Articles Posted in Pain And Suffering Claims

craftsmen-1438652-1024x683A lawsuit out of Lafayette Parish demonstrates how Louisiana law allocates workers’ compensation benefits. To qualify for benefits, an employee must be injured during the course of employment. Temporary Total Disability (TTD) Benefits are paid while the employee is unable to work due to an injury. Supplemental Earnings Benefits (“SEB”) are a bit more technical. SEBs are paid when the injured worker has reached “maximum medical improvement” and is no longer eligible for TTD, but is incapable of earning 90% of pre-accident wages.

Our case begins on August 16, 2006, when Ronald Leleux, a carpenter for Numa C. Hero & Son (“Numa Hero”), was injured on the job while trying to escape from a swarm of wasps. About eight months following the accident Leleux was awarded TTD (the “consent judgment”). On November 18, 2010, Leleux consulted Dr. Daniel Hodges for pain management. Nearly two years later Leleux met with Dr. Douglas Bernard, who was recommended by Numa Hero. Dr. Bernard’s report indicated that Leleux had benign degenerative disk disease and that Leleux could perform unrestricted work activities. On August 7, 2013, Leleux saw a third doctor who was appointed by the Workers’ Compensation Judge (WCJ), Dr. Christopher Belleau. Dr. Belleau testified in a deposition that Leleux had reached maximum medical improvement and was capable of sedentary work. Less than one year after Dr. Belleau’s deposition, Numa Hero filed a motion asking to modify the earlier consent judgment. During the trial on the motion, the WCJ considered Leleux’s testimony, Dr. Belleau’s deposition, and the records of Dr. Bernard and Dr. Hodges. The WCJ issued a judgment modifying Leleux’s benefits from TTD to SEB. Displeased with the outcome, Leleux appealed the WCJ’s modification to the Louisiana Third Circuit Court of Appeal.

Pursuant to La.R.S. 23:1221(1)(d), when a claimant’s condition has stabilized and treatment is no longer required, TTD is not appropriate and a determination regarding the extent of the claimant’s disability must be made. See Navarre v. K-Mart, 803 So.2d 206 (La. Ct. App. 2001). La.R.S. 23:1310.8 sets forth the WCJ’s authority to modify compensation awards. Two provisions of La. R.S. 23:1310.8 were at issue in this case: subsection (A)(1), which applies to a reclassification of benefits, and subsection (B), which applies to a change in the amount of compensation or a request to end the payment of benefits.

arabic-pharmacy-1549734-768x1024When you get hurt on the job, it is common to seek workers’ compensation benefits to help with the costs of your injury.  However, the employer will likely at some point seek to diminish or cease payment altogether. In a recent case out of the Parish of Calcasieu, we learn just how far an employer must go in helping a former employee find a replacement job before reducing benefits.

Kenneth Clark was working as an assistant manager at Walgreens in Moss Bluff when he hurt his back.  A visit to Dr. Erich Wolf and an MRI revealed three herniated disks. After undergoing a discectomy and epidural steroid injections, Dr. Wolf released Mr. Clark to work eight hours per day at light to minimal-medium duty. Later, Mr. Clark was determined to have reached maximum medical improvement.

Walgreens voluntarily paid Mr. Clark Temporary Total Disability (TTD) benefits equaling his average weekly wage of $727.37. Once Mr. Clark reached maximum medical improvement, Walgreens changed Mr. Clark’s TTD benefits to Supplemental Earnings Benefits (SEB) to a weekly rate of $244.89 based on Mr. Clark’s wage earning capacity of $360.00. Mr. Clark then challenged the reduction of his benefits and sought penalties and attorney fees.

baseball-in-the-grass-1557579-1024x683Peanuts and cracker jacks are two cornerstones of the game of baseball.  However, surgery is not. Yet, when one little leaguer got struck by a baseball during practice, the league’s insurer tried to get out of picking up some of his medical bills. The Louisiana Third Circuit Court of Appeal, however, was not going to let the insurance company off so easily.  

