Bossier Elec. v. Cubley

821 So. 2d 685, 2002 WL 1301276
CourtLouisiana Court of Appeal
DecidedJune 14, 2002
Docket35,852-WCA, 35,853-WCA
StatusPublished
Cited by10 cases

This text of 821 So. 2d 685 (Bossier Elec. v. Cubley) 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
Bossier Elec. v. Cubley, 821 So. 2d 685, 2002 WL 1301276 (La. Ct. App. 2002).

Opinion

821 So.2d 685 (2002)

BOSSIER ELECTRIC, Appellant
v.
George CUBLEY, Appellee.
George Cubley, Appellee
v.
Bossier Electrical Contractors, Inc., Appellant.

Nos. 35,852-WCA, 35,853-WCA.

Court of Appeal of Louisiana, Second Circuit.

June 14, 2002.

*686 Christopher R. Phillip, for Appellant.

William R. Long, Shreveport, for Appellee.

Before NORRIS, WILLIAMS and PEATROSS, JJ.

*687 WILLIAMS, Judge.

In this worker's compensation case, the employer, Bossier Electrical Contractors, Inc., appeals a judgment finding that the claimant, George Cubley, was entitled to temporary total disability benefits and supplemental earnings benefits, subject to a credit for the employer's prior payments. The worker's compensation judge denied the employer's claim for forfeiture and reimbursement of benefits paid and assessed penalties and attorney fees. For the following reasons, we reverse in part and affirm in part.

FACTS

The claimant began working as an electrician at Bossier Electrical Contractors, Inc. ("BEC") in April 1998. At that time, he completed an employee health questionnaire and did not list all of his prior surgical procedures. Claimant had been previously diagnosed with carpal tunnel syndrome and had undergone surgery on his left wrist in 1997. Despite this condition, claimant had been able to perform his duties as an electrician.

On August 12, 1999, claimant injured his left elbow pulling cable through a conduit while working for BEC at a college in Shreveport. The claimant did not seek medical treatment at the time and continued working until October 25, 1999, when he was terminated due to a reduction in BEC's workforce. On that same date, claimant saw Dr. Marion Milstead for treatment of his left elbow injury and the resulting aggravation of his carpal tunnel condition.

On December 16, 1999, BEC began paying the claimant temporary total disability (TTD) benefits at the maximum rate of $384 per week, retroactive to the date of November 11, 1999. BEC mistakenly paid claimant TTD benefits of $367 for the week of May 7-13, 2000, an under payment of $17. Thereafter, BEC resumed TTD payments of $384 weekly through October 28, 2000.

The claimant began working as an electrical inspector for the City of Shreveport on October 16, 2000, with an annual salary of $25,132. BEC began paying claimant supplemental earnings benefits (SEB) on December 1, 2000, based on his new salary. BEC did not pay SEB for the period of October 28, 2000, when the TTD payments ended, through November 30, 2000.

In December 1999, BEC filed a claim for forfeiture of claimant's benefits and reimbursement for compensation paid, contending that claimant failed to truthfully answer the health questionnaire and that he made false statements to obtain benefits in violation of LSA-R.S. 23:1208.1 and 23:1208. Claimant filed a claim alleging that BEC had failed to authorize medical treatment for his left elbow and failed to timely pay disability benefits. The claimant also sought penalties and attorney fees. The matters were consolidated for trial.

After a hearing, the worker's compensation judge (WCJ) issued oral reasons for judgment, finding that claimant had not violated the statutory forfeiture provisions and that he was entitled to medical treatment related to his left elbow injury. The WCJ rendered judgment ordering BEC to pay claimant the $17 shortage in TTD benefits and awarding claimant SEB of $642.31 for the period of October 16, 2000 through November 30, 2000, subject to a credit for TTD already paid by BEC. The WCJ assessed a penalty of $2,000 for BEC's failure to timely pay benefits and awarded claimant $4,000 in attorney fees. BEC filed a motion to modify the judgment to reflect the WCJ's finding that BEC was entitled to a credit for compensation paid prior to the disability date. *688 After a hearing, the WCJ rendered an amended judgment adding a clause that BEC was entitled to a credit for any TTD benefits paid prior to December 6, 1999, the date of claimant's disability from work. BEC appeals the judgment.

DISCUSSION

BEC contends the WCJ erred in finding that claimant was entitled to receive compensation benefits. BEC argues that claimant forfeited his right to benefits by failing to truthfully answer the health questionnaire.

A work injury subsequent to a known permanent partial disability qualifies an employer to seek reimbursement for worker's compensation benefits from a statutorily designated second injury fund under certain circumstances. Wise v. J.E. Merit Constructors, Inc., 97-0684 (La.1/21/98), 707 So.2d 1214. A claimant's untruthful statement regarding his permanent partial disability that prejudices an employer's ability to seek reimbursement from the fund gives rise to an affirmative defense, whereby the injured employee forfeits all compensation benefits. Wise, supra. A permanent partial disability (PPD) is defined as any permanent condition, whether due to injury or disease, of such seriousness as to constitute a hindrance or obstacle to obtaining employment. LSA-R.S. 23:1378(F).

An employer may inquire about previous injuries, disabilities or other medical conditions and the employee shall answer truthfully. LSA-R.S. 23:1208.1. Failure to answer truthfully shall result in the employee's forfeiture of benefits, provided that said failure directly relates to the medical condition on which the claim for benefits is based or affects the employer's ability to receive reimbursement from the second injury fund. The written form inquiring about past medical conditions must contain a notice advising the employee that failure to answer truthfully may result in forfeiture. LSA-R.S. 23:1208.1.

Thus, the statute provides for forfeiture under narrow circumstances: there must be an untruthful statement, prejudice to the employer and compliance with the notice requirements of the statute. Wise, supra. The penalty of forfeiture will be imposed only when the employer is prejudiced, i.e., when the false statement directly relates to the medical condition on which the claim for benefits is based or affects the employer's ability to receive reimbursement from the second injury fund. Resweber v. Haroil Construction Co., 94-2708 (La.9/5/95), 660 So.2d 7. The employer has the burden of proving each element of the statute. Forfeiture of benefits is a harsh remedy and the statute should be strictly construed. Wise, supra.

In the present case, the claimant was required to complete BEC's form entitled "Health Questionnaire" as part of the hiring process. Near the top of the first page, the form asked "Do you have or have you ever had any of the following?" The form contained an extensive list of medical conditions to which the employee was to mark "yes" or "no." Following this list were seven additional medical inquiries. At the bottom of the second page was a notice cautioning that the failure to answer truthfully could result in forfeiture of benefits.

In his responses, claimant wrote "yes," to a question asking if he had ever received treatment for a neck condition. When asked about prior surgery, he wrote "yes neck." In reply to a question about having any physical impairments or disabilities, claimant responded "neck surgery in 1988." He answered the question, "Have you ever had a worker's compensation injury?" by writing "Yes, nothing but *689 x-rays." Claimant responded "no" to another question: "Have you ever received compensation or medical benefits under worker's compensation?"

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Bluebook (online)
821 So. 2d 685, 2002 WL 1301276, Counsel Stack Legal Research, https://law.counselstack.com/opinion/bossier-elec-v-cubley-lactapp-2002.