Florida Court Clarifies Misrepresentation Defense and Major Contributing Cause in Successive Workplace Injury Claims

The claimant initially injured her shoulder at work in 2021. During that claim, it was determined she made misrepresentations, which barred her from receiving further benefits under Florida Statute § 440.105.

In 2022, the claimant suffered a subsequent industrial accident while turning a bus steering wheel, reinjuring her shoulder. When she filed a new claim for workers’ compensation benefits, the employer/carrier denied the same. They argued that because the claimant lost her right to benefits for the 2021 injury due to misrepresentations under § 440.105, she was also foreclosed from receiving benefits for the 2022 injury. The employer/carrier further contended that doctors identified the 2021 shoulder injury as the major contributing cause of her need for benefits after the 2022 accident.

Regarding the major contributing cause denial, the court reiterated its prior holdings in Pearson v. Paradise Ford, 951 So. 2d 12 (Fla. 1st DCA 2007) and Pizza Hut v. Proctor, 955 So. 2d 637 (Fla. 1st DCA 2007). The court explained that the major contributing cause analysis applies only when a claimant’s need for treatment or benefits results from the combination of a work-related accident and a pre-existing condition unrelated to employment.

Here, because both accidents were work-related, the major contributing cause analysis was inapplicable. Denial of the claimant’s 2022 claim based on the misrepresentation defense from the 2021 injury was also misplaced. The employer/carrier conflated compensability with entitlement to benefits.

The court clarified that forfeiture of benefits in the prior claim did not render either the 2021 or 2022 accident non-compensable. Compensability relates to whether a work-related accident and an injury occurred, not whether the claimant is entitled to benefits.

Finally, the court held that the prior misrepresentation defense did not foreclose the claimant’s entitlement to benefits for the separate 2022 workplace accident. The second accident was genuine and not merely an attempt to revive benefits from the previously barred 2021 claim.