On June 1, 2010, nine-year-old Michael Folley was hit in the mouth by an errant baseball during his baseball team’s practice. On May 20, 2011, Tonya Csaszar, on behalf of her son Michael, brought suit against Nationwide Insurance, alleging that Michael would require future medical treatments and surgeries as he got older. Nationwide, having paid some medical expenses, denied further coverage based on a provision of the policy limiting coverage to medical expenses incurred within three years of the accident.  Nationwide moved for summary judgment arguing coverage for Michael under the policy had terminated.  The Judicial District Court for the Parish of LaFayette denied the motion and Nationwide appealed.  

The parties disputed when the injuries were “incurred” and thus subject to coverage. Nationwide argued that there was no ambiguity in the meaning of “incurred” in the language of the policy and any medical treatment beyond the three-year cap was not subject to coverage. The Plaintiffs contested however that due to Michael’s young age, he would need additional medical treatment to accommodate physical changes as he grew.  Nationwide’s policy did not define the word “incur.”  

old-school-bus-1431364-1024x683Sometimes when a plaintiff is awarded damages at trial he or she may believe that the damage amount does not match the injury he or she incurred. When this situation happens, what can a plaintiff do to challenge the damage award? And how easy is it get an increase in the damages amount? A recent First Circuit Court of Appeal case involving a Terrebonne Parish man provides guidance towards answering these questions.

Arthur Mitchell was riding a public bus when the bus was cut off by, requiring the bus driver to suddenly brake to avoid the collision. As a result of the sudden braking, Mr. Mitchell was thrown forward into the metal change box located behind the driver’s seat. Mr. Mitchell brought a lawsuit against the driver who cut off the bus, Jacob Simmons, claiming that Mr. Simmons caused severe injuries to his neck, back, body, and mind. At trial, Mr. Mitchell was awarded a total damage amount of $15,718 of which $1,000 was for future medical expenses, $1,000 was for past pain and suffering, and $13,718 was for past medical expenses.

Mr. Mitchell, believing that his damages were undervalued at trial, appealed the trial court’s decision. He argued that when a jury awards future medical expenses for injuries that the jury must also award future pain and suffering damages.  Mr. Mitchell argued that because the trial court did not award future pain and suffering, that the court erred in its assessment of the final damages total.

oil-refinery-1240489-1024x599Often, the facts of a lawsuit are unclear. One strategy that lawyers often use to prove their version of events is to use an expert witness to corroborate their side’s story. Expert witnesses are individuals who possess knowledge in a field or area that the average person knows little to nothing about. Frequently, both sides in a lawsuit end up utilizing experts who often times have differing opinions about the facts surrounding the lawsuit. But how does a judge or jury determine which expert is correct? Recently, the Fifth Circuit Court of Appeal for the State of Louisiana addressed these questions in a workers’ compensation case.

David Allensworth worked for two different companies, Gulf South Systems (“GSS”) and Grand Isle Shipyard (“GIS”) as a cleaner, cleaning storage tanks containing gasoline, crude oil, diesel fuel, and condensate. One day, Mr. Allensworth visited an urgent care center with complaints of abdominal pain and weight loss. A CT scan revealed a large abdominal mass which was later diagnosed as non-Hodgkin’s lymphoma. A cause of non-Hodgkin’s lymphoma is toxic exposure to benzene with is contained in crude oil and gasoline. Mr. Allensworth filed a lawsuit against GSS and GIS for workers’ compensation benefits claiming that his exposure to benzene while working for the companies caused his non-Hodgkin’s lymphoma. Workers’ compensation pays for an employee’s medical expenses and lost wages when an employee is injured on the job.

