NWCDN Members regularly post articles and summary judgements in workers’ compensations law in your state.
Select a state from the dropdown menu below to scroll through the state specific archives for updates and opinions on various workers’ compensation laws in your state.
Contact information for NWCDN members is also located on the state specific links in the event you have additional questions or your company is seeking a workers’ compensation lawyer in your state.
Gotte vs Air Conduit, LLC 22-C-0097 (La. 6/8/2022) 347 So. 2d 860
(OWC Judge Melissa St. Mary District 03)
Summary: The Court refused to grant a Writ of Certiorari on a Third Circuit Judgment affirming
the reduction of a claimant’s benefits due to his failure to cooperate with vocational
rehabilitation with two dissenting opinions urging legislative action.
The claimant was collecting SEB following a shoulder injury which required multiple surgeries.
The employer retained a vocational counselor to provide rehabilitation in accordance with
Louisiana workers compensation law. The counselor was unable to contact the claimant or his
attorney after several attempts. For this reason, the employer availed itself of the 50 %
compensation reduction provision in LA RS 23:1226(B)(3)(c) without the need for a hearing.
The claimant filed a disputed claim for compensation and the matter went to hearing. The
Louisiana Workers’ Compensation Office found that the claimant refused to cooperate with
vocational rehabilitation and reduced his compensation by 50%. The claimant argued on appeal
to the Third Circuit that the vocational counselor had a conflict of interest with the claimant
because she was chosen by the employer.
The Third Circuit upheld the employers’ reduction based on a prior Supreme Court opinion
holding this particular conflict of interest has been legislatively resolved.
The claimant applied for a Writ of Certiorari, which was denied by a majority of Justices. Justice
Genovese disagreed, and would have granted the writ. He opined the reduction of claimant’s
benefits without a hearing amounted to “sham rehabilitation” and a denial of due process.
Perceiving a Justice Griffin concurred in the writ denial, admonishing “this area of the law
warrants legislative reform.”
Boudreaux v. Take 5, LLC 2022-42 (La. App. 3 Cir. 10/5/2022) Not yet released for
publication.
(OWC Judge Paula Murphy District 04)
Summary: the claimant’s orthopedic injury while performing regular job duties caused by no
unusual strain is a compensable injury.
{01453324.DOCX;1}
The claimant was employed as an assistant manager at an oil change station. He was changing
oil in the pit under the cars, which requires him to unscrew tight oil filters over his head. At this
particular station, the filters were very tightly fixed, requiring the claimant to apply extra force.
He reported a back injury about a week later, due to having struggled with several filters
throughout the day.
The case went to trial and the employer moved for a directed verdict (involuntary dismissal). The
Louisiana Workers’ Compensation Hearings Officer denied the motion and entered judgment in
favor of the claimant, finding that he proved an injury.
The employer appealed the finding of a work injury, as the claimant did not identify an “actual,
identifiable, precipitous event” as the cause of his injury. The Third Circuit disagreed with this
analysis, citing precedent that an injury is compensable if the claimant can identify with some
particularity the manifestation of the accidental injury.
Hot Topics in Louisiana Workers’ Compensation Law
LaPoint vs Commerce & Industry Insurance Company 20-388 (La. App 3 Cir. 4/27/22) --So.3d -- (awaiting publication)
(OWC Judge Dianne Marie Mayo, District 03)
Summary: Judgment of Georgia state court barring Employer’s claim for reimbursement of benefits paid under Louisiana Workers’ Compensation scheme is not res judicata in claim for reimbursement made in Louisiana
The employer’s right to recover from a third party tortfeasor in out of state litigation was addressed by Louisiana Courts. Employee was hired in Louisiana to work in Louisiana. Later Employee moved to Georgia, continuing to work for the same Employer.
While working in Georgia, Employee was crushed by a vehicle owned and operated by USCI, another contractor doing work at the site. Immediately after the accident, the Employer accepted the claim and paid medical and compensation benefits to the employee under Georgia law. Shortly after his accident, Claimant moved back to Louisiana. At this point, the employer began paying the benefits under Louisiana Law.
