Balsamo v. Jones

685 So. 2d 1140, 1996 WL 709194
Louisiana Court of Appeal·Decided December 11, 1996·No. 28885-CA·Published·Cited by 25 cases

Opinion

685 So.2d 1140 (1996)

Steven BALSAMO, Plaintiff-Appellee,
v.
Danny JONES, Defendant-Appellant.

No. 28885-CA.

Court of Appeal of Louisiana, Second Circuit.

December 11, 1996.

*1142 Patricia L. Barfield, Baton Rouge, for Defendant-Appellant.

Francis C. Broussard, Monroe, for Plaintiff-Appellee.

Before NORRIS, BROWN and WILLIAMS, JJ.

NORRIS, Judge.

The defendants, Danny Jones and Louisiana Worker's Compensation Corporation ("LWCC"),[1] appeal an order of the Worker Compensation Hearing Officer ("WCHO") in favor of the plaintiff, Steven Balsamo. The WCHO found that Balsamo sustained a workrelated injury, awarded accrued medical expenses, ordered the defendants to provide cervical, wrist and knee surgery, and assessed penalties of $750 and attorney fees of $1,000. Balsamo has answered the appeal, seeking additional attorney fees. For the reasons expressed, we amend and affirm.

Factual and procedural background

Balsamo, a concrete finisher, was hired by Danny Jones, who is apparently a general contractor with his brothers Johnny and Bobby Ray Jones. Balsamo's job was to pour and finish concrete at Kitchen Brothers Mfg., a sawmill in south Monroe; the Joneses' job was to enlarge the mill and construct an elevated conveyor belt for lumber. Balsamo's employment was on an "as needed" basis, and entailed about three days of concrete work. Balsamo usually brought one or two men to assist him; on the date of the accident, November 2, 1994, he was using Floyd Cook and Lester Hatfield. There were also employees of Kitchens Brothers and of the Joneses on the site most of the time.

When they were nearly through pouring an east-west slab on November 2, Balsamo and two of Jones's men were raking concrete as it came off the truck. According to Balsamo, he hollered to the truck driver to give another load; when he heard the truck rev up, he straightened himself, turned to guide the concrete, and struck his head on one of the steel beams that overhung the slab. He testified that he hit his forehead extremely hard, close to the bridge of his nose; he fell on one knee in reinforcement wire, where concrete had not yet been poured. Jones's men (identified by Balsamo only as "a Mexican and a black guy") helped him up, and he resumed raking. Moments later, he noticed his head was bleeding and he was dizzy, so he sat down a while. He did not finish the pour.

Balsamo testified that neither of his men saw the accident, but he told one of them, Lester, that it had happened; Lester corroborated this. Balsamo also testified that he told Johnny Jones about the accident at the end of the day, but Johnny denied it; in fact, he testified that he was supervising Balsamo the entire day and did not see any accident. One witness, William Smith, testified that he saw it and generally corroborated Balsamo's account. Smith was the cement truck driver who was waiting on Balsamo's order to break another load.

Balsamo testified he did not go to a doctor at first because he thought he would get better; however, headaches and dizziness persisted, and his left knee continued to swell, so he went to the St. Francis emergency room on November 17 and reported knee and neck pain to Dr. Charles Blackmon. A radiologist, Dr. Barraza, detected no fractures. Dr. Blackmon prescribed conservative treatment and advised follow-up with an orthopedist or neurosurgeon.

Danny Jones filed an accident report with LWCC in late November.[2] In it he related Balsamo's account of the accident, that he had hit his head on a steel beam, and "when he fell he twisted his neck, back and knee." Ex., 39.

Balsamo testified that he has worked almost continuously since the accident, albeit *1143 in some pain. He saw an orthopedist, Dr. Douglas Brown, in January 1995, again reporting that he struck his head on a beam and fell, injuring his neck and left knee. He also complained, for the first time, of numbness in his left arm and hand. Dr. Brown found no fractures, but diagnosed "left meniscal tear, post traumatic, left carpal tunnel syndrome, occupationally related, left thoracic outlet syndrome, possibly post traumatic, pre-existing degenerative C3, 4, 5 discs." His report recommended arthroscopy and partial meniscectomy of the left knee, on an outpatient basis, and a nerve conduction study on the left hand; if this showed a compressed carpal tunnel, then a carpal tunnel release could be performed at the same time as the arthroscopy. Ex., 56. In a follow-up note of April 4, 1995, Dr. Brown reiterated the need for the nerve conduction study and knee arthroscopy. There is no mention of neck surgery. The nerve conduction study, performed on April 6, showed "possible compression of the ulnar nerve at wrist and median nerve." Ex., 53.

Balsamo filed this contested claim in March 1995. He alleged that he had injured his neck and knee and, for the first time, his wrist; however, he described the accident as he "hit head on beam, fell twisting knee." R.p. 3. Jones's defense was that the accident was "staged" and Balsamo was not disabled because he worked continuously after the incident.

At the hearing in December 1995 Balsamo waived his claim for weekly benefits because he works for cash only and keeps no wage records. Balsamo and Smith testified about the accident; Hatfield and the Joneses testified that they saw no accident. Ronald Talton, an employee of Balsamo's who was not present on November 2, testified about the wage agreement between Balsamo and Jones. Nora Washington, LWCC's adjuster, testified as to her handling of the claim and decision not to pay. The St. Francis medical records were introduced in lieu of expert testimony or depositions. Regarding his disability, Balsamo stated that as a result of this accident, he injured his neck, knee and wrist, sustaining pain he had never experienced before. However, he admitted on cross examination that he had indeed suffered neck pain and headache prior to this injury, in connection with an auto accident in 1986. He also admitted on cross that he slipped and fell in Super One and sprained his ankle; although he mentioned this in a discovery deposition about one month before the hearing, defense counsel asked the WCHO to hold the record open for the hospital records of that accident. Balsamo's attorney did not object. The WCHO refused, however, citing a Hearing Officer rule.

Ruling from the bench, the WCHO found that the only disinterested witness was Smith, who saw an accident. She stated that Balsamo had trouble with his memory, but his account of the accident was consistent with his deposition and with the history he gave at St. Francis. She also noted that Balsamo related the accident to his employees, Hatfield and Talton. By contrast, she found the Jones brothers' testimony to be self-serving. She therefore accepted Balsamo's account and found a work-related accident. She found that Dr. Blackmon at St. Francis "diagnosed cervical and knee problems consistent with the accident," and that Balsamo was therefore "entitled to the recommended treatment from Dr. Brown." She also found that Dr. Brown wanted a nerve conduction study on Balsamo's left hand; she ordered this, with surgery if shown to be necessary. She awarded unpaid medical bills of $536. Finally she found Jones and LWCC were arbitrary and capricious in failing to pay the claim, so she assessed penalties of $750 and attorney fees of $1,000.

The ruling was reduced to an order of January 9, 1996, which directed the defendants to pay for the treatment recommended by Dr. Brown, "including cervical surgery, wrist surgery, and knee surgery." R.p. 171 (emphasis added).

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Balsamo v. Jones, 685 So. 2d 1140, 1996 WL 709194 (La. Ct. App. 1996).

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