Arrant v. Wayne Acree PLS, Inc.
164 So. 3d 321
La. Ct. App.2015Background
- Arrant injured his back in a work accident (June 30, 2012) while driving a company vehicle.
- Arrant filed Form 1008 (May 1, 2013) seeking MRI and left SI nerve block treatment.
- LWCC denied MRI requests; Arrant paid $800 for MRI and $600 deposit for Dr. Brown’s exam.
- Arrant alleged the insurer refused to reimburse and sought penalties and costs.
- WCJ upheld a prescription defense; later, LWCC authorized neurosurgeon of Arrant’s choice; case dismissed with prejudice.
- Arrant appealed; trial court affirmed; issues center on prescription, medical director decisions, and timely treatment.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Prescription/timing for MRI review | Arrant timely appealed medical director denial. | 15-day UC rule governs appeal; late review bars merits. | Prescription affirmed; 15-day period valid; review barred. |
| Merits of medical director denial of MRI | MRI denial merits should be reviewed on appeal. | Merits reviewed only if timely appeal confirmed; issues premature here. | Merits not reviewed; preserved by prescription ruling. |
| Reimbursement of $600 deposit and penalties for treating-physician choice | Defendants’ failure to reimburse timely; penalties warranted. | Payment was timely; testing under $750 non-emergency threshold; no penalties. | No penalties; timely reimbursement found. |
| Delay in authorization to Arrant’s neurosurgeon (Dr. McHugh) | LWCC delayed beyond reasonable time; penalties warranted. | Delay reasonable due to ongoing litigation; within 60-day rule. | No penalties; delay deemed reasonable; authorization timely. |
Key Cases Cited
- Church Mut. Ins. Co. v. Dardar, 145 So.3d 271 (La. 2014) (discusses La. R.S. 23:1203.1 structure and objectives)
- Buxton v. Iowa Police Dep’t, 23 So.3d 275 (La. 2009) (manifest error standard for factual findings)
- Winford v. Conerly Corp., 897 So.2d 560 (La. 2005) (manifest error framework in review)
- Morgan v. Glazers Wholesale Drug Co., 79 So.3d 417 (La. App. 2d Cir. 2011) (manifest error application in WC cases)
- Dean v. Southmark Constr., 879 So.2d 112 (La. 2004) (established manifest error review context)