Articles Posted in Workers Compensation

entering-arkansas-1215127-1024x671Workers’ compensation provides an avenue for workers injured on the job to receive the compensation a worker deserves. But what happens when a resident of one state is injured while working for a company in another state? A recent case out of the Second Circuit Court of Appeal for Louisiana addressed this issue when a Monroe, Louisiana worker, working for an Arkansas company, was injured in Mississippi.

Levi Williams was injured in Mississippi while driving a truck for Morris Transportation, Inc. (“Morris Transportation”), an Arkansas company. After the accident, Mr. Williams applied for and was granted, workers’ compensation benefits in Arkansas. Those benefits went away after Morris Transportation released Mr. Williams from work. Subsequently, Mr. Williams sought workers’ compensation benefits in Louisiana. Morris Transportation contested Mr. Williams’s request and the matter went before a Workers’ Compensation Judge (“WCJ”). At a hearing, the WCJ ruled in favor of Mr. Williams, holding that Mr. Williams was entitled to Louisiana workers’ compensation benefits. Under Louisiana law, an injured employee is entitled to workers’ compensation when injured while working outside the state if the employment contract is made in Louisiana. La. R.S. 23:1035.1 (2016). The WCJ found that the contract, in this case, was made in Louisiana and therefore, Mr. Williams was entitled to Louisiana workers’ compensation benefits. Morris Transportation, disagreeing with the WCJ’s assessment, appealed the decision.

On appeal, the Second Circuit Court of Appeal examined whether the employment contract between Mr. Williams occurred in Louisiana. Both Mr. Williams and Morris Transportation dispute the facts surrounding the formation of the employment contract According to Mr. Williams, he previously worked for Morris Transportation, but left to work for another employer. A little while after Mr. Williams left Morris Transportation, he called Morris Transportation and was told by an employee that he could come back and work for his former employer. Mr. Williams claimed that during this call he was told by by Morris Transportation that he could “come back.” Mr. Williams testified that the day after the phone call he drove, signed a driver qualification form, and began to working. Morris Transportation, conversely, argued that the phone conversation between Mr. Williams and itself did not form a contract. It claimed that the phone conversation could not constitute an employment contract because Mr. Williams had not gone through the employment process required before Morris Transportation hires an employee.

scaffolding-1518087-1024x768What happens to Workers’ Compensation Benefits once a claimant is awarded benefits and employment is terminated after the fact? Is the employee still entitled to the awarded benefits? In general, an employee must be injured within the course of employment to qualify for benefits. Supplemental Earnings Benefits (“SEBs”) are paid when the injured worker has reached maximum medical improvement but is not capable of earning 90% of pre-accident wages. This case explains what happens when an employee is fired after being awarded SEBs.

Kenneth Andrews worked as a journeyman for Thrasher Construction, Inc. (“Thrasher”). On January 7, 2013, Mr. Andrews fell off a scaffold after some boards flipped up and injured his wrist, arm, shoulder, knees, and back. On October 15, 2013, Mr. Andrews filed a disputed claim for compensation against Thrasher and SeaBright Insurance Company (“SeaBright”). On the same day that Mr. Andrews completed his required medical exam, Thrasher filed a notice of suspension and terminated his workers’ compensation benefits. Pursuant to La. R.S. 23:1201.1(K)(8)(a)(vii), Mr. Andrews filed a motion for expedited summary proceedings to lift the suspension of his benefits, alleging that Thrasher arbitrarily and capriciously terminated his benefits.

On January 12, 2015, the case proceeded to trial. The Workers’ Compensation Judge (“WCJ”) rendered judgment in favor of Mr. Andrews and awarded him SEBs. The WCJ also ordered that a Functional Capacity Evaluation (“FCE”) be performed for Mr. Andrews. Thrasher and SeaBright appealed the WCJ’s judgment to the Louisiana First Circuit Court of Appeal, alleging that the WCJ improperly awarded Mr. Andrews SEBs without the claimant first making a prima facie showing of entitlement.

loadin-the-lumber-1250972-1024x736Direct employment is the traditional and most common employer-employee relationship. But what happens when a statutory employee is injured on a work site? A statutory employee is an employee as defined by a state’s statute. While the employer is not the direct employer, the employer becomes the employer of record by force of law. Any worker injured while in the course and scope of employment for a statutory employer must be extended the same protection and benefits as those owed to the employees of the direct employer. This slip-and-fall accident case out of Tangipahoa Parish further describes the rights of Louisiana’s statutory employees in workers’ compensation cases.

