9 Key Cases on Florida’s Heart-Lung Statute

Key Cases

For those lucky enough to be in attendance at oral arguments before Florida's 1st District Court of Appeals as part of WCI, the Barrett v. Manatee County Sheriff's Office case touched on the Sunshine State's "heart-lung statute," §112.18, Fla. Stat. (2026).

What is the Rule?

According to the statute:

Any condition or impairment of health of any Florida state, municipal, county, port authority, special tax district, or fire control district firefighter or any law enforcement officer, correctional officer, or correctional probation caused by tuberculosis, heart disease, or hypertension resulting in total or partial disability or death shall be presumed to have been accidental and to have been suffered in the line of duty unless the contrary be shown by competent evidence. However, any such firefighter, law enforcement officer, correctional officer, or correctional probation officer must have successfully passed a physical examination upon entering into any such service as a firefighter, law enforcement officer, correctional officer, or correctional probation officer, which examination failed to reveal any evidence of any such condition. Such presumption does not apply to benefits payable under or granted in a policy of life insurance or disability insurance, unless the insurer and insured have negotiated for such additional benefits to be included in the policy contract.

When does the Presumption not Apply?

For any workers’ compensation claim occurring on or after July 1, 2010, a law enforcement officer, correctional officer, or correctional probation officer suffering from tuberculosis, heart disease, or hypertension is presumed not to have incurred such disease in the line of duty as provided in this section if the law enforcement officer, correctional officer, or correctional probation officer:

(1) Departed in a material fashion from the prescribed course of treatment of his or her personal physician and the departure is demonstrated to have resulted in a significant aggravation of the tuberculosis, heart disease, or hypertension resulting in disability or increasing the disability or need for medical treatment; or

(2) Was previously compensated for tuberculosis, heart disease, or hypertension and thereafter sustains and reports a new compensable workers’ compensation claim, and the law enforcement officer, correctional officer, or correctional probation officer has departed in a material fashion from the prescribed course of treatment of an authorized physician for the preexisting workers’ compensation claim and the departure is demonstrated to have resulted in a significant aggravation of the tuberculosis, heart disease, or hypertension resulting in disability or increasing the disability or need for medical treatment.

What are the 7 Key Cases?

(1) Caldwell v. Division of Retirement, 372 So. 2d 438 (Fla. 1979). The heart-lung statute affects the burden of persuasion. It embodies the social policy of the state "which recognizes that firemen are subjected during their career to the hazards of smoke, heat, and nauseous fumes from all kinds of toxic chemicals as well as extreme anxiety derived from the necessity of being constantly faced with the possibility of extreme danger. The legislature recognized that this exposure could cause a fireman to become the victim of tuberculosis, hypertension, or heart disease." The statutory presumption relieved Caldwell from the necessity of proving an occupational causation of heart disease. The statute cast on the employer the burden of persuading the trier of fact that the disease was caused by a non-occupationally related agent. The presumption would be meaningless if the only evidence necessary to overcome it is evidence that there has been no specific occupationally related event that caused the disease.

(2) Bivens v. City of Lakeland, 993 So.2d 1100 (Fla. Dist. Ct. App. 2008). Taken as a whole, the medical testimony did not show that essential hypertension, the form of hypertension suffered by Claimant, was arterial or cardiovascular. The critical testimony was that of the EMA. The EMA testified that the condition itself does not affect one's cardiovascular system. To the contrary, it merely renders one susceptible to future ailments which could. Therefore, there is no record evidence that the JCC could rely on demonstrating essential hypertension is arterial or cardiovascular in nature. Consequently, the JCC properly found the condition was not a form of hypertension covered by the presumption.

