Nancy Pannell v. Escambia County School District and Risk Management Services, Inc.
CourtDistrict Court of Appeal of Florida
Date FiledApril 15, 2020
Docket1D18-2854
StatusPublished
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Full Opinion
FIRST DISTRICT COURT OF APPEAL
STATE OF FLORIDA
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No. 1D18-2854
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NANCY PANNELL,
Appellant/Cross-Appellee,
v.
ESCAMBIA COUNTY SCHOOL
DISTRICT and RISK
MANAGEMENT SERVICES, INC.,
Appellees/Cross-Appellants.
_____________________________
On appeal from an order of the Judge of Compensation Claims.
Nolan S. Winn, Judge.
Date of Accident: August 31, 1999.
April 15, 2020
DUNCAN, J. SCOTT, ASSOCIATE JUDGE.
In this workers’ compensation case, Appellant/Cross-
Appellee, the claimant below (Claimant), appeals the Judge of
Compensation Claims’ (JCC’s) order denying her claim for
permanent total disability (PTD) benefits. Appellees, the
employer/carrier/servicing agent (E/C), cross-appeal the JCC’s
award of temporary total disability (TTD) benefits and
supplemental income benefits. For the reasons explained below,
we reverse the JCC’s denial of PTD benefits and entitlement to
penalties, interest, costs, and attorney’s fees. We affirm the issues
on cross-appeal without further comment. 1
Background
This is a twenty-year-old workers’ compensation claim, and
therefore it is unsurprising that the medical and procedural
history leading up to the final hearing is extensive. But, because
this case turns on purely legal issues, it is unnecessary to duplicate
the JCC’s commendable effort in summarizing the evidence.
Instead, the focus here is on the relevant undisputed facts that
apply to the legal errors.
During the proceedings below, the parties stipulated that
Claimant sustained compensable injuries to her neck, back, and
right shoulder, and that Claimant sustained a psychiatric injury
as a result of the accident, resulting in depression. The E/C
continued to provide medical care for Claimant’s compensable
conditions through the date of the final hearing, which occurred in
April 2018. Claimant previously successfully petitioned for
disability retirement via the Florida Retirement System in June
2003, listing conditions that pre-existed her workplace injuries.
Upon retirement, Claimant was forty-nine years old. She turned
fifty the following year.
The E/C ceased paying TTD in January 2002 when Claimant
had exhausted her 104 weeks of eligibility for these benefits.
Claimant was not yet at overall maximum medical improvement
(MMI) at that time. However, in 2017 (fourteen years post-
retirement), in the wake of the Florida Supreme Court’s decision
in Westphal v. City of St. Petersburg, 194 So. 3d 311 (Fla. 2016),
the E/C paid additional TTD benefits for the period February 20,
2002, through April 9, 2003. 2 Although assigned permanent
1 Our reversal on the PTD issue and affirmance on the issues
raised in the cross-appeal render moot Claimant’s separate issue
on appeal concerning temporary partial disability benefits.
2 The court in Westphal held that the 104-week statutory cap
on temporary benefits in effect at the time was unconstitutional
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impairment ratings for some of her injuries in 2003, Claimant did
not reach overall MMI until May 27, 2011. Nevertheless, the JCC
found that the parties agreed Claimant would have reached
“statutory MMI based upon 260 weeks of [TTD] benefits being
exhausted” as of December 30, 2004.
In 2017, Claimant (by that time 62 years old) filed petitions
for benefits seeking, inter alia, TTD benefits from January 1, 2002,
and PTD benefits from November 10, 2004 (as amended at the
final hearing). The JCC ultimately awarded TTD from April 10,
2003, through December 30, 2004 (resulting in Claimant receiving
260 weeks of TTD), but denied all PTD benefits. The JCC’s grounds
for denying PTD are discussed below.
The JCC’s Order
Applying the 1999 version of section 440.15(1), Florida
Statutes, the JCC explained that entitlement to PTD benefits
required Claimant to prove she suffered a “catastrophic injury” as
defined in section 440.02(37)(f), Florida Statutes. 3 This in turn
required applying a five-step analysis. See Butler v. City of
Jacksonville, 980 So. 2d 1250 (Fla. 1st DCA 2008). This test asks:
1) is claimant performing substantial gainful activity; 2) does
claimant have a severe impairment; 3) does claimant’s severe
impairment meet or equal an impairment specifically listed in 20
C.F.R., part 404, Subpart P, Appendix 1; 4) can claimant perform
his/her past relevant work; and 5) based on claimant’s age,
education, and work experience, can claimant perform other
similar work found in significant numbers in the national
economy? Id. at 1252.
and reinstituted the 260-week limit from the pre-1994 version of
the statute. 194 So. 3d at 327.
