Bordelon v. Lafayette Consolidated Government
149 So. 3d 421
| La. Ct. App. | 2014Background
- Bordelon was injured in September 2003 while employed by LCG, requiring surgery for a disc protrusion and ongoing prescription meds.
- LCG authorized CVS/Caremark for prescriptions; in May 2010 notified that future IWP bills would not be paid.
- In April 2011 Bordelon ordered meds from IWP despite the notice; he filed a 1008 for pharmacy choice in June 2011.
- In February 2012 WCJ granted summary judgment that LCG had the right to choose the pharmacy; Bordelon could move for change if timely meds were not delivered.
- On May 11, 2012 Bordelon moved for choice of pharmacy; WCJ found LCG’s choice reasonable and limited IWP bills to $750 under La.R.S. 23:1142.
- Bordelon appealed alleging error on pharmacy choice, the $750 cap, and failure to award penalties and attorney fees.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Pharmacy choice determination | Bordelon argues employee may choose pharmacy; Sigler conflicts Patin’s Tire Service. | LCG asserts its choice of pharmacy was reasonable and proper under Sigler. | Affirmed: LCG’s choice deemed reasonable; no basis to force a change. |
| Application of the $750 cap | Bordelon contends 23:1142 should apply; not 23:1203. | LCG argues 23:1142 applies to outstanding IWP charges. | Affirmed: 23:1142 적용 upheld and $750 cap correctly used. |
| Penalties and attorney fees | Bordelon seeks penalties and fees for late payment by LCG. | LCG contends no error in WCJ’s findings and penalties are unwarranted. | Affirmed: no manifest error; penalties/fees not awarded. |
Key Cases Cited
- Sigler v. Rand, 896 So.2d 189 (La.App. 3 Cir. 2004) (employee may choose diagnostic provider but not necessarily the pharmacist)
- Louisiana Clinic v. Patin’s Tire Service, 731 So.2d 525 (La.App. 3 Cir. 1999) (employer cannot dictate diagnostic testing location/provider)
- Rebel Distributors Corp., Inc. v. LUBA Workers’ Comp., 137 So.3d 91 (La.App. 3 Cir. 2014) (addressed 23:1142 applicability and penalties framework)
- Brown v. KTBS, Inc., 974 So.2d 784 (La.App. 2 Cir. 2008) (patient-choice state; reimbursed under fee schedule or actual costs)