Hebert v. Conner-Monceaux General Contractors

922 So. 2d 1236, 2006 La. App. LEXIS 149, 2006 WL 241504
CourtLouisiana Court of Appeal
DecidedFebruary 1, 2006
DocketNo. WCA 05-760
StatusPublished

This text of 922 So. 2d 1236 (Hebert v. Conner-Monceaux General Contractors) 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
Hebert v. Conner-Monceaux General Contractors, 922 So. 2d 1236, 2006 La. App. LEXIS 149, 2006 WL 241504 (La. Ct. App. 2006).

Opinion

EZELL, Judge.

b The issue in this workers’ compensation case concerns the termination of Greg Hebert’s benefits based on a finding by the workers’ compensation judge that Greg and his wife Patricia made material misrepresentations in order to obtain payment for attendant care services. Mr. Hebert claims Dr. James Perry’s testimony should not have been admitted due to improper communication by the Louisiana Workers’ Compensation Corporation with Dr. Perry and the physical therapist. Without Dr. Perry’s testimony, Mr. Hebert claims that there is no proof of fraud.

FACTS

Mr. Hebert was employed as a carpenter for Conner-Manceaux General Contractor. While working on January 13, 2000, Mr. Hebert fell twenty-nine feet from a roof sustaining injuries to his arms, legs, head, and back. Mr. Hebert suffered multiple fractures of both legs and both arms and two separate fractures of his vertebrae. He also suffered a traumatic brain injury. He was treated and stabilized in Lake Charles by Dr. Perry, an orthopedic surgeon, and then sent to Houston for specialized treatment of his ankle. On May 22, 2001, Mr. Hebert resumed follow-up treatment in Lake Charles with Dr. Perry.

At that time, Mr. Hebert still had problems with his legs and some residual problems with his back fracture. During the next several visits with Dr. Perry, Mr. Hebert did not show much improvement. Mr. Hebert was always in a wheelchair on his visits to Dr. Perry’s office.

On March 4, 2002, Dr. Perry wrote an order for attendant care because Mr. Hebert was unable to care for all of his personal needs. Dr. Perry testified that Mrs. Hebert requested the order and he complied because it was his understanding that Mr. Hebert could not care for any of his own needs. As of June 25, 2002, Dr. Perry | ¡>ppined that Mr. Hebert had [1238]*1238reached maximum medical improvement but that he still suffered with some residual abnormalities from the fractures.

As a result of Dr. Perry’s order for attendant care, Mrs. Hebert was paid $5.15 an hour for ten hours a day, seven days a week by the Louisiana Workers’ Compensation Corporation (LWCC). It was decided that Mrs. Hebert would quit her job with the Calcasieu Parish School Board as a cafeteria technician to take care of her husband.

On August 16, 2002, Mrs. Hebert returned to her employment with the school board. However, she continued to receive payment from the LWCC for the attendant care services.

Around June 2002, the LWCC became suspicious that Mr. Hebert was functioning better than his medical reports indicated. The LWCC began video surveillance on Mr. Hebert, which lasted for a year. The video was shown to Dr. Perry in addition to Rusty Eckels, a physical therapist who performed a functional capacities evaluation on Mr. Hebert on June 3, 2003. Based on the video and the meetings with these healthcare professionals, Mr. Hebert’s temporary total disability benefits (TTD) were terminated on July 11, 2003. Attendant care benefits were last paid on July 30, 2003.

On July 30, 2003, Mr. Hebert filed a disputed claim for compensation with the Office of Workers’ Compensation. In April 2004, the LWCC filed a third-party demand against Mrs. Hebert, in addition to filing a separate formal claim against Mrs. Hebert. The two cases were consolidated.

Trial was held on October 13, 2004. The workers’ compensation judge (WCJ) took the matter under advisement and issued oral reasons for judgment on December 13, 2004. The WCJ held that the Heberts violated La.R.S. 23:1208 by continuing to ^accept the attendant care payments after Mr. Hebert’s condition improved to the point that he could drive and shop. The WCJ ordered restitution of all attendant care payments made to Mrs. Hebert from July 18, 2002 to August 2, 2003, in the amount of $18,746, and forfeiture of all benefits after July 12, 2003. The Heberts were also ordered to pay $7,500 in investigation and litigation costs. Mr. Hebert appealed the judgment.