Devon Energy Production Company, L.P. (“Devon”) was involved in the drilling of a well in Kentwood, Louisiana. Devon entered into an agreement with Asset Security for it to provide security services for Devon at the drilling site. The agreement provided that Devon was to be considered the statutory employer of Asset Security’s employees for purposes of La. R.S. 23:1061(A)(3) and Devon was entitled to the Louisiana protections that are afforded a statutory employer. On July 16, 2012, Ms. Shannon Robinson Kazerooni slipped and fell from the stairs when exiting the mobile trailer at the drilling site. Ms. Kazerooni was a reserve deputy with the Tangipahoa Parish Sheriff’s Office, which had an agreement with Asset Security to provide police officers for security assignments.

Ms. Kazerooni filed a lawsuit against Devon, alleging that the accident and her resulting injuries were caused by Devon’s negligence, and Monster Rentals, LLC, (“Monster”), alleging that Monster provided a defective trailer. Devon asserted the affirmative defense that Devon was the statutory employer of Ms. Kazerooni and that Ms. Kazerooni’s exclusive remedy was workers’ compensation benefits pursuant to LSA-R.S. 23:1061. Devon filed a motion for summary judgment, arguing that Ms. Kazerooni was a statutory employee pursuant to the agreement between Devon and Asset Security and that Devon was immune from suit for tort damages because Ms. Kazerooni’s exclusive remedy was workers’ compensation benefits from Devon. On October 14, 2015, the trial court granted Devon’s motion for summary judgment. Ms. Kazerooni appealed the trial court’s decision to the Louisiana First Circuit Court of Appeal, arguing that there was an unresolved genuine issue of material fact as to whether she was a statutory employee because she was merely a volunteer.

energy-1495365-1024x768After making a successful workers’ compensation claim, an insurer may make a subrogation claim, which is the right of an insurer to recover the amount paid out in a claim from a third party that caused the claim to occur. However, failure to properly reserve this right can affect an insurer’s right to recovery and possibly bar recovery altogether. A recent lawsuit in the Orleans Parish highlighted this fact.

In the aftermath of Hurricane Gustav, numerous workers were needed in order to restore Louisiana’s power grid. Mr. Scarberry was a former electrical lineman for Oklahoma Gas and Electric company (OGE). OGE is part of the Southeastern electrical Exchange (SEE), which is a nonprofit trade association composed of numerous utility companies that provide electricity throughout the U.S. Members in the SEE enter into Mutual Assistance Agreements, which govern relationships between requesting members and responding members. In this case, Entergy Gulf States Louisiana L.L.C. and Entergy Services, Inc. (collectively referred to as Entergy) requested the assistance of OGE in restoring power throughout Louisiana. As a result of this request, Mr. Scarberry began working for Entergy in Jennings, Louisiana under an agreement.  

During his efforts, Mr. Scarberry was severely electrocuted and became permanently disabled as a result of the accident with no chance for gainful employment in the future. Mr. Scarberry filed a lawsuit in July 2009 against Entergy. During this period, Mr. Scarberry received workers compensation from OGE in the amount of $150,162.49. OGE received reimbursement for these payments from Entergy, which was acknowledged with a “receipt” executed on August 1, 2011, pursuant to their agreement.  OGE also reserved their right to subrogation with the receipt.  

knee-x-ray-2-1562058-768x1024Workers’ compensation laws require companies to set aside a fund to pay their employees for work-related injuries. But what happens when the employer also has long-term disability insurance and the injured employee collects both workers’ compensation benefits as well as the employer-funded long-term disability benefits? Receiving benefits from the correct source of workers’ compensation income can prevent the headache of having to pay back thousands of dollars years later.   

A Parish of Caddo woman, Sheila Hill, was hired by Fresenius Medical Care NA (“FMC”) to work as a dialysis technician at its facility in Bossier City. She later began to experience tingling and numbness in her arms and began to see Dr. Clint McAlister, an orthopedist. Dr. McAlister diagnosed Ms. Hill with severe bilateral carpal tunnel syndrome (“CTS”), which was caused or aggravated by her work duties. Dr. McAlister recommended release surgery. A second orthopedist, Dr. Michelle Ritter, concurred with Dr. McAlister’s diagnosis and treatment plan.

