21 years of service here in Florida. I have recently seen a cardiologist after complications and have been diagnosed with severe atrial fiburllation and cardio myopothy with an ejection fraction of 10%; in laymen’s terms … heart failure.
I currently undergoing treatments through medications and exploratory minor surgeries. Worse case scenario, would be my heart doesn’t improve to where it needs to be for a high hazardous occupation; with light duty may or may not being an option. Im utilizing personal leave presently, however concerned this will ultimately burn off in time. Additionally, I’m concerned of the medical expenses to be incurred.
As soon as you become disabled, either losing time from work for treatment, shifted to a lower paying light duty job, or discharged altogether, apply for workers’ compensation.
If you are discharged also apply for in line of duty pension benefits; and Social Security.
An ejection fraction of below 30%, if it stays there despite treatment, is an automatic qualifier for Social Security.
Sorry for the delay in responding. If the essential skills form completed by your doctor indicates you no longer have the essential skills to perform corrections work you should immediately and file a claim under the heart/lung bill for compensation from the first day you missed work. I would seek counsel relatively quickly if you get any negative feedback from your employer, or have any difficulty filing your claim. All comp cases must be to trial in 210 days (7 months) so that is the longest it could take you to find out if you case is approved. It could also be approved without any static whatsoever, assuming you passed a pre-employment physical.
My claim was recently disapproved…what steps should I take now?
Talk to a lawyer in your area. Look at the board certified lawyers in the yellow pages or online.
I am retired from Tampa Fire Rescue Line of Duty heart and hypertension. I also worked a part time job in the medical field for 30 yrs paying into the social security system. I was diagnose with end stage renal and now I am on dialysis and receive medicare for my treatments. My Fire and Police pension was a private pension plan and didnot pay into the social security system. But with my partime work I was able to earn my quarters to receive social security disability. Does the heart and lung bill allow me to receive social security disability payments since I receive a monthly pension check that is a tax free?
The heart/lung bill is a claim for workers compensation benefits. The combination of Social Security disability payments, comp payments and in line of duty pension benefits cannot exceed 100% of your salary at the time of your disability. So the short answer is yes, you can receive all 3 benefits but the comp is the last payment calculated, so comp gets to subtract your in line of duty pension and social security payment from your gross salary and what’s left is what they pay.
The key in your case is if your apply for benefits under the heart/lung statute you must immediately advise your employer your were concurrently employed (had a side job) and you must produce your payroll records from that job to prove your total income. You want comp to add your earnings from Tampa Fire Rescue and your part-time medical job together when calculating your average weekly wage. The burden is on you to produce those records or comp doesn’t have to pay you for them.
I’m currently employed as a lieutenant/paramedic assigned to an ambulance with a large Florida fire/rescue department. I have been employed with this agency for over 28 years. I’m currently enrolled in the cities DROP plan with 1 year and 5 months participation, with 3 and a half years till full retirement. I am currently off work due to heart bypass surgery that has corrected; a one time line of duty onset. I have no health problems other than the CABG, and am fit and healthy. My surgeon states I can return to full duty, but the W/C cardiologist states, I can no longer perform firefighting duties, though I have explained to him and provided the agencies SOP on my job description which does not allow me to be involved in firefighting, as I need to be readily available to treat and transport victims and rehab firefighters. I was hired as a paramedic/FF and still maintain my FL FF certificate (required), though I have not been assigned to firefighting duties for the last 27 and a half years. I understand I have a Cat 2 impairment rating of between 15 and 29 % due to the CABG, and a function level 1. In the past, this agency has provided L/D assignments and returned individuals to full duty with the same impairment. Now the agency wants to retire any person with this rating, and essentially make them disabled. I have passed my post surgical nuclear exercise stress test and have not been assigned a MMI as of yet. I want to return to full duty and can pass their FFD exam. I’m scheduled to meet with my doctor and W/C in 2 weeks. CAn you advise as to what legal options I have if they attempt to retire me. Thank you.
I can think of 2 possibilities. One is to file a workers’ compensation claim under the heart/lung bill and the second is to file claim for discrimination.
The minute you started losing income you were potentially eligible for lost wage benefits under the heart/lung bill. But if you are nearing MMI, you still have to be able to prove an inability to perform sedentary work to collect total disability benefits, which, by your own admission, you cannot.
My other thought is a claim for discrimination under the ADA as what you are saying is your job doesn’t require you to perform firefighting tasks, but you are being let go anyway. You are claiming you can perform your job, but they are not allowing you to, which is what the ADA is designed to prevent.
I am going to privately send you the name of an attorney who deals with the administrative level procedures at the fire department and have you give him a call.
I retired as a firefighter about 1.5 years ago. Prior to that I was treated for hypertension. On my own, i stopped going to the doctor for this disease.
I did not receive any treatment for about six years. I never “closed out” with workman’s comp, just simply stopped going.
Less than a year after retiring, I suffered a major heart attack. My understanding of the Heart/Lung Bill is since I’m not currently employed, I have no case. However, since I never closed out, does the fact I sought no further treatment pre-empt me from any benefits?
If your original treatment for hypertension was paid for by workers’ compensation, the case is closed anyway, even though you didn’t settle. If you let more than one year pass between authorized doctor’s visits, a workers’ compensation case closes automatically. So yes, it would preclude further benefits.
If I am diagnosed with heart disease say 3 years before I retire, will my accidental death benefit be paid to my beneficiary if I die due to a heart attack after I have retired? Would my retirement have to be due to heart disease rather than a voluntary retirement in order to be covered?
This issue has nothing to do with the heart/lung bill. What you have apparently, is an additional insurance policy for accidental death. Accidental death policies only cover death by accident, as defined by the policy. They do not cover heart attacks, as that is generally not considered an accident, at least not in any policy I have ever read.
Please consult your policy for the definition of accidental death.
If that policy is in place when you retire, and assuming it covered heart attacks, as long as the premium is paid you would not have to leave work under the heart-lung bill to be covered. But again, I have never seen any accidental death policy cover heart disease.
I was hired by a large Sheriff’s Office when I was 18 years old and I retired from the agency after serving for 33 years. A year beore I retired, I completed a w/c claim for high blood pressure developed over the years I was working. The claim was approved and w/c began paying for blood pressure medicine. Recently, I was transferred to a new doctor by w/c and after a battery of new tests, the doctor advised me that he would recommend the case not be considered work related. W/c has been paying for my blood pressure medicine for 5 years without a problem and now, even though nothing else in my health has changed, they have cut off this benefit.
Do I have any recourse or should I just start paying out of pocket for my medication and be happy it was paid for 5 years?
I hate to sound lawyerish, but I would hire a lawyer to at least look into the situation. There is a one year statute of limitations on your case, running from the date of your last authorized doctor’s visit. That new doctor must come up with a cause for your hypertension, which is personal to you and unrelated to work. You can use the opinion of your prior doctor, get an IME or settle the case, but I wouldn’t advise doing nothing. You also have the right to a one time change of physician if they don’t pull the plug on you. Boy the carrier gets tired of paying, and they find the right doctor to spout the party line. The presumption is on your side. So, at least bounce the facts off a lawyer. You are welcome to call anytime. We are all paid on contingency, so believe me, we will not take cases we can’t win. I investigate, then file suit. I have to have one physician that supports my position.
I am a State Law Enforcement Officer and approximately 8 months ago I suffered chest pains and after several tests, it was determined that I had cardiac artery blockage and I found myself in the hospital and a stent placed in my right cardiac artery. I filed a WC claim under the Heart Bill and recently received a letter from the state, which stated that my claim had been found compensable for Coronary Artey Disease and Hypertension. I understand that the state will pay my medical bills and prescriptions related to this condition, but I don’t understand the “disability percentage” that I have heard mentioned. Do I have to hire an attorney in order file for this? How does this work? Thank you.
In order to receive compensation for lost wages you must be disabled within the meaning of the statute, which in your case means you can no longer work as a law enforcement officer. If you are off work per an authorized physician, you will collect 66% of your salary, but not for the first week. If you are on restricted duty, earning less than 80% of your salary, you will receive approximately 64% of the difference in your salary.
Payment should be automatic, with the submission of employee earnings reports to the carrier, but if there is a problem, contact a lawyer.
I suffered a heart attack in October 2010. I filed a claim with my employer with w/c. my employer is very helpful and wants to cover me, but w/c has filed 2 denials. I am a smoker and a little over weight. I am trying to quit smoking and have lost some weight. I have changed my diet and it is working good. the smoking is very difficult but i am trying. What should I do?
First, are you disabled? Missing time from work? Let’s assume so.
Second, I personally won’t file suit until I have an opinion from a physician that your heart attack resulted from heart disease, the cause of which is unknown. If your physician says the major contributing cause for your attack was smoking, being overweight or some inherited condition, we are going nowhere with that doctor’s opinion and would have to get another. If the doctor can’t say, we could file suit.
I trust the denials from your employer are already based on some physicians testimony. They might even list the doctor’s name in the denial. If you are not comfortable getting this information from your doctor, a lawyer like myself can get the information, I just think doctors usually respond better to a question from you, than a letter from a lawyer. Doctors hate to commit to any opinion. A letter from a lawyer is downright terrifying to them.
No i am not disabled but i am on alot of medication. some of which my insurance does not cover. plus my medical bills are really racking up. i had a stay in the hospital that was very expensive. the doctors say that the cause was a blood condition that causes clotting. it is called liden factor 5 mutation. but i am sure that the stress before the attack led to it. i was really stressed at work the days leading up to it. not sure if this helps u any.
If I have a high blood pressure issue now and have a heart attack or a heart blockage will I be denied heart lung cause I have high blood pressure?
I can’t tell you if a claim will be approved or denied, but if you passed a pre-employment physical, then developed high blood pressure, it should not be a barrier to your claim.
Is hypertrophic cardiomyopothy covered under the heart and lung bill? My city is saying it is a genetic disease and is not covered under the heart and lung laws.
Unfortunately, hypertrophic cardiomylopathy is a genetic disease. You either inherit the disease or it can be a de novo mutation of a gene. Either way, your cardiologist can identify a cause for the thickening of your heart wall which is not work related.
If a cardiologist cannot identify a cause of the disease, you win. If they can identify a cause, and it is not work related, you lose. This is a form of heart disease that is only genetic and cannot be caused by the adverse, stressful conditions first responders are exposed to.
This is of course, my opinion, based largely on what I have read. There is no case on point. Please ask your cardiologist “Is there any other way to get this condition?” Just to be sure.
Stroke is not specifically mentioned in the statute, but most strokes are caused by hypertension. So the results of the stroke are compensible if the underlying condition is hypertension.
Stroke is not specifically mentioned in Florida Statute 112.18. But most strokes are caused by high blood pressure, so there are several cases finding strokes compensable because of underlying hypertension.
