City of Pembroke Pines v. Ortagus
2010 Fla. App. LEXIS 16608
Fla. Dist. Ct. App.2010Background
- Claimant, a firefighter for the City, was diagnosed with hypertension during an annual physical on May 11, 2005 and assigned to light duty with medication.
- After several days off work and two days of light duty, he returned to normal duty and reached maximum medical improvement on May 17, 2005.
- Since then, he has required continued medical treatment, including blood pressure and cholesterol medications, semi-annual physicals, and annual stress tests.
- In January 2009, after the employer/carrier had paid medical benefits for over three years, they terminated benefits arguing that under § 112.18, the claimant became ineligible once he returned to normal duty.
- The JCC ruled that the employer/carrier must continue paying for treatment of hypertension even though the claimant is no longer disabled and can perform his duties.
- The court affirmed, holding that compensability established under § 440.151(1)(a) allows ongoing medical care for a compensable occupational disease as long as it remains the major contributing cause of the need for medical care.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether ongoing hypertension treatment is required after return to normal duty | Ortagus asserts ongoing medical care is compensable if hypertension remains major contributing cause. | City argues benefits cease when disability ends and presumption applies only during disability. | Yes; ongoing treatment remains compensable as the condition remains a compensable occupational disease. |
| Effect of § 112.18 presumption on medical benefits duration | Presumption fully supports compensability and continued medical care. | Presumption applies only during period of disability, after which medical benefits may stop. | Presumption does not cap benefits; medical care continues as long as hypertension is the major contributing cause. |
Key Cases Cited
- City of Port Orange v. Sedacca, 953 So.2d 727 (Fla. 1st DCA 2007) (occupational disease can be compensable even when disability is not permanent)
- Fuller v. Okaloosa Corr. Inst., 22 So.3d 803 (Fla. 1st DCA 2009) (presumption fully met the claimant's burden on major contributing cause)
- City of Miami v. Thomas, 657 So.2d 927 (Fla. 1st DCA 1995) (disability not required for compensability of a given condition's medical benefits)
- Engler v. Am. Friends of Hebrew Univ., 18 So.3d 613 (Fla. 1st DCA 2009) (once compensability is established, carrier cannot contest occupational cause but can contest specific treatment)