JOHNNY COUSAIN VS. SMITTY‘S SUPPLY, INC. AND NATIONAL UNION FIRE INSURANCE COMPANY
No. 2025-C-01318
Supreme Court of Louisiana
June 29, 2026
NEWS RELEASE #030
FROM: CLERK OF SUPREME COURT OF LOUISIANA
Thе Opinions handed down on the 29th day of June, 2026 are as follows:
BY Weimer, C.J.:
AFFIRMED. SEE OPINION.
JOHNNY COUSAIN VS. SMITTY‘S SUPPLY, INC. AND NATIONAL UNION FIRE INSURANCE COMPANY
No. 2025-C-01318
SUPREME COURT OF LOUISIANA
WEIMER, Chief Justice*
WEIMER, Chief Justice*
A writ was granted in this matter to determine whether the forfeiture of workers’ compensation benefits, for making a willful misrepresentation in violation of
FACTS AND PROCEDURAL HISTORY
On June 30, 2021, Johnny Cousain was involved in a work-related motor vehicle accident, which he reported to his employer, Smitty‘s Supply, Inc., on the same day, but reported no injuries at that time. He was terminated from his employment two days later. Mr. Cousain then reported neck and back injuries to Smitty‘s by letter, through counsel, demanding authorization of an initial evaluation by his choice of orthopedic surgeon. Thereafter, he filed a disputed claim for compensation with the Office of Workers’ Compensation (“OWC“), alleging that Smitty‘s had not paid any wage benefits or authorized any medical treatment.
The misrepresentation at issue arose from Mr. Cousain‘s March 3, 2022 deposition, where Mr. Cousain testified that, two days after the accident, he sought emergency room care at North Oaks Medical Center for his injuries. He further testified that he underwent an x-ray and was placed off work for two days. The medical records, however, showed that Mr. Cousain did not receive emergency room care two days after his accident. Smitty‘s filed an amended answer in the OWC, asserting that Mr. Cousain made an intentional misrepresentation for the purpose of obtaining workers’ compеnsation benefits and, thus, had forfeited his right to benefits.
At trial, Mr. Cousain testified that he had received care at North Oaks on many other occasions for other reasons and was merely confused about the dates of his care. The WCJ, however, did not find this claim of confusion credible, stating:
Mr. Cousain was asked in his March 3, 2022, deposition about his medical care related to his workplace injuries. Mr. Cousain reported that he had care at North Oaks emergency room within two days of the accident. Mr. Cousain went into detail about this care. However, the medical records introduced at trial show that Mr. Cousain did not get care at North Oaks for injuries from the June 30, 2021, accident. Mr. Cousain alleges thаt because he had so many visits to North Oaks for other matters that he was confused and mistaken. Mr. Cousain‘s testimony was clear and resolute. Mr. Cousain was not receiving benefits at the time of the deposition, and emphasizing medical care shortly after the accident would help to prove a contested injury. Mr. Cousain was seeking benefits, and he seemed to be aware that whether he was injured was a contested matter. In observing Mr. Cousain‘s testimony and demeanor during the trial, the court did not believe that Mr. Cousain accidentally confused receiving care at North Oaks for this accident. The court finds that Mr. Cousain willfully made false statements in his deposition for the purpose of obtаining workers’ compensation benefits.
The WCJ found that Mr. Cousain violated
Smitty‘s filed a writ application in this court, which was granted. Cousain v. Smitty‘s Supply, Inc., 25-01318 (La. 1/28/26), 427 So.3d 692. Mr. Cousain has not separately filed a writ in this court to challenge the lower courts’ finding that he willfully made a false statement for the purpose of obtaining benefits.3 Accordingly, the sole issue before this court is whether the ensuing forfeiture of benefits is prospective only or retroactive to the date of the accident.
DISCUSSION
The Louisiana Workers’ Compensation Act contains two separate anti-fraud forfeiture provisions by which employers may defеnd against paying a claim.