My brother works at a neighboring Sheriff’s Office to you (manatee). He has just over 24 years there. Since Dec 2010 he has had a lot of stress at his job, and most recently added stress (he never had a problem prior to this at work). This past week while at the doctors for a pain of some sort, it was determined he was in AFib and he was ordered straight to the Cardiologist. Since the stress has been so severe he has been seriously contemplating just retiring, however, we are not so sure he should do that.
He passed his pre-employment screenings in 1986 and subsequent physicals, and in 2003 began blood pressure meds the lowest dose 5mg and low cholesterol meds. He has been on the force since 1986. Last year (2010) he had the life scan and everything was excellent. Two weeks ago, he was at the doctor and the A Fib did not show up.
He told his supervisor about the A Fib and the supervisor said yeah prove it, and that was it.
He just wants to retire, any suggestions?
There are multiple causes for A Fib, including high blood pressure and stress. If the A fib is caused by high blood pressure, it is compensable. Stress is not compensable. Talk to the cardiologist about the cause.
Disability is the second prong of this equation. Your brother does not get compensated for loss of income unless his job as a sheriff is impacted. He must be off work, or restricted from work by a physician in order to collect lost wages. Again, have a conversation with the doctor. If he is told to stop work, or to perform other duties, he should file for workers’ comp.
I have been employed as a police officer for sixteen years. In 2004, I suffered my first heart attack and was accepted under the heart and lung bill. My meds and doctor’s visits are taken care of by workers comp. I have since suffered two additional heart attacks. my question is if i am on the bill and due to complications need to apply for disabilities do I have to contend with the 2010 revision of persumtion. I ask because I have a family history and used to be a smoker.
You need to file for workers’ compensation using the dates of the two new incidents. They will be considered seperate incidents under the statute. I don’t believe there will be a problem with acceptance, as they picked up your first heart attack as compensable in 2004. Disability, however is another matter. If you have not been able to return to work after your most recent heart attack, lost wages are now at issue. You may be disabled from employment.
In regard to the issue of your pre-employment physical, you do not have establish your eligibility again. You have to pass the physical once.
So, first is to notify workers’ compenation of the claim and to advise you are now disabled. Workers’ comp should be paying your medical bills. If you run into a problem, contact a workers’ compensation lawyer.
career firefighter and recently suffered a heart attack. This bill should extend into retirement because what they were exposed to doesn’t just stop when they retire.
Most of them are affected AFTER they retire. Why are they not covered then? What can we do to cover them??????
Nothing that I am aware of. The second prong of the filing requirement is that the condition cause a disability, meaning an inability to perform one’s job. Once a firefighter retires, they can no longer claim “disability” as they are no longer working by choice. I have never seen any situation where benefits were extended to a retired first responder. But I understand and sympathize with your point of view. If I made the rules a whole lotta things would change in this system.
Are volunteer firefighters covered under this bill? The statute states “Actively employed.” Our volunteer firefighters are treated as subcontractors and issued 1099s from the City, however are covered by the Ciy’s Worker’s Comp carrier.
Here is an opinion from then attorney general Bob Butterworth. I gather most volunteers are not covered, but please read the entire opinion. It is available online if you type in “112.18 and volunteer figrefighter” into any search engine.
RE: FIREFIGHTERS–MUNICIPALITIES–COUNTIES–VOLUNTEERS–full time firefighter employed by governmental entity does not lose statutory presumption if also working as a volunteer firefighter. s. 112.18, 112.191, F.S.
Does a full-time paid firefighter who is employed by a governmental entity lose the presumption afforded in s. 112.18, F.S., if he also works as a volunteer firefighter for another governmental entity?
A full-time paid firefighter who qualifies for the presumption afforded in s. 112.18, F.S., does not lose the presumption merely because he also performs services as a volunteer firefighter for another governmental entity.
The presumption contained in s. 112.18(1), F.S., thus affects the burden of persuasion. It relieves the claimant from the necessity of proving an occupational causation of the enumerated diseases and places on the employer the burden of proving that the disease or medical condition was caused by a non occupationally related agent.
In Lansford v. Broward County Board of County Commissioners, the court held that an individual employed by the emergency services division in the county and assigned to duties as a paramedic was not entitled to the statutory presumption afforded by s. 112.18, F.S., since he did not meet all the criteria set forth in s. 112.191(1)(b), F.S.
You state that the City of Plantation maintains a volunteer fire department. A number of the city’s part-time volunteer fire-fighters are also full-time paid firefighters for other municipalities or counties who fully meet the criteria set forth in s. 112.191(1)(b), F.S. The firefighters are concerned, however, that they may lose the presumption to which they are entitled through their full-time employment if they volunteer their services to the City of Plantation.
However, unlike Lansford, each of the firefighters in the instant inquiry is a full-time uniformed firefighter employed by a governmental entity as specified by s. 112.18, F.S., whose primary duty is the prevention and extinguishing of fires, the protection of life and property, the enforcement of state and local fire prevention codes and the enforcement of laws pertaining to the prevention and control of fires. Each is certified pursuant to s.633.35, F.S., and is a member of a duly constituted fire department. Thus, unlike Lansford, the firefighters in the instant inquiry fully meet the criteria set forth in s. 112.191(1)(b), F.S., through their full-time employment as firefighters with another municipality or county.
The courts have stated that s. 112.18, F.S., “embodies the social policy of the state which recognizes that firemen are subjected during their career to the hazards of smoke, heat, and nauseous fumes from all kinds of toxic chemicals as well as extreme anxiety derived from the necessity of being constantly faced with the possibility of extreme danger.” Therefore, as a statute enacted in the public interest, s. 112.18, F.S., should be given a liberal construction.
While volunteer firemen for the City of Plantation are not entitled to the presumption afforded by s. 112.18, F.S., by virtue of those services, I find nothing in either s. 112.18 or s. 112.191, F.S., which removes firemen who are otherwise fully entitled to the presumption in s. 112.18, F.S., simply because they also perform volunteer services. Rather I am of the opinion that the exclusion of volunteer firemen from the definition of firefighter was intended to exclude individuals who only perform firefighting services as volunteers. Accordingly, I am of the opinion that a full-time paid firefighter who qualifies for the presumption afforded in s. 112.18, F.S., does not lose the presumption merely because he also performs services as a volunteer firefighter for another governmental entity.
I am a 4 yr. Corrections Officer and 2 weeks into this career i had a heart attack Nov. 07. Nothing was filed as far as workers comp or anything because I was off that day. I read that the heart & lung bill says the 3 stipulations and I passed the 1st 2 but the disabled part..I never lost any pay or position. Is or was workers comp supposed to pay for any of my meds? If so, I guess its been to long to file anything at this time due to the statue of limitations? I really appreciate your time and thoughts on this matter.
No, you would not have been able to file for this heart attack because you were not disabled by it. There was no loss of earnings or change of position. The fact that the statute of limitations has run has nothing to do with it, so reast easy. You didn’t miss a thing. But if you have more problems in the future, you will know to file, just don’t change employers. If you were to change emploters, you might have to pass a new physical in which case your heart attack will be a pre-existing condition, along with whatever caused it. Beware these little pitfalls.
Hello , I am 25 year FF/PM getting ready to retire, Up until the last few years i was pretty healthy, but now i am on high blood pressure medication. is there anything I can do with the heart lung bill.
It all depends on whether your doctor limits your duties. Remember, you must have passed a physical and be disabled from work before the claim can go anywhere. Disability is defined as an inability to perform your duties as a firefighter/paramedic. Any claim for disability must be made before you retire or with 180 days of retirement.
It doesn’t take total disability either. Just a limitation in your duties that would have dropped you to another position or limited your pay. If it’s time for you to end your service and you’ve been lucky enough not to be restricted by your doctor, you may want to go quietly. If you’ve been pushing to stay in the game and your blood pressure is really problematic, once your doctor delivers a restriction incompatible with your job duties, you can file a claim.
I’m attending a meeting of attorney’s tomorrow where we will collaborate on this very topic. We will all be trading cases I’m sure, as only decision which are appealed are publicly printed. Decisions by judges largely rely on word of mouth, so please check back on this site by Monday, January 23, 2012 for a posting of additional tid bits. I rely on word of mouth among firefighters to tell one another what flies and what doesn’t. So check back and help me tell the latest.
Hello, My name is Andrew Turner, I was a Fire-medic with Sarasota county for over 27 years, i retired in March of 2009, and a year later had a heart cath and stent , no signs of heart trouble while I was working, I would like to know If I have any claims for future heart issues, I am having a stress test in late March of this year. I request info on filing a claim for future expenses for any heart issues that occur in the future.
The statute was amended 7/1/10 to require that any claims for heart disease, TB or hypertension must be filed within 180 days of leaving employment. If you retired in 2009 with no claim filed, the employer is going to raise the 180 day rule and deny any claim you make. If there are any additional facts you want me to consider, please let me know.
The state statute states that the employee must past a pre employment physical. A firefighter passed a pre employement phisical when he is initially hired at a department. This firefighter was layed off and upon being re-hired did not take a pre employement phisical. This employee then underwent the yearly physical and received a clean bill of health. The employee then suffered a stroke (cerebral bleed) that was caused by Hypertention while on a call at work. This Firefighter was denied workers comp because he did not undergo a pre employement physical when he was rehired. Can you please shed some light on this issue and the possibilty of challenging this denial.
The statute reads that a firefighter must pass a pre-employment physical upon entry into service. There are few cases interpreting this portion of the statute. I have copied the text of Cumbie v. City of Milton below. Read the dissent.
In Cumbie, the claimant lost because the City didn’t require a pre-employment physical at the time Cumbie was hired. He took and passed one 2 years after he was hired. He lost simply because he didn’t take the physical, upon entering service, even though he showed no signs of heart disease 2 years after he was hired. Go figure.
An Appeal from a Workers’ Compensation Order. Michael DeMarko, Deputy Commissioner.
Claimant appeals an order denying his claim for workers’ compensation benefits. We affirm.
Claimant contends the deputy commissioner erred in finding that because he did not undergo a physical examination upon entering his employment as a fireman, he was not entitled to the statutory presumption of ? 112.18, Fla. Stat. Section 112.18 provides that any condition or impairment of health of any fireman caused by tuberculosis, heart disease or hypertension and resulting in total or partial disability or death shall be presumed to have been accidental and suffered in the line of duty unless the contrary be shown by competent evidence. As an apparent quid pro quo for granting this presumption to firemen the legislature further provided, “However, any such fireman shall have successfully passed a physical examination upon entering into any such service as a fireman, which examination failed to reveal any evidence of any such condition.” ? 112.18(1), Fla. Stat.
