Davis v. Boise Cascade Co.

149 So. 3d 331, 14 La.App. 3 Cir. 156, 2014 La. App. LEXIS 2345, 2014 WL 4851754
Louisiana Court of Appeal·Decided October 1, 2014·No. No. 14-156·Published·Cited by 1 cases

Opinion

GENOVESE, Judge.

_jjln this workers’ compensation casé, Defendant/Employer, Boise Cascade Company (Boise), appeals the judgment of the Office of Workers’ Compensation (OWC) in favor of Plaintiff/C laimant, Travis Davis, finding that Mr. Davis’ average weekly wage (AWW) was $704.17, and awarding him a $2,000.00 penalty for Boise’s failure to properly calculate temporary total disability benefits (TTD), a $4,000.00 penalty for its discontinuance of TTD, two $2,000.00 penalties for its failure to timely authorize medical treatment, and $15,500.00 in attorney fees. Mr. Davis has answered the appeal relative to the denial of his claim for penalties and attorney fees for Boise’s failure to provide vocational rehabilitation and seeks an increase in the penalty awarded for the discontinuance of TTD along with additional attorney fees for work done on appeal. For the following reasons, we affirm the judgment in its entirety, and we render an attorney fee award in-favor of Mr. Davis for work done on appeal.

FACTUAL. AND PROCEDURAL. HISTORY

Mr. Davis injured his lower- back in the course and scope of his employment with Boise on February 10, 2012,1 while operating a loader at Boise’s plywood mill in Florien, Louisiana. At the time of his injury, Mr. Davis, a full-time hourly wage earner, was being paid $15.82 per hour ($23.73 for any overtime hours). Following his accident, Mr. Davis continued working with Boise, performing light-duty work through May 31, 2012. Beginning June 1, 2012, Boise was no longer able to make the necessary light-duty accommodations; therefore, it began paying Mr. [334]*334Davis TTD at the rate of $507.98. Boise paid Mr. Davis TTD from June 1, 2012, until January 27, 2013, when TTD was terminated based on the |2opinion of Dr. Douglas Bernard, an orthopedic surgeon providing a second medical opinion (SMO), that Mr. Davis was able to return to work without restrictions.

Because Dr. Bernard’s opinion that Mr. Davis was able to return to work differed from the opinion of Dr. Pierce Nunley, Mr. Davis’ treating orthopedist, OWC granted Boise’s request for an independent medical examination (IME). Dr. Steven Kautz conducted the IME on April 9, 2013, and opined that Mr. Davis was able to perform light-duty work with some restrictions. Since Boise had not previously extended an offer of light-duty work to Mr. Davis, it reinstated TTD on May 7, 2013, retroactive to January 27, 2013.

There initially being some uncertainty as to the date of injury, the parties agreed that the correct date of injury was February 10, 2012. Therefore, Boise recalculated Mr. Davis’ AWW, basing its computation upon the hours Mr. Davis had worked from January 15, 2012, through February 4, 2012. Using this time frame as the four full weeks prior to the date of injury, Boise found that Mr. Davis had worked 157 hours, yielding an average of 39.25 hours per week. Boise’s new calculation resulted in an AWW of $632.80 and a corresponding TTD payment of $421.87. Boise continued to pay Mr. Davis benefits at this rate through the date of trial.

During Mr. Davis’ receipt of indemnity benefits, issues also arose as to medical treatment. Specifically, Dr. Nunley requested authorizations for a discogram and a total lumbar disc replacement surgery, which were denied on multiple occasions. The factual and procedural background surrounding Dr. Nunley’s repeated requests for approval, the repeated denials, the subsequent approvals, and the filing of appeals with both the Medical Director and the OWC is quite extensive. However, ultimately, both requests were approved by Boise and were performed prior to trial.

|sMr. Davis filed a Disputed Claim for Compensation against Boise and its Third Party Administrator, Sedgwick Claims Service. Following several supplemental and amending pleadings, the parties were able to reach agreements as to some matters in dispute. When the matter proceeded to trial, the remaining issues included the correct calculation of AWW, the discontinuance of TTD from January 27, 2013, through May 7, 2013, the denial of the discogram, the denial of the lumbar surgery, the alleged failure to provide proper vocational rehabilitation, and penalties and attorney fees.

Following a trial on the merits, the WCJ determined that Mr. Davis’ AWW was $704.17 resulting in a TTD payment of $469.45, and Boise was ordered to pay TTD at this rate retroactive to June 1, 2012. On Mr. Davis’ claims for penalties and attorney fees, Mr. Davis was awarded a $2,000.00 penalty for Boise’s failure to pay TTD at the correct rate, a $4,000.00 penalty for its discontinuance of TTD on January 27, 2013, a $2,000.00 penalty for its failure to timely authorize the disco-gram, a $2,000.00 penalty for its failure to authorize the lumbar surgery, and $15,500.00 in attorney fees. Finally, Mr. Davis’ claim for penalties and attorney fees for Boise’s alleged failure to provide vocational rehabilitation was denied. A judgment in accordance therewith was signed on November 12, 2013. From said judgment, Boise appeals, and Mr. Davis has answered the appeal.

ASSIGNMENTS OF ERROR

Boise presents the following assignments of error for our review:

[335]*335 Assignment of Error # 1
In light of the legislative declaration that the workers’ compensation laws are not to be construed in favor of either party, it was error for the workers’ compensation judge to consider wages of an hourly employee beyond the four full weeks preceding the accident when calculating the AWW pursuant to [La.R.S. 23:1021(12)(a) ].
14Assignment of Error #2
Appellant based its calculation of claimant’s AWW on the wording of the statute which provides the method for calculating the AWW of a full[-]time hourly worker. Considering that claimant argued alternative methods for calculating his AWW, it was error for the workers’ compensation judge to award penalties and attorney[ ] fees simply because he did not agree with appellant’s calculation.
Assignment of Error # 3
When the decision to terminate claimant’s temporary total disability benefits was based on the opinion of an orthopedic surgeon that claimant could return to work without restrictions, and appellant made an offer to claimant to return to work, which claimant did not accept, it was error for the worker’s compensation judge to award penalties and attorney[ ] fees for the alleged wrongful termination of benefits.
Assignment of Error # 4
Appellant’s decision to file a Form 1009 appeal of a [utilization review (UR) ] determination that the discogram was medically necessary was based on a reasonable belief that it was an “aggrieved party,” as defined in [La.R.S. 23:1203.1], Where the delay in approving the discogram resulted from appellant’s decision to argue an unresolved issue of law, it was error for the workers’ compensation judge to award penalties and attorney[ ] fees for the failure to timely authorize the discogram.
Assignment of Error # 5
Appellant’s decision to file a Form 1009 appeal of a UR determination that lumbar disc replacement surgery was medically necessary was based on a reasonable belief that it was an “aggrieved party,” as defined in [La.R.S. 23:1203.1].

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Davis v. Boise Cascade Co., 149 So. 3d 331, 14 La.App. 3 Cir. 156, 2014 La. App. LEXIS 2345, 2014 WL 4851754 (La. Ct. App. 2014).

149 So. 3d 331 (Davis v. Boise Cascade Co.) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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