Russell v. Regency Hosp. of Covington, LLC

998 So. 2d 301, 2008 La.App. 1 Cir. 0538, 2008 La. App. LEXIS 1489, 2008 WL 4899118
CourtLouisiana Court of Appeal
DecidedNovember 14, 2008
Docket2008 CA 0538
StatusPublished
Cited by10 cases

This text of 998 So. 2d 301 (Russell v. Regency Hosp. of Covington, LLC) 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
Russell v. Regency Hosp. of Covington, LLC, 998 So. 2d 301, 2008 La.App. 1 Cir. 0538, 2008 La. App. LEXIS 1489, 2008 WL 4899118 (La. Ct. App. 2008).

Opinion

998 So.2d 301 (2008)

Tracie L. RUSSELL
v.
REGENCY HOSPITAL OF COVINGTON, LLC.

No. 2008 CA 0538.

Court of Appeal of Louisiana, First Circuit.

November 14, 2008.
Rehearing Denied December 15, 2008.

*302 Ben E. Clayton, Slidell, LA, for Plaintiff-Appellant, Tracie L. Russell.

Kirk L. Landry, Baton Rouge, LA, for Defendants-Appellees, Regency Hospital of Covington, LLC and American Casualty Co.

Before PETTIGREW, McDONALD, and HUGHES, JJ.

PETTIGREW, J.

Claimant appeals from a judgment of the Office of Workers' Compensation Administration *303 ("OWCA"), which awarded medical benefits, medical reimbursement, penalties and attorney fees in favor of claimant. Claimant's employer and its insurer have filed a timely answer to the appeal. For the following reasons, we vacate the judgment in part, and render; and amend in part, and as amended, affirm the awards of medical benefits, medical reimbursement, penalties and attorney fees.

FACTS

Trade Lynn Russell, claimant herein, has been a licensed, certified nursing assistant since December 1993, and commenced employment as a patient care technician by Regency Hospital in Covington, Louisiana on January 5, 2005. In the early morning hours of June 4 or 5, 2005, Ms. Russell sustained an injury as she assisted a registered nurse in lifting and turning an obese patient at the hospital. Ms. Russell alleged that as she assisted in lifting and turning the patient, she heard three "popping" noises coming from her left shoulder. Thereafter, Ms. Russell attempted to contact her nursing supervisor, but being unsuccessful, she sought treatment the following afternoon from her regular physician, Dr. Roy Saguigiut. According to Ms. Russell, Dr. Saguigiut diagnosed her as having sustained a sprain to her trapezius muscle. When the nursing supervisor returned her calls, Ms. Russell testified that she filled out the necessary paperwork, and was later sent to be evaluated by Dr. Mohammed Yousuf. Dr. Yousuf also diagnosed Ms. Russell's condition as a sprained trapezius muscle. Ms. Russell continued to work during this time.

Ms. Russell recalled that around November or December of 2005, Dr. Yousuf referred her for treatment with Dr. Mark Hontas, an orthopedist. In connection with one such visit, Ms. Russell testified that she tendered a co-payment of $30.00. Ms. Russell also testified that in August 2006, she was notified in a letter of the termination of her employment by Regency Hospital. Following a visit in November 2006, Ms. Russell was discharged[1] by her physical therapist.

In connection with her testimony at trial, Ms. Russell admitted that she did not seek medical treatment between November 2006 and June 2007. In June 2007, Ms. Russell claimed that she was advised by Belinda Brown, a claims adjuster with American Casualty Company ("American Casualty"), the insurer of Regency Hospital, that due to the termination of her employment, her entitlement to further medical benefits ended. Until that time, American Casualty had paid for Ms. Russell's treatment with physicians, including Dr. Hontas.