The claimant did not undergo a physical examination upon entering employment a a fireman for the City of Milton. The statute creating the presumption is very clear and unambiguous and requires a physical examination upon entering into any service as a fireman as a prerequisite to entitlement to the presumption. A physical examination prior to the receiving the benefit of the presumption is a reasonable requirement in order to determine if any of the conditions covered by the statute existed prior to employment. It is not function of an appellate court to amend, repeal or disregard the clear and unambiguous language of a statute, even if the result may appear inequitable and the wisdom of its enactment questionable. Citizens v. Public Service Commission, 435 So.2d 784 (Fla. 1983); Good Housekeeping Gas Company v. Kitler, 492 So.2d 700 (Fla. 1st DCA 1986). The enactment, repeal or modification of a legislative act is the sole prerogative of the legislature.
SHIVERS, J., CONCURS. ERVIN, J., DISSENTS.
In November 1984, following the recommendation of claimant’s treating physician that claimant’s hypertension and arteriosclerotic heart disease prevented him from carrying out his duties as fire chief of the City of Milton, claimant retired, and brought his claim for compensation benefits pursuant to section 112.18(1). The parties agree that without the presumption contained in the statute, claimant would not be entitled to benefits.
(1) Any condition or impairment of health of any Florida municipal, county, port authority, special tax district, or fire control district firemen caused by tuberculosis, heart disease or hypertension resulting in total or partial disability or death shall be presumed to have been accidental and to have been suffered in the line of duty unless the contrary be shown by competent evidence. However, any such firemen shall have successfully passed a physical examination upon entering into any such service as a fireman, which examination failed to reveal any evidence of any such condition.
that foremen are subjected during their career to the hazard of smoke, heat, and nauseous fumes from all kinds of toxic chemicals as well as extreme anxiety derived from the necessity of being constantly faced with the possibility of extreme danger. . . .
The legislature disposed of the need to introduce proof that the enumerated diseases were occupational hazards of the fireman involved by assuming that they are hazards faced by all firemen.
Caldwell v. Division of Retirement, Florida Department of Administration, 372 So.2d 438, 441 (Fla. 1979).
The employer at bar argues that there is no ambiguity in the statute, hence no need for interpretation. I cannot agree. The statute reasonably implies that in order for the exception to be applicable, the employer must first establish a policy that all firemen, upon entering employment, successfully pass a physical examination that does not disclose the existence of a hypertensive condition. No such policy was required by the City of Milton. to place construction on the statute in the manner advocated by appellee, and as adopted by the Commission, would make the exception, in my judgment, repugnant to the purpose for which the statute was directed: to eliminate the necessity of proof that the condition contracted during a fireman’s employment was one which arose out of the corse of his employment.
Cases from out-of-state jurisdictions, in construing statutes having presumptive clauses similar to that at bar, have, unlike the Florida industrial Relations Commission, decline to give literal effect to language in statutes that requires the employee to have successfully undergone a physical examination at the time of his employment. See Linnell v. City of St. Louis Park, 305 N.W.2d 599 (Minn. 1981) (en banc); Worden v. County of Houston, 356 N.W.2d 693 (Minn. 1984). In both cases the Minnesota Supreme Court held that the purpose of the statutorily required pre-employment physical examination is to establish that the worker is free from the diseases or conditions specified in the statute, and that where the evidence of the reasonable inferences therefrom satisfy the statutory purpose, strict compliance with the requirement of such examination is unnecessary. See also City of Waynesboro, Sheriff’s Department v. Harter, 222 Va. 564, 281 S.E.2d 911 (1981) (presumption favoring compensability not negated by failure of employee to take pre-employment physical, since employer did not have a policy requiring such examinations at the time of employee’s entry into service). Accord County of Amherst Board of Supervisors v. Brockman, 224 Va. 391, 297 S.E.2d 805 (1982).
In the case at bar, the City of Milton similarly had no policy requiring pre-entry physicals at the time of claimant’s employment as a firefighter. The first employer-mandated physical taken by claimant was successfully passed by him some two years following his entry into service, as were several others taken thereafter over a span of nearly 20 years. In fact, it was only until 1982 that claimant was first diagnosed as having hypertensive cardiovascular disease. Considering the fact that the employer had no requirement that firemen undergo physical examinations at the time of enter into service, as well as the reasonable inferences derived from the evidence, it is altogether apparent that claimant was free from an hypertensive condition at the time of such entry. Accordingly, appellant should be afforded the full benefit of the statutory presumption, and the order of the deputy below reverse.
If you were hired as a part time officer after passing a pre employment physical and then hired with the same agency as a full time officer approx. 9 months later, are you required to have an additional pre employment physical to qualify for heart and lung.
I answered this writer offline, but the upshot of my answer was I didn’t think so.
That’s a tough question. First, I don’t know if you are employed primarily as a firefighter with the forest service. Please look at the definition in Florida Stature 112.191(1)(b).
The other question is the bleed. 80% of all subarachnoid bleeds are caused by an aneurysm. The other 10% by AVM’s, both of which are generally considered idiopathic. There is no connection to heart disease or high blood pressure. However I am not a doctor, and several cardiologists have suprised me by connecting various ailments to high blood pressure. Yes you have a weak vessel, but was it going to burst regardless or was the nature of your work causing such high pressure, the high pressure was the major contributing cause of the bleed? All you need is a cardiologist to say the major cause of the bleed was your pressure. The flip side is the defense lawyer will argue there could not have been a bleed without a weak wall, which cannot be work related. Chicken or egg argument. It all rests on the doctor.
I would adise you to ocument the claim and have a discussion with your doctor. These types of claims are being made on a case by case basis.
I am a law enforcement officer and I had triple bi-pass heart surgery. Worker’s Compensation handled my case. I was under the impression that the Florida Heart/Lung bill would pay for my hospital bills but they have not done so. What is my next step?
They should have paid the bills. If they do not pay the bill you can file a claim for compensability of the surgery and payment of the bills. You don’t want to bring a claim for just the bills, as the defense attorney may claim the judge does not have jurisdiction. Technically, judges do not have jurisdiction over just bills, unless you paid them and are requesting reimbursement.
I would like to know what makes you think workers comp handled the claim. There could also be the problem of the hospital not submitting the bills to workers comp. The first thing you should do is call the hospital’s billing department and confirm they sent the bill to the correct address, and when. If it’s been more than 30 days, might want to hire a lawyer.
Very well! I sent a copy of the bills to the workman conpensation office over 2 months ago.and still no response. I will contact a lawyer next week. I will return to you of my final results once it’s over. Thank you very much.
i retired on the heart/lung bill approximately one year and 3 months ago. Can I work as a reserve police officer, without pay, and suffer no consiquences of voluntarying my time to assist another agency. I dont wont to loose the beneifits i am presently receiving….
When you say you retired on the heart/lung bill, I am going to assume you retired with full disability pay through workers’s compensation, not just the medical benefits. You can never lose the medical benefits while you are receiving permanent and total disability benefits, but 2 things come to mind. PTD benefits for dates of accident after 10/1/03 end at age 75. Second, I have had carriers move to end PTD benefits based on improvement in medical condition. Your doctor must have advised you could not perform sedentary work. Yes, you can volunteer, but I would avoid anything that would approach full time volunteer work, or work that involves physical labor. It’s not an uncommon question. People don’t want to sit around in retirement. But an insurance carrier is paying based on your disability. The older you get, the more likely the carrier will leave you alone, but if you are under 62, use your common sense. It’s not police or firefighting work they want to know you can’t do, but the sit down office job. So don’t let a carrier get 40 hours of surveillance tape on you working, or you will be accused of voluntarily limiting your income and they will pull the plug. If the carrier voluntarily picked you up as PTD, they can suspend those benefits without a court order. If they paid you pursuant to a court order, they have to get another order to suspend benefits. Again, just use your common sense, make it a part-time endeavor and you will be safe. Enjoy.
I am paramedic but work in a fire service. I even wear a badge that id me as a firefighter. Recent heart problem on the job, county made it workers comp. Although not fire, I routinely respond to working fires. I just don’t pack out. Iwork the same hours in the same stations, go to the same fires and am special risk under fl retirement. can Heart lung cover me?
Below is a copy of Lansford v. Broward County Board of County Commissioners. It is one of 2 cases from the appellate court that tries to define exactly who is a “firefighter” under the terms of this statute. Read it and see if it answers your question. But if your employer put your injury under workers compensation, there is nothing to be gained by having it filed as a heart/lung case. The heart lung bill helps get an injury accepted under workers’ comp. It doesn’t do anything else. You are already there.
BROWARD COUNTY BOARD OF COUNTY COMMISSIONERS, Appellee.
Richard A. Sicking, of Kaplan, Sicking & Bloom, P.A., Miami, for appellant.
Anthony J. Beisler, III, of Anthony J. Beisler, P.A., Ft. Lauderdale, for appellee.
McCORD, GUYTE P., Jr. (Ret.), Associate Judge.
William R. Lansford appeals from an order of the deputy commissioner denying his claim for TTD and medical benefits on the ground that he was not a “fireman” as defined in Section 112.191(1)(b), Florida Statutes (1983) and therefore not entitled to the presumption set forth in Section 112.18(1), Florida Statutes (1983). We affirm.
Lansford is employed by the Emergency Services Division in Broward County, Florida.
[A]ny duly employed uniformed fireman employed by an employer, whose primary duty is the prevention and extinguishing of fires, the protection of life and property therefrom, the enforcement of municipal, county, and state fire prevention codes, as well as the enforcement of any law pertaining to the prevention and control of fires, who is a member of a duly constituted fire department of such employer, and not a volunteer fireman.
At the hearing on the claim, Lansford testified that his duties involve “[trying] to limit the loss of life. We try to assist anyone that is injured from any cause.” Other evidence adduced at the hearing showed that, as a part of these duties, EMS paramedics are called to all structural fires to treat fire victims or injured firemen. Paramedics do not, as a rule, enter the structure, but wait outside to assist the injured as they are removed. The skills test administered to firemen involves hoses, pumps, water pressure and fire equipment, while paramedics are tested on knowledge of medications and rescue techniques. Transfers within the ESD between the fire and EMS sections are available if the pertinent skills test is passed.
The deputy denied Lansford’s claim. He found that, because a “fireman” was statutorily defined as having the primary duty of extinguishing fires and protecting life and property therefrom and Lansford’s principal duty was medical care, he was not a fireman entitled to the presumption of Section 112.18(1). We agree.