IMPROPER COMMUNICATION WITH HEALTH CARE PROVIDERS

Mr. Hebert argues that the testimony of Dr. Perry and the surveillance video should not have been admitted because representatives of the LWCC met with them without any notice to him in violation of the health care provider-patient privilege of La.Code Evid. art. 510. Mr. Hebert claims that the LWCC failed to meet its burden of proof under La.R.S. 23:1208 without Dr. Perry’s testimony.

In June 2003, David Lorino, a claims specialist with the LWCC, and Fabian Blache, also with the LWCC, met with Dr. Perry to show him the video. After viewing the video, Dr. Perry ordered a functional capacity evaluation (FCE). The FCE was performed by Mr. Eckels. Mr. Lorino and Mr. Blache then showed the video to Mr. Eckels.

Louisiana Code of Evidence Article 510(A)(8)(a)(iv) provides that there is not a confidential communication when there is a transmittal of information to “[a] patient’s health care insurer, including any entity that provides indemnification to a patient.” Comment (h) to Article 510 further provides that “[t]he phrase ‘health care insurer’ in Paragraph (A)(8)(a)(iv) is broader than entities denominated as insurance companies, and, as this Paragraph expressly states, includes any entity that [1239]*1239provides indemnification to patients, hence including self-insurers and government plans, etc.”

|4In Farr v. Riscorp, 97-2164 (La.App. 4 Cir. 4/8/98), 714 So.2d 20, writ denied, 98-1232 (La.6/26/98), 719 So.2d 1058, the fourth circuit held that a workers’ compensation carrier met the definition of a health care insurer since it was statutorily obligated to provide medical benefits to employees for on-the-job injuries. We agree and find that Mr. Hebert is not protected by the health care provider-patient privilege afforded by Article 510. Therefore, there was no confidential communication with Dr. Perry and Mr. Eckels and we agree with the WCJ’s decision to admit the video and Dr. Perry’s testimony.

FORFEITURE OF BENEFITS

Mr. Hebert argues that the WCJ erred in finding that he and his wife violated La.R.S. 23:1208. He claims that the evidence is clear that he and his wife did not make any misrepresentations with regard to his medical condition. The whole issue surrounds the payment of attendant care benefits to Mrs. Hebert to care for Mr. Hebert.

In finding that the Heberts committed fraud in continuing to accept attendant care benefits the WCJ stated:

As earlier stated, L.W.C.C. agreed to pay Mrs. Hebert attendant care payments because she had taken leave of absence from work and was staying with her husband. Unbeknownst to L.W.C.C., Mrs. Hebert returned to her employment for the Calcasieu Parish School Board on August the 16th, 2002, a fact she apparently did not reveal until over a year later. Instead, she continued to provide handwritten time sheets to justify payments for her being a full-time caregiver for her husband at a time when she was elsewhere.
The medical evidence certainly supports Mr. Hebert’s argument that he probably cannot return to the type of physical work he has done all his life. Dr. Mayes, his pain management physician, and Dr. Charles Robinson, his psychiatrist, have not released him to -return to any employment. There’s no question that his 29-foot fall from a roof during which he seriously injured most of his body has taken its toll. But, that’s a given.

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Related

Farr v. Riscorp
714 So. 2d 20 (Louisiana Court of Appeal, 1998)
City of Shreveport v. Baylock
107 So. 2d 419 (Supreme Court of Louisiana, 1958)
Lanthier v. Family Dollar Store
848 So. 2d 605 (Louisiana Court of Appeal, 2003)
Wood v. Brian Harris Autoplex
923 So. 2d 17 (Louisiana Court of Appeal, 2005)
Resweber v. Haroil Const. Co.
660 So. 2d 7 (Supreme Court of Louisiana, 1995)
Holmes v. Hendricks
4 La. App. 1 (Louisiana Court of Appeal, 1926)

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922 So. 2d 1236, 2006 La. App. LEXIS 149, 2006 WL 241504, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hebert-v-conner-monceaux-general-contractors-lactapp-2006.