Hammons v. ABB CE SERVICES, INC.Hammons v. ABB CE SERVICES, INC.
William Daniel HAMMONS
v.
ABB C-E SERVICES, INC. and Transportation Insurance Company.
Court of Appeal of Louisiana, First Circuit.
*372 J. Arthur Smith, III, Baton Rouge, for Plaintiff-Appellee William D. Hammons.
Kirk L. Landry, Baton Rouge, for Defendants-Appellants ABB C-E Services, Inc. and Transportation Insurance Co.
Before LOTTINGER, C.J., WATKINS, SHORTESS, CARTER, LeBLANC, FOIL, GONZALES, WHIPPLE, FOGG, PITCHER, PARRO, FITZSIMMONS, KUHN, JJ., and REDMANN[1] and TANNER[2], JJ. Pro Tem.
FOGG, Judge.
In this worker's compensation action, ABB C-E Services, Inc., and Transportation Insurance Company appeal the award of compensation, interest, and penalties and attorney's fees to William D. Hammons, the plaintiff.
The parties stipulated that the plaintiff injured his left knee in the course and scope of his employment on October 31, 1990. The plaintiff, a 63 year old boilermaker, underwent arthroscopic surgery on the left knee on February 15, 1991. By September, 1992, the treating orthopedic surgeon declared the plaintiff a candidate for total knee arthroplasty with restrictions of no prolonged sitting or standing; by October, 1992, the plaintiff had developed right knee pain and swelling with x-rays indicating collapse with bone-on-bone contact of the medial component.
The defendants initially paid the plaintiff temporary total disability benefits, and then supplemental earnings benefits (SEB) at the maximum rate from September 30, 1991, until December 9, 1991. At that time, they reduced the SEB and then, on August 4, 1993, terminated it. The plaintiff filed this worker's compensation claim on November 18, 1993, and trial was held on April 14, 1994.
The hearing officer awarded the plaintiff SEB from August 27, 1991, until April 14, 1994, in the amount of $1212.60 per month with legal interest from the date of judicial demand until paid; permanent total disability benefits from the date of trial, April 14, 1994, in the amount of $1481.66 per month with legal interest from the date of judicial demand until paid; penalties of $2000.00 and attorney's fees of $1500.00; and costs, including expert witness fees of $500.00 for Dr. Stephen Speeg and $600.00 for Mr. Curtis Charrier.
On appeal, the defendants contend that the hearing officer erred in finding that the plaintiff was permanently totally disabled; in calculating the amount of SEB; in determining the rate of compensation payable to the plaintiff for permanent total disability; in determining the interest owed to the plaintiff; in ruling that the defendants were *373 arbitrary and capricious; and in finding them responsible for costs and experts' fees and in determining the amounts of those fees. The plaintiff answered the appeal seeking an increase in the award of attorney's fees.
Regarding their contention that the hearing officer erred in determining that the plaintiff was totally permanently disabled, the defendants claim that the plaintiff's various other health problems rendered him unable to work as opposed to his knee injury. In her reasons for judgment, the hearing officer detailed the plaintiff's many health problems, and observed that because he had been regularly working as a boilermaker with most of those problems, the plaintiff would "still be working had he not injured his knee." The hearing officer continued,
[T]he accident literally took his legs out from under him. Once this was [sic] occurred, this man with a 3rd grade education and years of boilermaking expertise, began to spiral. His depression worsened, he developed the lumbar facet disease, his arthritis accelerated, and he generally deteriorated to the point where he cannot work at all.
The hearing officer concluded that due to losing the strength of his left and then his right knee, the plaintiff was unable to work, and that the condition of his knees, together with his "horrible general medical condition," constituted permanent total disability.
A pre-existing disease or infirmity of the employee does not disqualify a claim if a work-related injury aggravates, accelerates, or combines with the pre-existing disease or infirmity to produce disability. Toth v. Ensco Environmental Services, Inc.,
The defendants contend that the permanent total disability benefits awarded the plaintiff exceed the maximum rate of compensation permissible under the Louisiana Worker's Compensation Law. Under
B. [T]he average weekly wage in all employment subject to the Louisiana Employment Security Law shall be determined by the administrator of the office of employment security on or before August 1 of each year as of the quarter ending on the immediately preceding March 31 of each year. The average weekly wage so determined shall be applicable for the full period during which compensation is payable when the date of occurrence of injury falls within the twelve-month period commencing September 1 following the determination.
According to the Louisiana Register (Vol. 16, No. 8, August 20, 1990), of which we are authorized to take judicial notice under
The defendants contend that the plaintiff was not entitled to SEB as awarded by the hearing officer because the hearing officer did not base her computation on the two jobs the defendants claimed were available to the plaintiff. The plaintiff is entitled to SEB if the injury has resulted in the employee's inability to earn wages equal to ninety percent or more of wages at the time of injury.
