Court Opinion

ID: 9909473
Source: CourtListenerOpinion
Date Created: 2023-12-13 16:03:57.713583+00
Date Added: 2024-06-11T12:49:25.845332
License: Public Domain

FIRST DISTRICT COURT OF APPEAL
                STATE OF FLORIDA
                  _____________________________

                         No. 1D2021-3530
                  _____________________________

SEMINOLE COUNTY, FLORIDA and
JOHNS EASTERN COMPANY, INC.,

    Appellants,

    v.

CHAD BRADEN,

    Appellee.
                  _____________________________

On appeal from the Office of the Judges of Compensation Claims.
Thomas W. Sculco, Judge.

Date of Accident: January 24, 2021.

                        December 13, 2023

M.K. THOMAS, J.

     The Employer, Seminole County, and its Servicing Agent,
Johns Eastern Company, Inc. (Seminole County), appeal a final
order of the Judge of Compensation Claims (JCC), awarding
workers’ compensation benefits to Chad Braden, a firefighter. The
issue is whether, after a concession by Seminole County that the
“heart-lung statute” 1 and its presumption of work causation
applied to Braden’s heart attack and subsequent heart transplant

    1 § 112.18, Fla. Stat. (2021).
which occurred after his diagnosis of COVID-19, the JCC erred in
finding that Seminole County failed to rebut the statutory
presumption. Because competent, substantial evidence supports
the JCC’s determination, we affirm.

                              I. Facts

     Braden was hired by Seminole County as a firefighter in 1993
after a clean pre-employment physical. In the early 2000s, he
suffered cardiac problems that Seminole County accepted as
compensable. Braden received treatment, including an ablation of
the heart. Thereafter, Dr. Pollack, an authorized cardiologist,
treated Braden yearly, including a visit about ninety days before
Barden’s heart attack in 2021. At that appointment, Dr. Pollack
reported that Braden was doing well and released him with no
work restrictions.

     On December 27, 2020, Braden tested positive for COVID-19.
On January 24, 2021, less than a month later, he suffered a heart
attack. Despite extensive medical treatment, Braden’s medical
condition continued to deteriorate, and he required an angioplasty
to open a 100% occluded artery. He declined further, suffering a
cardiogenic shock, acute congestive heart failure, and ventricular
irritability. Later, he developed a blood clot in his leg, pulmonary
emboli (blood clots in the lungs), and suffered an acute non-
hemorrhagic occipital stroke (caused by a clot). A permanent
defibrillator was placed in his heart. But he suffered blockages in
his cardiac stents and repeat surgeries were required. In March
2021, he received a heart transplant.

     Braden filed a Petition for Benefits seeking indemnity and
medical benefits on grounds that his heart attack stemmed from
“heart disease” and thus the statutory presumption of work
causation under section 112.18 applied. He asserted a date of
accident of January 24, 2021, the date of the heart attack. At first,
Seminole County conditionally accepted the heart attack as
compensable, filing a “120-day” letter under section 440.20(4),
Florida Statutes, reserving its right to pay and investigate.
However, on the 120th day, Seminole County denied
compensability.

                                 2
     Prior to hearing, the parties completed the required Pre-Trial
Stipulation. Braden sought compensability under section 112.18. 2
Seminole County asserted as a defense, among others, that the
claim was denied in its entirety because “[c]riteria for the
presumption was not satisfied and/or presumption rebutted.” But
at the merits hearing, it withdrew the defense and stipulated that
section 112.18 applied and that Braden was entitled to the
statutory presumption of work causation. Thus, the sole issue
before the JCC was whether Seminole County successfully
rebutted the presumption.

     Braden argued that his claim was compensable, and the heart
attack and related treatment and resulting disability were the
natural progression of his preexisting, previously accepted as
compensable, heart-lung statute claim. 3 He denied that the cause
of his medical condition was COVID-19.