At trial, Mr. Allensworth submitted the sworn statement of Dr. Jack Saux as an expert oncologist. Dr. Saux concluded that Mr. Allensworth’s non-Hodgkin’s lymphoma was caused by toxic exposure to benzene, which most likely happened when Mr. Allensworth cleaned his employers’ storage tanks. GIS and GSS countered with its own medical expert, who testified that though there is some association between benzene and lymphoma, there is no evidence that benzene exposure caused Mr. Allensworth’s non-Hodgkin’s lymphoma. The Workers’ Compensation Judge (“WCJ”) concluded that Mr. Allensworth did not prove that his disease was a result of his employment. In doing so, the WCJ noted that Dr. Saux based his opinion on Mr. Allensworth’s statement in which Mr. Allensworth claimed he only wore a regular shirt and overalls while cleaning the tank. It was based only on this statement, and not on an examination, that Dr. Saux concluded that exposure to benzene from Mr. Allensworth’s job likely caused Mr. Allensworth’s disease. The WCJ also noted that the testimony of GIS and GSS’s expert stated that Mr. Allensworth did wear protective equipment when cleaning the tanks.

billiard-2-1434095-1024x683When an employee is injured in the course of his or her job, then the employee will receive wage replacement and medical benefits in the form of workers’ compensation. Workers’ compensation takes the place of a lawsuit an employee can bring when he or she is injured on the job by someone’s negligence. Because employers are responsible for providing a safe work environment, it stands to reason that employers are responsible when that environment is unsafe. While workers’ compensation provides a necessary service to injured workers, there are always those who would try to take advantage of the system. This struggle to try to provide for those who are legitimately injured while at work and deny claims for those who try to defraud the system gives rise to a complex body of law. One reoccurring issue that often surfaces in workers’ compensation cases is whether an employee is injured while on the job. Recently, the Fifth Circuit Court of Appeal examined this issue when determining whether an employee for a pool table installing company injured his back while on the job.

Nunzio Galiano worked for Lucky Coin Machine Company (Lucky Coin) as a pool table installer. Mr. Galiano was regularly required to lift and move large objects during the course of his duties, including 200-pound slates for pool tables. In August of 2013, Mr. Galiano began to experience pain in his lower back. He did not tell his employer about the pain until he could no longer stand it. Mr. Galiano hesitated to inform his employer of the extent of his back pain because he feared being fired if he told the whole truth. When Mr. Galiano finally went to a doctor, the doctor told him that the pain was not caused by kidney issues, which Mr. Galiano had assumed to be the cause prior to the doctor visit, but rather sacroiliac (SI) joint dysfunction. When told that Mr. Galiano’s work environment involved heavy lifting, the doctor indicated that there may be a connection between that and the bad back. Mr. Galiano then filed for and was awarded, workers’ compensation benefits. Mr. Galiano’s employer, Lucky Coin, appealed this decision arguing that Mr. Galiano’s injury was not caused while he was on the job.

Louisiana law requires that an employee prove 1) that there is an injury, 2) arising out of the employment, 3) caused by an accident, and 4) that the injury is more than simply a gradual deterioration or progressive degeneration. La. R.S. 23:1031 (2016). An employee bringing a workers’ compensation claim is only required to prove the injury more likely than not occurred while the employee was on the job. Marange v. Custom Metal Fabricators, Inc., 93 So.3d 1253, 1257 (La. 2012).

sprinkler-1316192-1024x681Accidents can happen at any time, even at work.  Sometimes these accidents can aggravate a pre-existing injury.  In a claim for workers’ compensation benefits, employers may use the existence of an old injury to deny payment of benefits despite a clear work accident with medical repercussions.  This was the case for a government employee in Winnsboro, Louisiana.   

Mr. Jay Marshall was an employee of the Town of Winnsboro’s water department for 33 years where he worked as a supervisor. For years he had back pain from injuries but always sought treatment and returned to work.  Mr. Marshall had been taking pain medication since 2002.  On November 2012, while working with his crew, Mr. Marshall pulled a rod out of the ground,  hurt his back,  and was unable to work the rest of the day.  After the accident, Mr. Marshall went to his physician, Dr. Roland Ponarski, complaining of back pain.  Dr. Ponarski did not recall Mr. Marshall mentioning a recent work accident during the visit.  Mr. Marshall was referred to neurosurgeon Dr. Bernie G. McHugh. Mr. Marshall provided a patient history to Dr. McHugh which included back pain from a work injury originating in the 1990s.  Dr. McHugh opined that someone with a disease like Mr. Marshall’s should only be performing sedentary work and that the most recent workplace injury in conjunction with his degenerative disease certainly worsened the pain.  Risk Management, Inc., the worker’s compensation adjuster for Winnsboro, sent Mr. Marshall to Dr. Jorge Rodriguez for a second opinion in 2013.  Dr. Rodriguez concluded that no surgery was needed and that over the counter pain medication was enough if Mr. Marshall was restricted to light duty work.  

