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Pension_01-18-2022MinSM-UNREDACTEDPresent: BOARD OF TRUSTEES City of Longwood Police Officers and Firefighters Pension and Trust Fund Longwood City Commission Chambers 175 West Warren Avenue Longwood, Florida SPECIAL MEETING MINUTES JANUARY 28, 2022 3:00 P.M. Robert Redditt, Chair Bruce Kubec, Vice-Chair Kevin Little, Secretary Chris Eichler, Member Cole Copertino, Member Pedro Herrera, Board Attorney Michelle Longo, City Clerk Magdaia Ridore, Human Resources Director Molly Ralston, Human Resources Generalist Joshua lamaio, Longwood Firefighter James Spears, Attorney Court Reporter 1. Call to Order. Chair Redditt called the meeting to order at 3 :01 p.m . 2. Pledge of Allegiance 3. Informal Hearing Joshua lamaio Disability Mr. Herrera explained how the Board would proceed with the hearing. He said several months again the proceedings began for this informal hearing and during the discussions, it was requested that the matter be tabled to allow time for additional records that would be forthcoming . At this time the records have been received as well as a transcript and at this point, we are resuming the hearing. He suggested the hearing should proceed from scratch instead of from where things left off from the last meeting. He noted that while this is a difficult matter, he urges the board to remember they are fiduciaries to the pension fund and that they should compartmentalize and focus on the record, evidence, and testimony presented. He said they have to decide, as a board, whether or not the burden of proof and preponderance of the evidence has been met by the member, satisfying the conditions of eligibility. He then defined the preponderance of the evidence. He told the board that as part of their binders they were provided with a set of five (5) questions that if the member is able to address, and the board find to be affirmative, would satisfy the local law obligations of the ordinance as well as statutory obligations in Chapter 175 and 185 in terms of satisfying the requirements for a disability pension. He then Pension 01-28-2022/1 listed the questi o ns. 1. Is there an i njury that caused the disability? 2. Is the injury connected 3. Is the injury permanent? 4 . For the injury or i llness, has the member reached maximum medical improvemen t . 5. Can this indi v idual perform reasonable and efficient services as a police officer or firefighter? Mr. Herrera the n stated if each quest ion was answered in the affirmative it would be his recommendation that all conditions have been satisfied and the benefit applicati o n should be granted . If they answer one of the questions with a no, he stated t he member or attorney may be able to answer those questions. He then said if the application is rejected , part of their obligation is to advise where the applic ation was deficient. At the end of the hearing, he expects to hear one of thre e motions, the granting of the application, the denial of the application, or to table the matter in the event that they needed more information or time to deliberate . He said if the application was denied the member will be given the opportunity to appeal the decision . In this instance, they would need to reconvene for a formal administrative hearing. Mr. Herrera expl ained that a formal administrative hearing would include special counsel, depositi o ns, and a trial-like structure . If at a formal administrative hearing the member was denied, he would have one final opportunity to appeal with the Circuit Board. This would include all information previously gathered and written briefs from both parties outlining their stance. The judge would then issue a reco m mended order back to the Board of Trustees for a final decision . He said it would be his advice that the board follows the judge's order. Mr. Herrera aske d if the board had any further questions regarding the process and then turned it over to the member and his attorney, James Spears, who would be present i ng the member's case to the board . Mr. Spears thanked Mr. Herrera and the board for their attendance and for considering his cl ient's application. He began by giving a synopsis of the records in the binder and stated Josh lamaio would be giving a statement afte r . He stated his cl ient was terminated on February 12, 2020 , because he was found not fit for duty by his psychiatrist, Dr. Syed . He notes his client was terminated by the City and that this is an important fact . Mr. lamaio worked as a firefighter lieutenant param edic with the City from 2006 until the date of his termination in 2020. Mr. Spears said t hat when this began Mr. lamaio was unaware he was deal i ng with post-trauma t ic stress disorder (PTSD) or the anxiety disorders he has since been assigned by various doctors. Complications began when he started experiencing ches t pain and dizziness during a work shift. During this shift, he was on call and had to call a co -worker for relief so he could go to the hospital. Pension 01 -28-20 22/2 After his time in the hospital, he returned to work and underwent thorough evaluations . These reports were provided . The hospital staff was unable to figure out what was going on and Mr. lamaio was kept out of work by h is primary physician at Advent Health. The symptoms continued and he was eventually referred to the Mayo Clinic in November