Neil Laugand v. Four Points by Sheraton

CourtLouisiana Court of Appeal
DecidedFebruary 26, 2025
Docket2024-CA-0687
StatusPublished

This text of Neil Laugand v. Four Points by Sheraton (Neil Laugand v. Four Points by Sheraton) 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
Neil Laugand v. Four Points by Sheraton, (La. Ct. App. 2025).

Opinion

NEIL LAUGAND * NO. 2024-CA-0687

VERSUS * COURT OF APPEAL FOUR POINTS BY SHERATON * FOURTH CIRCUIT * STATE OF LOUISIANA *******

APPEAL FROM THE OFFICE OF WORKERS' COMPENSATION NO. 19-01228, DISTRICT “08” Honorable Catrice Johnson-Reid, The Office of Workers' Compensation ****** Judge Monique G. Morial ****** (Court composed of Judge Daniel L. Dysart, Judge Nakisha Ervin-Knott, Judge Monique G. Morial)

Arthur G. Laugand 2718 Onzaga Street New Orleans, LA 70119

COUNSEL FOR PLAINTIFF/APPELLANT

Thomas Michael Ruli Jeffrey Charles Napolitano JUGE NAPOLITANO GUILBEAU RULI FRIEMAN & WHITELEY 3320 West Esplanade Avenue North Metairie, LA 70002

COUNSEL FOR DEFENDANT/APPELLEE

AFFIRMED FEBRUARY 26, 2025 This is a workers’ compensation case. Claimant seeks review of the Office

MGM of Workers’ Compensation’s (OWC) judgment granting defendant-employer’s DLD NEK motion for involuntary dismissal, which dismissed his claim for certain medical

benefits. Claimant also seeks review of the OWC judgment finding that he

committed fraud and thereby forfeited his workers’ compensation benefits pursuant

to La. R.S. 23:1208. For the following reasons, we affirm.

FACTUAL AND PROCEDURAL HISTORY

This litigation arises out of a March 11, 2016 accident. Claimant, Neil

Laugand, was working as a bellman for defendant-employer, Springfield

Corporation d/b/a Four Point Sheraton Hotel, when his right shoulder and hand

were struck by the mirror of a vehicle traveling the wrong way down the street.

The accident is not in dispute. On February 21, 2019, after nearly three years of

medical treatment for a shoulder injury including two arthroscopic shoulder

procedures, Claimant filed a 1008 disputed claim for compensation form1 seeking

1 Louisiana Revised Statute 23:1310 pertains to the “[i]nitial filing of claim with office of

workers’ compensation administration,” and it provides: A. If, at any time after notification to the office of the occurrence of death or injury resulting in excess of seven days lost time, a bona fide dispute occurs, the

1 approval for an MRI of his cervical spine. Defendants, Springfield Corporation and

LUBA Casualty Insurance Company, filed an answer to the claim, in which they

admitted to the accident and resulting shoulder injury, but contended that

Claimant’s newly raised cervical spine complaints were not related to the accident

at issue and are thus not compensable.

On January 7, 2020, Claimant filed an amended disputed claim for

compensation, seeking additional benefits and challenging the calculation of the

average weekly wage rate and the accuracy of the indemnity benefits paid.2

Defendants filed a reconventional demand and supplemental and amending

answer, wherein they alleged the affirmative defense of fraud under La. R.S.

23:1208.3

The matter proceeded to trial on September 9, 2022. At the conclusion of

Claimant’s case-in-chief, the defense moved for an involuntary dismissal of

Claimant’s claims. The trial judge found that Claimant failed to meet his burden to

prove that his cervical complaints or radicular symptoms were related to the March

11, 2016 accident and granted the motion for involuntary dismissal. As to

employee or his dependent or the employer or insurer may file a claim with the state office, or the district office where the hearing will be held, on a form to be provided by the assistant secretary. B. In addition to any other information required by the assistant secretary, the claim shall set forth the time, place, nature, and cause of the injury, the benefit in dispute, and the employee’s actual earnings, if any, at the time of the filing of the claim with the office. 2 This amended disputed claim for compensation was subsequently voluntarily dismissed by

Claimant prior to trial. 3 On April 9, 2021, Defendants filed a motion for summary judgment on their fraud defense,

contending that Claimant fraudulently sought an increase in his indemnity benefits calculation based on a misrepresentation that he had amended his 2015 tax return to reflect an increased income. On August 3, 2021, the OWC denied Defendants’ motion for summary judgment. In its written judgment, the OWC stated that it was unable to consider Claimant’s IRS documentation in connection with the motion for summary judgment because the documents were not verified and/or authenticated. Nevertheless, the OWC found the determination of the subjective issue of intent to commit fraud inappropriate for summary judgment and denied Defendants’ motion for summary judgment.

2 Defendants’ fraud defense pursuant to La. R.S. 23:1208, the OWC determined that

Claimant willfully “made statements and misrepresentations regarding his wages,

earnings, tax filing and tip income, solely for the purpose of increasing his average

weekly wages and compensation rate in an effort to seek additional workers’

compensation benefits.”4 The judgment ordered that Claimant had forfeited his

right to workers’ compensation benefits pursuant to La. R.S. 23:1208. This timely

appeal followed.

LAW AND ANALYSIS

On appeal, Claimant seeks review of the judgment granting Defendants’

motion for involuntary dismissal and dismissing his claim for medical treatment.

He further appeals the OWC’s judgment on Defendant’s fraud claim, wherein the

OWC made a factual finding that Claimant committed fraud in violation of La.

R.S. 23:1208. Because a finding of fraud in a workers’ compensation case results

in a forfeiture of all benefits, including medical benefits, as a matter of law, we

will first address the judgment finding that Claimant committed fraud in violation

of La. R.S. 23:1208.

Fraud

The workers’ compensation statutes have a separate anti-fraud forfeiture

provision by which employers may affirmatively defend against paying a claim.

Lovas v. Gallagher Bassett Servs., Inc., 18-0801, p. 11 (La. App. 4 Cir. 3/20/19),

4 The OWC took Defendants’ fraud claim under advisement and issued a written judgment on

February 3, 2023. The judgment also awarded restitution to Defendants and assessed a $5,000.00 civil penalty against Claimant, made payable to the Kids Chance Scholarship Fund pursuant to La. R.S. 23:1208. Claimant subsequently filed a motion for new trial, which the OWC denied. We note that the amount of restitution awarded is not provided in the judgment and thus it is premature to determine whether the restitution amount awarded complied with La. R.S. 23:1208(D) as that issue is not before this Court at this time.

3 267 So.3d 129, 137(quotations omitted). This Court has recently discussed these

anti-forfeiture provisions as follows:

La. R.S. 23:1208 applies to situations in which, during a pending claim, a claimant has made a false statement or misrepresentation for the specific purpose of obtaining workers' compensation benefits. Id. La. R.S. 23:1208 provides that:

[i]t shall be unlawful for any person, for the purposed of obtaining or defeating any benefit or payment under the provisions of this Chapter, either for himself or for any other person, to willfully make a false statement or representation.

In addition[sic] to criminal and civil penalties, the fraud provisions state that any person violating Section 1208 “may be ordered to make restitution” and “shall forfeit any right to compensation benefits under this Chapter.” La. R.S. 23:1208(D), (E). Fraudulent statements encompass those made to anyone, including the employer, physicians, or insurer. Resweber v. Haroil Constr. Co., 94- 2708, pp. 1-2 (La. 9/5/95), 660 So.2d 7, 9.

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