Captain v. Citgo Petroleum Corp.

940 So. 2d 731, 6 La.App. 3 Cir. 481, 2006 La. App. LEXIS 2196, 2006 WL 2781409
CourtLouisiana Court of Appeal
DecidedSeptember 27, 2006
DocketWCA 06-481
StatusPublished
Cited by5 cases

This text of 940 So. 2d 731 (Captain v. Citgo Petroleum Corp.) 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
Captain v. Citgo Petroleum Corp., 940 So. 2d 731, 6 La.App. 3 Cir. 481, 2006 La. App. LEXIS 2196, 2006 WL 2781409 (La. Ct. App. 2006).

Opinion

940 So.2d 731 (2006)

Sarah CAPTAIN
v.
CITGO PETROLEUM CORPORATION.

No. WCA 06-481.

Court of Appeal of Louisiana, Third Circuit.

September 27, 2006.

*733 Deanne Breaux McCauley, Rabalais, Unland & Lorio, Covington, LA, for Defendant/Appellant, *734 Citgo Petroleum Corporation.

Marcus P. LaCombe, The Townsley Law Firm, Lake Charles, LA, for Secondary Plaintiff/Appellant, Sarah Captain.

Court composed of OSWALD A. DECUIR, MARC T. AMY, and BILLY HOWARD EZELL, Judges.

EZELL, Judge.

Sarah Captain and her employer, Citgo Petroleum Corporation, both appeal a judgment from the Office of Workers' Compensation. Both have alleged errors with the workers' compensation judge's decision.

FACTS

On January 29, 2004, Ms. Captain was injured when the chair she was sitting in slipped out from under her and she fell to the concrete floor, hitting her neck on the chair. Due to complaints of pain in her knees, neck, and back, Citgo sent Ms. Captain to Dr. Allen Richert. MRI's of her neck, back, and left knee were performed. There were some degenerative changes in her lower back and a herniation was observed at C5-6 with some bulging at C6-7. There were severe degenerative changes in her knee. However, the knee problems are not at issue in this case because all medical evidence indicated that the changes were caused by Ms. Captain's morbid obesity. Ms. Captain is five-feet-two-inches tall and weighs from 300 to 330 pounds.

Dr. Richert referred Ms. Captain to an orthopedic surgeon, Dr. David Perry, who first saw Ms. Captain on February 20, 2004. Ms. Captain returned to see Dr. Perry on February 26, 2004 with her MRI's. Dr. Perry then recommended that Ms. Captain be treated conservatively with over-the-counter medication and return to work.

On March 2, 2004, Nancy Murphy, a senior claim representative with Ace Esis who handled the claim for Citgo, wrote a letter to Ms. Captain informing her that Dr. Perry had released her to return to work as of February 27. However, on March 15, 2004, Ms. Captain was seen by a podiatrist, Dr. Mickey Peshoff, for an infected toe. He restricted her from wearing steel toe boots. Since Citgo could not accommodate this request, she continued to receive temporary total disability benefits she had been receiving since her accident at work. Dr. Peshoff did release her to return to work on April 13, 2004. Benefits were then discontinued.

Ms. Captain requested that Ms. Murphy allow her to see a neurosurgeon. Ms. Murphy indicated to Ms. Captain that she would have to see Dr. Perry to determine whether she needed to see a neurosurgeon. At this time, Ms. Captain hired an attorney.

On May 3, 2004, Ms. Murphy received a request from Ms. Captain to see her choice of orthopedic surgeon, Dr. Dale Bernauer. Ms. Captain saw Dr. Bernauer on June 9, 2004. At that time, her neck and back were hurting with the pain radiating down into her shoulders and arms. Dr. Bernauer opined that the fall caused the herniation in her neck. He offered her pain management therapy, hoping it would help her get back to gainful employment. Dr. Bernauer commented that there was nothing else he could do for her due to her morbid obesity. Dr. Bernauer continued seeing Ms. Captain emphasizing that she needs pain management therapy. He also recommended weight loss surgery.