3 A catastrophic injury is defined as any injury that would
qualify a claimant to receive social security disability benefits
under the Social Security Act as it existed on July 1, 1992. See
§ 440.02(37)(f), Fla. Stat. (1999).
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The JCC found that Claimant satisfied steps one, two, and
four, but not step three. 4 Thus, to qualify for PTD, Claimant had
to satisfy step five. The JCC determined that Claimant did not,
explaining as follows:
Timing is of particular importance with regards to
step 5. Claimant’s date of birth is 05-04-54. As . . .
Claimant’s vocational expert testified, age is a crucial
factor in a social security disability determination. In
fact, both vocational experts agree that in 2003 when
Claimant retired at the age of 49, as transferable skills
are irrelevant prior to age 50, Claimant was not at that
time disabled. Both also agree such finding would change
on 05-04-04 when Claimant turned 50 simply due to the
mere passage of time and Claimant simply reaching the
age of 50 despite the fact all of her then treating
physicians . . . had released her to return to sedentary
work. In other words, simply due to the passage of time,
Claimant would suddenly be deemed disabled and
unemployable as she would have no transferable skills
from her previous work as a school bus driver or a school
bus aide. In other words, according to both vocational
experts, when Claimant retired in 2003 for reasons
totally unrelated to the industrial accident and the
injuries sustained therein, she was employable and not
disabled. I find therefore as Claimant was not disabled in
2003 when she retired and as she retired for reasons
totally unrelated to the industrial accident her
retirement in 2003 severed the causal connection
between the industrial accident and Claimant’s
entitlement to permanent and total disability benefits.
Citing Siegel v. AT&T Communications, 611 So. 2d 1345 (Fla.
1st DCA 1993), the JCC acknowledged that the mere fact of
retiring does not foreclose eligibility for PTD benefits. The JCC
noted that the claimant in Siegel suffered a deterioration in her
4 If a claimant fails to establish disability at step three, a
claimant’s residual functional capacity is assessed and used to
determine steps four and five. Butler, 980 So. 2d at 1252.
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work-related condition after her retirement and found that
Claimant here in this case did not. The JCC then analyzed Siegel
and Houck v. Lee County Board of Commissioners, 995 So. 2d 1102
(Fla. 1st DCA 2008), to find that “[w]hile Mr. Houck’s retirement
severed the causal relationship between his disability and the
industrial accident, he presented evidence his work related
injuries worsened subsequent to retirement thus re-establishing
such causal connection. Unlike Mr. Houck, Claimant has
presented no evidence her work-related conditions have
deteriorated since her retirement.”
As explained below, it is in this reasoning, and in his
interpretation and application of the cited cases, that the JCC
erred. And because this case turns on the application of the law to
undisputed facts, our review is de novo. See Sedgwick CMS v.
Valcourt-Williams, 271 So. 3d 1133, 1135 (Fla. 1st DCA 2009)
(holding where relevant facts are undisputed, court reviews de
novo the JCC’s application of law to those facts).
Discussion
The JCC’s primary error was to focus on Claimant’s
retirement date, as well as her age and disability status at that
time, because the relevant date for determining whether a
claimant qualifies for PTD is the date of either overall MMI or at
the expiration of her entitlement to temporary benefits, whichever
occurs first (assuming the claimant can prove that she would
remain totally disabled when overall MMI – what the JCC referred
to as “statutory MMI” – is reached). See Westphal, 194 So. 3d at
320. As noted, Appellant exhausted her entitlement to temporary
benefits as of December 30, 2004, well before she reached overall
MMI in 2011.
Despite finding that both vocational experts testified
Claimant would qualify as disabled on May 4, 2002, under the
statutorily mandated social security standards, the JCC denied
PTD benefits based, in part, on the “mere passage of time and
Claimant simply reaching the age of 50.” In doing so, the JCC
committed an error similar to that committed by the judge in
Houck v. Lee County Board of Commissioners.
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Houck involved the same version of the statute at issue here,
and the claimant also retired before reaching MMI (thus, before
eligibility for PTD). The claimant in Houck sought PTD from
November 14, 2005. In the order denying PTD benefits:
the JCC found that Claimant established that his
workplace injury was “catastrophic” as that term is
defined in section 440.02(34), Florida Statutes (1995). In
finding that Claimant retired “at least by 1998,” however,
the JCC concluded that it would be inconsistent with the
purpose and policy of Florida’s Workers’ Compensation
Law that “compensation would now be payable to replace
something, to wit: the ability to earn wages, that
[Claimant] himself long ago surrendered when he
retired.” The JCC found that Claimant did not meet his
burden of proof and denied permanent total disability
benefits.