(3) Scherer v. Volusia Department of Corrections, 171 So.3d 175 (Fla. Dist. Ct. App. 2015). In interpreting what the statute meant by "occurring on or after July 1, 2010," since the date of filing the claim was not determinative, the date of disablement or the occurrence of an industrial injury must be determinative. In legal parlance, claims arise, may remain viable or be extinguished, can be stated, pleaded or alleged, and may be filed, settled, compromised, abandoned, dismissed, prosecuted, defended, litigated, and adjudicated. Rarely, if ever, however, do claims "occur." Industrial accidents and occupational diseases, on the other hand, do "occur" from time to time. Occupational diseases become "an injury by accident" (and thus "occur") upon the date of disablement, partial or total, a date which falls on one side of July 1, 2010, or the other. Once an industrial injury occurs, the term "claim" refers, not only to a petition for benefits or other assertion of rights, but also to the vesting of rights arising under chapter 440 on account of the injury.

(4) City of Port Orange v. Sedacca, 953 So.2d 727 (Fla. Dist. Ct. App. 2007). A permanent impairment for hypertension does not constitute a "disability" for purposes of the heart-lung statute, unless there is evidence of actual wage loss.

(5) Punsky v. Clay County Sheriff's Office, 18 So.3d 577 (Fla. Dist. Ct. App. 2009). The heart-lung presumption does not vanish upon presentation of contrary evidence. Instead, it remains with the claimant who establishes his or her entitlement to the presumption and the presumption is itself sufficient to support an ultimate finding of industrial causation unless overcome by evidence of sufficient weight to satisfy the trier of fact that the tuberculosis, heart disease or hypertension had a non-industrial cause. It is the evidence of non-industrial causation that may be found to rebut the presumption, not the mere existence of risk factors or conditions. Unless the statutory presumption is rebutted, the presumption is an adequate substitute for evidence of occupational causation and compels the legal result that a claimant has proven occupational causation.

(6) Rocha v. City of Tampa, 100 So. 3d 138 (Fla. Dist. Ct. App. 2012). Somewhere between cases where there are no medical work restrictions due to the covered condition and cases where it is physically impossible for claimants to work during hospital treatment for the covered condition, there is a space for a claimant whose body might retain the physical strength and coordination to perform his job duties for a time, but who has been officially advised by his doctor — via medical work restrictions — to forbear from engaging in his work so as to avoid potential further injury or death due to his tuberculosis, heart disease, or hypertension. Such a claimant meets the definition of disability because his work restrictions both (a) are legitimately imposed as medically necessary "because of the injury" and (b) create actual incapacity by interfering with his ability "to earn in the same or any other employment the wages which the employee was receiving at the time of the injury."

(7) Walters v. State, 100 So.3d 1173 (Fla. Dist. Ct. App. 2012). If the presumption applies, the claimant is under no obligation to establish occupational causation redundantly by adducing evidence beyond what was necessary to give rise to the presumption in the first place. Specifically, there is no requirement to put on proof meeting the requirements of section 440.151 (titled "Occupational diseases"), unless and until the section 112.18 presumption is rebutted.

(8) North Collier Fire Control & Rescue District v. Harlem, 371 So. 3d 368 (Fla. Dist. Ct. App. 2023). The court applied the term “heart disease” based on its original meaning. Basically, it is the type of disease affecting and weakening the heart muscle through a degradation of the vessels or the valves, and which was prevalent as major cause of death in the United States in the 1950s and 1960s. The JCC's determination that Harlem's aortic aneurysm was “heart disease,” such that the heart-lung presumption could apply, conflicted with what that term assuredly meant at the time the statute originally was enacted. The Harlem case is particularly important because it limited the reach of the First DCA's earlier decision in City of Venice v. Van Dyke, 46 So. 3d 115 (Fla. Dist. Ct. App. 2010), which had treated certain aortic disease as "heart disease" under the heart-lung statute.

(9) Lakatis v. Citrus County Sheriff's Office, 429 So.3d 52 (Fla. Dist. Ct. App. 2026). The standard for rebutting the heart-lung presumption is demanding. To overcome the presumption, the E/C must establish that the disabling impairment was caused entirely by non-work factors. Evidence showing that non-occupational causes were substantial, predominant, or even overwhelmingly likely does not satisfy that burden

Practice Notes

As the court in City of Jacksonville v. Ratliff, 217 So. 3d 183 (Fla. Dist. Ct. App. 2017), explained, the presumption remains unless the employer proves that "the" or "all" possible causes of the underlying condition and the disabling event were non-occupational. 

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