McClure v. City of Pineville

944 So. 2d 795, 6 La.App. 3 Cir. 279, 2006 La. App. LEXIS 2735, 2006 WL 3498300
Louisiana Court of Appeal·Decided December 6, 2006·No. 06-279·Published·Cited by 12 cases

Opinion

944 So.2d 795 (2006)

Howard McCLURE
v.
CITY OF PINEVILLE.

No. 06-279.

Court of Appeal of Louisiana, Third Circuit.

December 6, 2006.

*797 Daniel E. Broussard, Jr., Broussard, Bolton, Halcomb & Vizzier, Alexandria, LA, for Plaintiff/Appellee, Mary McClure.

Thomas J. Solari, Attorney at Law, Lake Charles, LA, for Defendant/Appellant, City of Pineville.

Gregory E. Bodin, Russell L. Mosely, Taylor, Porter, Brooks & Phillips, Baton Rouge, LA, for Defendant/Appellant, Louisiana Workers' Compensation Corporation.

Court composed of OSWALD A. DECUIR, JIMMIE C. PETERS, and MICHAEL G. SULLIVAN, Judges.

SULLIVAN, Judge.

This is a workers' compensation claim under the Heart and Lung Act, La.R.S. 33:2581. The employer and its workers' compensation carrier appeal the judgment rendered in favor of the claimant, which awarded her death benefits, funeral expenses, medical expenses, penalties, and attorney fees associated with the death of her husband, a retired fireman. For the following reasons, we reverse in part, amend, and affirm the judgment as amended.

Facts

Howard McClure was employed by the Pineville Fire Department (Pineville) for more than forty years. He retired in May 2000. In February 2003, he was diagnosed with lung cancer; he died as a result of this cancer in July 2003. His widow, Mary McClure, sought death benefits pursuant to the provisions of the Heart and Lung Act, La.R.S. 33:2581.

Pineville had workers' compensation coverage with Louisiana Municipal Risk Management Association (LMRMA) which was administered through Risk Management, Inc. (hereinafter referred to collectively as RMI) for the period January 1, 1987 through December 31, 1998. Louisiana Workers' Compensation Corporation *798 (LWCC) provided Pineville workers' compensation coverage for the period January 1, 1999 through December 31, 2001. Beginning January 1, 2002, Pineville was self-insured; RMI was the administrator of its claims. On January 1, 2003, Pineville had coverage again with LMRMA/RMI.

After Mrs. McClure sought benefits, RMI filed a disputed claim, seeking a declaratory judgment that it was not responsible for the benefits sought. Mrs. McClure filed a Reconventional Demand seeking death benefits from RMI[1] and LWCC. She then named Pineville as a defendant.

The WCJ tried Mrs. McClure's claims against Pineville and LWCC and took the matter under advisement. Thereafter, the WCJ issued oral reasons granting judgment in favor of Mrs. McClure and against LWCC and Pineville as follows:

Death benefits at the rate of $226.09 per week from July 22, 2003, together with interest on each payment from February 24, 2004 or its due date until paid.
Medical benefits incurred in connection with Mr. McClure's diagnosis and treatment of his lung cancer in the amount of $120,112.52 together with legal interest thereon from February 24, 2004 until paid;
Funeral expenses in the amount of $5,000.00 together with legal interest thereon from February 24, 2004 until paid;
Pineville and LWCC were each assessed with penalties for:
  Failure to pay indemnity benefits    $2,000.00
  Failure to pay funeral expenses      $2,000.00
  Failure to pay medical expenses      $2,000.00

Pineville and LWCC were also each assessed with attorney fees in the amount of $5,000.00. The WCJ denied Mrs. McClure's claim for temporary total disability benefits from February 1, 2003 until July 22, 2003.

LWCC and Pineville appealed the judgment of the WCJ; Mrs. McClure answered the appeal, seeking additional attorney fees for work performed on appeal.

Assignments of Error

LWCC assigns five errors:

1. The WCJ erred in refusing to allow evidence of Mr. McClure's "last injurious" exposure.
2. The WCJ erred in ruling that LWCC was responsible for the payment of death benefits, medical costs, and funeral expenses because there was no conclusive evidence presented at trial which proved that Mr. McClure's exposure during the period it provided workers' compensation coverage to the Pineville Fire Department caused his lung cancer.
3. The WCJ erred in concluding that LWCC failed to rebut the presumption contained in the Heart and Lung Act, La.R.S. 33:2581.
4. The WCJ erred in assessing LWCC with death benefits.
5. The WCJ erred in assessing LWCC with penalties and attorney fees for its refusal to pay death benefits, medical expenses, and funeral expenses.

Pineville also assigns five errors:

1. The WCJ erred in assessing Pineville with death benefits because the claimant failed to produce evidence that she was receiving any pecuniary *799 support at the time of her husband's death.
2. Alternatively, the WCJ erred in assessing Pineville with death benefits where the decedent was not receiving any wages at the time of his death.
3. The WCJ erred in assessing penalties and fees against Pineville for resisting payments based on its litigation of an unsettled question of law.
4. The WCJ erred in assessing penalties against both Pineville and LWCC, in contravention of limitations on the imposition of and the amount of penalties under La.R.S. 23:1201(F).
5. The WCJ erred in increasing the total award of attorney fees by $2,500 when a clarification on the award was sought.

Standard of Review

Factual findings of the WCJ should not be set aside unless they are manifestly erroneous or are clearly wrong. However, if the WCJ committed a reversible error of law or manifest error of fact, this court must ascertain the facts de novo from the record and render a judgment on the merits. Bonnette v. Conoco, Inc., 01-2767 (La.1/28/03), 837 So.2d 1219.

Discussion

Heart and Lung Act

As previously stated, Mrs. McClure's claims are predicated on the Heart and Lung Act, La.R.S. 33:2581, which provides:

Any disease or infirmity of the heart or lungs which develops during a period of employment in the classified fire service in the state of Louisiana shall be classified as a disease or infirmity connected with employment. The employee affected, or his survivors, shall be entitled to all rights and benefits as granted by the laws of the state of Louisiana to which one suffering an occupational disease is entitled as service connected in the line of duty, regardless of whether the fireman is on duty at the time he is stricken with the disease or infirmity. Such disease or infirmity shall be presumed, prima facie, to have been caused by or to have resulted from the nature of the work performed whenever same is manifested at any time after the first five years of employment.

Last Injurious Exposure

LWCC stipulated that it provided Pineville workers' compensation coverage from January 1, 1999 through December 31, 2001. Its first assignment of error is based upon the following provision of the policy[2] LWCC issued to Pineville:

A. How This Insurance Applies
This workers compensation insurance applies to bodily injury by accident or bodily injury by disease. Bodily injury includes resulting death.
. . . .
2. Bodily injury disease must be caused or aggravated by the conditions of your employment.

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McClure v. City of Pineville, 944 So. 2d 795, 6 La.App. 3 Cir. 279, 2006 La. App. LEXIS 2735, 2006 WL 3498300 (La. Ct. App. 2006).

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