Marek Krysiak v. City of Kissimmee, Toho Water Authority/Preferred Government Claims Solutions
CourtDistrict Court of Appeal of Florida
Date FiledFebruary 13, 2020
Docket1D18-5241
StatusPublished
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Full Opinion
FIRST DISTRICT COURT OF APPEAL
STATE OF FLORIDA
_____________________________
No. 1D18-5241
_____________________________
MAREK KRYSIAK, CORRECTED PAGES: pg 2, & 5
CORRECTIONS ARE UNDERLINED IN
RED
Appellant, MAILED: March 10, 2020
BY: FTA
v.
CITY OF KISSIMMEE, TOHO
WATER AUTHORITY/PREFERRED
GOVERNMENT CLAIMS
SOLUTIONS,
Appellees.
_____________________________
On appeal from an order of the Judge of Compensation Claims.
Thomas W. Sculco, Judge.
Date of Accident: October 12, 2016.
February 13, 2020
PER CURIAM.
In this workers’ compensation case, Claimant appeals the
Judge of Compensation Claims’ (JCC’s) order finding that
Claimant is not entitled to make his own selection of a one-time
change of physician, and that temporary partial disability (TPD)
benefits are not payable because Claimant’s postinjury
employment was terminated due to his misconduct. We affirm the
JCC’s ruling on the issue of the one-time change based on his
determination that Claimant acquiesced to the
Employer/Servicing Agent’s (E/SA’s) choice of physician and thus
waived the option of making his own selection. But we reverse his
ruling on the TPD benefits because the record contains no
competent, substantial evidence that Claimant committed the
misconduct resulting in his discharge from employment.
I
Procedural Background
On October 12, 2016, Claimant sustained a compensable
workplace injury to his left shoulder. He was initially subject to
work restrictions, but in February 2017, the authorized physician
placed him at maximum medical improvement with no work
restrictions and no permanent impairment. Although Claimant
returned to full duty work, he was discharged on October 31, 2017,
for violating the Employer’s substance abuse policy. Claimant
subsequently filed petitions for benefits (PFBs) seeking
authorization of Dr. Winters as his one-time change of physician
under section 440.13(2)(f), Florida Statutes (2016), and payment of
TPD benefits.
II
One-Time Change
Section 440.13(2)(f) provides:
Upon the written request of the employee, the carrier
shall give the employee the opportunity for one change of
physician during the course of treatment for any one
accident. Upon the granting of a change of physician, the
originally authorized physician in the same specialty as
the changed physician shall become deauthorized upon
written notification by the employer or carrier. The
carrier shall authorize an alternative physician who shall
not be professionally affiliated with the previous
physician within 5 days after receipt of the request. If the
carrier fails to provide a change of physician as requested
by the employee, the employee may select the physician
and such physician shall be considered authorized if the
treatment being provided is compensable and medically
necessary.
2
The E/SA denied Claimant’s request for Dr. Winters as his one-
time change of physician on the ground that they had already
timely authorized Dr. Reuss. In the alternative, the E/SA
maintained that Claimant acquiesced to their selection of Dr.
Reuss and, as a result, waived the option of selecting Dr. Winters
as his one-time change. The JCC ultimately found in favor of the
E/SA on the acquiescence argument. For that reason, he did not
address the issue of the timeliness of the E/SA’s authorization.
The salient facts on the acquiescence issue are not disputed.
On March 6, 2018, Claimant’s attorney sent the E/SA’s attorney a
fax requesting authorization of an alternate orthopedist. In a
follow-up email sent March 10th, Claimant’s attorney informed
the E/SA’s attorney that he had not received a response to this
request and would forward information on Claimant’s choice of
orthopedist shortly. On March 27th, Claimant filed a petition for
benefits (PFB) seeking an alternate orthopedist under section
440.13(2)(f) and naming Dr. Winters as his selection of the one-
time change of physician.
Neither the E/SA nor their attorney responded directly to
Claimant’s attorney’s fax or email correspondence. The claims
adjuster later admitted that she received the March 6th fax from
the Claimant’s attorney a few days after it was sent, but stated she
did not consider this to be a request for a one-time change under
the statute because the email requested an “alternate” doctor. She
did not authorize a one-time change until designating Dr. Reuss in
the E/SA’s March 30th response to Claimant’s March 27th PFB.
On April 3rd, the claims adjuster sent Claimant and his
attorney a letter stating that she had scheduled an appointment
with Dr. Reuss for April 20th. Claimant’s attorney emailed the
E/SA’s attorney on April 12th and advised him that Claimant
would not accept Dr. Reuss because the E/SA did not respond to
the one-time change request within five days of the request.
Claimant’s attorney requested the E/SA authorize Dr. Winters as
the one-time change and stated that Claimant would treat with
Dr. Winters under the self-help provisions of the statute if they
failed to do so. After April 12th, Claimant attended at least two
3
appointments 1 with Dr. Reuss—he evidently never saw Dr.