Employee filed a negligence suit in Georgia state court against USCI. After USCI and the Claimant settled the case, a dispute remained as to the amount of reimbursement out of the settlement due the Employer for compensation and medical benefits made. The Employer and Employee reached an amicable resolution as to only the amount paid in the form of Georgia workers’ compensation benefits, with all parties reserving their rights as to reimbursement of the Louisiana compensation benefits.
Employee filed for a summary judgment in the Georgia Court to preclude Employer from collecting on its claim for reimbursement for benefits paid the claimant under Louisiana law. The Georgia court (applying lex loci delicti) found that Employer was precluded from asserting its claim for reimbursement for Louisiana benefits in a Georgia Court.
Employee filed suit to enforce the Georgia judgement in Louisiana. The suit was unopposed, and the Louisiana District Court ordered that the Georgia judgement was entitled to full faith and credit in Louisiana. This judgment was not appealed.[1]
Employer filed a claim in the Louisiana Workers’ Compensation Office requesting a forfeiture of his benefits due to his failure to reimburse it from the proceeds of the third-party case. The compensation judge overruled Claimant’s exception of lack of subject matter jurisdiction, and the parties proceeded to a formal hearing. The Compensation Judge correctly applied the statute, ordering the employee to pay two thirds of the amount retained in his trust account, the remaining third being payable to the employee’s attorney under applicable statute.[2]
Employee appealed, for the first time urging the exception of res judicata. Employee argued that the Georgia state court judgment was a final decision as to the Employer’s right to reimbursement and credit even as to the benefits paid under Louisiana law. The Court of Appeals sustained the exception of res judicata, dismissing the Employer’s claim for reimbursement and credit.
Supreme Court granted the Employer’s writ taking up the exception of res judicata. The Georgia Court did not have subject matter jurisdiction over the recovery of benefits paid under Louisiana law. The Georgia Court’s judgment, though valid, did not adjudicate the Employer’s rights to recover its lien falling under Louisiana law. The Supreme Court overturned the decision and remanded the case to the Third Circuit. The Third Circuit then reinstated the original judgment of the Louisiana Workers’ Compensation Office awarding 2/3 of the settlement recovery to the employer.
Batiste vs Minerals Technology, Inc. 21-795 (La. App. 3 Cir. 6/8/2022) (unpublished opinion).
(OWC Judge Anthony Palermo, District 04)
Summary: Judgment awarding attorney fees of $5,000.00 was an abuse of
discretion and increased to $46,800.00 based upon an hourly rate of $225.00.
On remand from the Third Circuit, the workers’ compensation judge awarded the Claimant supplemental earnings benefits (SEB), penalties for failure to provide medical treatment, and attorney’s fees.
The Claimant appealed, urging the compensation judge erred in failing to award penalties for non-payment of indemnity benefits, failing to award a penalty of $8,000.00 for failure to provide treatment on many occasions and awarding an abusively low attorney fee.
The judgment of Louisiana Workers’ Compensation Office awarded attorney’s fees of $5,000.00 to counsel for the Employee after a successful prosecution of the claim for supplemental earnings benefits (SEB). The Employee did not submit evidence of his attorney’s time spent or his hourly rate.
Claimant’s post trial brief “outlined his time” spent before the Louisiana Workers’ Compensation Office through trial. Claimant’s counsel spent a total of 208 hours through trial and two appeals. The Third Circuit found that $225.00 per hour was a reasonable hourly fee and increased the award of attorneys’ fees from $5,000.00 to $46,800.00. The Court found that the award of $5,000.00 was an abuse of discretion by the Workers’ Compensation Judge.
Howard vs Rio Sol Nursing Home 2021-824 (La. App. 3 Cir. 6/15/22) 344 So.3d 216
(OWC Judge James J. Braddock)
Summary: Judgment reducing benefits based on available jobs within 45 miles of Claimant’s rural home reversed because the jobs were not in the Claimant’s geographical region.
The Claimant injured her neck and back while working as an LPN for the Employer. The Employer instituted indemnity benefits. The Claimant’s physician released the Claimant to light duty and the vocational counselor assigned to the case identified 3 light duty jobs within 50 miles of the Claimant’s rural home. The Employer reduced benefits based upon the vocational evidence.
The Claimant filed a Disputed Claim for Compensation alleging improper reduction of her benefits. The Claimant appealed, alleging the Workers’ Compensation Judge erred in not finding her entitled to temporary total disability benefits and in finding the reduction of benefits proper.
