Causby v. Perque Floor Covering

694 So. 2d 430, 96 La.App. 5 Cir. 990, 1997 La. App. LEXIS 992, 1997 WL 163615
CourtLouisiana Court of Appeal
DecidedApril 9, 1997
DocketNo. 96-CA-990
StatusPublished

This text of 694 So. 2d 430 (Causby v. Perque Floor Covering) 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
Causby v. Perque Floor Covering, 694 So. 2d 430, 96 La.App. 5 Cir. 990, 1997 La. App. LEXIS 992, 1997 WL 163615 (La. Ct. App. 1997).

Opinion

laCANNELLA, Judge.

Both parties appeal a workers compensation judgment. We affirm.

On March 11, 1993 plaintiff, Dennis Caus-by, was employed as a laborer by defendant, Perque Floor Covering (Perque). On that date, he was lifting furniture when he felt a “pull” in his lower pelvic area. Due to the injury, he had to undergo surgical removal of his left testicle. Plaintiff was paid weekly workers compensation medical benefits from March 19,1993 through April 1,1993. Plaintiff returned to work in April of 1993. He inquired about additional benefits, but was informed by R. Todd Justice (Justice), the claims adjuster, that he was not entitled to any farther benefits.

Plaintiff went to an attorney in February of 1995 seeking information about further benefits. On May 24, 1995, plaintiff filed a disputed claim for compensation against Per-que and the Louisiana Workers’ Compensation Corporation (LWCC). Plaintiff claimed permanent partial disability benefits for the loss of his testicle, plus penalties and attorney fees against defendants for their alleged arbitrary and capricious refusal to pay said benefits. On September 8, U1995, defendants filed a peremptory exception of prescription. The hearing on the exception was held on October 6, 1995. On November 9,1995, the exception was denied. Defendants applied for Supervisory Writs to this court. In December of 1995, this court denied the writ application, holding that defendants had an adequate remedy on appeal.

On August 15, 1996, a trial on the merits was held and a judgment was rendered on August 29, 1996 in favor of plaintiff, awarding him disability benefits in the amount of $307 per week for fifty weeks for the loss of his testicle. In the judgment, the hearing officer found that the prescription issue was res judicata, that plaintiff failed to establish entitlement to any additional benefits for scarring or disfigurement, that defendants were entitled to a credit for previously-paid benefits and that defendants were not arbitrary and capricious in refusing to pay benefits.

On appeal, defendants first assert that the hearing officer was manifestly erroneous in denying the exception of prescription. Second, defendants assert that the hearing officer erred in awarding plaintiff permanent partial disability benefits, when plaintiff failed to prove that the usefulness of his genito-urinary system was impaired.

In plaintiffs appeal, he asserts that the hearing officer erred in limiting the benefits to fifty weeks of disability, instead of the maximum of one hundred weeks. He also asserts that the hearing officer erred in failing to find that defendants were arbitrary and capricious in refusing to pay benefits and in failing to award penalties and attorney fees. Further, plaintiff requests a separate award of attorney fees for the appeal.

La. R.S. 23:1209 provides:

[432]*432§ 1209. Prescription; timeliness of filing; dismissal for want of prosecution
A. In case of personal injury, including death resulting therefrom, all claims for payments shall be | ¿forever barred unless within one year after the accident or death the parties have agreed upon the payments to be made under this Chapter, or unless within one year after the accident a formal claim has been filed as provided in Subsection B of this Section and in this Chapter. Where such payments have been made in any case, the limitation shall not take effect until the expiration of one year from the time of making the last payment, except that in eases of benefits payable pursuant to R.S. 23:1221(3) this limitation shall not take effect until three years from the time of making the last payment of benefits pursuant to R.S. 23:1221(1), (2), (3), or (4). Also, when the injury does not result at the time of, or develop immediately after the accident, the limitation shall not take effect until expiration of one year from the time the injury develops, but in all such cases the claim for payment shall be forever barred unless the proceedings have been begun within two years from the date of the accident.

In this case, plaintiff filed his claim more than one year from the date of the accident. Thus, the claim is prescribed on its face. However, he claims that he relied on misinformation given him by defendants’ claims adjuster, which induced him into not filing a claim for further benefits. The hearing officer concluded that prescription was interrupted based on the adjuster’s misleading information.

Initially, we note that the hearing officer incorrectly declared that the exception of prescription was res judicata. Since there was neither a transaction or compromise or final judgment on the prescription issue, res judicata is inapplicable. See: La. C.C. art. 3078 and La. R.S. 13:4231.

