Turner v. Maryland Cas. Co.

518 So. 2d 1011, 1988 La. LEXIS 48, 1988 WL 1926
CourtSupreme Court of Louisiana
DecidedJanuary 18, 1988
Docket87-C-1563
StatusPublished
Cited by28 cases

This text of 518 So. 2d 1011 (Turner v. Maryland Cas. Co.) is published on Counsel Stack Legal Research, covering Supreme Court of Louisiana primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Turner v. Maryland Cas. Co., 518 So. 2d 1011, 1988 La. LEXIS 48, 1988 WL 1926 (La. 1988).

Opinion

518 So.2d 1011 (1988)

Tyrone TURNER, Sr.
v.
MARYLAND CASUALTY CO.

No. 87-C-1563.

Supreme Court of Louisiana.

January 18, 1988.
Rehearing Denied February 11, 1988.

*1013 Kevin P. Monahan, Baton Rouge, for applicant.

John L. Dardenne, Jr., Kennon, White & Odom, Baton Rouge, for respondent.

DENNIS, Justice.

In this worker's compensation case the injured employee filed suit against the employer's insurer to enforce performance of an agreement between them to an award of compensation recommended by the Office of Worker's Compensation Administration. The employee coupled with this suit a separate action for total and permanent disability benefits. We are called upon to decide (1) whether the employee may file suit in court to enforce performance of the agreed award without first seeking administrative relief, and (2) whether the employer's insurer, by its failure to file a timely dilatory exception, waived its objection to the prematurity of the total and permanent disability claim, or other claims included therein, which had not been submitted to the administrative claims process. At the administrative level the Office of Worker's Compensation Administration recommended and the parties agreed to an award that "worker's compensation benefits should be paid in accordance with law." When the employer's insurer terminated compensation payments four months later, the employee brought suit for enforcement of the agreed award and for total and permanent disability benefits. After a trial, the district court rejected all of the employee's demands, focusing only on the total and permanent disability claim, which the court found to be without merit. The court of appeal affirmed, 513 So.2d 559, adopting the trial court's reasons. We reverse and remand the case to the district court for further proceedings. (A) Under *1014 the Worker's Compensation Act, the parties' agreement to a compensation award pursuant to an administrative recommendation is a conventional obligation whose performance the employee may have enforced by the proper court; the Act does not provide any administrative remedy which must be exhausted before such a suit. (B) When there is a dispute as to compensation an employee cannot file a ripe action thereon until the issue has been submitted to the Office of Worker's Compensation Administration and one of the parties has rejected that agency's recommended resolution. The objection to a premature suit is waived, however, if the defendant fails to raise it through a timely filed dilatory exception. (C) In the present case, the employee properly filed suit in court for the enforcement of the insurer's performance under the agreed award. Moreover, the insurer waived its objection to the prematurity of the employee's total and permanent disability action and any other claims included therein. Since both lower courts passed over the employee's action to enforce the agreement and other claims included within his total and permanent disability cause, and because of the unusual circumstances involved, the case will be remanded to the district court for an adjudication of these issues.

FACTS

Plaintiff, Tyrone Turner, was injured in an employment-related accident on July 7, 1983. Mr. Turner filed a claim with the Director of the Office of Worker's Compensation, which issued a recommendation on November 1, 1983, that "worker's compensation benefits should be paid in accordance with the law." Mr. Turner signified his acceptance by signing the recommendation form on November 2, 1983. Maryland Casualty Company, the employer's insurer, failed to file a rejection of the recommendation within the thirty day period provided by law. Pursuant to La.R.S. 23:1310.1, the director issued a certificate documenting that the parties had informally resolved the claim, in accordance with the terms of the director's recommendation. Maryland Casualty continued paying benefits of $150 per week until February 27, 1984, when it unilaterally terminated all payments of benefits to Mr. Turner. Mr. Turner brought suit directly in court on September 14, 1984, demanding payment of benefits in accordance with the recommendation, along with a claim that his disability be classified as permanent and total. Mr. Turner alleged that the severity of his physical disability had continually increased. After trial, the court dismissed plaintiff's suit, solely for the reason that the plaintiff had failed to establish total and permanent disability at the time of trial. Plaintiff appealed, and the court of appeal affirmed, adopting the written reasons for judgment assigned by the trial judge.

STATUTORY PROVISIONS REGARDING ADMINISTRATION OF CLAIMS

Informal Dispute Resolution

Act 1 of the 1983 Extraordinary Session created the Office of Worker's Compensation Administration and established administrative procedures for the informal resolution of claims. Under the procedures, an employee, his dependent, the employer, or the insurer may file a claim regarding worker's compensation with the director when a dispute arises over compensation in connection with a worker's injury resulting in excess of seven days lost time or death. La.R.S. 23:1310. Within thirty days after receipt of the claim, the director shall issue a recommendation for resolution of the dispute to the parties. La.R.S. 23:1310.1. The recommendation is advisory only and, although admissible into evidence, shall not be accorded any presumption of correctness. Id. Each party is instructed by the recommendation to notify the director of his acceptance or rejection of the recommendation within thirty days of his receipt thereof. Id.; Rule LWC-19. A party who fails to notify the director timely of his rejection is conclusively presumed to have accepted the recommendation. La.R.S. 23:1310.1.

Trial of Civil Action

If any party rejects the recommendation of the director, the employee or his dependent *1015 may file a civil action in court on the claim within sixty days of the receipt of the recommendation or within the period established in La.R.S. 23:1209, whichever occurs last. La.R.S. 23:1311(A). A suit for compensation is premature if the claim has not been submitted to the director for informal resolution. La.R.S. 23:1314(A). However, this objection is waived by the defendant if the dilatory exception of prematurity is not timely filed. La.C.C.P. art. 926, 928; cf. Disotell v. Wadsworth Golf Construction, 500 So.2d 371, 373 (La.1987); Bailey v. Pacific Marine Insurance Co., 509 So.2d 508, 511-12 (La.App. 3d Cir.1987), cert. den. 510 So.2d 377 (La.1987); Moody v. K & B Equipment Co., 508 So.2d 927, 928 (La. App. 4th Cir.1987); Brignac v. Liberty Mutual Insurance Co., 496 So.2d 1306, 1308 (La.App. 3d Cir.1986); Rich v. Geosource Wireline Services, Inc., 490 So.2d 1165, 1172 (La.App. 3d Cir.1986) (failure to obtain recommendation prior to bringing action to modify); Watson v. Amite Milling Co., Inc., 504 So.2d 1149, 1153 (La.App. 5th Cir.1987) (filing before 1331(C) period had elapsed); Dupre v. Travelers Insurance Co., 477 So.2d 1279, 1282 (La.App. 3d Cir. 1985) (failure to follow pleading requirements of 23:1314).

Modification of an Agreed Award

If the parties have accepted the director's recommendation either expressly or tacitly, either party may apply for a recommended modification of the agreed award at any time after six months from the date of the acceptance.[1] La.R.S. 23:1331(C). Disotell v. Wadsworth Golf Construction, supra, at 373; Bailey v. Pacific Marine Insurance Co.,

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Bluebook (online)
518 So. 2d 1011, 1988 La. LEXIS 48, 1988 WL 1926, Counsel Stack Legal Research, https://law.counselstack.com/opinion/turner-v-maryland-cas-co-la-1988.