     Seminole County responded that the evidence was sufficient
to rebut the statutory presumption of work causation because
Braden’s heart attack and decline were caused by COVID-19,
which he contracted outside of work. In response to the defense,
Braden offered an alternative argument that if the JCC found the
cause of his impairment and resulting disability to be the virus,
that he contracted COVID-19 at work.

     At the hearing, Braden testified that he woke up on December
27, 2020, not feeling well. He took a COVID-19 test because he had
worked with two or three co-workers who had recently tested

    2  Braden did not assert entitlement to benefits under
exposure, repetitive trauma, or occupational disease, among other
statutory bases to support compensability of his condition. See §§
440.02(1), 440.09, 440.151, Fla. Stat.
    3  Yet Braden did not assert the earlier date of accident from
the early 2000s, even though he had continued to receive workers’
compensation benefits under that claim. At oral argument,
Braden’s counsel argued a new date of accident was required
because section 112.18 requires that a firefighter’s condition or
impairment result in disability.

                                3
positive. He also tested positive. Braden assumed he contracted
the virus from his co-workers because “those are the only people I
know that have tested positive for COVID, that I’ve been around.”

    Evidence presented at the hearing established that one co-
worker was out of work starting on December 18, 2020, due to
COVID-19; another worked with Braden on December 22, 2020,
and tested positive on December 24, 2020; a third worked with him
on December 22, 2020, and tested positive five days later. In the
ten days before Braden’s positive COVID-19 test, he worked two
24-hour shifts—one on December 22, 2020, and another on
December 25, 2020.

     While not at work in the days just before his positive test,
Braden engaged in normal activities, including going to the gas
station, eating inside restaurants, and going to the grocery store.
Outside of work, he encountered his girlfriend, his daughter, his
son, and possibly his daughter’s roommate. Braden’s girlfriend
lives with him and did not deviate from her normal routine in the
weeks right before his COVID-19 diagnosis. But she never tested
positive for the virus.

     Braden’s daughter testified that around the time of his
positive COVID-19 diagnosis, she worked from home one or two
days a week and at her office the rest of the week. She worked with
about 40–50 people at her office, and that some had tested positive
for COVID-19 at some point. She could not recall how many times
she visited her father in the days leading up to his positive test but
acknowledged that she had spent Christmas with Braden, her
mother, and her brother. She denied ever testing positive for
COVID-19.

     Braden’s son testified that he is in the military, stationed at
Camp Lejeune in North Carolina, and had visited Braden for the
holidays. He took a commercial flight from North Carolina to
Orlando, Florida, with a layover in Charlotte. He initially stayed
at Braden’s house, but he could not recall what he did during the
five or six days right before Braden’s positive test. He never tested
positive for COVID-19.

                                  4
     Fire Chief Drozd was deposed regarding what, if any, safety
policies had been implemented to prevent the spread of COVID-19
among firefighters. He testified that a host of policies were in effect
to address the issue, including requiring firefighters to wear masks
and socially distance themselves while at work. Also, a spraying
service was under contract to regularly decontaminate the station.
Chief Drozd could not recall anyone being disciplined for violating
COVID-19 protocols at work.

     Cardiologist, Dr. Nocero, was authorized by Seminole County
to provide treatment after Braden’s heart attack. But Seminole
County denied compensability of the claim before treatment
began. Dr. Nocero reviewed Braden’s medical history. When asked
his opinion regarding what caused Braden’s heart attack and heart
transplant, Dr. Nocero testified that the COVID-19 infection was
the cause. In support of his causation opinion, Dr. Nocero
discussed current research into the relationship between COVID-
19 and heart disease, Braden’s lack of cardiac symptoms at the
most recent cardiology appointment before contracting COVID-19,
Braden’s multiple clots at different locations in the body after
contracting COVID-19, and the statistical unlikelihood of repeat
clotting following angioplasty and stenting (which he stated was
.6%). Dr. Nocero was asked if there was “any way for [him] to tell,
as you sit here under oath today, where [Braden] contracted
COVID-19,” and he answered “[n]o.”

