Cajun Rental & Services v. Hebert

918 So. 2d 605, 2005 La.App. 3 Cir. 482
CourtLouisiana Court of Appeal
DecidedDecember 30, 2005
Docket05-482
StatusPublished
Cited by3 cases

This text of 918 So. 2d 605 (Cajun Rental & Services v. Hebert) 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
Cajun Rental & Services v. Hebert, 918 So. 2d 605, 2005 La.App. 3 Cir. 482 (La. Ct. App. 2005).

Opinion

918 So.2d 605 (2005)

CAJUN RENTAL & SERVICES
v.
Edwin "Sonny" HEBERT.

No. 05-482.

Court of Appeal of Louisiana, Third Circuit.

December 30, 2005.

Mark L. Riley, Onebane Law Firm, Lafayette, Counsel for Plaintiff/Appellee: Cajun Rental & Services.

*606 Jason M. Welborn, Lafayette, Counsel for Defendant/Appellant: Edwin "Sonny" Hebert.

Court composed of JIMMIE C. PETERS, MARC T. AMY, and ELIZABETH A. PICKETT, Judges.

AMY, Judge.

In this workers' compensation matter, the insurance company contends that the claimant employee has violated La.R.S. 23:1208 thereby forfeiting his rights to further workers' compensation benefits. The workers' compensation judge found that the claimant intentionally misrepresented his abilities for the purpose of bolstering his entitlement to workers' compensation benefits. The claimant appeals, arguing that the workers' compensation judge committed manifest error in terminating benefits after finding that a violation of La.R.S. 23:1208 had occurred. For the following reasons, we affirm.

Factual and Procedural Background

The record indicates that Edwin "Sonny" Hebert and his wife owned and operated Cajun Rental & Services, Inc (hereinafter "Cajun Rental"). According to Mrs. Hebert, Cajun Rental had mowing contracts with the State of Louisiana and the City of Lafayette. Mr. Hebert was the corporation's operations manager. Mr. Hebert testified that his duties included operating equipment during the day and repairing any equipment that was broken.

The underlying accident in this workers' compensation matter occurred on July 12, 2001, when Mr. Hebert and his crew were preparing to leave a job site. Mr. Hebert was attempting to load a four wheeler onto the back of a pickup truck when it flipped over and rolled over him. The record shows that Mr. Hebert sustained serious injuries to both shoulders, his left knee, and several nerve bundles. The occurrence of the work-related accident is not at issue.

Since the accident, Mr. Hebert has been under the primary care of his orthopedic surgeon, Dr. Roland Miller, and has been referred to different physicians for evaluation and treatment of his injuries. Medical records establish that Mr. Hebert had surgery on his right shoulder to repair a tear of the right rotator cuff. The surgery adequately repaired the tear. However, according to Dr. Miller, complications from the surgery left Mr. Hebert with a detached deltoid muscle in his right shoulder. Surgery was also performed on Mr. Hebert's left knee which, according to Dr. Miller, was successful in repairing his medial meniscus and condylar damage.

Dr. Miller requested that Mr. Hebert be evaluated by the Center for Work Rehabilitation, Inc. at the Fontana Center for the performance of a functional capacity evaluation ("FCE"). Mr. Hebert completed a FCE on February 3, 2003 and February 4, 2003. Scott Guidry, the occupational therapist performing the FCE, concluded that Mr. Hebert could not return to his previous work level, but he could safely work at a light-medium work level. Mr. Guidry made a number of findings as to Mr. Hebert's abilities that were questioned by Dr. Miller.

Mr. Hebert did not agree with the FCE report and, in a February 10, 2003 letter, pointed out to his medical case worker what he believed were discrepancies in his evaluation. Mr. Hebert was particularly concerned with the FCE report's findings as to the physical activities he could perform. In addition, Mr. Hebert complained of certain conditions under which he alleges the FCE was performed. Further, he insisted that he signed the FCE report under duress. Mr. Guidry and Paul Fontana, the owner of the Fontana Center, *607 testified at the hearing and denied many of Mr. Hebert's allegations.

Subsequently, Highlands Insurance Company, the workers' compensation insurer for Cajun Rental, hired a private investigator, to conduct surveillance of Mr. Hebert. Videotape segments of a number of surveillance periods were entered into evidence. Highlands contends, in its brief to this court, that the videotapes reveal Mr. Hebert "engaging in other activities that he contended he could not do. (Driving far distances, operating an ATV, and using his arms and legs in various ways.)" One of the surveillance tapes dated October 16, 2003 relates to Mr. Hebert's presence at a church where Highlands contends he was hired to provide "equipment and services[.]"

As a result, Highlands terminated Mr. Hebert's benefits and filed a disputed claim form contending that Mr. Hebert violated La.R.S. 23:1208 and as such forfeited his rights to further benefits. Specifically, Highlands asserted that Mr. Hebert misrepresented to both Highlands and his physicians his activity level and residual abilities, misrepresented activities and abilities related to his FCE, and denied engaging in work for which he has been recompensed. Mr. Hebert also filed a form claiming that Highlands unreasonably terminated his benefits.

After a hearing, the workers' compensation judge found that Mr. Hebert had intentionally misrepresented his abilities for the purpose of bolstering his entitlement to workers' compensation benefits. Therefore, benefits were forfeited pursuant to La.R.S. 23:1208.

In the instant appeal, Mr. Hebert has designated the following assignments of error:

I. The trial Court committed manifest error and abused its discretion in terminating claimant/appellant's workers' compensation benefits.
II. The trial Court committed manifest error in finding Mr. Hebert had violated Louisiana Revised Statute 23:1208, despite uncontroverted medical evidence establishing the extent and nature of his disability.
III. The trial Court committed manifest error in finding that defendant, Highland, established a "willful misrepresentation" for the purpose of obtaining benefits, as required by La.R.S. 23:1208.

Discussion

Violation of La.R.S. 23:1208

Mr. Hebert argues that the trial court was manifestly erroneous in concluding that Highlands demonstrated that the requirements of La.R.S. 23:1208 were satisfied by any of his statements or representations. In part, Mr. Hebert focuses upon medical evidence suggesting the severity of his injuries. He contends that the weight of this evidence indicates that findings as to his ability to work in the FCE were incorrect. Furthermore, he questions the workers' compensation judge's observation that, although he reported to his physician that he was able only to sit for a limited period of time, that he appeared to sit throughout the hearing without difficulty. He notes that the report to his physician was made over two years before the hearing. Finally, he contends that surveillance videotape of him engaging in alleged work does not reveal either that he was working at the time of the filming or that he was engaging in any activities that he asserted that he could not perform. He argues that any such activities caused substantial pain or were not sustainable. In short, Mr. Hebert contends that the evidence lacks sufficient weight to indicate that he made willful *608 misrepresentations in any regard in order to affect his eligibility for workers' compensation benefits.

Louisiana Revised Statutes 23:1208 provides, in pertinent part:

A. It shall be unlawful for any person, for the purpose of obtaining or defeating any benefit or payment under the provisions of this Chapter, either for himself or for any other person, to willfully make a false statement or representation.

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Bluebook (online)
918 So. 2d 605, 2005 La.App. 3 Cir. 482, Counsel Stack Legal Research, https://law.counselstack.com/opinion/cajun-rental-services-v-hebert-lactapp-2005.