Jeansonne v. American Native Const.

710 So. 2d 306, 97 La.App. 3 Cir. 1228, 1998 La. App. LEXIS 398, 1998 WL 100370
CourtLouisiana Court of Appeal
DecidedMarch 6, 1998
Docket97-1228
StatusPublished
Cited by8 cases

This text of 710 So. 2d 306 (Jeansonne v. American Native Const.) 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
Jeansonne v. American Native Const., 710 So. 2d 306, 97 La.App. 3 Cir. 1228, 1998 La. App. LEXIS 398, 1998 WL 100370 (La. Ct. App. 1998).

Opinion

710 So.2d 306 (1998)

Anastasia JEANSONNE, Plaintiff-Appellee,
v.
AMERICAN NATIVE CONSTRUCTION, et al., Defendants-Appellants.

No. 97-1228.

Court of Appeal of Louisiana, Third Circuit.

March 6, 1998.

*307 Chris J. Roy, Jr., Alexandria, for Anastasia Jeansonne.

Thomas D. Travis, Baton Rouge, for American Native Const. and LWCC.

Before DECUIR, AMY and PICKETT, JJ.

AMY, Judge.

In this workers' compensation case, American Native Construction and its workers' compensation carrier, Louisiana Workers' Compensation Corporation, appeal an award of attorney's fees and a decision holding them liable for payment of two outstanding medical bills submitted for payment after the employee entered into a compromise with the third party tortfeasor, where monies paid by the third party tortfeasor remained after satisfying American Native's subrogation claim. For the reasons which follow, we reverse.

DISCUSSION OF THE RECORD

On June 2, 1995, Anastasia Jeansonne [Jeansonne] was injured in an automobile accident while in the course and scope of her employment with American Native Construction [American Native]. Several weeks after the accident, Jeansonne filed a workers' compensation claim with Louisiana Workers' *308 Compensation Corporation [LWCC] for compensation benefits and medical benefits. Jeansonne also pursued a tort claim against the driver of the other vehicle who was at fault in the accident, as well as State Farm Insurance Company, the other driver's liability carrier. Prior to filing suit, a compromise was reached between Jeansonne and State Farm. The settlement was for $20,000.00, from which, LWCC received $6,102.94, the amount paid to or on behalf of Jeansonne in worker's compensation benefits or medical benefits.

Approximately three months after the tort claim was settled, Jeansonne made a demand to LWCC for payment of two outstanding medical bills incurred on or about the date of the accident, one in the amount of $559.00 from Rapides General Hospital for emergency room care and another for $112.00 from the Schumacher Group. Jeansonne also questioned two charges reimbursed to LWCC by State Farm. The defendants, acknowledging that the outstanding medical bills were compensable expenses under workers' compensation law, contended that they were entitled to take a dollar for dollar credit against the money received by Jeansonne in her settlement with State Farm. Jeansonne eventually filed a disputed claim form to recover $578.20 paid to LWCC by State Farm, and for payment of the two outstanding medical bills. In response, American Native and LWCC filed an exception of no subject matter jurisdiction. Jeansonne filed a motion for summary judgment. The workers' compensation judge deferred consideration of both the exception to subject matter jurisdiction and the motion for summary judgment, until after a hearing on the merits.

A hearing was held on March 13, 1997, at which time, the workers' compensation judge concluded that the dispute over reimbursement of monies paid to LWCC by State Farm, that were allegedly paid in derogation of the Louisiana Worker's Compensation Act, was outside the Office of Workers' Compensation's [OWC] subject matter jurisdiction. The workers' compensation judge denied Jeansonne's motion for summary judgment. After finding the outstanding medical bills to be within the exclusive jurisdiction of the OWC, the workers' compensation judge held the defendants responsible for payment of the two outstanding medical bills. Additionally, the workers' compensation judge ordered the defendants to pay $4,000.00 in attorney's fees.[1]

American Native and LWCC appeal, alleging the following as errors: (1) OWC had no subject matter jurisdiction over a dispute concerning the proceeds of a tort claim against a third party tortfeasor; (2) alternatively, if OWC did have subject matter jurisdiction over the claim, the defendants were entitled to an offset for the two medical bills incurred before settlement but presented several months later; (3) because the defendant's were entitled to an offset against the settlement of the third party tortfeasor, the workers' compensation judge erred in ordering the insurer to pay medical bills presented after the settlement; and (4) the workers' compensation judge erred in awarding Jeansonne attorney's fees. Jeansonne answers this appeal requesting additional penalties and attorney's fees.

MERITS

SUBJECT MATTER JURISDICTION

First, we address American Native and LWCC's contention that the OWC did not have subject matter jurisdiction over the claim to a credit or offset against settlement proceeds realized in a compromise between the employee, Jeansonne, and State Farm. In response, Jeansonne contends that the workers' compensation judge correctly denied the defendants' exception of no subject matter jurisdiction because the issue before the tribunal was payment of past due medical bills incurred as a result of a work related injury.

Article 5, Section 16 of the Louisiana Constitution vests original jurisdiction over all civil matters in the district courts unless *309 provided otherwise by another provision of the constitution or where the Louisiana legislature has "provided by law for administrative matters...." In the area of workers' compensation, our legislature has vested workers' compensation judges with "exclusive jurisdiction over all claims or disputes arising out" of the workers' compensation chapter. La.R.S. 23:1310.3(E). "[M]ere involvement of a workers' compensation statute or claim does not automatically subject the entire matter to the jurisdiction of the OWC. [Citations omitted]. Rather, the claim must be closely and carefully scrutinized before making such a jurisdictional determination." Orthopedic Specialists of Louisiana v. Western Waste Industries, Inc., 28,281, p. 4 (La. App. 2 Cir. 5/13/96); 674 So.2d 1180, 1182.

In support of its contention, American Native and LWCC cite several appellate cases, including: Cajun Bag and Supply v. Baptiste, 94-1218 (La.App. 3 Cir. 3/1/95); 651 So.2d 943, Orthopedic Specialists of Louisiana, 28,281; 674 So.2d 1180, and Gordon v. Waste Management of New Orleans, 94-1252 (La.App. 4 Cir. 12/15/94); 648 So.2d 1037, writ denied, 95-0691 (La.4/28/95); 653 So.2d 595.

In Cajun Bag, the employer, believing the employee's claim for compensation was falsified, filed notice of a disputed claim for compensation against the employee, Baptiste. Baptiste reconvened seeking reinstatement of benefits. We held that a claim must "actually `arise out' of the Worker's Compensation Act, rather than merely relate to worker's compensation in general, for [workers' compensation judges] to enjoy original jurisdiction over it." Id. at p. 9; 948. We determined that the OWC was not the proper forum to assert a general claim for reimbursement. Unlike the source of the employer's reimbursement claim in Cajun Bag, the credit or offset American Native and LWCC are attempting to invoke does arise out of La.R.S. 23:1102(B).

In Orthopedic Specialists of Louisiana, a medical provider filed a disputed claim for compensation seeking payment for medical services rendered to Fugate for injuries he suffered in the course and scope of his employment. Fugate, his employer, and the third party tortfeasor entered into a compromise agreement whereby the employer would receive less than the full amount of its employer's lien and Fugate agreed to waive his right to collect additional compensation benefits. This compromise agreement was subsequently approved by the district court.

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Bluebook (online)
710 So. 2d 306, 97 La.App. 3 Cir. 1228, 1998 La. App. LEXIS 398, 1998 WL 100370, Counsel Stack Legal Research, https://law.counselstack.com/opinion/jeansonne-v-american-native-const-lactapp-1998.