     Braden underwent an independent medical examination
(IME), with Dr. Mathias, a cardiologist, who testified, “[i]t’s
impossible to tell” where Braden caught the virus. Dr. Mathias did
not believe that Braden’s heart attack or transplant had anything
to do with his earlier diagnosis of COVID-19. He admitted that “I
don’t know one way or another, since there is no definitive test that
can be used to clarify this . . . .”

     Dr. Renae, an infectious disease specialist, also performed an
IME. After considering certain facts, including how many hours
Braden was at work versus not at work during the possible viral
infection period, Dr. Renae testified:

    I think given all the facts that you presented, just from a
    pure mathematical simple equation, even though it’s

                                  5
    possible he could have acquired [COVID] at the station,
    it’s more probable he acquired it elsewhere just from a
    pure, you know, time equation. We know COVID is
    everywhere, we know it’s possible to essentially catch it
    anywhere, including a restaurant, a delivery to the home,
    a supermarket, a cleaner’s, the gas station and all these
    places that if you just add up all the hours the probability
    is he caught it somewhere else. Other than the station.

Even so, Dr. Renae admitted, “it’s impossible to say that he
definitely didn’t get it at work” and that he “[did not] think you can
rule it out with 100% certainty,” adding that COVID-19’s
incubation period is “as loose as it gets, they say two to 14 days.”

    In the final order, the JCC quoted Dr. Mathias’s testimony
that it was “impossible” to know where Braden contracted the
virus and that Dr. Nocero “did not know” where Braden contracted
the virus. He then rejected Dr. Renae’s opinion “as inconsistent
with the circumstantial evidence in the case and as not supported
by persuasive reasoning,” noting that even if the virus is
everywhere, “it does not necessarily follow that the risk of
contracting Covid-19 is the same everywhere.”

     The JCC emphasized that Braden had presented a
“presumption only” claim, dictating the relevant standard for
rebuttal. He recounted that Drs. Mathias and Nocero testified that
they did not know where Braden contracted COVID-19, and Dr.
Renae testified that it was unlikely he got it at work. The JCC
found the testimony of Dr. Nocero logical, reasonable, consistent
with the best available current research, consistent with the
medical opinions of other medical experts that treated Braden, and
consistent with common sense. To the extent the experts disagreed
on causation, the JCC accepted the opinions of Dr. Nocero and
rejected the contrary opinions of Dr. Mathias, finding his
reasoning to be less persuasive. The JCC noted that while Dr.
Mathias acknowledged that there was less than 1% statistical
likelihood of the complications Braden suffered following his initial
angioplasty and stenting, Dr. Mathias rejected COVID-19 as a
likely explanation despite the well-known connections documented
in current research and in other medical opinions offered in the
case.

                                  6
     The JCC accepted Seminole County’s argument that COVID-
19 caused Braden’s heart disease, heart attack, and heart
transplant. But the JCC found that Seminole County failed to
rebut the presumption of work causation by proving that Braden
contracted the virus outside of work. The JCC regarded the
timeline significant because medical testimony established a
minimum two-day incubation period before someone who is
infected can become ill and spread the virus, meaning that it was
less likely for Braden to have infected his co-workers than it was
for them to have infected him. Furthermore, all of Braden’s close
contacts never developed symptoms nor tested positive for COVID-
19, making it less likely (though possible) that one of them was the
source of his infection. The JCC was not persuaded by the masking
and social distancing protocols in place at the fire station at the
time Braden was infected where no evidence was presented as to
the efficacy, if any, of these protocols in reducing the risk of
contracting the virus. Consequently, the statutory presumption of
compensability prevailed, and the JCC found Braden’s claim
compensable.

    The JCC summarily denied Seminole County’s motion for
rehearing.

