Mai v. American Seafoods Co.

160 Wash. App. 528
CourtCourt of Appeals of Washington
DecidedMarch 14, 2011
DocketNo. 63969-2-I
StatusPublished
Cited by11 cases

This text of 160 Wash. App. 528 (Mai v. American Seafoods Co.) is published on Counsel Stack Legal Research, covering Court of Appeals of Washington primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Mai v. American Seafoods Co., 160 Wash. App. 528 (Wash. Ct. App. 2011).

Opinion

¶1 American Seafoods Co. LLC and Northern Hawk LLC (collectively ASC) appeal a judgment [533]*533for maintenance, compensatory damages, and attorney fees awarded because they failed to pay maintenance and cure to Tuyen Thanh Mai. ASC contends it had no obligation to pay maintenance and cure during the period of time Mai refused to attend an independent medical examination (IME) as requested by ASC. ASC also asserts that insufficient evidence supports the trial court’s award of compensatory damages and attorney fees.

Leach, A.C.J.

[533]*533f 2 We hold that under the facts of the case, ASC could not condition Mai’s receipt of maintenance and cure upon her attendance at an IME. We also hold that substantial evidence supports the trial court’s findings that ASC withheld maintenance and cure unreasonably, arbitrarily, and willfully. We therefore affirm the trial court’s award of maintenance, compensatory damages, and attorney fees.

FACTS

¶3 On March 29, 2005, Mai injured her left knee while off-loading 40-pound boxes of frozen seafood from the F/T Northern Hawk. Off-loading involves moving the boxes from a box elevator, then to an incline conveyor, and then to a dock conveyor. Workers lift the boxes off the dock conveyor and load them onto nearby pallets. Mai was working near the transfer point between the incline conveyor and dock conveyor when the two conveyors became misaligned. A box slid from the incline conveyor and struck Mai on her left knee, causing her immediate pain.

f 4 On April 1, Mai reported that her left knee was still swollen and painful. Dr. Charles Peterson began treating Mai five days later. Dr. Peterson noted that Mai suffered “pain and swelling in the knee and it clicks and pops and [has] difficulty working.” After administering a MeMurray’s test,1 he ordered an MRI (magnetic resonance imaging) scan. Dr. Peterson diagnosed Mai with a degenerative medial meniscus with a probable tear.

[534]*534¶5 Dr. Peterson performed a left knee arthroscopy and medial meniscectomy without complication. During the surgical procedure, he found a horizontal tear and a tear in the posterior half of Mai’s medial meniscus. Postsurgery, Mai engaged in physical therapy and began using a knee brace. On August 4, Mai reported to Dr. Peterson that she had tried to return to work but suffered from increased pain and swelling. Dr. Peterson prescribed a new knee brace. At a follow-up appointment, Mai reported that the new brace had not helped very much. Dr. Peterson recommended that she have the brace adjusted and noted that though she was not yet released for work, Mai could work as a night watch when the boat returned.

¶6 ASC arranged for Mai to have a second MRI with orthopedist Jonathan L. Franklin in October 2005. Dr. Franklin’s examination noted tenderness in the medial and posteromedial joint line, a painful McMurray’s test, and pain with full flexion of the left knee. The MRI scan also revealed a tear in the remaining body of the medial meniscus.

¶7 Later that year, Mai left Seattle for California, where she sought treatment from Dr. Bert Tardieu, who had previously treated her for injuries to her right knee. In December, Dr. Tardieu noted diffuse swelling, synovial thickening, and tenderness in Mai’s medial compartment of the left knee. Dr. Tardieu examined the MRI results obtained by Dr. Franklin and noted that Mai might still have a meniscus tear but recommended she try more conservative treatment options before surgery. Mai returned to Dr. Tardieu in January 2006, still complaining of painful popping in the knee joint. In March 2006, Dr. Tardieu performed surgery and found a complex tear of the medial meniscus and excised the torn fragments.

f 8 After surgery, Mai continued to experience discomfort in her left knee. On September 22, 2006, Dr. Tardieu observed that “it is clear that even with the knee brace on, she will not be safe for unsteady or uneven walking surfaces.” Dr. Tardieu prescribed a gym membership to develop [535]*535strength in her lower left leg and to delay her total knee arthroplasty.

¶9 ASC abruptly ended maintenance and cure payments in November 2006. In a letter dated December 4, ASC’s counsel wrote,

Enclosed is American Seafoods’ check no. 134921 in the amount of $375.00 paying maintenance to Ms. Tuyen for the period of November 16th through November 30, 2006.

It is unclear whether Ms. Tuyen is entitled to continue to receive maintenance & cure, as her “treatment” over the past few months has consisted of going to a gym and taking pain medication. The last couple of chart notes indicate that her condition is neither improving nor worsening. It is unclear whether anything she is currently doing is curative.

It will be necessary to obtain an explanation from her treating physician Dr. Tardieu as to the nature of her treatment before any further maintenance & cure benefits will be paid.

¶10 On December 15, Dr. Tardieu noted that Mai was “a total knee candidate” but that she “should keep forestalling” and “delay [the procedure] as long as possible” by taking anti-inflammatory drugs, exercise, and by wearing the knee brace. In Dr. Tardieu’s opinion, Mai was “permanently disabled from ever returning to her work as an ocean-going fisherman or fish preparation employee.”

¶11 On April 5, 2007, ASC’s counsel wrote a letter, stating,

Dr. Tardieu has diagnosed [Ms. Tuyen] with bilateral degenerative arthritis of the knees. For quite some time now, he has prescribed physical therapy and medication for this condition____

The medical evidence indicates that her treatment is palliative in nature. Under these circumstances, Ms. Tuyen is no longer entitled to payment of maintenance and cure.

We understand Dr. Tardieu believes Ms. Tuyen is a candidate for a total knee replacement. Such surgery is obviously curative in nature. Should Ms. Tuyen decide to have the surgery, it would be covered by maintenance and cure.

[536]*536¶12 On May 1, Dr. Tardieu observed that Mai was not making significant progress and recommended Mai proceed with the total knee replacement (TKR) procedure. On May 16, ASC received a request to pay for a TKR, which was tentatively scheduled for June 11.

¶13 Five days before surgery, ASC faxed notice that it would not pay for the procedure. Instead, ASC insisted that Mai undergo an IME with Dr. Franklin in Seattle. In a letter to Mai’s attorney, ASC’s attorney explained his client’s sudden refusal to approve surgery,

[T]he surgery was first discussed last year, but Ms. Tuyen took no action nor showed any interest in pursuing it. In any event, American Seafoods wishes to investigate the request for this surgery before providing approval, given the drastic nature of the procedure.

We understand Ms. Tuyen has had symptoms for some time relating to her left knee. She has undergone two prior surgeries. It may very well be that total knee replacement is the logical next step. If so, as previously mentioned, the procedure would be curative in nature and covered by maintenance and cure. However, given the drastic nature of this surgery, American Seafoods wants an independent evaluation to determine whether Ms. Tuyen has reached the point of requiring it and whether any alternative treatment, short of such surgery, is available and recommended.

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Cite This Page — Counsel Stack

Bluebook (online)
160 Wash. App. 528, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mai-v-american-seafoods-co-washctapp-2011.