Coleman v. Walter Industries, Inc./Jim Walter Homes

56 So. 3d 1258, 2010 La.App. 1 Cir. 1145, 2011 La. App. LEXIS 187, 2011 WL 576095
CourtLouisiana Court of Appeal
DecidedFebruary 11, 2011
DocketNo. 2010 CA 1145
StatusPublished
Cited by4 cases

This text of 56 So. 3d 1258 (Coleman v. Walter Industries, Inc./Jim Walter Homes) 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
Coleman v. Walter Industries, Inc./Jim Walter Homes, 56 So. 3d 1258, 2010 La.App. 1 Cir. 1145, 2011 La. App. LEXIS 187, 2011 WL 576095 (La. Ct. App. 2011).

Opinion

KUHN, J.

12CIaimant-appellant, Donna Coleman, appeals the judgment of the Office of Workers’ Compensation (OWC), against employer-appellee, Walter Industries, Inc./ Jim Walter Homes (Jim Walter Homes), awarding her indemnity benefits and denying certain medical benefits. Finding the language of that portion of the judgment that denies medical benefits too broad, we amend the judgment. As amended, the OWC judgment is affirmed.

PROCEDURAL BACKGROUND

Claimant filed a disputed claim form in January 2009, subsequent to the termination of certain medical benefits by her employer in December 2008, averring that indemnity benefits had been discontinued in June 2008. Her employer answered, generally denying claimant’s entitlement to further relief. After a hearing on the merits of her claim, OWC concluded that she had sustained a compensable work-related accident on December 31, 2007, and awarded her indemnity benefits through June 29, 2008. OWC denied her claim for continuing medical benefits after December 22, 2008. Claimant appeals asserting entitlement to further medical benefits and to indemnity benefits after June 29, 2008.

MEDICAL BENEFITS

Claimant contends OWC erred in denying her medical benefits subsequent to December 22, 2008. She expressly challenges OWC’s conclusion that the complex regional pain syndrome from which she suffers is not related to her accident.

The injured employee’s right to medical expenses is separate and distinct from her right to disability benefits, and an employer has a statutory duty to furnish all necessary medical treatment caused by a work-related injury. See La. R.S. 23:1203; Bonvillain v. Preferred Indus. and LWCC, 2004-0849, p. 16 (La.App. 1st Cir.5/27/05), 917 So.2d 1, 10. It is the employee’s burden to prove that the ex penses are reasonably necessary for treatment of a medical condition caused by the work injury. See Louisiana Ins. Guar. Ass’n v. Weller, 2007-0571, p. 7 (La.App. 1st Cir.11/2/07), 977 So.2d 29, 34. The question of whether a claimant is entitled to medical benefits is ultimately a question of fact, and OWC’s resolution of that issue may not be disturbed by the appellate [1260]*1260court in the absence of manifest error or unless clearly wrong. Weller, 2007-0571 at p. 7, 977 So.2d at 34.

The evidence establishes that beginning in May 2006, claimant worked in sales at the Hammond office of Jim Walter Homes. On December 31, 2007, she walked into the doorway of the room where the office fax machine was located and, as she maneuvered around her boss who was standing in front of the doorway, claimant hit a four-shelf file cabinet with her left hip. Thinking she had bruised herself, claimant continued working. She testified that the more she worked and walked, the worse the pain became. But she continued working. Finally, on January 31, 2008, she sought medical care at a walk-in clinic after reporting the incident to her employer and at the direction of her employer’s workers’ compensation administrator.

Claimant initially was treated by Dr. Mark Daunis, who took x-rays and issued prescriptions for swelling and pain of her left hip bone. After seeing him three times, she was referred to Dr. B.J. Chais-son, an orthopedist. Unhappy |4with Dr. Chaisson’s treatment, claimant selected Dr. Neils J. Linschoten as her orthopedist. On April 1, 2008, Dr. Linschoten assessed her with post-contusional greater trochan-teric bursitis. Noting claimant’s hypersensitivity and disproportionate level of symptomatology at the bruising site, Dr. Linschoten was concerned that claimant may suffer from reflex sympathetic dystrophy (RSD).