Winters. At the final hearing, Claimant testified that he had no
choice but to attend appointments with Dr. Reuss because he
lacked the money to pay for an unauthorized physician.
Because the JCC made no findings concerning the timeliness
of the E/SA’s response, this issue turns on whether the JCC erred
when he found Claimant waived the right of selection. To the
extent the question turns on resolution of the facts, our standard
of review is competent, substantial evidence (CSE); to the extent it
involves an interpretation of law, review is de novo. See Benniefield
v. City of Lakeland, 109 So. 3d 1288, 1290 (Fla. 1st DCA 2013).
In Pruitt v. Southeast Personnel Leasing, Inc., 33 So. 3d 112,
114 (Fla. 1st DCA 2010), this Court held that section 440.13(2)(f)
does not . . . give the employee an absolute right to select
the alternate physician. Only if the E/C does not timely
authorize an alternate physician does the statute give the
employee the option of selecting the physician. If the
employee fails to exercise that option, he or she may
waive the right to select the alternate physician.
This court affirmed the denial of the claimant’s selection of the one-
time change of physician in Pruitt and found no error under
circumstances where “not only did Claimant fail to select an
alternate treating physician, but he also acquiesced in the E/C’s
selection of the alternate physician . . . .” Id. See also Gadol v.
Masoret Yehudit, Inc.,/U.S. Adm’r Claims, 132 So. 3d 939, 941
(Fla. 1st DCA 2014) (noting that claimants can waive right to
select doctor under section 440.13(2)(f) “[a]s demonstrated in
Pruitt (where the claimant never named his selection of doctor, and
treated with the employer/carrier’s selection of alternative
physician”)).
1 Although the medical reports indicate Claimant saw Dr.
Reuss at least once before his last appointment on May 30, 2018,
the actual date of his first appointment—specifically, whether
Claimant attended the April 20th appointment initially scheduled
by the adjuster—is unclear from the record.
4
As Claimant correctly points out, Pruitt is not factually on
point because the claimant there never named his choice for the
one-time change of physician. Here, not only did Claimant select
Dr. Winter as his one-time change, he also expressly objected to
the E/SA’s selection of Dr. Reuss. Although we agree that the facts
in this case may be persuasive on these points, whether Claimant
nevertheless waived the option of selecting the one-time change
depends on Claimant’s response to the E/SA’s selection given the
totality of the circumstances.
Here, Claimant’s act of attending an appointment with Dr.
Reuss contradicted his previously expressed objection and his
stated intent to treat instead with Dr. Winters. We cannot accept
Claimant’s argument that, having once objected, he can never
acquiesce in the E/SA’s selection. 2 Under these circumstances,
Claimant should have informed the E/SA that his attendance at
any appointment with Dr. Reuss was under protest. Because he
did not, we find that the JCC did not err when he found that
Claimant acquiesced to the E/SA’s selection of Dr. Reuss as his
one-time change and thus waived the right to make his own
selection.
III
Misconduct
Effective October 1, 2003, section 440.15(4)(e) provides that
“[i]f the employee is terminated from postinjury employment based
on the employee’s misconduct, [TPD] benefits are not payable as
provided in this section. . . .” Under section 440.02(18),
“Misconduct” includes, but is not limited to, the
following, which shall not be construed in pari materia
with each other:
(a) Conduct evincing such willful or wanton disregard of
2 While we agree with Claimant that prior case law concerning
the deauthorization of physicians is relevant in the analysis—in
particular, Crenshaw v. Florida Farm Bureau, 489 So. 2d 186 (Fla.
1st DCA 1986), which was cited as authority in Pruitt—we do not
find that these cases mandate a different result here.
5
an employer’s interests as is found in deliberate violation
or disregard of standards of behavior which the employer
has the right to expect of the employee; or
(b) Carelessness or negligence of such a degree or
recurrence as to manifest culpability, wrongful intent, or
evil design, or to show an intentional and substantial
disregard of an employer’s interests or of the employee’s
duties and obligations to the employer.
The employer has the burden of proving misconduct sufficient to
disqualify an employee from receiving benefits. See, e.g., Cesar v.
Reemp’t Assistance Appeals Comm’n, 121 So. 3d 1181, 1182 (Fla.
1st DCA 2013). 3 See also Trihn Trung Do v. Amoco Oil Co., 510 So.
2d 1063, 1064 (Fla. 4th DCA 1987) (noting that “the question [on
review of a denial of an unemployment compensation claim for
misconduct] is whether the evidence supports a conclusion that
[the discharged employee] was guilty of misconduct as that term is
defined by the statute”). Thus, in this case, the issue is not whether
the Employer had cause or the right to terminate Claimant’s
employment, but instead whether the E/SA proved termination
was based on acts of misconduct, as defined in the statute.
