Edmondson v. PCA International, American Studios

859 So. 2d 31, 2003 La. App. LEXIS 2056, 2003 WL 21513253
CourtLouisiana Court of Appeal
DecidedJuly 2, 2003
DocketNo. 2002 CA 1989
StatusPublished
Cited by2 cases

This text of 859 So. 2d 31 (Edmondson v. PCA International, American Studios) 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
Edmondson v. PCA International, American Studios, 859 So. 2d 31, 2003 La. App. LEXIS 2056, 2003 WL 21513253 (La. Ct. App. 2003).

Opinion

I,KUHN, J.

Claimant-appellant, Syvonne Edmondson, appeals a judgment rendered by the Office of Workers’ Compensation (OWC), which denied her request for supplemental earnings benefits (SEB) but awarded her a penalty of $2,000 and attorney fees in the amount of $1,500. Defendant-employer, PCA International/Ameri-ean Studios (PCA) answered the appeal. We affirm.

FACTUAL AND PROCEDURAL BACKGROUND

In April 1998, Edmondson injured her neck when she was taking down overheard photography equipment while working as a photographer for PCA. She had surgery to her neck and was paid indemnity benefits for the nine months she was unable to work. In August 1999, Edmondson returned to work for PCA in a limited duty capacity until December 2000, when she was laid off by her employer. In February 2001, Edmondson filed this disputed claim, averring entitlement to indemnity benefits as a result of the April 1998 injury.1 On April 18, 2001, PCA filed an an[33]*33swer denying Edmondson’s claim. Edmondson amended her claim on April 26, 2001, and added Reliance Insurance Company (Reliance) as the workers’ compensation insurer of PCA.2 PCA filed a motion to stay the proceeding, averring that insurer Reliance had. been declared insolvent, placed into liquidation, and by an order of the Commonwealth of Pennsylvania, all lawsuits |swere stayed. And on October 22, 2001, the workers’ compensation judge (WCJ) signed an order staying Edmondson’s claim.

On June 17, 2002, a hearing on the merits was held. The WCJ dismissed Edmondson’s request for SEB, but determined that Edmondson was entitled to a penalty of $2,000 and attorney fees of $1,500. Only PCA was cast in judgment for the penalty and attorney fees.

Edmondson appealed the denial of her claim for SEB; and PCA answered the appeal, challenging the imposition of the penalty and attorney fees.

DENIAL OF THE CLAIM FOR SEB

In reasons transcribed into the record, the WCJ determined that Edmondson was not entitled to SEB because she failed her burden of proving she was unable to earn 90% of her pre-injury wages, noting:

Edmondson offered the records of her physician, Dr. Guidry; however these records do not place any restrictions on Edmondson which would limit her em-ployability.

Entitlement to SEB is governed by La. R.S. 23:1221(3).3 In order to recover |4SEB, a claimant must first prove by a preponderance of the evidence an inability to earn wages equal to 90 percent or more of the wages she earned before the accident. La. R.S. 23:1221(3)(a); Smith v. Louisiana Dep’t of Corrections, 93-1305, p. 4 (La.2/28/94), 633 So.2d 129, 132. And it is only after such a showing that the burden of proof shifts to the employer who, if he wishes to contend that claimant is earning less than he is able to earn so as to defeat or reduce SEB, bears the burden of proving that claimant is physically able to perform a certain job and that the job was offered to claimant or the job was available to claimant in her or the employer’s community or reasonable geographic region. Id., 93-1305 at p. 5, 633 So.2d at 132-33.

On appeal, Edmondson’s primary complaint is that after she was laid off, PCA had “a duty to at least try vocational rehabilitation services.” But before any [34]*34duty to utilize rehabilitative services for job placement arises, Edmondson first had to prove that she was unable to earn 90 percent of her pre-accident wages as a result of her injury. And after reviewing the record, we find nothing to support a determination that Edmondson was in any way limited or restricted by her doctors from performing any work. Although the medical records of Dr. Guidry admitted into evidence show that on two occasions he prescribed physical therapy for Edmondson, that showing simply does not sustain her burden of proving an inability to earn 90 percent of her pre-accident wages due to the work-related injury as required under La. R.S. 23:1221(3)(a). Thus, the burden of proving a duty on the part of PCA to offer Edmondson vocational rehabilitative services never arose. Accordingly, lacking the requisite evidence to sustain a finding of | .¡inability to earn 90 percent of pre-injury wages due to an injury, the WCJ correctly denied Edmondson’s claim for SEB.

IMPOSITION OF PENALTY AND ATTORNEY FEES

The WCJ awarded Edmondson a penalty of $2,000 and attorney fees of $1,500. The judgment casts only PCA with liability for these awards. And in its answer to the appeal, without challenging the quantum awarded, PCA suggests that it was legal error for the WCJ to impute to it the actions or inactions of Reliance and/or LIGA4 in failing to timely pay Edmondson’s medical claims. The WCJ’s transcribed reasons state:

PCA’s Workers’ Compensation carrier Reliance Insurance Company was declared insolvent [on] October 3rd, 2001. LIGA thereafter became involved and Vince Listi, the adjuster, was subpoenaed to appear for trial by Edmonson’s attorney to testify and produce the claim file. Listi failed to appear.
-!' * *
Edmondson testified she submitted various doctors’ bills and prescription invoices to the carrier/employer. She further testified these charges were directly related to her medical treatment in connection with her April 6, 1998, injury and that the invoices have yet to be paid. The adjuster could have presented himself to defend not paying these invoices but he did not. Therefore, the bills accepted into evidence are the responsibility of the Defendant.

Generally, when a party fails to produce a witness who is available to him and gives no reasonable explanation, the presumption arises that the witness’s testimony would have been unfavorable. Moran v. Harris, 93-2226, p. 8 (La.App. 1st Cir.11/10/94), 645 So.2d 1244, 1248, writ denied, 94-3046 (La.2/17/95), 650 So.2d 253. The WCJ must consider all the facts and circumstances 1 fiin the case in deciding whether the presumption will apply. See Moran, 93-2226 at p. 8, 645 So.2d at 1248.

Thus, based on the reasons set forth above, it is clear that the WCJ applied an adverse presumption against PCA for the failure of adjuster Listi to testify.

Louisiana Revised Statute 23:1201 sets forth the provisions for the imposition of a penalty and attorney fees in this case, providing in relevant portion:

E. Medical benefits payable under this Chapter shall be paid within sixty days after the employer or insurer receives written notice thereof.
[35]*35F. Failure to provide payment in accordance with this Section shall result in the assessment of a penalty in an amount equal to twelve percent of any unpaid compensation or medical benefits or fifty dollars per calendar day, whichever is greater, for each day in which any and all compensation or medical benefits remain unpaid, together with reasonable attorney fees for each disputed claim; however, the fifty dollars per calendar day penalty shall not exceed a maximum of two thousand dollars in the aggregate for any claim. Penalties shall be assessed in the following manner:
(1) Such penalty and attorney fees shall be assessed against either the employer or the insurer, depending upon fault.

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Bluebook (online)
859 So. 2d 31, 2003 La. App. LEXIS 2056, 2003 WL 21513253, Counsel Stack Legal Research, https://law.counselstack.com/opinion/edmondson-v-pca-international-american-studios-lactapp-2003.