The authorities cited by Lansford herein are not persuasive. In Daniels v. Division of Retirement, 389 So.2d 340 (Fla. 1st DCA 1980), the claimant was accepted as a firefighter as well as an emergency medical technician; there was no issue as to his identity.’ Similarly, Stanford v. Florida, Claim No. 266-48-6438 (1977), aff’d. IRC (1978), involved a forest ranger who had the stated “regular” duty of fighting fires. Kanarr v. Broward County Board of County Commissioners, Claim No. 451-90-1883 (1984) is factually on all fours with the instant case, but we decline to follow that decision.
criteria to qualify as a fireman. It was not contended in Kanarr, and is not contended here, that a paramedic shares with firemen the numerous other duties enumerated in the statute which are not concerned with the protection of life. Therefore, the deputy was correct in his conclusion that Lansford was not a fireman entitled to the presumption of Section 112.18(1).
ERVIN and WIGGINTON, JJ., concur.
I was a EMT and firefighter here in Fl. in Nov. 1998 I suffered a heart attic while on duty EMS 24/48. I was denied workers comp. and LTD. I had to use my medical insurance to cover my heart attic. My personal physician and the cardiologist Dr. both stated it was in-line-of-duty disability and checked ( sever limitation of functional capacity; permanently incapable of any kind of work; totally and permanently disabled from-gainful employment) I have tried to get SSI and was denied. All this after 17 years with the county.
My thought’s are at the time of my heart problems we had the 112.18 and it clearly states that I would be covered. Have I been derailed from this benefit I know it has been 10 yrs ago and I did file. I had to quit so I could be rehired from 24/48 to 40 hr week a different class after a short period of time. I had to quite I couldn’t handled the stress and ended up having a third heart cath. After changing to a 40 hr work week and taking a 65% reduce retirement pay just to cover my health insurance. Based on the fact that I did qualify for LTD and they turned me down can I go back and get back payments for all these years? I know you talk about the 180 days to file a claim I did the first time nothing had changed from the first time so why would I file again. so I had to retire (quite) the insurance company now said I needed to have file a new claim when I retired. They wouldn’t pay then why a few months later.
My concern is the 2 year statute of limitations. Once workers’ compensation denies your claim, you have the right to file a Petition for Benefits and try and obtain your benefits through legal means. The statute begins to run from the date of accident. As you pointed out, in Heart/Lung cases, a claim must be filed within 180 days of retirement.
You need to make an appointment and speak with an attorney.
I am employed in dade county, correctional officer and was injured on the job . I was placed on the heart bill from the incident. Now, the risk management dept has closed my case. I need to know if the dept can legally close out my medical case. I am stil attending the doctor for check up but my health insurance is now paying for it. What can I do to get back on the heart bill and to receive medical treatment under the bill.
There could be legitimate legal reasons why it changed. If you went more than a year between medical appointments, the case may have closed. If the work related condition was no longer the “major contributing cause” of the need for treatment, your employer could in theory, end tretmnt under workers’ comp. But the latter is a call for your doctor, and generally you are made aware by letter that your doctor has made such a statement. If you were consistentely seeing a doctor and you have no idea why you were switched over to your personal insurance, get to a lawyer’s office. As I said in my last post, these are contingency cases and a quick review of your medical records will likely reveal the reason. Also, carriers will get away with whatever you let them get away with. It’s like being turned down for Social Security. A certain number of people will go away without quetioning, or fighting for their rights. Carriers play the odds employees will do nothing about their decisions all the time.
My husband had problems at a fire and was diagnosed with a genetic sodium channlopathy called brugada syndrome. his ff friends are telling him he has rights under the FL Heart lung law. He wants to hire a lawyer. I keep telling him he is wasting his time and money because this is not heart disease but a clear genetic syndrome documented in his recent medical records. Am I right?
I had to look that one up. By and large I would say you are right. The condition has to be related to heart disease, but there is case law finding arrythemias compensable, and you normally wouldn’t affiliate heart electrical function with “disease” in the classic sense. At least I didn’t. From what I read, you can diagnose the condition by DNA testing or by ECG, looking for a particular pattern. I would guess your husband has probably not had a DNA test, so the diagnosis was made by ECG. It may be worth his while to have a second cardiac opinion, since the diagnosis may cause his cardiologist to suggest a less demanding career.
The heart/lung bill creates a rebuttable presumption. If the desease is genetic, the dfense attorney will use the information to prove the cause of the condition is not work related and your husband could lose his case. But hiring an attoney is free. These are contingency cases. A good lawyer will throughly investigate before filing suit. So it won’t hurt to let him get some legal counsel and let another pair of eyes look at the records. It won’t cost a thing, and he may have a case in there somewhere.
The City does not yet know he has this yet. We have a meeting coming up. They told us since we did not tell them that he had hypertension in what they said is required within 2 years of being tx’d that they will not cover any heart condition and then threatened us and said if we take them to court we will have to pay all the City’s money back if we lose. They do not even know about the Brugada yet. We have thus gotten scared because even though a representing attorney may be free we would have to pay the City back all their costs. I have googled some cases and found one where Dade County was being paid several hundred thousand dollars so we are scared to death and feel paralyzed to do anything as we would lose everthing we have. We will eventually get genentic testing but data varies as to results. Only about 50 to 70% of Brugada pts. actually have a positive result due to possible yet undiscovered gene mutations by scientists. Thanks so much. We feel crippled. This has been a nightmare. My husband went into a fire a strong man and came out forever changed. He is devestated.
Well you are right about the costs. But the statute of limitations argument is a weak one. Generally, the ststute of limitations runs from the date a reasonable person knew or should have known they had a work related injury. Not all people recognize high blood pressure as work related. You can also argue this constitues an exposure injury, so each day worked is a new injury. The employer would have a difficult time with prejudice in this case. Late notice must be shown to be prejudicial. Prejudice would be difficult to show here.
I am a firefighter, passed the pre-employment physical 12 years ago with no indications of hypertension, and a physical each of the last 10 years, without any noted hypertension. I recently filed a workers comp claim for hypertension from work related stress, and was diagnosed by the employers workers comp cardiologist as signiciant “unspecified essential hypertension” on two seperate visits over two months. The treating cardiologist placed me initially in a no work status for the first month than to limited duty now, pending another visit in one month. The treating physcian prescribed two seperate medications noting “significantly elevated” blood pressure. He requested a EKG doppler of the heart and stress test, but until after my blood pressure stablizes. I have not violated any past medical recomendations.
Questions: Can the “unspecified essential hypertension” be covered under the Heart lung Bill standing alone? If not, what additional diagnosis must be made to supplement the “unspecified essential hypertension”? Should I be requesting for the one time change of cardiologist to my own doctor?
The Bivins v. City of LKeland case dealt with essential hypertension. In a nutshell, you have all the makings of a standalone workers’ compensation cased based on hypertension. All Bivins said was that in cases of essential hypertension the doctor must specify whether or not it is arterial or cardiovascular in origin. Since it must be one or the other, and both are likely compensable, you can’t really go wrong. Yes the claim may be denied because essentil hypertension, means hypertension of unknown origin, but it is well settled among practioners that essential hypertension is arterial or cariovascular in origin, and therefore compensable.
Once you have lost time from work as a result, and lost time for more than just the time it took to make a dignosis or complete testing, you have satisfied all the elements of a viable claim under the heart/lung bill. You dont want to request a one time change unless you are at an absolute dead end. When you request the change, if the carrier responds to your written request within 5 days, the carrier selects the doctor. So you are not likely getting to a doctor of your choice.
My advice would be to have an attorney file your claim. If it is denied, a deposition of the doctor will likely fix the problem. You could also ask the cardiologist to address the issue of cardiac v. arterial. You may get a favorable response from the doctor, but I would go to a lawyer before I did that. Its safer and should not cost you any of your benefits. If successful, the carrier would be responsible for fees and costs, but you need to discuss your responsibility for costs if you lose you claim.
But so far, sounds like a good claim to me.
My husband is a current law enforcement officer of 13 years. In March of this year he suffered 2 heart issues and this month had another issue which resulted in a pace maker. His employer is pushing the issue of him applying for the heart bill, which I think he should take. We have asked several people about the bill and have had several different answers about what benefits he may receive and if he can work a different non law enforcement job if he decides to apply for the bill. His doctors have already told him to find a less stressful line of work and leave law enforcement. What benefits could he receive and will he be allowed by the bill to work outside of law enforcement?
The bill allows all medical treatment and medications to be paid for under the bill. If he looses wages at his regular job, or must take another job at lesser earnins, he is entitle to 80% of 80% of the differential in wages. Always consult an attorney before filing you claim. Buy it looks fairly straightforward.
I have worked in the Department of Corrections for 10 years. My age is 67. I am still employed. I have the following concerns. I took the pre-employment physical prior to employment. I was diagnosed with Sage 4 Renal Failure on 12/29/11. I am a type II diabetic taken and also I have Hypertension. Over the years I am sure the diabetic and hypertension have gotten worse due to the type of employment. Some Diabetic medications were changed to two types of Insulin My question is do I qualify to pursue anything under the Florida Heart and Lung Bill Thank You.
That is a tough question. You bear the burden of proving hypertension is the major cause of your disability. 43% of all renal failure is caused by diabetes. A little over 20% of renal failure cases are caused by hypertension. You have both risk factors, and your doctor might very well tell you your kidney disease is caused by a combination of both diseases. Have a chat with your nephrologist. Ask if they can tell you the cause. I expect it’s going to be a combination, but if high blood pressure is more than 50% of the cause, you might have a case. The condition must put you out of work in order to be compensable.
im a paramedic in nw fl been medic for 22 yrs i just had open heart surgery 3 wks ago im wanting to know is paramedic’s covered under this bill?
My husband had a stroke while on duty as a Firefighter. He had just drove the ambulance across town and brought the patient in to the ER when one of he’s guys guys said Lt. are you ok you don’t look ok, He said yes we just had a code save I’m sweating from that. Long of it is that he did have a major stroke with 4 clots and TPA was given but were are still fighting the AFIB and it was a year as of 9/of last year. He did return to work for 8 shifts and while on duty again went in to AFIB. Does he meet the heart lung bill. Work comp has paid everything.
Since workers compensation has paid everything so far, it sounds like compnsability is not an issue. There are two medical issues mentioned. A stroke and afib. There is an appellate case on both issues. Remember, we are crawling along on a case by case basis on this law. Some employers don’t fight these claims vigrously, others deny everything. If the cardiologist says the stroke was caused by heart disease or hypertension, it’s covered. If not, it’s unrelated. The same is true of the afib. Nothing is black and white. There have been several cases which I thought were far afield from what I typically thought of as heart disease.
The issue which is not clear is whether your husband is losing time from work because of his condition. If so, you need to consult with an attorney to see if his conditionss could be the result of heart disease or hypertension.