On August 31, 2004, Ms. Captain filed a claim with the Office of Workers' Compensation. She requested reinstatement of benefits and the authorization of pain management *735 therapy. She also requested penalties and attorney fees.

Dr. Lynn Foret was appointed to perform an independent medical examination. Dr. Foret examined Ms. Captain on November 16, 2004. Dr. Foret's report indicates that he also recommended pain management therapy in addition to weight loss surgery.

Prior to trial, Ms. Captain amended her claim to include a request to see a neurosurgeon and an award of penalties and attorney fees for Citgo's failure to authorize the examination. The case went to trial on June 3, 2005. Judgment was rendered on November 14, 2005. The workers' compensation judge (WCJ) ordered that Ms. Captain be treated by a pain management physician of her choice. He also ordered that she be paid past-due benefits at $429.00 a week from April 13, 2004, with credit for any and all wages and sick pay earned by her subsequent to the date of the accident. Although the WCJ refused to order weight loss surgery, he did order that she be evaluated by a weight reduction specialist. Ms. Captain's demand to see a neurosurgeon was denied. A $2,000.00 penalty was assessed for failure to institute compensation benefits timely in addition to another $2,000.00 penalty for failure to provide pain management therapy. Attorney fees were also awarded in the amount of $7,000.00. Both parties appealed this judgment, with Ms. Captain appealing the ruling on the neurosurgeon and Citgo appealing the other rulings.

CHOICE OF DOCTOR

Ms. Captain claims the trial court erred in refusing her request to be evaluated by a neurosurgeon. In oral reasons, the WCJ ruled that he did not think an evaluation by a neurosurgeon was appropriate because no doctor thought that it would help her at this point.

Louisiana Revised Statutes 23:1121(B) provides that an employee has a right to select one treating physician in any field or speciality. However, this statute must be read in conjunction with La. R.S. 23:1203(A), which requires that treatment be medically necessary in order for the employer to be responsible for the expenses. Scott v. Piccadilly Cafeteria, 97-1584 (La.App. 3 Cir. 4/1/98), 708 So.2d 1296.

Ms. Captain's own treating orthopedic surgeon, Dr. Bernauer, did not think that she needed to see a neurosurgeon. The record is absolutely devoid of any evidence that Ms. Captain needs to see a neurosurgeon. Furthermore, there is no evidence that a neurosurgeon could help Ms. Captain at this time. Therefore, we affirm the decision of the WCJ that an evaluation by a neurosurgeon is not necessary.

FORFEITURE OF BENEFITS

Citgo argues on appeal that the WCJ erred in not finding that Ms. Captain had made wilful misstatements in violation of La.R.S. 23:1208, thereby forfeiting workers' compensation benefits. In the same vein Citgo argues that Ms. Captain is not credible and, therefore, any medical opinions based on statements made by Ms. Captain to the doctors cannot be reliable.

Louisiana Revised Statutes 23:1208(A) provides: "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." A violation of La.R.S. 23:1208 may result in forfeiture of benefits. La.R.S. 23:1208(E). Importantly, La.R.S. 23:1208 must be strictly construed because forfeiture is a harsh remedy. *736 Whaley v. Christus St. Patrick Hosp., 04-1296 (La.App. 3 Cir. 2/2/05), 893 So.2d 915, writ denied, 05-531 (La.4/29/05), 901 So.2d 1070. Moreover, the employer bears the burden of proving an La.R.S. 23:1208 violation. Id. The question of whether an employee has forfeited his right to workers' compensation benefits is one of fact that will not be disturbed on appeal absent manifest error. Wells v. Dunham Price, Inc., 04-209 (La.App. 3 Cir. 9/29/04), 883 So.2d 495.

Price v. Ratcliff Const. Co., 05-239, p. 4 (La.App. 3 Cir. 11/2/05), 915 So.2d 979, 982-83.

There is no doubt that Ms.

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Bluebook (online)
940 So. 2d 731, 6 La.App. 3 Cir. 481, 2006 La. App. LEXIS 2196, 2006 WL 2781409, Counsel Stack Legal Research, https://law.counselstack.com/opinion/captain-v-citgo-petroleum-corp-lactapp-2006.