Case Name: Warren ZUNDELL, Appellant, v. DADE COUNTY SCHOOL BOARD and Gallagher Bassett Services, Inc., Appellees
Court: Florida District Court of Appeal
Jurisdiction: Florida
Decision Date: 1992-12-15
Citations: 609 So. 2d 1367
Docket Number: No. 91-1848
Parties: Warren ZUNDELL, Appellant, v. DADE COUNTY SCHOOL BOARD and Gallagher Bassett Services, Inc., Appellees.
Judges: JOANOS, C.J., and BOOTH, SMITH, ALLEN, MINER and KAHN, JJ., concur.
Reporter: Southern Reporter, Second Series
Volume: 609
Pages: 1367–1385

Head Matter:
Warren ZUNDELL, Appellant, v. DADE COUNTY SCHOOL BOARD and Gallagher Bassett Services, Inc., Appellees.
No. 91-1848.
District Court of Appeal of Florida, First District.
Dec. 15, 1992.
Steven M. Dunn of Dunn & Johnson, P.A., Miami, for appellant.
Steven Kronenberg and Sylvia A. Krai-nin, of Adams, Kelley, Kronenberg & Kelley, Miami Lakes, for appellees.

Opinion:
WOLF, Judge.
In this workers' compensation appeal, appellant/claimant, Warren Zundell, seeks reversal of an order of the judge of compensation claims (JCC) which denied his claim for benefits on the ground that appellant's injury, an internal cardiovascular failure, diagnosed as an intracerebral subarachnoid hemorrhage, was noncompensable because the injury failed to meet the test promul gated by the Florida Supreme Court in Victor Wine & Liquor, Inc. v. Beasley, 141 So.2d 581 (Fla.1961), and Richard E. Mosca & Co., Inc. v. Mosca, 362 So.2d 1340 (Fla.1978).
Appellant urges us to hold that, unless there is proof of a preexisting condition, a cardiovascular failure may be compensable without proof of an unusual physical strain or overexertion not routine to his job. A holding of compensability on that basis and the facts of the instant case would require this court to make a number of substantial changes in existing law. Those changes would include (1) finding that proof of an emotional strain which may be routine to a particular job would be sufficient to demonstrate compensability of internal cardiovascular failures, (2) a requirement that an employer would have the burden of proof to demonstrate a preexisting condition pri- or to the employee having to prove- the requisite conditions for compensability of an internal cardiovascular failure, and (3) a determination that the failures of the internal cardiovascular system should be treated differently than heart attacks. We decline to make these substantial changes as we find no legal support for appellant's position. We therefore affirm the decision of the JCC.
Claimant recounted the facts pertaining to his injury during his deposition and later at the claims hearing. His testimony relating to the incident was identical in both instances, with the exception of one particular difference, as noted herein. Claimant testified at his deposition that on January 5, 1988, he was employed as a teacher in mathematics and in such capacity taught a ninth-grade class at Hialeah Junior High School. He stated that he was subject to a certain amount of stress from the school administrators for the reason that all teachers were to be evaluated that year based upon, among other things, the scores their students received on certain performance tests. On the date in question, one of his students entered class and engaged in various disruptive activities, including talking to other students, chewing gum, and other unauthorized behavior. After repeatedly attempting to get the child under control, claimant finally asked him to remove a large wad of gum from his mouth, and the student complied by throwing the gum "like a baseball into the waste can" and then screaming at the top of his lungs, "The gum is gone." Claimant promptly told him to report to the vice principal's office, to which request the child shouted, "You asked me to throw the gum away. I threw the gum away."
When Zundell attempted to escort the pupil to the office, the latter refused, stating that he intended to remain in class, at which point claimant announced, "You're not going back to my class." The child then replied that if he hit appellant, he would get into trouble. Appellant stated that he suddenly felt extremely tense because of the student's reaction. Later, after he had been taken to the disciplinary office, the student, without apparent authorization, returned to the classroom, and claimant was again forced to remove him to the school's disciplinary room. Shortly after returning to the classroom, appellant felt an unusual sensation come over him. He was unable to move his arms or stand up; he vomited and began to experience an excruciating headache. A rescue crew was immediately summoned, and claimant was taken by emergency vehicle to a local hospital.
Dr. Basil Yates, a neurosurgeon, testified that in his opinion, founded upon reasonable medical probability, the unusual confrontation between the student and claimant caused the claimant's subarach-noid hemorrhage. Dr. Yates felt that the claimant did not suffer from a preexisting condition, and that the hemorrhage was caused by a sudden surge of blood as a result of an elevation of blood pressure precipitated by the emotional encounter with the student. The doctor primarily based his opinion on several arteriograms which failed to reveal any evidence of an aneurysm (a bulge in the arterial wall), arterial malfunction, or lesion. The doctor was asked, however, whether the arterio-gram would reveal a prior weakening of vessels in his brain. He responded
You can't tell that. The only thing an arteriogram does is outline the arteries. If there is a bulge on the artery, you can see that, but you have no idea of the integrity of the walls.