While working as a Police Officer for 23 years, I was diagnosed with high blood pressure (Hypertension) on Jan 2005 and placed under the florida heart bill. In August of 2006 I took a normal retirement and pension from my dept. and went to work for another police dept. as a Police Officer. While working for the other dept. for 2 months, I suffered a stroke and was covered by my previous dept. under the florida heart bill. While I was unable to work because of the stroke, the new dept. terminated me because I could not complete the probationary period. After I recovered I had applied for other dept. but no dept. would hire me. In April of 2011, I had Heart Bypass surgery and was covered by my original dept. under the heart bill. My Cardiologist told me that I won’t be able to work as a Police Officer because of my condition. My question is, am I entitled to any compensation because I can not work as a Police Officer.
Oddly enough, no. The presumption just gives you a leg up on compensability of your condition. But once your condition is considered work related, you are on the same footing as every other injured worker. You can receive temporary lost wage benefits prior to MMI, but once at MMI, you must be permanently and totally isbled in order to collect lost wages. The current definition of PTD is an inability to perform sedentary work within a 50 mile radius of your home. Police and firemen are always tough clients because a minor injury can end their career with no compensation for lost wages due. If you meet the definition of PTD you can claim lot wages to age 75, if not, just being off the police force may not entitle you to any further lost wages.
No. You have to be unable to perform sedentary work within a 50 miles radius of your home to receive PTD benefits. Firefighting is not sedentary work. Sedentary work requires the ability to sit 6 hours a day and lift objects weighing up to 10 pounds. So the rule requires your doctor to provide work restrictions, essentially saying desk work is beyond your capability. The 50 mile radius is just designed to keep insurance companies from requiring rural claimants drive long distances to find sedentary work. But your doctor must put you in a less than sedentary category. Work is generally defined into broad categories like very heavy, heavy, medium, light and sedentary. Think of a receptionist that answers a phone, that does very light, 10 pounds or less, filing. That is sedentary work. When your doctor says you can’t do that kind of work, we are cooking with Crisco. Don’t you love this law? Written by insurance carriers, for insurance carriers and blessed by our pro-business legislature.
Seriously, most firefighters are in great shape. Only the most serious, painful injuries, or heart conditions are enough to prohibit sedentary work. So the heart-lung bill makes a lot of claims compensable, but rarely results in a firefighter or policeman with a PTD claim.
I am law enforcement, almost 25 yrs of service. I just had an attack of “atrial fibullation” and had to be hospitalized for several days. I have an option for a complete cure, atrial ablation. A doctor stated to me it can be related back to stress and possible hyper-tension although I have never been diagnosed with it. I have raised blood pressure, but not what would be called high blood pressure that requires medical intervention. I had a rep call from the workman’s comp office out of Tallahassee and got the feeling that they’re looking for any reason to deny my claim. Is there any history of claims involving this type of ailment? What was the outcome?
There is a 2010 case, almost on point. Type in Martz v. Volusia County into your search engine. AF is considered heart disease all by itself, and a few days in the hospital was considered a long enough time to establish the disability requirement. So the claimant won.
After 39 years in law enforcement, 17 with the State of Florida, I was just diagnosed by a cardiologist with cardiomyopathy, the cause of which he cannot explain. Tests show that 3 years ago my heart was better than average, now the same nuclear stress testing shows a marked decrease in function. The only difference, a transfer to a much higher stress position in the agency. I am now on medication but have not lost any time. Workers comp turned down my claim without even asking for an exam or records, for that reason. What am I to do? No one seems to have an answer as how to make an effective claim since I have not lost time.
There is nothing to do. Disability is a required component of a claim. The definition of disability however, can be just a few days in the hospital. It doesn’t mean a few missed hours of work though. The definition is still up for grabs. Here’s what you don’t do. Don’t retire because of the condition. Let your doctor restrict you if need be. Missed time from work because of the condition (more than a few hours) constitutes disability. And don’t move to another department or employer, where a new pre-employmnt physical would be needed.
So my advice is wait. If it becomes debilitating, you will be on comp. If the condition remains stable, be grateful. If you have to retire because it’s your time, well at least there is no more stress.
Police and firemen are often my most difficult client’s, and not just in heart/lung cases. In any type of comp case they are difficult clients because they do specialized work that pays well. One minor injury may be enough to end their career because they have to be able to pass a physical. But the injury rarely prevents other employment. Meaning they are injured, off the force and earning a quarter of what they made before. Welcome to Florida workers’ comp. A world of unfair.
I have been a Corrections officer for over 20 years. I was diagnosed with both A-fib and A-flutter last year. This required missed work on several occasions both last year and recently. One instance was a 3 day stay in the hospital while being placed on a new medication. I received a double ablation not quite three weeks ago. I was in normal rhythm after completion of the procedure, however the follow up (yesterday) revealed I’m back in A-fib again. Medication has been increased. Possibly looking at ‘shocking’ my heart and possibly another ablation in a few months. I am currently on light duty per my cardiologist due to the blood thinners I’m talking. His fear is for me to be in a physical altercation where I may be injured or cut. My supervisor suggested looking into disability to see if it is an option. Thank you.
First, let me thank you for being a corrections officer. I think it is one of the most demanding jobs out there. You are always on high alert.
If you are unable to return to work because of your heart, there is in line of duty disability available through the state. If you are over 55, you would probably qualify for Social Security disability.
As far as the heart/lung bill, if you passed a pre-employment physical, next time you miss a few days, file for workers compensation. You want your treatment and medicine covered. The disability requirement is satisfied once you miss work for more than just “day” long treatment. Once filed and accepted, keep your medical care open by seeing your authorized provider at least once a year. You can collect lost wages for up to 2 years while on temporary disability. Permanent disability if you cannot perform sedentary work. Just understand you don’t collect for being unable to perform corrections work on a permanent basis, but able to perform other work.
You do not want to find yourself in that no mans land of inability to work in prison, but able to work doing something less stressful. Thats a bad pace to be.
As far as I am aware, atrial fibrillation is considered heart disease. See, Martz v. Volusia County Fire Service 2010, and Carney v. Sarasota Sheriff’s Department, 2009.
If you missed some time from work or have a restriction, you may have a case. Time to talk to a lawyer. You are welcome to call my office, depending on where you are, I can suggest a lawyer. Look at the Martz case. If you find a case, specifically on point, try hiring the lawyer who handled a similar case. Always a good start.
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I have a question in regards to work comp. and a request to our pension for the pre-employment physical before covering a presumption under the heart and lung bill.
According to the Statute, it just states that you must have passed a pre-employment physical. In order to be accepted into the pension in our city, you must pass or you will not be hired.
Can the work comp. carrier still request the records or can the individual just get a letter from the pension office stating that the individual passed the physical with no problems.
The workers’ compensation carrier will generally ask for the physical. Once you have a work related injury, it’s a first party claim, just like a homeowners’ claim. To get coverage, you have a contractual obligation to cooperate, which means the carrier gets to plow through your medical records.
I have had many clients pass a physical, with signs of high blood pressure. Just because a person has high blood pressure, does not mean they won’t pass a physical. But it may preclude benefits under the heart, lung bill.
Thank you for the information. The law enforcement side has a Physicians Assessment form- CJSTC75 and CJSTC75A. Can this form also be used by the Firefighters as proof on the pre-employment physical that you were free from the 3 Presumptions?
Section 7 addresses all 3 of the presumptions. I would think that if it can be used by law enforcement, that it would be able to be used by the fire department as well.
Thank you in advance for all the information you are providing.
I have been in Corrections for 16+ years. Around early 2010 I had went to the doctor cause I wasn’t feeling well, which was when my doctor found that my blood pressure was elevated. (This was during the time when the company I had been working for since 1997, contract was going to be taken over by a new vendor.) Around mid 2010 the new vendor did take over our facililty and I was blessed to gain employment (at the same rank) with the new agency. (But what I didn’t know was the increased stress levels I was going to endure… transition, management, change, etc…) Within 6 – 8 mos (early 2012) of being hired on the stress was so intense that i found myself via EMS from my doctors office one morning after i got off work, due to “Hypertensive Crisis”. Well to this date my blood pressure still hasn’t improved. I don’t know where to start or how to go about the Heart Bill. Any helpful information or guidance would be great. thank you for taking your time to review this. Have a wounderful day.
Two thoughts. First, many new employers require a new physical and you didn’t mention if the new vendor required a physical. If they did, you need to have passed with no signs of high blood pressure or heart disease. Second, you may file a claim under the heart lung bill, once you become disabled, which means an inability to perform your job duties or lost time from work relative to your high blood pressure/heart disease. The lost time needs to be more than diagnostic testing.
Having said that, I am very aware of the realities of today’s economy. Any lawyer who tells you that filing a workers’ compensation claim does not affect your relationship with your employer is being unrealistic. In advising client’s whether to file a claim, I try to balance their medical needs against any potential negative impact it may have on their employment relationship. I have told client’s to use their private health insurance before, especially when their claim may be difficult to prove. If you have a continuing need for medical care, or you know you can’t continue in your current circumstances, filing the claim is a no brainer. But talk to your cardiologist first, as their testimony can be key to the successful pursuit of your claim. We want the cardiologist telling you there are a variety of causes for your high blood pressure, nothing genetic, nothing that he can put his finger on. You win if the doctor can’t find a specific, non-work related cause for your high blood pressure.
Thank you for your reply. Since asking this question, I have since found out that if individuals were hired with us after 2008 there is a form that the physician fills out at the pre-employment physical. It is FDLE form CJSTC 75 and it has the presumption language on that form to show yes or no to the big 3 conditions. The form started in 1996 so for some of the Florida people out there with the same question, they might want to investigate. As for myself or anyone else in our city that was hired prior to these dates, I guess we are stuck with giving them access. If asked for records to determine whether they are going to cover a cardiac problem, I tell my fellow employees to narrow the information released to only records relating to TB, Cardiovascular Disease and Hypertension with respect to the pre-employment physical.
While I agree with your response, my reply was intended to be broader. The workers’ compensation statute gives the carrier broad access to your non-work related medical records. Carriers routinely subpoena every single medical record from my clients. The only time I have been able to successfully block the carrier’s access to medical records has been to block psychiatric records when the claim was for a physical injury. Any medical records relating to physical problems may lead to admissible evidence and are therefore discoverable. In short, I have not had much luck keeping my clint’s personal records personal. Once you file a comp claim, your records are wide open. Another reason to consider whether to file a claim.
I was diagnosed with Pericarditis and Pleurisy by a cardiologist years ago while working as a police officer. I later learned that it was caused from SLE. Since then, the unpredictability of the job, stress, and exposure to the elements has exascerbated my condition causing me to be off work [FMLA] for several weeks. Have there been any cases under this bill relating to Pericarditis/Pleurisy?
There is only one and pericarditis was mentioned in passing. The general premise is that if you have high blood pressure or heart disease and you had a clean physical, you have met your burden. You don’t have to prove why you have it. The burden then shifts to the employer/carrier to prove some non-work related cause.
