Perot v. Natchitoches Parish Hospital

643 So. 2d 378, 94 La.App. 3 Cir. 258, 1994 La. App. LEXIS 2633, 1994 WL 541471
CourtLouisiana Court of Appeal
DecidedOctober 5, 1994
DocketNo. 94-258
StatusPublished
Cited by2 cases

This text of 643 So. 2d 378 (Perot v. Natchitoches Parish Hospital) 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
Perot v. Natchitoches Parish Hospital, 643 So. 2d 378, 94 La.App. 3 Cir. 258, 1994 La. App. LEXIS 2633, 1994 WL 541471 (La. Ct. App. 1994).

Opinion

liLABOBDE, Judge.

The employer appeals the finding of the hearing officer that plaintiff, a nurse’s helper, is entitled to temporary total disability from April 10 through September 30, 1992, medical expenses, attorney fees of $2,500, and legal interest.1 Plaintiff answers the appeal, seeking supplemental earnings benefits (SEB) and penalties on untimely payment of her temporary total disability benefits. We affirm the hearing officer’s decision, and amend the judgment to award plaintiff SEB, unpaid temporary total disability benefits and statutory penalties.

Having reviewed the record in detail, we set forth the hearing officer’s written reasons in their entirety:

| .¡WRITTEN REASONS

This matter arises out of a claim for workers’ compensation benefits filed on behalf of plaintiff, MARCHELL PEROT. The parties stipulated at trial that an incident occurred on September 23, 1991 after a June, 1991 straining incident. Plaintiff has not returned to work since November 4, 1991. The parties also stipulated that Dr. Sandifer was plaintiff’s choice of physician.

At issue are the nature and extent of the plaintiffs disability, if any; unpaid medical bills; and penalties and attorney fees for any failure to pay workers’ compensation benefits to which plaintiff is entitled.

Plaintiff testified that she was 46 years old at the time of trial. She has a high school education and attended Vo-Tech school for two months in 1987. Her work history includes babysitting and sewing at home. She worked for defendant as a nurse’s aide for 5 years. Her job duties involved total patient care.

On direct examination, plaintiff testified that she strained her back on June 18, 1991 while lifting a patient. She did not work for one month and then returned September 23, 1991.

On September 23, 1991, she was transferring a patient from the | abed to a wheel chair when she injured her back. She did not work for a couple of weeks.

On November 4, 1991, plaintiff was again lifting a patient when her abdomen began to hurt on the left side. Later, she felt back pain.

Plaintiff did not testify regarding any disability. On cross examination, she acknowledged that she injured her abdomen on the above dates and not her back. She stated the back problems began the day after the last injury. On cross examination, she also testified that there was a period after the accident when she could not do her housework, but she could not remember how long. [380]*380She felt she was able to return to work a couple of months before trial on November 13, 1992, but made no attempts to return to work.

A preponderance of the evidence indicate that plaintiff was not timely paid after the 1st and 2nd incidents. No explanation was provided.

Following the last incident, temporary total disability benefits were paid until April 10, 1992. Martha Walker, claims adjuster for Hospital Services of Louisiana, a self insured fund, testified that benefits were suspended at that time. The decision to suspend benefits was based on plaintiffs alleged failure to cooperate with her doctor’s recommendations. The witness stated that the plaintiff had totally failed to cooperate with Intracorp’s medical management of her case.

On November 20, 1991, Intracorp representatives had forwarded to Ms. Walker a summary of the reports of Drs. Smith and Norwood.

There was a period, from November 15, 1991 through January 17, |41992, when the office of Ms. Walker flooded and benefits were not paid. The witness’ testimony is accepted as credible and the defense is not found to be arbitrary for this period of nonpayment.

Ms. Walker did not adequately explain, however, why she felt plaintiff was not cooperating with medical management sufficiently to justify suspension of benefits. She stated that plaintiff did not seek authorization for certain treatment and testing, but that it would have been denied if authorization was requested. The defense had no medical records indicating plaintiff could return to work when benefits were suspended.

Ms. Walker’s letter to Ms. Perot, dated April 15, 1992, indicates that Dr. Smith had diagnosed possible muscular strain with no evidence of neurologic involvement. Further, Dr. Donald Smith, a neurosurgeon, had recommended physical therapy and a followup appointment, which Ms. Walker felt plaintiff had not kept. Ms. Walker denied an examination by plaintiffs choice of physician, Dr. Baer Rambaeh, orthopaedist, on the ground that plaintiff had already been seen by her choice of physician, Dr. William Nor-wood, a general surgeon.

Renee Turner, who worked as a RN in the field of medical management for Intracorp on plaintiffs case, testified at trial. She stated that plaintiff was not cooperative in that she would not sign a consent form or an 19 form. She also did not communicate well and took an “unusual” amount of time explaining. Plaintiff said that some of the questions were “none of her business”. Even so, the interview lasted 2½ hours.

Plaintiff complained of pain in the low back and groin area. IsAn MRI revealed evidence of disc disease and lipomatosis of the cord. There was no evidence of nerve impingement.

A CT scan showed a central bulging disc associated with hypertrophy at the L4 space. A myelogram showed a simple disc bulge versus a central disc at L4-L4 and a bind spot at L5-S1. At L4-L5 there was anterior indentation of the sac, which did not appear to affect the nerve roots.

Ms. Perot’s treating physicians, Norwood and Rambaeh, did not indicate that her complaints of pain were inconsistent with objective findings. Dr. Smith, neurosurgeon, thought plaintiff might be exaggerating her symptoms. Dr. Glenn Sholte, neuro-consult, thought plaintiff might be exaggerating. By November 4,1992, Dr. Phillip Osborne, algol-ogist, felt plaintiff was exaggerating and that she could perform sedentary to medium-type work.

Based on a review of the medical records introduced at trial and the testimony of the plaintiff, it is the finding of the Office of Workers’ Compensation that plaintiff was disabled "from working through September, 1992. All unpaid medical bills related to testing and/or treatment for plaintiffs abdominal and back condition should be paid by the defense.

It also the finding of the Office of Workers’ Compensation that the issue of suspension of plaintiffs benefits for failure to cooperate with medical management and/or the termination of benefits due to nondisability was not reasonably controverted. Statutory penalties are awarded in addition to attorney [381]*381fees in the amount of $2,500.00. The parties should prepare a judgment in accordance with this decision.

I (¡ISSUES

The parties having stipulated that claimant was injured in the course and scope of her employment, the issues raised by defendant are whether she remained temporarily totally disabled beyond April 10, the date her temporary total disability and medical benefits were terminated, and if so, whether defendant’s termination of benefits was arbitrary and capricious, entitling claimant to attorney fees.

Each of the errors assigned by defendant springs essentially from questions of fact which we are loath to reverse.

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Bluebook (online)
643 So. 2d 378, 94 La.App. 3 Cir. 258, 1994 La. App. LEXIS 2633, 1994 WL 541471, Counsel Stack Legal Research, https://law.counselstack.com/opinion/perot-v-natchitoches-parish-hospital-lactapp-1994.