Based upon this evidence, the JCC found After reviewing the evidence, I find that this claim must be denied. Florida law requires that, in order for a cardiac or vascular failure to be compensable, it must be accompanied by either a physical trauma or a physical over-exertion not routine to the type of job duties to which the claimant was accustomed. There is absolutely no evidence that the claimant sustained any sort of physical trauma or touching. In fact, the claimant's testimony is uncontradicted that at no time was he touched by the disruptive student, nor did the disruptive student at any time even threaten to touch him, or make a violent gesture toward him. Both parties stipulated that the claimant sustained an internal failure of the cardiovascular system. In the absence of any evidence of a physical touching or physical over-exertion, I find that the claimant's interna] cardiovascular failure must be deemed noncompensable. Victor Wine and Liquor, Inc. v. Beasley, 141 So.2d 581 (Fla.1961); Richard E. Mosca & Company, Inc. v. Mosca, 362 So.2d 1340 (Fla.1978); Skinner v. First Florida Building Corporation, 490 So.2d 1367 (Fla. 1st DCA 1986).
Appellant appeals this determination. It is undisputed that the factual determinations in the JCC's order are supported by competent substantial evidence. The dispute is one concerning the application of Victor Wine and Richard E. Mosca.
A claimant in all compensation cases must satisfy three elements of proof in order to establish a compensable injury: (1) That the worker suffered an accident, (2) that the accident occurred during the course of employment, and (3) the accident arose out of the employment. Southern Bell Tel. and Tel. Co. v. McCook, 355 So.2d 1166 (Fla.1977). At issue in the instant case is the "arising out of employment" or causation element. This component must be established by showing a causal connection between the employment and the injury. Strother v. Morrison Cafeteria, 383 So.2d 623 (Fla.1980).
The supreme court has determined that because of certain unique factors in cases which involve heart attacks and internal failures of the cardiovascular system, the causation element must be proven in a particular fashion. Victor Wine, supra; Richard E. Mosca, supra.
In Victor Wine, the supreme court held that for a heart attack to be compen-sable, the claimant must show that he or she was subject to unusual strain or overexertion not routine to the type of work that the employee was accustomed to performing. In Richard E. Mosca, the court further determined that
1) Heart attacks and internal failures of the cardiovascular system are to be treated in the same manner for the purposes of establishing the causation element in compensation cases, and
2) "Emotional strain is too elusive a factor independent of any physical activity in determining whether there is a causal connection between a heart attack or other failure of the cardiovascular system and claimant's employment."
Richard E. Mosca, supra at 1342. The claimant and the minority, however, would urge us to find that cardiovascular failure, allegedly precipitated by emotional stress, may be compensable because Victor Wine and Richard E. Mosca are distinguishable; the facts in those cases reveal that there was some kind of preexisting condition pri- or to the compensable incident. We reject the theory that a preexisting condition is a necessary element of proof prior to applying Victor Wine and Richard E. Mosca for the following reasons:
1) Requiring proof of a preexisting condition is contrary to the very reason for establishing a special test for determining compensability in heart attack and cardiovascular cases;
2) There have been a number of decisions from this court which have applied Victor Wine and Mosca without any mention of a preexisting condition; and
3) There have been no cases which hold that an employer has an initial burden of proof prior to applying the Victor Wine standard.
In Tintera v. Armour & Co., 362 So.2d 1344, 1346 (Fla.1978), the supreme court approved the reasoning of the Industrial Relations Commission which found that
Victor Wine is premised upon recognition of the fact that a great portion of our work force comes upon the work scene with heart defects that would result in heart attacks in any event.
In many of these cases, the existence of a preexisting heart or cardiovascular defect may be difficult or impossible to establish. In a number of cases, it is apparent that the incident would not have occurred without the undetectable defect, and notwithstanding the existence of such a prior defect, it is difficult, if not impossible, to directly attribute the injury to emotional stresses. See Richard E. Mosca, supra. The instant case is illustrative of the difficulties involved.