                            II. Analysis

     On appeal, Seminole County argues that the JCC reversibly
erred in finding it failed to rebut the statutory presumption of work
causation for Braden’s alleged condition or impairment.
Specifically, it asserts: first, that the JCC erred when it rejected
unrefuted medical testimony because the JCC did not provide a
reasonable explanation for doing so and instead substituted his
own medical opinion for that of the infectious disease expert; and
second, competent evidence does not support the JCC’s conclusion
that Seminole County failed to rebut the statutory presumption of
work causation with prooff that the COVID-19 infection was
nonwork-related. Additionally, Seminole County argues that
section 112.18 creates an unconstitutional, irrebuttable
presumption when COVID-19 causes heart disease in a first
responder. We address each argument in turn.

                                 7
                          A. Presumption

     To the extent an issue turns on resolution of the facts, the
review standard is competent, substantial evidence; to the extent
it involves an interpretation of law, the standard is de novo. See
Benniefield v. City of Lakeland, 109 So. 3d 1288, 1290 (Fla. 1st
DCA 2013).

     Here, the parties did not raise nor litigate, even alternatively,
other available causes of action which could support
compensability under the Workers’ Compensation Law such as
occupational disease, repetitive trauma, aggravation of a pre-
existing condition or hindrance to recovery, for example. See
§§ 440.151, 440.09(1)(b), Fla. Stat.; Gallagher Bassett Services-
Orlando v. Mathis, 990 So. 2d 1214 (Fla. 1st DCA 2008); Festa v.
Teleflex, Inc., 382 So. 2d 122 (Fla. 1st DCA 1980). Instead, the
claim was brought exclusively under section 112.18 with a listed
date of accident of January 24, 2021. Then, Seminole County
conceded the statutory elements of section 112.18 were satisfied
and the presumption of work causation applied to Braden’s claims.

     This is the third case reviewed by this Court in which a first
responder claimed entitlement to benefits under section 112.18
after a viral infection resulted in a cardiac event. Notably, in all
three, the employer/carrier/serving agent conceded that the “heart
lung” statute applied and, thus, its presumption of work causation
for the claimant’s impairment or condition. Hence, the only
question before the JCCs in each of these cases was whether that
conceded presumption of work causation was rebutted with
competent evidence.

     In Walters v. State, DOC, Division of Risk Management, 100
So. 3d 1173, 1175 (Fla. 1st DCA 2012), the claimant suffered heart
disease as a result of viral gastroenteritis. The parties stipulated
to the factual predicate necessary to give rise to the statutory
presumption of occupational causation. Id. Ultimately, the JCC
denied compensability of the claim. Id. While acknowledging that
the statutory presumption arose, the JCC ruled that the
employer/carrier had rebutted the presumption with testimony
that the claimant’s heart disease was attributable to viral
gastroenteritis, and that the claimant had not proven that the viral

                                  8
gastroenteritis was an occupational disease in the manner
contemplated by section 440.151, Florida Statutes. Id. This Court
reversed the JCC’s order, explaining as follows:

         If the presumption applies, the claimant is under no
    obligation     to    establish     occupational   causation
    redundantly by adducing evidence beyond what was
    necessary to give rise to the presumption in the first
    place. Specifically, there is no requirement to put on proof
    meeting the requirements of section 440.151, Florida
    Statutes (2009), (titled “Occupational diseases”), unless
    and until the section 112.18 presumption is rebutted. “[A]
    claimant’s burden of proving major contributing cause
    (MCC) by medical evidence, is fully met where the
    presumption contained in section 112.18(1) is applied . . .
    .”

          ....

          The judge of compensation claims erroneously
    imported into this Heart and Lung Statute case the legal
    requirements claimants must meet to demonstrate
    entitlement to workers’ compensation benefits for other
    “occupational diseases” as provided for in section 440.151,
    Florida Statutes (2009). Mr. Walters sought to establish,
    not an occupational disease, but a “condition or
    impairment of . . . any . . . correctional officer . . . caused
    by . . . heart disease . . . resulting in total or partial
    disability . . . presumed to have been accidental and to
    have been suffered in the line of duty.” § 112.18(1), Fla.
    Stat. (2009). In shifting the burden to the claimant to
    prove that the offending virus was work-related, the
    judge of compensation claims failed to give proper effect
    to the section 112.18 presumption. The State never
    rebutted the presumption of an “an accident” in the line
    of duty, a presumption that arose in the present case on
    stipulated facts.