A. It shall be unlawful for any person, for the purpose of obtaining or defeating any benefit or payment under the provisions of this Chapter, either for himself or for any other person, to willfully make a false statement or representation.
....
E. Any employee violating this Section shall, upon determination by workers’ compensation judge, forfeit any right to compensation benefits under this Chapter.
This court has found
In Resweber, 94-2708 at 7, 660 So.2d at 12, this court held that Section 1208 clearly applies to any willful false statements or representations made “for the purpose of obtaining or defeating any benefit or payment” and has no language limiting it to only certain types of false statements, i.e., statements other than those relating to prior injuries. In examining the legislative history of
The history of Section 1208 indicates a clear legislative intent to prevent and discourage fraud in relation to workers’ compensation claims, and Sеction 1208 should not be subjected to a strained interpretation which would undercut that legislative intent. ... The legislature has determined workers’ compensation fraud is a severe and growing problem and has continually amended Section 1208 to make it easier to enforce and to make the penalties stiffer. It is clear from the history of the statute that the legislature intended that any false statements or representations willfully made for the purpose of obtaining benefits would result in forfeiture of those benefits, and this legislative intent cannot be ignored.
Id., 94-2708 at 7-8, 660 So.2d at 12-13.
In Duplessis, 02-0632 at 2, 831 So.2d at 956, the employee, who had been receiving benefits for nine years, falsified mileage reports seeking more mileage reimbursement thаn owed. While the WCJ found that the employee had willfully submitted false mileage reports in violation of
Soon after, the First Circuit, sitting en banc, considered the timing of the forfeiture in Leonard. There, the WCJ and the court of appeal found the forfeiture of benefits effective from the date of the misrepresentation forward. Leonard, 03-0040 at 9, 879 So.2d at 730. The employee admitted in his trial testimony that he lied about back pain to medical providers at a hospital emergency room to obtain medication due to drug addiction. Id., 03-0040 at 5, 879 So.2d at 728. The appellate court majority reasoned that Duplessis did not address when the forfeiture was to be effective and did not require forfeiture of benefits dating back to the time of the injury. Id., 03-0040 at 8, 879 So.2d at 730. Looking to this court‘s opinion in Resweber, the majority acknowledged this court‘s statement that
Three judges authored separate concurrences agrеeing with the majority‘s conclusion and further focusing on the statute as a whole, particularly the interplay between Subsections D and E. Subsection D provides:
In addition to the criminal penalties provided for in Subsection C of this Section, any person violating the provisions of this Section may be assessed civil penalties by the workers’ compensation judge of not less than five hundred dollars nor more than five thousand dollars payable to the Kids Chance Scholarship Fund, Louisiana Bar Foundation, and may be ordered to make restitution. Restitution may only be ordered for benefits claimed or payments obtained through fraud and only up to the time the employer became aware of thе fraudulent conduct.
Judge Whipple‘s concurrence noted that, under Subsection D, an employee who violates this statute may be ordered to pay restitution only for “benefits claimed or payments obtained through fraud“—not all benefits ever paid. Leonard, 03-0040 at 1, 879 So.2d at 731 (Whipple, J., concurring). If Subsection E were read to provide that forfeiture of all benefits is retroactive to the date of the accident, regardless of when the misrepresentation occurs, then presumably, the employee
Judge McClendon‘s concurrence likewise considered Subsections D and E in light of one another. Id., 03-0040 at 1, 879 So.2d at 733 (McClendon, J., concurring). The сoncurrence emphasized that statutory provisions should be construed as a whole with the remainder of the statute, and all statutes on the same subject matter should be read together and interpreted as a whole to effect the legislative intent and should be construed in such a way as to reconcile, if possible, apparent inconsistencies or ambiguities so that each part is given effect. Id. It is presumed that the intention of the legislative branch is to achieve a consistent body of law. Id.
