Kelone v. Pinecrest State School

626 So. 2d 89, 1993 La. App. LEXIS 3342, 1993 WL 451517
CourtLouisiana Court of Appeal
DecidedNovember 3, 1993
DocketNo. 93-40
StatusPublished
Cited by2 cases

This text of 626 So. 2d 89 (Kelone v. Pinecrest State School) 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
Kelone v. Pinecrest State School, 626 So. 2d 89, 1993 La. App. LEXIS 3342, 1993 WL 451517 (La. Ct. App. 1993).

Opinion

GUIDRY, Judge.

Defendants, Pineerest State School (Pine-crest) and the Office of Risk Management (ORM) appeal a decision of the Office of Worker’s Compensation (OWC) awarding plaintiff, Lena Kelone, temporary, total disability benefits for a month longer than that [90]*90paid by the ORM and supplemental earnings benefits thereafter until defendants find work for her in the geographical area and within her limitations or until she receives appropriate vocational rehabilitation to place her in a better and identified job market, plus penalties and attorney’s fees. We affirm.

At the outset, we note that, in brief, attorney for plaintiff prays for additional attorney’s fees both for his trial work and “... for answering this appeal”. As we find neither an appeal by plaintiff, nor an answer to appeal in the record, we will not consider 'those issues.

FACTS

Ms. Kelone was injured in the course and scope of her employment on April 21, 1989, when she slipped and fell backwards, landing on her buttocks, while in the kitchen at Pine-crest. Plaintiff had sustained a prior work-related injury to the thoracic area of her back in 1984 when she was struck by a patient. It does not appear from the record that Ms. Kelone received any worker’s compensation benefits for the earlier injury, but she was under constant medical care from the date of her injury until January 1989 when she was scheduled to have a first rib resection to relieve what had been diagnosed as thoracic outlet syndrome. That operation was indefinitely postponed when, during pre-op testing in the hospital, it was discovered that Ms. Kelone had a cardiac problem which would require by-pass surgery.

In this case the preexisting diagnosis of thoracic outlet syndrome (TOS) is significant in that some of the symptoms which plaintiff related to her fall in 1989 are some of the same symptoms as those of which she complained in connection with the TOS.

Ms. Kelone stated that she didn’t remember the exact date upon which she sought medical treatment after her April 1989 fall, but she did remember that it was Dr. Davidson, the same orthopedist who had treated her for TOS, whom she consulted. Plaintiff complained to Dr. Davidson of back and hip pain. Dr. Davidson treated her conservatively without success and, in August 1989, Ms. Kelone was referred to Dr. Luiz DeAraujo, a neurosurgeon in Lafayette, who saw plaintiff on two occasions. Ms. Kelone’s main complaint to Dr. DeAraujo was pain in her neck radiating into the base of the skull and both shoulders; however, she also maintained complaints of low back pain. Dr. DeAraujo could find no neurological basis for plaintiff’s complaints and suspecting soft tissue injury referred Ms. Kelone to Dr. Robert D. Franklin, a rehabilitative medicine specialist. Dr. Franklin became and is plaintiff’s primary treating physician.

Dr. Franklin first saw Ms. Kelone on August 17, 1989 on referral from Dr. DeAraujo for neck pain. At this time, Ms. Kelone was continuing to complain of low back pain, although her major complaint was related to her neck. Ms. Kelone had not mentioned her TOS problem to Dr. DeAraujo, neither did she mention it to Dr. Franklin. On this initial visit, Dr. Franklin detected muscle spasms in plaintiff’s neck. The spasms along with the patient’s history, as related to him, led Dr. Franklin to feel that Ms. Kelone was suffering from myofascial pain syndrome and he began a conservative course of treatment.

Between August 1989 and May of 1990, Ms. Kelone failed to progress as Dr. Franklin anticipated and, on the May 7, 1990 visit, Ms. Kelone’s complaints of severe neck pain prompted him to suggest a cervical MRI. When she returned for her June 13, 1990 visit with the same complaints, the MRI was ordered. However; the test was not performed until January 1991.

