Johnson v. St. Frances Nursing & Rehabilitation Center

155 So. 3d 689, 14 La.App. 3 Cir. 599, 2014 La. App. LEXIS 3057, 2014 WL 7273897
CourtLouisiana Court of Appeal
DecidedDecember 23, 2014
DocketNo. 14-599
StatusPublished
Cited by2 cases

This text of 155 So. 3d 689 (Johnson v. St. Frances Nursing & Rehabilitation Center) 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. St. Frances Nursing & Rehabilitation Center, 155 So. 3d 689, 14 La.App. 3 Cir. 599, 2014 La. App. LEXIS 3057, 2014 WL 7273897 (La. Ct. App. 2014).

Opinion

KEATY, Judge.

Lin this workers’ compensation case, St. Frances Nursing & Rehabilitation Center appeals a judgment in favor of its former employee, Lucy Johnson, ordering Supplemental Earnings Benefits (SEBs), statutory penalties, and attorney fees, and holding that Johnson did not violate the provisions of La.R.S. 23:1208(A). For the following reasons, we affirm in part and reverse in part.

FACTS AND PROCEDURAL HISTORY

On July 5, 2006, in the course and scope of her employment as a nurse employed by St. Frances, Johnson was injured by a patient who hit her in the back of her head and neck. As a result of her injuries, Johnson sought treatment from Dr. Clark Gunderson, an orthopedic surgeon, who performed a three-level cervical disc fusion. He subsequently released her to return to work with restrictions in November 2007. Following her initial release, Johnson maintained a part-time schedule working light duty at St. Frances from November 2007 through February 2008. Johnson testified that she experienced pain while working part time although it was controlled by pain medication prescribed by Dr. Gunderson.

In February 2008, after Dr. Gunderson released her to work full duty, Johnson began working with restrictions on a full-time schedule until June 2008. Johnson testified that during her transition from part-time, light-duty work to full-time, full-duty work, her pain increased and “became very excruciating.” She returned to Dr. Gunderson and advised that her increased pain was uncontrolled by medication. As a result, Dr. Gunderson reduced her release to light duty in May 2008. , Based upon Johnson’s continued subjective complaints of pain, Dr. Gunder-son changed his opinion to no-work status from June 5, 2008, through November 2008. Dr. Gunderson subsequently released her to return to light-duty |awork with restrictions in November 2008, in her position with St. Frances. Johnson returned to work that same month and worked only two days as she was unable to perform the duties within the restrictions. Dr. Gunderson again placed her on a no-work status. During a regularly-scheduled appointment with Dr. Gunderson approximately eight months later on July 27, 2009, Dr. Gunderson maintained Johnson’s no-work status. Dr. Gunderson also opined that Johnson was not a surgical candidate and referred her to Dr. Stephen Katz, a pain management physician.

On July 28, 2009, Johnson presented to Dr. Katz. Dr. Gunderson testified that he was aware that Dr. Katz had taken over Johnson’s care as of July 28, 2009. Dr. Gunderson testified that he deferred to Dr. Katz regarding Johnson’s restrictions and/or ability to return to work as of the date of his referral. Johnson testified that during her initial visit with Dr. Katz, she was never asked to demonstrate any physical abilities related to work duties nor did he discuss with her any ability to return to work. Johnson testified that she was not asked to walk across the room, bend, [692]*692stoop, reach up, or reach down. According to excerpts from the employer’s adjuster’s file, dated August 14, 2009, Dr. Katz advised that he would offer “only to monitor medications [with] no discussion of return to work abilities.”

