Church Mutual Insurance Co. v. Dardar
145 So. 3d 271
| La. | 2014Background
- Ms. Thelma Dardar injured her back in 1999; settlement in 2008 reserved medical benefits under the Act.
- In 2012, Dardar filed a disputed claim (Form 1008) alleging insurer failed to authorize requested treatments and sought penalties and fees.
- Employer/insurer asserted prematurity due to La. R.S. 23:1203.1 and Form 1009 submission requirements.
- OWC held the medical treatment schedule applies to requests after its effective date, regardless of injury date; court of appeal reversed.
- Issue presented: whether 23:1203.1 can be applied retroactively to pre-schedule injuries; court holds statute is procedural and prospective.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Retroactive application of 23:1203.1? | Dardar: statute is substantive and retroactive. | Church Mutual: applies to disputes after 2011, regardless of injury date. | Statute is procedural; applies prospectively. |
| Does 23:1203.1 change substantive medical rights? | Schedule narrows rights by preauthorizing only certain treatments. | No substantive change; it's a mechanism to determine necessity. | Procedural framework; does not alter substantive right to medical care. |
| Do claimants have a vested right to pre-schedule medical treatment due to injury date? | Injuries prior to schedule create vested rights; retroactivity would violate due process. | Right to treatment accrues only when necessary; no pre-schedule vesting. | No vested right prior to schedule; statute operates prospectively. |
Key Cases Cited
- Walls v. American Optical Corp., 740 So.2d 1262 (La. 1999) (retroactivity framework via Planiol; determine actual retroactivity before art. 6 analysis)
- Cole v. Celotex Corp., 599 So.2d 1058 (La. 1992) (causes of action accrual and vested rights)
- Planiol, Treatise on the Civil Law § 243, no reporter (pre-1980) (retroactivity standard for laws; two-part inquiry)
- M.J. Farms, Ltd. v. Exxon Mobil Corp., 998 So.2d 16 (La. 2008) (two-step inquiry for retroactivity; role of intent)
- Frith v. Riverwood, Inc., 892 So.2d 7 (La. 2005) (general rule: law at time of injury governs; trigger for retroactivity)