STATE OF LOUISIANA COURT OF APPEAL, THIRD CIRCUIT
11-1088
JOHN VITAL
VERSUS
STINE, INC.
**********
APPEAL FROM THE OFFICE OF WORKERS’ COMPENSATION, DISTRICT 3 PARISH OF CALCASIEU, NO. 06-06320 SAM L. LOWERY, WORKERS’ COMPENSATION JUDGE
PHYLLIS M. KEATY JUDGE
Court composed of Sylvia R. Cooks, Elizabeth A. Pickett, and Phyllis M. Keaty, Judges.
AFFIRMED.
Michael B. Miller Attorney at Law Post Office Box 1630 Crowley, Louisiana 70527-1630 (337) 785-9500 Counsel for Plaintiff/Appellee: John Vital
James R. Morris Morris Law Firm 2917 Ryan Street Lake Charles, Louisiana 70601 (337) 990-0256 Counsel for Defendant/Appellant: Stine, Inc. KEATY, Judge.
In this workers’ compensation case, the employer appeals from a judgment
denying its motion to modify the weekly compensation due its former employee.
For the following reasons, we affirm.
FACTS AND PROCEDURAL HISTORY
John Vital injured his back and left leg on September 14, 1998, in the course
and scope of his employment with Stine, Inc., when he slipped and fell while
carrying a box of roofing shingles. Dr. Clark Gunderson, a board certified
orthopedic surgeon, performed a laminectomy from L3 to L5 with a
decompression and lumbar fusion on Vital in July of 2003. Vital filed a 1008
Disputed Claim for Compensation (1008) in April of 2006, alleging that Stine was
paying him an incorrect compensation rate, that Stine was not providing him with
vocational rehabilitation, and that Stine had either made late payments or
underpaid his weekly compensation benefits. The 1008 included a claim for
penalties and attorney fees.
Following an April 24, 2008 trial, Stine stipulated that Vital had been
injured in a work-related accident and that he was entitled to temporarily total
disability benefits (TTDs) in the amount of $213.11 per week. On February 21,
2011, Stine filed a motion to modify seeking to have the workers’ compensation
judge (WCJ) declare that Vital was no longer temporarily totally nor permanently
totally disabled. The motion was tried on April 4, 2011. After the presentation of
evidence, counsel for Vital agreed that if Vital was no longer permanently or
temporarily totally disabled, he would no longer be entitled to supplemental earnings benefits (SEBs) because he had already received in excess of the
maximum 520 weeks of benefits.1
In oral reasons for judgment rendered on May 2, 2011, the WCJ stated that
Stine had failed to meet its burden of proving that Vital was no longer disabled.
Written judgment was signed on May 24, 2011, denying Stine’s motion to modify.
Stine now appeals, asserting in its sole assignment of error that the WCJ erred in
finding Vital “to still be temporarily, totally disabled” and in denying its motion to
modify.
DISCUSSION
In Odom v. Kinder Nursing Home, 06-1442, p. 5 (La.App. 3 Cir. 4/25/07),
956 So.2d 128, 132, we noted:
“The issue of disability within the framework of the workers’ compensation law is a legal rather than a purely medical determination. LeBlanc [v. Grand Isle Shipyard, Inc., 95-2452 (La.App. 1 Cir. 6/28/96)], 676 So.2d [1157,] 1161. The issue of disability is determined with reference to the totality of the evidence, including both lay and medical testimony. LeBlanc, 676 So.2d at 1161.” Walker v. High Tech Refractory Servs., Inc., 03-1621, p. 4 (La.App. 1 Cir. 6/25/04), 885 So.2d 1185, 1188. See also Rideaux v. Kohl’s Dep’t Stores, Inc., 11-914 (La.App. 3 Cir. 12/7/11), __
So.3d __, and Green v. Nat’l Oilwell Varco, 10-1041 (La.App. 3 Cir. 4/27/11), 63
So.3d 354.
Pursuant to La.R.S. 23:1310.8(B), a party may re-open a workers’ compensation case and the workers’ compensation judge may modify an award on the grounds of a change in condition. “A party who seeks a modification of a worker’s compensation judgment must prove by a preponderance of the evidence that the worker’s disability has increased or diminished.” Lormand v. Rossclaire Constr., 01-515, p. 2 (La.App. 3 Cir. 12/12/01), 801 So.2d 675, 676. . . . The factual finding of a workers’ compensation judge that [a party] has demonstrated a change in condition is entitled to great weight and will not be disturbed unless clearly wrong. Lormand, 801 So.2d 675.
