Certistaff, Inc. v. Owen, 181 So. 3d 1218

Claimant (gas technician) fell from a ladder on Dec. 5, 2013, landing on his right side; Employer/Carrier (E/C) initially accepted the right-shoulder injury and authorized treatment.
Claimant had long-standing bilateral shoulder pathology (prior right rotator cuff repair ~1999–2000; two left cuff surgeries 2002 and 2005) and reported intermittent shoulder pain treated with OTC meds before the fall.
Treating physician (Dr. Patterson) and Claimant’s expert (Dr. Fiore) differed on causation; E/C sought an independent expert medical examiner (EMA), Dr. Greene, who concluded the preexisting degenerative arthritis and chronic rotator cuff disease were the major contributing cause (MCC) of the need for shoulder replacement.
The JCC rejected the EMA’s presumptively correct opinion, found the compensable work accident was the MCC of Claimant’s need for surgery, reasoning Claimant may have been asymptomatic and the preexisting condition had not independently required treatment prior to the accident.
On appeal, the district court reviewed whether the JCC articulated clear and convincing evidence to rebut the EMA and whether the compensable injury was the MCC under Florida workers’ compensation law.

Issue	Plaintiff's Argument (Claimant)	Defendant's Argument (E/C / EMA)	Held
Whether the JCC permissibly rejected the EMA’s presumptively correct causation opinion	EMA was wrong; compensable fall was the MCC because it made the underlying condition symptomatic and precipitated need for surgery	EMA opined preexisting degenerative arthritis/rotator cuff pathology was the MCC; EMA’s opinion is presumptively correct and not overcome	Reversed: JCC failed to articulate clear and convincing evidence to rebut EMA; must accept EMA absent such articulation
Whether the compensable accident was the MCC of the need for shoulder replacement under §440.09(1)(b)	The accident combined with preexisting condition to cause/prolong need for treatment; claimant may have remained asymptomatic absent the fall	Preexisting degenerative changes were the primary cause and would likely lead to surgery even without the fall	Court found medical evidence supported EMA that preexisting pathology was MCC; JCC erred by focusing solely on lack of prior physician treatment and ignoring objective pathology and EMA testimony

City of Fort Pierce v. Spence, 155 So.3d 1197 (Fla. 1st DCA 2014) (discusses MCC analysis when preexisting condition is present)
Trejo-Perez v. Arry’s Roofing, 141 So.3d 220 (Fla. 1st DCA 2014) (substance of evidence controls over ‘‘magic words’’ in causation findings)
Mobile Med. Indus. v. Quinn, 985 So.2d 33 (Fla. 1st DCA 2008) (JCC must articulate reasons when rejecting EMA opinion)
Travelers Ins. v. Armstrong, 118 So.3d 865 (Fla. 1st DCA 2013) (JCC cannot merely state a treating physician’s view is most logical without explaining why)
Pizza Hut v. Proctor, 955 So.2d 637 (Fla. 1st DCA 2007) (application of §440.09(1)(b) when injury combines with unrelated preexisting condition)
Ullman v. City of Tampa Parks Dep’t, 625 So.2d 868 (Fla. 1st DCA 1993) (JCC factual findings reviewed for any legally permissible view of the evidence)
Gilbreth v. Genesis Eldercare, 821 So.2d 1226 (Fla. 1st DCA 2002) (legal conclusions reviewed de novo)