Stelly v. CNA Insurance Co.

177 So. 3d 159, 15 La.App. 3 Cir. 379, 2015 La. App. LEXIS 2088, 2015 WL 6447040
CourtLouisiana Court of Appeal
DecidedOctober 21, 2015
DocketNo. 15-379
StatusPublished

This text of 177 So. 3d 159 (Stelly v. CNA Insurance 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
Stelly v. CNA Insurance Co., 177 So. 3d 159, 15 La.App. 3 Cir. 379, 2015 La. App. LEXIS 2088, 2015 WL 6447040 (La. Ct. App. 2015).

Opinions

GENOVESE, Judge.

In this workers’ compensation case, Claimant, Donald Blaine Stelly, appeals a judgment of the Office of Workers’ Compensation (OWC) in favor of his employer, Fresenius Medical Care NA,1 and its insurer, CNA Insurance Company (collectively Fresenius), denying his Motion for Summary Judgment,2 finding him to be temporarily and totally disabled, and ordering that he submit to vocational rehabilitation. For the reasons that follow, we affirm in part, reverse in part, and render.

[161]*161 FACTS AND PROCEDURAL HISTORY

Mr. Stelly was injured in a work-related accident on September 10, 2005, when he fell from a ladder. Consequently, Freseni-us paid Mr. Stelly’s related medical expenses and also paid him workers’ compensation indemnity benefits. In connection with his injury, Mr. Stelly underwent vocational rehabilitation.

However, on March 19, 2014, Mr. Stelly filed a Disputed Claim for Compensation (1008), claiming that there existed a bona-fide dispute as to whether |2his current disability status was temporary total or permanent total. Also in dispute was Fre-senius’ entitlement to have an additional functional capacity evaluation (FCE) performed. Mr. Stelly sought permanent and total disability status along with penalties and attorney fees. Concomitant with the 1008, Mr. Stelly filed a Motion for Determination of Permanent, Total Disability, Disallowance of Demand for Functional Capacity Examination and Opposition to Motion to Suspend Benefits.

Additionally, on May 12, 2014, Mr. Stelly filed a Motion for Summary Judgment, contending “that there is no dispute as to any material fact, since his treating physician, Dr. George R. Williams[,] and defendant’s physician, Dr. Thad Broussard[,] have both declared that plaintiff, DONALD BLAINE STELLY, is permanently and totally disabled! ] and that he is entitled to judgment as a matter of law.”3 The hearing on that motion was deferred to trial on the merits.

In response, Fresenius filed an answer generally denying the allegations contained in Mr. Stelly’s 1008. It also filed a motion for the suspension of benefits and a motion to compel an FCE. Additionally, Fresenius argued that Mr. Stelly’s Motion for Summary Judgment was premature since Mr. Stelly failed to attend the FCE and that material facts remained in dispute since the physicians disagreed on whether Mr. Stelly was permanently and totally disabled.

Considering the motions filed, on July 1, 2014, the workers’ compensation judge (WCJ) ordered that an independent medical examination (IME) be performed by Dr. Clark Gunderson, an orthopedic surgeon. Dr. Gunderson’s |sopinion was sought on the issues of Mr. Stelly’s disability status and the need for the additional FCE.4 The IME was performed on August 7, 2014.

Fresenius, thereafter, scheduled an FCE for September 26, 2014. Mr. Stelly sought to quash the FCE, arguing that Fresenius was not entitled to an additional FCE, having already had one performed by a medical professional of its choosing. After the issue was submitted on briefs, the WCJ signed a judgment on September 24, 2014, denying Fresenius’ motion to compel an additional FCE.

Mr. Stelly subsequently re-urged his motion for summary judgment and attached two additional items in support thereof, a 2009 FCE report by the Fonta-na Center and the reports of Genex Services, the rehabilitation counseling service. This motion was also deferred to the trial on the merits.

Following a trial on the merits, the WCJ: (1) denied Mr. Stelly’s Motion for Summary Judgment; (2) found Mr. Stelly to be temporarily and totally disabled; and, (3) ordered that Mr. Stelly submit to vocational rehabilitation. From said judgment, Mr. Stelly appeals.

[162]*162 ASSIGNMENTS OF ERROR

Mr. Stelly presents the following assignments of error for our review on appeal:

ASSIGNMENT OF ERROR # 1
The [t]rial [c]ourt erred in failing to grant the Motion for Summary Judgment, as the evidence uncontrovertedly establishes that [Mr. Stelly] is physically disabled and has undergone a failed attempt at rehabilitation^]
ASSIGNMENT OF ERROR # 2
The [t]rial [cjourt erred in failing to recognize that [Mr. Stelly] has already undergone a failed attempt at rehabilitation and in | ¿applying a standard of “some physical activities” to the determination of disability, rather than “to engage in any self-employment or occupation for wages of any kind” under [La.R.S.] 23:1221(2).
ASSIGNMENT OF ERROR # 3
The [t]rial [c]ourt erred in finding [Mr. Stelly] temporarily totally disabled rather than permanently totally disabled under [La.R.S.] 23:1221(2), as the evidence clearly shows that [he] is permanently unable [“]to engage in any.self-employment or occupation for wages of any kind.[”]

LAW AND DISCUSSION

In his first assignment of error, Mr. Stelly contends that the WCJ erred in denying his motion for summary judgment. We disagree.

In Hitchcock v. Heritage Manor Nursing Home, 05-1010, pp. 4-5, (La.App. 3 Cir. 2/1/06), 922 So.2d 764, 767, (emphasis added) this court, discussing motions for summary judgment, stated:

In considering whether a genuine issue exists, courts cannot consider the merits, make credibility determinations, evaluate testimony or weigh evidence.
Pritchard v. American Freightways Corp., 37,962, pp. 3-4 (La.App. 2 Cir. 12/10/03), 862 So.2d 476, 478 (emphasis added) (citations omitted). If in evaluating the evidence, the court considered the merits, made credibility determinations, evaluated testimony, or weighed evidence, summary judgment must be reversed.
Strickland v. Doyle, 05-11, p. 4 (La.App. 3 Cir. 4/6/05), 899 So.2d 849, 852, writ denied, 05-1001 (La.6/3/05), 903 So.2d 466.

In the instant matter, in order to determine the disability status of Mr. Stelly, and considering the evidence presented, the WCJ would have been required to evaluate testimony and to weigh the evidence, which is impermissible at the summary judgment stage. Accordingly, genuine issues of material fact remained so as to preclude the grant of summary judgment, and we affirm the WCJ’s denial | Bof same.

Both Mr. Stelly’s second and third assignments of error address the WCJ’s failure to find that he is permanently and totally disabled.5 In Colwell v. Summit [163]*163Retirement Ctr., 12—1186, p. 3 (La.App. 3 Cir. 3/6/13), 128 So.3d 1029, 1032, writ denied, 13-755 (La.App.5/31/13), 118 So.3d 395, this court stated the following with respect to an appellate review of an employee’s disability status:

The finding of disability within the framework of the workers’ compensation law is a legal rather than a purely medical determination. Therefore, the question of disability must be determined by reference to the totality of the evidence, including both lay and medical testimony. Ultimately, the question of disability is a question of fact, which cannot be reversed in the absence of manifest error. Severio v. J.E. Merit Constructors, Inc., 2002-0359, p. 7 (La.App. 1 Cir.

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177 So. 3d 159, 15 La.App. 3 Cir. 379, 2015 La. App. LEXIS 2088, 2015 WL 6447040, Counsel Stack Legal Research, https://law.counselstack.com/opinion/stelly-v-cna-insurance-co-lactapp-2015.