In Williams v. William Wrigley, Jr. Co., 94-370 (La.App. 5 Cir. 11/16/94); 646 So.2d 1092, 1094, this court stated:

Claimant’s position, that an employer and/or insurer who lulls the injured employee into a false sense of security, thus inducing forbearance in the prosecution of a compensation claim is estopped to plead prescription to the injured employee’s untimely suit, is well established in the law. See, Mella v. Continental Emsco, A Division of Youngstown Sheet and Tube Company, 189 So.2d 716 (La.App. 1 Cir.1966), writ refused 249 La. 762, 191 So.2d 141 (1966); Landry v. Ferguson, 279 So.2d 185 (La.1973); Dupaquier v. City of New Orleans, 260 La. 728, 257 So.2d 385 (1972); Baker v. Grinnell Fire Protection Systems, Inc., 487 So.2d 700 (La.App. 5 Cir. 1986), writ den. 493 So.2d 639 (La.1986). In order to prove that her tardiness in filing a claim was due to her being lulled into a false sense of security, a workers’ compensation claimant must show that words, actions, or inactions on the part of the employer caused her forbearance. Lynn v. Berg Mechanical, Inc., 582 So.2d 902 (La.App. 2 Cir.1991); Keller v. Marathon Oil Co., 613 So.2d 795 (La.App. 5 Cir.1993).

Here, plaintiff contends that he was late in filing a claim for further benefits because he was told by the claims adjuster that he was not entitled to receive any more benefits. Plaintiff testified that, at the time, he thought about seeing an attorney and that he knew the claims adjuster was not an attorney. He also stated that Justice was the person who would know if he had further rights. He testified that he knew that Justice was a claims representative and “Yeah, he worked for workers’ comp. I figured he knew what he was talking about. He does it every day for his living.” Further, “Uh-huh (Affirmative Response). When he told me it wasn’t worth nothing, I figured there wasn’t no use getting a lawyer.” The hearing officer found that plaintiff was justified in sitting on his rights and in not filing a claim. Under all of the circumstances herein, we cannot say that the hearing officer was erroneous. Therefore, we affirm the judgment of the hearing officer in denying the exception of prescription.

Alternatively, defendants contend that the hearing officer erred in awarding plaintiff disability benefits.

[433]*433La. R.S. 23:1221(4)(p) provides for permanent partial disability involving cases not provided for specifically, as follows:

(p) In cases not falling within any of the provisions already made, where the employee is seriously and permanently disfigured or suffers a permanent hearing loss solely due to a single traumatic accident, or

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Related

Keller v. Marathon Oil Co.
613 So. 2d 795 (Louisiana Court of Appeal, 1993)
Lindon v. Terminix Services, Inc.
617 So. 2d 1251 (Louisiana Court of Appeal, 1993)
Landry v. Ferguson
279 So. 2d 185 (Supreme Court of Louisiana, 1973)
Lescuer v. Liberty Mut. Ins. Co.
552 So. 2d 521 (Louisiana Court of Appeal, 1989)
Dupaquier v. City of New Orleans
257 So. 2d 385 (Supreme Court of Louisiana, 1972)
Williams v. Hospital Service, Inc.
663 So. 2d 749 (Louisiana Court of Appeal, 1995)
Mella v. Continental Emsco
189 So. 2d 716 (Louisiana Court of Appeal, 1966)
Williams v. William Wrigley, Jr. Co.
646 So. 2d 1092 (Louisiana Court of Appeal, 1994)
Lynn v. Berg Mechanical, Inc.
582 So. 2d 902 (Louisiana Court of Appeal, 1991)
Baker v. Grinnell Fire Protection Systems, Inc.
487 So. 2d 700 (Louisiana Court of Appeal, 1986)
Mella v. Continental Emsco
191 So. 2d 141 (Supreme Court of Louisiana, 1966)
Tuggle v. United States Fidelity & Guaranty Co.
228 So. 2d 671 (Louisiana Court of Appeal, 1969)
Baker v. Grinnell Fire Protection Systems, Inc.
493 So. 2d 639 (Supreme Court of Louisiana, 1986)

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Bluebook (online)
694 So. 2d 430, 96 La.App. 5 Cir. 990, 1997 La. App. LEXIS 992, 1997 WL 163615, Counsel Stack Legal Research, https://law.counselstack.com/opinion/causby-v-perque-floor-covering-lactapp-1997.