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Sedgwick CMS and The Hartford/Sedgwick CMS vs Tammitha Valcourt-Williams
Case Number: 17-0096
Judge: Allen Winsor
Court: FIRST DISTRICT COURT OF APPEAL STATE OF FLORIDA
Plaintiff's Attorney: James N. McConnaughhay
Defendant's Attorney: Bill McCabe
Tammitha Valcourt-Williams, a workers’ compensation claimant, tripped over her dog while reaching for a coffee cup in her kitchen. Because she had a work-from-home arrangement, and because her fall occurred during working hours, ValcourtWilliams sought workers’ compensation benefits. The Judge of Compensation Claims determined the injury was compensable, concluding that the work-from-home arrangement meant the employer “imported the work environment into the claimant’s home and the [c]laimant’s home into the work environment.” But
the question is not whether a claimant’s “home environment” becomes her “work environment”; the question is whether the employment—wherever it is—“necessarily exposes a claimant to conditions which substantially contribute to the risk of injury.” Sentry Ins. Co. v. Hamlin, 69 So. 3d 1065, 1068 (Fla. 1st DCA 2011) (citing Acker v. Charles R. Burklew Constr., 654 So. 2d 1211 (Fla. 1st DCA 1995)). Here, the relevant risk was that the claimant might trip over her dog while reaching for a coffee cup in her kitchen. That risk exists whether the claimant is at home working or whether she is at home not working. It existed before Valcourt-Williams took her job, and it will exist after her employment ends (so long as she maintains a home with a dog). Because the risk did not arise out of the employment, we must reverse. Valcourt-Williams was a workers’ compensation claims adjuster for Sedgwick CMS, an appellant here. She was assigned to Sedgwick’s Lake Mary office, but Sedgwick permitted her to work from her home in Sierra Vista, Arizona. Because of the different time zones, Valcourt-Williams began work at 4 a.m. local time to meet the Lake Mary office’s 7 a.m. start time. On the day of the accident, Valcourt-Williams had been working three hours when she went downstairs for a cappuccino. As she reached to get a cup, she fell over one of her two dogs. The fall resulted in knee, hip, and shoulder injuries, as well as a workers’ compensation claim. Sedgwick denied the claim, contending that the injuries did not arise out of the employment. After a hearing, the JCC sided with Valcourt-Williams, and Sedgwick appealed. The relevant facts are undisputed, and we review de novo the JCC’s application of law to those facts. Aills v. Boemi, 29 So. 3d 1105, 1108 (Fla. 2010). Employers must provide workers’ compensation benefits when employees sustain injuries from accidents “arising out of work performed in the course and the scope of employment.” § 440.09(1), Fla. Stat. (2016). Accidents occur “in the course and the scope of employment” when they occur “in the period of  employment, at a place where [the employee] would reasonably be, while fulfilling her duties.” Bryant v. David Lawrence Mental Health Ctr., 672 So. 2d 629, 631 (Fla. 1st DCA 1996). Here, the parties agree that Valcourt-Williams’s injuries occurred in the
course and scope of her employment: the injury was during work hours, her home was where she “would reasonably be,” and her coffee break was a permissible “comfort break,” see Bayfront Med. Ctr. v. Harding, 653 So. 2d 1140, 1142 (Fla. 1st DCA 1995) (noting that “a worker’s attendance to personal comfort during a refreshment break . . . does not . . . remove the worker from the course and scope of his employment” (marks omitted)). “Course and scope” is not the issue here. The issue here is whether the injury was “arising out of” the employment. See Southern Bell Tel. & Tel. Co. v. McCook, 355 So. 2d 1166, 1167-68 (Fla. 1977) (noting “separate elements” of “in the course” and “arising out of” employment); Sentry Ins., 69 So. 3d at 1070 (workers’ compensation does not cover accidents that occur in course and scope but that do not arise out of employment). As the Florida Legislature specified, “‘[a]rising out of’ pertains to occupational causation. An accidental injury or death arises out of employment if work performed in the course and scope of employment is the major contributing cause of the injury or death.” § 440.02(36), Fla. Stat.; accord Strother v. Morrison Cafeteria, 383 So. 2d 623, 628 (Fla. 1980) (“[T]o be compensable, an injury must arise out of employment in the sense of causation and be in the course of employment in the sense of continuity of time, space, and circumstances.”). More simply, the “arising out of” limitation “requires that the risks that caused [c]laimant’s accident and injuries  be work-related.” Sentry Ins., 69 So. 3d at 1068. An accident is thus