Cain v. Aquarius Builders, Inc.

680 So. 2d 69, 96 La.App. 5 Cir. 66, 1996 La. App. LEXIS 1503, 1996 WL 422222
CourtLouisiana Court of Appeal
DecidedJuly 30, 1996
Docket96-CA-66
StatusPublished
Cited by10 cases

This text of 680 So. 2d 69 (Cain v. Aquarius Builders, 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
Cain v. Aquarius Builders, Inc., 680 So. 2d 69, 96 La.App. 5 Cir. 66, 1996 La. App. LEXIS 1503, 1996 WL 422222 (La. Ct. App. 1996).

Opinion

680 So.2d 69 (1996)

Jeffrey A. CAIN
v.
AQUARIUS BUILDERS, INC.

No. 96-CA-66.

Court of Appeal of Louisiana, Fifth Circuit.

July 30, 1996.
Rehearing Denied October 17, 1996.

*71 J. Paul Demarest, Angela C. Imbornone, Michelle R. Demarest, Favret, Demarest, Russo & Lutkewitte, New Orleans, for Plaintiff/Appellee, Jeffrey A. Cain.

Denis Paul Juge, Mayra Leyva, Juge, Napolitano, Leyva & Guilbeau, Metairie, for Defendants/Appellants, Aquarius Builders, Inc.

Before GAUDIN, BOWES, and WICKER, JJ.

BOWES, Judge.

Defendants, Aquarius Builders, Inc., and Louisiana Workers' Compensation Corporation, appeal from a judgment finding that the plaintiff is entitled to further medical benefits under the Louisiana Workers' Compensation Statutes and also finding that they were arbitrary and capricious in their failure to pay same.

PROCEDURAL HISTORY

Jeffrey Cain was injured on August 20, 1993 when he fell off a roof while in the course and scope of his employment with defendant. He collected medical benefits and temporary total disability until February 2, 1994, when he was released to work by his treating physician.

Plaintiff filed a disputed claim for compensation on February 18, 1994. He supplemented his claim with an amended petition to claim data form and disputed claim for compensation form, which the trial court ordered filed on August 30, 1994. In this amended petition, plaintiff also requested authorization to select a new treating physician. On October 11, 1994, plaintiff filed a request for independent medical examination with the Office of Workers' Compensation. The request was denied by the Office on October 20, 1994. Pursuant to plaintiff's request to change treating physician, a hearing was held on January 23, 1995. Judgment was rendered on February 22, 1996 denying the plaintiff's request. Trial on the merits was had on August 2, 1995. The trial court rendered judgment on September 6, 1995 awarding medical benefits and finding that the defendant was arbitrary and capricious in its failure to pay same. On the court's own motion, the judgment was amended on September 8, 1995 to assess penalties of *72 $2,000.00 for defendant's arbitrary and capricious failure to pay. Defendants appeal.

FACTS

The following facts were stipulated at trial:

1. That claimant, Jeffrey Cain, sustained an injury to his left shoulder on August 20, 1993 while in the course and scope of [h]is employment with Aquarius Builders, Inc.

2. That claimant was paid a total of $2,555.31 in temporary total disability benefits through February 2, 1994 and [benefits] were terminated based on his release to return to work by Dr. Rozas.

3. That medical expenses of $4,649.57 were paid to or on behalf of claimant.

The testimony regarding Mr. Cain's injury which was presented at trial is as follows:

Jeffery Cain testified that he fell off a roof and hurt his left shoulder in August of 1993. The defendant employer sent him to Dr. Calhoun, who referred plaintiff to Dr. Earl Rozas, an orthopaedist. Plaintiff was treated by Dr. Rozas, who performed surgery on that shoulder. Dr. Rozas released him to work in February of 1994; however, at that time he was still complaining of pain in his shoulder. Cain testified that when he told Dr. Rozas that he was in still in pain, Dr. Rozas told him that there was no further treatment available and that Cain should learn to be right handed.

