Sorile v. Lott Oil Co.
160 So. 3d 178
La. Ct. App.2015Background
- Roland Sorile, a fuel-truck operator, alleged back injury from handling a fuel hose on February 26, 2013; no witnesses to the incident.
- Sorile delayed reporting a workplace injury; early medical records and coworkers contain statements indicating onset at home, and he first reported a work accident on March 14, 2013.
- MRI and neurosurgeon evaluation (Dr. Dowd) showed L4-5 and L5-S1 pathology; Dr. Dowd performed microdiscectomies on April 16, 2013.
- Lott Oil denied a work accident, disputed causal connection, and asserted Sorile willfully made false statements to obtain benefits under La. R.S. 23:1208 and 23:1208.1.
- The Workers’ Compensation Judge (WCJ) found Sorile credible, awarded TTD, SEB (zero earning capacity), and ongoing medical benefits, allowed Blue Cross Blue Shield’s medical lien, and denied employer’s fraud claim and Sorile’s request for penalties/attorney fees.
- On appeal, this court affirmed the WCJ in all respects and declined to consider Sorile’s Answer to Appeal as filed in the trial tribunal after the suspensive appeal was granted.
Issues
| Issue | Plaintiff's Argument (Sorile) | Defendant's Argument (Lott Oil) | Held |
|---|---|---|---|
| Existence of work accident (unwitnessed) | Testimony that he felt burning while lifting hose on Feb. 26; circumstantial corroboration by wife, prior benign back history, later medical findings | Early statements to ER, PA, coworkers said onset at home; only later claimed workplace injury after MRI/surgeon visit — argues fabrication | WCJ credited Sorile’s testimony and corroboration (wife, Drs. McBride and Dowd); appellate court affirmed — no manifest error |
| Compensable injury and entitlement to benefits | Back pathology shown on MRI and treated surgically; injury occurred in course/scope of employment; sought TTD, SEB, medicals | Causation disputed because initial reports placed onset at home; contends lack of contemporaneous workplace report undermines compensability | WCJ’s factual findings that injury was work-related and compensable were reasonably supported; benefits affirmed |
| Fraud/forfeiture under La. R.S. 23:1208 & 23:1208.1 | Denies willful misrepresentation; explanations for delayed/variant reporting (thought it was a pulled muscle, low education, prior similar minor episodes) | Argues false/untruthful statements to medical providers and employer were willful to obtain benefits — seeks forfeiture and restitution | WCJ found no willful misrepresentation for purpose of obtaining benefits; appellate court upheld that finding and rejected employer’s fraud claim |
| Employer liability for insurer lien & procedural posture of answer to appeal | Sorile did not contest WCJ’s recognition of BCBS lien; separately sought penalties/fees below and additional fees on appeal | Lott Oil argued it should not be liable for BCBS lien if no compensable injury; also pursued suspensive appeal, divesting trial court jurisdiction | Having found a compensable accident, court held Lott Oil liable for BCBS medical lien; appellate court declined to consider Sorile’s Answer to Appeal filed in trial court after suspensive appeal was granted (trial court divested of jurisdiction) |
Key Cases Cited
- Marange v. Custom Metal Fabricators, Inc., 93 So.3d 1253 (La. 2012) (standard for proving unwitnessed work accident and appellate review of credibility findings)
- Bruno v. Harbert Int'l, Inc., 593 So.2d 357 (La. 1992) (employee may prove unwitnessed accident by testimony plus absence of contradictory evidence and corroborating post-incident circumstances)
- Ardoin v. Firestone Polymers, L.L.C., 56 So.3d 215 (La. 2011) (unwitnessed-accident proof elements and credibility deference)
- Canter v. Koehring Co., 283 So.2d 716 (La. 1973) (appellate deference to trial court factual findings and credibility evaluations)
- Vidrine v. La-Tex Rubber & Specialties, Inc., 958 So.2d 146 (La. App. 3 Cir. 2007) (appellate respect for reasonable credibility evaluations)
- Resweber v. Haroil Constr. Co., 660 So.2d 7 (La. 1995) (fraud/forfeiture standards referenced in worker’s compensation fraud analysis)
- Burnett v. Vector Elec. & Controls, Inc., 40 So.3d 477 (La. App. 3 Cir. 2010) (elements required to prove fraud under La. R.S. 23:1208)
- Dugas v. AutoZone, Inc., 103 So.3d 1271 (La. App. 3 Cir. 2012) (application of elements for La. R.S. 23:1208 and 23:1208.1)