WAUSAU INSURANCE COMPANY AND CAREMATRIX CORP. D/B/A BAILEY VILLAGE, APPELLANTS,
v.
MICHAEL TILLMAN, APPELLEE
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In this workers' compensation case, the Florida appellate court reversed a determination that an employee's claimed injuries from drinking contaminated Kool-Aid were compensable, holding that without expert medical evidence establishing causation for non-observable medical conditions, the claim could not be sustained.
A claimant alleging non-readily observable medical conditions resulting from workplace incidents must present expert medical evidence to establish a causal connection between employment and the injuries. Where no medical evidence of any nature is offered, it is error to determine the claim is compensable, and the claim must be dismissed.
[1] A claimant must present expert medical evidence to establish a causal connection between employment and alleged injuries when the medical conditions are not readily obser…
[2] In workers' compensation cases, the claimant bears the burden of establishing a causal connection between employment and alleged injuries.
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Join FLexlaw to unlock all legal intelligence“It was the claimant's burden to establish the existence of a causal connection between his employment and his alleged injuries. Because the medical conditions which the claimant alleged had resulted from the workplace incident were not readily observable, he was obliged to present expert medical evidence establishing that causal connection.”
Establishes the fundamental requirement for proving non-observable work-related injuries
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Join FLexlaw to unlock all legal intelligenceThe claimant alleged he sustained serious throat and stomach damage and aggravation of pre-existing cirrhosis after drinking Kool-Aid to which an unkn…
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[*124] WEBSTER, J.
In this workers’ compensation case, the employer and carrier seek review of a non-final order determining that the claimant’s alleged injuries were compensable. We have jurisdiction. Fla. R.App. P. 9.180(b)(1)(C). Because the claimant’s alleged medical condition was not readily observable and no expert medical evidence was offered to establish a .causal connection between the claimant’s employment and the alleged injuries for which benefits were sought, we reverse.
The claimant alleged that he sustained serious damage to his throat and stomach, and aggravation of a pre-existing cirrhosis condition, when he drank some Kool-Aid that he had previously made and to which some unknown substance had been added by some unknown person without his knowledge.
The evidence to support those allegations was weak at best.
However, for purposes of this appeal, we find dispos-itive the fact that no medical evidence of any nature was offered. More particularly, no medical evidence was offered to suggest either that the claimant had suffered the injuries of which he complained, or that any of those injuries had been caused by drinking the Kool-Aid. It was the claimant’s burden to establish the existence of a causal connection between his employment and his alleged injuries. Because the medical conditions which the claimant alleged had resulted from the workplace incident were not readily observable, he was obliged to present expert medical evidence establishing that causal connection. E.g., Ackley v. General Parcel Service, 646 So. 2d 242 (Fla. 1st DCA 1994) (determination of the cause of psychiatric illness is essentially a medical question, requiring expert medical evidence); Crest Products v. Louise, 598 So. 2d 1075 (Fla. 1st DCA 1992) (because the claimant’s pain in her low back and leg were not the result of any readily observable medical condition, the claimant was obliged to present expert medical evidence establishing a causal connection between her employment and the condition complained of); Peters v. Armellini Express Lines, 527 So. 2d 266 (Fla. 1st DCA 1988) (soft tissue injuries are not readily observable and, therefore, expert medical evidence is necessary to establish a causal connection between the claimant’s employment and such an injury).
See also Closet Maid v. Sykes, 763 So. 2d 377 (Fla. 1st DCA 2000) (en banc) (discussing when medical evidence is necessary to establish causation).
The claimant having failed to present any medical evidence whatsoever, it was error for the judge of compensation claims to conclude that the claim was compensable.
Accordingly, we reverse, and remand with directions that the claim be dismissed.
REVERSED and REMANDED, with directions.
ERVIN and WOLF, JJ., CONCUR.
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Previewing 3 of 5 citing cases — full citator treatment, depth of discussion, and citing context are member features.
Join FLexlaw to unlock all legal intelligenceAuthorities Cited
- Closet Maid & Crawford & Co. v. Sykes, 763 So. 2d 377 (Fla. 1st DCA 2000)
- Peters v. Armellini Express Lines & Nationwide Ins., 527 So. 2d 266 (Fla. 1st DCA 1988)
- Ackley v. Gen. Parcel Serv. & Am. States Ins., 646 So. 2d 242 (Fla. 1st DCA 1994)