Bell v. Mid City Printers, Inc.

54 So. 3d 1226, 2010 WL 5423724
CourtLouisiana Court of Appeal
DecidedDecember 22, 2010
Docket2010-CA-0818
StatusPublished
Cited by18 cases

This text of 54 So. 3d 1226 (Bell v. Mid City Printers, Inc.) 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
Bell v. Mid City Printers, Inc., 54 So. 3d 1226, 2010 WL 5423724 (La. Ct. App. 2010).

Opinion

JAMES F. McKAY, III, Judge.

| plaintiff, Johnny Bell, Jr., appeals the judgment of the Office of Workers’ Compensation, finding that back surgery was not medically necessary for the injuries sustained in his work-related accident, denying his claim for indemnity benefits, and denying his claim for penalties and attorneys’ fees. Defendant, Mid City Printers, Inc., answers this appeal, asserting that the workers’ compensation judge (“WCJ”) erred in failing to find that Mr. Bell willfully made false statements for the purpose of obtaining benefits. For the reasons set forth below, we affirm.

STATEMENT OF FACTS AND PROCEDURAL HISTORY:

On May 3, 2001, while acting in the course and scope of his employment as a delivery driver for Mid City Printers, Mr. *1230 Bell was rear-ended by an eighteen wheeler. Immediately after the accident, Mr. Bell treated at St. Tammany Hospital for neck and back pain. Mid City Printers began paying medical and indemnity benefits to Mr. Bell on May 7, 2001.

Mr. Bell treated with chiropractor Dr. Robert Thompson from May 2001 through May 2003. On May 21, 2001, Dr. Thompson released Mr. Bell to return |2to work with lifting restrictions of less than twenty pounds. On May 23, 2001, Dr. Thomson re-evaluated Mr. Bell and noted that he should be excused from work until his condition improved.

Mr. Bell returned to work with Mid City Printers approximately two weeks after the accident. Indemnity benefits were terminated on June 7, 2001, but medical benefits continued to be paid. Mr. Bell’s indemnity benefits were voluntarily reinstated on June 21, 2009.

On his return to work at Mid City Printers, Mr. Bell was offered the same number of hours at the same rate of pay. Mid City Printers made modifications for Mr. Bell, providing him assistance with heavy lifting. Mr. Bell was permitted to attend his doctors’ appointments during the work day without a reduction in pay. He was also permitted to miss work due to pain as long as he notified his supervisor. Mid City Printers treated these absences as excused absences.

On February 1, 2002, Mr. Bell was terminated from his employment for “excessive absence.” David Mack, Mr. Bell’s supervisor at the time he was terminated, testified at trial that throughout his employment (before and after the accident) Mr. Bell often missed work without calling in. He stated that he warned Mr. Bell more than once, explaining to Mr. Bell that if he kept missing work without calling in, he would be let go.

On May 2, 2002, Mr. Bell filed a disputed claim for compensation, seeking indemnity benefits, medical benefits, penalties and attorneys’ fees. Following his | ^termination from Mid City Printers, Mr. Bell worked for Sycamore Hydraulics, as a delivery driver, from July 30, 2002, until November 18, 2002.

On January 6, 2004, Mr. Bell began treating with Dr. Stefan G. Pribil, a neurosurgeon. Dr. Pribil diagnosed Mr. Bell with a disc herniation at L3-4 and L4-5 with decreased disc space at L5-S1. Dr. Pribil recommended a CT scan and opined that Mr. Bell would need surgical intervention. Dr. Pribil indicated in his January 12, 2007 report that he needed to review Mr. Bell’s MRI, but stated surgery was “an option” at that time because Mr. Bell was not improving with conservative therapy-

Mr. Bell saw Dr. Gregor J. Hoffman for an updated independent medical examination (“IME”) on August 23, 2003, October 23, 2003, and November 22, 2004. After reviewing Mr. Bell’s history and diagnostic studies, Dr. Hoffman noted degenerative disc disease at the L4-5 level together with mild bulges at L3-4 and L5-S1. Dr. Hoffman further indicated that nonoperative treatments had been exhausted, and recommended another MRI, possibly a myelogram/CAT scan. The record does not reflect any follow-up reports by Dr. Hoffman after November 22, 2004.

