Taylor v. Tommie's Gaming

878 So. 2d 853, 2004 WL 1418171
CourtLouisiana Court of Appeal
DecidedJune 25, 2004
Docket38,568-WCA
StatusPublished
Cited by10 cases

This text of 878 So. 2d 853 (Taylor v. Tommie's Gaming) 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
Taylor v. Tommie's Gaming, 878 So. 2d 853, 2004 WL 1418171 (La. Ct. App. 2004).

Opinion

878 So.2d 853 (2004)

Gregory M. TAYLOR, Plaintiff-Appellant
v.
TOMMIE'S GAMING and Bridgefield Insurance Company, Defendants-Appellees.

No. 38,568-WCA.

Court of Appeal of Louisiana, Second Circuit.

June 25, 2004.
Rehearing Denied August 12, 2004.

*855 Fischer & McMahon, by Mark K. Manno, for Appellant.

Eskridge E. Smith, Jr., by Eskridge E. Smith, Jr., Linda S. Blackman, Bossier City, for Appellees, Tommie's Novelty Gaming and Bridgefield Casualty Insurance Company.

The Wanko Law Firm, LLC, by D. Steven Wanko, Jr., for Appellee, U.S. Specialty Insurance Company.

Before CARAWAY, PEATROSS & DREW, JJ.

PEATROSS, J.

This appeal arises out of a disputed claim for workers' compensation benefits between claimant, Gregory Taylor, and his employer, Tommie's Novelty and Gaming ("Tommie's"). The WCJ dismissed Taylor's claim for benefits and awarded Tommie's, Bridgefield Insurance Company ("Bridgefield") and U.S. Specialty Insurance Company ("Specialty"), restitution under La. R.S. 23:1208. The WCJ denied Defendants' request for penalties and ordered the parties to brief the issue of the amount of restitution due and set that matter for later hearing. The WCJ signed a subsequent judgment setting restitution due to Bridgefield at $12,833.62 and the amount due to Specialty at $62,340.37. Taylor now appeals and Defendants Tommie's and Bridgefield answered the appeal. For the reasons stated herein, we reverse and remand in part and affirm in part.

FACTS

Taylor was injured in a car accident during the course and scope of his employment with Tommie's on November 9, 2000. His injuries included herniated disks and Dr. Marco Ramos performed surgery on Taylor's neck. No disputed workers' compensation claim was filed for this injury; Specialty, Tommie's then workers' compensation insurer, paid Taylor medical and indemnity benefits in the amount of $40,432.14. In May 2001, Taylor returned to light duty work at Tommie's; and, in August 2001, he began his regular duty work as a video poker technician. Taylor alleges that, on September 14, 2001, he sustained another work-related injury to his neck while moving a 700-pound pool table at Tommie's place of business. Either the same or next day, Taylor claims to have injured his neck again moving a pin ball machine to Tommie's residence. Collectively, these events form the basis of Taylor's injury for which he seeks compensation in the present suit. Taylor claims the second injury was actually a "re-injury" of the prior herniated disks suffered in the November 2000 work-related automobile accident. Between the two injuries, Tommie's changed workers' compensation carriers from Specialty to Bridgefield, so Bridgefield was the carrier at the time of the injury providing the basis for the instant workers' compensation claim. Taylor initially named only Bridgefield as defendant in the suit, but later added Specialty as a defendant on the theory that the second injury was an *856 aggravation of the first, which occurred while Specialty covered Tommie's. Specialty disputed the claim and refused to pay benefits. Bridgefield paid medical expenses in the amount of $3,746.11 and disputed the remainder of the claim. Bridgefield filed a cross-claim against Specialty alleging that, to the extent the current injury was a result of the prior neck injury from the November 2000 automobile accident, Specialty was liable for medical and indemnity benefits and penalties and attorney fees.

Specialty and Bridgefield filed reconventional demands against Taylor alleging that he made false statements in order to obtain compensation benefits and, therefore, under La. R.S. 23:1208, he forfeited his right to any benefits and should be ordered to pay full restitution for any benefits paid to him and reasonable costs of the investigation plus attorney fees. Taylor filed an exception of vagueness in response to Specialty's reconventional demand, which was denied.[1]

Trial was held on this matter on April 15, 2003. At the close of Taylor's testimony, Defendants moved for an involuntary dismissal which was granted by the WCJ. The WCJ found that Taylor had violated La. R.S. 23:1208 and that Specialty and Bridgefield were entitled to restitution. The WCJ refused to cast Taylor with a civil penalty and did not award attorney fees. A judgment was entered to that effect, holding the amount of restitution open pending a hearing and submission of briefs on the issue. Following that hearing, a second judgment was entered awarding restitution to Bridgefield in the amount of $12,833.62 and to Specialty in the amount of $62,340.37. Taylor's motion for new trial was denied.

This appeal ensued, with Taylor raising the following assignments of error:

1. The trial court erred granting defendant's Motion for Involuntary Dismissal before the close of plaintiff's case-in-chief.
2. The trial court committed manifest error by denying plaintiff's Motion for New Trial.
3. The trial court erred in failing to sustain plaintiff's Exception of Vagueness.
4. The trial court erred in denying plaintiff's request to proffer exhibits.
5. The trial court erred in refusing to set a hearing on the issue of whether a successor Judge should have decided the Motion for New Trial.
6. The trial court erred in ruling that appellant committed fraud in violation of La. R.S. 23:1208.
7. The trial court committed manifest error in ruling that restitution is owed by the plaintiff to the defendant.
8. The trial court erred in setting the amounts of restitution owed by the plaintiff to the defendants.

Defendants Tommie's and Bridgefield answered the appeal asserting that the restitution award in favor of Tommie's and Bridgefield should be increased and the restitution award in favor of Specialty should be reduced. Alternatively, Tommie's and Bridgefield urge that, if the restitution awards are affirmed, this court remand the matter for a ruling on their claim filed against Specialty.

DISCUSSION

Fraud, Forfeiture of Benefits and Entitlement to Restitution

We will first address the substantive finding of fraud, forfeiture of Taylor's *857 benefits and Defendant's entitlement to restitution. In assignments of error numbers 6 and 7, Taylor argues that the WCJ committed manifest error in finding fraud and in awarding Defendants restitution. We disagree. La. R.S. 23:1208 provides, in pertinent part:

A. It 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.
B. It shall be unlawful for any person, whether present or absent, directly or indirectly, to aid and abet an employer or claimant, or directly or indirectly, counsel an employer or claimant to willfully make a false statement or representation.
C. * * *
(2) Whoever violates any provision of this Section, when the benefits claimed or payments obtained have a value of two thousand five hundred dollars or more, but less than a value of ten thousand dollars shall be imprisoned, with or without hard labor, for not more than five years, or fined not more than five thousand dollars, or both.
* * *

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Cite This Page — Counsel Stack

Bluebook (online)
878 So. 2d 853, 2004 WL 1418171, Counsel Stack Legal Research, https://law.counselstack.com/opinion/taylor-v-tommies-gaming-lactapp-2004.