Rhonda Timberlake v. Christus Health Central Louisiana D/B/A Fara Insurance Services

Louisiana Court of Appeal·Decided October 30, 2013·No. WCA-0013-0166·Unknown

Opinion

STATE OF LOUISIANA

COURT OF APPEAL, THIRD CIRCUIT

13-166

RHONDA TIMBERLAKE VERSUS

CHRISTUS HEALTH CENTRAL LOUISIANA D/B/A FARA INSURANCE COMPANIES

**********

APPEAL FROM THE

OFFICE OF WORKERS’ COMPENSATION, DISTRICT 02 PARISH OF RAPIDES, DOCKET NO. 10-7681 HONORABLE JAMES L. BRADDOCK, PRESIDING **********

SYLVIA R. COOKS

JUDGE

**********

Court composed of Sylvia R. Cooks, Marc T. Amy, and Phyllis M. Keaty, Judges.

AFFIRMED AS AMENDED.

Maria A. Losavio Losavio Law Office, LLC 1821 MacArthur Drive P.O. Box 12420 Alexandria, LA 71315-2420 (318) 767-9033 ATTORNEY FOR PLAINTIFF/APPELLANT Rhonda Timberlake

John C. Turnage Meyer, Smith & Roberts, LLP 1550 Creswell Shreveport, LA 71101 (318) 222-2135 ATTORNEY FOR DEFENDANTS/APPELLEES Christus Health Central Louisiana d/b/a Christus St. Frances Cabrini Hospital

COOKS, Judge.

Both the employer and worker assert various errors in the judgment rendered by the Office of Workers’ Compensation following a work accident involving the Claimant.

FACTS AND PROCEDURAL HISTORY On March 30, 2010, the Claimant, Rhonda Timberlake, alleged she sustained a left wrist and forearm injury while in the course and scope of her employment as a registered nurse with Christus Health Central Louisiana d/b/a Christus St. Frances Cabrini Hospital (hereafter Cabrini). The alleged injury occurred when Claimant was repositioning an Intensive Care Unit (ICU) patient. A claim for workers’ compensation benefits was eventually filed. Cabrini is self- insured for purposes of this claim. F.A. Richard and Associates, Inc., (FARA) is the third-party administrator of Cabrini’s workers’ compensation claims.

After the injury, Claimant, upon referral by Cabrini, received care from Dr.

Gordon Webb, an occupational medicine specialist. Restrictions were placed on Claimant, but she continued her employment with Cabrini. Claimant then chose Dr. William Crenshaw, an orthopedist, as her choice of physician. She was seen by Dr. Crenshaw on several occasions. During the course of her treatment with Dr. Crenshaw, Claimant underwent an MRI, EMG and nerve conduction studies. She had her arm placed in a cast and was advised to begin physical therapy. She was restricted from working on May of 2010 and began receiving temporary total disability (TTD) benefits until she returned back to work with other restrictions on June 15, 2010.

Dr. Crenshaw suggested that Claimant be evaluated by his partner, Dr. Mark Dodson, also an orthopedic specialist. Claimant agreed, and Dr. Dodson examined her on June 16, 2010. On the day following the examination by Dr. Dodson, Claimant called the adjuster for FARA, Joanna Cannatella, and requested to be

evaluated by another orthopedic hand specialist, Dr. Richard Morrow. Ms. Cannatella denied this, believing the change to Dr. Dodson was a prior change of orthopedic specialists. Claimant remained under Dr. Dodson’s care until she was granted the right to be treated by Dr. Richard Morrow.

According to Claimant, when she returned to work, Cabrini had to find things for her to do under her work limitations. She was moved around to various areas, many involving monitoring and administrative duties. Claimant earned approximately $26.00 per hour. It was subsequently alleged by Cabrini that Claimant missed periods of work due to unrelated illnesses or family events. Claimant disputed that, and claimed she missed work only for problems related to her arm injury.

In October of 2010, Claimant was released to return to her nursing duties in the ICU Unit. Claimant left her employment at Cabrini in November of 2010 because, according to her, she was not making near the money she was making prior to her injury. She stated this was largely due to Cabrini failing to offer Claimant sufficient shifts that would earn her close to her pre-accident wages. She also testified there were rising tensions in the ICU because she was still working there with restrictions and her co-workers were forced to compensate for her medical limitations.

In an effort to earn more money, Claimant accepted contract nursing jobs in California. Claimant stated this job also appealed to her because she was able to work with more ambulatory patients rather than bedbound ICU patients. She testified she earned $30.00 an hour during this employment. It was maintained this level of remuneration still did not reach 90% of her pre-accident wages.

Following the denial by Ms. Cannatella on June 17, 2010 of her request to be seen by Dr. Morrow, Claimant retained legal counsel. Several requests were made by Claimant to Cabrini to get pre-authorization to see Dr. Morrow, which

were all denied. Dr. Morrow’s policy required written pre-authorization from the employer for an initial evaluation of Claimant since she was a workers’ compensation patient. No pre-authorization was given.

Counsel for Claimant filed a Motion for Authorization of Treatment with Dr.

Morrow. On March 10, 2011, a hearing on that motion was held before the Office of Workers’ Compensation (OWC). The Workers’ Compensation Judge (WCJ) ruled in favor of Claimant and ordered Cabrini to allow Claimant to obtain medical treatment with Dr. Morrow. The issue of whether a penalty and attorney fees were warranted for Cabrini’s failure to timely authorize this change was deferred to the trial on the merits.

Claimant began treatment with Dr. Morrow in March of 2011. During this time, claimant was working periodically in California. On September 15, 2011, Dr. Morrow, concerned with Claimant’s lack of improvement, scheduled several diagnostic tests, an arthrogram, an Electromyography (EMG) and a nerve conduction study (NCS). After discussing the results with Claimant, Dr. Morrow recommended surgery on her wrist and took her completely off of work. Cabrini did not begin paying TTD benefits to Claimant until November 13, 2011, the date of the wrist surgery.

Trial on the merits was held on March 28, 2012, focusing primarily on indemnity, penalties and attorney fees allegedly owed. Average weekly wages were stipulated to be $1,549.83, which resulted in a maximum temporary total disability (TTD) rate of $577.00 per week. Claimant alleged for the months of July, August and September 2010, she returned to work at Cabrini under restrictions and was unable to earn at least 90% of her pre-accident wages. Claimant also requests supplemental earnings benefits (SEB) from December 2010 through September 2011 when she was “forced’ to leave Cabrini to work out of

state resulting in less than 90% of her pre-accident wages. Claimant also requested penalties and attorney fees for Cabrini’s unreasonable failure to pay SEB.

Claimant also maintained she was entitled to TTD benefits from September 27, 2011 to November 13, 2011 (the date she began receiving TTD benefits). Claimant maintained Dr. Morrow removed her from work on September 27, 2011 and recommended surgery. Penalties and attorney fees were also requested for Cabrini’s non-payment of TTD benefits during that time period.

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