Angelle Concrete, Inc. v. Sandifer

930 So. 2d 1200, 2006 La. App. LEXIS 1243, 2006 WL 1408446
CourtLouisiana Court of Appeal
DecidedMay 24, 2006
Docket2006-38
StatusPublished
Cited by2 cases

This text of 930 So. 2d 1200 (Angelle Concrete, Inc. v. Sandifer) is published on Counsel Stack Legal Research, covering Louisiana Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Angelle Concrete, Inc. v. Sandifer, 930 So. 2d 1200, 2006 La. App. LEXIS 1243, 2006 WL 1408446 (La. Ct. App. 2006).

Opinion

930 So.2d 1200 (2006)

ANGELLE CONCRETE, INC.
v.
Jerry SANDIFER.

No. 2006-38.

Court of Appeal of Louisiana, Third Circuit.

May 24, 2006.

*1201 Earl G. Pitre, Pitre, Halley & Sikich, Lake Charles, LA, for Appellee, Angelle Concrete, Inc.

Thomas E. Townsley, Lake Charles, LA, for Appellant, Jerry Sandifer.

Court composed of JOHN D. SAUNDERS, GLENN B. GREMILLION, and ELIZABETH A. PICKETT, Judges.

PICKETT, Judge.

The claimant, Jerry Sandifer, appeals a judgment of a Workers' Compensation Judge (WCJ) finding that the claimant's employer, Angelle Concrete, Inc. (Angelle), was justified in terminating his indemnity benefits. On appeal, the claimant seeks reinstatement of indemnity and medical benefits, plus penalties and attorney's fees for the defendant's arbitrary and capricious handling of his claim. We affirm in part and reverse in part the judgment of the WCJ and remand the case with instructions.

FACTS

The parties stipulated that the claimant was injured in the course and scope of his employment as a truck driver on October 29, 2003. It is also undisputed that the claimant owned and operated his own private business, a detail shop, Jerry's Soft Touch, which he opened in September 2003.

As a result of the October 29, 2003 accident, Mr. Sandifer suffered an injury to his right shoulder which was diagnosed as a rotator cuff tear. He was initially seen by Dr. Nathan Cohen, the company's choice of physicians. When Dr. Cohen recommended surgery, Mr. Sandifer decided to consult Dr. Dale Bernauer, who had operated on him previously. Dr. Bernauer concurred with Dr. Cohen, i.e., that surgery was indicated. Neither doctor felt that the claimant could continue his duties as a cement truck driver and, Mr. Sander was placed on temporary total disability (TTD) status. In November and early December 2003, the claimant was placed under video surveillance on a number of occasions. The tapes revealed the claimant working at his detail shop and at a friend's business. On December 5, 2003, the claimant executed a LDOL-WC-1025 form. The form informed the claimant that "[i]t is unlawful for you to work and receive workers' compensation benefits, except for supplemental earnings benefits." The form goes on to define supplemental earnings benefits and warns the employee that "you must notify your employer or insurer of the earning of any wages . . ." The form also warns the claimant that failure to comply with its directives can result in a fine and/or imprisonment and the loss of workers' compensation benefits.

After reviewing the surveillance tapes, the claimant's medical records, and the 1025, the adjuster for Gray Insurance Company, Angelle's workers' compensation carrier, filed a form 1008, Disputed Claim for Compensation, and terminated Mr. Sandifer's benefits effective December 21, 2003. The case came on for a hearing on May 5, 2005, and judgment was rendered in favor of the defendants on September 6, 2005. This appeal followed.

LAW AND DISCUSSION

In Dean v. Southmark Const., 03-1051, p. 7 (La.7/6/04), 879 So.2d 112, 117, the supreme court discussed the standard of review in workers' compensation cases:

In worker's compensation cases, the appropriate standard of review to be applied by the appellate court to the OWC's findings of fact is the "manifest error-clearly wrong" standard. Brown v. Coastal Construction & Engineering, Inc., 96-2705 (La.App. 1 Cir. 11/7/97), 704 So.2d 8, 10, (citing Alexander v. *1202 Pellerin Marble & Granite, 93-1698, pp. 5-6 (La.1/14/94), 630 So.2d 706, 710). Accordingly, the findings of the OWC will not be set aside by a reviewing court unless they are found to be clearly wrong in light of the record viewed in its entirety. Alexander, 630 So.2d at 710. Where there is conflict in the testimony, reasonable evaluations of credibility and reasonable inferences of fact should not be disturbed upon review, even though the appellate court may feel that its own evaluations and inferences are as reasonable. Robinson v. North American Salt Co., 02-1869 (La.App. 1 Cir.2003), 865 So.2d 98, 105. The court of appeal may not reverse the findings of the lower court even when convinced that had it been sitting as the trier of fact, it would have weighed the evidence differently. Robinson, 865 So.2d at 105.

The record establishes that the claimant suffered an on the job injury—a tear to the rotator cuff of his right shoulder. Both the company physician, Dr. Cohen and the claimant's own physician, Dr. Bernauer agreed in that diagnosis and both recommended surgery. Yet, the defendant failed to authorize the surgery, claiming it wanted another opinion. We find the defendant's refusal to authorize the surgery arbitrary and capricious and award the claimant $2,000.00 in penalties and $5,000.00 in attorney's fees for this unwarranted action.

We next address the issue of indemnity benefits. In her judgment, the WCJ found "the defendant was justified in stopping claimant's workers' compensation benefits based on claimant's representation that he could not work, yet he was working and earning money in his auto detail shop business. At the time claimant signed the Form 1025, he was earning money in his auto detail shop."

At the May 5, 2005 hearing, the claimant testified as follows:

Q. Did you read the form before you signed it?
A. Yes, sir, I did.
Q. Did you talk with your lawyer before you signed it?
A. Yes, sir, I did.
Q. Did you know what you were signing when you signed it?
A. No, sir, not really. I thought it was just a—make sure my workmen's comp keep going; that's what I thought it was for.
Q. But you called your lawyer to get advice?
A. Yes, sir, I did.
Q. And you got the advice?
A. And my lawyer's advice was to sign it and give it back, and it was told to me that everybody in the company had to sign one of those.
Q. And you knew this form is a—it's unlawful for you to work and receive workers' compensation disability benefits, right?
A. Yes, it said that.
Q. Okay. And you knew you that when you signed it?
A. I knew what it —
Q. And you knew that when you signed it?
A. My understanding when I signed that, it was that they wouldn't cut my workmen's comp out; that was my understanding.
Q. But you read it?
A. Yes, I read it.
Q. You read it? So, you read and you signed it after you talked to your lawyer?
A. That's right, I did.
Q. And you knew—you knew what you were signing; you knew you were signing this form?
*1203 A. I talked to my lawyer. My lawyer told me to sign it.
Q. How much money did you make while you were working at your Jerry's Soft Touch?
A. Not enough, that's for sure. I went in the hole.
Q. You would charge up to $65 to do a large truck?
A. A full detail, yes, sir.
Q. And 50 to $55 to detail a car?
A. Do what?
Q. 50 to $55 to detail a car?
A. Yes, sir.
Q.

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Bluebook (online)
930 So. 2d 1200, 2006 La. App. LEXIS 1243, 2006 WL 1408446, Counsel Stack Legal Research, https://law.counselstack.com/opinion/angelle-concrete-inc-v-sandifer-lactapp-2006.