Carradine v. Regis Corp.
52 So. 3d 181
La. Ct. App.2010Background
- Carradine worked as a hairdresser at Smart Style in Wal-Mart, Lake Charles, LA; break outside the building where she sat on a bench; pant leg snagged on a chain-link fence causing a face-first fall with visible contusions.
- Post-accident, she reported injuries to Wal-Mart and her supervisor and sought medical care; treated by Dr. Hardey for neck strain and contusions and returned to work the next day.
- Her neck pain worsened over time; she began seeing Dr. Gunderson (orthopedic) in Sept. 2008, who diagnosed cervical spondylosis and facet arthropathy and treated with PT and meds.
- She later consulted Dr. Bravin for headaches/vision issues; by Feb. 2009 her pain escalated and she obtained a work release; surgery (anterior cervical fusion) was recommended.
- Carradine did not file for workers’ compensation until March 9, 2009; Regis denied compensability and arranged an IME with Dr. Holland who opined pre-existing disease exacerbated by the fall.
- The WCJ found the injury arose out of and during employment, awarded indemnity, medical expenses, penalties, and attorney’s fees; Regis appealed on multiple grounds.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the injury arose out of and during course of employment | Carradine’s fall occurred on Wal-Mart premises during a permitted break. | Regis contends the injury did not arise out of or during employment. | Arising out of and in course of employment established. |
| Indemnity benefits for disability | Disability supported by Dr. Gunderson’s records and Carradine’s testimony. | Evidence undermines disabling status. | Disability proven by clear and convincing objective medical evidence; award sustained. |
| Medical expenses causally related to fall | Expenses relate to injuries from the fall; treated as compensable. | Some expenses possibly due to pre-existing conditions. | Medical expenses compensable; no improper causation finding. |
| Whether medical expenses are capped at $750 per provider | Exception in La.R.S. 23:1142(E) applies; cap not applicable. | Cap applies absent compensability denial; pre-denial expenses capped. | La.R.S. 23:1142(E) applies retroactively to exclude pre-denial expenses from cap. |
| Penalties and attorney's fees for late payments | Regis violated timing requirements; penalties warranted. | Some defenses justified; penalties limited. | Penalties awarded; additional appellate attorney’s fees granted; overall penalties upheld. |
Key Cases Cited
- Mundy v. Dep't of Health & Human Res., 593 So. 2d 346 (La. 1992) (arising out vs. course; mutually dependent concepts)
- St. Alexandre v. Texas Co., 28 So. 2d 385 (La. App. Orl. 1946) (permitted breaks on premises can be in course of employment)
- Margin v. Barthelemy, 638 So. 2d 291 (La. App. 4 Cir. 1994) (premises defects and increased exposure on premises as employment-related risk)
- White v. Fresenius Medical Care, 801 So. 2d 1239 (La. App. 3 Cir. 2001) (exception to cap when compensability denied; reasonable treatment of unusual claim timelines)
- Schindler v. Orleans Regional Security, 862 So. 2d 1032 (La. App. 4 Cir. 2003) (conflicting interpretations of 23:1142(E) and retroactivity debate)