By Michael M. Riedhammer, B.C.S.
An employee just fell while working! Will he or she receive workers’ compensation benefits? Do we know why the fall occurred? Or do we have no idea what caused the fall? What exactly was he or she doing when the fall took place? Was it something related to their job?
Valcourt-Williams is the Answer!
Just short of three years ago we thought we had all the answers when the First DCA gave us an opinion explaining when an accident “arises out of” employment and can be deemed compensable (aka Sedgwick CMS v. Valcourt-Williams).
As discussed in a previous HPS Alert, the key holding in Valcourt-Williams is that for a case to be compensable the injuries must “arise out of employment” which means that there must be “occupational causation.” Simply, the accident and injury must be caused by a risk that is not existent in the claimant’s non-employment life.
Or is it?
In the years since that holding, the JCCs have tried to apply its rationale to the fact-specific cases that have come before them. Many cases that would have been held compensable before this decision were now being found to be not compensable. Recently, the First DCA issued two opinions that strive to better define the parameters of the Valcourt-Williams holding.
On February 16, 2022, the court released the decision of Silberberg v. Palm Beach County School Board and York Services Group, 2022 WL 480740 (Fla. 1st DCA 2022). In this case, the claimant, a teacher, was injured in a fall in the classroom. He fell when he stood up from a sitting position, after his leg went numb. The JCC denied compensability finding that the injury did not “arise out of” the claimant’s work as a teacher. The JCC followed Valcourt-Williams and found that there was no evidence that “the physical surroundings on the job in any way contributed to the risk of an injury more than they would have in non-employment life.” The appellate court agreed, and affirmed this decision. The First District seemed to be particularly swayed by the fact that the two medical experts, one hired by each party, agreed that the numbness in the claimant’s leg could have happened anywhere. The court also found it important that the cause of Claimant’s fall was not unknown; rather, there was an identifiable cause and, by all accounts, the claimant’s employment did not contribute to it.
Less than a week later, on February 21, 2022, a decision was released in Soya v. Health First, Inc. and CCMSI, 2022 WL 620619 (Fla. 1st DCA 2022). The claimant in this case was leaving work and fell into a door. She was carrying some non-work items and did not know what caused her to fall and there was no identifiable hazard. The JCC denied compensability finding that the employment did not expose the claimant to “conditions that would substantially contribute to the risk of injury to which the claimant would not normally be exposed during her non-employment life.” This time, the First DCA reversed, finding that the fall was compensable. Citing back to older decisions, such as Ross, Caputo, and Walker (which many practitioners believed had been indirectly overturned by Valcourt-Williams) the appellate court explained that “[w]here an accident’s cause is unknown, it is error to deny compensability on grounds that the accident ‘could have happened elsewhere.’” The court went on to declare that “[c]lumsiness is covered” and to reiterate that where there is only one cause of an accident (in this case, leaving work) the claimant should not be required to present more evidence showing that his or her employment is the major contributing cause.
So, now we have all the answers, right? Well, at least we have some more things to consider. Every case is different and every case is going to fall somewhere on the spectrum of compensability. The close cases of whether an accident “arises out of” employment will require a deep dive into all of the available facts and evidence. The ultimate determination of whether an accident should be denied or whether an injured worker should receive benefits will require us to apply those facts and evidence to the continuously growing body of case law. Seeking the counsel of an experienced workers’ compensation attorney will certainly aid in this endeavor. If you are dealing with a Workers’ Compensation case and would like to discuss your options, please contact Michael M. Riedhammer (954.523.9922) or any member of our Haliczer Pettis & Schwamm legal team: