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workers-1215831-1-1024x683Worker’s compensation protects workers from unexpected accidents by providing for their medical care and lost wages if ever they suffer an incapacitating accident. And in most instances, a worker’s compensation claim will cover any subsequent accidents which arise from the work-related injury. But when the link between a new accident and the original work-related one is too far removed, an injured worker may have difficulty advancing his claim. For example, can you file a workers compensation claim for an at-home accident?

On July 21, 2014, Raymond Namias was alone when he suffered an injury on the job. The engine upon which he was working slid backward, smashing his right hand. Namias claimed the accident caused additional damage to his right wrist, shoulder, and back. About a month later, on August 31, Namias fell down his stairs in his home. Namias claimed the two accidents were connected, asserting back pain from the job site injury caused numbness in his leg, and that the numbness caused the fall. He filed a worker’s compensation claim for the injuries sustained in both incidents.

Namias’ employer, Sunbelt Innovative Plastics (“Sunbelt”), disputed the extent of his injuries. Additionally, Sunbelt disputed the fact that Namias’ work-related injuries caused his August 31 fall at home. Sunbelt asserted that Namias was not entitled to workers’ compensation for either incident. The matter went to trial before a Worker’s Compensation Judge (“WCJ”).

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bedroom-bliss-no-3-1542621-1024x768Workers’ compensation claims can be very stressful for the injured employee. Because of this, the law in Louisiana will help offset the legal costs of workers’ compensation claim denials by employers by awarding penalties and attorney fees ( PA&F) if the employer is found to have improperly denied the employees claims for medical treatment. This was the case for a Calcasieu Parish employee who experienced trouble sleeping due to pain from her injury. So, what do you do when your employer denies your workers compensation benefits?

Stephanie Lemelle Ardoin was injured while working for the Calcasieu Parish School Board at the beginning of 2013. After the injury, she was awarded workers’ compensation benefits and received treatment for her back injury. Ms. Ardoin’s treatment included a laminectomy. She also had a fusion of her L4-5 vertebrae performed by Dr. Chris Gunderson.

Following the surgery, Ms. Ardoin received care from Dr. Gunderson and was also provided with care from Dr. Daniel Hodges to deal with pain. She received care from Dr. Hodges because she was still experiencing pain and was having problems sleeping. Eventually, both doctors gave a prescription for an adjustable mattress to help with the sleeping issues. The adjustable mattress request was sent to WellComp Managed Care Services for review. WellComp denied this request on the grounds that it did not meet the Workers Compensation insurance guidelines. WellComp stated the claim was inadequate because there was no medical rationale to support the need for the adjustable mattress.

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slot-machines-1417312-704x1024There is a strong public policy reason for voiding all contracts that concern illegal activity. A Shreveport casino used the help of an excellent attorney to rely on this principle when a customer brought a lawsuit against it because his use of a preferred slot machine was discontinued. Because there was no possible way for a contract to be formed there was not a legal avenue to bring the lawsuit under. Thus leaving the question, can you sue for never hitting the jackpot?

Matt Master alleged that he was given the exclusive use of their preferred slot machine for a 16 ½ month period by Red River Entertainment, LLC which does business by the name Sam’s Town Casino. Both Mr. Master and his wife were given the exclusive use of a slot machine. When they weren’t using it, the machine was “capped” by the Casino’s management, this prevented others from using the machine while he and his wife were taking a break. This “capping” period started off for periods of a couple of hours and eventually would be granted for periods up to a whole day.

The machine was selected by Mr. Master because the jackpot was around $101,000 and it had not hit a jackpot for 2 years. Over 16 ½ months, the jackpot of the machine increased to $155,300. Mr. Master alleged that the Casino’s management told him that the machine was probably close to hitting another jackpot. He also alleged that in 2013 he lost over $500,000 on the machine. After failing to hit the jackpot over 16 ½ months Mr. Master filed a complaint with the State Gaming Commission to investigate why the machine had never hit a jackpot. Once the Casino’s management learned of the complaint, Mr. Master was banned from the slot machine and the casino. Mr. Master filed a lawsuit based on his dismissal from the Casino as well as the slot machine never reaching a jackpot. The Casino responded by arguing that there was no cause of action. The Trial Court agreed and dismissed Mr. Master’s claims.

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pills-pills-pills-3-1326912-1024x683In the aftermath of suffering injuries from medical malpractice, filing a suit might not be at the top of your list. However, in order to maximize your chance of recovery, it is imperative that you timely file your claim without delay. So what happens when you do not file a suit quickly enough?

Brian Snavely was a patient of Dr. Rice and her affiliated entities. Snavely sought care from Dr. Rice for chronic pain that started with an industrial accident in 1999. That care included being prescribed narcotics. In 2010, Snavely was involved with an automobile accident with Kayse Vincent. Following this accident, Snavely received further treatment from Dr. Rice. While Snavely was seeking damages against Vincent for that accident, he died of a drug overdose. The plaintiff, Linda Snavely, was Brian Snavely’s mother. Ms. Snavely first filed a Request to Convene a Medical Review Panel, which is an initial malpractice hearing against qualified healthcare providers, against Dr. Rice and her entities under the Louisiana Medical Malpractice Act (LMMA), La.R.S. 40:1299.41-.49. Dr. Rice, as a licensed physician, could be subjected to a Medical Review Panel. However, her affiliated entities could not be. Dr. Rice responded to the Request to Convene a Medical Review Panel by filing an Exception of Prescription, which is a pleading seeking delay or dismissal of a lawsuit or other action because the time period to bring that action has expired. The exception and dismissal were subsequently granted. Ms. Snavely then sought damages against Dr. Rice’s entities as she alleged their treatment led to Brian’s death. The Rice entities filed an Exception of Prescription and it too was granted.

The exception of prescription is laid out in La. C.C.P. art. 927. The burden of proof lies on the requesting party. When Appeals Courts review it, they use a manifest error standard of review, which means no deference is given to lower courts. The time limit for filing claims is one year; which means an Exception of Prescription is proper if a lawsuit or other action is filed after one year. La. R.S. 9:5628(A). However, that rule is only valid from when damages are immediately apparent. See In re Medical Review Panel for Claim of Moses, 788 So.2d 1173, 1178 (La. 2001).

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https://www.louisianapersonalinjurylawyerblog.com/wp-content/uploads/sites/310/2019/05/3_26_19-60.-Butler-v.-Jefferson-Parish--1024x683.jpgNo one can ever truly be prepared for the death of a loved one. It can present many unforeseen challenges, especially when complicated by the process of obtaining survivors’ benefits.

After the death of her husband, Jane Butler filed a “disputed claim for compensation” seeking death benefits, as allowed under La. R.S. 23:1231, with the Office of Workers’ Compensation (OWC). La. R.S. 23:1231 provides benefits for any legal dependents of an employee whose death occurs within two years resulting from an injury. Mrs. Butler filed the disputed claim on January 7th, 2013. Her husband Robert Butler, a retired Jefferson Parish firefighter, passed away from a heart attack on May 5th, 2013.

Mrs. Butler contended her husband experienced chest pains and underwent surgery placing a stent in his right coronary artery in July 2004. On September 23rd, 2004, Mr. Butler filed a claim under La. R.S. 33:2581, commonly known as the Heart and Lung Act, for compensation and disability benefits. Mr. Butler continued to receive these benefits up to his death in May 2013. However, Mr. Butler’s original death certificate listed his death as attributable to “unspecified natural causes.” The coroner corrected Mr. Butler’s death certificate to appropriately reflect the cause of death, myocardial infarction, in October 2014.

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https://www.louisianapersonalinjurylawyerblog.com/wp-content/uploads/sites/310/2019/05/3_26_19-20.-Thibodeaux-v.-Donnell-1024x683.jpgThe birth of a child is something many soon-to-be parents look forward to with both excitement and nervousness. Concern for the health and safety of both mother and child are common, and often, unnecessary. Sadly, this is not always true. In the case of one Terrebonne Parish family, the arrival of a baby girl was accompanied by an unfortunate medical mistake. The family’s medical malpractice claim raised important distinctions in assessing and apportioning damages as it moved into the Louisiana First Circuit Court of Appeal.

