Dumas v. Hartford Ins. Co.

583 So. 2d 31, 1991 La. App. LEXIS 1797, 1991 WL 101044
CourtLouisiana Court of Appeal
DecidedJune 13, 1991
Docket90-CA-1753
StatusPublished
Cited by11 cases

This text of 583 So. 2d 31 (Dumas v. Hartford Ins. Co.) 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
Dumas v. Hartford Ins. Co., 583 So. 2d 31, 1991 La. App. LEXIS 1797, 1991 WL 101044 (La. Ct. App. 1991).

Opinion

583 So.2d 31 (1991)

Albert J. DUMAS
v.
The HARTFORD INSURANCE COMPANY, et al.

No. 90-CA-1753.

Court of Appeal of Louisiana, Fourth Circuit.

June 13, 1991.
Rehearings Denied July 17, 1991.

*32 Rudolph R. Schoemann, Schoemann & Associates, New Orleans, for plaintiff/appellee.

Monica C. Sanders, Frederick A. Miller & Associates, Metairie, for defendants/appellants.

Dona J. Dew, New Orleans, for Hibernia Nat. Bank.

Before KLEES, CIACCIO and PLOTKIN, JJ.

PLOTKIN, Judge.

Both parties to this worker's compensation suit have appealed the trial court judgment finding plaintiff Albert J. Dumas totally, temporarily disabled and awarding him additional worker's compensation benefits and additional medical expenses against the defendants, Hibernia National Bank and Hartford Insurance Co. We amend the judgment to clarify which additional medical expenses the defendants are liable to pay and to award the plaintiff penalties and attorney's fees. In all other respects, the trial court judgment is affirmed.

Facts:

Plaintiff Albert J. Dumas was injured February 19, 1988 in the course and scope of his employment as an engineer's helper at Hibernia National Bank, when he fell some ten to fifteen feet off a 20-foot ladder while attempting to change a light bulb in a chandelier in the bank's main office located at 812 Gravier Street in New Orleans. The plaintiff landed flat on his back on a marble table, hitting a triangularshaped calendar laying on the table. He claims that he injured his back, spine, neck, head, and lower extremities.

Immediately after the accident, the plaintiff was taken to the emergency room at Tulane Medical Center, where he was treated by a Dr. Kirby. He was subsequently treated by two other Tulane doctors, Ollie Edmunds, an orthopedist, and Leon Weisberg, a neurologist, for back pain, neck pain, and headaches. Dr. Edmunds diagnosed a soft-tissue injury, specifically a strain to the back and neck. Dr. Edmunds testified that the plaintiff refused to allow him to conduct examinations, that he failed to follow his recommendations for treatment, and that he missed several appointments for tests. Dr. Edmunds clearly believed that the plaintiff's soft tissue injury was resolved much sooner than the plaintiff admitted and that the plaintiff was malingering during the last few months he provided treatment.

Dr. Edmunds followed plaintiff for a year, then released him to return to work on February 16, 1989 when he decided that he could no longer help him because of his attitude. Plaintiff went back to work at Hibernia on March 2, 1989, but worked only a couple of hours before complaining of pain and leaving. Hibernia then terminated plaintiff's employment.

Subsequent to these events, on July 18, 1989, the plaintiff consulted Dr. Edna Doyle, a physical and rehabilitative medicine specialist, who diagnosed a mild sacroiliac disfunction and recommended therapy and a work hardening program. Dr. Doyle testified by deposition that the injury was caused by the work-related accident and that most doctors do not look at the sacroiliac joint when a patient comes in with a back problem. A problem in the sacroiliac could cause pain when the patient sits, Dr. Doyle stated. She recommended physical therapy two times a week for four to six weeks.

At the time of the accident, Dumas was earning $937.25 per month on his job with Hibernia. Additionally, Dumas was a member of the Louisiana National Guard, doing military police work, allegedly earning $66.77 per week. Hibernia paid him weekly workers' compensation of $195.23 for his salary from Hibernia from the time of the accident until the time he was released to return to work by Dr. Edmunds. Hibernia also paid him the difference between the amount paid by Hartford and his regular salary. Additionally, the defendants paid plaintiff's medical expenses incurred *33 in connection with his treatment by Drs. Edmunds and Weisberg, but did not pay other medical expenses, including those incurred in the consultation with Dr. Doyle.

On January 31, 1989, before his benefits were terminated, the plaintiff filed suit seeking increased benefits and additional medical expenses. Specifically, the plaintiff alleged that he was entitled to $216.15 per week because of his job with the military. The case was submitted to the trial judge on the basis of pleadings, depositions, and other documents. After reviewing the evidence, the trial court issued a judgment in favor of the plaintiff, finding him totally, temporarily disabled. The judge found that Dumas was entitled to $195.23 per week "pending further order of the court," with credit for the $10,152 in weekly benefits paid prior to the trial. The judge also ordered the defendants to pay "all outstanding medical, drug, and therapy bills, plus all necessary mileage at the rate of $.20 per mile, with interest." The plaintiff's request for additional benefits to compensate him for the salary he earned from the military prior to the accident was denied.

Both parties appealed. Hibernia and its insurer contest the trial court's ruling that Dumas was temporarily, totally disabled and the finding that Hibernia is liable for additional medicals and mileage. Regarding the additional medicals, the defendants argue specifically that they should not be liable for payment of expenses for treatment of plaintiff's cocaine addiction and that he should not receive an award for future medicals because he has previously refused to follow his physicians' recommendations. The plaintiff appeals the trial court's refusal to award him additional compensation for his second job, as well as the trial judge's failure to award penalties and attorney's fees for the defendants' arbitrary and capricious discontinuation of his workers' compensation benefits.

Total, Temporary Disability

Under the provisions of LSA-R.S. 23:1221, the plaintiff must prove that he was unable to engage in any self-employment or gainful occupation for wages before he may be found temporarily totally disabled for purposes of worker's compensation. Hibernia asserts that the trial court incorrectly found that the plaintiff had met that burden.

First, the defendants challenge the trial court's acceptance of Dr. Doyle's testimony, saying that the testimony of Drs. Edmunds and Weisberg is more credible than that of Dr. Doyle for two reasons. First, Hibernia notes that the Tulane doctors treated the plaintiff from the time of the injury for more than a year, when he was released to return to work. On the other hand, Dr. Doyle was not consulted until more than 18 months after the accident. Additionally, Hibernia claims that Dumas was referred to Dr. Doyle by his attorney.

Second, Hibernia claims that Dr. Edmunds' testimony was entitled to the most weight because he was Dumas' "treating physician." The defendants note that Dr. Edmunds saw the plaintiff 13 times over the course of more than a year, while Dr. Doyle saw the plaintiff only three times, beginning almost a year and a half after the accident. Additionally, the defendants claim that even if Dr. Doyle's testimony is given great weight, the trial court's holding that Dumas was temporarily, totally disabled is not supported by the record because Dr. Doyle herself said that she believed Dumas could have performed his job duties, even without the recommended physical therapy.

A constant refrain in all of Hibernia's arguments on this issue is the allegation that the medical evidence indicates that Dumas was malingering. The defendants place special emphasis on Dr.

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Cite This Page — Counsel Stack

Bluebook (online)
583 So. 2d 31, 1991 La. App. LEXIS 1797, 1991 WL 101044, Counsel Stack Legal Research, https://law.counselstack.com/opinion/dumas-v-hartford-ins-co-lactapp-1991.