Janet C. Lemoine v. Town of Simmesport
Opinion
STATE OF LOUISIANA
COURT OF APPEAL, THIRD CIRCUIT
08-429
JANET C. LEMOINE VERSUS TOWN OF SIMMESPORT
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APPEAL FROM THE
OFFICE OF WORKERS’ COMPENSATION, DISTRICT 02 PARISH OF RAPIDES, NO. 06-08811 JAMES L. BRADDOCK, WORKERS’ COMPENSATION JUDGE
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MICHAEL G. SULLIVAN
JUDGE
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Court composed of Sylvia R. Cooks, Michael G. Sullivan, and Billy Howard Ezell, Judges.
Cooks, J., dissents and assigns reasons.
AFFIRMED.
Jerold Edward Knoll The Knoll Law Firm Post Office Box 426 Marksville, Louisiana 71351 (318) 253-6200 Counsel for Plaintiff/Appellant:
Janet C. Lemoine
Mark D. Boyer Boyer & Hebert 1810 Florida Avenue, SW, Suite B Denham Springs, Louisiana 70726 (225) 664-4335 Counsel for Defendant/Appellee:
Town of Simmesport
Joseph B. Stamey Stamey & Miller Post Office Drawer 1288 Natchitoches, Louisiana 71458-1288 (318) 352-4559 Counsel for Defendant/Appellee:
Louisiana Municipal Risk Management Agency
SULLIVAN, Judge.
Janet Lemoine appeals a judgment of the Office of Workers’ Compensation (OWC) which dismissed her claims against the Town of Simmesport. For the following reasons, we affirm.
FACTS AND PROCEDURAL HISTORY Ms. Lemoine was injured on October 6, 2006, while collecting money for the Simmesport Cares Program (the Cares Program) at a roadblock set up on Highway 1 in Simmesport, Louisiana. After suffering a seizure, she fell and hit her head on the highway. The fall caused permanent brain damage and left her in a semi-vegetative state, totally dependent upon others, and, according to the neurosurgeon who performed brain surgery on her, with no chance of full recovery. As a result of her injuries, Ms. Lemoine was interdicted and her daughter was appointed as her curatrix.1 On December 27, 2006, Ms. Lemoine filed a Disputed Claim for Compensation against the Town of Simmesport (the Town), her employer at the time of her injury. Risk Management, Inc. (Risk Management), as administrator of the Town’s workers’ compensation insurer, denied Ms. Lemoine’s claim in a letter to the Mayor of Simmesport, James Fontenot, dated November 30, 2006, on the basis that her injury was not work related. The Town later filed an answer to the disputed claim denying that Ms. Lemoine was injured by an accident arising out of and in the course and scope of her employment.2
1 All of the pleadings in this matter by Ms. Lemoine have been filed on her behalf by her curatrix. For ease of discussion, we will refer to the pleadings as being filed by Ms. Lemoine.
2 By way of an amended answer, the Town affirmatively pled the defense of intoxication, i.e., it claimed that Ms. Lemoine was intoxicated by alcohol and non-prescribed controlled substances at the time of her accident. Several weeks later, however, the Town filed a second amended answer removing the defense of intoxication by alcohol. Approximately one month thereafter, the Town
Several weeks before the originally scheduled trial, Risk Management discharged the Town’s attorney of record and informed the Town that it would no longer provide the Town with coverage or a defense to Ms. Lemoine’s lawsuit. As a result, the Town filed a third-party demand against Risk Management alleging that it was owed coverage and/or a defense to Ms. Lemoine’s claims by virtue of the insurance contract between them.3 Risk Management filed exceptions and an answer to the Town’s third-party demand.
Ms. Lemoine filed a motion for summary judgment against the Town and Risk Management on the issues of whether she had suffered a work-related accident and whether the accident had occurred during the course and scope of her employment with the Town, thus entitling her to workers’ compensation benefits, along with penalties, interest, and attorney fees. The Town opposed the motion. Following a hearing, the workers’ compensation judge denied Ms. Lemoine’s motion. Ms. Lemoine timely sought writs in this court. In a decision rendered on January 9, 2008, this court denied the writ finding no error in the trial court’s ruling.4 Trial on the merits was held on January 10, 2008. At the close of the evidence, Risk Management moved for an involuntary dismissal. The workers’ compensation judge granted the motion and dismissed Ms. Lemoine’s claims against the Town with prejudice. The third-party demand filed by the Town against Risk Management was dismissed with prejudice as well.
filed a third amended answer removing the defense of intoxication by non-prescribed controlled substances.
3 The Town later amended its third-party demand to change the name of the third-party defendant to Louisiana Municipal Risk Management Association. For ease of discussion, we will continue to refer to that entity as Risk Management.
4 See Lemoine v. Town of Simmesport, an unpublished writ bearing docket number 08-28 (La.App. 3 Cir. 1/9/08).
Ms. Lemoine now appeals, assigning the following errors:
1. The Workers’ Compensation Court committed an error of fact and law in holding that she was not within the course and scope of her employment with the Town of Simmesport at the time of her injury.
2. The Workers’ Compensation Court committed an error of fact and law in holding that La.R.S. 33:404 and La.R.S. 33:321 do not vest authority in the Mayor of Simmesport to establish the Simmesport Cares Program on behalf of the Town of Simmesport.
DISCUSSION
The Louisiana Supreme Court set out the standard of review to be employed in workers’ compensation cases in Banks v. Industrial Roofing & Sheet Metal Works, Inc., 96-2840, pp. 7-8 (La. 7/1/97), 696 So.2d 551, 556 (citations omitted):
Factual findings in workers’ compensation cases are subject to the manifest error or clearly wrong standard of appellate review. In applying the manifest error-clearly wrong standard, the appellate court must determine not whether the trier of fact was right or wrong, but whether the factfinder’s conclusion was a reasonable one.
“The determination of coverage is a subjective one in that each case must be decided from all of its particular facts.” Jackson v. Am. Ins. Co., 404 So.2d 218, 220 (La.1981). A worker bringing a compensation action against her employer bears the burden of proving, as a threshold requirement, that she suffered “personal injury by accident arising out of and in the course of employment.” La.R.S. 23:1031; Bruno v. Harbert Int’l Inc., 593 So.2d 357 (La.1992). The word “accident” as used in La.R.S. 23:1031 is defined as “an unexpected or unforeseen actual, identifiable, precipitous event happening suddenly or violently, with or without human fault, and directly producing at the time objective findings of an injury which is more than simply a gradual deterioration or progressive degeneration.” La. R.S. 23:1021(1).
This court explained in Lexington House v. Gleason, 98-1818, pp. 2-3 (La.App.
3 Cir. 3/31/99), 733 So.2d 123, 124, writ denied, 99-1290 (La. 6/25/99), 746 So.2d 603 (alteration in original):
Under La.R.S. 23:1031(A), an employer is required to pay workers’ compensation to an employee not otherwise eliminated from receiving benefits if the employee sustains an injury by accident “arising out of and in the course of his employment . . . .” The “arising out of”
and the “in the course of” elements are not synonymous but cannot be considered in isolation from each other. Jackson v. American Ins. Co., 404 So.2d 218 (La.1981). A strong showing with reference to one of these elements may compensate for a relatively weak showing with reference to the other. Id. In Jackson, the court found that the “arising out of” element in the case before it was satisfied by two factors: the extent to which employee attendance at the event was mandatory and the degree to which the employer’s purpose was served by the activity which gave rise to the injury. The court also explained that the “in the course of” element generally relates to the time and place of the accident as it relates to that of the regular employment.
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