Following a high-risk pregnancy, Kimberly Thibodeaux gave birth to her daughter, Gabrielle, on November 20th, 2003. Dr. James Donnell performed the cesarean section that delivered Mrs. Thibodeaux’s fourth child. Complications arose from the c-section, including a severe laceration to Mrs. Thibodeaux’s bladder. Ultimately, Dr. Donnell performed an emergency hysterectomy and placed sutures into Mrs. Thibodeaux’s bladder without consulting a urologist before attempting to repair Mrs. Thibodeaux’s bladder himself. Mrs. Thibodeaux experienced extreme abdominal pain and discomfort following the delivery, eventually necessitating further treatment under the care of urologist Dr. Robert Alexander. Mrs. Thibodeaux’s abdomen was reopened, the sutures removed, stents and a catheter were placed into her bladder in an attempt to regain any functional use. Mrs. Thibodeaux continued her treatment with Dr. Alexander, who determined the damage to Mrs. Thibodeaux’s bladder was permanent in April 2007. Mrs. Thibodeaux continued to suffer from a range of painful symptoms, including frequent urination, leakage, pain during sex and urination, and abdominal spasms.

Mrs. Thibodeaux, along with her husband Todd and on behalf of their daughter, filed a medical malpractice suit against Dr. Donnell. In May 2014, the jury trial returned a verdict in the Thibodeauxs’ favor, finding that Dr. Donnell had breached the applicable standard of care in treating Mrs. Thibodeaux, and that his breach caused her injuries. The jury awarded $60,000 for Mrs. Thibodeaux’s medical expenses but did not award any general damages. Both the Thibodeauxs and Dr. Donnell filed motions challenging the damages award. The trial court denied both motions, and the Thibodeauxs filed an appeal in the First Circuit. After determining both motions were filed in an appropriate manner within the stated deadline, the court concluded the Thibodeauxs had cleared a path for their appeal concerning damages. See La. R.S. 13.850(A).

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68-photo-3_26_19-819x1024Can an inmate be awarded damages from an injury caused by the employees of the correctional facility? According to the 5th Circuit Court of Appeal, the answer is yes. Mr. Miller was an inmate at Elayne Hunt Correctional Facility when an employee of the facility pulled him out of his bunk and threw him on the ground. Miller sued Captain Credit and the State of Louisiana for negligence under state law as well as violations of the 8th amendment under 42 U.S.C. §§ 1331 and 1983. Miller claimed that Captain Credit, as an employee for the state of Louisiana violated his civil rights with his act of negligence and that the federal district court has jurisdiction in this case.

When the case went to trial, a jury found that the employee acted with negligence and therefore awarded Mr. Miller damages. Captain Credit moved to alter the judgment under Fed. R. Civ. P. 56(e), arguing that Miller failed to prove a causal relationship between his shoulder injury and the negligent act. The district court denied their motion and they appealed the Fifth Circuit.

Federal Rule 59(e) gives the district court the authority to alter or amend a judgment when they have committed a “manifest error of law or fact”, and the appellate court reviews for an abuse of discretion. See Schiller v. Physicians Res. Grp., 342 F.3d 563,567 (5th Cir. 2003). For this type of appeal, the district court’s decision and the decision-making process need only be reasonable for the decision to be affirmed.

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64-photo-3_26_19-1024x684If you believe you are eligible for retirement, disability, or other benefits from the Social Security Administration (“SSA”), it is imperative that you understand how prior events, including those that may have led to overpayment of prior benefits, can affect your ability to collect these benefits.