Buster Fontenot, a vocational rehabilitation consultant assigned to Johnson in 2008, developed a modified licensed practical nurse (LPN) job analysis in order to enable Johnson to return to work. Fonte-not met with Dr. Katz on September 11, 2009, wherein Dr. Katz agreed that Johnson could return to work in a modified LPN position. Despite the foregoing, Johnson testified that Dr. Katz never told her that he believed that she was able to return to work. Approximately two months | «¡later on November 9, 2009, Dr. Katz withdrew' his opinion rendered on September 11, 2009, when Johnson advised him that Dr. Gunderson placed her on a non-return to work status. Dr. Katz’s medical record on that date states that in order to avoid confusion, he would defer to Dr. Gunderson for determination of Johnson’s return to work status.

Johnson returned to Dr. Gunderson oh April 20, 2010, with complaints of pain and trouble swallowing. Dr. Gunderson removed her fusion hardware on May 9, 2011, in order to alleviate the pain she experienced when swallowing. Johnson subsequently underwent a functional capacity examination (FCE) on May 1, 2013, which was rendered by physical therapist David Regan. Johnson testified that she was aware that Regan believed that she intentionally misrepresented her physical capabilities during her examination. According to the FCE, Regan opined that “the INVALID results identified in this assessment and Functional Assessment Overview represent the levels Ms. Johnson chose to demonstrate as her physical capabilities. The numbers do not represent her true safe capabilities as Ms. Johnson intentionally manipulated the results of the assessment.” According to Regan’s deposition testimony, he did not attempt to determine whether the alleged misrepresentations during Johnson’s FCE were willfully made. Regan testified that he deferred that issue to Dr. Gunderson for investigation.

Johnson received medical and indemnity benefits from the onset of her disability through the beginning of September 2009. St. Frances terminated indemnity benefits from September 11, 2009, through May 7, 2011. Indemnity benefits were reinstated and paid from May 9, 2011, through the date of trial which |4began on October 23, 2013. Johnson’s indemnity benefits were based upon an average weekly wage (AWW) of $413.13.

Following termination of benefits on September 11, 2009, Johnson filed the instant claim for reinstatement of benefits, penalties, attorney fees, and a psychological evaluation and/or care by a mental health professional. St. Frances countered with the assertion that Johnson committed fraud, thereby forfeiting her right to benefits pursuant to La.R.S. 23:1208(A), by misrepresenting her condition to her treating physicians and by misrepresenting her physical capabilities during the FCE.

After a trial on the merits, the workers’ compensation judge (WCJ) held that Johnson did not commit fraud for purposes of La.R.S. 23:1208(A) forfeiture and awarded her $35,723.53 in SEBs from September 11, 2009, through May 9, 2011, utilizing an AWW of $413.33 per week. The WCJ awarded Johnson $4,000.00 in statutory penalties, ordered St. Frances to authorize a mental health evaluation, and awarded attorney fees.

St. Frances has appealed, asserting the following assignments of error:

[693]*6931. The Workers’ Compensation Judge erred in failing to find that Ms. Johnson violated [La.R.S. 23:1208(A) ] when she intentionally misrepresented her physical capabilities at her functional capacity examination.
2. The Workers’ Compensation Judge erred in finding that claimant, Lucy Johnson, was entitled to Supplemental Earnings Benefits for the period of September 11, 2009 through May 9, 2011.
8. The Workers’ Compensation Judge erred in finding that [Johnson] is entitled to an award of penalties and attorney fees.

|,STAND ARP OF REVIEW

In Foster v. Rabalais Masonry, Inc., 01-1394, p. 2 (La.App. 3 Cir.3/6/02), 811 So.2d 1160, 1162, writ denied, 02-1164 (La.6/14/02), 818 So.2d 784 (citations omitted), this court noted the standard of review applicable in workers’ compensation cases as follows: “Factual findings in workers’ compensation cases are subject to the manifest error or clearly wrong standard of appellate review.

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155 So. 3d 689, 14 La.App. 3 Cir. 599, 2014 La. App. LEXIS 3057, 2014 WL 7273897, Counsel Stack Legal Research, https://law.counselstack.com/opinion/johnson-v-st-frances-nursing-rehabilitation-center-lactapp-2014.