WHEN IS AN INJURY COMPENSABLE UNDER THE WORKERS’ COMPENSATION LAW?

By: Richard E. Guttentag, Esq., Stearns, Roberts & Guttentag, L.L.C.

An injury must “arise out of” one’s employment and must occur “in the course and scope of” that employment in order to be compensable under the Workers’ Compensation Law.

In Caputo v. ABC Fine Wine & Spirits, 2012 WL 2814008 (Fla. 1st DCA 2012), Claimant, an electrician for his Employer, fell and hit his head on the floor while cutting down shelving in his Employer’s store, suffering a head injury.  The shelving work that Claimant was performing at the time he was injured was within his job scope.  Claimant filed a petition for benefits seeking a determination that the accident was compensable, and seeking temporary disability benefits from the date of the accident, penalties, interest, attorney’s fees and costs.  The Employer/Carrier (E/C) denied the claim on the basis that Claimant’s fall resulted either from a pre-existing or idiopathic condition (i.e. a condition that develops without an apparent or known cause).  The Judge of Compensation Claims (JCC) denied compensability of Claimant’s injury ruling that the injury was idiopathic, occurred fortuitously while Claimant was at the Employer’s store, and was not caused by the employment. Claimant appealed the JCC’s Order.

Two factors must be present in order for an injury to be compensable: (1) the work must have been performed in the course and scope of employment; and (2) the work must be the major contributing cause of the accident or injury.  In this case, the E/C conceded that Claimant’s injury occurred in the course and scope of his employment, while performing his job duties on the Employer’s premises.  Thus, the dispute in this case was limited to whether the injury wascaused by Claimant’s employment.

The appellate court reasoned that if an employee has no prior weakness or disease, any exertion connected with employment and causally connected with the injury as a medical fact is adequate to satisfy the legal test of causation.  Further, if there is only one cause of a claimant’s injuries, rather than competing causes, a claimant is not required to present additional evidence going to the issue of whether the work-related accident was the major contributing cause of the injuries.

In this case, the Appellate Court determined that there was an absence of any evidence which could support a finding that there were competing causes of Claimant’s injuries, as it was undisputed that Claimant’s head injuries resulted from Claimant’s head hitting the floor while Claimant was engaged in the duties of his employment. Further, there was no evidence that Claimant had pre-existing conditions which may have caused Claimant’s injuries.  Thus, the appellate court concluded that Claimant satisfied the major contributing cause requirement by establishing a sufficient connection between his work and the accident by producing evidence that Claimant’s injuries resulted from Claimant’s head impacting the floor while Claimant was performing his job duties in his Employer’s store.  Accordingly, the appellate court reversed the JCC’s Order, ruling Claimant’s injuries were compensable.

This case demonstrates that in order for an accidental injury to be compensable under the workers’ compensation law, the work must have been performed in the course and scope of employment, and the work must be the major contributing cause of the accident or injury.

About the Author: Richard E. Guttentag is a partner with Stearns, Roberts & Guttentag, L.L.C., and is Board Certified in Construction Law by the Florida Bar. Mr. Guttentag exclusively in construction law including construction lien claims and defense, payment and performance bond claims and defense, bid protests, construction contract preparation and negotiation, and construction and design defect claims and defense. He can be reached for consultation at [email protected].

Share Now:

Categories

Subscribe To Our Newsletter