Id. at 1176.

                                  9
     Then in Orange County and Alternative Service Concepts v.
Wilder, 107 So. 3d 480, 480 (Fla. 1st DCA 2013), the claimant
requested compensability under section 112.18 of his heart
condition which resulted from viral cardiomyopathy. The
employer/carrier stipulated that the claimant met the
prerequisites of proof for application of the presumption of
occupational causation, “including that her viral cardiomyopathy
constitutes ‘heart disease’ as that term is used in section 112.18.”
Id. Yet, the employer/carrier argued that the JCC erred when it
failed to find that the employer/carrier had rebutted the
presumption by showing that the cause of the cardiomyopathy was
a virus. Id. at 480–81. In the order appealed, the JCC found that
the employer/carrier failed to meet its burden of proving the
claimant’s employment was not the source of the virus. Citing
Walters, this Court found that the JCC’s determination that the
employer/carrier failed to rebut the presumption was supported by
competent, substantial evidence. Id. at 481.

     To be clear, Walters and Wilder were decided in the specific
context in which the cases were litigated. That is, in both cases,
the employer/carriers conceded that the predicates for the
application of the presumption of work causation under section
112.18 were satisfied despite the heart disease in those cases
arising from a viral etiology. These concessions, in and of
themselves, set the employer’s rebuttal burden—to prove that the
virus causing the claimants’ heart conditions were contracted
outside of work. 4 See Walters, 100 So. 3d at 1176 (“If the
presumption applies, the claimant is under no obligation to
establish occupational causation redundantly by adducing
evidence beyond what was necessary to give rise to the
presumption in the first place . . . . The State had the burden to
prove he did not get the virus at work and failed to carry its

    4 Where the claimant presents no medical evidence supporting

the presumption of work causation (called “presumption only”), the
employer’s burden in rebutting it is to prove with competent
evidence “that the disease causing disability or death was caused
by a specific, nonwork related event or exposure.” See Caldwell v.
Div. of Ret., Fla. Dep’t of Admin., 372 So. 2d 438, 441 (Fla. 1979).

                                10
burden.”). Once the presumption is conceded, the claimant’s
occupational causation burden is satisfied.

     Here, because Seminole County stipulated to the
presumption—its rebuttal burden was cemented. As a
“presumption only” claim, it was required to prove by competent
evidence that the disease resulting in Braden’s disability was
caused by a nonwork related event or exposure. Without the
concession by the Employer, Braden would have needed to prove
entitlement to the presumption under section 112.18 with proof
that his heart disease caused an impairment or condition resulting
in disability. See Holcombe v. City of Naples/Johns E. Co., Inc.,
328 So. 3d 311, 314 (Fla. 1st DCA 2021) (employer challenged
application of the statutory presumption where there was evidence
of secondary hypertension in the claimant’s preemployment
physical); Williams v. City of Orlando, 89 So. 3d 302, 302–03 (Fla.
1st DCA 2012) (employer did not concede application of the
presumption, arguing instead that essential hypertension did not
fall under one of the conditions covered by section 112.18); Bivens
v. City of Lakeland, 993 So. 2d 1100, 1103–04 (Fla. 1st DCA 2008)
(holding “essential hypertension” is not the form of hypertension
covered by the presumption of 112.18); City of Miami v. Thomas,
657 So. 2d 927, 928 (Fla. 1st DCA 1995) (this Court rejected the
JCC’s finding that the term “hypertension” as used in section
112.18, was meant to include “any kind of hypertension”).

