Safford v. Hammerman & Gainer International, Inc.

198 So. 3d 227, 2016 La.App. 4 Cir. 0209, 2016 La. App. LEXIS 1410, 2016 WL 3938512
CourtLouisiana Court of Appeal
DecidedJuly 20, 2016
DocketNo. 2016-CA-0209
StatusPublished
Cited by3 cases

This text of 198 So. 3d 227 (Safford v. Hammerman & Gainer International, 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
Safford v. Hammerman & Gainer International, Inc., 198 So. 3d 227, 2016 La.App. 4 Cir. 0209, 2016 La. App. LEXIS 1410, 2016 WL 3938512 (La. Ct. App. 2016).

Opinion

ROSEMARY LEDET, Judge.

|, This is a workers’ compensation case. The claimant, Floyd Safford, appeals from the November 4, 2015 judgment of the Workers’ Compensation Judge (“WCJ”) granting the exception of prescription filed by the defendant, the New Orleans Fire Department (“NOFD”), and dismissing with prejudice the claimant’s claim for, indemnity benefits under the Heart and Lung Act, La. R.S. 33:2581. 1For the reasons that follow, we reverse and remand.

1 ¡TACTUAL AND PROCEDURAL BACKGROUND

Given the sole issue presented in this case is prescription, we present the factual and procedural background in the form of the following chronology:

• January 7, 1975 — Mr. Safford commenced employment with NOFD.
• November 7, 1997 — Mr. Safford, while on duty, suffered a cardiac ■ event, which he déseribed in his deposition as his “heart just started hurting really bad.” He was treated on that same day at the emergency room, and his diagnosis was a possible mitral valve prolapse. Although he reported this event to NOFD, this cardiac condition did not result in him missing any further work.
• December 8, 2004 — Mr. Safford severely injured his left hand on-the-job. Following this hand injury, he never returned to fulltime duty as a firefighter. Thereafter, NOFD began paying his medical bénefits for his hand injury.
• December 16, 2004 — NOFD commenced paying Mr. Safford temporary total disability (“TTD”) benefits for his hand injury.
• May 1.3, 2005 — Mr, Safford had surgery on his left hand.
• January 15, 2006 — Mr. Safford retired and began receiving a disability pension. The primary reason he re[230]*230tired was because of the disability due to his hand injury. Mr. Safford, however, acknowledged in his deposition that his cardiac condition also contributed to his retirement.
• February 1, 2006 — NOFD commenced paying Mr. Safford supplemental earning benefits (“SEB”) for his hand injury.
• September 24, 2009 — Mr. Safford suffered another cardiac event — an atrial fibrillation attack.
• June 11, 2010 — Mr. Safford filed a workers’ compensation claim for his cardiac condition under the Heart and Lung Act, completing the following two forms: (i) an Employer’s Report of Occupational Injury or Disease, and (ii) a Form 1007. The “Employer’s ' Report of Occupational Injury of Disease” stated that it is “a report of injury and not a claim.” On that form, he listed the injury or' disease as atrial fibrillation attacks occurring on November 7, 1997; • August 11, 2009; November 25, 2009; February 17, 2010; and June 5, 2010. On the Form 1007, he indicated that the purpose |aof the filing was “medical only.”2 Effective retroactive to . the date those forms were filed (June 11,2010), NOFD commenced paying Mr. Safford’s medical bills for his cardiac condition.
• January 24, 2011 — COSMSI—NOFD’s third-party administrator — sent Mr. Safford a letter stating: “[t]his letter is to inform you we received notice of "your Heart and Lung claim on 6/16/10. After investigation and our Second Medical opinion, doctor agreed with your physician[.] Your claim has been accepted under the Heart and Lung act effective 6/11/10.”
• December 31, 2014 — NOFD ceased paying. Mr. Safford SEB benefits for his -hand' injury because it had complied with its 520-week indemnity obligation under the Louisiana Workers’ Compensation Act.3
• February 16,' 2015 — In response to NOFD’s correspondence confirming that Mr. Safford’s indemnity benefits in connection with his hand injury would be terminated upon the expiration of NOFD’s 520-week indemnity obligation, Mr. Safford’s counsel sent a letter to NOFD demanding that it pay Mr. Safford indemnity (SEB) benefits through 2020 for Mr. Safford’s cardiac condition. The letter further stated that Mr. Safford “has been receiving medical benefits for his cardiac condition since June of 2010” and that “[sjince this occupational disease is separate from his hand injury, Mr. Safford is entitled to supplemental earnings benefits for his cardiac condition. The cardiac condition is a new ■■ injury.”
"• March 31, 2015 — Mr. Safford filed a disputed claim — a Form 1008 — alleging that he “was treated for a cardiac condition beginning 9/24/09. Carl Levie, M.D. confirmed Dr. Iteld and .Dr, Bethala’s diagnosis of atrial fibril[231]*231lation on 9/28/10.”4 In the Form 1008, he identified the bona-fide dispute as “[n]o wage benefits have been paid.”
14» July 28, 2015 — NOFD filed an exception of prescription.5 In- support, NOFD cited La. R.S. 23:1209(A)6 and La. R.S. 23:1031.1(E),7 which it contended require any suit for indemnity benefits be filed within one year of the manifestation of the condition. NOFD pointed out that Mr. Safford’s claim for indemnity benefits arising out of his cardiac condition — which began as early as 1997, which contributed to his retirement in 2006, and which was diagnosed as atrial fibrillation no later than September 28, 2010 — was not filed until March 31,2015., NOFD. thus contended the claim was prescribed.
• August. 18, 2015 — Mr. ' Safford attested — in the affidavit he presented in opposition to the NOFD’s prescription exception — that he “believed the | fiCity of New Orleans had approved SEB benefits related to my cardiac condition. I was lulled into a false sense of security by my continued receipt of SEB benefits following approval of my cardiac condition claim.”8

[232]*232WORKERS’ COMPENSATION JUDGES’ ACTION

At the hearing on the exception, the WCJ noted that to invoke the estoppel exception a claimant must show “some type of active conduct on behalf of the employer or its agents” and that here there was “no active engagement,” The WCJ, however, acknowledged that “both sides have very valid arguments” and took the matter under advisement. Thereafter, the WCJ rendered judgment granting the NOFD’s exception of prescription and dismissing with prejudice Mr. Safford’s claim for indemnity benefits associated with his cardiac condition.

Rejecting Mr. Safford’s contention that NOFD lulled him into not filing suit timely, the WCJ, in her written reasons for judgment, reasoned as follows:

Mr. Safford ... argues that the City of New Orleans is 'estopped from raising the prescription defense because the adjuster lulled him into not filing suit. Mr. Safford presented insufficient evidence to demonstrate any action, intentional or otherwise, on behalf of the employer or its insurer to attempt in any way' to discourage him from filing suit. After applying for medical benefits in June 2010, CCSMSI [the NOFD’s third-party administrator] sent him a letter on January 24, 2011, approving his Heart and Lung claim. If he was not receiving indemnity benefits, he could have and should have filed suit after that time.9

| (¡This appeal followed.

STANDARD OF REVIEW

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Bluebook (online)
198 So. 3d 227, 2016 La.App. 4 Cir. 0209, 2016 La. App. LEXIS 1410, 2016 WL 3938512, Counsel Stack Legal Research, https://law.counselstack.com/opinion/safford-v-hammerman-gainer-international-inc-lactapp-2016.