Hypolite v. Louisiana Workers' Compensation Corp.

206 So. 3d 255, 16 La.App. 3 Cir. 387, 2016 La. App. LEXIS 2031
CourtLouisiana Court of Appeal
DecidedNovember 2, 2016
DocketWCA 16-387
StatusPublished

This text of 206 So. 3d 255 (Hypolite v. Louisiana Workers' Compensation Corp.) 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
Hypolite v. Louisiana Workers' Compensation Corp., 206 So. 3d 255, 16 La.App. 3 Cir. 387, 2016 La. App. LEXIS 2031 (La. Ct. App. 2016).

Opinion

EZELL, Judge.

|,Earnest Hypolite appeals the decision of the workers’ compensation judge that he forfeited his right to workers’ compensation benefits because he deliberately made false statements in order to obtain workers’ compensation. For the following reasons, we hereby affirm the decision of the workers’ compensation judge.

FACTS

On April 30, 2012, Mr. Hypolite sustained a workplace accident in the course and scope of his employment at the M.A. Patout sugar mill, when he slipped and fell, allegedly aggravating a prior injury to his back. Indemnity and medical benefits were paid by M.A. Patout and their workers’ compensation insurer, the Louisiana Workers’ Compensation Corporation (LWCC). LWCC terminated those benefits on July 7, 2012, after investigating Mr. Hypolite’s claim and coming to the conclusion that he had made false statements to his treating physician, Dr. John Sledge, III, and that he was collecting income from a personal business while he was receiving temporary total disability benefits.1

After a five-day trial, the workers’ compensation judge found that Mr. Hypolite had violated La.R.S. 23:1208 by making false statements and that he forfeited his right to receive workers’ compensation benefits. From that decision, Mr. Hypolite appeals.

FORFEITURE OF BENEFITS

On appeal, Mr. Hypolite asserts six assignments of error. He claims that the [257]*257workers’ compensation judge erred (1) in finding fraud when LWCC failed to 12carry its burden of proof; (2) that the workers’ compensation judge erred in finding fraud for reasons not pled specifically in LWCC’s answer; (3) in finding fraud upon evidence not actually admitted into evidence; (4) in finding fraud based on other income where LWCC and M.A. Patout allegedly failed to follow proper procedure; (5) in finding false statements to Dr. Sledge and to Vince Dubois, PT; (6) and in finding statements in Mr. Hypolite’s recorded statement rose to the level of fraud. Because they specifically overlap in our analysis, we will deal with Mr. Hypolite’s first and fifth assignments of error together.

Mr. Hypolite’s first claims that the workers’ compensation judge erred in finding that LWCC proved that he committed fraud.

Louisiana Revised Statutes 23:1208 provides in pertinent part:

A. It shall be unlawful for any person, for the purpose of obtaining or defeating any benefit or payment under the provision of this Chapter, either for himself or for any other person, to willfully make a false statement or representation.
[[Image here]]
E. Any employee violating this Section shall, upon determination by workers’ compensation judge, forfeit any right to compensation benefits under this Chapter.

The Louisiana Supreme Court in Resweber v. Haroil Constr. Co., 94-2708, 94-3138, p. 14 (La. 9/5/95), 660 So.2d 7, 16, addressed the proof required to prove fraud under La.R.S. 23:1208:

By its plain words Section 23:1208 requires only that 1) the claimant make a false statement or representation, 2) the statement or representation be willfully 'made, and 3) the statement or representation be made for the purpose of obtaining workers’ compensation benefits. The legislature has made a policy decision that willful and deliberate false statements made specifically for the purpose of obtaining workers’ compensation benefits is an attempt to defraud the workers’ compensation system and should be dealt with harshly. The legislature |Rhas shown a continued effort over recent years to make Section 1208 easier to enforce and to make its penalties stronger.

The Resweber court noted the false representations must be made for the purpose of obtaining benefits and must be more than inadvertent or inconsequential statements. The court stated:

It is evident that the relationship between the false statement and the pending claim will be probative in determining whether the statement was made willfully for the purpose of obtaining benefits. A false statement which is inconsequential to the present claim may indicate that the statement was not willfully made for the purpose of obtaining benefits. Clearly, an inadvertent and inconsequential false statement would not result in forfeiture of benefits.

Id. Louisiana Revised Statutes 23:1208 applies to statements made to insurance investigators and physicians alike; and it imposes no requirement that the employer show prejudice. Id.

A decision to impose or deny forfeiture under La. R.S. 23:1208 is a factual finding which will not be disturbed on appeal absent manifest error. Brooks v. Madrison Parish Serv. Dist. Hosp., 41,957 (La. App. 2 Cir. 3/7/7), 954 So.2d 207, writ denied, 07-720 (La. 5/18/07), 957 So.2d 155. To reverse a fact finder’s determination under this standard of review, an appellate [258]*258court must undertake a two-part inquiry: (1) the court must find from the record that a reasonable factual basis does not exist for the finding of the trier of fact; and (2) the court must further determine the record establishes the finding is clearly wrong. Stobart v. State, Dep’t of Transp. and Dev., 617 So.2d 880 (La.1993). Ultimately, the issue to be resolved by the reviewing court is not whether the trier of fact was right or wrong, but whether the fact finder’s conclusion was a reasonable one. Id. If the factual findings are reasonable in light of the record reviewed in its entirety, a reviewing |4 court may not reverse even though convinced that had it been sitting as the trier of fact, it would have weighed the evidence differently. Id.

Having reviewed the record before us, we cannot find error in the workers’ compensation judge’s finding that Mr. Hy-polite deliberately made false statements to his doctors and physical therapist in order to receive workers’ compensation benefits.

On May 16, 2012, Mr. Hypolite complained to Dr. Sledge that he was experiencing back pain. He complained of pain in his lower back and left leg that increased with “sitting, standing, walking, driving or riding in a vehicle, flexion, and extension.” He stated that his leg would sometimes give way and that he was not able to tolerate the pain with walking or sitting. Most crucially, he rated his pain at a ten on a scale of zero to ten. These complaints stand in stark contrast, however, to surveillance video obtained by LWCC.

LWCC obtained video of Mr. Hypolite on several days, beginning May 27, 2012, and through June 17, 2012. He is seen throughout those days walking and driving without any sign of discomfort whatsoever.

On May 27th, just eleven days after stating he could not tolerate walking due to his “ten out of ten” pain, he was caught on film walking, bending over, and crouching to roll up a deflated fun jump. With two other men, Mr. Hypolite could be seen pulling on the deflated jump to fold it up, often in a jerky manner, rolling up the jump, backing up his pick-up truck, and rolling the large jump onto a flatbed trailer. At no time did Mr. Hypolite appear to be in pain; rather, he appeared to be smiling as he exited his truck after backing it into place.

The next day, Mr. Hypolite was again caught on film moving a fun jump, this time alone and without any help. In the May 28th video, Mr.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Stobart v. State Through DOTD
617 So. 2d 880 (Supreme Court of Louisiana, 1993)
Brooks v. MADISON PARISH SERVICE DIST. HOS.
954 So. 2d 207 (Louisiana Court of Appeal, 2007)
Resweber v. Haroil Const. Co.
660 So. 2d 7 (Supreme Court of Louisiana, 1995)
Clark v. Diamond B. Const.
803 So. 2d 1113 (Louisiana Court of Appeal, 2001)

Cite This Page — Counsel Stack

Bluebook (online)
206 So. 3d 255, 16 La.App. 3 Cir. 387, 2016 La. App. LEXIS 2031, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hypolite-v-louisiana-workers-compensation-corp-lactapp-2016.