Lachney v. Delaney

628 So. 2d 46, 1993 La. App. LEXIS 2951, 1993 WL 394619
CourtLouisiana Court of Appeal
DecidedOctober 6, 1993
DocketNo. 93-24
StatusPublished
Cited by2 cases

This text of 628 So. 2d 46 (Lachney v. Delaney) 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
Lachney v. Delaney, 628 So. 2d 46, 1993 La. App. LEXIS 2951, 1993 WL 394619 (La. Ct. App. 1993).

Opinions

STOKER, Judge.

This is a worker’s compensation case. Claimant Keith Lachney1 appeals a judgment denying his claim for permanent total disability benefits, penalties, and attorney fees. The issues presented in this appeal are primarily factual. We affirm in part and reverse in part.

FACTS

This worker’s compensation case arises from an accident on April 4, 1985. Keith Lachney, who was working for James E. Delaney as a brick mason, stepped in a rut and twisted his right foot and ankle. He fractured the first and second cuneiform and suffered a severe sprain of the medial plantar ligament, all of which caused the first metatarsal and part of the cuneiform to drift medially and interiorly, resulting in a deformity of the foot with lateral deviation. Subsequently, Lachney developed severe arthritis in his foot.

After the accident, Delaney’s worker’s compensation insurer, Great American Insur-[48]*48anee Co., began paying Laehney temporary total disability benefits based on his prior wage of $16 per hour for a forty hour week. Great American continued to pay weekly benefits and medical expenses through the end of December 1989, after which it terminated all benefits on the basis of the opinion of Lachney’s primary treating physician, Dr. Douglas McKay. Dr. McKay, an orthopedist, had released Laehney to work without restriction as long as he wore his orthopedic boots. Great American also refused to guarantee payment for any more orthopedic boots for Laehney.

RULING BY THE ADMINISTRATIVE HEARING OFFICER

Laehney filed this claim for continuation of his worker’s compensation benefits and medical expenses, as well as for penalties and attorney fees.

The hearing officer denied his claim for continued benefits, finding that Laehney was not permanently totally disabled and that he had a 25% permanent partial disability in his right foot. The hearing officer further found that Laehney was able to work and that he had not been truthful when he stated that he lived in constant pain, since he refused to undergo the recommended surgery to alleviate his pain. The surgery had been recommended by Dr. Cedric Lowery, an orthopedic surgeon who evaluated Laehney’s foot at the request of Great American, and by Dr. Frank Anders, an orthopedic surgeon who referred Laehney to Dr. McKay, as well as by Dr. McKay, Lachney’s primary treating physician. Finally, the hearing officer found that Great American had not been arbitrary and capricious in terminating Laehney’s benefits.

Laehney appeals this judgment, contending the hearing officer erred in failing to find he is permanently totally disabled under the substantial pain doctrine. Laehney also claims that Great American should have borne the burden of proving he was not totally disabled after it consented to pay him benefits. Laehney argues that Great American did not have the right to terminate benefits without first seeking a ruling from the Office of Workers’ Compensation (OWC) and, thus, Great American was arbitrary and capricious in terminating his benefits.

PERMANENT DISABILITY

Laehney argues on appeal that the hearing officer erred in failing to award him permanent total or permanent temporary disability benefits pursuant to LSA-R.S. 23:1221(2) or (4) and the jurisprudential odd lot doctrine, which was allegedly in effect at the time of Lachney’s injury.

The 1983 amendments to the Worker’s Compensation Act established a stricter standard for proving permanent total disability. The plaintiff must prove by clear and convincing evidence that he is unable to engage in any employment or self-employment, regardless of the nature of employment or self-employment. The existence of pain suffered by the employee is not relevant to a determination of total permanent disability. The nature, character, location and availability of employment are similarly irrelevant. Augustine v. Paul Wall Truck Line, Inc., 603 So.2d 770 at 775 (La.App. 3d Cir.), writ denied, 608 So.2d 193 (La.1992), and cases cited therein; LSA-R.S. 23:1221(2)(d). Also, Paul v. Gipson, 614 So.2d 1275 (La.App. 2d Cir.1993).

Laehney testified that he is a self-employed farmer. He works full time supervising his employees, who do the hard physical labor, in his small farming operation. Therefore, Laehney cannot be classified as permanently totally disabled, despite the fact that he allegedly has been working in pain. See LSA-R.S. 23:1221(2)(b). The “substantial pain” or “odd lot” doctrine was no longer applicable to determinations of permanent total disability at the time of Laehney’s injury.

Moreover, Laehney does not qualify for permanent partial disability. His primary treating physician, Dr. McKay, assigned a 25% disability rating to Lachney’s right foot. Dr. Anders and Dr. Lowery each assigned a 20% disability rating to his foot. At the time of Lachney’s injury, a claimant must have [49]*49had a disability rating greater than 50% to qualify for permanent partial disability benefits under LSA-R.S. 23:1221(4).

Therefore, the hearing officer did not err in failing to award Lachney permanent total or permanent partial disability benefits. We turn now to consideration of supplemental earnings benefits (SEB).

SEB

If the claimant is employed or self-employed, then the burden of proof is on the claimant to prove by clear and convincing evidence, that a work related injury resulted in his inability to earn wages equal to 90% or more of his wages at the time of injury. However, if the claimant is not employed or self-employed or is earning less than he is able to earn, the burden is on the employer to show the employee is physically capable of performing employment which is offered or available. LSA-R.S. 23:1221(3)(c)(i); Daigle v. Sherwin-Williams Co., 545 So.2d 1005 (La.1989); Guillory v. City of Lake Charles, 614 So.2d 165 (La.App. 3d Cir.1993); Hebert v. Grey Wolf Drilling Co., Inc., 611 So.2d 674 (La.App. 3d Cir.1992). To determine whether the claimant has established a prima facie case for entitlement to SEB, the court must consider whether he presented sufficient evidence to prove he was unable to earn the requisite percentage of his preinjury wages. Hinton v. Scott Hydraulics, Inc., 614 So.2d 820 (La.App. 2d Cir.1993), and eases cited therein.

Under LSA-R.S. 23:1221(3), an injured employee is entitled to SEB if, by reason of the injury, the employee is unable because of substantial pain, to engage in any employment or self-employment. The circumstances necessary to support such an award must be established by clear and convincing proof, unaided by any presumption of disability, that solely as a consequence of substantial pain, plaintiff was unable to engage in any employment or self-employment. Rosella v. Dede’s Wholesale Florist, 607 So.2d 1055 (La.App. 3d Cir.1992), and eases cited therein.

Pain experienced by a claimant seeking compensation benefits is a question of fact to be resolved by the trier of fact. The physical inability of a claimant to return to work due to substantial pain is a question of fact and will not be disturbed unless clearly wrong. The degree of pain is a factual determination which depends to a great extent on the trial judge’s evaluation of the claimant’s credibility. Hollier v. American Bldg. Systems, Inc., 503 So.2d 701 (La.App. 3d Cir.1987), and cases cited therein. See also, Adams v. NOLA Fleet Shipyard, 617 So.2d 88 (La.App. 4th Cir.1993); Lewis v.

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Bluebook (online)
628 So. 2d 46, 1993 La. App. LEXIS 2951, 1993 WL 394619, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lachney-v-delaney-lactapp-1993.