282 So.3d 199
La.2019Background
- Kerry Simmons was injured at work (Oct. 12, 2011) and received workers’ compensation from his employer, Cintas, which paid $18,435 in medical charges under the statutory WC schedule; providers originally billed $24,435, so $6,000 was "written off."
- Simmons sued third‑party defendant Cornerstone for tort damages; Cintas and its WC carrier intervened but Simmons later settled with Cintas, with Cintas waiving reimbursement.
- Defendants moved in limine to exclude evidence of the $6,000 "write‑off," allowing only evidence of the amount actually paid by WC; Simmons sought to admit the full billed amount under the collateral source rule.
- Trial court granted defendants’ motion and excluded the write‑off; the Third Circuit denied relief (2–1). Simmons sought and the Louisiana Supreme Court granted supervisory review limited to whether the collateral source rule permits admission of the write‑off.
- The Louisiana Supreme Court affirmed: the collateral source rule does not permit recovery of or jury consideration of medical charges that were never paid and that the plaintiff was not and cannot be required to pay under the WC statutory fee schedule.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the collateral source rule allows admission/recovery of medical charges "written off" under WC fee schedule | Simmons: write‑offs are payments from an independent source and tort deterrence supports admission; WC benefits diminished his patrimony | Defendants: plaintiff never paid or will pay the excess; write‑offs are phantom charges and not actual damages | Held: No — write‑offs are not collateral source payments the plaintiff received and are excluded from jury consideration |
| Whether participation in WC scheme qualifies as "consideration" diminishing patrimony for collateral source purposes | Simmons: waiver of tort suit and receipt of WC operate as consideration/diminution | Defendants: WC is legislative compromise; employee did not pay for benefits and received reciprocal advantages | Held: No — mere participation or waiver under WC does not constitute the required diminution or consideration |
| Whether jury may see evidence of WC payments or amounts paid by WC | Simmons: jury should see full medical picture including billed amounts | Defendants: only amounts actually paid by WC should be proven to jury; write‑offs irrelevant | Held: Jury may hear only the amount actually paid; write‑offs that plaintiff never incurred/owed are excluded |
| Whether allowing recovery of write‑offs would produce windfall or punitive effect | Simmons: deterrence justifies greater recovery | Defendants: recovery of unincurred charges would be windfall/punitive absent statutory authorization | Held: Allowing recovery of write‑offs would be an impermissible windfall and effectively punitive, so disallowed |
Key Cases Cited
- Louisiana Dept. of Transp. & Dev. v. Kansas City S. Ry. Co., 846 So.2d 734 (La. 2003) (defines collateral source rule and its purpose)
- Bozeman v. State, 879 So.2d 692 (La. 2004) (Medicaid write‑offs not recoverable where plaintiff paid no consideration)
- Bellard v. American Central Insurance Co., 980 So.2d 654 (La. 2008) (examines collateral source rule and patrimony diminution in WC/UM context)
- Cutsinger v. Redfern, 12 So.3d 945 (La. 2009) (collateral source analysis where WC benefits and solidarity issues arise)
- Hoffman v. 21st Century N. Am. Ins. Co., 209 So.3d 702 (La. 2015) (declines to apply collateral source rule to attorney‑negotiated medical discounts)
- Deperrodil v. Bozovic Marine, Inc., 842 F.3d 353 (5th Cir. 2016) (LHWCA write‑offs not recoverable; plaintiff may not recover billed but unpaid amounts)
- Chauvin v. Exxon Mobil Corp., 158 So.3d 761 (La. 2014) (discusses public policy limits on punitive damages and windfalls)