995 So. 2d at 1103–04 (footnote omitted).
In reversing, the Houck court held that the JCC applied the
incorrect standard and instructed the JCC to “make a factual
determination as to whether there is conclusive proof that
Claimant has a substantial earning capacity following the
November 14, 2005, date of maximum medical improvement” and,
if not, to award benefits. Id. at 1104. The court also noted that
“[t]he public policy concerns which govern the JCC’s ruling were
addressed by the Florida Legislature in section 440.15(1)(b),
Florida Statutes (2003), a statute which is inapplicable to
Claimant for his April 21, 1995, date of accident.” Id. at 1104 n.1.
The JCC here erred by including in his analysis a “time”
element that does not exist in the statute, and in effect injected a
“policy” rationale similar to the one the JCC used in Houck as a
basis for denying the PTD claim, and which this court made clear
was addressed by the statute’s amendment in 2003. This was just
as erroneous here as it was in Houck.
The entitlement to workers’ compensation benefits operates
in real time–benefits have the potential to become ripe, due, and
owing along a linear timeline, not all at once as in a tort case. The
JCC erred by reading into Houck a requirement that a claimant
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who retires prior to when the possibility of entitlement to PTD
ripens must show a deterioration in her condition upon reaching
MMI in order to establish entitlement to PTD benefits. No such
requirement was enunciated in either Siegel or Houck, or even in
Southern Bell Telephone & Telegraph Co. v. Seneca, 512 So. 2d
1005 (Fla. 1st DCA 1987), upon which the JCC also relied. The
JCC erroneously determined that the Claimant’s retirement
severed the causal connection and, for entitlement to PTD benefits
post-retirement, the Claimant had a two-fold burden: 1) to re-
establish causation between the compensable injuries and her
inability to return to gainful employment; and 2) to establish that
the compensable injuries had deteriorated to such a degree after
retirement that she was now disabled.
In fact, the analysis used in Siegel and Seneca had no
application here because the standard for proving entitlement to
PTD benefits differed at the time those cases were decided. In
Siegel, the claimant’s accident occurred in 1988 or 1989. 611 So. 2d
at 1347. In Seneca, the claimant’s accident occurred in 1980. 512
So. 2d at 1005. For dates of accidents between August 1, 1979, and
December 30, 1993, section 440.15(1)(b) provided:
(b) Loss of both hands, or both arms, or both feet, or both
legs, or both eyes, or of any two thereof or paraplegia or
quadriplegia shall, in the absence of conclusive proof of a
substantial earning capacity, constitute permanent total
disability. In all other cases, permanent total disability
shall be determined in accordance with the facts. In such
cases, no compensation shall be payable under paragraph
(a) if the employee is engaged in, or is physically capable
of engaging in, gainful employment; and the burden shall
be upon the employee to establish that he is not able
uninterruptedly to do even light work [available within a
100-mile radius of the injured employee’s residence
(added in 1990)] due to physical limitations.
(emphasis added).
The provision’s focus was on whether an employee can
demonstrate he cannot engage in any light work due to physical
limitations. Contrast that with the vocational analysis found in the
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social security analysis at step 5–“whether, based on the
claimant’s age, education, and work experience, the claimant can
perform other similar work [similar to past relevant work] found
in significant numbers in the national economy.” Butler, 980 So.
2d at 1252.
Thus, because Claimant was disabled based on the five-step
sequential analysis on December 30, 2004, the date on which all
TTD benefits were exhausted, and remained so on May 27, 2011,
when she reached overall MMI, she met the “catastrophic injury
test,” and the burden shifted to the E/C to offer conclusive proof of
a substantial earning capacity. By using her retirement date as the
central component to determine whether the Claimant was
entitled to PTD, the JCC committed legal error.
At the hearing, the E/C’s vocational expert testified that
Claimant was unable to perform any of the potential jobs she
identified in her labor market survey. Because the E/C offered no
evidence to establish that Claimant retained a substantial earning
capacity, we reverse the JCC’s denial of PTD benefits and remand
for entry of an order finding Claimant is entitled to PTD benefits
effective December 31, 2004, along with any other benefits or costs
due and owing as a result of such award.
REVERSED.
WOLF and M.K. THOMAS, JJ., concur.
_____________________________
Not final until disposition of any timely and
authorized motion under Fla. R. App. P. 9.330 or
9.331.
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Kimberly A. Hill of Kimberly A. Hill, P. L., Fort Lauderdale, and
David M. Cohen of the Law Office of David M. Cohen, P.A.,
Hollywood, for Appellant/Cross-Appellee.
Joseph L. Hammons of The Hammons Law Firm, Pensacola, for
Appellees/Cross-Appellants.
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