The hearing officer determined that the two jobs the defendant found for the plaintiff were "obviously unavailable"; yet, she noted that the plaintiff did seek one of the jobs which had already been filled when he applied. As to the second job as a donut cutter, the plaintiff's treating orthopedic surgeon had conditionally approved the job with the restriction of "no prolonged standing"; the plaintiff testified that he learned that the job required heavy lifting and constant standing when he looked into it. We have reviewed the testimony and evidence and the hearing officer's conclusion that the jobs offered were not available to the plaintiff is not manifestly wrong.
The defendants also contend that the hearing officer erred in awarding SEB for the period from August 27, 1991, through April 14, 1994, because the plaintiff applied for retirement benefits in August, 1993, and began receiving them shortly afterwards. Under
The plaintiff called an adjuster for the defendant insurer and asked her about the effect of his acceptance of retirement benefits on his worker's compensation benefits. After discussing the matter with her supervisor, the adjuster informed the plaintiff that his acceptance of retirement benefits "would not in any way alter your workers [sic] compensation benefits." At the plaintiff's request, she sent him a letter on October 11, 1991, which also said this. The plaintiff was not represented by counsel when he made the inquiry; based on the adjuster's representations, he applied for retirement benefits. He testified that if he had not been given this advice, he would not have applied for the retirement pension because he "couldn't afford to, because I was getting more money there [worker's compensation benefits] than I get from my pension."
The hearing officer found that the defendant insurer misled the claimant and that because the insurer's representative wrote the letter and gave this advice to the plaintiff, *375 it was liable for penalties and attorney's fees for its termination of the plaintiff's SEB. Moreover, by awarding SEB from August 27, 1991, until April 14, 1994, the hearing officer did not apply
The defendants contend that the hearing officer erred in finding them responsible for penalties and attorney's fees under
The defendants contend that the hearing officer erroneously awarded legal interest from the date of judicial demand until paid.
The defendants also complain that the hearing officer's award of expert witness fees for Dr. Speeg and Mr. Charrier is excessive. The defendants assert that the plaintiff should have presented their testimony by deposition. Under
*376 The plaintiff has asked for an increase of attorney's fees on appeal. An increase in attorney's fees is usually warranted on appeal where the defendant appeals and obtains no relief when the appeal has necessitated additional work on the part of the plaintiff's counsel. Pitcher v. Hydro-Kem Services, Inc.,
For the foregoing reasons, the judgment is amended to award the plaintiff supplemental earnings benefits (SEB) from August 27, 1991, until April 14, 1994, in the amount of $1212.60 per month with legal interest from June 6, 1994, the date ordered paid by the hearing officer, until paid and to award the plaintiff permanent total disability benefits from the date of trial, April 14, 1994, in the amount of $282.00 per week. Legal interest is awarded on all permanent total disability benefits which had accrued as of June 6, 1994; the interest on these benefits runs from June 6, 1994 until the date of satisfaction. Legal interest is awarded on permanent total disability benefits due after the hearing officer's judgment from the date each respective payment is due until the date of satisfaction. In all other respects, the judgment is affirmed. The plaintiff is awarded additional attorney's fees from the defendants of $1500.00 for this appeal, with legal interest thereon from the date of this judgment until paid. Costs of this appeal are to be paid by the defendants.
AMENDED, AND AS AMENDED, AFFIRMED.
SHORTESS, J., concurs with reasons.
CARTER, J., concurs in part and dissents in part with reasons.
WHIPPLE, J., concurs in part, and dissents in part, for reasons assigned.
PARRO, J., dissents in part for the reasons assigned by REDMANN, J. Pro Tem.
FITZSIMMONS, J., concurs and assigns reasons.
KUHN, J., concurs and assigns reasons.
REDMANN, J., Pro Tem., dissents in part and assigns reasons.
SHORTESS, Judge, concurring.
Although equitable estoppel or estoppel in pais is not favored under Louisiana law[1] and is to be applied with caution,[2] the application of that doctrine is appropriate under the facts of this case.
The doctrine of equitable estoppel is designed to prevent injustice by barring a party, under special circumstances, from taking a position contrary to his prior acts, admissions, representations, or silence. American Bank & Trust Co. v. Trinity Universal Ins. Co.,
The party asserting equitable estoppel must prove three elements: (1) a representation by conduct or word; (2) justifiable reliance; *377 and (3) a change in position to his detriment because of the reliance. Wilkinson v. Wilkinson,
The representation required for the application of equitable estoppel is usually characterized as a "misrepresentation." That term generally implies intent and suggests deliberate falsification. Black's Law Dictionary 1001 (6th ed. 1990); Webster's Third New International Dictionary Unabridged 1445 (1981). In State ex rel. Porterie v. Gulf, Mobile & Northern R.R. Co.,
Generally, a misrepresentation of law does not invoke equitable estoppel. Wadley v. Gleason,
Plaintiff has proved all three elements required to invoke equitable estoppel. Plaintiff introduced into evidence a letter from Kim J. Taylor, a senior claim representative with CNA, which states: "I have discussed this matter with my supervisor, and we have agreed that your retirement benefits are something that you have worked for and earned, and your acceptance of them would not in any way alter your workers compensation benefits." This document proves a representation was made to plaintiff that his retirement would not affect his receipt of worker's compensation supplemental earnings benefits. Through his testimony plaintiff proved he retired in reliance on this representation. He further proved this representation was to his detriment because his worker's compensation benefits were terminated when he retired, and his retirement benefits were less than the worker's compensation benefits.