In 2010, Johnson applied for retirement insurance benefits with the SSA. He was then advised that he had been overpaid disability insurance benefits from 1974 to 1976 and that any retirement insurance benefits would be withheld until the $4,535.90 prior overpayment amount was satisfied. Johnson requested a hearing before an administrative law judge and testified that he didn’t receive disability benefits in 1976, 1977, or 1978. He did receive disability benefits in 1970, but those benefits were discontinued in 1974 or 1975 after advising the SSA that he had returned to work. He also specified that he didn’t recall getting a notice of overpayment and demanded that they provide proof of the alleged overpayments. The administrative law judge ruled against Johnson and ruled that he was liable for the full amount. Johnson requested a review of the decision but was denied by the Appeals Council.

Three years later, Johnson filed an action in the district court seeking a review of the decision made by the administrative law judge. The SSA moved for summary judgment, and the magistrate judge issued a Report and Recommendation and recommended that the matter be remanded to the Commissioner of the SSA for a determination supported by substantial evidence regarding the overpayment allegedly made to Johnson. The district court adopted the Report and Recommendation and ordered the case to be remanded. They further specified to Johnson that they were affirming the decision that Johnson received overpayments, but reversing the determination concerning the amount of overpaid benefits, and remanding for a determination of benefits owed with supporting evidence.

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63-photo-3_26_19-1024x683There are unique laws governing benefits and remedies for injured seamen. It is important to know the specific laws and defenses applicable to claims as an injured seaman.

Mr. Bourdreaux hurt his body including his back while working for Transocean and they paid for his living and medical expenses as required when a seaman gets injured on the job, as well as an allowance for food, for five years. BX sued them for additional money and also sought increased damages for the mismanagement of past benefits. He also sued for other claims under the Jones Act. See Pub. L. No. 66-261, 41 Stat. 988 (1920).

During discovery, Transocean found that BX failed to notify the company of past back problems in the medical questionnaire he was given prior to his employment. As a result, they filed a partial summary judgment on the claim for more money relying on the McCorpen defense, which allows a company to avoid paying a claim if previous medical problems were not disclosed. See McCorpen v. Cent. Gulf S.S. Corp., 396 F.2d 547, 549 (5th Cir. 1968). The district court agreed and granted summary judgment on those claims. Transocean also filed for summary judgment on the negligence and unseaworthiness claim, but the motion was denied by the district court. Furthermore, Transocean filed a counterclaim against Bourdreaux seeking to recover the payments; however, the parties settled prior to the Court’s ruling on that issue.

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paper-family-1186206-1024x676Summary judgment is a legal standard many courts use when there are not enough facts in dispute to even proceed with a lawsuit. When applicable, this is a good strategy for a defense attorney to use because it purges claims that have no merit, saving time and money. The Fifth Circuit Court of Appeal demonstrated this principle within the context of an employment discrimination lawsuit. The following case demonstrates how an employer can use the Courts to deny a Family Medical Leave Act Claim.

Michelle Calderone was an employee of TARC in Hammond, Louisiana. While she was employed, Calderone was involved in a car accident where she was initially diagnosed with a chip fracture to her ankle. Nine days after the accident, she returned to work. About a month later, Calderone was further diagnosed with a crack in her sternum and was instructed to remain on bed rest. TARC’s CEO, Kathleen Abels, gave Calderone permission to work from home. A month later, Calderone proposed splitting up her time equally at home and at work, and Abels agreed. Calderone submitted a doctor’s note allowing her to work the split schedule, which specified no lifting, climbing, or travel and warned of the injury’s existence for 6 months or more. After the split schedule began, Abels gave Calderone a document that characterized her split schedule as temporary and only in effect until March 31, 2012. She did not sign the document, but she submitted a written response opposing some aspects of the document, such as her disability characterization, the revocation of the split schedule, and the failure to inform her of FMLA rights. Abels denied Calderone request.

After Calderone’s doctor gave the release, Calderone returned to a full-time schedule. Calderone did not request any leave thereafter or object to resuming her split schedule. Seven months after returning to a full-time schedule, Calderone resigned stating that she cannot successfully complete her duties under Abels’ management but failed to mention any issues regarding her leave, injuries from the car accident, or timing of her return to work from those injuries.

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