Articles Posted in Workers Compensation

new_zealand_accident_insurance_0-1024x768If you are injured on the job, you might be entitled to compensation through the workers’ compensation system. What happens if your employer denies your claims for treatment recommended by your treating physicians? Can your employer be required to pay you penalties and fees?

Betty Citizen hurt her back while she was trying to move a bike while working at Wal-Mart. Wal-Mart denied her physical therapy that her treating neurosurgeon recommended. She filed a 1009 Form, which the Medical Director denied for being untimely. Citizen then filed a 1008 Form, claiming she was entitled to receive attorney fees and penalties because Wal-Mart had arbitrarily and capriciously handled her claims. 

Once Wal-Mart formally denied her physical therapy, Citizen filed another 1009 Form. The Medical Director denied that request as well, finding there was no required documentation about the results of prior therapy. On the day of the hearing, Wal-Mart approved the recommended physical therapy. Therefore, the only issue was whether Wal-Mart had acted arbitrarily and capriciously in denying Citizen’s physical therapy. 

worker_masonry_concrete_stones-1024x691While involved in a legal dispute, there are strict timelines that must be followed, not only for filing an initial lawsuit, but also for filing any subsequent appeals. However, arguments can arise about what timeline applies to a certain factual situation. 

Angela Jackson was injured while working at Family Dollar. Jackson filed a claim against Family Dollar. The Office of Workers’ Compensation awarded her medical expenses, disability, and supplemental earnings benefits. It also awarded her attorney’s fees and penalties against Family Dollar. 

Family Dollar filed an appeal about a month and a half after the Office of Workers’ Compensation issued the judgment in Jackson’s favor. However, Family Dollar did not indicate if it was a devolutive or suspensive appeal. 

fire_department_resuscitation_1256591-1024x768Honesty is the best policy. This is especially true in the workers’ compensation space, because if you are found to have been fraudulent, you forfeit your right to workers’ compensation benefits. 

Before Alex Turner started working for Chicago Bridge, he completed the Louisiana Office of Workers’ Compensation Second Injury Questionnaire. He then started working as a carpenter’s helper for Chicago Bridge at a site in Hackberry, Louisiana. Approximately a month after he was hired, Turner injured his back while on the job. He immediately reported his injury to his supervisor and was taken to the onsite medical facility.

Chicago Bridge reassigned Turner to sedentary work. Turner complained the work still hurt his back because he had to lean over a table, so he refused to complete the sedentary work. He was eventually fired for insubordination. In Turner’s workers’ compensation case, the workers’ compensation judge found he was entitled to Supplemental Earnings Benefits and denied Chicago Bridge’s argument Turner had forfeited his right to workers’ compensation benefits by committing fraud. 

construction_worker_work_worker-1024x683When receiving medical care, the choice of medical professional can influence your treatment. If you have been injured on the job, you might not be sure if you can pick your own doctor or if you have to use a doctor your employer selects. Under the Louisiana Workers’ Compensation Act, an injured worker is entitled to select a physician in any specialty for an initial visit. The employer is not required to approve the employee’s choice of physician. What happens if the employer claims the employee was not injured on the job? 

Blann Kyle filed a workers’ compensation claim against Boise Cascade Company (“Boise”), claiming he had lost his hearing as a result of his employment at a paper mill located in DeRidder, Louisiana. He filed the claim seven years after he retired. Kyle then filed a motion for an expedited hearing, under La. R.S. 23:1121. Kyle claimed Boise had not authorized his initial visit with his choice of physician. Kyle wanted the workers’ compensation judge to order Boise to authorize his initial visit to the physician he had selected, reimburse him for the medical expenses resulting from the testing and treatment by that physician, and pay penalties and attorneys’ fees. Boise countered that Kyle’s claims were prescribed, meaning he had waited too long to bring his workers’ compensation claim. Boise also claimed it was not proper for Kyle to request penalties and attorneys’ fees with his motion for an expedited hearing. The workers’ compensation judge denied Kyle’s motion, holding there was a “tenuous link” between Kyle’s alleged hearing loss and his employment. Therefore, Boise had acted properly in refusing him the choice of a physician. Kyle filed an appeal. 