3 This Court previously held that the definition of
“misconduct” in Chapter 440 is so similar to the one in
unemployment compensation statute that a JCC is not free to
ignore its judicial construction in unemployment compensation
law. See Thorkelson v. NY Pizza & Past, Inc., 956 So. 2d 542, 545
(Fla. 1st DCA 2007) (citing definition of misconduct in § 443.029(a-
b), Fla. Stat. (2004)). The statutory definition of misconduct for
unemployment compensation cases has since been expanded. See
§ 443.036(30)(c)-(e), Fla. Stat. (2011). These changes were not
made in the definition of “misconduct” in Chapter 440 which has
not been amended since its adoption in 2003. See § 440.02(18), Fla.
Stat. (2018). It follows that the pre-2011 case law addressing
disqualification from unemployment compensation based on
misconduct remains relevant in workers’ compensation cases.
6
Whether a claimant commits misconduct connected with work
is a question of law, but the findings of fact on which the legal
question is based must be accepted if supported by CSE. See
Thorkelson v. NY Pizza & Past, Inc., 956 So. 2d 542, 545 (Fla. 1st
DCA 2007) (citing Sauerland v. Fla. Unemp’t Appeals Comm’n, 923
So. 2d 1240, 1241 (Fla. 1st DCA 2006)).
The E/SA argued below that Claimant committed misconduct
by violating the Employer’s policy on substance abuse. Generally,
a single isolated instance of failing to follow employer policy has
not been viewed as rising to the level of misconduct. See Ash v.
Fla. Unemp’t Appeals Comm’n 872 So. 2d 400, 402 (Fla. 1st DCA
2004) (“While a violation of an employer’s policy may constitute
misconduct, ‘[r]epeated violations of explicit policies, after several
warnings, are usually required.’” (quoting Barchoff v. Shells of St.
Pete Beach, Inc., 787 So. 2d 935, 936 (Fla. 2d DCA 2001) (footnote
omitted))). In this case, the E/SA submitted evidence of corrective
action taken in 2016 when Claimant violated the policy by
purchasing alcohol while on duty. At that time, Claimant was
given warning by way of a “last chance agreement” in lieu of
termination.
Rebecca Martinez, the Employer’s human resources director,
testified that Claimant’s employment was terminated when he
broke that last chance agreement with a second violation.
According to Martinez, the Employer has posted on its website a
135-page written employee policy manual. The written policy was
not submitted in evidence; however, Martinez testified that the
policy prohibits, among other things, being “under the influence”
of alcohol while at work. She conceded that the policy does not
designate a specific prohibited alcohol level or otherwise define the
phrase “under the influence.”
In late 2017, Claimant’s supervisor contacted Martinez with
complaints that Claimant was demonstrating poor attendance
patterns and had been absent for more than a couple of days
without calling in. Martinez drafted a letter to Claimant to notify
him that his absence would be considered job abandonment, but
he contacted the Employer before the letter was sent. Martinez
testified that when Claimant returned to work, the supervisor
called her and told her that Claimant “does not look ready to work.”
7
She recommended that Claimant be sent for testing to determine
the presence of alcohol or drugs. According to Martinez, the test
came back twice as “positive” and Claimant’s employment was
terminated.
The JCC ultimately found that the E/SA proved the
misconduct defense based on Claimant’s intentional violation of
the substance abuse policies given the “totality of the evidence.”
On appeal, Claimant argues that the JCC erred to the extent he
relied on Martinez’s testimony on the test results and that the
record does not otherwise contain CSE to support a finding that
Claimant was “under the influence” when he was discharged. We
agree that the vague second-hand description of Claimant’s
appearance that day is insufficient: Martinez admitted that she
did not have any personal interaction with Claimant at that time
and had no opportunity to observe him or his behavior, and the
supervisor, who actually saw Claimant, did not testify. Because
Claimant was discharged for being under the influence while at
work, we also find little probative value in the evidence concerning
his absences. 4 In short, without evidence of the test results and
accompanying admissible evidence interpreting those results, the
record here contains no CSE in support of the JCC’s finding of
misconduct.
In this case, the E/SA chose not to submit the test results or
evidence from anyone with personal knowledge of the testing. At
the final hearing, Claimant testified that he was told that his
employment was terminated because he tested positive for alcohol.
During cross-examination, the E/SA attempted to question
Claimant in greater detail about the test results, but Claimant
objected based on hearsay grounds. The JCC allowed the question
to establish Claimant’s understanding of the reason his
employment was terminated, but he ruled that the E/SA could not
use this testimony to admit direct evidence of the specific facts of
the test results. When Martinez was later asked if she learned the
4 In an amendment to the pretrial stipulation, the E/SA
expressly raised a misconduct defense based on alcohol abuse, not
absenteeism. Misconduct, as an affirmative defense, must be pled
with specificity. See Fla. Admin. Code R. 60Q-6.113(h).