compensable only if “the employment necessarily expose[d] claimant to conditions that would substantially contribute to the risk of injury and to which the claimant would not normally be exposed during his nonemployment life.” Acker v. Charles R. Burklew Const., 654 So. 2d 1211, 1212 (Fla. 1st DCA 1995); accord Glasser v. Youth Shop, 54 So. 2d 686, 687-88 (Fla. 1951) (finding injury did not arise out of employment because claimant “was not on the stairs because of his employment; he would have been there in any event, regardless of whether he had brought his work home”); Medeiros v. Residential Cmtys. of Am., 481 So. 2d 92, 93 (Fla. 1st DCA 1986); Grenon v. City of Palm Harbor Fire Dist., 634 So. 2d 697, 699 (Fla. 1st DCA 1994) (“The employment must, in some way, contribute an ‘increased risk’ of injury peculiar to
that employment; otherwise, the statutory requirement that the injury ‘arise out of employment’ would be eliminated.”). This court has not hesitated to apply the “arising out of” limitation where workplace injuries flowed from risks unrelated to an employee’s work. In Medeiros v. Residential Communities of America, for example, we held that if someone is injured at work after fainting—but would have fainted just the same had she not been at work—the resulting injury is not compensable. 481 So. 2d at 93. The claimant in Medeiros could not succeed because she could “not demonstrate that her physical surroundings on the job in any way contributed to the risk of injury any more than they would have in non-employment life.” Id. That same rule applies whether the injury follows fainting, see id., a heart attack, or—like here—a fall, see, e.g., Leon Cty. Sch. Bd. v. Grimes, 548 So. 2d 205, 208 (Fla. 1989) (finding fall noncompensable because claimant’s “employment in no way contributed to her injury”); Duval Cty. Sch. Bd. v. Golly, 867 So. 2d 491, 494 (Fla. 1st DCA 2004) (“[W]e cannot say that a fall to a level concrete floor is automatically compensable, irrespective of the cause of the fall.”); Hernando Cty. Sch. Bd. v. Dokoupil, 667 So. 2d 275, 277 (Fla. 1st DCA 1995) (“The fact that the claimant was in the course and scope of his employment when he fell is insufficient; there must be some finding that the employment created an increased risk of the fall itself or of the injuries which resulted.”). Regardless of the type of injury, compensability always turns on whether the employment led to the risk—whether there was “occupational causation,” § 440.02(36), Fla. Stat. In other words, it is not enough to say this was a “workplace trip-and-fall” because there is no statutory trip-and-fall exception. Whether the accident is a fall—or anything else—a claimant cannot prevail unless there was occupational causation, a risk not existent in the claimant’s “non-employment life.” Mederios, 481 So. 2d at 93; accord Glasser, 54 So. 2d at 687 (“Since industry must carry the burden, there must then be some causal connection between the employment and the injury, or it must have had its origin in some risk incident to or connected with the employment, or have followed from it as a natural consequence.”). In ValcourtWilliams’s case, there is no such risk. Instead, it is undisputed
that features of Valcourt-Williams’s “non-employment life”—her dog, her kitchen, her reaching for a coffee cup—caused the accident. To adopt Valcourt-Williams’s contrary view, we would have to hold that an employee’s tripping over her own dog at home on a Friday is attributable to risks of employment while the same employee’s tripping over the same dog at the same home on a Saturday is not. We would have to hold that a home light fixture’s falling on an employee in the afternoon is attributable to risks of employment while the same home light fixture’s falling on the same employee in the evening is not. And in doing so, we would have to set aside the “arising out of” limitation the Legislature enacted. Cf. Southern Bell, 355 So. 2d at 1168 n.3 (noting claimant’s concession that the same “activity might give rise to the same [injury] if it occurred after work-hours, though in that case there would be no recovery” and concluding that, “[i]n short, [claimant] requested this Court to construe the ‘arising out of’ requirement out of the statute, for all practical purposes”); Hernando Cty. Sch. Bd., 667 So. 2d at 276-77 (“[I]f all falls onto all surfaces were compensable, the statutory requirement that the injury arise out of the employment would be completely eradicated.”); Grenon, 634 So. 2d at 699 (“The Florida Supreme Court has expressly declined to broaden the purpose of workers’ compensation legislation to allow recovery for all injuries occurring in the workplace, including those arising out of conditions personal to the claimant which are not caused or aggravated by industry.”). We ought not do that. To be sure, a handful of our earlier cases have overlooked or ignored the statutory “arising out of” limitation, and we have not always been consistent in our application of that limitation. For example, in Holly Hill Fruit Products, Inc. v. Krider, this court upheld a claimant’s award where the claimant had been hit by a car after leaving work to buy cigarettes. 