Lynch v. a DOOR WORKS, INC.
72 So. 3d 1033
| La. Ct. App. | 2011Background
- Lynch worked for Door Works from Oct 27, 2007 to Mar 6, 2008; he alleges abdominal injury beginning Dec 12, 2007 worsened by lifting a door on Dec 15, 2007.
- Injury diagnosed as a ventral hernia; surgery recommended but not authorized pending investigation.
- Summit Claims conducted an investigation into the claim; Lynch worked light duty Dec 20, 2007 through Mar 6, 2008.
- Lynch filed a Disputed Claim for Compensation on Jun 6, 2008; Door Works denied the claim and asserted fraud in its reconventional demand.
- WCJ found a compensable work-related accident in the week of Dec 11–15, 2007, and awarded penalties and attorney fees; Door Works appealed.
- Appellate court affirmed the WCJ, awarding Lynch $3,500 in attorney fees on appeal.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Lynch’s injury was a compensable work accident. | Lynch cites medical corroboration of work-related onset. | Door Works challenges causation and notes disputed testimony. | Yes; injury established as work-related by preponderance of the evidence. |
| Whether Lynch committed workers' compensation fraud under La.R.S. 23:1208. | Lynch did not commit fraud; evidence supports a work-related accident. | Door Works contends fraud based on inconsistent statements. | No fraud; evidence supports compensable claim. |
| Whether Lynch is entitled to workers’ compensation benefits. | Beneficiary entitled to benefits for compensable injury. | Employer disputing causal relation and scope of benefits. | Entitled to benefits under the Workers' Compensation Act. |
| Whether Lynch is entitled to penalties and attorney fees for failure to pay benefits. | Penalty and fees warranted; employer delayed benefits. | No penalties or fees if not liable for improper denial. | Yes; penalties and attorney fees awarded. |
Key Cases Cited
- Dousay v. Dousay Floor Covering, 966 So.2d 677 (La.App. 3 Cir. 2007) (establishes causation and work-related injury standards)
- Winford v. Conerly Corp., 897 So.2d 560 (La.3/11/05) (manifest error review in WC appeals acceptable when reasonable)
- Baker v. Conagra Broiler Co., 640 So.2d 494 (La.App. 3 Cir. 1994) (preexisting condition cannot bar recovery; protection for worker as found)
- Halker v. Am. Sheet Metal, 861 So.2d 740 (La.App. 3 Cir. 2003) (employer takes worker as found; preexisting condition may be aggravated by work)
- Simpson v. Lafayette Consol. Gov't, 29 So.3d 727 (La.App. 3 Cir. 2010) (appeal-initiated attorney-fee enhancement when unsuccessful on appeal)