96 So. 3d 537
La. Ct. App.2012Background
- Reid-Lopez, an EMT for A-Med Ambulance, sustained a July 9, 2008 work accident with weekly indemnity of $522 through June 25, 2010.
- The employer’s adjuster Evans determined overpayment and possible prior injuries pre-dating the current claim.
- The trial court found pre-existing back injuries (including a 2004 back injury with PT) and that Reid-Lopez withheld prior medical history to gain workers’ compensation.
- The court concluded Reid-Lopez made false statements to obtain benefits, triggering forfeiture under La. R.S. 23:1208.
- The appellate standard requires deferential review of factual credibility and manifest error; the trial court’s credibility determinations were upheld.
- The judgment affirmed forfeiture of benefits based on credibility determinations and medical-history concealment.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Reid-Lopez forfeited benefits under 23:1208 for willful misrepresentation. | Reid-Lopez argues no willful misrepresentation. | Employer asserts intentional concealment of pre-existing injuries. | Affirmed; trial court's findings support forfeiture. |
Key Cases Cited
- Faulkner v. Better Serv., Inc., 67 So.3d 646 (La.App. 5 Cir. 2011) (forfeiture standards and credibility reviews emphasized)
- Gibbs v. Delasandro Painting and Decorating, 868 So.2d 804 (La.App. 5 Cir. 2004) (discusses evidence burden and misrepresentation considerations)
- Sevin v. Greenbriar, 807 So.2d 1179 (La.App. 1 Cir. 2002) (precedent on concealment of prior injuries)
- Sweeden v. Hunting Tubular Threading, Inc., 806 So.2d 728 (La.App. 5 Cir. 2001) (background on manifest-error review and credibility)
- Lee v. Smith, 4 So.3d 100 (La.App. 5 Cir. 2008) (credibility and factual sufficiency in workers’ comp)