Louisiana courts have recognized that hearing loss can be caused by occupational exposure and can be an occupational disease where an injured worker is entitled to workers’ compensation. See Arrant v. Graphic Packaging International, Inc. Under La. R.S. 23:1121, an injured worker is entitled to select a physician in any specialty without his employer’s approval. If the employer denies that, the employee has the right to request an expedited proceeding. The employee can also receive attorney’s fees and penalties. 

lying_promises_deception_dishonesty-1024x768What are the consequences of lying in a workers’ compensation claim? They can be harsh, as shown in the following lawsuit. Betty Reeder, a Certified Nursing Assistant (CNA) at Hardtner Medical Center, found herself embroiled in a legal battle after suffering an injury on the job. This article examines the details of the lawsuit, delves into the relevant Louisiana workers’ compensation law, and analyses the Appeals Court decision that shaped the outcome.

The chain of events leading to the lawsuit began in January 2013, when Betty Reeder tripped and fell on a wheelchair while performing her duties as a CNA. Following the accident, she received financial and medical support from the Louisiana Hospital Association Workers’ Compensation Interlocal Risk Management Agency through its agent, HSLI. She received weekly payments based on her average weekly wage for over a year, totaling approximately $23,000. 

However, the situation took a contentious turn when HSLI accused Reeder of making false statements to obtain compensation. The case went to trial, with Reeder having to forfeit her right to workers’ compensation benefits by violating La.R.S. 23:1208. Faced with the Workers Compensation Judge’s (WCJ) initial ruling against her, Reeder appealed the decision and sought a reconsideration of her case.

site_truck_vehicle_transport-1024x683The discovery process of litigation is vital to a well-informed judgment rendered by the court. But discovery can be halted, disrupted, or dismantled by various motions. Finding and gathering all the necessary information in a lawsuit is incredibly important for all sides. Still, it requires showing a need for that information and the presence of facts in dispute. Identifying and presenting disputed facts of a case is necessary to help protect your case from a summary judgment dismissal. 

Heniff Transportation, LLC (“Heniff”) was a licensed professional truck driver transporting dangerous chemicals. One of the plaintiffs, Carl Davis, was a self-employed independent contractor working for Heniff. During this work, Carl attempted delivery of a tank of hydrochloric acid to GEO Specialty Chemicals (“GEO”). GEO personnel found defects in the tank, which Heniff owned. To address the defect, Heniff directed Carl to have Bastrop Tank Wash (“Bastrop”) repair the tank. Bastrop allegedly repaired the tank, but when Carl and GEO later began transferring the hydrochloric acid from the tank, the allegedly repaired hose ruptured, hydrochloric acid escaped from the fittings, and Carl’s required protective gear was knocked off his body. As a result, Carl suffered injuries to his eyes, face, and body. 

Carl and his wife, April, sued Heniff, Bastrop, GEO, Sparta Insurance (later replaced by Arch Insurance), ABC Insurance, and DEF Insurance, for damages and loss of consortium. In response, Bastrop filed for summary judgment, arguing that the part of the exploded hose was not a part that Bastrop repaired.

worker_shoes_shoes_work-1024x768Should an employer continue to pay for work-related injuries even after an employee has “fully recovered”? At issue is a decision that terminated an employee’s entitlement to certain benefits. After the employee suffered a work-related injury and received temporary total disability benefits, her former employer, The Walgreen Company, filed a motion to modify the judgment. This led to litigation and a subsequent appeal.

Former Walgreens employee Alyce Mouton, a resident of Metairie, Louisiana, was injured while performing her duties at Walgreen Drug Stores in that city. Initially, the Workers’ Compensation Judge (WCJ) of the Louisiana Fifth Circuit Court of Appeal ruled in her favor, awarding her temporary total disability benefits and ordering Walgreens to pay for all reasonable and necessary medical treatment resulting from her workplace injuries. However, Walgreens later filed a motion to modify the judgment, alleging a change in Mouton’s condition and seeking to convert her benefits from temporary total disability to supplemental earnings benefits (SEBs). This dispute eventually led to an appeal when Mouton challenged the decision. See Mouton v. Walgreen Co.

In Louisiana, the workers’ compensation system is governed by specific laws designed to protect the rights of both employees and employers. One such statute is Louisiana Revised Statutes 23:1310.8. This statute grants the WCJ continuing power and jurisdiction over each case. It allows for modifying or amendment of prior findings or orders when such changes are warranted in the judge’s opinion. In addition, the statute allows for review of any award upon motion of a party, particularly in cases where there has been a change in circumstances. The WCJ may then enter an award that terminates, reduces, or increases the compensation previously awarded.

car_accident_bellingham_fire-1024x683Ordinarily, when one is involved in an automobile accident, the injured party files a claim with the at-fault driver’s insurance company.  When a person is involved in an accident with a co-worker in the course of their employment duties, however, the injured party may collect workers’ compensation instead. Can the injured employee “double-dip” and also collect under a Uninsured/underinsured motorist policy?  This was the issue in a recent case out of Delcambre, Louisiana.   