FMC accepted the claim as work-related and began paying Ms. Hill temporary total disability (“TTD”) benefits. Ms. Hill underwent two carpal tunnel release surgeries in 2012, which was performed by Dr. Michael Acurio. Dr. Acurio diagnosed Ms. Hill as suffering the degenerative joint disease of the left basilar joint along with ongoing residual CTS.  

outdoor-1436934-1024x768Workers compensation laws require an employee to be injured within the course of employment to qualify for benefits. However, what happens when an employee is injured without any witnesses present? How can the employee prove that the accident really happened? This case out of Calcasieu Parish demonstrates the burden for a workers’ compensation claimant in Louisiana to prove an unwitnessed accident.

Thomas Gibson was employed by Resin Systems (“Resin”) as a maintenance man and was injured while loading iron beams in December of 2012. On January 28, 2013, Mr. Gibson filed Form 1008, a disputed claim for compensation, against Resin and its insurer LUBA Casualty Insurance Company, claiming that he injured a muscle in his back. Resin filed a general denial and disputed that Mr. Gibson was injured at work. Following a trial, the Workers Compensation Judge (“WCJ”) found that Mr. Gibson suffered a compensable injury and that Resin owed both penalties for failure to pay benefits and also attorneys fees for failure to reasonably controvert the claim. Resin appealed the WCJ’s judgment to the Louisiana Third Circuit Court of Appeal.  

Louisiana’s Supreme Court has outlined the burden of proof for a workers’ compensation claimant to prove an unwitnessed accident. An employee may prove by testimony alone that an unwitnessed accident has occurred when: (1) no other evidence discredits or casts serious doubt upon the worker’s version of the incident; and (2) the worker’s testimony is corroborated by the circumstances following the alleged incident. See Bruno v. Harbert International, Inc., 593 So.2d 357 (La. 1992). The fact-finder’s determinations as to whether the worker’s testimony is credible and whether the burden of proof has been met are factual determinations that are not be disturbed on appeal without a showing of manifest error.

anvil-and-hammer-1176425-1024x681An employee injured during the course of employment is generally entitled to workers’ compensation benefits. But can the actions of the employee in their free time affect the continuation of benefits? That was the case for a Parish of Lafayette employee who decided to perform side jobs involving heavy manual labor while collecting workers’ compensation benefits.

Donovan Meche was employed by Supreme Service & Specialty Company. Mr. Meche injured his mid- and lower back in November 2012 while swinging a sledge hammer. Mr. Meche saw several doctors to treat his back pain. The first orthopedic surgeon Mr. Meche saw recommended that he not work and undergo physical therapy. The next orthopedic surgeon, Dr. Heard, prescribed medication and physical therapy. Dr. Heard placed exact physical limitations which limited Mr. Meche to lifting ten pounds and sitting and standing no more than twenty minutes.

Supreme later obtained an independent medical examination of Mr. Meche which found that Mr. Meche was not able to return to his former job, but he could perform “sedentary or light duty.” Supreme offered Mr. Meche light-duty work and terminated Mr. Meche’s benefits.  Mr. Meche accepted the light-duty work, but only worked six hours over three painful days. Mr. Meche did not return to work for Supreme, but he did subsequently perform heavy manual labor working for his neighbor erecting an awning at his house and assisting a flooring contractor. Dr. Heard was not informed of these activities.

Employers and workers’ compensation insurance companies are continually looking for ways to cut their workers’ compensation claim amounts. For the injured employee, a workers’ compensation claim is a new process. But for the employer and insurance company reducing costs is a continual process. This litigation can even continue to happen years after winning an initial award. This was the case for a Parish of Lafayette employee in a recent case in the Louisiana Third Circuit Court of Appeal. Doctor examinations and testimony about an injury can always be required and, as in this case, improvement of an employee’s condition for the better can call for a reduction in workers’ compensation benefits.

Viel Olivier was a self-employed carpenter who was injured in 2003 while unloading a miters saw from his truck. He had contracted with LUBA Workers’ Compensation for his workers’ compensation insurance. Initially, Mr. Olivier was determined to be temporarily and totally disabled and was awarded workers’ compensation benefits.

