Articles Posted in Workers Compensation

“My neck, my back, my neck and my back” is a cliche that has been used in television shows and movies when someone gets hurt in an accident and likely tends to file a lawsuit. Although Caddo Parish, Louisiana woman, Ruth Toliver, may not have used the exact phrase, she did fall on the job and filed for workers’ compensation benefits. After receiving a workers’ compensation settlement, she filed a lawsuit to recover for additional injuries.  But whether Ms. Toliver could recover twice proved another matter.   

While on the job working for Entergy Services, Inc (ESI), Ruth Toliver injured her neck and left shoulder when she fell from a three-foot high stepladder and hit the floor. She received workers’ compensation benefits shortly after the incident and continued to receive the benefits until they were terminated close to the end of 2010. Mrs. Toliver disputed the termination of benefits with the Office of Workers’ Compensation in January of 2011. Mrs. Toliver and ESI agreed to settle the matter for $58,909.93 that would be paid to Mrs. Toliver, plus all the related medical bills that she incurred prior to the date of settlement. The agreement provided that $43,909.93 of the settlement would be earmarked for a Medicare account for future medical bills. The total amount of workers’ compensation benefits that ESI paid Mrs. Toliver was $397,763.75.

The agreement released ESI from any and all liability for the work accident. About two years after signing the settlement agreement, Mrs. Toliver filed a lawsuit with the Louisiana Trial Court, claiming that in addition to her initial injuries, she also injured her head, right shoulder, and back in the fall. ESI objected to Mrs. Toliver’s lawsuit based on the settlement agreement. ESI argued that she was barred by claim preclusion because the settlement agreement was signed into a final order of approval and dismissal.  The Trial Court agreed and Mrs. Toliver appealed the decision.

An accident at the workplace is never fun, not for the employer, and certainly not for the employee.  In addition to the difficulty of the injury itself, determining who pays for the medical treatment is often in dispute.  Whether there is enough evidence to show that the accident actually caused the injury helps a judge decide if the employer is required to pay.  This connection may also play into whether the payment will be limited to a $750 cap.

Ms. Mangiaracina, an employee with Avis Budget Group, injured her shoulder, back, and thumb, at her workplace when her office chair fell forward.  Ms. Mangiaracina had a pre-existing injury to her left shoulder for which she was receiving medical treatment.  This injury did not affect her ability to work, and after the accident, her doctors found that her shoulder worsened.  She had surgery a few months later.  An adjuster for Avis’ insurer determined that all of Ms. Mangiaracina injuries were considered pre-existing and did not make any payments for the medical expenses.   Avis’ insurer responded to requests for payment by stating the need for the surgery was not related to the workers’ compensation claim.

As a result, Ms. Mangiaracina filed a disputed claim for compensation.  The Office of Workers’ Compensation ruled for Ms. Mangiaracina and awarded her temporary total disability benefits on a weekly basis against Avis. The workers’ compensation judge decided that Ms. Mangiaracina did, in fact, sustain a work-related injury, that her pre-existing injury was actually aggravated by the accident and that the surgery was reasonable.  The judge determined that she was disabled for three months after the surgery, and as a result awarded her all the related medical and transportation expenses against Avis.

In the world of workers’ compensation, being injured while on the job is an obvious requirement.  Things tend to get muddled however in these cases over accident dates, pre-existing injuries, and the actual cause of the injury.  In the following case, Carlos Harvey had all these things working against him in his claim for workers’ compensation benefits against his employer Sol’s Pipe & Steel (“Sol’s”).  

Mr. Harvey allegedly suffered a shoulder injury while pulling steel weighing between five and 550 pounds.  Initially, Mr. Harvey stated the injury occurred on August 8, 2011.  Mr. Harvey testified he reported the accident to his supervisors, T.J. Anderson and Mark Price, then reported to LSU E.A. Conway Memorial Hospital for treatment.  Mr. Harvey went to the hospital several more times and an MRI confirmed a shoulder injury.

To receive workers’ compensation benefits, an employee must show he suffered a personal injury by an accident arising out of and in the course of his employment.  La. R.S. 23:1031(A).  The employee shows an on the job injury by proving that before the accident he was in good health and his symptoms of the disabling condition appeared after the accident.  See Dow v. United Parcel Service, 124 So.3d 36 (La. Ct. App. 2013).   Additionally, the employee must bring the claim within two years of the accident.