The doctor's diagnosis in this case is based upon the fact that the arteriogram revealed no prior condition. Yet when asked whether the arteriogram would have revealed a weakness in the artery wall that may have led to the escape of blood, the doctor had to admit it would not. The speculative nature of the doctor's testimony concerning the prior existing condition coupled with the high incidence of heart and cardiovascular disease demonstrates the necessity for adopting a legal causation test as was done in Victor Wine and Richard E. Mosca. Abrogation of the Victor Wine test in this type of situation would allow compensation to be paid in many cases where it could not be reliably proven that the industry brought about the injury. The supreme court in University of Florida v. Massie, 602 So.2d 516 (Fla.1992), cautioned against such an attempt by this court to legislate. Id. at 526.
Further, this court has applied the tenets of Victor Wine and Mosca in numerous cases where there is no mention of a preex isting condition. See, e.g., Diaz v. City of Miami, 427 So.2d 1085 (Fla. 1st DCA 1983); City of Opa Locka v. Quinlan, 451 So.2d 965 (Fla. 1st DCA 1984); Hodgen v. Burnup and Simms Engineering, 420 So.2d 885 (Fla. 1st DCA 1982). In City of Opa Locka and Diaz, while the facts surrounding the incident are recited, there is no mention of any preexisting condition. In those cases and in Hodgen, the general rule is restated: Emotional strain alone is not sufficient to establish a causal connection between employment and heart attacks or internal failures of the cardiovascular system. In addition, there is no prior Florida precedent which would indicate that Victor Wine shall only be applied where the employer has proven a preexisting condition. Such a rule would violate the general concept that the burden of proof is on the claimant to demonstrate compensability in all instances and the rule enumerated in Richard E. Mosca that the link between emotional stress alone and injuries of this type is too tenuous to provide for compens-ability. We therefore affirm.
In light of the lack of direct precedent on this important and potentially far-reaching issue, we certify the following question to be of great public importance:
WHETHER AN EMPLOYER IS REQUIRED TO PROVE THE EXISTENCE OF A PREEXISTING CONDITION IN COMPENSATION CASES INVOLVING HEART ATTACKS AND INTERNAL FAILURES OF THE CARDIOVASCULAR SYSTEM AS A PREREQUISITE TO THE APPLICATION OF THE TEST FOR COMPENSABILITY ESTABLISHED IN VICTOR WINE & LIQUOR, INC., V BEASLEY AND RICHARD E. MOSCA & CO., INC. V. MOSCA?
JOANOS, C.J., and BOOTH, SMITH, ALLEN, MINER and KAHN, JJ., concur.
WEBSTER, J., dissents in part and concurs in part with opinion with which SHIVERS, WIGGINTON, ZEHMER and BARFIELD, JJ., concur.
ERVIN, J., dissents with opinion with which ZEHMER, J., concurs.
.We are not unmindful of the cases that hold that a heart attack may be found to be compen-sable where there is a second separate work-related accident involving physical contact which precipitates the heart attack. See Popiel v. Broward County School Bd., 432 So.2d 1374 (Fla. 1st DCA 1983), rev. denied, 438 So.2d 831 (Fla. 1983), and cases cited therein. The facts in this case do not support a finding of compensa-bility on this basis.
. It would appear that the minority and the . claimant would provide that the preexisting condition would have to be established much like an affirmative defense. The law provides no support for this proposition.
. During his later testimony before the JCC, appellant added certain facts that he had not mentioned during his deposition. He stated that when the student attempted to return to the classroom, claimant barred his reentry at the door, and when the pupil told claimant that he intended to regain admittance, claimant responded, "You are going to have to walk over me if you want to walk in here." According to claimant, the student then said, "Well, if I hit you I am going to. get in trouble." Claimant recounted that he and the student were standing by the door and staring at each other, nose to nose. At this point, he suddenly felt the muscles at the back of his neck getting extremely tense and he became very nervous. Claimant nevertheless turned to direct the student down the hallway, and when he placed his hand upon the latter to guide him out, the student suddenly jumped back. Claimant was startled by this reaction, saying he thought he was "going to get slammed." Immediately following this second encounter, he again experienced a strange tenseness coming over him, but the sensation disappeared, and he was able to return the child to the disciplinary room. The remainder of appellant's in-court testimony pertaining to his collapse paralleled his deposition testimony.
. A subarachnoid hemorrhage involves the escape of blood from the vessels into the sub-arachnoid space of the cranium. Dorland's Illustrated Medical Dictionary 750 (27th ed. 1988).
. Disparate treatment or test for compensability, depending upon the nature of the injury, is not unusual and has been provided for in a number of situations. See, e.g., § 440.151, Fla. Stat. (occupational diseases); Festa v. Teleflex, Inc., 382 So.2d 122 (Fla. 1st DCA 1990) (repetitive trauma or exposure), rev. denied, 388 So.2d 1119 (Fla.1980).