Seeking a second opinion, the workers’ compensation administrator sent claimant to Dr. Joseph E. Broyles, who first examined her on May 23, 2008. He concluded that claimant had arthritis of the left hip as well as significant femoral head contusion. Dr. Broyles testified that the femoral head contusion could have been caused by the December 31, 2007 incident of running into the file cabinet; but noted that it was just as likely that it was caused by arthritis. Whether the event caused the femoral head contusion or aggravated a preexisting condition, Dr. Broyles attributed her pain to the incident in the fax room. Dr. Broyles concurred with Dr. Linschoten’s diagnosis of post-contusional greater trochanteric bursitis. Noting her hypersensitivity to touch, which was not explained by the arthritis and femoral head contusion, Dr. Broyles also suspected claimant may suffer from RSD. Because she was impressed with Dr. Broyles’ treatment, claimant selected him as her choice of physician.

Dr. Broyles continued treating claimant through August 2008. He placed claimant under physical restrictions for work. He had a cortisone steroid preparation injected into claimant’s left hip to address the arthritic component of claimant’s pain and Lidoderm patches and Neurotin to address that attributed to the suspected RSD. Eventually, Dr. Broyles referred claimant to Dr. Jihad George Jiha, |sa specialist in interventional pain management, for treatment associated with the suspected. RSD.

On October 27, 2008, Dr. Jiha first examined claimant. Based on his examination, Dr. Jiha thought claimant may have complex regional pain syndrome (CRPS), testifying that was the name the medical community had replaced for what Dr. Broyles had referred to as RSD. He explained that RSD involved only neuropathic pain of the sympathetic nerve; but because that pain can occur in other nerves as well, the reference was changed.

Based on his limited treatment of claimant, Dr. Jiha opined more probable than not claimant suffered from CRPS as a result of the incident in the fax room. But because much of the information he had been able to garner in the limited treatment he had been able to administer was subjective, he was not 100% certain. He [1261]*1261conceded that other possible diagnoses were local trauma, local sprain, and local contusion. According to Dr. Jiha, CRPS can occur after a severe trauma, a minor trauma, surgery, or without any known stimulus at all. Despite his opinion, Dr. Jiha conceded that CRPS caused by trauma usually happens in less than a month; within a week or two of the event. He stated that CRPS can last between two and four years, indicating that in the majority of those who have it, the pain ultimately goes away. Since claimant had not returned for further treatment after he administered one sympathetic nerve block for which she subjectively reported positive results, he was unable to determine if claimant would respond well to further sympathetic nerve blocks or whether she would be a better candidate for pain relief from a neurolytic sympathetic nerve block.

| ^Although we may have concluded differently had we been the trier of fact, the record supports OWC’s conclusion that the ensuing medical expenses related to the CRPS from which claimant suffers were not expenses reasonably necessary for treatment of a medical condition caused by a work injury. As noted above, claimant’s treating physician, Dr. Broyles, referred her to a specialist, Dr. Jiha. And Dr. Jiha admitted that CRPS can be caused without any known stimulus at all. He also indicated that CRPS usually appears within one or two weeks of a triggering traumatic event. Yet, the record supports a finding that claimant continued to work for a month after she hit the file cabinet with her hip. As such, OWC could have reasonably found that claimant’s CRPS was not caused by the incident of hitting her hip into the file cabinet in the fax room.

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Cite This Page — Counsel Stack

Bluebook (online)
56 So. 3d 1258, 2010 La.App. 1 Cir. 1145, 2011 La. App. LEXIS 187, 2011 WL 576095, Counsel Stack Legal Research, https://law.counselstack.com/opinion/coleman-v-walter-industries-incjim-walter-homes-lactapp-2011.