Judge Kuhn further concurred to recognize the underlying principle that workers’ compensation claims are in derogation of the general rights of tort victims and that forfeiture is an infliction of “a draconian penalty that deprives workers’ compensation claimants of their rights to compensation not reasonably related to ... the misrepresentation.” Id., 03-0040 at 1, 879 So.2d at 732 (Kuhn, J., concurring).
In dissent, Chief Judge Carter criticized the majority‘s reading of Duplessis as having not addressed the point in time at which the forfeiture of benefits is to be effective. Leonard, 03-0040 at 1, 879 So.2d at 734 (Carter, C.J., dissenting). Rather, Chief Judge Carter was “convinced” that the clear and unambiguous language of Section 1208, this court‘s decisions in Resweber and Duplessis, and the First Circuit‘s decision in LeBlanc, “lead to the inescapable conclusion” that a violation of Section 1208 results in the forfeiture of all benefits the employee would
The Third Circuit similarly rejected an employer‘s argument that benefits must be forfeited retroactively to the date of the accident where the employee was otherwise entitled to benefits prior to the misrepresentation. In Jim Walter Homes, Inc. v. Guilbeau, 05-1473, p. 11 (La. Aрp. 3 Cir. 6/21/06), 934 So.2d 239, 246-47, the court reasoned that if
As indicated by Subsection D, it is clear that the intent of the legislature was to punish claimants who make false statements or representations to obtain benefits. Otherwise, the legislature would
have provided restitution for any workers’ compensation benefits that the employer paid before it became aware of the fraudulent conduct. The reason for this is simple. Before the misrepresentation, there has been no punishable conduct. The triggering mechanism is the fraudulent conduct. Once the misrepresentation occurs, the provisions of La. R.S. 23:1208 apply, and from that point the claimant‘s right to benefits is forfeited. Any other interpretation would have the effect of promoting a system whereby the employers would fail to commence the payment of workers’ compensation benefits in the hope of a future false statement which would relieve it completely of the obligation of paying workers’ compensation benefits, including its own actions which would be punishable under the Workers’ Compensation Act. This would thwart the purpose of the Workers’ Compensation Act which was passed for the joint benefit of labor and management in order to insure that employees who became disabled as a result of their labors in hazardous industries would have, during the period of their disability, a weekly income for the upkeep of themselves and their families.
Apeck, 03-486 at 6, 862 So.2d at 1093 (internal quotations and citations omitted).5
Smitty‘s urges this court to adopt the diverging view of another circuit court. In Moran v. Rouse‘s Enters., LLC, 19-239 (La. App. 5 Cir. 12/26/19), 286 So.3d 1245, the Fifth Circuit upheld the retroactive forfeiture of benefits from the date of the accident for an intentional false statement, which the employee made in her deposition mid-claim. Before the deposition, the employer had contested the employee‘s entitlement to any benefits based on an intoxication defense. Id., 19-239 at 2, 286 So.3d at 1247. The court of appeal held that the statutory language “shall ... forfeit any right to compensation benefits” requires the forfeiture of all benefits, regardless of when the fraudulent conduct or misrepresentation occurs. Id., 19-239 at 11, 286 So.3d at 1252-53. The court found its holding was consistent with this court‘s analysis in Duplessis and agreed with Chief Judge Carter‘s dissent in Leonard, that if the legislature had intended to limit the application of time, as it did in
The split in the circuits regarding the interpretation of
It is presumed that every word, sentence, or provision was intended to serve some useful purpose, that some effect is to be given to each such provision, and that no unnecessary words or provisions were employed. McGlothlin v. Christus St. Patrick Hosp., 10-2775, p. 11 (La. 7/1/11), 65 So.3d 1218, 1228. Courts are bound, if possible, to give effect to all parts of a statute and to construe no sentence, clause, or word as meaningless and surplusage if a construction giving force to, and preserving, all words can legitimately be found. Id.