On Appeal, the Thid Circuit found that the Employer failed to carry its burden of proving the existence of actual jobs in the claimant’s geographical region that were available to the Claimant. Specifically, the Court rejected the three jobs because they were not in the Claimant’s geographical region.
The Claimant’s hometown of Mansura, a small rural area in Avoyelles Parish, Louisiana. The jobs identified for the Claimant were within 45 miles of her home in the City of Alexandria. The Claimant went to Alexandria for her medical care. Louisiana Courts have not set a standard mileage radius to determine whether the job is within the Claimant’s geographic region. This is decided on a case-by-case basis.
The Employer argued that is reasonable to expect the Claimant to drive 45 miles to work in Alexandria because there are very few jobs in her immediate geographic region. The Court took judicial notice of the distance between the Claimant’s home/ Employer’s premises from Google Maps. The Court found the jobs were outside her geographic region. The Court reasoned that because she takes daily medication that makes her drowsy and driving causes her pain level to increase, it was unreasonable to expect her to drive 350 miles round trip to work every week for a $10.00 per hour job plus $150.00 per week in SEB. Accordingly, the Third Circuit found the jobs to be outside of her geographic region, reversing the trial Court’s finding of a proper reduction in benefits. The Court ordered SEB benefits reinstated to the date of reduction at the full TTD rate.
[1] Although this this judgment was not a dispositive fact in this case, this point is included to emphasize the administrative nature of the Employer’s subrogation remedy in out of state third-party cases.
[2] LA R.S. 23:1103 C. (1) If either the employer or employee intervenes in the third party suit filed by the other, the intervenor shall only be responsible for a share of the reasonable legal fees and costs incurred by the attorney retained by the plaintiff, which portion shall not exceed one-third of the intervenor's recovery for prejudgment payments or prejudgment damages. The amount of the portion of attorney fees shall be determined by the district court based on the proportionate services of the attorneys which benefitted or augmented the recovery from the third party. The employee as intervenor shall not be responsible for the employer's attorney fees attributable to postjudgment damages nor will the employer as intervenor be responsible for the attorney fees attributable to the credit given to the employer under Subsection A of this Section. Costs shall include taxable court costs as well as the fees of experts retained by the plaintiff. The pro rata share of the intervenor's costs shall be based on intervenor's recovery of prejudgment payments or prejudgment damages.
Guidry v. Worknet 2000, Inc., 2021-89 (La. App. 3 Cir. 8/11/21)
(OWC Judge Anthony Palermo, District 4)
Summary: Claimant precluded from the receipt of workers’ compensation benefits based on his own actions (horseplay) is also precluded from recovering damages from a third-party in a subsequent tort suit.
The Court of Appeal of Louisiana, Third Circuit affirmed lower court judgments dismissing Claimant, Robert Guidry’s workers’ compensation claim and tort suit for damages. Claimant was employed as a lumber puller with Worknet 2000, Inc. On the date of the incident, Claimant was engaged in lumber pulling at Gaiennie Lumber Company, LLC (“Gaiennie”), and was working alongside co-worker Marion Sam. At some point, another co-employee, Joseph John arrived driving a forklift, and commenced to complete donuts while Claimant held on to the side of the machine. In the process, Claimant either got off or fell off of the forklift which then rolled over his right leg causing serious, disabling injuries.
Claimant filed a workers’ compensation claim against his employer and its workers’ compensation insurer. After a trial on the merits, the workers’ compensation judge (“WCJ”) took the matter under advisement, and later issued a ruling denying benefits because Claimant was engaged in horseplay and therefore not within the course and scope of his employment. Claimant also filed a suit for damages against his employer, Gaiennie, and Joseph Johns, alleging negligence, intentional tort, and vicarious liability. Gaiennie filed a motion for summary judgment on the basis of statutory employer immunity which was granted, resulting in the dismissal of Claimant’s disputed claims with prejudice.