of 2019 . During this time Mr. lamaio was out on FMLA (family medical leave act). His numerous Mayo Clinic evaluation reports were provided . At the recommendation of one of the Mayo Clinic 's doctors, Mr. lamaio was referred to psychologist Dr . Wi lli am Bobo . This took place on November 13 , 2019. Mr. Spear went on to state that Mr. lamaio had never seen a mental health professional or been asked about his mental health prior to this point. After a discussion between Mr. lamaio and Dr. Bobo , the psychologist noted the traumatic events Mr. lamaio had witnessed due to his job had led to instances of distressing dream s, intrusive thoughts, and flashbacks. The doctor also noted Mr. lamaio experienced guilt about not being able to return to work and was debating seeking out less stressful employment . In the same report, there is a reference to the h istory of a fellow co -worke r comm itting suicide . Doctor Bobo diagnosed Mr. lamaio with anxiety disorder, sub -threshold PTSD -like symptoms, and possible recurrent limited symptom panic attacks . He was then referred for si x sessions of the r apy . Medication was also discussed at this time, but due to the concerning side effects of some medications, it was decided between Mr. lamaio and the psychologist, to begin with, therapy . Mr. Spear explain s that Mr. lamaio was then referred to and began se ssi ons with trauma counselor Ute Krantz . Records from Ms . Krantz were included and provide a thorough synopsis of what Mr. lamaio had experienced over the course of his caree r . Mr. lamaio began treatment with her on November 21 , 2019 . He continues to receive treatment from her today . Mr. Spear said during this time his client was out of work on FMLA. At this time Dr. Marcus Merriweather received a fit for duty letter for Mr. lamaio. This was how he was first refe r red to Dr . Syed . Dr. Syed 's return letter, dated February 11, 2020, noted M r . lamaio had depressive disorder, anxiety disorder, and chronic PTSD. There is a reference of medication and it was recommended the patient was unable to go back to work as a firefighter or EMT at that time and needed to find a new line of work that did not involve stress and drama . The following day Mr. lamaio was terminated . Mr. Spear said that after that point the City opened a workman 's compensation case , but Mr. lamaio was unable to get in to see the workman's compensation psychologist, Dr . Noel Figueroa , until April of 2020. He explains that th is doctor never had the records that would have been required to make a thorough and proper evaluation . Mr. Spear then went on to explain how the evalua ti on process under workman 's compensation was different and was used to determine if Mr. lamaio was eligible for lost wages. Mr. Spear explained that Dr. Figueroa did not feel Mr. lamaio met the cr iteria for a PTSD diagnosis because he had not specified events. He felt was important to note Dr. Figueroa 's lack of Pensio n 0 1-28-2022/3 records and insistence that his role was to prescribe medication. He stated after two visits the doctor no longer wanted to see Mr. lamaio and recommended he see another doctor, Dr. Martinez. He explained that after Dr. Figueroa's recommendation, Mr. lamaio went on to be evaluated by Dr. Martinez. Dr. Martinez's evaluation clearly diagnosed Mr. lamaio with PTSD and indicated that he should not be working in any capacity. He said this was around the time Dr. Harding, the board's IME (independent medical examiner) made his determination. Dr. Harding stated the record did not show symptom endorsement specifically meeting the criteria for PTSD. It was also noted that his colleague Dr. Horn, who performed the neuropsychological testing, said current testing revealed meeting much of the criteria for PTSD however it appears he has not met all of the criteria as dictated by the DSM (Diagnostic and Statistical Manual of Disorders). His report went on to say a more appropriate diagnosis may be increased chronic stress response resulting in anxiety not otherwise specified. Chair Redditt asked what the DSM was. Mr. Spear informed the board that it is a criterion set forth by a medical board that has a listing of what ailments must be met for a full diagnosis of PTSD. He then summarized the evaluations and opinions of each mental health provider. He asked the board to look at the issues before them and he felt all of them could be answered affirmatively in favor of Mr. lama io and to approve his disability application. Mr. lamaio provided some of his background and role with the city. He stated he lives with his wife, three children, and brother. He explained he began his work as a firefighter because he wanted to help people. Mr. lamaio then listed his education, training, and duties his role required of him . He said the job can take a toll mentally and physically. He said he previously felt as though PTSD and anxiety were reserved for people that had seen combat. He noted he never suffered from anxiety or depression and so it was not on his radar. He explained that on July 3, 2019, he went to shift as a healthy man and has not been the same mentally, emotionally, or physically since. Mr. lamaio then detailed the events of that day and his subsequent medical evaluations. He noted that during this period he was depressed, lost a significant amount of weight, was unable to perform