In January 2013, Mr. Marshall filed an injury report on the November 2012 accident with Winnsboro.  Risk Management denied Mr. Marshall’s claim, did not pay an indemnity and did not provide for any medical treatment. Subsequently, Mr. Marshall filed a dispute with the Office of Workers’ Compensation. The Workers’ Compensation Judge (“WCJ”) found Mr. Marshall was entitled to temporary disability benefits beginning September 2013, covering supplemental earning benefits, as well as $500 as a penalty and $2000 in attorneys fees.

money-money-money-1241634-1024x768There are many questions involved in filing and pursuing a lawsuit. How do I file? When must I file? Against whom do I file it? What amount of damages do I seek? Most people are unaware that there are different types of damages. An attorney’s trial strategy not only plays a critical role in if the plaintiff is awarded compensation but also in how much the plaintiff is awarded, as highlighted by the following case.

Lana Averette was driving on Highway 1 in Port Allen when she was struck by an Entergy bucket truck driven by an employee of Entergy Gulf States Louisiana, L.L.C. (“Entergy”). On June 11, 2013, Ms. Averette filed a lawsuit against Entergy and the employee (“Defendants”), asserting that she had suffered spinal injuries from the accident. During his closing statement to the jury at the end of the trial, Ms. Averette’s attorney asked the jury not to award her future general damages, but to award her the cost of the future medical treatments she would be required to undergo because of her injuries. The jury returned a verdict in favor of Ms. Averette in the amount of $42,373.00 for past lost wages, $58,378.00 for past medical expenses, $75,000.00 for past mental anguish and emotional distress, $75,000.00 for past lost enjoyment of life, $75,000.00 for past pain and suffering, and $500,000.00 for future medical expenses. Defendants filed a motion for judgment notwithstanding the verdict or alternatively a motion for new trial, arguing that it was error as a matter of law to award Ms. Averette future special damages without awarding future general damages. The Judicial District Court for the Parish of West Baton Rouge denied the motions and Defendants appealed to the Louisiana First Circuit Court of Appeal. On appeal, Defendants argued that because Ms. Averette waived her claim for future pain and suffering, she waived her claim for future medical expenses.

General damages seek to compensate the plaintiff for losses of life or lifestyle which cannot be measured definitively in terms of money, such as pain and suffering. See McGee v. A C and S, Inc., 933 So.2d 770, 774 (La. 2006).  In contrast, special damages are those which may be calculated with relative certainty, including medical expenses.  In reviewing a jury’s award of special but not general damages, a reviewing court must ask if the award is so inconsistent that it is an abuse of discretion.  See Wainwright v. Fontenot, 774 So. 2d 70 (La. 2000).  Under certain circumstances, the Court of Appeal noted that evidence presented at trial could support an award of medical expenses without an award of general damages. Thus, the question before the Court of Appeal was whether the jury made inconsistent awards based on the record of evidence.

children-at-play-1328051-1024x685There really can be several hazards in a grocery store: rogue carts, other shoppers, scattered merchandise, to name a few.   Even more common is the infamous puddle of water.  Inevitably in a store full of liquids, patrons can slip and fall in a neglected puddle.  But when should the grocery store (or any merchant) be required to compensate a patron for injuries sustained in a slip and fall case?  This was the subject of a recent case out of Marrero, Louisiana.   