473 So. 2d 829, 830 (Fla. 1st DCA 1985). The court held that the claimant’s leaving work for an “off-premises refreshment break of insubstantial duration” was not enough to “remove [the claimant] from the course and scope of his employment.” Id. at 830-31. But the decision never addressed whether the accident was “arising out of” the employment. Id. To the extent Holly Hill is read to allow
compensation without an “arising out of” component—without occupational causation—it cannot square with the clear statutory directive. See also Bayfront Med. Ctr. v. Harding, 653 So. 2d 1140 (Fla. 1st DCA 1995) (relying on Holly Hill to find compensable off-premises car accident while employee sought food or cigarettes); Gray v. Eastern Airlines, Inc., 475 So. 2d 1288 (Fla. 1st DCA 1985) (relying on Holly Hill to find compensable a flight attendant’s basketball injury from a YMCA pick-up game on a flight layover). Moreover, in at least one case, we arguably suggested that any injury suffered on a “comfort break” within the course and scope of employment was necessarily “arising out of” employment. In Pan American World Airways v. Wilmot, we found compensable a flight attendant’s injury after—while at dinner on a layover—she “attempted to light a cigarette, and burned her hand when the entire matchbook went up in flames.” 492 So. 2d 1373, 1373 (Fla. 1st DCA 1986). This court considered the dinner to be within the “course and scope” of employment. But rather than analyze the “arising out of” limitation, the court rejected an argument that “risks arising from [smoking] are not job-related” by saying the argument “ignores another principle particularly applicable to workers’ compensation cases, the personal comfort doctrine.” Id. at 1374. To the extent Wilmot suggests that injuries necessarily arise out of employment whenever the personal-comfort doctrine brings the injury within the course and scope of employment, we reject it as inconsistent not only with the statute but also with the supreme court’s Southern Bell decision. See 355 So. 2d at 1168 (rejecting compensability of bathroom injury sustained in course and scope of employment because the accident was “simply not one ‘arising out of . . . employment” (alteration in original)). If any ambiguity remains, we hope to remove it now: For any injury to be compensable, it must “arise out of” the employment; there must be—as the statute says—“occupational causation.” § 440.02(36), Fla. Stat. None of this is to say, of course, that work-at-home arrangements immunize employers from workers’ compensation claims. Just as employer-premises accidents can have occupational causation, so too can work-at-home accidents. Had
Valcourt-Williams suffered an injury from a risk her employment introduced—a repetitive stress injury from typing all day, as one potential example—it would be no answer for the employer to say she was hurt in her own home. Cf. Metro. Dade Cty. v. Russell, 637 So. 2d 69, 70 (Fla. 1st DCA 1994) (noting that accidents can be compensable if “the injury resulted from an effort, exertion, risk, or strain beyond that which is normally encountered in Claimant’s non-employment life”). Nor are we holding—as the dissents mistakenly suggest—that there can be no compensability unless the employee is actively working at the time of the accident. An accident on a break, for example, might still “arise out of employment,” § 440.02(36), Fla. Stat., where “the employment necessarily expose[d] claimant to conditions that would substantially contribute to the risk of injury,” Acker, 654 So. 2d at 1212. But none of this relates to the situation we face here. Here, the risk at issue—that Valcourt-Williams would trip over her own dog in her own kitchen while reaching for a coffee cup—was not a risk her employment introduced. The Legislature has determined the reach of the workers’ compensation law. And under the system the Legislature enacted, “[i]f industry does not contribute to the risk of the accident resulting in injury, the workers’ compensation law does not require industry to contribute to the cost of the injury.” Sentry Ins., 69 So. 3d at 1071. Here, the employer did not contribute to the risk that Valcourt-Williams would trip over her dog. The workers’ compensation law therefore does not require the employer to cover the cost of the injury.