Olivier v. City of Eunice

92 So. 3d 630, 11 La.App. 3 Cir. 1054, 2012 WL 2015809, 2012 La. App. LEXIS 805
CourtLouisiana Court of Appeal
DecidedJune 6, 2012
DocketNo. 11-1054
StatusPublished
Cited by8 cases

This text of 92 So. 3d 630 (Olivier v. City of Eunice) 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
Olivier v. City of Eunice, 92 So. 3d 630, 11 La.App. 3 Cir. 1054, 2012 WL 2015809, 2012 La. App. LEXIS 805 (La. Ct. App. 2012).

Opinion

PICKETT, Judge.

| Employer appeals judgment denying its exception of prescription and awarding firefighter medical benefits, a penalty, attorney fees, and costs. We reverse in part and affirm in part.

FACTS

The facts in this case are not in dispute. Dwayne Olivier was employed as a firefighter by the City of Eunice (the City) from 1985 until 2007. He injured his back in 2006 and has been disabled due to that injury since that time.

Prior to that, in 2004, Mr. Olivier began experiencing chest pain for which he sought treatment. He was ultimately diagnosed as having aortic valve bicuspid stenosis and underwent surgery in 2010 to replace his bicuspid aortic valve to relieve the symptoms of the stenosis. Mr. Olivier made several written requests to the City for reimbursement of his medical expenses and authorization for medical treatment. The City denied his requests, contending his heart condition was not work-related. Mr. Olivier was a beneficiary under a Blue Cross Blue Shield of Louisiana (Blue Cross) health insurance plan provided through his wife’s employer, and he submitted his medical expenses to Blue Cross for payment when the City did not pay or authorize the expenses. Blue Cross paid his claims.

In 2008, Mr. Olivier filed this action for workers’ compensation benefits, seeking authorization for medical treatment and reimbursement for medical expenses for his heart-related problems pursuant to the Heart and Lung Act. La.R.S. 33:2581. He also sought penalties and attorney fees for not providing medical treatment and not paying his medical expenses. Mr. Olivier’s medical expenses associated with his heart condition for the period 2006 through the date of trial totaled $121,247.48; Blue Cross paid $115,653.17 of those expenses. The remaining $5,594.31 represents deductibles and co-payments for which Mr. Olivier |2was responsible. In addition, Mr. Olivier spent $2,260.86 on lodging, meals, and mileage in connection with treatment he received from 2006 to the time of trial.

The City filed an exception of prescription which the Workers’ Compensation Judge (WCJ) denied. The City applied for supervisory writs to the Third Circuit Court of Appeal and for writ of certiorari to the Louisiana Supreme Court. Both applications were denied. See Olivier v. City of Eunice, an unpublished writ bearing docket number 09-1325 (La.App. 3 Cir. 3/2/10), and Olivier v. City of Eunice, 10-757 (La.6/4/10), 38 So.3d 304, respectively.

Four issues were presented at the trial on the merits:' (1) whether the claim for [633]*633medical expenses had prescribed; (2) whether the medical expenses were causally related to an injury/illness arising out of employment; (8) if the medical expenses were related, whether the City was entitled to a medical expense offset under La.R.S. 23:1212(A); and (4) if related, whether penalties and attorney fees should be imposed.

At the conclusion of the trial, the WCJ took the matter under advisement. Thereafter, he issued Oral Reasons for Judgment in which he held: (1) he would not re-examine the prescription issue because of the writ denials; (2) the presumption of the Heart and Lung Act was not rebutted, and the City was obligated to pay for all treatment and expenses related to Mr. Olivier’s “cardiac condition”; (3) the City was entitled to a 64.5% medical expense offset in the amount of $74,596.29 under La.R.S. 23:1212(A); (4) Mr. Olivier was entitled to an award of $41,056.88, which is the percentage (35.5%) of the medical expenses already paid by Blue Cross that was not subject to the offset; and (5) Mr. Olivier was entitled to recover $5,594.31 attributable to co-payments on his medical expenses, $928.26 in meals and lodging, and $1,332.60 in mileage; (6) Mr. Olivier |3was entitled to a $2,000.00 penalty for the City’s denial of benefits; and (7) Mr. Olivier was entitled to an attorney fee award of $12,600.00.

