Dennis CAUSBY
v.
PERQUE FLOOR COVERING and Louisiana Workers' Compensation Corporation.
Supreme Court of Louisiana.
*24 Leslie M. Koch, Baton Rouge, for Applicant.
Joseph G. Albe, Metairie, for Respondent.
VICTORY, Justice.[*]
We granted a writ to determine whether Dennis Causby's claim for workers' compensation benefits has prescribed under La. R.S. 23:1209. After review of the record and the applicable law, we reverse the Fifth Circuit's holding that prescription was suspended and hold that Causby's claim has prescribed.
FACTS AND PROCEDURAL HISTORY
On March 11, 1993, Causby was injured during the course and scope of his employment with Perque Floor Covering ("Perque") while he was lifting furniture. As a result of this accident, Causby underwent surgery to remove his left testicle on March 12, 1993. Causby was paid weekly workers' compensation benefits from March 19, 1993 through April 1, 1993. Medical benefits were also paid on behalf of Causby. Causby returned to work in April of 1993.
Todd Justice ("Justice") was the claims adjuster working for Louisiana Workers' Compensation Corporation ("LWCC"), which provided workers' compensation insurance to Perque. Justice testified that LWCC terminated Causby's weekly disability benefits on April 1, 1993 because Causby had returned to work. Sometime in April, Justice contacted Causby by telephone to tell him his benefits were being terminated. Causby asked Justice if he was entitled to any more workers' compensation benefits and, because loss of a testicle was not a scheduled injury under the Workers' Compensation Act at that time, Justice told him he would not be receiving any further benefits.[1]
In February of 1995, Causby met with an attorney who informed him that he was entitled to workers' compensation benefits for his loss of a testicle. Accordingly, Causby filed this suit for permanent partial disability benefits on May 24, 1995.
The defendants filed an exception of prescription, claiming that Causby's suit had prescribed as it was filed more than one year from the date of the last workers' compensation payment. Following a hearing, the workers' compensation judge held that prescription was interrupted in April of 1993 when Justice told Causby he was entitled to no further benefits, stating that this was an intentional act by Justice upon which Causby relied to prevent Causby from asserting any further claims for his loss. The Fifth Circuit denied writs finding that defendants had an adequate remedy on appeal.
After a trial on the merits on August 14, 1996, the workers' compensation judge found that Causby was entitled to fifty (50) weeks of disability benefits in the amount of $307.00 per week for the loss of his testicle. In addition, the judge found that the issue of prescription was res judicata.
While noting that the issue of prescription was not res judicata, the Fifth Circuit Court of Appeal affirmed the judgment of the hearing officer denying the exception of prescription and awarding disability benefits. Dennis Causby v. Perque Floor Covering and Louisiana Workers' Compensation Corporation, 96-CA-990 (La.App. 5th Cir. 4/9/97), 694 *25 So.2d 430. We granted a writ to consider whether the lower courts were correct in finding that prescription had been interrupted or suspended. Dennis Causby v. Perque Floor Covering and Louisiana Workers' Compensation Corporation, 97-C-1235,
DISCUSSION
There is no dispute that Causby's last payment of temporary total disability benefits was in April of 1993. La. R.S. 23:1209[2] provides the prescriptive period for workers' compensation claims. In cases such as this, where disability benefits have been paid, a claimant has one year from the date of the last payment to file his claim. Because Causby did not file his claim until May 24, 1995, the suit is prescribed on its face. The burden falls upon the claimant to show that the running of prescription was interrupted or suspended in some manner. Lima v. Schmidt,
Although Civil Code article 3467 provides that prescription runs against all persons unless they are included in some exception established by law[3], "[t]his court has, however, accepted in certain limited situations the common law doctrine Contra non valentem agere non currit which means that prescription does not run against a person who could not bring his suit." Nathan v. Carter,
This Court has recognized four judiciallycreated categories of contra non valentem:
(1) where there was some legal cause which prevented the courts or their officers from taking cognizance of or acting on the plaintiff's action;
(2) where there was some condition coupled with a contract or connected with the proceedings which prevented the creditor from suing or acting;
(3) where the debtor himself has done some act effectually to prevent the creditor from availing himself of his cause of action; and
(4) where some cause of action is not known or reasonably knowable by the plaintiff, even though his ignorance is not induced by the defendant.
Wimberly v. Gatch, 93-2361 (La.4/11/94),
In workers' compensation cases, this Court has applied the doctrine of contra non valentem to suspend prescription in certain situations based on conduct of the employer or employer's representative which effectually prevents the employee from filing his claim.[4] In Landry v. Ferguson, an uneducated farm laborer did not file his suit timely because his employer assured him that he would take care of him.