Annique Johnson, Wanda Theriot, and Emily Laester were employees of Le Bon Manger, Inc. While acting within the course and scope of their employment; the employees were in a car accident while Laester was driving.  Laester was at fault, and the employees sustained injuries.  Johnson and Theriot filed claims for workers’ compensation benefits and settled those claims.  Later, Johnson and Theriot (Plaintiffs) filed a civil lawsuit against their employer, Laester, and State Farm under separate policies for each party.  State Farm filed a motion for summary judgment to dismiss the case because the Plaintiffs already collected under workers’ compensation law.  The plaintiffs appealed to the Louisiana Third Circuit Court of Appeal.       

Under Louisiana law, fellow employees have statutory immunity from lawsuits brought by co-employees for which workers’ compensation laws provide the sole remedy.  See La. R.S. 23:1032.  This lack of standing to bring a lawsuit automatically means there can be no lawsuit against the co-employee car insurance company.  See Hebert v. Clarendon Am. Ins. Co.  Essentially, the availability of workers’ compensation erases the existence of an uninsured/underinsured motorist and erases the availability of that coverage.  

texas_flag_texas_flag-1024x683It’s pretty common for large corporations to conduct business across multiple state lines. So, too, it’s expected that employees for these types of companies will also have connections with multiple states based on their employment with the corporation. In these situations determining which state and Court has jurisdiction over legal claims when such issues arise can become an incredibly fact-specific inquiry. This was the case for one Workers’ Compensation Judge (“WCJ”), who found that the Office of Workers’ Compensation (“OWC”) located in Lafayette, Louisiana had subject matter jurisdiction to decide the legal claims of a former Tyson-employed truck driver.

Frank Verret (“Mr. Verret”), a Louisiana resident, was hired as a long-haul truck driver for Tyson Foods, Inc. (“Tyson”) in 1999. Initially, he drove to a Tyson facility in Center, Texas, to apply for a position and later called to inquire about the status of his application from his home in Louisiana. During that phone call, Mr. Verret claimed that Tyson hired him for the long-haul truck driver position. Afterward, he drove back to Texas, picked up his truck, and began employment.

Years later, in 2015, while driving his Tyson truck through Oklahoma, Mr. Verret crashed into the median barrier. Mr. Verret was hospitalized and treated for his injuries in Oklahoma, then was sent to Texas for an employer-mandated drug screening before returning to Arkansas, where he had begun his route before the crash. A few months after the crash, a then-retired Mr. Verret filed a Disputed Claim for Compensation against Tyson.

court_justice_interior_architecture-1024x768Getting workers’ compensation from an employer is already difficult, but it is even more so when the claim is filed in the wrong court. Although employees are entitled to workers’ compensation, the claim has to be filed in the correct jurisdiction. The following case shows what happens when you are injured while working and attempt to file a claim for workers’ compensation in a state where you were not employed. 

Louisiana resident Lemcy Cortez was hired by Triple F Oil Field Service, LLC, to drive trucks in Oklahoma. The day after he arrived in Oklahoma, Cortez was involved in an automobile accident that allegedly led to elbow and back injuries. He filed a Disputed Claim for Compensation in the Louisiana Office of Workers’ Compensation (OWC) against Triple F and its insurer for workers’ compensation benefits which he alleged his employer refused to pay. Triple F and its insurer claimed Cortez lacked subject matter jurisdiction. Triple F believed Cortez was hired in Oklahoma, and Cortez believed he was hired in Louisiana. 

Cortez claimed he was hired over the phone in Louisiana, but in his recorded statement to the insurance company’s interviewee, he stated he was hired by Triple F in Oklahoma. Cortez offered two affidavits to support his position that he was hired in Louisiana. In the first, he claimed he contacted Triple F about the job while he was in Louisiana. He claimed he was contacted by Triple F in Louisiana when he was offered the job and accepted it over the phone. In the second, he claimed the company’s Vice President called him to offer him the job, and he knew Cortez lived in Louisiana. In addition, he claimed he understood he had been officially hired by Triple F at that point, and the company had made living arrangements for his move to Oklahoma. 

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