124 So. 3d 36
La. Ct. App.2013Background
- James Dow, a UPS driver of 33+ years, struck his head on a loading-dock door on April 14, 2009; parties stipulated the accident was work-related.
- Initial imaging (CT, MRI) showed no acute brain injury; treating physicians diagnosed concussion/contusion and later post-concussion syndrome and occipital neuralgia; imaging showed cervical degenerative changes and a C6-7 disc protrusion.
- Claimant retired May 29, 2009, then received and later had workers’ compensation benefits terminated March 31, 2010; he sought supplemental earnings benefits (SEB) alleging inability to earn 90% of pre-injury wage due to persistent pain and medication effects.
- Medical opinions conflicted: treating pain specialists (Drs. McLeod, Holaday, Odenheimer) found occipital neuralgia and chronic symptoms with varying work restrictions; UPS’s IME neurologist (Dr. McWilliams) attributed most symptoms to preexisting degenerative spine disease and other non-work causes, concluding the on-the-job bump was minor.
- WCJ credited the evidence that the work injury was minor and that claimant failed to prove his ongoing disability and medication dependence were caused by the work accident; claim for SEB was denied and termination of benefits upheld.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Causation of ongoing neck/head/back disability | Dow: post-accident symptoms began with the accident and continued; treating doctors link pain to the accident | UPS: medical evidence shows degenerative cervical disease, other conditions, and that the bump was trivial; ongoing symptoms not causally related | Held for defendant: claimant failed to prove work injury caused disabling condition |
| Entitlement to Supplemental Earnings Benefits (SEB) | Dow: cannot earn ≥90% pre-injury wage due to pain/medication; SEB should apply | UPS: claimant did not prove the inability to earn 90% is due to the work injury; medical evidence shows recoverable or non-work causes | Held for defendant: claimant not entitled to SEB |
| Necessity of pain medication as work-related treatment | Dow: medications are necessary to control work-related pain and limit his ability to work | UPS: medications are tied to non-work conditions or inappropriate dosing; treating notes indicate issues unrelated to the work event | Held for defendant: WCJ found lack of evidence meds were required due to work injury |
| Standard of review on appeal | Dow: WCJ erred in credibility/causation findings | UPS: WCJ’s factual credibility determinations entitled to deference | Held: appellate court applied manifest-error standard and found WCJ’s factual findings reasonable |
Key Cases Cited
- McLin v. Industrial Specialty Contractors, Inc., 851 So.2d 1135 (La. 2003) (worker must prove injury arose out of employment to recover)
- Modicue v. Graphic Packaging, 4 So.3d 968 (La. App. 2009) (claimant bears burden to show disability is related to on-the-job injury)
- Taylor v. Columbian Chemicals, 744 So.2d 704 (La. App. 1999) (causal connection requirement for compensable disability)
- Scott v. Super 1 Foods, 48 So.3d 1133 (La. App. 2010) (prima facie proof may be shown by demonstrating good pre-accident health and onset of symptoms at accident)
- Poissenot v. St. Bernard Parish Sheriff’s Office, 56 So.3d 170 (La. 2011) (purpose of SEB is to compensate lost wage-earning capacity)
- Roach v. Libbey Glass, Inc., 107 So.3d 759 (La. App. 2012) (employee must prove inability to earn 90% of pre-injury wages to obtain SEB)
- Fuentes v. Cellxion, Inc., 27 So.3d 1045 (La. App. 2009) (appellate review of WCJ factual findings governed by manifest-error standard)
- Gilbert v. Willis-Knighton Workkare Clinic, 20 So.3d 1149 (La. App. 2009) (credibility and factual determinations rest with WCJ)
- Winford v. Conerly Corp., 897 So.2d 560 (La. 2005) (when two permissible views exist, appellate court must defer to factfinder)
- Stobart v. State, 617 So.2d 880 (La. 1993) (standard for reviewing manifest error in factual findings)
- Sheppard v. Isle of Capri, 909 So.2d 699 (La. App. 2005) (conflicting testimony resolved by WCJ and not disturbed absent manifest error)
