Daniel v. New Orleans Public Service, Inc.

861 So. 2d 721, 2002 La.App. 4 Cir. 2427, 2003 La. App. LEXIS 3549, 2003 WL 22976155
CourtLouisiana Court of Appeal
DecidedDecember 3, 2003
Docket2002-CA-2427
StatusPublished
Cited by13 cases

This text of 861 So. 2d 721 (Daniel v. New Orleans Public Service, 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
Daniel v. New Orleans Public Service, Inc., 861 So. 2d 721, 2002 La.App. 4 Cir. 2427, 2003 La. App. LEXIS 3549, 2003 WL 22976155 (La. Ct. App. 2003).

Opinion

861 So.2d 721 (2003)

Edward DANIEL, Jr.
v.
NEW ORLEANS PUBLIC SERVICE INC., et al.

No. 2002-CA-2427.

Court of Appeal of Louisiana, Fourth Circuit.

December 3, 2003.
Rehearing Denied January 15, 2004.

*722 Marie Riccio Wisner, New Orleans, LA, for Plaintiff/Appellant.

Kenneth P. Carter, Joseph K. West, Margaret Jenkins Savoye, Entergy New Orleans, Inc., New Orleans, LA, for Defendant/Appellee.

(Court composed of Judge PATRICIA RIVET MURRAY, Judge JAMES F. McKAY, III, Judge DAVID S. GORBATY).

PATRICIA RIVET MURRAY, Judge.

The plaintiff appeals the trial court's judgment dismissing his petition for worker's *723 compensation benefits. For the reasons that follow, we affirm.

FACTS AND PROCEEDINGS BELOW

The original plaintiff, Edward Daniel, Jr., filed the instant lawsuit on April 4, 1987 against his employer, New Orleans Public Service, Inc. ["NOPSI"], seeking benefits for permanent total disability, as well as penalties for NOPSI's alleged arbitrary and capricious failure to pay said benefits. Plaintiff alleged that he had experienced three injury-causing accidents while working as a master mechanic/welder/pipe fitter: (1) On January 29, 1986, Mr. Daniel lost his grip on a boiler tube he was replacing, and it fell and struck him in the head; (2) On May 27, 1986, he snapped his neck and injured his back while pulling on pipe wrenches; and (3) On July 30, 1986, he became dizzy, slipped, and fell, injuring his back. According to the record, Mr. Daniel ceased working completely on August 7, 1986.[1]

On September 29, 1986, Mr. Daniel filed a complaint with the Office of Workers' Compensation ["OWC"] reporting his January 29th injury.[2] On October 30, 1986, the OWC issued a recommendation in response to the complaint; the recommendation was that no disability benefits were owed, but that medical expenses should be paid by the employer. Contemporaneous with the first recommendation, the OWC also issued separate recommendations for the May 27th and July 30th injuries.[3] Regarding the May 27th incident, the OWC recommended that only medical expenses be paid; however, with regard to the July 30th injury, the recommendation was that NOPSI should pay medical expenses plus temporary total disability benefits in the amount of $254.00 per week from October 8, 1986 until Mr. Daniel was "physically able to return to gainful employment." NOPSI never disputed Mr. Daniel's entitlement to medical expenses, which are not the subject of the instant case; NOPSI declined, however, to pay Mr. Daniel any workers' compensation disability benefits.

Mr. Daniel never returned to gainful employment. With the workers' compensation dispute unresolved, he applied for non-occupational long-term disability benefits from NOPSI's insurance carrier, Connecticut General Life Insurance Company ["CIGNA"]. On December 19, 1986, NOPSI sent Mr. Daniel a letter informing him that by extending his sick leave and combining it with his vacation time, NOPSI had arranged for him to continue receiving his pay through February 10, 1987. On February 3, 1987, NOPSI was notified by CIGNA that Mr. Daniel had been conditionally approved for long-term disability benefits, which he began to receive as of February 11, 1987. The insurance carrier noted that Mr. Daniel would have to submit to an independent medical exam ["IME"] to confirm his continued eligibility for those benefits. Mr. Daniel continued to receive those benefits until June 30, 1987, when the benefits were terminated because Mr. Daniel had failed to show up for the IME scheduled in *724 March. On the same date, NOPSI also terminated Mr. Daniel's employment. The record shows that Mr. Daniel subsequently sought a review of the termination of benefits, but the termination was ultimately reconfirmed because Mr. Daniel failed to show up for a second IME scheduled on July 22, 1987.