Due to the refusal of Regency Hospital and American Casualty (collectively, "defendants") to authorize medical treatment, Ms. Russell filed a Disputed Claim for Compensation with the OWCA on June 12, 2007, wherein she asserted a claim for medical treatment, statutory penalties and reasonable attorney fees. Ms. Russell concedes that although her claim for disability or "indemnity" benefits has prescribed, she asserts that her claim for medical benefits remains viable. Ms. Russell testified that approximately a month after retaining an attorney she received a letter from American Casualty advising that there must have been a misunderstanding on her part, and medical benefits resumed.

*304 On December 4, 2007, defendants filed a Motion In Limine precluding the introduction, at the trial of this matter, of issues, witnesses and exhibits related to the treatment of Ms. Russell, or her claimed entitlement to statutory penalties and attorney fees.

A trial was held in this matter on December 5, 2007. At trial, a June 11, 2007 letter from Ms. Russell's attorney that was mailed and faxed to Ms. Brown of American Casualty advising of the attorney's representation and requesting reimbursement of a $30.00 medical co-payment was introduced as "Claimant's Exhibit # 1."

Following the trial and a review of the exhibits and testimony, the workers' compensation judge ("WCJ"), on December 19, 2007, signed a judgment denying the Motion In Limine filed by defendants. The aforementioned judgment further held that as alleged by Ms. Russell, there was a gap by defendants in the payment of medical expenses, and that said gap was without legal justification or cause. The WCJ also found that Regency Hospital had offered no evidence to suggest that its refusal to pay medical benefits was legally justifiable, or that its actions should not be sanctioned through the imposition of statutory penalties.

The WCJ awarded Ms. Russell a statutory penalty of $2,000.00 based upon the unjustified failure by defendants to authorize and pay for treatment with Dr. Mark Hontas, the physician chosen by Ms. Russell. The WCJ ordered Regency Hospital to authorize and pay the reasonable cost of treatment by Dr. Mark Hontas, subject to the applicable OWCA fee schedule, and awarded Ms. Russell's attorney a fee of $750.00 in connection with the failure of defendants to authorize and pay for the aforesaid treatment. In addition, the WCJ ordered defendants to reimburse Ms. Russell the sum of $30.00, representing her out-of-pocket insurance co-payment. Finally, the WCJ further awarded Ms. Russell's attorney an additional attorney's fee of $250.00 in connection with the failure of defendants to tender the aforementioned $30.00 reimbursement. From this judgment, Ms. Russell has appealed, and defendants have timely answered the appeal.

ISSUES

In connection with her appeal in this matter, Ms. Russell presents the following issues for review and consideration by this court:

1) Whether or not the trial court erred in awarding only $750.00 as an attorney's fee in connection with the failure and refusal of defendants to approve medical treatment;
2) Whether or not the trial court erred in awarding only $250.00 as an attorney's fee in connection with non-payment of a $30.00 reimbursement sought by Ms. Russell; and
3) Whether or not the trial court should have awarded statutory penalties in connection with the failure and refusal of defendants to make the requested $30.00 reimbursement to Ms. Russell.

The defendants, in their answer to Ms. Russell's appeal, have set forth the following issues for review and consideration by this court:

1) Whether the trial court committed legal error in assessing two separate attorney fees, where the Workers' Compensation statutes allow a maximum of one;
2) Whether the trial court erred in allowing Ms. Russell to present a claim at trial that was not timely provided to defendants by way of pleadings or discovery; and
*305 3) Whether the trial court committed manifest error or otherwise abused its discretion in awarding any penalty or attorney fee in connection with this claim.

STANDARD OF REVIEW

Factual findings in a workers' compensation case are subject to the manifest error standard of review. McCray v. Delta Industries, Inc., XXXX-XXXX, p. 4 (La. App. 1 Cir.

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Cite This Page — Counsel Stack

Bluebook (online)
998 So. 2d 301, 2008 La.App. 1 Cir. 0538, 2008 La. App. LEXIS 1489, 2008 WL 4899118, Counsel Stack Legal Research, https://law.counselstack.com/opinion/russell-v-regency-hosp-of-covington-llc-lactapp-2008.