What happens when an accident happens at the workplace? Well, you would immediately head to the doctor. You would rely on your medical records to show the truth when you talk to your insurance company. However, what happens when the medical administration doesn’t agree that your medical records are demonstrative of the truth? Strengthening your case against corporations that attempt to veil the importance of your medical records requires the very best attorneys possible.

Plaintiff James Arness Thomas was a forklift operator for Marsala Beverage Company. In November 2010, Mr. Thomas fell off of his forklift when a truck driver pulled forward unexpectedly. The defendant, Marsala Beverage Company, never disputed that the accident occurred in the course of the plaintiff’s employment and that he was injured.

At the time of his injury, the plaintiff suffered damage to his neck, back, arms, and wrists. Mr. Thomas returned to work temporarily, and then stopped working. The Marsala Beverage admitted that he was temporarily disabled, and paid Mr. Thomas compensation and medical benefits. In the meantime, Mr. Thomas consulted a long line of specialists, including orthopedists and neurosurgeons.

Workers’ compensation is a form of insurance run by the state government which pays wage replacement and medical benefits to employees injured on the job.  Temporary Total Disability Benefits or “TTD” require the employer or its workers’ compensation carrier to pay indemnity benefits roughly equal to two-thirds of the employee’s average weekly wages. But in order to benefit from TTD or other types of disability benefits, the employee must prove an inability to work and that the accident at issue arose out and in the course of his or her employment. A recent case out of the Louisiana Second Court of Appeal illustrates these requirements.

Ms. Maxwell was working as a caregiver for Care Solutions when she was attacked and severely beaten at Glenwood Regional Hospital in West Monroe.  Ms. Maxwell was attending to a client at his home. On Care Solutions’ instructions, she took him to the hospital when he complained of chest pain and breathing problems. She was assaulted by an unknown assailant in the parking lot and sustained severe injuries to her face.

Ms. Maxwell was not able to work since January 22, 2014.  She filed a disputed claim for workers’ compensation the following February because Care Solutions refused to provide her with workers’ compensation benefits.  Care Solutions admitted that she had been injured while employed with them but disputed that the injury arose out of and in course of her employment.

Companies that do business in multiple states must consider that individual states have their own laws, which must be followed if a company plans to do business in that state. It can never hurt to do your due diligence before you begin operations and a good attorney can be a vital resource. Recently, a Louisiana appellate court overturned the decision of a Worker’s Compensation Judge (WCJ) who ordered an out-of-state pharmacy to receive over $7,000 in reimbursement for providing prescription drugs to a worker’s compensation claimant over a seven-month period in 2010.

The Louisiana Second Circuit Court of Appeal held that Injured Workers Pharmacy (“IWP) was not entitled to reimbursement for fulfilled prescriptions for Oxycodone, Tizanidine, and other medications. Louisiana state law only allows an employee to seek out of state treatment and services when they are unavailable in Louisiana or are provided at similar prices to those found locally.

The case’s origins lie in a slip and fall accident at a Sonic hamburger restaurant. Clenon Naron was performing job duties in the restaurant’s freezer when he injured his back in July 1999. Naron was issued a prescription card for medications relating to the workplace injury. The claim was eventually assigned to the Louisiana Insurance Guarantor’s Association (LIGA). Naron used the prescription card to refill his prescribed medications without incident until February of the following year.

You may be entitled to compensation for any injury that occurs on the job. The extent of compensation depends on the extent of your injuries. See La. R.S. 23:1221. The employer and the employee often disagree on the amount of compensation. When this happens, a court of law often becomes the forum for resolution. Such was the case with an employee in Louisiana named Ta’Shanta Dupard.

In November 2013, a hammer fell on Ms. Dupard and struck her in the knee while she was working at MMR Construction. The blow resulted in a knee contusion and laceration, which left a permanent scar on her knee. Dupard filed a claim against her employer claiming that she was entitled to worker’s compensation benefits due to the serious and permanent disfigurement to her knee. The parties agreed that Dupard was entitled to compensation for her injuries, but disagreed as to exactly how much.

Ms. Dupard had a weekly salary of $1,058.62 at the time of her injury. According to Louisiana Worker’s Compensation laws, this yielded a maximum compensation rate of $619 per week. MMR believed that five weeks’ compensation was adequate for the scar, whereas Dupard’s attorneys claimed 25 weeks was the proper benchmark because the scar was a permanent disfigurement.