daily activities, and began to have nightmares about the victims of previous work-related calls . He said that while he had family and church members assisting him and his family, it was also at this time that the city's Human Resources Director notified him that she could no longer hold his job because his FMLA had expired. Fear of losing his job caused feelings of shame and depression. He said he tried to go back on shift three times. After this point, he noted he began receiving therapy . He said in December 2019 Human Resources wanted him to go in for a fit for duty test. He then explained the process of mental evaluation for the fit for duty test and stated Dr. Syed determined he could not return to work as a firefighter. Dr. Syed offered therapy and medication options. A review of the severe medication side effects led Mr. lamaio to pursue therapy alone . He stated the City fired him on February Pensio n 0 1-28-2022/4 12, 2020, due to the previously mentioned determination of Dr . Syed . He then went on to say he continues to receive treatment from many of the same doctors. He said the Mayo Clinic called to inform him that the pain in his esophagus was a stress response . Mr. lamaio then spoke about his negat ive experiences with Dr . Figueroa and Dr . Harding . He noted that he only meet w ith Dr. Figueroa twice virtually, once in April and once in May. Dr. Figueroa told him on his first appointment he did not have any of his records and called him the wrong name multiple times, compromised another patient's confidenti ality in his presence, and was late. On the second appointment, he again was told he did not have records , couldn 't proceed further, and that his job was to prescribe medication. Mr. lamaio said Dr. Harding excluded the traumatic events discussed with him from his report. He also stated he never expressed changing career paths with Dr. Harding and the discussion that took place was in fact one in which Mr. lamaio simply assisted a friend on a construction -type job for a few days. He felt the doctor was upset that he was not taking medication. He said he and Dr. Harding disagreed on whether the current treatment was the correct path. Mr. lamaio explained that he still has bouts of depression, bad dreams, and still gets anxious about things he did not use to . He requested the board review the case carefully and grant him the application . Chair Redditt asked whether he was an EMT during the entirety of his Longwood employment. Mr. lamaio replied i n the affirmative . Chair Redditt asked if the symptoms only began to flare up in 2020. Mr. lamaio said they began in July of 2019 and he had no symptoms prior. Chair Redditt asked for Mr. lamaio's thoughts regarding the rapid onset of symptoms after nearly 14 years without them. Mr. lamaio said the doctor explained the experiences build -up to a snapping moment. He also sa id his final year with the fire department included a lot of employee turn over resulting in his team being comprised of less expe ri enced co - workers. During this year he also responded to the sudden death of an infant, an incident in which a woman was mangled after being hit by a car, and many overdoses. He sa id he felt some of these calls could have gone better wi th a more experienced crew . He states the suicide of a co -worker and friend also impacted him . Chair Redditt asked if Mr. lamaio felt like this was a permanent situation . Mr. lamaio said he cannot speak about what the future will be , but that he has improved . He said to his knowledge nobody gets rid of PTSD and tha t it is lifelong. Member Copertino asked if they were to focus on the diagnosis of PTSD or the Pens io n 01 -28-2022/S PTSD and other conditions as well. Chair Redditt re sponded that he believes what they need to decide on is if the applicant is suffering from this condition and is it a total and permanent disability. He then asked Mr. Herrera to define permanent for them given this is related to a me ntal health condition. Mr. Herrera said the pension was a li f elong pension and so there is an obligation to be sure those are being paid out appropriately. In this case, he said, there is an obligation that the member remains disabled. He reminded the board that the standard is "disabled from rendering useful services as a firefighter". Th is means the individual can perform other jobs and receive a pension, but could not operate as a firefighter. Chair Redditt asked if the approval of the application was permanent if the member got bett er in 10 years. Mr. Herrera repl ied no. If the board were to discover the member is no longer disabled the pen sion would be revoked. Chair Redditt asked how that would be determined. Mr. Herrera stated the member would be reached out to and the treating physician would be required to write a letter to the board confirming they still treat the member for the condition and that the member remains disabled. Chair Redditt ask e d whose responsibility it is to check that . Mr. Herrera stated it falls under the purview of the board and frequency is also up to the board . Member Copertino asked Mr. Herrera if the board is r equired to determine based on the records if the disability is PTSD or is the disability other medical conditions includ i ng the anxiety disorder. Mr. Herrera stated the board has to determine if there is a disability. Even if it