Gary v. HB Zachry Co., Inc.

631 So. 2d 671, 1994 WL 30361
CourtLouisiana Court of Appeal
DecidedFebruary 2, 1994
Docket93-581
StatusPublished
Cited by9 cases

This text of 631 So. 2d 671 (Gary v. HB Zachry Co., Inc.) 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
Gary v. HB Zachry Co., Inc., 631 So. 2d 671, 1994 WL 30361 (La. Ct. App. 1994).

Opinion

631 So.2d 671 (1994)

Randy Joseph GARY, Plaintiff-Appellee,
v.
H B ZACHRY COMPANY, INC., Defendant-Appellant.

No. 93-581.

Court of Appeal of Louisiana, Third Circuit.

February 2, 1994.

*672 Rex Douglas Townsley, Lake Charles, for Randy Joseph Gary.

Benjamin Wakefield Mount, Thomas John Gayle, Lake Charles, for H B Zachry Co., Inc.

Before DOUCET and KNOLL, JJ., and CULPEPPER,[*] J. Pro Tem.

WILLIAM A. CULPEPPER, Judge Pro Tem.

This is a workers' compensation case. On September 26, 1990, plaintiff, Randy Joseph Gary, suffered an injury, allegedly to his back, while in the course and scope of his employment with defendant, H B Zachry Company, Inc. The hearing officer originally rendered judgment in favor of defendants, H B Zachry and Cigna Property and Casualty Ins. Co. (the insurer), finding that any disability plaintiff has was not caused by the accident. Plaintiff subsequently obtained objective evidence to support his claim of disability. Upon application for modification and reversal of judgment by plaintiff, the hearing officer ordered that the cause be reopened and the matter set for a new hearing on the merits. After a second hearing, the hearing officer held in favor of plaintiff. Defendants appeal.

The substantial issues are whether the hearing officer erred in:

1. denying defendants' exception of res judicata and granting a hearing for modification under LSA-R.S. 23:1310.8(A)(1);

2. failing to deny benefits because plaintiff did not truthfully answer his preemployment application as required by LSA-R.S. 23:1208.1;

3. finding plaintiff's low back injury causally related to the 1990 accident;

4. awarding full medical benefits, above the $750 cap provided by LSA-R.S. 23:1142(B), for testing and treatment not approved by defendants.

General Facts

Plaintiff worked for H B Zachry as a lead insulator. On September 26, 1990, he and a co-worker were working on a scaffold. A piece of equipment, being used by other employees, struck the scaffold. The scaffolding lifted up, pinning plaintiff between the scaffolding and a pipe and twisting him around.

*673 Plaintiff complained of back and neck pain following the incident, and he immediately sought medical attention. He began receiving weekly workers' compensation benefits on September 30, 1990.

Plaintiff initially saw Dr. Robert Dale Bernauer, an orthopedic surgeon, on October 3, 1990. He had multiple complaints at that time. Dr. Bernauer performed a normal orthopedic exam, placed plaintiff on physical therapy and continued to follow him.

A functional capacity evaluation was performed on January 3, 1991, and inconsistencies were noted.

Dr. Bernauer ordered an MRI, which was normal in the neck but showed some dehydration and bulging at L4-5 and a fusion at L5-S1. Plaintiff had sustained a prior back injury in 1985 and underwent a fusion at L5-S1 in 1986.

At some point, defendants obtained a video tape of plaintiff riding a motorcycle shortly after the accident, which Dr. Bernauer viewed.

Dr. Bernauer released plaintiff on February 22, 1991, to return to work within three days of that time, apparently because he felt that he had offered plaintiff everything he could and also because Dr. Bernauer found that plaintiff may have been a malingerer.

On March 3, 1991, defendants discontinued benefits based upon (1) misrepresentations by plaintiff on his preemployment application regarding his prior back injury and treatment; (2) the video showing plaintiff riding a motorcycle after the accident and his subsequent denial of the fact in a deposition; (3) the report from Lake Charles Memorial Hospital and the work hardening program in which plaintiffs answers were found to be inconsistent; and (4) Dr. Bernauer's report releasing plaintiff.

On March 11, 1991, plaintiff saw Dr. Dean Moore, a neurosurgeon. Plaintiff's chief complaints at that time were neck and low back pain. Dr. Moore found some limitation in motion, a positive straight leg raising test, and some weakness and decreased sensation in plaintiff's right foot. Dr. Moore did not know exactly what the problem was. He recommended additional testing of the back, specifically a CAT scan, Tomograms, and an EMG. He could not make any more out of his neck condition than a straining injury.

Plaintiff also saw Dr. Bernauer again on May 17, 1991. On that examination, Dr. Bernauer "didn't find a whole lot with him." He did find some questionable weakness and some sciatic nerve complaint. Dr. Bernauer was also of the opinion that the testing recommended by Dr. Moore should be done. However, he felt that there was still evidence of some functional overlay or exaggeration.

After the recommendations of further testing, on July 7, 1991, defendants reinstituted compensation and authorized various tests. The first test scheduled was the CAT scan. On July 23, 1991, plaintiff went to the Diagnostic Imaging Center to undergo that test. At that time there was some confusion over which area or areas were scheduled to be examined. Cynthia Richardson, an x-ray technician at the Center, testified that she told plaintiff that he was scheduled for a CAT scan of the lumbar spine. She testified that plaintiff informed her that nothing was wrong with his back but that there was something wrong with his neck. It was verified that plaintiff was to undergo a CAT scan on his lumbar spine. Plaintiff testified that he asked for both his neck and low back, and that he wanted to know why the test was not approved for his neck.

Plaintiff underwent the lumbar CAT scan which showed some mild posterior annular bulging centrally and on the left side at L4-5 with mild bilateral neuro foraminal narrowing and the previous fusion and laminectomy at L5-S1 on the left.

On August 4, 1991, defendants again terminated benefits on the basis of the testimony of Cynthia Richardson that plaintiff had stated that there was nothing wrong with his back and also on the basis of the reports that showed there was nothing wrong with plaintiff's neck. Defendants did not approve the EMG or Tomograms after the CAT scan because "[t]here was no reason for it." It was determined that it was not of interest to pay for additional tests when plaintiff did not have a back problem.

*674 The matter was set for trial. Plaintiff alleged entitlement to certain medical expenses, past-due compensation from March 3, 1991, until July 7, 1991, temporary total disability benefits after August 4, 1991, and other expenses. The hearing was held on September 17, 1991. On October 3, 1991, the hearing officer signed a judgment in favor of defendants, dismissing plaintiff's claim. The hearing officer stated:

"The evidence overwhelmingly shows that any disability the poor man may have is a result of longstanding emotional problems which were certainly not caused by the accident. (See July 1, 1991 evaluation report of Dr. Rennie Culver, M.D.) Furthermore, claimant is not credible. This is demonstrated by the falsehoods he gave on his employment application which could have affected the employer's right to relief from the Louisiana second injury board, his falsehoods given at his deposition concerning a riding a motorcycle after the accident, and the suspicious inconsistencies of his performance in the functional capacity evaluation. Consequently, any subjective complaints given by claimant to support an allegation of disability must be viewed critically by this Office, and after having done so, are found to be unreliable."

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Cite This Page — Counsel Stack

Bluebook (online)
631 So. 2d 671, 1994 WL 30361, Counsel Stack Legal Research, https://law.counselstack.com/opinion/gary-v-hb-zachry-co-inc-lactapp-1994.