MINTON-SUN, INC. AND EXECUTIVE RISK CONSULTANTS, APPELLANTS,
v.
ARCHIE HILLS, APPELLEE

Fla. 1st DCA | 1990-06-07
No. 89-2187
SMITH and WENTWORTH, JJ., concur.
563 So. 2d 162 Florida District Court of Appeal, First District (1990) Positive Treatment
Cited by 6 cases

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Synopsis

In this workers' compensation appeal, the court affirmed the judge's award of wage loss benefits, medical bills, and prescription/mileage reimbursement to an employee who injured his back in a compensable workplace accident and later experienced an aggravation of that injury. The appellate court rejected the employer/carrier's arguments regarding causation, reverse merger doctrine, and an idiopathic condition defense.


Holding

The court affirmed all three findings. The October 1988 couch incident was properly characterized as a temporary exacerbation of the compensable injury, not a separate injury triggering a reverse merger analysis. Wage loss benefits were properly awarded based on competent evidence that Hills' physical limitations from the compensable injury contributed to his wage loss. The idiopathic condition defense failed because Hills was exposed to risks in his employment environment different from those in non-employment life.


Headnotes

[1] A subsequent incident may be considered a temporary exacerbation of a compensable injury, rather than a new, distinct injury, if the claimant had not reached maximum medi…

[2] In wage loss benefit claims, the claimant bears the burden of proving that physical limitations subsequent to the accident were a contributing causal factor in the allege…

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Key Quotes

“the judge's observations on this point that at the time of the second noncompensable accident, claimant had not reached MMI from the initial compensable injury, was totally disabled and actively recuperating from major surgery on his low back, and was thus obviously still suffering from the effects of that compensable injury in October 1988”

Establishes the factual foundation for treating the October incident as an exacerbation rather than independent injury

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Facts & Procedural History

On January 14, 1987, Archie Hills injured his lower back when the wheel of a tractor he was driving slipped into an irrigation furrow. He was treated …

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Opinion of the Court
WIGGINTON, Judge.

OPINION

WIGGINTON, Judge.

This is an appeal from the order of the judge of compensation claims awarding wage loss benefits and payment of medical bills, and ordering the employer/carrier to pay all outstanding bills for prescriptions and mileage reimbursement requests related to treatment of claimant’s compensable injuries. The E/C raise three points on appeal challenging the judge’s order. We affirm on all three points.

Claimant injured his lower back in a compensable accident1 on January 14, 1987, when the wheel of the tractor he was driving for the employer slipped off into a two foot irrigation furrow jerking his body and shifting it in the seat. Claimant received treatment from Dr. Barrett, a neurosurgeon who ultimately performed back surgery in August 1988. On or around the first of October 1988, while recuperating, claimant suffered an incident from which he again experienced back pain, when he awoke suddenly while sleeping on a couch, jumped, and pulled himself up. He described a “terrible pull” in his back paralyzing him for a time with a burning sensation. At the hearing, he testified he was in severe pain for about three to four days when his condition began to improve. He again saw Dr. Barrett on October 18, who noted the jump off the couch which resulted in pain and which was gradually improving to the point where claimant was of the opinion he was “almost back to where he was two weeks ago.” In summary, Dr. Barrett’s testimony and medical records indicate that the January 14, 1987 compensable accident resulted in damage to the L3-4 and L4-5 levels. However, the October 1988 “couch jumping” incident involved the L5-S1 level and the SI joint. Those new findings were not present in earlier diagnostic studies. Dr. Barrett opined that as a result of the “condition” for which he was treated, claimant had a 15% permanent impairment and reached MMI on February 3, 1989. The doctor also opined that the “couch jumping” episode constituted an “aggravation” of claimant’s underlying back condition.

In her order, the judge found that claimant reached maximum medical improvement on February 3, 1989, and that as a result of the compensable injury he sustained a 15% impairment to the body as a whole. She accepted the testimony of Dr. Barrett that the condition for which he treated claimant was causally related to claimant’s accident of January 14, 1987, and that the “couch jumping” incident “constituted merely a temporary exacerbation of the injuries the claimant sustained in the industrial accident, and ... that Dr. Barrett’s testimony taken as a whole supports no other conclusion.” In answer to the E/C’s Point I on appeal, we hold that that latter finding by the judge was based on competent and substantial evidence and affirm.

Under Point II, the E/C argue the judge’s finding — that the October 1988 couch incident constituted a temporary exacerbation of the compensable injuries— amounted to an improper reverse merger. They assert that claimant sustained a non-compensable injury after his alleged compensable industrial accident resulting in an identifiable injury distinct from the injuries stemming from the compensable accident. Consequently, the E/C submit that they should not be held responsible for medical benefits and compensation benefits related to the new findings at the L5-S1 and SI joint following the October 1988 incident.