     Section 112.18 covers any condition or impairment of health
“caused by tuberculosis, heart disease, or hypertension . . . .”
(Emphasis added.) In the absence of a stipulation by the employer,
the question of whether a claimant’s condition or impairment gives
rise to the presumption of work causation under section 112.18 is
determined by the plain language of the statute. Here, as in
Walters and Wilder, in light of the similar concession by Seminole
County on the application of the presumption, we do not reach
whether an impairment or condition caused by a virus-caused
heart disease can give rise to the statutory presumption of work
causation under section 112.18.

    Rather, we consider only whether Seminole County met its
burden to overcome the statutory burden of work causation. Under
these facts, we find competent evidence supports the JCC’s

                                11
determination that Seminole County failed to rebut the statutory
presumption.

                    B. Constitutional Challenge

     Constitutional challenges to statutes are pure questions of
law subject to de novo review. See Scott v. Williams, 107 So. 3d
379, 384 (Fla. 2013) (citing Crist v. Ervin, 56 So. 3d 745, 747 (Fla.
2010)). For the first time on appeal, Seminole County raises an as-
applied constitutional challenge. 5 It asserts that “in cases where
COVID-19 causes heart disease in a first responder, section
112.18, Florida Statutes, creates an irrebuttable unconstitutional
presumption.” And this irrebuttable presumption wrongfully
shifts the costs of the pandemic onto employers and insurance
companies. We decline to address Seminole County’s as-applied
constitutional challenge. As discussed above, when Seminole
County conceded the application of the statutory presumption of
work causation for Braden’s claims, it abandoned multiple
defenses available under the Workers’ Compensation Law. The
employer cannot tie both arms behind its back and then be heard
to complain that it has been left defenseless. Cf. Rodriguez v.
Tallahassee Fire Dep’t/City of Tallahassee, 240 So. 3d 788, 789
(Fla. 1st DCA 2018) (identifying section 112.18 as a rebuttable
presumption); City of Jacksonville v. Ratliff, 217 So. 3d 183, 186
(Fla. 1st DCA 2017) (noting that section 112.18(1) “creates a
rebuttable presumption of occupational causation”); Martz v.
Volusia Cnty. Fire Servs., 30 So. 3d 635, 636 (Fla. 1st DCA 2010)

    5 Under Florida Rule of Appellate Procedure 9.425 in cases not

involving criminal or collateral criminal proceedings, when raising
a constitutional challenge, the party appealing must file a notice
of constitutional question and serve the notice and a copy of the
petition or brief on the office of the attorney general (AG). Seminole
County did not do so here, and this Court issued an order to show
cause requiring satisfaction of the rule. The AG was given an
opportunity to appear at oral argument and file briefs. The AG
could not appear at oral argument given the short notice but filed
argument via briefing. As a needed reminder, failure of a party to
comply with the requirements of rule 9.425 causes unnecessary
delay in the appeal and potential prejudice to the AG.

                                 12
(noting that section 112.18(1) affords certain public employees a
rebuttable presumption that a condition was suffered in the line of
duty).
     AFFIRMED.

ROWE, J., concurs in result only; OSTERHAUS, C.J., specially
concurs with opinion.

                  _____________________________

    Not final until disposition of any timely and
    authorized motion under Fla. R. App. P. 9.330 or
    9.331.
               _____________________________

Osterhaus, C.J., specially concurring.

      I concur insofar as Walters v. State, 100 So. 3d 1173 (Fla. 1st
DCA 2012) and Orange County & Alternative Service Concepts v.
Wilder, 107 So. 3d 480 (Fla. 1st DCA 2013) control the outcome
here. I also see little in Appellants’ constitutional argument
because Employer/Servicing Agents may reasonably disprove the
presumption of occupational causation in cases like this one by
showing that the claimant did not get the virus at work (or perhaps
by disputing the application of the § 112.18(1) presumption in the
first place).

                  _____________________________

Michael Broussard and Megan E. Oliva, Broussard, Cullen &
Blastic, P.A., Orlando, for Appellants.

James Robert Spears, Law Office of James Spears, PLLC, Orlando,
for Appellee.

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