LUBA later filed a motion to modify Mr. Olivier’s benefits because LUBA believed that Mr. Olivier was capable of light duty work and was no longer temporary and totally disabled from the injury. Mr. Olivier objected to this change and argued that LUBA was unable to meet its burden of proof with regard to a change in circumstances because the evidence was essentially the same as it had been at the previous hearing.

sickle-1383523-691x1024The workers’ compensation system exists to compensate employees when a work-related accident occurs.  Frequently, however, employers will attempt to deny or at least curtail benefits.  One common tactic is to blame an employee’s injuries on a pre existing medical condition rather than the work accident.  But does this excuse really work when a tree falls on an employee’s head?  As far fetched as it sounds, this was the scenario when an Ouachita Parish employer attempted to stop paying benefits after a tree accident.  

Bruce McCoy worked as a driver and groundsman for W.A. Kendall & Co., Inc. (“Kendall”). Mr. McCoy’s duties included cutting and dumping trees and tree limbs. While at work cutting trees,  a tree fell on Mr. McCoy causing a head injury. He needed treatment for headaches, neck pain, and a skull fracture. Doctors differed as to whether he could return to work and at what capacity. Once it was determined that Mr. McCoy could return to work with certain restrictions, Kendall offered him a job as a groundman.  Mr. McCoy did not respond however and Kendall terminated benefits.  A few months later, Mr. McCoy did request to return to his old position, however, he was denied.  Kendall’s vice-president opined that the denial was based upon Mr. McCoy’s possible inability to do the necessary work of a groundsman. Mr. McCoy then filed a claim for supplemental earning benefits (SEBs). The Workers’ Compensation Judge (WCJ) awarded $18,821.89 to Mr. McCoy in SEBs. Kendall appealed to the Louisiana Second Circuit Court of Appeal arguing that Mr. McCoy’s ongoing disabilities were actually the result of preexisting conditions because Mr. McCoy had diagnosed scoliosis.  

Workers’ compensation benefits are available to an employee for injuries sustained from an accident arising out of and in the course of employment pursuant to La. R.S. 23:1031(A).  A causal connection between accident and injury is established when an employee can demonstrate that before the accident they were in good health and post accident they have a disabling condition demonstrated by medical evidence supporting a reasonable possibility of a causal connection.  See Quinones v. USF & G, 630 So. 2d 1303 (La. 1994).  A pre-existing condition does not automatically bar benefits; the employee must show the accident aggravated the condition. See Peveto v. WHC Contractors, 630 So. 2d 1303 (La. 1994). Aggravation can be shown by a new disabling condition occurring at the time of the accident and supported by medical evidence.  

field-1-1381631-1024x641Imagine you are in a car accident, one that is so severe it results in you being airlifted to a hospital.  Recovery time is extensive and your mental capacities are foggy at a minimum.  While hospital bound, someone other than yourself files a claim for your workers’ compensation benefits.  Due to the hospital stay, you receive no notice of the claim or court hearings yet a decision is made denying benefits.  The real kicker? All this occurs in a state where you do not live. Sound a tad unjust? Yet this recently happened to a Kaplan, Louisiana man.

Steve Richard, a Louisiana resident, was injured in an automobile accident while driving to a work location in Mountrail, North Dakota.  His injuries required him to be airlifted to a hospital in Minnesota where he spent about a month recovering.   While in the hospital, Mr. Richard’s employer brought a claim workers’ compensation benefits on behalf of Mr. Richard before the North Dakota Workforce Safety & Insurance (“N.D. Workforce”): the administrative body that regulates workers’ compensation claims in North Dakota.   Mr. Richard contended he did not bring the action, never had notice of the decision, and never submitted documents requested by the N.D. Workforce. Moreover, Mr. Richard never received any correspondence on the matter because it was all mailed to his Kaplan, Louisiana address while he was recovering in the Minnesota hospital.  The N.D. Workforce denied benefits finding that the accident was caused by Mr. Richard’s drug and alcohol use and therefore not within the scope of his employment.   Mr. Richard did not appeal this decision presumably because he never brought it in the first place.

A few months later, Mr. Richard did file a claim for workers’ compensation benefits in Louisiana.   His employer Quality Construction & Production, L.L.C, (“Quality Construction”) and their insurance company filed an exception to the claim arguing that the claim was barred by the doctrine of res judicata because the claim had already been decided by another court.  The Louisiana Office of Workers’ Compensation Judge (WCJ) denied Quality Construction’s exception and the case was appealed to the Louisiana Third Circuit Court of Appeal.