Cain further testified that, because Dr. Rozas could offer no further relief, he went to see Dr. George Murphy, an orthopedist, who recommended arthroscopic surgery.

Cain also testified that subsequent to his first visit with Dr. Murphy, he had sustained a whiplash injury in an automobile accident when his car was hit in the rear. Cain testified that he had recovered fully from the accident and, at the time of trial, suffered from the same kind of pain he had suffered from prior to the automobile accident.

At the time of trial, Cain was employed because he said he needed to make a living. He has continued to work for the two year period prior to trial despite his continued complaints of pain. He testified that, at the time of trial, his shoulder was still very painful, and that if he had worked hard during the day, he would suffer an extremely painful night. Cain further testified that although Dr. Murphy had prescribed pain medication, he was unable to take it while working because it was a narcotic which made him sleepy.

Dr. Rozas testified by deposition that he first saw Cain on September 15, 1993. At that time he observed that Cain had some light swelling of left shoulder, with tenderness greatest around trapezius muscles and a painful range of motion in all directions. An x-ray of Cain's shoulder revealed a fracture through the distal portion of the clavicle without any displacement. As a result, Dr. Rozas diagnosed a fracture and contusion, he prescribed an arm sling, analgesics and muscle relaxants, and he placed Cain on no-work status.

Dr. Rozas next saw Cain two weeks later on September 21, 1993. X-rays showed an essentially healed fracture of the distal clavicle. Dr. Rozas prescribed a decreased use of the arm sling and physical therapy.

Cain's next visit to Dr. Rozas was on October 12, 1993. At that time, Cain complained of pain and a decreased range of motion. Because Cain had only attended two physical therapy sessions, Dr. Rozas discussed the importance of physical therapy.

Cain returned to Dr. Rozas on October 27, 1993, with continued complaints of pain. At that time, Cain had been actively participating in the physical therapy prescribed by Dr. Rozas. Rotation of the shoulder revealed crunching, grating and cracking of the AV joint. X-rays revealed hypertrophic (some excessive) bone formation in the form of bone spikes protruding into the AV space. Dr. Rozas also observed a torn cartilage and a torn meniscus, which had occurred at the time of the injury. These same symptoms were present on Cain's next visit on November 17, 1993.

On November 26, 1993, Dr. Rozas performed a "Mumford" surgery on Cain's shoulder. This surgery involves excising the distal half inch of the collarbone and removal of the torn cartilage. Cain suffered no post operative problems.

*73 Dr. Rozas saw Cain eight times from the date of surgery until February 23, 1994. During that time period, Cain regained full range of motion of the injured shoulder but Cain continued to complain of pain. On the February 2, 1994, Dr. Rozas determined that Cain could return to work and work through his post-operative pain and discomfort so he released Cain to work on February 3, 1994. Dr. Rozas next examined Cain on February 23, 1994, at which time he discharged him from treatment.

Cain sought treatment from Dr. Rozas twice more, on July 26 and August 31, 1994 and he complained of continual pain; however, Dr. Rozas could find no objective findings. He told Cain to continue working. At trial, Dr. Rozas testified that he does not feel that Cain is insincere in his complaints of pain, but he did think that Cain was able to continue working with the pain.

On cross-examination, and in response to Dr. Murphy's diagnosis, discussed, infra, Dr. Rozas testified that cartilage in Cain's shoulder was removed during the Mumford surgery, so that Cain could not have had torn cartilage in his shoulder. However, he could be suffering from impingement syndrome,[1] which was not uncommon with Cain's type of injury. Dr.

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Bluebook (online)
680 So. 2d 69, 96 La.App. 5 Cir. 66, 1996 La. App. LEXIS 1503, 1996 WL 422222, Counsel Stack Legal Research, https://law.counselstack.com/opinion/cain-v-aquarius-builders-inc-lactapp-1996.