Who has the burden to prove that accident is not major contributing cause?

Now it appears clear that once compensability has been adjudicated or stipulated to, the Employer/Carrier/Servicing Agent has the burden of proof that there is no causal connection between the injury and the requested benefit. In other words, we are dealing with two issues here. The claimant has to prove that the work accident is the major contributing cause of the injury. Once this is done via final hearing or via stipulation of the parties, including in the pre-trial stipulation, it is then the Employer/Carrier/Servicing Agent who has the burden of proof that the injury is not the major contributing cause of the requested benefit. In the recent case of Perez v. Southeastern Freight Lines, Inc. and Gallagher Bassett Services, Case No. 1D14-3821 (March 20, 2015), the JCC ruled in favor of the E/C/SA and found that the claimant failed to establish that “[t]he injury, its occupational cause, and any resulting manifestations or disability must be established to a reasonable degree of medical certainty, based on objective relevant medical findings” as required by Section 440.09(1). The First District Court of Appeal reversed holding that because the parties had stipulated to the compensability of the accident, the claimant did not have the burden to show a causal connection between the injury and the requested benefit. The court held that the “burden of proof regarding the causal connection is on the employer/carrier ‘to demonstrate a break in the causation chain, such as the occurrence of a new accident or that the requested treatment was due to a condition unrelated to the injury which the E/C had accepted as compensable.’” Bottom line, once the E/C/SA accepts compensability of an injury, claimant can obtain any requested benefit unless the E/C/SA can prove that the compensable injury is not due to the accident but due to a subsequent accident and/or a pre-existing non-industrial accident. Note that this opinion is not yet final until the parties have an opportunity to file a Motion for Rehearing. Most likely this is final opinion as there are now several cases reiterating this issue.

CategoryNews & Updates