Fortune v. Charbonnet-Labat Funeral Home

671 So. 2d 988, 95 La.App. 4 Cir. 1954, 1996 La. App. LEXIS 505, 1996 WL 114366
CourtLouisiana Court of Appeal
DecidedMarch 14, 1996
Docket95-CA-1954
StatusPublished
Cited by6 cases

This text of 671 So. 2d 988 (Fortune v. Charbonnet-Labat Funeral Home) 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
Fortune v. Charbonnet-Labat Funeral Home, 671 So. 2d 988, 95 La.App. 4 Cir. 1954, 1996 La. App. LEXIS 505, 1996 WL 114366 (La. Ct. App. 1996).

Opinion

671 So.2d 988 (1996)

Warren FORTUNE
v.
CHARBONNET-LABAT FUNERAL HOME and United States Fire Insurance Co.

No. 95-CA-1954.

Court of Appeal of Louisiana, Fourth Circuit.

March 14, 1996.

*990 Pete Lewis, Michelle K. Buford, Lewis & Caplan, New Orleans, for Plaintiff/Appellee.

Lisa A. Montgomery, Keith M. Matulich, Lobman, Carnahan and Batt, Metairie, for Defendants/Appellants.

Wiley G. Lastrapes, Jr., New Orleans, for Third Party Defendant/Appellee.

Before BARRY, LOBRANO and PLOTKIN, JJ.

PLOTKIN, Judge.

Defendants, Charbonnet-Labat Funeral Home and United States Fire Insurance Co. (hereinafter Charbonnet), appeal a judgment awarding plaintiff, Warren Fortune, workers' compensation supplemental earnings benefits (SEB), attorney fees, and penalties, and awarding third-party defendant Tulane Medical Center Clinic medical expenses. We affirm.

Facts and procedural history

Fortune, who had been a 30-year employee at Charbonnet, injured his back in a work-related accident on December 6, 1989. As a result of the injury, Fortune underwent two different surgical procedures to his back. Fortune's treating physician, Dr. James Butler of Tulane Medical Center, determined that Fortune had reached maximum medical improvement on November 11, 1992, and assigned Fortune a 25 percent whole body physical impairment and loss of physical function.

After Fortune had reached maximum medical improvement, Charbonnet started procedures to reduce Fortune's workers' compensation benefits. At the time of the accident, Fortune earned $280 per week. Charbonnet paid total temporary disability (TTD) benefits of $186.68 from the time of the accident until April 23, 1993, at which time the benefits were reduced to SEB benefits of $73.34, based on the belief that Fortune could work a minimum wage job for 40 hours per week.

In reaching that conclusion, Charbonnet engaged the services of Kathleen Jarman of Crawford & Co., who performed a labor market survey and reportedly discovered nine jobs which Fortune was qualified to perform. On March 24, 1993, the results of that labor market survey were sent to Dr. Butler, who apparently approved the jobs. Jarman also mailed the results of the labor market survey to Fortune's home, and later to Fortune's attorney. Fortune's benefits were reduced on April 23, 1993, almost exactly one month after the results of the labor market survey were sent to Dr. Butler.

Fortune filed suit seeking reinstatement of TTD benefits and payment of outstanding medical expenses. Defendants filed a third party suit against Tulane Medical Center Clinic. *991 following a hearing, the hearing officer found that Fortune was entitled to SEB rather than TTD benefits. He awarded Fortune full SEB benefits from the date of reduction, April 23, 1983, until July 1, 1993, when Fortune began working for his stepmother earning between $40 and $50 per week. After July 1, 1993, the hearing officer held, Fortune was to be paid SEB benefits with a reduction of $45 per week representing the wages he actually received. Further, the hearing officer imposed $7,500 attorney fees and 12 percent penalties on Charbonnet. Finally, the hearing officer required Charbonnet to pay the third-party defendant $2,069.56 in unpaid medical expenses.