If, on the other hand, your doctor comes up with a non-work related cause, it will be hard to move off square one. You bear the initial burden to have either a work related origin for your high blood pressure and I have never seen spot on testimony in this regard, unless there was some traumatic origin, like a chemical spill, or an idiopathic problem. Meaning we don’t know why you have it.
If your doctor says your high blood pressure was caused by lupus, it’s not work related. See my next post.
I currently work as Firefighter and have been for 20 years. I had chest pain at work. Full cardiac work up and I was diagnosed with Idiopathic pulmonary hypertension. I have had a pre-employment and yearly physical with no issues up to this point. Work comp paid for all the testing up to me being cleared back to duty by the cardiologist who said the IPAH was not related to my heart. I just got a phone call from workers comp and they have denied my claim for any further payments related to this condition. I have no pre-existing conditions. The cardiologist stated that he needs to see me back in 1 year to check my pressures with an echo. Why is this not covered under the heart and lung bill? Should I move ahead and hire an attorney?
You need to hire a lawyer. If the doctor says the IPAH was not work related, then what caused it? If there is a good answer, you may lose. If there is a maybe it was caused by this or that, answer, you could win. The carrier must rebut by proving a non-work related cause…and fortunately for you, we know little about why certain people get high blood pressure. Yes there is family history and weight, but those are rarely determinative. Genetic abnormalities are a good defense, but I didn’t hear that in your question. In short, the cardiologist must state what the non-work related cause is the major contributing cause and doctors hate to be pinned down to anything.
First, thank you for your quick response. The cardiologist filled out the work comp question form. He put down 0% preexisting or my personal contribution to the IPAH. He also put down only 10% work related. It did not add up to 100%. He just stated possible work related in his opinion. Very frustrating because I know this IPAH is going to get worse. I will retain an attorney. Again, thank you for your assistance.
In April of 2012 I went in for a checkup with my doctor. I advised him I had been feeling out of breath with my heart racing. I was referred to a cardiologist and have been diagnosed with atrial fibullation. I had to have my heart brought back into rhythm electrically (1 day at the hospital for procedure). Four days after the procedure I was admitted into the Emergency room again for my heart racing. Atrial Fibullation was back and I was advised I have hypertension also. I was put on medication to attempt to control my atrial fibbulation and hypertension. I continue to have issues with atrial fibbulation even with the medication. Now my doctor wants me to have an atrial ablation which is only 80% affective. In 2003 when I was hired I passed my employment physical with no issues. Do I even have a case??
Atrial fibrillation has been deemed to be a form of heart disease at least in the court commentary. See Martz v. Volusia County.
In 2004 after learning I had high blood pressure my health carrier denied my medication and informed me I was a heart bill candidate. I have since been treated and monitored yearly under the care of the workmans comp doctor. I retired from my agency in 2009 and relocated to central Florida. I was assigned a new cardiologist and have been faithly been under his care since. I am now employed by the state as an Investigator for the State Attorney’s Office. Two weeks ago my doctor administered a stress test and discovered I have a blockage. Is this a new claim through the State or does it carry over from my previous claim?
It should carry over from our prior claim. In most cases it is always preferable to expand on an open claim. The physician is already authorized, on board and generally only seeking authorization for additional testing.
Responses on this blog should not be construed as legal advice. Always talk to an attorney about your specific circumstnces.
No previous heart or lung issues.Recently diagnosed with asthma. Law enforcement since 1990. Could this be covered by this bill?
I have not seen any cases involving asthma covered by this statute. You should consult an attorney however as, depending upon the circumstances, some cases of asthma have been found to be work related, standing alone.
I have been working as a Law Enforcement Officer for 23 years. I was first hired as a mechanic with the agency and then went through the academy two years later and then transfered to patrol. Prior to being hired as a mechanic I had to have a physical done, which did not show any high blood pressure. On July 24, 2013 I had my fiance take me to the emergency room due to having numbness in my left arm, some slight chest pains and cold sweats. a complete work up was conducted, ie. ekg, 2decho, blood work and a nuclear stress test. the results came back that i did not have an event and my heart was fine. they diagnosed me with stage one hypertenssion (high blood pressure). I worked the day that I went into the hospital and was kept through the next day causing me to miss work. Should I make a claim to workers comp or have i not met the requirements?
The short answer is it probably is. But always be aware that if you change jobs, you will have to take a new physical and your hypertension would be considered pre-existing. The condition you described needs to satisfy the disability prong of the test. Please read Bivins v. City of Lakeland by typing it into a search engine. Bivins suggests missing time from work for medical tests alone, does not make a person disabled for the purpose of satisfying FS 112.18. There must be a medical restriction that limits your ability to fully or partially perform your job. However, also read Martz v. Volusia County which states missing work and being unable to perform job duties, even for a day, satisfies the disability prong of the test, which only requires temporary disablement. So if your doctor said you were off work that one day, that appears to be enough.
My comments on this blog should not be construed as legal advice, so please always consult an attorney about the specifics of your case.
You can qualify at any time, as long as you are still employed. (You also have 180 days after you retire to file a claim, but I do not recommend waiting until after you retire to file a claim for a variety of reasons!) But remember, you still have to meet the disabled prong of the test to make a claim stick. Read some of the other posts in this regard. You must either be temporarily or permanently restricted from performing your regular job duties because of your high blood pressure. The courts have interpreted temporarily restricted to include the time off incurred to be tested for your condition. So you still need to have missed some time from work to qualify.
My husband is an 18 year fire fighter with the same department. This year his department used a company called Life Scan to do their annual physicals. During my husband’s evaluation, they discovered he has an Aortic Aneurysm. They immedediately put him on light duty and he saw a Workman’s Comp doctor the next day who ordered a CAT scan to verify. We are now waiting to see a Cardiologist this Wed. It seems like we are too early in this to know what will happen, but someone has already told my husband he should get an attorney. My question is, when or how do we know if we she hire an attorney?
Aortic aneurysms can be caused by many things, among them atherosclerosis, or hardening of the arteries, which weakens arterial walls, hypertension(high blood pressure), local injury to the artery, which also could be work related, aging, STD’s or a congenital abnormality.
So compensability depends on what the cardiologist opines is the cause for the problem. If it’s pressure related, you should certainly talk to a lawyer.
How does the Heart Bill work with other health insurances?
Health insurance is used if the claim is denied. A denial of a claim is usually made formally on a DWC-4 form. That formal denial gives a claimant the right to use their health insurance to get care or testing done.
If it is a compensable heart/lung case, your private health insurance never comes into play.
There is at least one appellate case that says a-fib is considered heart disease. But there are many causes of a-fib, so you should never read too much into another case. Each person’s heart condition is evaluated separately. In heart/lung cases, I consider it a good case if the cardiologist can’t determine a cause for my client’s condition, or comes up with many potential causes. In those cases the statute gives the claimant the presumption the cause is work related.
It’s when the cardiologist determines a specific, non-work related, cause you have to worry. But at least one case has said a-fib is indeed, heart disease. Look under the 4 elements section of my article for the cite.
Anonymous I work as a firefighter/paramedic in south Florida. About 18 months ago a full body scan revealed I have an aortic arch aneurysm. Is this something that would fall under heart/lung bill, if it is determined I should not due this strenuous job anymore?
Aneurysms have been characterized as heart disease. The disability portion of the statute can be met with complete or partial inability to perform your usual job functions. So being restricted from some firefighter duties is enough to deem you “disabled”.
First, let me say I would like you to email me privately as there are too many issues to discuss in one reply. When you contact me I need to know if the comp case you settled was against this same employer. When you release a carrier, you generally release all prior claims, but if I understand you, the heart claim was never filed. Second, there is the issue of notice. You are way late in filing a claim. Third, your claim may have preceded the heart/lung bill altogether. If your heart attack occurred before the bill went into effect, there was no coverage. Fourth, you have to be disabled from work because of your heart condition to qualify for benefits.
That is really a question for your lawyer. One of the elements of the claim is disability, which I am confident you meet, given how sick you were. Ultimately though, in order to maintain a claim for total disability, a doctor must state you are unable to work. I am oversimplifying, but most claims under this bill result in medical care, not ongoing lost wages, because the cardiologists involved can be very unavailing. They tend to state police and firemen are capable of some work, even though they may not be able to handle their job. So one of the big picture questions you and your lawyer have to clarify is: Am I able to return to my job, another job in the department, any job? After 30 years, if your doctor wants you out of that stressful environment, you may want to stay out. Second, be clear on whether your lawyer has put the file into litigation. Once in suit, these cases head to trial in 7 months. If the file is not in suit, your lawyer may be trying to softball the claim in, and that is an ok tactic too, but you have no firm trial date in sight. Know if your lawyer has sued for compensability, then sit down and discuss your worry about which route to take. Your lawyer will know which way to go.
In 1994 I was diagnosis with a heart problem, It was determined Line of Duty the fire department filed line of duty injury. The states says that since I can work another job I cannot receive my inline of duty disability So I cannot work as a firefighter Paramedic but had to do other jobs. Because I had only 6 years in the system I loose all retirement benefits. The attorney i had at the time didn’t understand the State Statutes. I receive medical for life but not time off work. Is there anyway to get benefits for retirement since i was removed from service (terminated). I was in FRS.
I understand your injury was in line of duty, but if you had to give up paramedic work because of this injury, I am thinking there should have been in line of duty retirement. I would have to look up the number of years you need to be vested in the retirement system. I think it’s ten, but as I sit here…and it’s late when I have time to post I could be wrong. My direct email is leslie@lawyertampa.com and I will look that up for you tomorrow.
I am covered under Heart and Lung bill. I am retiring in 4 months. Do I still have the $50,000 death benefit once I retire as described under the bill at the beginning of this section?
And it goes on to talk about death benefits. The statute says and political subdivision, City, County, etc can acquire insurance contracts that cover disability. So you can have a seperate policy that covers disability as well, which is what I suspect you are referring to. Since it is a policy that is personal to your employer, I cannot comment on the requirements. But the Florida Statute, 440.16 makes no mention of retirement, just that death flows from the injury within 1 year, or 5 years with continuous disability.
Hi. I have been a law enforcement officer in south Florida for almost 25 years now. I was diagnosed with hypertension two years ago and have been taking B/P meds since. 4 weeks ago I was diagnosed with an ascending aortic aneurysm. The workmans comp cardiologist has already classified my aneurysm as ‘work related’. Being that my health will never return to the condition it was prior to my employment, should I not be entitled to ‘Permanent/ Partial Disability payments?