1 See La.R.S. 23:1221(3)(d)(ii). 2 Hardee v. City of Jennings, 07-242, pp. 2-3 (La.App. 3 Cir. 5/30/07), 961 So. 2d
531, 533, writs denied, 07-1779, 07-1799 (La. 11/9/07), 967 So.2d 505, 509.
In oral reasons for judgment, the WCJ stated:
A comprehensive reading and balanced evaluation of all the medical reports, opinions, and documents indicate Mr. Vital is as severely disabled today as he was years ago when he had the accident. In all likelihood his condition has deteriorated. It has certainly not improved, and the employment prospects for this 66-year-old man with very limited education and serious medical problems appear[s] to [have] no merit.
Several months after his July 2003 back surgery, Vital told Dr. Gunderson
that he was “a whole lot better than prior to surgery.” In July of 2004,
Dr. Gunderson recommended that Vital undergo a functional capacity evaluation
(FCE). After examining Vital and reviewing the results of the FCE,
Dr. Gunderson released Vital to modified duty on August 31, 2004, with the
following restrictions: he was to alternate sitting and standing and perform no
continual bending, stooping, climbing, or lifting over twenty pounds.
Vital returned to Dr. Gunderson on November 20, 2007, complaining of
increased back pain going down both legs to his knees that was aggravated by
activity. He told Dr. Gunderson that he had not returned to work after his 2003
back surgery. At that time, Dr. Gunderson believed that Vital was disabled given
the fact that he was sixty-three years old and his physical condition was not going
to change. Dr. Gunderson wrote Vital a prescription for Darvocet to control his
pain. In August of 2009, Dr. Gunderson requested, and Stine gave approval for,
Vital to have a lumbar MRI and an electromyography (EMG) of his left lower
extremity. The MRI revealed that Vital had post-surgical scarring at L4-5 and L5-
S1 and a disc bulge at L3-4 with moderate to severe articular facet degeneration
resulting in mild central canal stenosis and bilateral neural foraminal narrowing.
The EMG showed “[e]vidence of chronic denervations in [Vital’s] left tibialis
3 anterior, peroneus longus, and vastus lateralis muscles” which, to the evaluating
neurologist, Dr. Fayez Shamieh, suggested the presence of chronic L4 root irriation
on the left side. After reviewing the results of the MRI and EMG, Dr. Gunderson
recommended that Vital undergo a second back surgery, a decompressive lumbar
laminectomy at the L3-4 level.
Stine arranged for Vital to be examined by Dr. Michael Holland for a second
opinion. In his February 11, 2009 report, Dr. Holland opined that Vital was not
totally disabled and that he could return to the workplace at a light-duty level,
noting that Vital had an excellent outcome from his 2003 surgery.
Given the diverging opinions of Drs. Gunderson and Holland, the WCJ
appointed Dr. Lynn Foret, a board certified orthopedic surgeon, to conduct an
independent medical exam of Vital. Dr. Foret examined Vital on March 2, 2010.
He stated that the MRI showed that Vital had an abundance of scar tissue which
should give Vital “a lot of . . . back pain and spasm,” and will only worsen with
time. Dr.
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STATE OF LOUISIANA COURT OF APPEAL, THIRD CIRCUIT
11-1088
JOHN VITAL
VERSUS
STINE, INC.
**********
APPEAL FROM THE OFFICE OF WORKERS’ COMPENSATION, DISTRICT 3 PARISH OF CALCASIEU, NO. 06-06320 SAM L. LOWERY, WORKERS’ COMPENSATION JUDGE
PHYLLIS M. KEATY JUDGE
Court composed of Sylvia R. Cooks, Elizabeth A. Pickett, and Phyllis M. Keaty, Judges.
AFFIRMED.
Michael B. Miller Attorney at Law Post Office Box 1630 Crowley, Louisiana 70527-1630 (337) 785-9500 Counsel for Plaintiff/Appellee: John Vital
James R. Morris Morris Law Firm 2917 Ryan Street Lake Charles, Louisiana 70601 (337) 990-0256 Counsel for Defendant/Appellant: Stine, Inc. KEATY, Judge.