Furthermore, a statute should be construed in such way as to reconcile, if possible, apparent inconsistencies so that each part is given effect. Luv N’ Care, Ltd. v. Jackel Int‘l Ltd., 19-0749, p. 8 (La. 1/29/20), 347 So.3d 572, 578. Since the meaning is to be determined from a general consideration of the act as a whole, all parts, provisions, or sections must be read together; each must be considered with respect to, or in the light of, all the other provisions, and construed in harmony with the whole. Id. The intent as deduced from the whole will prevail over that of a
This court previously declared
Comparing Subsections D and E and recognizing that Subsection D specifies a time limited remedy while Subsection E does not, this court does not find, as Smitty‘s suggests, that the legislature‘s omission in Subsection E signals an
Reading Section 1208 as a whole, the phrase “any right to compensation benefits” is “quantitative, not temporal” and applies to benefits accruing after the misrepresentation only. See Leonard, 03-0040 at 9, 879 So.2d at 730. Stated another way, the quoted phrase addresses the amount of the benefits forfeited but not the timeframe covered by the forfeiture. Where the employer successfully proves a violation of Section 1208, the WCJ may order restitution for benefits obtained through the fraud under Subsection D and shall order forfeiture of benefits accruing after the fraud under Subsection E. Reading these subsections together and in light of one another to afford meaning to each, we find that the forfeiture is effective at the time of the misrepresentation, rather than at the time of the accident.
This court has commented on the balancing of interests and tradeoffs inherent within the application of the Act. We described the “quid pro quo” underlying the
The [A]ct, which is social legislation, was passed for the joint benefit of labor and management in order to insure that employees who became disabled as a result of their labors in hazardous industries would have, during the period of their disability, a weekly income for the upkeep of themselves and their families. It was also deemed advisable to provide for compensation, in cases of death, to the persons dependent upon the employee for support so that these persons would not be entirely bereft of funds during the period of time following the employee‘s death when they, of necessity, were compelled to reconstruct their lives and seek a means of support,—thus avoiding the possibility that these persons would become publiс charges. In order that this end might be accomplished, the Legislature provided for sacrifices to be made by both the employer and the employee. The employee was required to waive the right granted him under the general law,
Article 2315 of the Civil Code , in consideration of receiving a fixed percentage of his wages during the period of his disability. The employer, on the other hand, was deprived of the defenses afforded to him by the general law and he was assured that, in case any of his employees were injured, they would be entitled to no more than the amount stipulated in the statute as compensation during the period of disability.
O‘Regan v. Preferred Enters., Inc., 98-1602, p. 5 (La. 3/17/00), 758 So.2d 124, 128-29 (quoting Atchison v. May, 201 La. 1003, 10 So.2d 785, 788 (1942)).
Having recognized that the Act supplies benefits in exchange for forgoing a tort remedy, this court also observes in the Act a tradeoff between penalties and forfeiture. The balance between penalties and forfeiture, and the need for the Act to function as a fair trade, is particularly salient where, as here, no party has clean hands. The employer failed to institute benefits or pay medical bills when due and was assessed with penalties and attorneys’ fees as the Act provides under
The Act supplies penalties and attorney‘s fees, which are “imposed to discourage indifference and undesirable conduct by employers and insurers” that have failed to timely comply with their obligations to pay benefits to employees who have sustained compensable injuries. See Williams v. Rush Masonry, Inc., 98-2271 (La. 6/29/99), 737 So.2d 41, 46. A finding that Section 1208 applies retroactively to the date of the accident would alleviate the employer‘s obligation under
Any other interpretation would have the effect of promoting a system whereby the employers would fail to commence the payment of workers’ compensation benefits in the hope of a future false statement which would relieve it completely of the obligation of paying workers’ compensation benefits, including its own actions which would be punishable under the Workers’ Compensation Act.
Apeck, 03-486 at 6, 862 So.2d at 1093.
While Mr. Cousain‘s misrepresentation resulted in the forfeiture of his benefits as of the date of the lie, he was due benefits before that time for a period of
CONCLUSION
Reading the statute as a whole and in the broader context of the Act, we hold that an employee found in violation of
DECREE
AFFIRMED.