Carol Evans was shopping at the Marrero Winn-Dixie when she slipped in a puddle of standing liquid. Ms. Evans brought a lawsuit against Winn-Dixie for her injuries alleging that she slipped in the puddle of liquid in the meat section of the store. The store’s co-director, Mr. Scioneaux, helped Ms. Evans complete an incident report. Subsequently, Mr. Scioneaux successfully tracked down what he believed to be the source of the moisture, a leaking 24-pack of water. He then reviewed surveillance video of the aisle where the incident occurred and saw no evidence of any other injuries. He further testified that the person who had the leaking 24-pack of water in their grocery cart was in the aisle only one minute prior to the accident.  Ms. Evans testified that she did not notice any liquid on the floor until after she fell, and further described it as being clear. She also had no way to account for the length of time it had been present, and there were no prior complaints of water before Ms. Evans sustained her injuries. Winn-Dixie filed a motion for summary judgment, asserting that Ms. Evans could not show that Winn-Dixie had actual or constructive notice of the condition prior to her accident, which was required for a successful case.  The Judicial District Court for the Parish of Jefferson granted Winn-Dixie’s motion for summary judgment based on Ms. Evan’s failure to prove notice as required. Ms. Evans filed an appeal with the  Louisiana Fifth Circuit Court of Appeal.  

Merchants are tasked with the duty of keeping their premises in reasonably safe condition. This means that a merchant must exercise reasonable care in keeping aisles, passageways, and floors free from any hazardous conditions that could reasonably cause injury.  A plaintiff who sustains injuries while lawfully on the merchant’s premises must prove: [1] the condition created an unreasonable risk of harm that was reasonably foreseeable; [2] the merchant was aware of the condition that caused the damage, through either actual or constructive notice, prior to the injury; and [3] the merchant failed to exercise reasonable care to remedy the condition.  See La. R.S. 9:2800.6.  To succeed under a theory of constructive notice, a plaintiff must show that the hazardous condition existed for a period of time that it would have been discovered if the merchant exercised reasonable care. See Trench v. Winn-Dixie Montgomery LLC,  150 So.3d 472,475 (La. Ct. App. 2014). A plaintiff must present “positive evidence” of the existence of the condition prior to the accident.   For employee presence to constitute constructive notice, a plaintiff must show that an employee either knew or should have known of the condition.  The burden of presenting solid evidence in these cases is high; a plaintiff cannot successfully bring a slip and fall case based on speculation.  

Good medical treatment, even in a first-world country, can, unfortunately, be difficult to find.  Doctors make mistakes and sometimes even entire hospitals can be at fault.  In a recent case out of Ouachita Parish, a woman was delayed admission to a hospital for an extended period which ultimately led to her diminished chance of survival.  While relief under several theories of recovery was debated, her survivors were eventually compensated despite opposition from the Louisiana Patients’ Compensation Fund.  

injection-1-1323670-544x1024In November 2002, Ms. Annette Toston died at St. Francis Medical Center from complications from an underlying kidney infection.  Prior to her death, Ms. Toston was a patient at E.A. Conway Hospital where physicians determined she requested a surgical procedure only available at St. Francis.  Ms. Toston arrived at St. Francis on November 25, 2002, however, was not admitted until approximately fifteen hours after arrival.  Ms. Toston subsequently died during the operation.  Following the death of Ms. Toston, her seven children filed suit in the Fourth Judicial District Court.  On July 14, 2014, the Judge entered a judgment in favor of Ms. Toston’s seven children.  The written judgment assessed St. Francis with $100,000, damages and the Louisiana Patient’s Compensation Fund (“PCF”) with $400,000.  The PCF automatically covers all state healthcare providers and caps the recovery of damages against a qualified healthcare provider at $100,000, plus interest per patient per incident.  Any award in excess of the cap is paid directly by the PCF.  St. Francis entered into a settlement agreement with Ms. Toston’s family for the $100,000, under the conditions that it would be released from all liability, and reserving all rights to proceed against the PCF.  

The PCF appealed to the Louisiana Second Circuit Court of Appeal.   The PCF argued that the Trial Court erred in finding St. Francis liable in Ms. Toston’s death.  The PCF also argued that the Trial Court erred in finding that St. Francis breached the standard of care during Ms. Toston’s transfer to St. Francis. Additionally, the PCF challenged the damages award, arguing that Ms. Toston could not have had a close relationship with her children because of the ages and locations of her children.  

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