Claimant appealed both adverse rulings to the Court of Appeal of Louisiana, Third Circuit to review the correctness of those decisions. In support of his entitlement to workers’ compensation benefits, Claimant argues that while he admits to being engaged in horseplay, he maintains that he was in the process of returning to his duties when the accident occurred. In consideration of this fact, as noted in its opinion, the Court narrowed the issue to whether Claimant requested to stop or get off before the accident occur. Though Claimant argued that he purportedly asked Joseph John to stop prior to the accident, WCJ found the testimony and version of events offered by other witnesses, suggesting that Claimant did not ask to get off of the forklift, to be more credible.
Moreover, Claimant argues that since the WCJ denied recovery on the basis of horseplay, he cannot be further denied the opportunity to bring his claim in tort. The First Circuit flatly rejected Claimant’s contentions, finding that Claimant’s injuries would have been covered under the Louisiana Workers’ Compensation Act, but for his own engagement in horseplay which caused him injury.
Hebert v. Aramark Servs., Inc., 2021-0631 (La. App. 1 Cir. 7/30/21)
(19th Judicial District Court – Baton Rouge, Louisiana)
Summary: Claimant’s workers’ compensation file deemed discoverable in subsequent lawsuit.
The Court of Appeal of Louisiana, First Circuit reversed a district court ruling which denied the production of a Claimant’s worker’ compensation file in a subsequent tort suit for damages. In its opinion, the Court held that the confidentiality provision of La. R.S. 23:1293[1] does not operate to preclude a claimant’s `workers’ compensation proceeding file from being sought through discovery in a subsequent personal injury action arising out of the same circumstances. The Court reasoned that Louisiana law[2] dictates that the information sought through discovery must be reasonably calculated to lead to the discovery of admissible evidence. In this instance, the information sought in Claimant’s workers’ compensation file could lead to the discovery of admissible evidence regarding the nature and extent of the Claimant’s injuries.
Zinn v. Zagis, USA, L.L.C., 2020-00971 (La. 3/2/21)
Summary: Language on the back of settlement check requiring claimant’s acceptance and endorsement is not an unconditional tender of settlement funds under Louisiana law and allows for additional penalties and attorney’s fees to be imposed.
The Louisiana Supreme Court recently held that an employer who fails to unconditionally tender funds to a workers’ compensation claimant is subject to a mandatory award of penalties and attorney’s fees. In the case Zinn v. Zagis, USA, supra, the claimant settled his claim with his employer for $40,000 which was disbursed to him in two separate checks. The back of the settlement checks contained language which placed certain conditions on claimant’s acceptance and endorsement. Rather than contact the employer, claimant’s counsel retained the checks for 30 days then filed a motion seeking penalties and attorneys, which was ultimately granted by the Louisiana Supreme Court on the basis that the employer failed to unconditionally tender funds to claimant within 30 days as La. R.S. 23:1201(G) dictates.
Rodriguez v. Nola Motor Club, L.L.C., 19-447 (La. App. 5 Cir. 10/5/20), 304 So. 3d 147, 152, writ denied, 2020-01432 (La. 2/17/21)
Summary: Claimant forfeited his entitlement to workers’ compensation benefits after making false statements regarding pre-existing anxiety and heart related conditions.
In this case, the Court of Appeal of Louisiana, Fifth Circuit affirmed the decision of a workers’ compensation judge who found that a claimant forfeited his right to compensation by willfully making false statements to obtain benefits in violation of La. R.S. 23:1208. The claimant sought benefits after a work-related accident in which a go-cart engine produced a false explosion pulling claimant to the back and the top of the go-cart. Claimant filed a disputed claim for compensation alleging that he sustained injuries to his lower back and left shoulder. Claimant’s employer and its workers compensation carrier filed a motion for summary judgment contending that claimant had violated La. R.S. 23:1208 by making false statements for the purpose of obtaining benefits in his deposition. The workers’ compensation judge granted the employer and its workers’ compensation carrier’s motion, and the claimant appealed.
On appeal, the Fifth Circuit rejected the claimant’s argument that he was only seeking compensation for injuries to his lower back and left shoulder, and the statements he made regarding his anxiety and heart-related issues were inconsequential. Instead, the Court found the statements made by the claimant clearly and unambiguously indicated he suffered severe anxiety and heart-related issues as a result of the work-related accident. Moreover, claimant’s medical records indicated he was diagnosed and treated for anxiety less than two months prior to the work accident, he was taking anxiety medication the day of the work accident, and received significant medical treatment for his heart dating back to 2007 until as recently as three months prior to the work accident. Given the timing and extensive prior medical history, the Court believed it was highly unlikely that the claimant was mistaken or had a lapse in memory. Instead, it opined, at the very least, claimant was attempting to support or bolster his claim for injuries to his back and shoulder.