On April 4, 1987, while he presumably was still receiving long-term disability benefits, Mr. Daniel filed the instant workers' compensation action seeking permanent total disability benefits as a result of the three aforementioned work-related accidents, as well as penalties for his employer's alleged arbitrary and capricious failure to pay said benefits. On May 15, 1987, NOPSI answered the petition and filed an exception of prematurity asserting that Mr. Daniel had not actually filed a claim with the OWC for either the May 27th accident or the July 30th accident. On May 29, 1987, Mr. Daniel filed a claim form referencing those two accidents. On June 29, 1987, the OWC issued a new recommendation with regard to the July 30th accident, finding that no temporary total disability benefits were owed Mr. Daniel but that his related medical expenses should be paid. NOPSI's exception of prematurity was apparently never pursued.[4]

On February 3, 1995, during the pendency of this litigation, Mr. Daniel died, and his daughter was then substituted as plaintiff.[5] A bench trial was held in the district court[6] on June 18-21, 2001. On May 6, 2002, the trial court rendered judgment in favor of NOPSI, dismissing the plaintiff's claim with prejudice. In brief Reasons for Judgment, the trial court found that NOPSI was justified in withholding benefits because: "There was no contemporaneous medical information from a physician indicating that the plaintiff's back or head problems were due to a work related accident. From what [NOPSI] knew at the time, Mr. Daniel was not entitled to benefits."

On appeal, the plaintiff argues the trial court erred by concluding that the employee, Mr. Daniel, failed to establish the existence of a work related disability. Included in this argument by the plaintiff are specific assertions that the trial court erred by failing to award benefits pursuant to the October 30, 1986 recommendation of the Office of Workers' Compensation ["OWC"], which the plaintiff contends NOPSI was conclusively presumed to have accepted, and that the trial court erred by declining to apply the "odd lot" doctrine. Finally, the plaintiff contends that the trial court should have assessed statutory penalties against NOPSI for its allegedly arbitrary *725 and capricious refusal to pay benefits to Mr. Daniel.

DISCUSSION OF LAW

Workers' compensation cases are reviewed according to the "manifest error— clearly wrong" standard, which precludes the setting aside of the trial court's findings of fact unless they are clearly wrong in light of the record viewed in its entirety. Alexander v. Pellerin Marble & Granite, 93-1698 (La.1/14/94), 630 So.2d 706, 710. This standard applies particularly where there are credibility determinations involved. Owens v. Georgia Pacific Corp., 535 So.2d 990, 993 (La.App. 2d Cir.1988). However, the manifest error standard also applies in cases where the evidence before the trier of fact consists primarily or solely of written reports, documentary records and depositions. Alexander v. Pellerin Marble & Granite, supra, at 710.

In order to recover, the claimant in a workers' compensation case must prove: (1) a [work related] accident; (2) a disability; and (3) a causal connection between the accident and the disability. Marks v. Pride Aviation, Inc., 95-971, p. 2 (La.App. 3 Cir. 1/31/96), 670 So.2d 376, 377. In the instant case, it is undisputed that Mr. Daniel had three work related accidents, which together form the basis for this lawsuit; the issue at trial was whether any of these accidents rendered him totally disabled.[7]

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Bluebook (online)
861 So. 2d 721, 2002 La.App. 4 Cir. 2427, 2003 La. App. LEXIS 3549, 2003 WL 22976155, Counsel Stack Legal Research, https://law.counselstack.com/opinion/daniel-v-new-orleans-public-service-inc-lactapp-2003.