Simmons v. Associated Hospital Services, Inc.

862 So. 2d 1043, 2003 La.App. 4 Cir. 0768, 2003 La. App. LEXIS 3547, 2003 WL 22976142
CourtLouisiana Court of Appeal
DecidedDecember 3, 2003
DocketNo. 2003-CA-0768
StatusPublished
Cited by1 cases

This text of 862 So. 2d 1043 (Simmons v. Associated Hospital Services, 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
Simmons v. Associated Hospital Services, Inc., 862 So. 2d 1043, 2003 La.App. 4 Cir. 0768, 2003 La. App. LEXIS 3547, 2003 WL 22976142 (La. Ct. App. 2003).

Opinion

TERRI F. LOVE, Judge.

Plaintiff Sandra Simmons appeals, pro se, the trial court’s ruling that she failed to prove her injury was a work-related accident. Defendants, Associated Hospital Services, Inc. and Louisiana Workers’ [1045]*1045Compensation Corporation appeal the judgment in so far as civil penalties were not assessed against Simmons for willful misrepresentation. We affirm the judgment of the trial court for the following reasons.

FACTS AND PROCEDURAL HISTORY

On March 16, 2001, Sandra Simmons (“Simmons”) contends she suffered a slip and fall after she clocked out of work and was returning to her workstation. At the time of the accident, Simmons was employed as a “sheet runner” by Associated Hospital Services (“AHS”). AHS processes soiled laundry from local hospitals and medical facilities and Simmons’ primary duty was to run clean sheets through a large machine press. On March 16, 2001, Simmons contends that she was feeling ill and nauseous from the stench of soiled sheets in the plant. After informing her supervisor that she was feeling ill, Simmons contends that her supervisor advised her to clock out of work, return to her workstation and wait for him there so that he may speak with her. Simmons clocked out of work and was returning to her workstation when she slipped on a piece of plastic wrap. Claimant filed a claim with the Louisiana Workers’ Compensation Corporation (“LWCC”). On March 19, 2001, Simmons was informed that AHS terminated her employment.

Defendants AHS and LWCC maintain that Simmons never informed her supervisor that she was feeling ill. AHS claims that Simmons was upset that Simmons’ significant other, who was a co-employee, was sent home for disciplinary reasons. Simmons approached the supervisor who informed her to go back to work. AHS contends that in an act of subordination, Simmons decided to leave work and was informed if she clocked out, she was not to return. Based on this action, on March 19, 2003, AHS terminated Simmons’ employment. AHS alleges that Simmons’ injury was fabricated and is evidenced by the various inconsistent statements made by Simmons as it relates to the cause of the accident.

At the workers’ compensation hearing, AHS’ Production Manager Myles Peters testified, that immediately after Simmons’ alleged slip, she informed Peters that a cart hit her as she headed back to her workstation after clocking out. AHS admitted into evidence the ambulance report sheet, which indicated that Simmons informed the ambulance attendants that she tripped over a low railing as she headed back to her workstation after clocking out. However, Simmons testified that she fell on an approximate 8-inch by 10-inch ball of wrapping plastic as she headed back to her workstation. The workers’ compensation judge held that Simmons failed to prove, by a preponderance of the evidence presented, that she did suffer a slip and fall in the course and scope of her employment. The workers’ compensation judge also held that AHS and LWCC failed to carry their burden of proof in establishing that Simmons made willful misrepresentations in an effort to obtain workers’ compensation benefits. From this decision, Simmons, AHS and LWCC appeal.

LAW AND DISCUSSION

On appeal, in one assignment of error Simmons alleges that the workers’ compensation court erred in finding that she did not carry her burden of proof in establishing that she suffered a slip and fall sufficient to satisfy compensation pursuant to Louisiana Workers’ Compensation Act. Further, AHS and LWCC, allege the workers’ compensation court erred in finding that AHS and LWCC failed to carry the burden of proof required to establish that Simmons willfully violated La. R.S. 23:1208. La. R.S. 23:1208(A) provides in pertinent part:

[1046]*1046It shall be unlawful for any person, for the purpose of obtaining or defeating any benefit or payment under the provisions of this Chapter, either for himself or for any other person, to willfully make a false statement or representation.

First Assignment of Error

The standard for review in workers’ compensation cases is the manifest error-clearly wrong standard, which precludes the setting aside of a trial court’s findings of fact unless they are clearly wrong in light of the record reviewed in its entirety. Matthews v. Taylor Temporary, Inc., 97-1718, p. 1 (La.App. 4 Cir. 12/12/01), 707 So.2d 1021, 1022, citing Alexander v. Pellerin Marble & Granite, 93-1698 (La.1/14/94), 630 So.2d 706, 710. Further, “[t]he trial court’s determinations as to whether the worker’s testimony is credible and whether the worker has discharged his burden of proof are factual determinations not to be disturbed on review unless clearly wrong or absent a showing of manifest error.” Bruno v. Harbert Int’l., Inc., 593 So.2d 357, 361 (La.1992). The employee in a workers’ compensation case has the burden of proving that an accident occurred in the course and scope of his employment, that the accident caused his injury, and that the injury caused his disability. Gonzales v. Babco Farm, Inc., 535 So.2d 822, 823 (La.App. 2 Cir.), writ denied, 536 So.2d 1200 (La.1988); Walton v. Normandy Village Homes Ass’n, Inc., 475 So.2d 320, 324 (La.1985). It is by a preponderance of the evidence that the worker/claimant must prove the accident occurred. Bruno, 593 So.2d at 361. The burden that both the employee and employer bear in establishing whether compensation benefits are due was described by the court in Joffrion v. Bryant, 98-1439, p. 4 (La.App. 3 Cir. 4/14/99), 732 So.2d 767, 770. The court stated:

Initially, the employee must prove by a preponderance of the evidence that due to a workplace injury, he or she is unable to earn at least ninety percent of the wages earned prior to the injury. Seal v. Gaylord Container Corp., 97-0688 (La.12/2/97), 704 So.2d 1161. Once the employee satisfies that initial burden, in order to defeat the employee’s claim for supplemental earnings benefits (“SEBs”) the employer must demonstrate, by a preponderance of the evidence “that the employee is physically able to perform a certain job and that the job was offered to the employee or that the job was available to the employee in his or the employer’s community or reasonable geographic region.” 97-0688 at p. 8; 704 So.2d at 1166. However it is only after the employee carries his initial burden of establishing entitlement to SEBs that the burden shifts to the employer. See Smith v. Hamp Enterprises, Inc., 95-2343 (La.App. 4 Cir. 4/17/96), 673 So.2d 267.

At the trial on the merits, Simmons testified that she was not aware what happened when she fell. She contends that she “blacked out” upon her slip and fall and cannot remember the events surrounding the accident. On cross-examination Simmons testifies:

Q: Right. Now when you fell, you said, you didn’t see anything? You just fell?
A: No. I didn’t.
Q: At the time that occurred, you are telling us you have no clue why you just fell?
A: I have no clue.

During cross-examination, Simmons was asked about the recorded statement that she gave Darren Evans, the insurance company agent, in which she was asked, [1047]

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862 So. 2d 1043, 2003 La.App. 4 Cir. 0768, 2003 La. App. LEXIS 3547, 2003 WL 22976142, Counsel Stack Legal Research, https://law.counselstack.com/opinion/simmons-v-associated-hospital-services-inc-lactapp-2003.