Elie v. Sears, Roebuck & Co.

940 So. 2d 768, 6 La.App. 3 Cir. 395, 2006 La. App. LEXIS 2154, 2006 WL 2773853
Louisiana Court of Appeal·Decided September 27, 2006·No. No. 2006-395·Published

Opinion

COOKS, Judge.

|, The claimant, Anthony Elie, appeals the judgment of the Office of Workers’ Compensation that found he was not entitled. to continuing supplemental earnings benefits, the employer was owed a credit, and he was not entitled to certain penalties and attorney fees for late and/or non-payment of benefits.

FACTS AND PROCEDURAL HISTORY

Anthony Elie alleges he injured his left arm and shoulder on June 20, 2001 while employed as a part-time worker at Sears, Roebuck & Company in Alexandria, Louisiana. Mr. Elie stated he was lifting a [770]*770refrigerator when the injuries occurred. At the time of the incident, Mr. Elie earned $5.92 per hour at Sears, where he had “moonlighted” for approximately seven years. Mr. Elie also had a full-time job as a janitor with the Rapides Parish School Board, as well as another part-time “Sunday” job at Mount Calvary Baptist Church.

Sears sent Mr. Elie to Dr. Charles Smith for treatment following the accident. Dr. Smith prescribed anti-inflammatory medication and placed Mr. Elie into physical therapy. Mr. Elie was not able to perform his janitorial duties with the School Board, but continued working for the church and Sears, which found light-duty work for Mr. Elie. Sears began paying workers’ compensation benefits to Mr. Elie in December of 2001.

When Mr. Elie complained the medication was not helping and he could not tolerate the physical therapy due to severe pain, Dr. Smith referred Mr. Elie to Dr. Jeffrey Garrison, an orthopedist. Dr. Garrison recommended that Mr. Elie undergo shoulder surgery. After the first surgery, which occurred in December 2002, Mr. Elie went back to work at the School Board, which found light duty work for him to perform. Sears could not or would not provide light duty work for Mr. Elie. The first | ¡^surgery was not as successful as desired, and Dr. Garrison informed Mr. Elie he would need a second surgery, involving a bone graft from his hip to his shoulder. Prior to undergoing the second surgery, which occurred on October 3, 2002, Mr. Elie submitted a letter of resignation to the School Board on September 10, 2002. Mr. Elie attended physical therapy for approximately four months after the second surgery. While there was marked improvement in his condition after the second surgery, Mr. Elie continued to complain of pain and physical limitations in his shoulder and hip.

On April 8, 2003, Sears allowed Mr. Elie to return to work. It also discontinued all payment of benefits on that date, even though he was no longer employed at the School Board. On July 22, 2003, Mr. Elie saw Dr. Garrison and related he had “good and bad days with his shoulder and sometimes has some pain and discomfort.” Dr. Garrison found Mr. Elie had full active flexion and abduction motions. He recommended that Mr. Elie “be liberalized to full activity with regard to work and lifting.”

On Mr. Elie’s November 13, 2003 examination, Dr. Garrison noted he was having no significant pain and has “nearly full motion.” Dr. Garrison concluded the “patient is asymptomatic with regards to his shoulder with only occasional discomfort and at this point, I think has reached maximum medical improvement. He is quite functional with it.” Dr. Garrison scheduled Mr. Elie for a functional capacity evaluation (FCE).

The FCE, which was conducted on November 25, 2003, noted Mr. Elie “put forth valid, consistent and reliable effort throughout the evaluation.” The FCE found Mr. Elie had a residual fifteen percent permanent partial impairment of his left arm and a nine percent impairment of his body as a whole. With the noted impairments, |she fell in the U.S. Department of Labor’s Heavy (26 to 50 pounds) physical demand level.

On July 13, 2004, Mr. Elie filed a disputed claim for compensation against Sears. The WCJ noted that because Mr. Elie, at the time of the injury, was not working forty hours a week at Sears, he fell under the moonlighting provisions of the Workers’ Compensation Act. Because Mr. Elie continued at all times to work for the church, the WCJ found he was not eligible for temporary total disability benefits, but [771]*771was limited to a claim for supplemental earnings benefits (SEB). The WCJ calculated Mr. Elie’s base monthly SEB wages to be $2,225.42 (which included his earnings from Mt. Calvary Church, $150.00; Sears, $553.41; and the School Board, $1522.01). Under La.R.S. 23:1202(A)(2), “In no event shall monthly Supplemental Earnings Benefits exceed four and three tenths times temporary total disability benefits.” Thus, Mr. Elie would not be entitled to supplemental earning benefits that exceed four and three-tenths (4 3/10) times $157.87 a week (which is his temporary total disability compensation rate.) The WCJ concluded Mr. Elie was entitled to a maximum monthly supplemental earnings benefit of $678.84. There is no dispute among the parties that this is a correct calculation.1

The WCJ found Mr. Elie was entitled to SEB from September 10, 2001 through March 19, 2002, which encompassed the period of time between the injury and when Mr. Elie returned to light-duty work for the School Board after his first shoulder surgery. The WCJ held Mr. Elie was not entitled to SEB from March 20, 2002, when he returned to work at the School Board through September 10, 2002, when he | ¿resigned from his job with the School Board in anticipation of his second shoulder surgery. The WCJ held Mr. Elie was again entitled to receive SEB from September 11, 2002 through November 25, 2003. The WCJ concluded by November 25, 2003 Mr. Elie was “fully capable of performing heavy duty work which would mean he would be capable of performing his activities of a janitor at the School Board.” Further, he noted Mr. Elie “chose” not to return to work at the School Board, instead accepting employment at Crossroads Regional Hospital. Therefore, the WCJ held any claim for continuing SEB subsequent to November 25, 2003 was denied.

As to Mr. Elie’s claim for untimely payment of benefits, and the employer’s request for a credit for excessive payments, the WCJ set forth the following oral reasons for judgment:

Now we turn to probably the most complicated portion of Mr. Elie’s claim, that being his claim for untimely payment of benefits, whether he’s entitled to any type of SEB payments. If so, when. The employer’s claim for credits. The records reflect that at no time did the employer pay Mr. Elie the correct compensation rate. They always paid an excessive compensation rate. So in making my best determination from grafting out the payments of the payments made by the employer to the employee, and I would like to note with respect to the payments to Mr. Elie that the records reflect there’s a payment to Mr. Elie for a time period of March 20th of 2002 through April 2nd of 2002 of Three Hundred and Thirty-Two Dollars and Two cents ($332.02) per week when actually he was only due Three Hundred and Fifteen Dollars and Seventy-four Cents ($315.74) for that two-week period. Excuse me. That’s a two-week period. Then subsequently in May of 2002, there was a tender of another sum of money to Mr. Elie which also included the two weeks of April .20th, I mean, of [772]*772March 20, 2002 through April 2nd of 2002. And I apologize to counsel and to the Court of Appeal if I’m not being clear, but I’m going to do the best I can to show the credits due the employer and what SEB benefits may be due Mr. Elie. Based on the sums of overpay-ments made to Mr.

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Elie v. Sears, Roebuck & Co., 940 So. 2d 768, 6 La.App. 3 Cir. 395, 2006 La. App. LEXIS 2154, 2006 WL 2773853 (La. Ct. App. 2006).

940 So. 2d 768 (Elie v. Sears, Roebuck & Co.) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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