Charbonnet appeals, making three basic claims: (1) that the reduction of benefits was appropriate, (2) that the payments previously made to the third-party defendant were correct under the Louisiana Worker's Compensation Fee Schedule and that no further money is due, and (3) that its decisions and actions were not arbitrary and capricious.

1. Reduction of benefits[1]

Determination of the amount of SEB payments due an injured employee is governed by the provisions of LSA-R.S. 23:1221(3), which provides, in pertinent part, as follows:

(a) For injury resulting in the employee's inability to earn wages equal to ninety per cent or more of wages at time of injury, supplemental earnings benefits equal to sixty-six and two thirds percent of the difference between the average monthly wages at time of injury and average monthly wages earned or average monthly wages the employee is able to earn in any month thereafter in any employment or self-employment, whether or not the same or a similar occupation as that in which the employee was customarily engaged when injured and whether or not an occupation for which the employee at the time of injury was particularly fitted by reason of education, training, and experience, such comparison to be made on a monthly basis. Average monthly wages shall be computed as four and three tenths times the wages as defined in R.S. 23:1021(10).
(b) For purposes of Subparagraph (3)(a), of this Paragraph, the amount determined to be the wages the employee is able to earn in any month shall in no case be less than the sums actually received by the employee, including, but not limited to, earnings from odd-lot employment, sheltered employment, and employment while working in any pain.
(c)(i) Notwithstanding the provisions of Subparagraph (b) of this Paragraph, for purposes of Subparagraph (a) of this Paragraph, if the employee is not engaged in any employment or self-employment, as described in Subparagraph (b) of this Paragraph, or is earning wages less than the employee is able to earn, the amount determined to be the wages the employee is able to earn in any month shall in no case be less than the sum the employee would have earned in any employment or self-employment, as described in Subparagraph (b) of this Paragraph, which he was physically able to perform, and (1) which he was offered or tendered by the employer or any other employer, or (2) which is proven available to the employee in the employee's or employer's community or reasonable geographic region.
(ii) For purposes of Subsubparagraph (i) of this Subparagraph, if the employee establishes by clear and convincing evidence, unaided by any presumption of disability, that solely as a consequence of substantial pain, the employee cannot perform employment offered, tendered, or otherwise proven to be available to him, the employee shall be deemed incapable of performing such employment.

Generally, the purpose of SEB is "to compensate the injured employee for the wage *992 earning capacity he has lost as a result of his accident." Pinkins v. Cardinal Wholesale Supply, Inc., 619 So.2d 52, 55 (La.1993). In making these determinations, courts are required to be "mindful of the jurisprudential tenet that worker's compensation law is to be liberally construed in favor of coverage." Smith v. Louisiana Department of Corrections, 93-1305 (La. 2/28/94), 633 So.2d 129, 132; Reed v. Direct Installers, 95-CA-1684 (La.App. 4th Cir. 1/31/96), slip op. at p. 6, 669 So.2d 529, 533-34; Garner v. Sheats & Frazier, 95-39 (La.App. 3d Cir. 7/5/95), 663 So.2d 57, 61.

Generally, a claimant, such as Fortune in the instant case, has the initial burden of showing that he is entitled to SEB benefits because he is unable to earn 90 percent of his pre-injury wages. However, Charbonnet does not dispute that Fortune is entitled to SEB. Once the claimant's prima facie case has been proved, the burden shifts to the employer to prove that "the employee is physically able to perform a certain job and that the job was offered to the employee or that the job was available to the employee in his or the employer's community or reasonable geographic region." LSA-R.S. 23:1221(3)(c)(i);

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Bluebook (online)
671 So. 2d 988, 95 La.App. 4 Cir. 1954, 1996 La. App. LEXIS 505, 1996 WL 114366, Counsel Stack Legal Research, https://law.counselstack.com/opinion/fortune-v-charbonnet-labat-funeral-home-lactapp-1996.