286 So.3d 1245
La. Ct. App.2019Background:
- On Oct. 9, 2017 Moran slipped at work, sought ER care, and completed an employer drug test that later showed THC; Rouses terminated her after the positive result.
- Moran filed a disputed claim for workers' compensation benefits; employer initially invoked the intoxication presumption based on the drug test.
- Defendants later alleged Moran made willfully false statements in job/medical histories, invoking La. R.S. 23:1208 to seek forfeiture of benefits.
- The workers’ compensation judge found Moran suffered a compensable work injury but also found she willfully made false statements and forfeited any right to compensation under La. R.S. 23:1208; Moran appealed.
- Moran argued on appeal the statutory forfeiture should operate prospectively from the date of the fraud (her deposition in March 2018), not retroactively to the date of injury; Fifth Circuit affirmed the forfeiture of all benefits.
Issues:
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Scope/timing of forfeiture under La. R.S. 23:1208 (retroactive to injury vs. prospective from fraud) | Moran: forfeiture should be prospective beginning when fraud occurred (March 13, 2018) | Rouses: statute requires forfeiture of any right to benefits once fraud is determined, regardless of timing | Court: statute is clear and unambiguous; forfeiture of all benefits applies regardless of when the misrepresentation occurred — affirmed |
| Intoxication presumption from positive drug test (La. R.S. 23:1081) | Moran: did not contest fraud finding on appeal; trial court found presumption inapplicable due to immediacy of testing | Rouses: asserted presumption of intoxication based on positive THC result | Trial court found defendants not entitled to intoxication presumption; appellate court did not disturb that factual finding; remaining defensive challenge rendered moot |
Key Cases Cited
- Resweber v. Haroil Const. Co., 660 So.2d 7 (La. 1995) (discusses legislative intent to prevent workers’ compensation fraud and interprets §1208 broadly)
- St. Bernard Parish Police Jury v. Duplessis, 831 So.2d 955 (La. 2002) (Supreme Court held that a determination of fraud under §1208 results in forfeiture of all benefits)
- Leonard v. James Industrial Constructors, 879 So.2d 724 (La. App. 1 Cir. 2004) (First Circuit adopted prospective-only forfeiture approach)
- Jim Walter Homes, Inc. v. Guilbeau, 934 So.2d 239 (La. App. 3 Cir. 2006) (Third Circuit also read §1208 as applying prospectively from the date of the misrepresentation)
- Lee v. Alton Ochsner Medical Foundation, 890 So.2d 597 (La. App. 5 Cir. 2004) (Fifth Circuit precedent applying §1208 forfeiture to bar recovery of benefits)
- Apeck Construction, Inc. v. Bowers, 862 So.2d 1087 (La. App. 3 Cir. 2003) (discusses timing and effect of §1208 sanctions)