In this workers’ compensation case, the employer appeals from a judgment
denying its motion to modify the weekly compensation due its former employee.
For the following reasons, we affirm.
FACTS AND PROCEDURAL HISTORY
John Vital injured his back and left leg on September 14, 1998, in the course
and scope of his employment with Stine, Inc., when he slipped and fell while
carrying a box of roofing shingles. Dr. Clark Gunderson, a board certified
orthopedic surgeon, performed a laminectomy from L3 to L5 with a
decompression and lumbar fusion on Vital in July of 2003. Vital filed a 1008
Disputed Claim for Compensation (1008) in April of 2006, alleging that Stine was
paying him an incorrect compensation rate, that Stine was not providing him with
vocational rehabilitation, and that Stine had either made late payments or
underpaid his weekly compensation benefits. The 1008 included a claim for
penalties and attorney fees.
Following an April 24, 2008 trial, Stine stipulated that Vital had been
injured in a work-related accident and that he was entitled to temporarily total
disability benefits (TTDs) in the amount of $213.11 per week. On February 21,
2011, Stine filed a motion to modify seeking to have the workers’ compensation
judge (WCJ) declare that Vital was no longer temporarily totally nor permanently
totally disabled. The motion was tried on April 4, 2011. After the presentation of
evidence, counsel for Vital agreed that if Vital was no longer permanently or
temporarily totally disabled, he would no longer be entitled to supplemental earnings benefits (SEBs) because he had already received in excess of the
maximum 520 weeks of benefits.1
In oral reasons for judgment rendered on May 2, 2011, the WCJ stated that
Stine had failed to meet its burden of proving that Vital was no longer disabled.
Written judgment was signed on May 24, 2011, denying Stine’s motion to modify.
Stine now appeals, asserting in its sole assignment of error that the WCJ erred in
finding Vital “to still be temporarily, totally disabled” and in denying its motion to
modify.
DISCUSSION
In Odom v. Kinder Nursing Home, 06-1442, p. 5 (La.App. 3 Cir. 4/25/07),
956 So.2d 128, 132, we noted:
“The issue of disability within the framework of the workers’ compensation law is a legal rather than a purely medical determination. LeBlanc [v. Grand Isle Shipyard, Inc., 95-2452 (La.App. 1 Cir. 6/28/96)], 676 So.2d [1157,] 1161. The issue of disability is determined with reference to the totality of the evidence, including both lay and medical testimony. LeBlanc, 676 So.2d at 1161.” Walker v. High Tech Refractory Servs., Inc., 03-1621, p. 4 (La.App. 1 Cir. 6/25/04), 885 So.2d 1185, 1188. See also Rideaux v. Kohl’s Dep’t Stores, Inc., 11-914 (La.App. 3 Cir. 12/7/11), __
So.3d __, and Green v. Nat’l Oilwell Varco, 10-1041 (La.App. 3 Cir. 4/27/11), 63
So.3d 354.
Pursuant to La.R.S. 23:1310.8(B), a party may re-open a workers’ compensation case and the workers’ compensation judge may modify an award on the grounds of a change in condition. “A party who seeks a modification of a worker’s compensation judgment must prove by a preponderance of the evidence that the worker’s disability has increased or diminished.” Lormand v. Rossclaire Constr., 01-515, p. 2 (La.App. 3 Cir. 12/12/01), 801 So.2d 675, 676. . . . The factual finding of a workers’ compensation judge that [a party] has demonstrated a change in condition is entitled to great weight and will not be disturbed unless clearly wrong. Lormand, 801 So.2d 675.
1 See La.R.S. 23:1221(3)(d)(ii). 2 Hardee v. City of Jennings, 07-242, pp. 2-3 (La.App. 3 Cir. 5/30/07), 961 So. 2d
531, 533, writs denied, 07-1779, 07-1799 (La. 11/9/07), 967 So.2d 505, 509.
In oral reasons for judgment, the WCJ stated:
A comprehensive reading and balanced evaluation of all the medical reports, opinions, and documents indicate Mr. Vital is as severely disabled today as he was years ago when he had the accident. In all likelihood his condition has deteriorated. It has certainly not improved, and the employment prospects for this 66-year-old man with very limited education and serious medical problems appear[s] to [have] no merit.
