Pauley v. Wal-Mart Stores, Inc.

847 So. 2d 757, 2003 WL 21276233
CourtLouisiana Court of Appeal
DecidedJune 4, 2003
Docket02-1354
StatusPublished
Cited by4 cases

This text of 847 So. 2d 757 (Pauley v. Wal-Mart Stores, 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
Pauley v. Wal-Mart Stores, Inc., 847 So. 2d 757, 2003 WL 21276233 (La. Ct. App. 2003).

Opinion

847 So.2d 757 (2003)

Robert C. PAULEY
v.
WAL-MART STORES, INC.

No. 02-1354.

Court of Appeal of Louisiana, Third Circuit.

June 4, 2003.

*758 Marcus Miller Zimmerman, Lake Charles, LA, for Plaintiff/Appellee, Robert C. Pauley.

Charles Martin Kreamer, Sr. Allen & Gooch, Lafayette, LA for Defendant/Appellant, Wal-Mart Stores, Inc.

Court composed of NED E. DOUCET, JR., Chief Judge, GLENN B. GREMILLION, and ELIZABETH A. PICKETT, Judges.

GLENN B. GREMILLION, Judge.

The defendant, Wal-Mart Stores, Inc., appeals the judgment of the workers' compensation judge finding that the plaintiff, Robert Pauley, injured his back as a result of a work-related accident, that he did not commit fraud in obtaining workers' compensation benefits, and that he was a full-time employee. For the following reasons, we affirm.

FACTS

On February 15, 2001, Pauley alleged that he injured his lower back while lifting a case of motor oil at the Wal-Mart store located in DeRidder, Louisiana. His shift ran from 10:00 p.m. until 7:00 a.m., and he alleged that the accident happened at approximately 6:45 a.m. He stated that he felt an immediate pain and tingling in his lower back, radiating down to his toes, and that he had trouble walking. Although he did not report the accident before leaving, he returned with his grandmother at approximately 8:00 a.m. and did so. Pauley was sent by Wal-Mart to Dr. Charlotte Fowler, a family physician, who diagnosed him as suffering from a sprain and strain of his lumbar spine. A February 28, 2001 MRI revealed a herniated disc at L5-S1 with impingement of the right neural canal. Dr. James Perry, an orthopedic surgeon, treated Pauley conservatively with an epidural steroid injection, but then recommended that he undergo a discectomy at L5-S1. Wal-Mart obtained a second opinion from Dr. William Foster, a neurosurgeon, *759 who agreed with Dr. Perry's recommendation of surgery.

On May 9, 2001, Pauley filed a disputed claim for compensation based on Wal-Mart's failure to authorize the recommended surgery and to have his workers' compensation rate corrected. Wal-Mart denied Pauley's allegations and filed a First Supplemental and Amending Answer Alleging 1208 Fraud. It alleged that Pauley stated in his Wal-Mart associate statement and in a February 16, 2001 recorded statement that he had never injured his back before, when in fact he had suffered back injuries on three previous occasions, and that he failed to inform Drs. Perry and Foster of these prior injuries. Wal-Mart further alleged that, although Pauley denied suffering any previous work-related injuries in his recorded statement, he had, in fact, suffered two prior work-related injuries. Wal-Mart notified Pauley that it was terminating his workers' compensation benefits based on the aforementioned fraud effective August 13, 2001.

Following a hearing on the merits, the workers' compensation judge took the matter under advisement. Thereafter, she rendered written reasons for judgment finding that Pauley proved he suffered a work-related injury, that he was entitled to workers' compensation benefits as a full-time employee, and that he did not commit 1208 fraud. She further held that the matter was reasonably controverted, thus, denying Pauley's request for penalties and attorney's fees. Judgment was rendered on September 11, 2002. This suspensive appeal by Wal-Mart followed.

ISSUES

On appeal, Wal-Mart raises three assignments of error. It argues that the workers' compensation judge erred in finding that Pauley proved that he suffered a work-related accident, that he did not commit 1208 fraud, and that he was entitled to workers' compensation benefits as a full-time employee.

Pauley has answered the appeal alleging that the workers' compensation judge erred in failing to award him penalties and attorney's fees. He also seeks additional attorney's fees for work performed on appeal.