This case involves an incorrect representation of law. Insurance companies and their adjusters customarily have ready access to legal counsel. Taylor's letter indicates she discussed the matter with her supervisor; apparently she failed to consult with legal counsel before making a representation to plaintiff regarding the effect of his acceptance of retirement benefits. In relation to this unrepresented, relatively uneducated claimant, defendant's adjuster possessed a superior knowledge of worker's compensation law. Because the adjuster was in such a dominant position, plaintiff was lulled into believing, much to his detriment, that he could receive retirement benefits and worker's compensation benefits simultaneously. In my opinion, the facts of this case present one of the infrequent occasions in which equitable estoppel may be invoked under a misrepresentation of law.
I respectfully concur.
*378 CARTER, Judge, concurring in part and dissenting in part.
I agree with the majority opinion in all respects, except the majority's interpretation of
I dissent from the majority holding that interest runs on past due and unpaid indemnity benefits only from the date of the hearing officer's judgment. For reasons assigned by Judge Whipple in her concurring in part and dissenting in part opinion, I am of the firm opinion that interest on past due worker's compensation benefits is owed from the date each past due indemnity benefit was due until paid regardless of when the hearing officer ultimately issues an order to pay.
As so astutely set forth by Judge Whipple, the majority's resolution of this issue can only reward the late paying employer or insurer at the expense of the injured employee.
WHIPPLE, Judge, concurring in part and dissenting in part.
I concur for the reasons assigned by Judge Shortess. However, I dissent from the majority's holding with regard to the majority's interpretation of
The majority holds that
There is nothing in the Act which adopted this recordation scheme to suggest that the legislature intended to favor the recalcitrant employer (or insurer) who fails to pay benefits when due. Indeed, the recordation procedure created by
I find that the statute at issue does not address, and therefore could not have specifically overruled, the longstanding and appropriate jurisprudential rule that interest is owed on each past due, lawfully owed, and unpaid indemnity benefit, from the date due. From my reading of the statute, I find: (1) *379 that
Accordingly, I respectfully dissent.
FITZSIMMONS, Judge, concurring with reasons.
I agree with the interpretation of
As with the payment of past due awards, the original judgment is the keystone regarding the payment of any interest on future awards. Interest shall be due from the "date ordered paid."
KUHN, Judge, concurring with additional reasons.
I concur to clarify a point of concern regarding the interest awarded by this court on the total permanent disability benefits to be paid weekly after the date of the hearing officer's judgment. I note interest runs on each payment as it becomes due until payment is made without the need for claimant to rule the defendant-employer back into court to obtain these amounts as they become due.
REDMANN, Judge Pro Tem., dissenting in part.
I disagree with interpreting R.S. 23:1201.3(A)'s "the date ordered paid by the hearing officer" as meaning, as to installments already due when the entitlement to benefits is decided (though not as to those becoming due thereafter), the one date upon which that entitlement is decided. I note that interest on the $282 weekly benefits "ordered paid" by this court does not run from "the date ordered paid by the hearing officer" because the hearing officer did not order them paid.
In my opinion, "the date ordered paid by the hearing officer" should mean the same thing as to both due and undue installments, and should mean not the date of the hearing officer's decision but the date, as to each installment, when (as the hearing officer's decision specifies) it was, or is to become, due. That interpretation is consistent with the historical practice of interest from the dates, fixed by the court, on which each installment was or is to be due; and it is consistent with the title of Acts 1988 No. 938, which enacted § 1201.3(A). See
*380 Neither the title nor the body of Act 938 indicates a purpose to depart from the historic practice, and certainly the title does not suggest a purpose to deprive injured workers of interest on installments that the employer or insurer has not timely paid (even if in good faith). Today's statutory language is susceptible of interpretation providing the historic result: the hearing officer orders past due installments paid as of the date they were due, and undue installments as of the date they are to become due (and each, both due and undue, bears interest from its own "date [due as found by and therefore] ordered paid by the hearing officer").
NOTES
[1] Judge William V. Redmann, retired, is serving as judge pro tempore by special appointment of the Louisiana Supreme Court.
[2] Judge Thomas W. Tanner, retired, is serving as judge pro tempore by special appointment of the Louisiana Supreme Court.
[1] Wilkinson v. Wilkinson,
Notes
[2] Sanders v. General American Life Ins. Co.,
[1] "Every bill shall contain a brief title indicative of its object." Act 938's title, as pertinent, was: "[T]o create administrative hearing officer positions;... to provide for claims; ... to provide for payment of compensation; to provide penalties...." If the body of an Act with that title contained an express repeal of interest on past-due benefits to injured workers, I would deem it unconstitutional. I deem it equally wrong to find an implied repeal of interest in what is, at best, a provision subject to several interpretations.