An employee suffering an injury at work can be concerning for both the employee and employer. This concern can be increased when the injury sustained at work is an aggravation of a previous injury. However, as one Louisiana individual discovered, providing solid evidence backing your workers’ compensation claim can be critical to the lawsuit.
Mrs. Alexander worked as an administrative assistant at Stupp Bros in Baton Rouge. On February 12th, 2015, Mrs. Alexander was asked to order toner for the printer. Mrs. Alexander had to obtain the serial number from the back of the printer to collect toner and kneel down to acquire the serial number. While kneeling down and pulling the printer off the wall, Mrs. Alexander felt a tear on her back. Mrs. Alexander fell over and was transported Mrs. Alexander to Prime Medical with some assistance.
While at Prime Medical, Mrs. Alexander was diagnosed with a lower back strain, given over-the-counter medications, and was given a release to return to work. Mrs. Alexander complained about pain and said she had undergone two previous back surgeries while visiting Prime Medical. Four days after the accident, Mrs. Alexander went to the emergency room at Lane Regional Medical Center. An M.R.I. performed on Mrs. Alexander revealed several issues involving a disc in her back.
After the M.R.I., Mrs. Alexander met with Dr. Oberlander. Dr. Oberlander performed an M.R.I. on Mrs. Alexander and submitted a request for surgery on June 18th, 2015. This request was denied because a second opinion was required. Due to denying the request, Mrs. Alexander met with Dr. Owen. Dr. Owen reviewed the M.R.I. and determined that the back surgery would be premature. Since the opinions of these two doctors differed, Stupp requested an independent medical examination (IME). The doctor appointed for this was Dr. Ioppolo. Dr. Ioppollo determined that Mrs. Alexander was a surgical candidate, but that other conservative care should be undertaken before surgery.
Mrs. Alexander continued to see Dr. Oblerander to obtain other conservative care. After meeting with Mrs. Alexander for much of 2016, Dr. Oberlander noted that the back injuries had worsened. However, Mrs. Alexander needed a neuropsych evaluation before the surgery could occur. Dr. Oberlander had a rehab conference with Stupp’s medical case manager and expressed that the work-related injury likely worsened cervical spondylosis. Mrs. Alexander met with Dr. Frey in March 2016. Dr. Frey concluded that Mrs. Alexander’s symptoms and behavior that she verbally expressed should not be used in the decision-making process of whether or not to proceed with surgery.
Stupp paid Mrs. Alexander $610.22 every week, beginning from the date of the accident. Stupp then filed a petition under La. In R.S. 23:1314(E), Stupp sought a declaration of the compensation that Mrs. Alexander owed. Stupp alleged four things. One that Mrs. Alexander had not suffered a compensable injury on the day of the accident. Two, the extent to which Mrs. Alexander sustained an injury to her lower back, Mrs. Alexander did not injure her neck. Three, Mrs. Alexander was not entitled to compensation benefits due to fraud and misrepresentation.
The Office of Workers’ Compensation (“O.W.C.”) ruled in favor of Mrs. Alexander. Stupp then appealed the decision of the O.W.C. to the First Circuit Court of Appeal for Louisiana. On appeal, Stupp argued that the O.W.C.’s holding was incorrect for four reasons. First, Mrs. Alexander forfeited benefits under La. R.S. 23:1208 by misrepresentation. Second, the accident did not occur on February 12th, 2015. Third, the determination that Mrs. Alexander injured her neck on the day of the incident was incorrect. Fourth, Mrs. Alexander did not need neck surgery from the incident.
The first issue for the Court of Appeal to determine was if the O.W.C. was correct in finding that Mrs. Alexander had not violated La. R.S. 23:1208(E). An employee forfeits workers’ compensation rights if the employee makes a false statement or representation, the employee willfully makes the statement, and the statement is made to gain or defeat a benefit. Our Lady of the Lake Regional Medical Center v. Mire, 142 So.3d 52, 56 (La. Ct. App. 2014). The Court of Appeal determined that the Trial Court was correct when determining that Mrs. Alexander was not violating La. R.S. 23:1208(E). The court came to this conclusion because although Dr. Frey noted that Mrs. Alexanders’ expression surrounding her back pain should not be considered when determining whether or not to proceed with surgery, there was objective medical evidence that Mrs. Alexander was suffering from back pain.
The next issue for the Court of Appeal to determine was if O.W.C. was correct when finding that a work-related accident had occurred on February 12th, 2015. The Court of Appeal also needed to determine if there was an injury that day if Mrs. Alexander’s neck and back were injured on the day of the accident. The employee in a compensation action is the party that is required to establish that an accident occurred out of and in the course of employment, which caused the injury. La. R.S. 23:1031(A). An accident is an identifiable event that happened suddenly, with or without human fault, and directly produced the injury that occurred. La. R.S. 23:1021(A).
The testimony of an employee can be sufficient to satisfy the burden of proof required in an employee compensation action if two conditions are met. No other evidence discredits the version of the story that the employee provides. Two other circumstances after the incident validated the employee’s testimony. Bruno v. Harbert Intern. Inc., 593 So.2d 357, 361 (La. 1992); Vargas v. Petrin Corp., 115 So.3d 483, 487 (La. Ct. App. 2013). Such validation can occur from the testimony of co-workers, spouses, friends, or through medical evidence. Ardoin v. Firestone Polymers, L.L.C., 56 So.3d 215, 218 (La. 2011).
The Court of Appeal determined that the Trial Court was correct when holding that the work-related accident had occurred on February 12th and that Mrs. Alexander hurt her back and neck on the day of the accident. The Court of Appeal came to this decision because Mrs. Alexander’s testimony was validated by the deposition provided by Dr. Oberlander and the M.R.I. Additionally, no evidence conflicted with the testimony that Mrs. Alexander provided.
The final issue for the Court of Appeal to determine was if the neck surgery recommended by Dr. Oberlander was warranted. Although an IME’s medical conclusions should be given significant weight (La. R.S. 23:1123), the opinion of the IME is not conclusive, and the court should consider all of the evidence presented regarding the employee’s injury. Mosley v. Pennzoil Quaker State, 850 So.2d 1100, 1103 (2003). When a court must consider the evidence provided by multiple medical experts, the testimony of the treating physician should carry more weight than the physician who sees the employee only on a few select occasions. Scott v. Wal-Mart Stores, Inc., 873 So.2d 664, 669 (La. Ct. App. 2004).
The Court of Appeal found no error by the O.W.C. when determining that Mrs. Alexander required cervical surgery as recommended by Dr. Oberlander. The Court of Appeal came to this decision because the O.W.C. correctly gave more weight to the physician treating Mrs. Alexander, Dr. Oberlander.
This case demonstrates the importance of a knowledgeable attorney in workers’ compensation. Not only did the attorney representing Mrs. Alexander achieve the client’s desired result, but the attorney fended off an appeal that could have been costly to Mrs. Alexander. Therefore, such an experienced attorney can be a necessary tool in a worker’s compensation lawsuit.
Additional Sources: STUPP BROS., INC. D/B/A STUPP CORPORATION VERSUS ALMA ALEXANDER
Written by Berniard Law Firm Blog Writer: Brandon Tuley
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