During this same period, ORM hired In-traeorp to manage Ms. Kelone’s case. Intra-corp sent plaintiff to Dr. M. Lawrence Drerup, a neurosurgeon, for an IME on February 6, 1990. Before the examination, Dr. Drerup had been supplied copies of some of plaintiff’s medical records including some of those of Drs. Davidson, DeAraujo and Franklin. Inasmuch as Ms. Kelone’s major complaints at this time centered around her neck, Intracorp specifically requested Dr. Drerup to evaluate her for any cervical problems. The medical records supplied were also limited to Ms. Kelone’s cervical problems.

After he completed his examination of Ms. Kelone, he reported to Ms. Cyndi Lyles of [91]*91Intracorp Ms diagnosis of mild chronic cervical myofascial strain. He relayed to Ms. Lyles that from a neurological standpoint there was nothing he could offer Ms. Kelone and that neurologically she appeared to have reached maximum medical improvement (MMI). He stated that he found no need for further cervical testing and recommended heat massage, range of motion exercises and over-the-counter anti-inflammatory medication for pain. On March 30, 1990, Dr. Drerup approved a job analysis form prepared by Ms. Lyles indicating that Ms. Kel-one could return to her former duties.

Based upon reports from Intracorp and Dr. Drerup, defendants terminated Ms. Kel-one’s compensation benefits on May 15, 1990 and refused to pay for the cervical MRI ordered by Dr. Franklin on June 13, 1990. During that same June visit, Dr. Franklin concluded that Ms. Kelone had reached maximum medical improvement as to her cervical problems. However, he opined that she could not engage in the physical activities required of her former job but rather was only capable of light or sedentary duties such as answering telephones, acting as a receptionist, etc.

Dr. Franklin’s second deposition was taken May 20, 1992, just two weeks before the OWC hearing. He continues to treat Ms. Kelone for the same symptoms.

Defendants did finally pay for a cervical MRI wMeh was done in January of 1991 and wMch revealed no disc problems, but did show minimal spondylosis or arthritis at C3-4, C5-6 and C6-7. As the cervical MRI showed no basis for Ms. Kelone’s continued complaints, Dr. Franklin recommended plaintiff take a function capacity assessment test. TMs was done on April 22 and 23,1991. The results, which were received by Dr. Franklin on May 6, 1991, support his conclusion that Ms. Kelone is capable of no more than light duty employment. Dr. Franklin maintains that his original assessment that Ms. Kelone had reached maximum medical improvement as of June 13, 1990 and was capable of light or sedentary employment at that time was correct.

ACTIONS OF THE OWC BEFORE THE COURT ON APPEAL

The hearing officer concluded that Ms. Kelone was temporarily and totally disabled through June 13, 1990, and that she was due SEB beginning June 14, 1990. The hearing officer also concluded that inasmuch as ORM received the treating physician, Dr. Franklin’s, report of his June 13, 1990 examination approximately June 27, 1990, and since that report clearly showed that Ms. Kelone was not capable of returning to her former employment at that time, ORM was, as of July 1, 1990, arbitrary and capricious in refusing to reinstate compensation benefits and/or in not ordering a functional capacities evaluation at that time.

Defendants-appellants argue that (1) the hearing officer erred in extending claimant’s TTD benefits from May 15, 1990 (the date they terminated benefits) to June 13, 1990 and awarding claimant SEB beginning June 14,1990; and, (2) the hearing officer erred in awarding penalties and attorney’s fees.

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Cite This Page — Counsel Stack

Bluebook (online)
626 So. 2d 89, 1993 La. App. LEXIS 3342, 1993 WL 451517, Counsel Stack Legal Research, https://law.counselstack.com/opinion/kelone-v-pinecrest-state-school-lactapp-1993.