The US Court of Appeals for the Eighth Circuit in Florida has ruled that the Judge of Compensation Claims (JCC) erred in entering a judgment in favor of a corrections officer for a cardiac injury because medical evidence showed that strenuous exercise triggered the degeneration of his congenital heart condition into atrial fibrillation. The case is City of Jacksonville v. O'Neal, No. 1D19-597, 2020 Fla. App. LEXIS 5471 (Dist. Ct. App. Apr. 23, 2020).

In 2002, Adrian O'Neal, the claimant, was a twenty-nine-year-old corrections officer who began experiencing heart problems. Reportedly, when exercising, O'Neal's heart would flutter, causing lightheadedness. At that time, he was training to participate in Olympic-type track and flag-football competitions. He sought medical advice for his heart issues, and was diagnosed with atrial tachycardia and atrial fibrillation. On June 26th of that year, O'Neal underwent a cardiac catheterization. As part of this procedure, his doctor intentionally induced arrhythmias. O'Neal filed a workers' compensation claim based on the arrhythmias and listed June 26th as the date of the accident. Later, the doctor testified broadly that job stress could play a role in causing arrhythmias, but could not implicate job stress in the development of O'Neal's condition, instead, he stated that his understanding of the condition was that it had been triggered by elite level exercise.

After the initial hearing, the JCC determined that the claim was compensable under the correctional officer's occupational causation presumption in §112.18(1)(a) Fla. Stat. The JCC acknowledged that the atrial tachycardia was congenital, and concluded that his heart problems were a compensable injury that could have been triggered by job-related stressors. O'Neal's employer and insurance carrier (together E/C) appealed, and the appellate court reversed and remanded for additional findings related to the trigger-theory-based decision of the JCC. The court asked the JCC to identify the underlying condition and resulting diagnosis so the scope of E/C's potential liability could be determined. The JCC affirmed that the diagnosis was atrial tachycardia that degenerated into atrial fibrillation and concluded under the occupational presumption that his employment could have triggered the degeneration. E/C appealed again.

Under Florida law, when a covered officer passes a physical exam when entering the service, and later is disabled by heart disease or hypertension, under §112.18(1)(a) Fla. Stat. it is presumed that the condition was contracted accidentally and in the line of duty. Such an injury is compensable even if no evidence is presented to support a work-related cause, unless the E/C rebuts the presumption. In order to overcome the presumption, the E/C must essentially demonstrate that the injury arose from a nonwork-related cause.

The "trigger theory" of compensability requires three prongs to be satisfied:

  1. an underlying condition
  2. a "trigger," and
  3. resulting heart disease

The appellate court stressed that although the doctor identified job stress as an occupational trigger, he could not implicate job stress as the trigger in this case, and could not isolate it as the cause of the condition. The court concluded that the E/C had rebutted the presumption, and the evidence consistently conflicted with the statutory presumption in this case, and reversed and remanded the JCC's decision.

Editors Note: This case gives employers and carriers guidance for the rebuttal of the Florida "covered officers" presumption. Although the injured officers will not often be participating in Olympic level training programs if an E/C can present strong undisputed evidence that a condition had developed during a time of unusually strenuous activity on the part of the insured which is not work-related, the possibilities of a E/C friendly decision increase.