Several months after his July 2003 back surgery, Vital told Dr. Gunderson
that he was “a whole lot better than prior to surgery.” In July of 2004,
Dr. Gunderson recommended that Vital undergo a functional capacity evaluation
(FCE). After examining Vital and reviewing the results of the FCE,
Dr. Gunderson released Vital to modified duty on August 31, 2004, with the
following restrictions: he was to alternate sitting and standing and perform no
continual bending, stooping, climbing, or lifting over twenty pounds.
Vital returned to Dr. Gunderson on November 20, 2007, complaining of
increased back pain going down both legs to his knees that was aggravated by
activity. He told Dr. Gunderson that he had not returned to work after his 2003
back surgery. At that time, Dr. Gunderson believed that Vital was disabled given
the fact that he was sixty-three years old and his physical condition was not going
to change. Dr. Gunderson wrote Vital a prescription for Darvocet to control his
pain. In August of 2009, Dr. Gunderson requested, and Stine gave approval for,
Vital to have a lumbar MRI and an electromyography (EMG) of his left lower
extremity. The MRI revealed that Vital had post-surgical scarring at L4-5 and L5-
S1 and a disc bulge at L3-4 with moderate to severe articular facet degeneration
resulting in mild central canal stenosis and bilateral neural foraminal narrowing.
The EMG showed “[e]vidence of chronic denervations in [Vital’s] left tibialis
3 anterior, peroneus longus, and vastus lateralis muscles” which, to the evaluating
neurologist, Dr. Fayez Shamieh, suggested the presence of chronic L4 root irriation
on the left side. After reviewing the results of the MRI and EMG, Dr. Gunderson
recommended that Vital undergo a second back surgery, a decompressive lumbar
laminectomy at the L3-4 level.
Stine arranged for Vital to be examined by Dr. Michael Holland for a second
opinion. In his February 11, 2009 report, Dr. Holland opined that Vital was not
totally disabled and that he could return to the workplace at a light-duty level,
noting that Vital had an excellent outcome from his 2003 surgery.
Given the diverging opinions of Drs. Gunderson and Holland, the WCJ
appointed Dr. Lynn Foret, a board certified orthopedic surgeon, to conduct an
independent medical exam of Vital. Dr. Foret examined Vital on March 2, 2010.
He stated that the MRI showed that Vital had an abundance of scar tissue which
should give Vital “a lot of . . . back pain and spasm,” and will only worsen with
time. Dr. Foret believed that surgery would stir up the scar tissue again. He found
Vital to be very motivated and thought that he should be able to do some type of
sedentary mild work that did not involve lifting or prolonged sitting. Nevertheless,
when asked to assume that Vital had good days, where he could walk and help
with chores such as cooking and doing laundry, and bad days, where he could
hardly do anything, Dr. Foret acknowledged that Vital would be unable to hold
down any type of job.
At trial, Vital testified that his condition had gradually worsened, especially
in the past month. He stated that while the 2003 surgery initially relieved his pain,
his pain returned after about one year post surgery. According to Vital, in the
interim between his August 2004 and November 2007 visits with Dr. Gunderson,
he received Hydrocodone for back and leg pain from a Dr. Clawson who was 4 treating him for bladder infections. Vital explained that he has good and bad days,
but that the bad days outnumber the good, and that he has to remain in bed on
those bad days. He stated that he would like to work if able and that he would
have the second surgery recommended by Dr. Gunderson if it would relieve his
pain.
Stine assigns great significance to the fact that there was a three-year period
after his surgery when Vital did not seek the care of Dr. Gunderson, his treating
orthopedist. However, Vital testified that he received medication for his back and
leg pain during that time from a physician that he was seeing for an unrelated
condition. Stine also insists that Dr. Foret believed that Vital was not totally
disabled and was capable of performing some type of light-duty sedentary work,
while completely overlooking the fact that Dr. Foret agreed that Vital would be
unable to work at any type of job if he were to regularly have bad days. Given the
totality of the evidence and testimony, we cannot say that the WCJ was clearly
wrong in making the legal determination that Stine failed to meet its burden of
proving that Vital is no longer disabled.
DECREE
For the foregoing reasons, the judgment of the WCJ denying Stine, Inc.’s,
motion to modify John Vital’s benefits from temporarily totally disability benefits
to supplemental earnings benefits is affirmed. All costs of this appeal are assessed
against Stine, Inc.