Numerous court of appeal cases have recognized that prescription can be suspended in workers' compensation cases when the employer lulls the employee into a false sense of security, thus justifying the employee's delay in filing suit, but most courts have rejected that argument based on the facts of the particular case. See Davis v. Brown's Velvet Dairy Products,
*27 The factual scenarios in cases where courts have found that the running of prescription has been suspended by the actions of the employer in lulling the employee into a false sense of security are much different than the facts presented in this case. As discussed earlier, in Nathan v. Carter, the claims manager assured the claimant that a full investigation would be conducted after which the claimant would be given a lump sum settlement and actually threatened the claimant that if she hired an attorney, her benefits would be terminated.
Until the court of appeal opinion in this case, no reported Louisiana decision has held that an employee has been lulled into a false sense of security which would justify delay in filing a workers' compensation claim where the employer or claims adjuster tells the employee that he is not entitled to further benefits. In this situation, far from being lulled into a false sense of security that he will receive benefits, the employee is told, perhaps even in error, that he has no claim for benefits. At that point, the employee is put on notice that his only avenue for recovery is to hire an attorney and file suit within the established time limits. It is unreasonable for the employee to think that he can sit on his rights indefinitely until an attorney tells him he is actually entitled to benefits. We agree with the following reasoning of the Fourth Circuit opinion in Drane v. City of New Orleans, supra, authored by now Justice Lemmon:
A statement by the employer's representative that the employee has no valid claim is entirely different from one that the employee will be taken care of (as in Landry v. Ferguson, La.,279 So.2d 185 (1973)), or one that compensation will be paid without suit. The latter statements to the employee indicate that the employer has recognized the claim, and an employee alleging late filing on account of such statements would assert a cause of action to estop the employer from pleading prescription.
However, a statement by an employer's representative that the employee has no valid claim is the equivalent of the employer's denial of the claim. Such a statement would serve to notify the employee that he cannot rely on receiving compensation without suit and that he must seek legal advice or pursue his claim otherwise than through amicable settlement with the employer.
In this case, the adjuster told Causby that he was entitled to no further benefits. Causby testified that he knew the adjuster was not an attorney. In fact, at that time, the adjuster's statement was not even a misstatement of fact or law as loss of a testicle was not a scheduled injury under La. R.S. 23:1221(4)(a)-(o) and did not appear to fall under the "catch-all" provision of La. R.S. 23:1221(4)(p), allowing recovery "where the usefulness of the physical function of the ... genito-urinary system, as contained within the thoracic or abdominal cavities, is seriously and permanently impaired...." Furthermore, the case of Lindon v. Terminix Services, Inc.,
CONCLUSION
The statement by the adjuster does not fall within the limited exception recognized by the jurisprudence that statements by an employer that lull the employee into a false sense of security or prevent the employee from timely filing his lawsuit will suspend the running of prescription. Since the plaintiff's claim has prescribed on its face and the plaintiff failed to show a suspension or interruption, the lower courts should have sustained the exception of prescription.
DECREE
For the reasons stated herein, the judgment of the court of appeal is reversed, defendants' exception of prescription is sustained, and plaintiff's claim is dismissed.
REVERSED AND RENDERED.
NOTES
Notes
[*] Traylor, J., not on panel. Rule IV, Part 2, § 3.
[1] There is some question regarding Justice's exact words. It is unclear whether Justice said "you are not entitled to any more benefits" or "LWCC will not pay you any more benefits." However, this distinction is irrelevant in our view.
[2] La. R.S. 23:1209 A provides as follows:
In case of personal injury, including death resulting therefrom, all claims for payments shall be forever barred unless within one year after the accident or death the parties have agreed upon the payments to be made under this Chapter, or unless within one year after the accident a formal claim has been filed as provided in Subsection B of this Section and in this Chapter. Where such payments have been made in any case, the limitation shall not take effect until the expiration of one year from the time of making the last payment, except that in cases of benefits payable pursuant to R.S. 23:1221(3) this limitation shall not take effect until three years from the time of making the last payment of benefits pursuant to R.S. 23:1221(1), (2), (3), or (4). Also, when the injury does not result at the time of, or develop immediately after the accident, the limitation shall not take effect until expiration of one year from the time the injury develops, but in all such cases the claim for payment shall be forever barred unless the proceedings have been begun within two years from the date of the accident.
[3] The Civil Code provides that "prescription is interrupted when one acknowledges the right of the person against whom he had commenced to prescribe." La. C.C. art. 3464. This article has been applied where the debtor lulls the creditor into believing that he will not contest liability. Lima v. Schmidt, supra at 634. However, this legislatively-created exception does not apply because rather than acknowledging the debt, the adjuster told Causby that no debt was owing at all.
[4] We have also held that the running of prescription is suspended where the employer is paying the injured worker wages in lieu of compensation. Lester v. Rebel Crane & Service Co.,
[5] Although in 1973, the Third Circuit in Breaux v. Kaplan Rice Mill, Inc.,