Joseph v. Our Lady of the Lake Regional Medical Center

156 So. 3d 210, 2014 La.App. 1 Cir. 0181, 2014 La. App. LEXIS 2506, 2014 WL 5285714
Louisiana Court of Appeal·Decided October 16, 2014·No. No. 2014-CA-0181·Published·Cited by 2 cases

Opinion

CRAIN, J.

|2The defendants in this workers’ compensation proceeding appeal a judgment dismissing “this matter” and an order denying their motion for leave to file an amended responsive pleading. We amend the judgment of dismissal and, as amended, affirm the judgment. We reverse the order denying leave to the defendants to file an amended responsive pleading, and remand.

FACTS AND PROCEDURAL HISTORY

Delores Joseph instituted this proceeding by filing a claim against Our Lady of the Lake Regional Medical Center (OLOL) alleging an improper termination of her medical benefits. Joseph, who was employed with Ollie Steele Burden Manor, Inc. at the time of the subject accident in 2003, sought to recover penalties and attorney fees for the alleged improper termination of the benefits. OLOL and Ollie Steele filed a responsive pleading captioned “ANSWER” that admitted the occurrence of the work-related accident but denied that Joseph was entitled to any further medical benefits in connection with [212] the accident.1 The defendants also alleged the following:

Defendants assert that Claimant has violated LSA R.S. 23:1208, and has made intentional misrepresentations in order to obtain worker’s compensation benefits. Defendants are entitled to all remedies available to it for that violation.

The pleading concludes with a prayer that provides, in pertinent part:

Defendants further pray for all recovery available to [them] under LSA. R.S. 23:1208 and further request the imposition of all applicable civil fines and penalties against Claimant in connection with her violation of said provision.

A certificate at the bottom of the pleading indicates that it was mailed to Joseph’s counsel, but the record contains no indication that the pleading was ever served by the sheriff or mailed to the plaintiff by certified mail.

|sThe workers’ compensation judge (WCJ) assigned a trial date and directed each of the parties to file a pre-trial statement that included an itemization of the issues to be adjudicated at the trial. The list of trial issues in the defendants’ pretrial statement includes the question of whether Joseph violated Louisiana Revised Statute 23:Í208 and thus forfeited her right to future benefits, and whether OLOL and Ollie Steele are “entitled to restitution in connection with said violation.” Joseph’s pre-trial statement reflects that her alleged violation of Section 23:1208 is an issue in the case, but her pretrial statement does not mention any claim by the defendants for restitution or penalties based upon that alleged violation.

Counsel for both parties appeared in court on the morning of trial; however, after the WCJ announced the docket, Joseph’s counsel stated, “Your Honor, first, before we get started, I would like to make an oral motion to dismiss with prejudice and walk away from the claim.” Defense counsel replied, “Judge, while we certainly can’t — we would object to dismissal of the case and would also point out that we have a request for relief in our answer, pursuant to our 1208 defense.” After reciting the pertinent allegations in the answer previously reproduced herein, defense counsel stated:

So we actually have a claim for reimbursement, slash, restitution in this case. And so [plaintiffs counsel] may be able to dismiss her client’s claim at this point with prejudice, but we still have a claim that we would like to go forward with.

The WCJ then ruled:

The Court grants the motion to dismiss with prejudice. Although the defendant stated the 1208 defense in its answer, it did not file a reconventional demand setting forth its own cause of action for monetary relief in the way of restitution or costs.
The dismissal is granted with prejudice. The [c]ase is dismissed.

The WCJ signed a judgment ordering “that this matter be dismissed with prejudice.” OLOL and Ollie Steele filed a motion for new trial and, alternatively, a |4motion for leave to file an amended re-conventional demand (collectively, “post-judgment motions”), which the WCJ denied. The defendants appealed the judgment of dismissal and contend that the WCJ erred by not finding that the defendants stated a valid reconventional demand in their answer. The defendants also assign as error the WCJ’s refusal to allow them to amend their responsive pleading.

[213] LAW AND ANALYSIS

Section 23:1208A declares that 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.” A violation of the statute carries significant consequences, including criminal and civil penalties and the forfeiture of compensation benefits. La. R.S. 23:1208C and E. In addition to those penalties, restitution may be ordered for benefits claimed or payments obtained through fraud up to the time the employer became aware of the fraudulent conduct. La. R.S. 23:1208D.

In their first assignment of error, the defendants contend that the WCJ erred “by ruling that OLOL did not state a valid reconventional demand” in their answer for recovery against Joseph under Section 23:1208. In its oral ruling, the WCJ dismissed the “case” based upon its finding that OLOL “did not file a reconventional demand setting forth its own cause of action for monetary relief in the way of restitution or costs.” The WCJ later noted in an order denying the post-judgment motions that the “delays for filing [a] re-conventional demand had expired”; and in the order granting the appeal, the court wrote, “No Reconventional Demand was filed timely.”

The defendants’ answer includes allegations that Joseph violated Section 23:1208, that the defendants are entitled to “all remedies available to [them] for |fithat violation,” and prays for all recovery available under the statute. According to OLOL and Ollie Steele, those claims constitute a valid reconventional demand set forth in their answer in accordance with Louisiana Code of Civil Procedure article 1032, which provides:

An incidental demand shall be commenced by a petition which shall comply with the requirements of Articles 891, 892 and 893. An incidental demand instituted by the defendant in the principal action may be incorporated in his answer to the principal demand. In this event, the caption shall indicate appropriately the dual character of the combined pleading.

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Joseph v. Our Lady of the Lake Regional Medical Center, 156 So. 3d 210, 2014 La.App. 1 Cir. 0181, 2014 La. App. LEXIS 2506, 2014 WL 5285714 (La. Ct. App. 2014).

156 So. 3d 210 (Joseph v. Our Lady of the Lake Regional Medical Center) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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