Lachney v. Johnson & Johnson

689 So. 2d 691, 1997 WL 66580
CourtLouisiana Court of Appeal
DecidedFebruary 19, 1997
Docket96-724
StatusPublished
Cited by3 cases

This text of 689 So. 2d 691 (Lachney v. Johnson & Johnson) 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. Johnson & Johnson, 689 So. 2d 691, 1997 WL 66580 (La. Ct. App. 1997).

Opinion

689 So.2d 691 (1997)

Barbara LACHNEY, Plaintiff-Appellee,
v.
JOHNSON & JOHNSON/ORTHO BIOTECH, Defendant-Appellant.

No. 96-724.

Court of Appeal of Louisiana, Third Circuit.

February 19, 1997.
Writ Denied May 1, 1997.

*692 Jay Anthony Pucheu, Marksville, Chris J. Roy, Jr., Alexandria, for Barbara Lachney.

Susan Nunez Belsom, Monroe, for Johnson & Johnson/Ortho Biotech.

Before DOUCET, C.J., and THIBODEAUX, SAUNDERS, DECUIR and BABINEAUX[*], JJ.

DECUIR, Judge.

This is an appeal from a judgment of an Office of Workers' Compensation Hearing Officer granting claimant, Barbara Lachney, workers' compensation benefits for a period during which she received employer-funded short-term disability benefits from her employer, Johnson & Johnson/Ortho Biotech. We reverse.

FACTS

This suit arose as a result of an automobile accident. On April 20, 1995, Lachney, a drug sales representative for Johnson & Johnson, was injured when her vehicle was rear-ended by a third party not involved in this suit. It is undisputed that the accident occurred within the course and scope of Lachney's employment.

Johnson & Johnson maintained and completely funded a disability policy for its employees. Employees made no contributions to the plan. Under the policy, Lachney received eight weeks of her full average weekly wage of $1,826.92. At the end of eight weeks she began receiving seventy five (75%) percent of that amount for a period of eighteen weeks. As soon as the twenty-six weeks of employer-funded disability benefits ended, Johnson & Johnson instituted temporary total disability benefits at the maximum weekly rate of $323.00.

On September 19, 1995, thirty days before her short-term disability benefits ended, Lachney filed a disputed claim for worker's compensation benefits. Johnson & Johnson answered this claim on October 21, 1995, asserting its entitlement to a credit for short-term benefits voluntarily paid under the disability plan.

The hearing officer found that Johnson & Johnson was not entitled to a credit against indemnity benefits until the date of judicial demand. Therefore, the hearing officer awarded Lachney benefits for the period commencing with her accident until October 21, 1995, when Johnson & Johnson began paying weekly indemnity benefits. In addition, the hearing officer awarded penalties and attorney fees relating to some medical bills paid outside the sixty day time limit.

Johnson & Johnson lodged this appeal contesting the hearing officer's judgment regarding its entitlement to credit for short-term disability benefits previously paid. Lachney appeals the hearing officer's failure to award penalties and attorney fees for unpaid indemnity benefits during the period from the accident until October 21, 1995.

ENTITLEMENT TO OFFSET

Johnson & Johnson alleges that the hearing officer erred in her interpretation of La.R.S. 23:1225(C), Louisiana's wage-loss benefit coordination law. The crux of Johnson & Johnson's argument is that the hearing officer improperly found that it was not entitled to an offset until judicial demand. We agree.

La.R.S. 23:1225(C)(1) states that:

*693 C.(1) If an employee receives remuneration from:

(a) Benefits under the Louisiana Worker's Compensation Law.
(b) Old-age insurance benefits received under Title II of the Social Security Act to the extent not funded by the employee.
(c) Benefits under disability benefit plans in the proportion funded by an employer.
(d) Any other worker's compensation benefits,
then compensation benefits under this Chapter shall be reduced, unless there is an agreement to the contrary between the employee and the employer liable for payment of the worker's compensation benefit, so that the aggregate remuneration from subparagraphs (a) through (d) of this Subsection shall not exceed sixty-six and two-thirds percent of the average weekly wage.

Louisiana's Supreme Court interpreted this provision in Garrett v. Seventh Ward Hosp., 95-0017 (La.9/22/95); 660 So.2d 841. The Court stated:

The wage-loss coordination provision of Section 1225 C(1) was "designed to add all the benefits not funded by the employee; and, if the combined benefits exceeded 66 2/3 percent of the employee's average weekly wage, the employer would be given an offset of the excess against the obligation to pay workers' compensation benefits." Dennis P. Juge, Louisiana Workers' Compensation § 12:5 (1995). Section 1225 C(1) thus provides Louisiana employers with an offset against their worker's compensation obligation of benefits provided by different employer based sources and establishes a sort of state ceiling of benefits to which an employee is entitled. H. Alston Johnson, Bound in Shallows and Miseries: The 1983 Amendments to the Workers' Compensation Statute, 44 La. L.Rev. 669, 705 (1984); Wex S. Malone & H. Alston Johnson III, 13 Louisiana Civil Law Treatise-Workers Compensation Law and Practice § 289 (3d ed.1994).

Garrett, 660 So.2d at 845.

The Court also discussed the purpose of wage-loss benefit coordination laws as follows:

Wage-loss benefit coordination laws are designed to achieve a dual purpose: (1) to assure, when an employee suffers a wage loss because of disability, unemployment, advanced age or death, that a certain minimum portion of the employee's actual wages is continued or, in the case of death, that the employee's dependents receive some degree of recovery of lost support; and (2) to preclude an employee from contemporaneously collecting duplicative wage-loss benefits under different parts of the overall system of employer-based protection against loss of wages. Benefit coordination laws are based on the premise that an employee experiencing a period of wage loss should not be permitted to receive duplicative benefits from different parts of the overall system provided by the employer and thereby recover more than the amount of his or her actual wages. The theory is that an employee experiencing only one wage loss should be entitled to receive only one wage-loss benefit from the employer. Benefit coordination laws thus avoid duplicative benefits collected from the employer and prevent social legislation from becoming a "grab bag" of assorted, unrelated wage-loss benefits. 4 Arthur Larson, Worker's Compensation § 97.10 (1995).

Garrett, 660 So.2d at 843.

Admittedly, the supreme court's opinion in Garrett focused on whether La.R.S. 23:1225(C)(1)(c) applied to social security disability benefits. However, the court's opinion clearly indicates that there is no question as to the provisions applicability to voluntary employer-funded disability plans. In addition, Justice Calogero's impassioned dissent to the majority's decision in Garrett that La.R.S. 1225(C)(1)(c) applied to social security disability benefits, addressed the legislature's intent as to private disability plans as follows:

To me, it is evident that the Legislature only intended this offset to apply to private disability plans funded or supported by an employer, and not benefits available under the federal Social Security program. This *694 interpretation of the statute is supported by H. Alston Johnson, III, author of La. Civil Law Treatise, Vol. 13, Workers' Compensation Law and Practice, § 289 (3d ed.1994), who explains that the offset provision of La.R.S.

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689 So. 2d 691, 1997 WL 66580, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lachney-v-johnson-johnson-lactapp-1997.