8
results of the testing, the JCC allowed the question over
Claimant’s similar objection, but again for the limited purpose of
establishing the witness’s subjective understanding. However,
Claimant did not enter an objection when the E/SA immediately
asked a follow-up question and Martinez responded that the test
results were positive.
In a motion for rehearing, Claimant challenged the JCC’s
reliance on Martinez’s testimony establishing the positive test
results. In denying the motion, the JCC expressly recognized that
Martinez’s testimony constitutes inadmissible hearsay. 5
Nevertheless, he found that Claimant had waived any objection by
failing to raise a contemporaneous objection or to make a standing
objection. He explained that his ruling on the earlier question
concerning when Martinez “learned the results of the testing” was
proper because the question did not technically call for hearsay.
Based on the JCC’s findings on this point, the E/SA argue that
Claimant did not preserve his objection to Martinez’s testimony
concerning the positive test results.
We cannot agree and find the JCC’s explanation ultimately
unpersuasive. In his earlier rulings, the JCC emphasized that
questions about the test results would be permitted to prove state
of mind as opposed to the truth of the matter. And, although the
JCC expressly ruled that the E/SA could not rely on Claimant’s
hearsay testimony as a conduit to admit the test results, he
5 It is well-established that the Florida Evidence Code applies
to worker’s compensation proceedings. See Alford v. G. Pierce
Woods Mem’l Hosp., 621 So. 2d 1380, 1382 (Fla. 1st DCA 1993).
The Florida Statutes defines hearsay as a statement, other than
one made by the declarant while testifying at trial or hearing,
offered to prove the truth of the matter asserted. § 90.801(1)(c),
Fla. Stat. (2018). Under section 90.802, such out-of-court
statements are inadmissible as hearsay. But, if a statement is
offered for some purpose other than its truth, it is not hearsay. See
id.; Penalver v. State, 926 So. 2d 1118, 1132 (Fla. 2006). (“[I]f the
statement is offered for some purpose other than its truth, the
statement is not hearsay and is generally admissible if relevant to
a material issue in the case.”).
9
eventually relied on the truth of Martinez’s similarly inadmissible
testimony concerning the test results to find Claimant was under
the influence of alcohol while at work.
The failure to make a contemporaneous objection to the
admissibility of evidence can result in waiver so that hearsay
evidence can be considered when deciding if CSE supports a JCC’s
ruling below. See § 90.104(1)(a), Fla. Stat. (2018) (requiring timely
objection to admission of evidence with statement of specific
ground if not apparent from context). But section 90.104(1)(b)
further provides that “[i]f the court has made a definitive ruling on
the record admitting or excluding evidence, either at or before
trial, a party need not renew an objection or offer proof to preserve
a claim of error for appeal.” See, e.g., Everett v. State, 54 So. 3d
464, 476 (Fla. 2010) (finding where objection raised regarding
expert’s qualifications out of presence of jury, renewed objections
unnecessary each time opinion was offered).
Here, Claimant reasonably relied on the JCC’s prior rulings
limiting the purpose of the hearsay testimony concerning the test
results, and he assumed that Martinez’s testimony that the test
was positive was admitted to show only the Employer’s subjective
motivation; i.e., not as proof of the actual test results (the “truth of
the matter” of the hearsay statement). After all, these test results
themselves were clearly excluded from the evidence by the JCC.
Under the specific circumstances presented here, the objection to
hearsay testimony establishing the positive test results was
preserved. The JCC, therefore, erred when he relied on positive
test results as evidence that Claimant violated the Employer’s
substance abuse policy. Given the absence of CSE in support of
the finding of misconduct, we reverse.
In sum, we AFFIRM the JCC’s denial of Claimant’s request for
the authorization of Dr. Winters as his one-time change of
physician; we REVERSE the JCC’s finding of misconduct with
instructions to re-consider the claim for TPD benefits on REMAND.
WOLF and JAY, JJ., concur; KELSEY, J., concurs in part and
dissents in part with opinion.
10
_____________________________
Not final until disposition of any timely and
authorized motion under Fla. R. App. P. 9.330 or
9.331.
_____________________________
KELSEY, J., concurring in part and dissenting in part.
I concur with the majority’s affirmance on the one-time-
change issue. I respectfully dissent, however, from the majority’s
reversal on the misconduct issue. I conclude that competent,
substantial evidence supported the JCC’s finding that Claimant
was guilty of misconduct. I would therefore also deny Claimant’s
request for costs and fees.
_____________________________
Will B. Ramhofer of Ramhofer Garcia & Moore, PLLC, Miami, for
Appellant.
Kristen L. Magana and Megan Oliva of Broussard, Cullen &
Blastic, P.A., Orlando, for Appellees.
11