Rougeau v. Gottson Construction Co.

57 So. 3d 576, 10 La.App. 3 Cir. 1082, 2011 La. App. LEXIS 156, 2011 WL 408991
CourtLouisiana Court of Appeal
DecidedFebruary 9, 2011
Docket10-1082
StatusPublished
Cited by2 cases

This text of 57 So. 3d 576 (Rougeau v. Gottson Construction Co.) 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
Rougeau v. Gottson Construction Co., 57 So. 3d 576, 10 La.App. 3 Cir. 1082, 2011 La. App. LEXIS 156, 2011 WL 408991 (La. Ct. App. 2011).

Opinion

GREMILLION, Judge.

Lin this workers’ compensation matter, the defendants/appellants ask us to reverse the awards to plaintifflappellee of “reasonable and necessary medical treatment,” penalties and attorney fees, and the amount of attorney fees, $12,600.00. For the reasons that follow, we affirm.

FACTS

Hubert Rougeau was employed by Gott-son Construction Company as a roustabout-mechanic on February 23, 2009, when the drive shaft from a truck fell from a jack onto his left shoulder and elbow. Gottson denied the accident occurred as *578 Rougeau claimed and that he was injured. Rougeau pursued a disputed claim for compensation against Gottson. After trial, the WCJ found that Rougeau was injured as he claimed. Rougeau was awarded temporary total disability benefits of $393.09 per week beginning February 23, 2009, “reasonable and necessary medical treatment,” a penalty of $2,000.00 for Gott-son’s failure to pay weekly indemnity benefits, a $2,000.00 penalty for failure to pay Rougeau’s medical expenses, plus attorney fees of $12,600.00.

ASSIGNMENTS OF ERROR

Gottson and its insurer assign three errors: 1) the award of future medical expenses; 2) the award of penalties and attorney fees; and, 3) the amount of attorney fees.

ANALYSIS

Gottson maintains that an employer’s liability for medical expenses does not arise until they are incurred. Rougeau counters that the employer is liable for all necessary medical and non-medical treatment, pursuant to La.R.S. 23:1203. He concedes that a workers’ compensation claimant is not entitled to an award of future |2medical expenses, but that the right to pursue expenses is always reserved to the claimant. In this case, though, Rougeau disagrees with Gottson that the effect of the judgment is to render Gottson liable for future medical expenses. Nevertheless, Rougeau disagrees that the judgment should be altered because an employer not subject to a final, nonap-pealable, judgment who refuses medical treatment is not subject to penalties under La.R.S. 23:1201(G) 1 but rather under La. R.S. 23:1201(F); further, that the deletion of this provision of the judgment would force an unnecessary delay in having his claim for denied benefits heard by a WCJ; and lastly, that reserving the right to seek reimbursement only provides partial relief to the injured employee. Rougeau cites Wilson v. Ebasco Serv., Inc., 393 So.2d 1248 (La.1981), for the proposition that claims for future medical treatment have been allowed. Rougeau distinguishes between claims for future medical treatment and claims for future medical expenses.

In Wilson, one of the principal issues involved the employer’s responsibility to issue a letter of financial responsibility to a pain clinic. Without the letter, the clinic would not admit Wilson into its pain unit program in which she hoped to learn pain coping skills. When clinic personnel contacted the employer’s insurer, they were told that no such letter would be issued. Wilson then filed suit to force the issuance. The trial court sided with the employer’s contention that the petition failed to state a cause of action. A long line of jurisprudence had held that liability for an | oemployee’s medical expenses only arises as those expenses are accrued.

When the court of appeal affirmed the trial court’s ruling, Wilson sought writs from the Louisiana Supreme Court, which *579 granted her application. The supreme court reversed, finding that the refusal to issue the letter of financial responsibility amounted to a refusal to furnish treatment pursuant to La.R.S. 23:1203.

In the present matter, the WCJ’s judgment awards Rougeau reasonable and necessary medical treatment. This awards him nothing more than what is reserved to him as a matter of law. The right to seek reimbursement for reasonable and necessary treatment is provided for by La.R.S. 23:1203. According to La.Code Civ.P. art. 1841, a judgment may award any relief to which the parties are entitled. The law reserves the right to seek reimbursement for expenses of reasonable and necessary medical treatment. La.R.S. 23:1203.

Gottson complains of the award of penalties and attorney fees. A workers’ compensation claimant is entitled to attorney fees if an employer or insurer acts arbitrarily, capriciously, and without probable cause in withholding or terminating benefits; withholding benefits is not arbitrary and capricious when based on competent medical evidence. Courville v. Omni Drilling, 96-174 (La.App. 3 Cir. 7/10/96), 676 So.2d 861, writ denied, 96-2073 (La.11/8/96), 683 So.2d 276.

The WCJ found — and the evidence demonstrated — that an incident involving Rougeau did occur on February 23, 2009. The details of the incident are disputed, but the essentials are not. Rougeau was assisting a mechanic, Brian Fogleman, remove a transmission from a truck. The driveshaft, which weighed 150 to 200 pounds, began to fall. Rougeau redirected the driveshaft from his chest and face with his left hand. In avoiding the shaft, Roug-eau injured his elbow.

14Rougeau claimed that he notified Fo-gleman of the incident. Fogleman, whose testimony was presented by deposition, asserted that he did not learn of Rougeau’s injury until two days later. That same day, February 25, Rougeau went to the emergency room at Jennings American Legion Hospital. The attending physician, Dr. David Hardey, noted- that Rougeau’s elbow was swollen. Rougeau was diagnosed "with a contusion. The report stated that Rougeau was somewhat agitated when told that his elbow had not been fractured.

On February 27, Rougeau saw Dr. Paul B. Stringfellow of Crowley, Louisiana. Dr. Stringfellow noted a history consistent with Rougeau’s version of the accident. Dr. Stringfellow’s records reflect his observation of a prominence of the left epi-condyle. He diagnosed Rougeau with tendonitis. At the emergency room at Lake Charles Memorial Hospital on April 11, Rougeau was diagnosed with left epicon-dylitis.

Rougeau sought no further treatment until he saw Dr. Robert Morrow, a Lafayette, Louisiana, orthopedic surgeon, on June 4, 2009. Dr. Morrow diagnosed Rougeau with post-traumatic left shoulder discomfort, left lateral and medial epicon-dylitis, and left upper extremity complex pain syndrome. He recommended a referral to a pain management specialist. He deemed Rougeau incapable of work for at least two months, from June 4 to August 4, 2009. Rougeau did not return to Dr. Morrow, apparently because Gottson refused to authorize a further visit.

However, Rougeau did return to the emergency room at Lake Charles Memorial Hospital on June 20 with what those records describe as chronic elbow and shoulder pain. The personnel told Roug-eau to follow up with his primary care physician and with pain management.

I sThe claims adjuster, with Louisiana Workers’ Compensation Corporation, Gott-soris carrier, testified that she decided to deny Rougeau’s claim because her record *580 ed statements of Rougeau, his co-workers, and her review of the medical records convinced her that Rougeau was not injured in the incident.

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Bluebook (online)
57 So. 3d 576, 10 La.App. 3 Cir. 1082, 2011 La. App. LEXIS 156, 2011 WL 408991, Counsel Stack Legal Research, https://law.counselstack.com/opinion/rougeau-v-gottson-construction-co-lactapp-2011.