In answer to this argument, we first note the judge’s observations on this point that at the time of the second noncompensable accident, claimant had not reached MMI from the initial compensable injury, was totally disabled and actively recuperating from major surgery on his low back, and was thus obviously still suffering from the effects of that compensable injury in October 1988. The judge found nothing in the testimony of Dr. Barrett regarding the couch incident indicating a break in the causal chain between the industrial accident and the disability suffered by claimant at the time of the hearing and from which he had been suffering ever since the industrial accident.

Moreover, even assuming (without deciding) that the couch incident may be viewed as a subsequent independent cause of injury, a “reverse merger” analysis is inappropriate under the particular circumstances of the instant case where the claim was for wage-loss benefits. As correctly noted by the judge, where wage loss benefits are sought, “[t]he burden of proof is on the claimant to prove all elements of a wage loss claim, including the most basic element ‘that his physical limitation[s] subsequent to his accident were a contributing causal factor in his alleged wage loss.’ Superior Pontiac v. Hearn, 458 So. 2d 1197, 1199 (Fla. 1st DCA 1984).” Additionally, it was incumbent upon claimant under Section 440.15(3)(b)l., Florida Statutes (1985), to show that he suffered a permanent impairment arising from the compensable accident. In the instant case, there was competent and substantial evidence that claimant suffered a 15% impairment of the body as a whole, of which percentage at least some portion, if not all, was attributable to the compensable injury — based on the medical testimony of Dr. Barrett. Further, since the E/C do not contest the judge’s finding that claimant adduced competent and substantial evidence from which it could be inferred that a causal relationship existed between claimant’s wage loss and his physical limitations arising from the industrial accident, we affirm the award of wage loss in the instant case.

We also hold the judge properly ordered the E/C to pay certain medical bills found to be related to the industrial accident. Additionally, the judge did not err in finding the E/C responsible for “all outstanding bills for prescriptions and mileage reimbursement requests ... related to treatment for his compensable injuries.”

Finally, we affirm the judge’s rejection of the E/C’s idiopathic condition defense under Point III. The E/C attempt to argue that the accident was not compensable because any similar circumstance could have triggered an onset of claimant’s lower back symptoms, given evidence that claimant had a preexisting degenerative disc disease and osteophyte formations. Here, the defense of idiopathic condition must fail since claimant exposed himself to risks and conditions in his employment environment different from those encountered in his nonemployment life. Compare House v. Preferred Auto Leasing, 476 So. 2d 1337 (Fla. 1st DCA 1985).

For the foregoing reasons, the order of the judge of compensation claims is

AFFIRMED.

SMITH and WENTWORTH, JJ., concur. . Because of our resolution of Point III, the accident is deemed compensable.


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    …since been amended, the interpretation placed upon it ten years ago in Regency Inn has been followed in numerous subsequent decisions. See, e.g., Brosnan v. Sourbeck Roofing, Inc., 578 So. 2d 460, 462 (Fla. 1st DCA 1991); Minton-Sun, Inc. v. Hills, 563 So. 2d 162, 164 (Fla. 1st DCA 1990); Edwards v. Caulfield, 560 So. 2d 364, 374-75 (Fla. 1st DCA 1990); City of Clermont v. Rumph, 450 So. 2d 573, 576 (Fla. 1st DCA), review denied, 458 So. 2d 271 (Fla.1984). The type of evidence a claimant in a particular cas…
  • Atl. CAR Care, Inc. v. Aaron, 569 So. 2d 527 (Fla. 1st DCA 1990)
    …PER CURIAM. AFFIRMED. Cruise Quality Painting v. Paige, 564 So. 2d 1190 (Fla. 1st DCA 1990); Minton-Sun, Inc. v. Hills, 563 So. 2d 162 (Fla. 1st DCA 1990). WENTWORTH, JOANOS and ALLEN, JJ., concur.…
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    …ntial evidence to support an eight percent impairment rating for Appellee. Appellee has the burden to prove by competent substantial evidence the extent of her TMJ impairment from her condition after she reaches MMI. See Minton-Sun, Inc. v. Hills, 563 So. 2d 162, 164 (Fla. 1st DCA 1990). Here, Appellee fails to do so; her impairment rating before undergoing splint therapy does not support an impairment rating after the treatment. Cf. Delgado v. Omni Hotel, 643 So. 2d 1185, 1186 (Fla. 1st DCA 1994) (holding…

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