Mid City Printers sought a second medical opinion from Dr. Robert L. Applebaum, a neurosurgeon. Dr. Applebaum examined Mr. Bell on September 10, 2004, and reviewed Mr. Bell’s history, including Dr. Pribil’s recommendation of surgery. In March 2006, Dr. Applebaum recommended a myelogram followed by a CAT scan. Dr. Applebaum examined Mr. Bell a second time on May 21, 2007, |4and recommended that the myelogram and CAT scan be per *1231 formed. Dr. Applebaum examined Mr. Bell on November 17, 2008, and reiterated his recommendation for a myelogram and CAT scan. In a May 20, 2009 report, Dr. Applebaum indicated that he was unable to determine the medical necessity of lumbar surgery without the recommended tests. Mr. Bell testified at trial that he was unwilling to undergo the myelogram because he was told it could harm his kidneys (being diabetic) and because other doctors (Dr. Dietze and Dr. Ricciardi) said they would not recommend a myelogram.

Mr. Bell treated with Dr. David Shawa, Dr. Joseph Crapanzano, Jr., and Dr Adrian Blotner for pain management, receiving epidural steroid injections and various pain medications. Beginning July 2007, through the date of trial, Mr. Bell treated with Dr. James B. Denney for pain management. Dr. Denney prescribed pain medications and conducted random drug screenings to ascertain whether Mr. Bell was compliant with his medications.

The drug screening conducted February 1, 2008, demonstrated that Mr. Bell tested negative for his prescribed medication, Soma, in spite of the fact that Mr. Bell claimed to have taken the medication at 8:00 a.m. that morning. Mr. Bell also tested positive for marijuana at that time.

A follow-up drug screening on February 2, 2009, demonstrated that Mr. Bell tested negative for Soma and Valium (both prescribed by Dr. Denney) even though Mr. Bell indicated that he took Soma at 8 p.m. the night before and Valium at 8:00 15a.m. that morning. The screening also demonstrated that Mr. Bell tested positive for marijuana and amphetamines (not prescribed by Dr. Denney).

Dr. Denney stated in his deposition that testing negative for Soma and Valium was inconsistent with Mr. Bell’s claims that he was taking his medications as prescribed. He explained that Mr. Bell admitted to using marijuana, but claimed he did not know what amphetamines were. Dr. Den-ney found that claim to be incredulous. Dr. Denney further explained that there was some concern that Mr. Bell could have been selling his medications on the street. He considered sending Mr. Bell for substance abuse counseling, but wanted to continue his medications through surgery and make changes thereafter.

At trial, Mr. Bell stated that he could not explain the discrepancy concerning the negative test results for Soma and Valium. He admitted that he was given an amphetamine by a friend, only once in February 2009. The record reflects, however, that Mr. Bell tested positive for amphetamines and marijuana on March 12, 2008, at Lake-view Regional Medical Center Emergency Room after an automobile accident.

On February 2, 2009, after Dr. Pribil moved his practice to Texas, Mr. Bell began treating with neurosurgeon Dr. Donald D. Dietze. Following a lumbar disco-gram performed March 5, 2009, Dr. Dietze recommended a lumbar artificial disc replacement at L3-4 and L4-5 and an anteri- or lumbar interbody fusion at L5-S1.

l(;In light of the conflicting medical evidence regarding Mr. Bell’s need for surgery, the WCJ appointed orthopedic surgeon Dr. James E.

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Bluebook (online)
54 So. 3d 1226, 2010 WL 5423724, Counsel Stack Legal Research, https://law.counselstack.com/opinion/bell-v-mid-city-printers-inc-lactapp-2010.