Michael Spillman v. Career Adventures, Inc., and Risk Savers, LLC

Louisiana Court of Appeal·Decided August 11, 2021·No. 54,054-WCA·Published

Opinion

Judgment rendered August 11, 2021.

Application for rehearing may be filed within the delay allowed by Art. 2166, La. C.C.P.

No. 54,054-WCA

COURT OF APPEAL

SECOND CIRCUIT

STATE OF LOUISIANA

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MICHAEL SPILLMAN Plaintiff-Appellant versus

CAREER ADVENTURES, INC., Defendants-Appellees AND RISK SAVERS, LLC

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Appealed from the

Office of Workers’ Compensation, District 1W Parish of Caddo, Louisiana Trial Court No. 19-05721

Linda Lea Smith

Workers’ Compensation Judge

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FISCHER & MANNO Counsel for Appellant By: Mark K. Manno

Don Anzelmo Counsel for Appellees

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Before STONE, STEPHENS, and HUNTER, JJ.

STONE, J.

The plaintiff-appellant, Michael Spillman (“Mr. Spillman”), appeals the decision of the worker’s compensation judge (“WCJ”) denying his claim for benefits. The WCJ found that Mr. Spillman suffered a work-related injury (torn tendon in left elbow), but that Mr. Spillman: (1) failed to carry his burden of proving that, because of the elbow injury, he cannot earn at least 90% of what he was earning pre-injury; and (2) pursuant to La. R.S. 23:1208.1, he forfeited any benefits due to him by failing to truthfully answer his employer’s inquiries regarding any pre-existing medical conditions. On appeal, Mr. Spillman argues that both findings are erroneous, and requests that this court reverse the WCJ’s decision and award him benefits de novo. The defendant-appellee, Career Adventures, Inc. (“Career Adventures”), is a temporary staffing company for which Mr. Spillman began working in July of 2018. Mr. Spillman worked exclusively as a welder at General Electric while employed by Career Adventures. Career Adventures filed an answer to the appeal, and argues that the WCJ erred in finding that Mr. Spillman suffered a work-related injury.

For the following reasons, we affirm.

FACTS AND PROCEDURAL HISTORY Prior to the subject injury, Mr. Spillman had significant injuries and medical concerns as are more fully described herein. In a 2007 work- related accident, a 900-pound metal plate crushed Mr. Spillman’s left foot; as a result, he was disabled and on worker’s compensation benefits for approximately two years. This injury also left him with regional sympathetic dystrophy (“RSD”) of the left foot, which he was still being treated for at the time he began working at Career Adventures. Mr.

Spillman’s past injuries have also included a gunshot wound to his upper left leg that was treated surgically, and has continued to cause him chronic pain since. Mr. Spillman has been treated for chronic obstructive pulmonary disease (“COPD”) as far back as 2007.

In 2013, Mr. Spillman suffered an injury to the AC joint in his right shoulder that was surgically repaired. Then, in January of 2018, he was involved in a head-on motor vehicle accident and suffered injuries to his right shoulder and right knee which were still causing him high levels of pain as late as three weeks prior to the subject elbow injury (i.e., 15 months after the wreck). Additionally, throughout the decade prior to the subject injury, Dr. Wall (Mr. Spillman’s primary care and pain management physician), also treated for COPD, chronic pain, RSD, depression, anxiety, bipolar disorder, allergic sinusitis, chronic fatigue, hypertension, and other ailments and medical conditions.

Mr. Spillman applied for a job with Career Adventures in May of 2018. His application included a preemployment questionnaire styled “Office of Workers Compensation Administration Second Injury Board Questionnaire” wherein Career Adventures presented a battery of questions regarding Mr. Spillman’s medical history, current medical condition, and current medical treatment. One part of the questionnaire listed 52 diseases, ailments, and conditions and further instructed the applicant to check “yes” or “no” next to each. Mr. Spillman checked “no” next to each and every item listed. In doing so, Mr. Spillman falsely denied having COPD, hypertension, bipolar disorder, depression, and ADHD. It is undisputed that Career Adventures adequately provided notice of the risk of forfeiture for failure to answer truthfully pursuant to La. R.S. 23:1208.1.

Additionally, Mr. Spillman failed to answer questions which, if answered truthfully, would have revealed his history of severe injuries and numerous medical conditions. Furthermore, the questions Mr. Spillman failed to answer were part of a series of questions – and, notably, he did answer the questions which, answered truthfully, would not reveal any pre- existing medical conditions. The series of questions, and Mr. Spillman’s answers and non-answers, are as follows:

• Has any doctor ever restricted your activities? (Mr. Spillman did not answer this question).

• If yes, please list the restrictions: (Mr. Spillman did not list any restrictions).

• Are you currently restricted? Mr. Spillman truthfully denied current restrictions.

• What is the medical condition for which you are restricted? (Mr.

Spillman did not state any medical condition or conditions).

• Are you presently treating with a doctor…? (Mr. Spillman left this question blank).

• Please list the medical condition being treated. (Mr. Spillman did not list any conditions).

The questionnaire also requested the doctor’s name, address, and specialty. (Mr. Spillman did not respond to these requests).

• If you are presently taking medication other than those listed on the Explanation Page, please [list all such medications and provide the name of each prescribing doctor]. (Mr. Spillman did not respond to this request).

• Have you ever had an on-the-job accident? If you answered “Yes,”

please provide the date for each injury and the nature of each injury.

(Mr. Spillman did not answer these questions).

• How long were you on compensation? (Mr. Spillman did not answer this question).

• Has a doctor recommended a surgical procedure, which has not been completed prior to this date, including but not limited to knee, hip or shoulder replacement? Mr. Spillman truthfully answered this question “No.”

• Mr. Spillman also left blank a question regarding whether he ever had a surgical procedure.

Had Mr. Spillman provided truthful answers to all of these questions, he would have disclosed: (1) his foot having been crushed by a 900-pound metal plate in an “on-the-job” accident, and resulting two year receipt of

worker’s compensation disability benefits while being out of work, and chronic pain and RSD; (2) the gunshot wound to his upper left leg, which required surgery, and presumably a medical restriction of his activities; (3) the surgery to repair the AC joint in his right shoulder, and presumably a medical restriction of his activities, and apparent chronic pain; (4) the 14 prescription medications he was taking at the time he submitted the application, including but not limited to muscle relaxers, anticonvulsants, antidepressants, stimulants, and opioid pain medications.

Mr. Spillman contends that the insurance adjuster’s notes regarding his claim show that Career Adventures subsequently gained actual knowledge of his pre-existing conditions, and had time to correct this misinformation before the accident.1 Mr. Spillman worked for Career Adventures from July of 2018 until he sustained his left elbow injury in April of 2019. Career Adventures did not guarantee Mr. Spillman 40 hours a week, and Mr. Spillman often did not work that many hours. He also had significant absences for medical reasons. For example, from December 21, 2018, to January 2, 2019, Mr. Spillman was absent from work pursuant to a doctor’s excuse. Mr. Spillman also missed work because of his RSD, apparently on both February 7 and February 8, 2019. Dr. Wall wrote him an excuse for these days.

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Michael Spillman v. Career Adventures, Inc., and Risk Savers, LLC, (La. Ct. App. 2021).

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