[1] La. R.S. 23:1293 provides in pertinent part, “All medical records of an employee, all records of payment of compensation to an employee or his dependent, all records with respect to the rehabilitation or attempted rehabilitation of an injured employee, all employer reports of injury as required by R.S. 23:1306, all claims by an employee or his dependent filed pursuant to R.S. 23:1310, records submitted to the Louisiana Workers' Compensation Second Injury Board concerning claims for reimbursement arising out of a claim by an employee or his dependent filed pursuant to Chapter 10 of this Title, including but not limited to any and all records submitted for requests for reimbursement, documents maintained in the claim files regarding reimbursement and settlement requests, and all records submitted pursuant to R.S. 23:1378(A)(5), all safety plans pursuant to R.S. 23:1291(B)(4), all safety records of the OSHA section obtained in connection with the Insurance Cost Containment Act or the OSHA 7(c)(1) program, and all data produced pursuant to R.S. 23:1291.2, shall be confidential and privileged, shall not be public records, and shall not be subject to subpoena, except that records of the office may be produced in response to an order of a workers' compensation judge based upon his finding that the record is relevant and necessary to the resolution of a disputed claim pending before the office. Such confidentiality and privilege shall be strictly maintained by the assistant secretary and all employees of the office except as provided above or in Subsection B of this Section and shall be used exclusively for the purpose of discharging the duties and responsibilities of the office under this Chapter.”
[2] The information sought must be reasonably calculated to lead to the discovery of admissible evidence. See La. Code Civ. P. art. 1422.
Louisiana has adopted certain Medical Treatment Guidelines with the purpose of assisting with the decision making process regarding proposed medical treatment for injured workers. The Medical Treatment Guidelines have been effective for several years. For any dispute as to whether the recommended care or treatment is in accordance with the medical treatment schedule, or whether a variance from the medical treatment schedule is reasonably required, any aggrieved party may file a Disputed Claim for Medical Treatment appeal with the Office of Workers’ Compensation Medical Director.
This process was challenged by a group of claimants and their attorneys, under constitutional grounds. Unfortunately, in March of 2017, a district judge granted this challenge to the medical director system, finding the process unconstitutional, and enjoining the OWC from applying the regulations. The OWC then filed a suspensive appeal, and the issue is currently awaiting review by the proper appellate court. The OWC has resumed the medical review process during the pendency of the appeal. However, the future of the process is uncertain. We will monitor this issue on an ongoing basis.
In Burgess v. Sewerage & Water Board of New Orleans, 2016-2267 (La. 06/29/2017) the Louisiana Supreme Court has held that the choice of pharmacy in a workers’ compensation case belongs to the employer, and not the employee. Resolving a split in the state’s circuit courts of appeal, the Supreme Court acknowledged that La. R.S. 23:1203 obligates an employer “to furnish all necessary drugs” to the injured employee. The statute does not, however, directly address who has the right to choose the pharmacy to dispense the drugs. The Court noted that the Legislature could have explicitly given employees the choice of pharmacy, just as it gave employees the choice of physician under the statutory scheme, but the legislature did not. The Court reasoned that given the statutory ambiguity (and because prescription medications need only be furnished in a timely manner regardless of where they come from), as well as the cost-consciousness implicit in the statute, employers should control pharmacy dispensing.
The recent case of Clavier v. Coburn Supply Co., 2016-0625 (La. 06/27/2017) addressed the issue of choice of functional capacity evaluation (FCE). For the first time, the Louisiana Supreme Court ruled on the payment of such an FCE. The Employer had obtained an FCE and the claimant apparently disagreed with the results, and she sought an order from the workers’ compensation judge compelling Employer to pay for an FCE of the claimant’s choosing. When the judge denied the request, claimant ultimately pursued her appeal to the Louisiana Supreme Court. The Court denied the request and found that claimant was not entitled to an FCE with her choice of provider at Employer’s cost; Employer could not be required to pay for an FCE with her choice of provider.