is not PTSD, does the evidence suggests there is a disabling condition . He went on to say for the purp oses of the applicat ion, determining if they feel he has PSTD would be useful. He explained that th is is because PTSD can be directly linked to the events that are purported to have caused the condition . Chair Redditt asked if the pension is approved, and does Mr. lamaio understand that he would need to submit future examinations to ensure he remains disabled . He also asked if the timing o r frequency needed to be determined with the final decision. Mr. Herrera said the frequency could be determined at a later date . He said what needed to be determined that day was if a d isability was present and whether or Pension 01-28-2022 /6 not it is work-related. Mr. Spears asked Mr. Herrera what, if any, effect does Mr. lamaio's termination have on the analysis. Mr. Herrera said to the board that if the City terminated the member because he was no longer fit to perform the job then he feels it already answers two of the important questions they need to decide on; it answers whether there is a disability and whether it is total. He stated he would need further clarification as to whether the termination was a medical one because the termination letter from the City dated February 12 , 2020, read as though the reason was he was unable to do his work. Member Copertino asked Mr. Spears to speak to the email correspondence on the member's inability to perform . Mr. Spears reminded the board that Human Resources initially began the fit for duty evaluation by sending the member to Dr . Merriweather and Dr. Syed. Dr . Syed determined the member was unfit for duty on February 11, 2020 , and he was terminated on February 12 , 2020. Secretary Little asked Human Resources if the decision to terminate the member was based on the records received from Dr. Syed or for a different reason . Mrs . Ridore explained that she is the current Human Resources Directo r, but at the time of his termination, Ms . Lee Ricci was the Director. She expla i ned the letter was drafted in response to an email they had received from Mr. lamaio informing them he was unable to return to his duty. Secretary Little asked Mr. lamaio if his records had been supplied to Human Resources at the time the email was sent. Mr. lamaio replied yes . He stated he ment ioned the doctor's decision in the email and sent the report. Secretary Little asked to be clear, the City was in receipt of the docto r's information prior to drafting the termination letter on the 12 th . Mr. lamaio confirmed Ms . Ricci had requested the report when he met with her, but would need to see the email chain to be certain . Member Copertino asked for more clarification about Dr . Harding's report that he was unable to diagnose the member with PTSD . Mr. Herrera stated part of that was addressed in Dr. Harding's follow -up letter dated November 2, 2020. He said in that letter the diagnosis of generalized anxiety disorder is referenced. Pension 01 -28-2022/7 Chair Redditt sa id he thinks there are varying medical opinions of what the diagnosis is, but does not feel having PTSD is the deciding factor. He said it is whether the me m ber is disabled and unable to do the job. Mr. Herrera ask ed Mr. Spears if Dr. Figueroa changed his opinion in his deposition and w hat his final medical opinion was. Mr. Spears said Dr . Figueroa's medical opinion was that the member had incomplete or pa rtial PTSD. Mr. Herrera ask ed Mr. Spears if Dr. Figueroa had an opinion on whether the symptoms were work-related or what they may have been caused by . Mr. Spears replied yes . He stated Dr. Figueroa said a major contributing cause of his condition wa s the member's employment as a firefighter . He then referenced the transcript deposition. Mr. Herrera asked if there had been a resolution to the workman's compensation case . Mr. Spear said a settlement had just been reached with the City for a fixed amount of comp e nsation . Mr. Herrera informed the board that due to the settlement, there would be an offset with respe ct to the pension and what it would payout. This is to ensure the member wou ld not receive more than he would have made had he continued to wor k. Chair Redditt ask e d if there were any further questions. Member Eichler moved to grant the service -connected disability pens ion . Seconded by Secretary Little and carried by a unanimous roll call vote. Mr. Herrera told Mr. lamaio that he w i ll beg i n receiving payments and that the first step will be t o determine what that amount will be. He reminded Mr. lamaio that there will be an ongoing obligation to ensure he remains disabled. He also asked Mr. Spears to provide the worker's compensation settlement information to th e City Clerk . Secretary Little as ked if there were required votes to approve the payment amounts. Mr. Herrera said it will come before the board for ratification similar to other retirement situati o ns . Secretary Little as ked if they needed a motion to do the actuarial evaluation for the payment or if it was inclusive of the just-passed approval. Pen sion 0 1-28-2022/8 Mr. Herrera replied no . 4. Adjournment. Chair Redditt adjourned the meeting at 5:00 p.m. Minutes approved by the Board of Trustees: ~2 ,;;r-:-w Robert Redditt, Chair Pe nsio n 01 -28-2022/9 This Page Left Blank Intentionally Pension 01-28-2022/10