After a judgment was signed, the City filed a Motion for New Trial, seeking to: (1) replace language in the judgment regarding Mr. Olivier’s “heart condition” with his precise medical condition; (2) insert language into the judgment specifically granting the City a La.R.S. 23:1212(A) offset in the amount $74,596.29; and (3) reverse the $41,056.88 award of Mr. Olivier’s medical expenses paid by Blue Cross.

After a hearing on the Motion for New Trial, the WCJ: (1) granted the City’s request to replace the phrase “heart condition” with precise language; (2) denied the motion’s request to specifically insert the $74,596.29 figure into the judgment; and (3) denied the City’s request to reverse the $41,056.88 award to Mr. Olivier. An Order granting in part and denying in part the Motion for New Trial and an Amended Judgment were signed the same day. This appeal followed. Mr. Olivier answered the appeal, seeking an increase in the trial court’s award of attorney fees and an additional award of attorney fees for work performed on appeal.

ASSIGNMENTS OF ERROR

The City of Eunice assigns four errors:

1) The trial court committed legal error by employing an incorrect legal standard to govern the burden of persuasion necessary to rebut the presumption of causation under the Heart and Lung Act. Consequently, this Court should conduct a de novo review of the record on the issue of causation.
2) The trial court committed manifest error when it found that the City’s evidence did not rebut the presumption that Mr. Olivier’s aortic stenosis was causally related to employment.
3) The trial court committed legal error when it denied the City’s Exception of Prescription and refused to reconsider it at trial.
|44) The trial court committed legal error when it awarded Mr. Olivier $41,056.88 in medical expenses already paid by Blue Cross.

DISCUSSION

Did the WCJ apply the wrong burden of proof to the City’s defense?

In his reasons for judgment, the WCJ stated that to overcome the presumption of the Heart and Lung Act, an [634]*634employer must present “positive medical evidence that a firefighter’s heart condition was caused solely by something other than his employment and was not aggravated or accelerated in any way by that employment.” The City complains that this was error.

The Heart and Lung Act provides that after an employee has been employed five years as a firefighter, any heart or lung ailments suffered by the firefighter are presumed to be related to their employment. La.R.S. 38:2581. In McClure v. City of Pineville, 06-279 (La.App. 3 Cir. 12/6/06), 944 So.2d 795, writ denied, 07-40 (La.3/9/07), 949 So.2d 445, this court explained the application of the Heart and Lung Act:

The Heart and Lung Act provides that once a fireman has established that the presumption is applicable, i.e., lung disease manifested after he had been employed for five years, his employer must prove that the disease did not develop during his employment to relieve itself from the obligation of paying workers’ compensation benefits. La. R.S. 33:2581. It does not require “conclusive evidence” that exposure during his employment caused his heart or lung condition as argued by LWCC. To successfully defend a claim under the Heart and Lung Act, the employer must produce affirmative evidence to establish that the fireman’s heart or lung condition did not develop during his employment.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

McCallon v. Key Energy Servs., LLC
271 So. 3d 249 (Louisiana Court of Appeal, 2019)
Michael McCallon v. Key Energy Services, LLC
Louisiana Court of Appeal, 2019
Howard v. Nat'l Union Fire Ins. Co. of Pittsburgh
243 So. 3d 4 (Louisiana Court of Appeal, 2018)
Richard J. Borja v. Fara St. Bernard Parish Government
218 So. 3d 1 (Supreme Court of Louisiana, 2016)
Mangiaracina v. Avis Budget Group, Inc.
202 So. 3d 171 (Louisiana Court of Appeal, 2016)
Daniel v. Point to Point Directional Drilling, Inc.
139 So. 3d 613 (Louisiana Court of Appeal, 2014)

Cite This Page — Counsel Stack

Bluebook (online)
92 So. 3d 630, 11 La.App. 3 Cir. 1054, 2012 WL 2015809, 2012 La. App. LEXIS 805, Counsel Stack Legal Research, https://law.counselstack.com/opinion/olivier-v-city-of-eunice-lactapp-2012.