80 So. 3d 52
La. Ct. App.2011Background
- Lewis, a long-time Temple Inland employee, injured his right ankle on July 5, 2009 and underwent two surgeries, with restrictions through January 13, 2010.
- A December 10, 2009 functional capacity evaluation showed he could do light- to medium-duty work with restrictions, but Temple Inland’s job requirements exceeded those restrictions.
- A February 9, 2010 rehabilitation conference led to a conditional return-to-work arrangement, though Temple Inland would not provide a job within his restrictions.
- Lewis attempted to return to work February 15, 2010 with a cane; Temple Inland refused entry and terminated weekly indemnity benefits, claiming a full-duty release was given by the doctor.
- Dr. Plauche again restricted Lewis on February 22, 2010; Temple Inland refused to reinstate benefits, prompting Lewis to file Disputed Claim for Compensation seeking SEBs, mileage, penalties, and fees; later a second DCC was filed and both were tried November 2010.
- The WCJ awarded SEBs, mileage, penalties, and fees, but Temple Inland appealed; Lewis answered seeking additional penalties and fees.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether penalties/fees for failure to commence vocational rehabilitation apply | Lewis | Temple Inland | Not applicable; penalties/fees for failure to commence rehab do not apply |
| Whether penalties/fees for failure to reasonably controvert SEBs apply | Lewis | Temple Inland | Temple Inland failed to reasonably controvert; penalties/fees affirmed then amended on appeal |
| Whether Lewis retired or voluntarily withdrew from the workforce affecting SEBs | Lewis | Temple Inland | No manifest error; retirement not proved to trigger termination of SEBs under statute |
| Whether 23:1208 penalties were proven against Temple Inland officers for mileage claim fraud | Lewis | Temple Inland | Findings of willful false statements upheld; penalties imposed on Temple Inland (and ultimately on the company’s agents) |
| Appropriate penalties/fees for discontinuance of weekly benefits and on appeal | Lewis | Temple Inland | Discontinuance penalties increased to $8,000; attorney’s fees affirmed; limited increase for appellate work denied |
Key Cases Cited
- Chelette v. Riverwood International USA, Inc., 858 So.2d 412 (La. 2003) (23:1201(F) penalties apply to failure to commence payment, not to rehab)
- Clark v. Godfrey Knight Farms, Inc., 6 So.3d 284 (La.App. 1st Cir. 2009) (penalties/fees require reasonable controversion to be payable)
- Life Flight of New Orleans v. Homrighausen, 952 So.2d 45 (La.App. 1st Cir. 2006) (arbitrary and capricious discontinuance standard for benefits)
- Haynes v. Williams Fence and Aluminum, 851 So.2d 917 (La. 2003) (scope of 'claims due' and rehab-related penalties)
- Lanthier v. Family Dollar Store, 942 So.2d 732 (La.App. 3rd Cir. 2006) (awards for erroneous discontinuance may be broadened by appellate context)