Breaux v. Marine Elec. & Reliance Ins. Co.

369 So. 2d 196
CourtLouisiana Court of Appeal
DecidedJune 11, 1979
Docket6827
StatusPublished
Cited by13 cases

This text of 369 So. 2d 196 (Breaux v. Marine Elec. & Reliance Ins. Co.) 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
Breaux v. Marine Elec. & Reliance Ins. Co., 369 So. 2d 196 (La. Ct. App. 1979).

Opinion

369 So.2d 196 (1979)

Elmo BREAUX, Plaintiff and Appellee,
v.
MARINE ELECTRIC AND RELIANCE INSURANCE COMPANY, Defendants and Appellants.

No. 6827.

Court of Appeal of Louisiana, Third Circuit.

March 7, 1979.
Rehearing Denied April 19, 1979.
Writ Refused June 11, 1979.

*197 Lewis & Lewis, James T. Guglielmo, Opelousas, for defendants and appellants.

Shelton & Legendre, Thomas Robert Shelton, Lafayette, for plaintiff and appellee.

Before CULPEPPER, FORET and DOUCET, JJ.

CULPEPPER, Judge.

This is a suit for workmen's compensation benefits. The plaintiff, Elmo Breaux, contends he is totally and permanently disabled as the result of back injuries suffered on September 17, 1976 while employed by the defendant, Marine Electric. The trial judge found plaintiff totally and permanently disabled and awarded $77.60 per week for the period of disability beginning September 17, 1976. Additionally, the trial court awarded penalties and attorney's fees. The defendants, Marine Electric and its insurer, Reliance Insurance Company, appealed.

The issues on appeal are: (1) Was there an accident on September 17, 1976? (2) If such an accident did occur, what is the extent of the plaintiff's disability? (3) Were the defendants arbitrary and capricious in their termination of workmen's compensation benefits as of April 22, 1977, subjecting them to penalties and attorney's fees? (4) Were the defendants arbitrary and capricious in their failure to resume compensation benefits upon the receipt of medical bills, subjecting them to penalties and attorney's fees? (5) If the defendants were arbitrary and capricious, was the award of $7,500 for attorney's fees so excessive as to require a reduction by the appellate court?

THE ACCIDENT

Plaintiff alleges that on September 17, 1976 he injured his back while attempting to lift a large air conditioner compressor. His fellow worker and brother-in-law corroborated the plaintiff's claim that while lifting, he felt something pop in his back. He immediately quit working allowing the other workers to finish the job. Because it was lunchtime and the plaintiff was not working at the office location, he went home for lunch. He did not return to work that afternoon because of the pain. After lunch, the brother-in-law reported the accident. There is a record of the accident in the company's files, but it indicates that the accident occurred in the office warehouse while the plaintiff was moving an appliance. The plaintiff contends that his supervisor put this in the report despite his protestations that the location of the accident was not correct.

The trial judge found that there was in fact an accident on September 17, 1976 which caused the plaintiff's injuries. In view of the testimony outlined above, we hold that the trial court's finding of an injury on September 17, 1976 is not clearly wrong under the standard of appellate review of fact enunciated by the Supreme Court in Arceneaux v. Domingue, 365 So.2d 1330 (La.1978).

EXTENT OF DISABILITY

The next issue is the extent of plaintiff's disability. After the accident on September 17, 1976, plaintiff sought medical help on September 20, 1976 from Dr. Philip Purpera, a general practitioner. This doctor found lumbar spasm and referred plaintiff to an orthopedic surgeon, Dr. Blanda, who *198 confirmed Purpera's diagnosis of lumbar spasms and treated the patient conservatively for several months. In January of 1977, Dr. Blanda ordered a myelogram, which was negative. However, Dr. Blanda did note that the plaintiff's anuli meningeal index was enlarged, indicating a possible disc problem. Dr. Blanda then referred the plaintiff to Dr. Robert Martinez, a neurologist, to determine whether the patient suffered a neurological deficit. Dr. Martinez examined the plaintiff on January 31, 1977 and found no neurological abnormalities.

In a report to Reliance dated February 8, 1977, Dr. Blanda stated:

"PATIENT: BREAUX, ELMO DATE: 2/8/77
"FOLLOW UP VISIT: He still complains of some back pain. Neurological report from Dr. Martinez says that he does not feel that this man has a herniated disc. I think our investigative measures are complete. I have released him to return to work at light duty. I feel that he has only a chronic lumbar strain and should be able to return to work." (Emphasis added)

In a report to Reliance dated April 6, 1977, Dr. Blanda stated:

"PATIENT: BREAUX, ELMO DATE: 4/6/77
"The patient still complains of back pain. His exam again today was normal. It is my opinion that this man should return to work although he still complains of the pain in the lumbar area. All evaluations from neurology neurologic consultations have been normal yet he feels that his back is still working (sic) and he cannot return to his normal activities."

On receipt of Dr. Blanda's April 6, 1977 report that plaintiff could return to his normal duties, Reliance terminated compensation payments as of April 22, 1977.

After the termination of compensation benefits, plaintiff did not return to work. He continued to see Dr. Blanda and to complain of pain. Suit was filed on June 21, 1977. When Dr. Blanda examined the plaintiff on June 27, 1977, the pain running down the right leg had reoccurred. On July 11, 1977, Dr. Blanda performed a discogram, a procedure whereby a dye is injected directly into the disc to show whether there is any abnormality. This test was positive for a ruptured disc at L5-S1. A surgical laminectomy was performed on July 12, 1977. Plaintiff was discharged from the hospital on July 19, 1977.

Insofar as the record shows, Dr. Blanda last examined the plaintiff on August 29, 1977. He testified that on this examination plaintiff was recovering normally from surgery, but that he could not perform heavy labor. The doctor was of the opinion that it was not long enough after surgery to give a final rating of disability, but he stated that if plaintiff continued to progress as well as he had, he should only have about a 5% residual disability of the body as a whole. The doctor could express no opinion as to whether plaintiff would be able to return to the heavy labor involved in the work he was performing at the time of the accident, but he stated that he thought plaintiff would certainly be able to return to gainful employment. The doctor stated that, as a general rule, a final estimate of residual disability could not be made until six months after such disc surgery.

Under these facts we will first address the question of the extent of plaintiff's disability. Since the accident occurred on September 17, 1976, the 1975 amendments to the Workmen's Compensation Act are applicable. LSA-R.S. 23:1221(1) defines temporary total disability as follows:

"(1) For injury producing temporary total disability of an employee to engage in any gainful occupation for wages whether or not the same or a similar occupation as that in which the employee was customarily engaged when injured and whether or not an occupation for which the employee, at the time of injury, was particularly fitted by reason of education, training, and experience, sixty-six and two-thirds per centum of wages during the period of such disability."

LSA-R.S. 23:1221(2) defining "permanent total disability" is exactly the same as *199

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Bluebook (online)
369 So. 2d 196, Counsel Stack Legal Research, https://law.counselstack.com/opinion/breaux-v-marine-elec-reliance-ins-co-lactapp-1979.