FORFEITURE OF BENEFITS

La.R.S. 23:1208(A) provides, "It shall be unlawful for any person, for the purpose 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." Thus, in order for an employer to prove forfeiture pursuant to La.R.S. 23:1208, it must prove that a false representation was willfully made by the employee for the purpose of obtaining compensation benefits. Resweber v. Haroil Constr. Co., 94-2708 (La.9/5/95), 660 So.2d 7. An inadvertent or inconsequential false statement will not result in the forfeiture of benefits. Jim Walter Homes, Inc. v. Prine, 01-116 (La. App. 1 Cir. 2/15/02), 808 So.2d 818. Whether or not an employee has forfeited his right to such benefits is a question of fact, which will not be reversed on appeal in the absence of manifest error. Smith v. Quarles Drilling Co., 99-171 (La.App. 3 Cir. 6/2/99), 741 So.2d 829, writ denied, 99-1949 (La.10/8/99), 751 So.2d 227.

Wal-Mart introduced an associate statement in which Pauley stated he had never injured his back before. However, it introduced evidence that Pauley was treated at the W.O. Moss Regional Medical Center on January 22, 2001, after being involved in a one-vehicle accident on January 19, 2001. A lumbosacral spine x-ray was negative for acute compression fracture, but revealed a narrowed L5-S1 intervertebral *760 space. Pauley was diagnosed with a lumbar sprain, prescribed pain medication, and recommended to refrain from working for one week. The records of Dr. Chuen Kwok on January 29, 2001, reveal that Pauley reported he had been involved in a car accident two weeks prior and that he was taking hydrocodone for lower back pain.

Wal-Mart also introduced evidence that Pauley suffered a lower back injury on January 13, 2000, when he was assaulted by several assailants. During this incident, he was struck in the head by a two-by-four board, hit with beer bottles, and had his head shaved with an electric razor. He was treated at Women's and Children's Hospital in Lake Charles, and was diagnosed as suffering from a contusion of his back, as well as a broken nose. Finally, Wal-Mart introduced evidence that Pauley complained of lower back pain after the vehicle he was riding in was struck from behind in March 1993. He was treated at Women's and Children's Hospital for complaints of lower back pain. Cervical and lumbar spine x-rays were normal. He was diagnosed as suffering from minimal cervical and lumbar sprains. Drs. Perry and Foster both testified that Pauley failed to relate these incidents of prior back pain to them.

Wal-Mart next raised a statement made by Pauley in his recorded statement that he had never been involved in any motor vehicle accidents prior to his alleged work-related injury. However, it introduced evidence of his January 19, 2001 accident and three prior accidents in which he was involved. He sustained a knee injury in a December 1998 accident, sustained injuries to his shoulder and neck in an October 1996 accident, and was involved in the March 1993 accident discussed above.

Wal-Mart's final allegation of fraud pertains to Pauley's explanation in his recorded statement as to why he failed to immediately report his February 15, 2001 work-related accident. In his statement, he explained that he did not report the accident immediately because this was the first time he had been hurt at his job. However, Wal-Mart introduced evidence that Pauley had suffered two prior work-related accidents, both while working at Pepper's Restaurant in Lake Charles.

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

Related

Timberlake v. Christus Health Central
124 So. 3d 1201 (Louisiana Court of Appeal, 2013)
Scallon v. Boise Cascade Corp.
915 So. 2d 1004 (Louisiana Court of Appeal, 2005)
Louis Scallon v. Boise Cascade Corporation
Louisiana Court of Appeal, 2005
Smith v. Roy O. Martin Lumber Co.
871 So. 2d 661 (Louisiana Court of Appeal, 2004)
Tucker v. Security Industrial Insurance
865 So. 2d 998 (Louisiana Court of Appeal, 2004)
Kathy Tucker v. Security Industrial
Louisiana Court of Appeal, 2004

Cite This Page — Counsel Stack

Bluebook (online)
847 So. 2d 757, 2003 WL 21276233, Counsel Stack Legal Research, https://law.counselstack.com/opinion/pauley-v-wal-mart-stores-inc-lactapp-2003.