🚫 What Happens When a Presumption Claim Under F.S. 112.18 Gets Denied?
By Paolo Longo | Bichler & Longo | June 2025
If you’re a first responder in Florida who filed a workers’ compensation claim under the Heart/Lung Bill—also known as Florida Statute 112.18—you probably expected that your job-related hypertension or heart disease would be covered. But then the claim gets denied.
So what happens next?
At Bichler & Longo, we walk first responders through this situation every single day. The good news is: a denial is not the end of the road. In fact, it’s often just the beginning of the legal process. And if handled correctly, you still have a strong chance of securing the benefits you’ve earned. Here’s what happens step-by-step after a presumption claim under the Heart/Lung Bill is denied.
📄 Step 1: Understanding the Denial
When a claim is denied, the insurance carrier or your employer typically argues one of two things:
- You don’t qualify for the presumption (e.g., no pre-employment physical, wrong job classification, etc.), or
- They can rebut the presumption by pointing to other causes—like weight, family history, or lifestyle.
Even though Florida law requires clear and convincing evidence to rebut the presumption, that doesn’t stop many carriers from denying claims up front, hoping you’ll just walk away. Don’t!
🧾 Step 2: Filing a Petition for Benefits (PFB)
The formal legal process starts with a Petition for Benefits. This is the official way of telling the court what benefits you believe you’re entitled to—such as:
- Medical treatment
- Temporary total or partial wage loss
- Permanent impairment or disability payments
At Bichler & Longo, we make sure this petition is airtight. We clearly assert the statutory presumption under F.S. 112.18 and build the foundation of your case for litigation.
👩⚕️ Step 3: Building Your Case with Medical Evidence
After the petition is filed, we go to work gathering the evidence to prove your claim and defend the presumption. This usually involves:
- Records from your treating doctors
- Expert medical opinions from cardiologists or occupational medicine specialists
- Testimony about your job duties, stress levels, and incident history
- Depositions and employment documents
On the other side, the employer or insurer will try to rebut the presumption—often relying on their own hired medical expert to say your condition wasn’t caused by the job.
That’s why selecting and preparing the right medical experts is a crucial part of winning these cases.
🤝 Step 4: Mediation – A Chance to Settle
Before a trial takes place, the law requires both sides to attend mediation—a confidential meeting with a neutral third-party mediator who tries to help everyone reach a resolution. This is often where cases are settled.
If the facts are in your favor, the employer may offer:
- Ongoing medical care
- Backpay for time out of work
- A full or partial settlement of your claim
We use this opportunity to negotiate from a position of strength—and if the offer isn’t right, we don’t hesitate to walk away and prepare for trial.
⚖️ Step 5: Final Hearing (Trial)
If mediation fails, the case proceeds to a Final Hearing before a Judge of Compensation Claims. This is a bench trial—no jury, just the judge—and both sides present evidence. Your attorney will present:
- Expert testimony
- Medical records
- Legal arguments
- Your story
The judge then decides whether the presumption holds, whether it’s been rebutted, and what benefits (if any) you’re owed.
A written decision typically comes within a month or two. If the ruling goes against you, you can appeal—and we’ll guide you through that too.
👨⚖️ Why You Need Legal Help
Filing a presumption claim is hard enough. But fighting a denial is a whole different level. These cases turn on expert testimony, strict deadlines, and deep knowledge of Florida workers’ comp law.
We know how to win these fights because we’ve handled more presumption claims than any other firm in Florida. We’ve taken them all the way to trial—and won. And we’ve helped countless first responders get back their benefits, dignity, and peace of mind.
📞 Let’s Talk
If your claim has been denied under F.S. 112.18, don’t go it alone. Contact us for a free consultation: