The 1st DCA has again attempted to clarify the ever-evolving major contributing cause analysis under section 440.09(1)(b) in the case of Teco Energy, Inc. v. Williams, 42 Fla. L. Weekly D2663 (Fla. 1st DCA December 19, 2017).  In cases involving degenerative conditions, many practitioners have cited language in the case of Osceola County Sch. Bd. v. Pabellon-Nieves for the proposition that to qualify as a pre-existing condition under 440.09(1)(b), a degenerative condition must have required “some level of treatment” before the workplace accident in question. 

However, in Teco Energy, Inc. v. Williams case, the court stated that “the inquiry is whether the condition independently required treatment either before or after the compensable accident.”  In this case, concerning the MCC of the need for a total knee replacement, the claimant’s left knee osteoarthritis required no medical treatment and caused no disability or impairment before his compensable accident.  The E/C actually authorized treatment after the compensable accident date that was directed to the degenerative arthritis. However, because an EMA ultimately opined that the claimant’s pre-existing arthritis was the MCC of the need for the requested total knee replacement, the court held that it qualified as a pre-existing condition under 440.09(1)(b).