There is no category in Florida titled permanent partial, although there is such a category in other states. In Florida, there are 4 categories for payment of lost wages or disability. Three of those categories are based on your ability to work. Temporary total is an off work status. Temporary partial is paid to a worker, prior to reaching MMI, when they are released to work with restrictions. Whether they are owed money depends on whether the employer has work available. If they do, and the employer pays the worker more than 64% of his pre-injury salary, comp owes nothing. The last category is permanent total, which is paid after an employee reaches MMI and is determined to be unable to perform sedentary work.
Impairment benefits are owed purely as a result of having a permanent impairment. When a worker reaches MMI, the authorized doctor is supposed to refer to the Florida Guide to Permanent Impairment and rate the workers medical impairment. The rating is to the body as a whole, so for instance a 6% rating will garner 12 weeks of benefits, the rate of which is based on the workers AWW. Cardiologists are often unfamiliar with the rating guide and know nothing about proving a rating. They just release a worker to return to work assuming the workers has no rating, because they can work. If you’ve had a heart attack, you have a permanent impairment and are due a rating.
Most often workers are treated by the cardiologist they saw in the hospital and comp authorizes them, because care is complicated. So many workers have authorized doctors with little to no knowledge of their obligation to provide a rating. If the worker doesn’t know this, the carrier isn’t going to point it out. And ratings in heart cases are often 20 to 30 percent and that ain’t chump change. Call a lawyer if it’s happened to you.
i am a florida law enforcement officer injuryed in the line of duty .I was pt on 1-1-13 in the line of duty and paid into the frs a 3 % retirement then I received pt work comp and now soon to get ss can the state take money from the in line of duty pay from with I was investment retirement .the law reads workercomp and ss. I paid into the retirement fund . I need help.
I think you may be running into what we term a “Grice” offset. It simply is a cap on public employees benefits. It states the combination of comp, social security, and pension benefits can’t exceed 100% of the pre-injury salary. It may look like they are reducing your pension, but see if this cap is being applied.
I have been a correctional officer for 18 years in Florida, from 1997 – 2008 I has no issues with blood pressure/ hypertension. In 2009 I started having issues and continue to battle the hypertension. I have decided to resign from my job in mid May 2014, because in the last 3 years my battle has not improved, I have been in and out of ER’s more in the last 3 years then in my entire life span….
Q: Does the lung bill fall under a Disibility claim such as SSI?
Q: and is the WC & lung bill a seperate claim?
Your hypertension issues, or any issue for that matter, creates two separate claims. One for workers’ compensation, one for Social Security. If you settle your compensation case and receive a lump sum or receive a periodic payments for lost wages, Social Security will offset some of your Social Security income. The basic premise behind the offset is so people don’t receive more money monthly on disability, than they earn working. So Social Security or workers’ comp, reduces their payments a bit when you receive lost wage benefits under both programs. Which takes the offset just depends on the laws of your state. Proper timing of the comp settlement, or language in the settlement paperwork can minimize the offset. A lawyer can come in handy here.
The second thing that puzzles me is why are you resigning your position? If you are resigning because your high blood pressure is making work difficult or impossible, you really should talk to counsel before you resign. Once you resign, you make making a claim for lost wages under comp much more difficult. You have voluntarily limited your income by resigning your position. If a doctor does not feel you should continue, why would you pass up the potential comp claim?
A quick call to any heart lung lawyer, before you resign, will make all of your options clear. Then you can decide what to do with all the facts.
Sorry for the delay in responding. In Florida Statute 112.18 a claim must be made within 180 days of leaving the first responder position. In all other aspects, the statute of limitations in the regular 440 statute apply. So the statute has lapsed because your dad passed and left his job at least 4 years ago. The occupational disease statute has a longer limitations period, but heart disease has not been listed as an “occupational disease” for any first responder position.
Because heart disease is an ongoing event, like a repetitive trauma, a first responder must file a claim within 180 days if leaving the job, or within 2 years if they are unable to perform their first responder position but stay employed in some other “non-responder” position.
The other thing to watch is there is a rolling 1 year statute of limitations on medical care. If your case is accepted by comp and you leave employment, if more than 1 year passes between doctors visits (and you are not being paid lost wages) the claim can close.
Greetings. Thanks for your replies! I retired recently after 30+ years in Florida law enforcement. About 2 weeks before retirement (burning leave time at the end), I was diagnosed with AFib. I’ve been shocked (cardioversion) and tried multiple medications as well as offered an invasive ablation procedure to correct the AFib, but of course there is no guarantee. I did not file a claim before retiring. Is filing a claim worth pursuing? Is there a time limit for filing a claim? While I may not be disabled today from the AFib, should I file a claim in the event it becomes disabling in the future?
A law enforcement officer, correctional officer, or correctional probation officer is not entitled to the presumption provided in this section unless a claim for benefits is made prior to or within 180 days after leaving the employment of the employing agency.
So you have 180 days to file a claim after you leave work, or the claim is barred. The condition must also be debilitating within that timeframe. Read some of my posts on “specific cases” regarding the definition of disabled as it pertains to this statute.
The fact that you retired poses a bit of an issue in terms of eligibility for lost wages, but not for medical care. The decision whether to file a claim is certainly up to the individual, but treatement and medication for this condition can be expensive. It is probably best you talk to a lawyer about whether you have a viable claim and the pros and cons of filing a claim.
I was just diagnosed with a blood clot in my lower calf which traveled to my lung and the pulmonary artery, commonly called a Saddle Pulmonary Embolism, which can be fatal. I was at work at the time this occurred and was rushed to an emergency room. The quick action by another fellow officer probably saved my life. I have been an officer with this agency for twelve years. I am physically fit, but do suffer from hypertension. I did pass my pre-employment physical, and have yearly physicals done along with blood work. I was diagnosed by a cardiologist about three years ago as having what he called a larger then normal left ventrical. He then put me on Meteprolol, along with Losartan. The workers comp personnel tell me my claim will not be workers comp, because it is considered an illness not an on the job accident. Looking for your advice on how I may further pursue my claim, or if I even have one. Still out of work in recovery mode. The incident occurred on 06/25/14.
I am going to assume you are a police officer, here in Florida. Your claim sounds potentially compensable to me. Granted, the left ventricle can become enlarged due to viral illness, but it can also become enlarged due to heart disease. The quickest way to determine etiology is to ask the cardiologist, but I have to tell you, many cardiologist’s have never seen a workers’ compensation case before. They are unfamiliar with the terminology, rating system, you name it. Interestingly, workers comp carriers will often authorize your own personal physician for continued care, because of the lack of heart specialists that accept workers’ compensation.
So you need to speak to a lawyer, gather the records and conference with the doctor. Under no circumstances rely on what the insurance carrier suggests is, or is not, their responsibility. They will try and save money. Period.
Hello. First of all I would like to thank you for the service you provide here on this post. Absolutely invaluable. I am 55 years old and a law enforcement officer in Florida of more then 24 years. In March of this year I was diagnosed with hypertension and a ascending aortic aneurysm. I have been to see a Workers Comp Cardiologist who has written up my condition as “Work Related”. He said that he will not make a determination of MMI until after my next heart CT scan is completed at the end of this month. He wants to compare it to the CT done in March to determine the rate of growth of my aneurysm. I also missed a week of work in March in order to get my B/P stabilized but he put me back on full duty since. I was wondering what you thought I should expect to happen with Workers Comp, will they offer me a settlement and how much of a settlement have you seen in the past of persons with my medical issues. Thank you again.
First let me say I’m a bit surprised you remain at full duty, assuming you do not have a desk job. Your aneurysm must be slight or your blood pressure well controlled, or both. Most physicians restrict the activities of someone with your condition, just to lessen blood pressure risk. I’m going to assume based just on what you have said you are non-surgical and so my answer will be simplified.
I suspect the doctor will place you at MMI and provide you with an impairment rating. This will result in the payment of impairment benefits to you for a certain number of weeks. Please refer to Florida Statute 440.15 for a discussion of impairment benefits and their calculation. Once paid, workers’ comp may offer you a settlement, but generally they do nothing. Most cities and counties are cash poor, so settlements are not as common as you might think.
Assuming you remain at full duty, comp will continue to pay for your medical treatment and wait for you to retire. It’s the most cash effective thing to do. You need to consult with an attorney to make sure your rating is in the ball park and to discuss your options as you get older. It would take pages for me to cover your retirement options, just suffice it to say you need to understand your legal remedies before you tell your employer you intend to retire.
Also appreciate the Florida impairment guides provide huge leeway when deciding your impairment rating. A rating could run from 10% to 50% on this type of problem, a potential difference of tens of thousands of dollars, depending on who is doing the rating.
You want to consult with a lawyer who has experience with aneurysms and their typical ratings. You also want to understand what to expect as you approach retirement and what to do if you prefer a lump sum settlement, which would require your resignation and closure of your medicals. A very important decision.
Your assumption is correct. My aneurysm (as of March 2014) is small at 4.3 cm and my B/P is somewhat controlled. I was also suprised (as you said) that the Workers Comp Cardiologist put me back to work on the streets of South Florida with my condition and not on Light Duty, but thats not under my control. My next CT scan is soon and my only hope is that my aneurysm stays small, but I believe that to be unrealistic given the daily stress of my job. Thank you again for the information.
My father was recently diagnosed with cancer near his carotid artery. He is a retired police officer and I was wondering if he would qualify for the heart and lung bill?
My knee, jerk reaction is no, but I would speak to an attorney anyway. It sounds like your dad unfortunately has cancer, not heart disease. The bill was designed to allow conditions, supposedly related to increased stress, namely high blood pressure and clogged arteries to be compensable. How we tie in cancer to heart disease I’m not sure, but there are some very clever lawyers out there. Speak to one.
I am currently a LEO in Florida, and in the D.r.o.p., with three years to go. Recently, a scan revealed some heart issues that may turn out to be serious. Am I covered under the bill?
I hate to sound vague, but it depends on whether heart issues were revealed by the scan. Heart disease is covered, other conditions might not be. Need a little more information.
I work for a Sheriff’s department in Florida where I’ve been employed for the past 21 years. Approximately 17 months ago I was diagnosed with hypertension. I have been seeing a doctor and have been treated with medications. Although I’m being treated, my hypertension tends to go out of control now and again. This causes me to be out of work due to the debilitating severity. Besides seeing my family doctor, I have not dealt with anyone or made any workers compensation claims. What if any, should be my course of action? Should I file a workers comp claim? Is there a possibility this falls under the heart and lung act? Should I hire an attorney?
Sounds like you have a case. Recall you must have passed a pre-employment physical and be aware of the notice requirements which remain 30 days from the time you knew or should have known you had a work related injury. This is complicated because your case is not compensable until you start losing time from work. Also, filing it under comp may mean you have to see a different doctor. You will get your medication paid for, but if you are just missing a day or two here and there you may not be compensated for lost wages.
The real reason to file is in case the hypertension becomes more severe and impacts your continued ability to perform your job. You can call HR and file yourself or consult an attorney in your area. This is purely a preferance on your part.
Hi. I am an active firefighter with hypertension and cardiovascular disease, both diagnosed in 2012. I am getting ready to retired at 60, next month. Is the cardio vascular disease covered under the Heart Lung Bill – if so, what do I do. Thank you.
Cardiovascular disease is another term for heart disease, which is intended to be covered under this statute along with hypertension. There are two more prongs to cover before I would advise reporting the condition to workers’ compensation. Passing a pre-employment physical and being determined to be disabled. You have to lose time from work in some sense (and there is loads of case law on this one area) in order to be determined to be disabled. If you have cardiovascular disease or hypertension, but don’t lose time from work, you are not disabled and are therefore not eligible for benefits.
Read some of the earlier posts regarding the term “disabled” as it pertains to the heart-lung bill.
First, Thank you very much for your time and service to the police/firefighter community. Regarding the above two prongs, I did pass a pre-employment physical many yeas ago and was cleared for full duty. I have missed work for the hypertension repeatedly, but not specifically for the coronary artery disease. I will read your posts on disabled and contact your office. Thank you.
If you missed work for the coronary artery disease, but you see the same doctor for both conditions, as I suspect you do, I wouldn’t do a thing. If you are taking medication for the coronary artery disease that comp is not paying for, then you need to file a claim.
First off I would like to thank you for the service you provide. I am a Florida firefighter and recently had an off duty MI. I had one stent placed and am off of work for a month. I will then need to take a nuclear stress test before returning to duty, probably light duty for awhile. I have been diagnosed with coronary artery disease and still have a few other blockages being treated with meds. I passed the pension boards pre-employment physical but they did note that I had high cholesterol. I have also been to my personal physician over the years and have been told I have high cholesterol. I have taken statins periodically but they have always made me feel awful and I have read that they are very bad for you. I have always believed that proper nutrition was the best medicine. I also found out that my mom has a history of coronary artery disease. Workman’s Comp has been paying all of my bills and my employer is very supportive. My pension board has a history of supporting their members and they vote on disability claims. I know of a case of a former employee that was successful with filing for total disability even though the pension boards 3 doctors advised that he was not disabled. I would like to continue working but am afraid that if I need to file for disability I may be refused because of my history of high cholesterol and my family history. Thank you for your time.
My first thought is workers’ compensation has been paying your bills. That means workers’ compensation has taken the position that your claim is compensable. In such cases, I like the do nothing approach. Once workers’ comp has been paying a claim for 120 days or more, they generally are precluded from denying the claim thereafter unless there is some reason why they could not have found out about your high cholesterol. That information is readily available in your personal physicians file, so it would not be difficult to find. I had almost an identical situation. Let the 120 days go by without breathing on it.
Good Morning and thanks for all the information you provide to those who inquire regarding the heart/lung bill.
I am a law enforcement officer for a police agency in South Fla. filed a claim, prevailed, and as a result I am now covered under the Heart Bill.
The current workman’s comp carrier for the city I work for has been covering all my bills, meds, etc. However, it has come to my attention that the city is in the process of changing from the current workman’s comp carrier to another, not known at this time.
Regardless of who the new carrier/vendor is and since my case was against my employer and current W/C carrier, will my case be transferred to the new carrier and case worker, or remain with the current one?
Once the city does change carriers how will this affect my standing if at all?
It depends. Sometimes new carriers commit to providing coverage for existing claims, but more often than not, your case will remain with the original carrier, with no interruption in services.
25 year firefighter currently working and covered under heart/lung bill for doctors and medicine. When I retire does heart/lung bill still pay for doctor and medicine?
Yes. But you still have the one year statute of limitations for medical care.
Follow up to the previous question; the ans was yes, that after retirement workers comp still covers the individual, but what was meant by the one year statute of limitations for medical care?
There is a one year statute of limitations for medical care when you are NOT receiving monies for lost wages. It is a rolling statute of limitations. Each time you see the authorized WC doctor, you have one year to see him again. Let more than 1 year pass without seeing the doctor and the medical case closes. You lose your ability to see the doctor and have comp pay for it. If you are receiving lost wage benefits, like PTD benefits this rule doesn’t apply. The adjuster has to catch your lapse and refuse treatment. Sometimes adjusters don’t see a year has gone by, but most adjusters now have computer programs that notify them if you have gone without care, so they can pull the plug on your case. It is your job to keep track.
police officer over 23 years, heart attack 2013 on duty. stint placed in RCA. have been receiving benefits. Now I have been diagnosed with Rheumatoid Arthritis. would that be covered under the heart bill. Doctor states heart problems and RA have been linked together.
I have never seen arthritis covered, but there is always a first. Anything causally related to the original injury will be covered. So if you have a back surgery under comp and after the surgery, you have a limp that wears out your knee, it’s covered. But a doctor must state, within a reasonable degree of medical certainty A caused B to occur. Most people who are obese have high blood pressure or diabetes. But most doctor’s will not state definitively obesity caused the diabetes. Statistically, they come together, but stating one caused the other requires testimony backed up by research. I, personally, have never heard of arthritis being caused by stenting. There are probably 10 risk factors for RA, one of which might be heart disease. If I were the defense attorney, I would be looking at all the other factors you have which make you at high risk for RA. I your doctor finds you have multiple risk factors, you will likely lose that issue.
from hypertension? I was hoping you could help me to understand the Impairment Ratings and could advise how to reach a true impairment rating for me. Thank you so much.
The impairment guide really doesn’t have anything under hypertension related to aneurysms. But an aneurysm doesn’t have to be rated under the hypertension section alone. Assuming your cardiologist considers the condition work related, the doctor is free to use the symptomatic limitation section, congenital or heart disease sections. Whichever section best describes your resulting limitation is appropriate. Then the doctor uses the combined rating chart to put multiple ratings all together.
If your cardiologist is unfamiliar with the guides or just doesn’t want to look at them for you, it may be time for an IME. You can always package up your records and select a physician to review your records and offer an alternative rating. There are strict rules for obtaining an IME, which I won’t go into here, but suffice it to say you are not going crazy. The impairment guides use a very broad brush when it comes to cardiovascular conditions. This is by design to give your doctor broad latitude to determine your rating by functional impairment, rather than by condition. Some aneurysms create no real functional loss. Others may create severe work restrictions, mainly depending on size and location. This guide allows you doctor to pull ratings from multiple sections and many doctors are much more generous than others.
You may want to consult with an attorney.
I am a 53 yo fire/medic for a south fla city. I’ve been employed with my current city for over 13 years and had a pre physical when I was hired and several physicals after my hire. In late September while off duty I exhibited signs and symptoms of a stroke, headache, confusion, very high BP, weakness and numbness, loss of taste, I was taken to the ER and stroke alerted by the ER physician and after a MRI was told I had a right thalamus stroke. I notified my employer and was hospitalized. My employer put me out on workmans comp and I haven’t worked for over 2 months since the event. I was sent home on hypertension medication, cholesterol med, aspirin and plavix. Prior to the stroke I was on no meds and no symptoms for any medical conditions, I was very healthy. So far I have seen a WC cardiologist and a WC neurologist. The cardiologist continues the meds and ran more test and found a PFO (Patent Forman Ovales) and an ASA (Atrial Septal Aneurysm). The neurologist found me to have Arteriosclerosis as well. Some of the deficits resolved and some I continue to have as well as some that I found once I returned home. I was told by my administration that they have filed my case under the Heart Lung Bill. I’m at a high risk for another CVA, and feel I would be unable to continue as FF mentally or physically? Should I obtain an attorney understands the components of the Heart Lung Bill? Any advise, info, or assistance would be appreciated.
You should absolutely have an attorney on standby. The workers’ comp carriers operate on a pay and investigate basis. The law gives them 120 days to decide whether to accept your case as compensable. In the interim, they are gathering up your preexisting medical records looking for risk factors for your conditions and presenting their findings to your cardiologist. If the cardiologist gets enough information to rebut the presumption afforded by the statute, you will be cut off with a letter in the mail. Then when you hire a lawyer, it will take them 45-60 days just to catch up. If you can’t afford that kind of delay, you might want to have a lawyer on standby.
I had an MI off duty back in July and ended up with a stent in my LAD. While I was recovering and in cardiac rehab, I started feeling poorly and ended up back in the cath lab in late September where I got received another stent in a different artey. I was concerned early on because I read about passing a pre employment physical “without any evidence of the condition being treated.” I had high cholesterol show up on my pre employment physical. Well, the 120 days has passed and I received a letter from my workmans comp carrier saying that they accepted my case. So, my question is- if my cardiologist clears me for full duty(firefighter), but my wife doesn’t want me to go back to firefighting, am I eligible to go out on disability under the Heart and Lung bill? I have been told that I would receive 85% of my salary averaged from the last 3 years tax free. I am pretty confused. Thank you for all that you do for us.
P.S.- I haven’t worked for 6 months, not even light duty.
If your cardiologist clears you to return full duty you will receive monies for impairment benefits and ongoing medical care, but you won’t be able to go out on disability in the traditional sense. I assume you mean going out on the Heart-Lung bill to mean getting paid biweekly on workers compensation. The only class of folks who do that are those who are permanently disabled under the comp law. If you doctor returns you to full duty, you don’t meet the definition of permanently and totally disabled.
But, if you have your years in and just want to settle your case, I’m sure the carrier might be open to it. Normally this involves cutting all ties with workers’ comp, to include medical care. Best to get some counsel if you are going to go down that road.
The heart-lung bill just gives preferences to first responders in what is considered a work injury. In all other aspects heart-lung cases are just like any other workers’ compensation claim.
I am a firefighter and had an MI about 5 months ago and received a stent. I started cardiac rehab and after about a month I started feeling poorly and ended up back in the cath lab with another stent to a different artery. I have been in cardiac rehab for a few weeks now and my cardiologist tells me he will get me back to full duty. My question is what if I do not want to go back to full duty? After speaking with my family we agree that at my age, 45, it would be ridiculous to put myself at risk. Can my employer force me back to full duty if I have anxiety about returning to firefighting? Is my best course of action to file for a disability pension with my pension board? I don’t have enough time on to retire with a livable wage but the disability pension would be doable? Thank your time and consideration.
Your employer can never force you back to work. The standards for a disability pension and workers compensation benefits are also two completely different things. Workers’ compensation requires the inability to perform sedentary work. The requirements for a disability pension can vary by jurisdiction. Many first responder lawyers practice in both areas as a cardiac event often leads to exactly your sentiments about returning to work. Talk to one who handles cases in your county. They can tell you what is necessary for a pension claim.

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