Necaise v. AC Co. of South Louisiana, Inc.

499 So. 2d 1074
CourtLouisiana Court of Appeal
DecidedOctober 8, 1986
Docket85-1062
StatusPublished
Cited by13 cases

This text of 499 So. 2d 1074 (Necaise v. AC Co. of South Louisiana, Inc.) 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
Necaise v. AC Co. of South Louisiana, Inc., 499 So. 2d 1074 (La. Ct. App. 1986).

Opinion

499 So.2d 1074 (1986)

Richard Wayne NECAISE, Plaintiff-Appellant,
v.
A.C. COMPANY OF SOUTH LOUISIANA, INC., American Insurance Company and Fireman's Fund Insurance Company, Defendants-Appellees.

No. 85-1062.

Court of Appeal of Louisiana, Third Circuit.

October 8, 1986.

David K. Balfour, Lafayette, for plaintiff-appellant.

Denis Paul Juge, New Orleans, Kermit A. Doucet, Lafayette, David McCroskey, New Iberia, Chris G. Robins and Edward C. Abel, of Onebane and Assoc., Lafayette, for defendants-appellees.

Before FORET, STOKER and KING, JJ.

KING, Judge.

The sole issue presented by this appeal is whether or not an employer and its worker's compensation insurance carrier can unilaterally take an "offset" provided for by LSA-R.S. 23:1225, from the worker's compensation benefits judicially owed to the employee under a court judgment, without first making a judicial demand and obtaining judicial approval for the "offset."

On September 25, 1984, Richard Wayne Necaise (hereinafter referred to as plaintiff) filed a written motion in the trial court requesting that the trial court order A.C. Company of South Louisiana, Inc., and its worker's compensation insurance carrier, Fireman's Fund Insurance Company (hereinafter referred to as the defendants), to show cause why they should not be ordered to pay worker's compensation benefits owed under a prior judgment, medical expenses, future medical care, and penalties and attorney's fees. All issues, except the defendants' right to claim an "offset", *1075 were disposed of by stipulation. A hearing was held and the trial court rendered judgment in favor of the defendants, which was signed on July 10, 1985, finding that the defendants had properly taken an "offset", pursuant to LSA-R.S. 23:1225, from the worker's compensation benefits judicially owed to plaintiff. From this judgment plaintiff has devolutively appealed. We reverse.

FACTS

In February, 1979, plaintiff was injured while in the course and scope of his employment with defendant, A.C. Company of South Louisiana, Inc. Plaintiff filed suit to collect worker's compensation benefits. After a trial on the merits, the trial court found that plaintiff was totally and permanently disabled as a result of the employment related injury and rendered judgment, which was signed on June 16, 1980, awarding plaintiff weekly compensation benefits of $141.00 per week, medical expenses, penalties and attorney's fees. The defendants commenced paying plaintiff the judicially ordered worker's compensation benefits.

Subsequent to the trial court judgment finding total and permanent disability, plaintiff incurred additional medical expenses which the defendants contended were not incurred as a result of the employment related injury. Pursuant to a rule filed by plaintiff, a hearing was held and the trial court rendered judgment, dated April 29, 1982, ordering the defendants to pay the medical expenses in question, as well as penalties and attorney's fees.

In September, 1982, plaintiff applied for Social Security disability benefits. Plaintiff's application for Social Security disability benefits was approved by the Social Security Administration on September 9, 1983, with the benefits payable retroactive to September, 1981. The Social Security Act permits the Social Security Administration to reduce the payment of Social Security disability benefits whenever the claimant is also receiving worker's compensation benefits. 42 U.S.C. 424a (1976). Since the Social Security Administration was aware of the fact that plaintiff was receiving worker's compensation benefits, the Social Security Administration took an "offset" from the Social Security benefits owed to plaintiff and his family, including the benefits owed from September, 1981 through September, 1983. After taking the offset ($544.60 per month), the Social Security Administration still paid plaintiff Social Security benefits of $199.40 per month. Due to cost of living increases by December, 1983 the Social Security benefits plaintiff and his family received were increased to $321.10 per month.

The defendants were aware of plaintiff's application for and receipt of Social Security disability benefits and on August 30, 1983 James Kenny, a general adjuster with Fireman's Fund Insurance Company, wrote to the Social Security Administration and asked that the defendants be given credit for the amount of the monthly worker's compensation benefits that the defendants were paying and for which the Social Security Administration had then taken an "offset" from plaintiff and his family's monthly Social Security benefits. After determining that plaintiff had been declared by judgment of court as totally and permanently disabled and that payment of worker's compensation benefits to plaintiff had been ordered by the Court, the Social Security Administration eventually removed the "offset" on May 3, 1984, at which time the Social Security benefits that had been withheld from plaintiff and his family due to the "offset", beginning in September, 1981 through May, 1984, in the amount of $17,373.30 were paid to plaintiff and his family.

The record does not indicate the exact date that the defendants stopped paying worker's compensation benefits to plaintiff. In brief to this Court, appellant states that the defendants started unilaterally claiming the "offset" and stopped plaintiff's worker's compensation benefits as of August 30, 1983, the date of the adjuster's letter to the Social Security Administration. Appellees, in their brief to this Court, deny *1076 that they stopped paying worker's compensation benefits to plaintiff until the Social Security Administration removed its offset. The allegations in plaintiff's rule state that defendants refused to pay worker's compensation benefits as of April 3, 1984. The record does contain a letter from Mr. Kenny addressed to the Social Security Administration, dated April 20, 1984, which states:

"You have received earlier correspondence on this file which should indicate that the offset as provided for [by] the Louisiana Workmen's Compensation Statute has been taken, but I would take this opportunity to advise formerly [sic] and again that this offset has been taken and to ask you to remove your offset immediately. Our offset is taken in accordance to that time in which it was proper for you to take your offset and we would ask that you advise us when you remove the Social Security Administration offset."

Thus, it appears from the record that defendants in fact did stop paying plaintiff worker's compensation benefits at some point in time before the Social Security Administration actually removed its "offset" on May 3, 1984.

On September 25, 1984, plaintiff filed a motion requesting that the defendants be ordered to show cause why they should not be condemned to pay outstanding and due worker's compensation benefits and medical benefits, to provide additional medical care recommended by treating physicians, and to pay attorney's fees and penalties. In a pre-hearing memorandum addressed to the trial court, the defendants alleged that they owed no weekly worker's compensation benefits to plaintiff because of their entitlement to the reduction of worker's compensation payments during the period of time when plaintiff received Social Security benefits, as provided for by LSA-R.S. 23:1225.

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Bluebook (online)
499 So. 2d 1074, Counsel Stack Legal Research, https://law.counselstack.com/opinion/necaise-v-ac-co-of-south-louisiana-inc-lactapp-1986.