Johnson v. Basic Industries, Inc.

711 So. 2d 843, 97 La.App. 3 Cir. 1136, 1998 La. App. LEXIS 837, 1998 WL 175607
CourtLouisiana Court of Appeal
DecidedApril 15, 1998
Docket97-1136
StatusPublished
Cited by6 cases

This text of 711 So. 2d 843 (Johnson v. Basic Industries, Inc.) 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
Johnson v. Basic Industries, Inc., 711 So. 2d 843, 97 La.App. 3 Cir. 1136, 1998 La. App. LEXIS 837, 1998 WL 175607 (La. Ct. App. 1998).

Opinion

711 So.2d 843 (1998)

Joe Ann JOHNSON, Plaintiff-Appellant,
v.
BASIC INDUSTRIES, INC., Defendant-Appellee.

No. 97-1136.

Court of Appeal of Louisiana, Third Circuit.

April 15, 1998.

*844 Nicholas Pizzolatto, Jr., Lake Charles, for Joe Ann Johnson.

Nicholas Canaday, III, Baton Rouge, for Basic Industries.

Before SAUNDERS, SULLIVAN and GREMILLION, JJ.

SULLIVAN, Judge.

Joe Ann Johnson appeals a judgment ordering forfeiture of her workers' compensation benefits based upon a finding that she willfully misrepresented her mileage reimbursement claims. For the following reasons, we affirm.

Discussion of the Record

Johnson injured her right knee and ankle on March 2, 1994, when she fell on a scaffold while working for Basic Industries, Inc. She filed a disputed claim for compensation on June 29, 1995, after Basic's insurer, The Insurance Company of the State of Pennsylvania (ICSP), reduced her temporary total disability benefits to supplemental earnings benefits.

In October of 1996, Johnson, Basic, and ICSP recited in open court the terms of a compromise of Johnson's claim for past benefits, including a stipulation that defendants would pay Johnson's travel expenses upon documentation. Before this compromise was reduced to judgment, however, the workers' compensation judge granted Johnson's request to withdraw from it. The case was again placed on the trial docket. On May 9, 1997, Basic and ICSP filed a motion to disqualify Johnson from future benefits pursuant to La.R.S. 23:1208, alleging that she "grossly and intentionally" misrepresented her claims for mileage reimbursement.

After her injury in 1994, Johnson received medical treatment from numerous health care providers within the city limits of Lake Charles, Louisiana, including Dr. Lynn Foret, Dr. Melvin Morris, St. Patrick's Hospital, Lake Charles Physical Therapy, Advanced Rehab Services, Inc., Thrifty-Way Pharmacy, and Walgreen's Drugstore. On her mileage reimbursement forms, Johnson represented that her address was 208 Libby Street in Lake Charles. To document the mileage for each trip, Johnson either listed the number of miles purportedly traveled from the Libby Street address to each health care provider or she recorded beginning and ending odometer readings.

ICSP paid Johnson four mileage checks totaling $594.48 for 2,477 miles traveled between September of 1994 and November of 1995. On March 25, 1997, Johnson's attorney submitted a request for payment of $744.84, representing an additional 2,806 miles claimed plus a $71.40 shortage from the previous checks. At that time, ICSP became suspicious of Johnson's mileage claims and hired an investigator, James Kenneth Faul, to verify them.

At trial on the motion to disqualify, Faul testified that he was hired to determine the actual mileage from the Libby Street address to six of the health care providers, without knowing the purpose of his assignment. Faul's figures differed greatly from those submitted by Johnson. For example, on some of her claim forms, Johnson represented that a round trip from Libby Street to Dr. Foret's office ranged from 20 to 24 miles, whereas Faul measured that distance at 7.8 miles. Johnson claimed that a round trip to Dr. Morris' office (from Libby Street) was 10 miles, but Faul measured a round trip of only.8 of a mile. From Libby Street to Thrifty-Way Pharmacy, Johnson claimed a 25 mile round trip, but Faul measured only 3.2 miles.

*845 Confronted with these discrepancies, Johnson at first denied that she lived at 208 Libby Street. She explained that she received her mail at this address, which was her mother's home; therefore, she used it on the mileage forms to avoid confusion. She claimed to have lived at several other Lake Charles residences during the period of her treatment, including 3034 General Marshall Street and 2824 Foret Drive, but she no longer remembered from which of these addresses she traveled to her health care providers.

Johnson admitted that the mileage on all forms indicating travel from Libby Street was incorrect, but she testified that she did not understand that the form required the exact address from where travel began. She further testified that the mileage she claimed was, in fact, less than what was traveled because she failed to report multiple trips to her doctors' offices and to pharmacies when the insurance company refused to authorize medication or treatment. She also believed that the mileage her friends traveled from their homes to pick her up was compensable.

At the close of the evidence, the workers' compensation judge granted defendants' motion to disqualify, finding that Johnson made willful misrepresentations on the claim forms and in her testimony at trial. The workers' compensation judge stated as follows:

Some of the reasons that I make this finding is that, Ms. Johnson, I find your testimony to have been extremely evasive on your place of residence. You were only able to recall where you resided at a particular point in time when it was, in fact, possibly to your advantage to do so. You testified that you did not understand the forms and, therefore, used your mailing address ... but, in fact, Ms. Johnson, in my dealings with you in this proceeding I've, in fact, found you to be a very bright, not at all unintelligent, person and I find it extremely difficult to believe that you truly did not understand what you were, in fact, filling out.
The odometer readings, almost every one would have had to be from a different vehicle. Very few match up in a logical sequence and, again, I find it inconceivable that a different vehicle would have been used for each different odometer reading.
Further, while you've testified that there were variables involved, as in different people picking you up from different places, that often times other stops were necessary ... and that sometimes you had to make several trips on a particular day, with all those variables the actual miles requested only varied within a two mile range. So, again, I just do not find the testimony credible and can only find that it was a willful intent to misstate the mileage and, obviously, the mileage was misstated to some significant fashion and that it was a willful intent to obtain additional mileage benefits under the Workers' Compensation Act.

(Emphasis added.)

On appeal, Johnson argues that (1) the workers' compensation judge erred in finding she willfully misrepresented her mileage; (2) mileage expenses are not "benefits" that would trigger the forfeiture provisions of La.R.S. 23:1208; and (3) the workers' compensation judge did not have jurisdiction to decide the forfeiture claim.

Opinion

La.R.S. 23:1208 provides in part:

A. It shall be unlawful for any person, for the purpose of obtaining or defeating any benefit or payment under the provisions of this Chapter, either for himself or for any other person, to willfully make a false statement or representation.
....
E. Any employee violating this Section shall, upon determination by hearing officer, forfeit any right to compensation benefits under this Chapter.

In Menard v. Mama's Fried Chicken, 97-488, p. 2 (La.App. 3 Cir.3/6/98); 709 So.2d 303, 304, this court recently explained:

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Bluebook (online)
711 So. 2d 843, 97 La.App. 3 Cir. 1136, 1998 La. App. LEXIS 837, 1998 WL 175607, Counsel Stack Legal Research, https://law.counselstack.com/opinion/johnson-v-basic-industries-inc-lactapp-1998.