Moses v. Grambling State University

762 So. 2d 191, 2000 WL 594721
CourtLouisiana Court of Appeal
DecidedMay 15, 2000
Docket33,185-WCA
StatusPublished
Cited by12 cases

This text of 762 So. 2d 191 (Moses v. Grambling State University) 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
Moses v. Grambling State University, 762 So. 2d 191, 2000 WL 594721 (La. Ct. App. 2000).

Opinion

762 So.2d 191 (2000)

Sharon Johnson MOSES, Plaintiff-Appellee,
v.
GRAMBLING STATE UNIVERSITY, Defendant-Appellant.

No. 33,185-WCA.

Court of Appeal of Louisiana, Second Circuit.

May 15, 2000.
Writ Denied September 22, 2000.

*193 Louisiana Department of Justice by Victoria Reed Murry, Assistant Attorney General, Counsel for Appellant.

James E. Franklin, Jr., Shreveport, Counsel for Appellee.

Before CARAWAY, PEATROSS & SAMS (Pro Tempore), JJ.

PEATROSS, J.

The State of Louisiana and Grambling State University (hereinafter collectively referred to as "Defendant"), appeals a ruling by the Workers' Compensation Judge ("WCJ") increasing the indemnity benefits paid to Plaintiff, Sharon J. Moses, by including health insurance premiums, retirement benefits and holiday pay, paid by Defendant on her behalf, in the calculation of her average weekly wage; granting credit for sick or annual leave used for reasons associated with a work-related injury; and awarding penalties of $2,000 and attorney fees of $7,000.[1] Plaintiff has answered the appeal, asking for an increase in attorney fees for the handling of this appeal and for the inclusion of sick and annual leave accrued by her in the calculation of indemnity benefits. For the reasons stated herein, we reverse in part, amend in part, and, as amended, affirm those portions of the judgment not reversed.

FACTS AND PROCEDURAL HISTORY

Plaintiff was working in a sedentary capacity for Defendant in 1996 when she slipped and fell on a recently cleaned floor that had not yet dried. Plaintiff injured her shoulder and her back, but missed only five days of work which were taken as sick leave. Plaintiff continued to seek medical treatment, but missed very little work related to her injuries. It was not until February 1998 that Plaintiff missed a full seven days of work within a two-week period as a result of the 1996 accident, activating workers' compensation indemnity benefits. Her medical bills associated with the work-related accident were paid by Defendant.

In January 1998, due to her continued pain, Plaintiff's treating physician requested an MRI and myelogram which revealed two bulging disks. Plaintiff was referred to Dr. Douglas Brown, an orthopaedist, who reduced her work days to half days for approximately three weeks. On February 11, 1998, Dr. Brown prescribed work hardening for Plaintiff which would necessitate her being off of work for a few weeks. Plaintiff filed an LDOL-WC-1008 form when she was advised by Defendant that her claim was prescribed and that indemnity benefits for her time off would not be forthcoming.

*194 Once legal action was taken, Plaintiff's file was sent to Defendant's Office of Risk Management where it was determined that there was no issue of prescription. Plaintiff was eventually paid indemnity benefits in May 1998, retroactive to April 17, 1998. At the time of trial, all medical benefits had been paid, including the cost of two surgical procedures, a left L4-5 automated lumbar nuclectomy and a decompressive lumbar laminectomy and diskectomy; and the amount of indemnity benefits and the reimbursement of expended sick and annual leave were the only remaining matters still in dispute. Plaintiff did receive indemnity benefits from Defendant up to and beyond the date of trial, although Defendant did not authorize payment of indemnity benefits for the period of February 11, 1998, to April 16, 1998, until the day before trial of this matter.

At trial on the merits, the parties stipulated to the following facts:

1) Plaintiff was employed by Defendant at an annual salary of $18,307.92, calculating to an average weekly wage of $352.08.
2) Plaintiff was injured on the job in November 1996.
3) As of the date of trial, Plaintiff was receiving indemnity as well as medical benefits.
4) Plaintiff's compensation rate was $234.73 per week, based on her average weekly wage of $352.08. In addition to her salary, a health insurance premium in the amount of $44.76 per week was paid on her behalf by Defendant.
5) Defendant paid retirement benefits in the amount of $43.66 per week on behalf of Plaintiff.
6) Plaintiff was given paid holidays, which calculated to a value of $18.95 per week.
7) Plaintiff accrued annual and sick leave each at a rate of 14 hours per month.

Plaintiff asserts on appeal that the calculation of indemnity benefits should have included the amount of her insurance premiums and retirement benefits paid by Defendant on her behalf. Plaintiff also asserts that the amount of her holiday pay and annual and sick leave earned should have been included in the calculation. She further demands reimbursement of the annual and sick leave she expended in relation to this injury and additional attorney fees for the cost of defending and answering this appeal.

DISCUSSION

Defendant's Assignment of Error No. 1: The WCJ was manifestly erroneous in finding that Defendant was arbitrary and capricious in failing to pay workers' compensation benefits to Plaintiff from February 8, 1998, to April 16, 1998.

Defendant asserts that it was acting within reason when it did not begin to pay Plaintiff indemnity benefits until May 1998, despite her request for indemnity benefits in February 1998. Defendant points out that it was reasonable for it to question Plaintiff's entitlement to indemnity benefits since she had not missed seven days work within a two-week period, invoking her entitlement to benefits, for over one year after the injury.

The WCJ's factual findings are subject to the manifest error rule. Alexander v. Pellerin Marble & Granite, 93-1698 (La.1/14/94), 630 So.2d 706; Mitchell v. AT & T, 27,290 (La.App.2d Cir.8/28/95), 660 So.2d 204, writ denied, 95-2474 (La.12/15/95), 664 So.2d 456. Under the manifest error rule, the reviewing court does not decide whether the factual findings are right or wrong, but whether they are reasonable. Stobart v. State, Through Dept. of Transp. & Dev., 617 So.2d 880 (La.1993).

Although Defendant is entitled to take a reasonable amount of time to determine Plaintiffs entitlement to indemnity benefits, we do not believe, however, that four months is a reasonable period of time. See La. R.S. 23:1201(f). More importantly, and something Defendant fails to address, is that Defendant did not authorize payment of the indemnity benefits for the period of February 8 through May 16, *195 1998, until the day before trial of this matter, April 21, 1999. We find that such action was arbitrary and capricious. The WCJ did not err in penalizing Defendant for its behavior in this regard.

Defendant's Assignment of Error No. 2: The WCJ committed manifest error in ruling that payment for holidays should be included in the calculation of Plaintiff's average weekly wage.

The WCJ calculated that Plaintiff received an equivalent of $18.95 per week in the fringe benefit of paid holidays. This figure was based on Plaintiff's salary and the number of paid holidays authorized by Defendant. It is Defendant's position that, if Plaintiff is entitled to an addition of fringe benefits to the calculation of her average weekly wage, paid holidays should not be considered since that amount is already figured in Plaintiff's salary. We agree.

As stated above, the amount of $18.95 per week was calculated using Plaintiff's base salary.

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Bluebook (online)
762 So. 2d 191, 2000 WL 594721, Counsel Stack Legal Research, https://law.counselstack.com/opinion/moses-v-grambling-state-university-lactapp-2000.