Valerie Fabacher v. Stine, Inc.

Louisiana Court of Appeal·Decided October 9, 2013·No. WCA-0013-0471·Unknown

Opinion

STATE OF LOUISIANA

COURT OF APPEAL, THIRD CIRCUIT

13-471

VALERIE FABACHER VERSUS STINE, INC.

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APPEAL FROM THE

OFFICE OF WORKERS‘ COMPENSATION – DISTRICT 4 PARISH OF ACADIA, NO. 10-03688 SHARON MORROW, WORKERS‘ COMPENSATION JUDGE

**********

JIMMIE C. PETERS

JUDGE

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Court composed of John D. Saunders, Jimmie C. Peters, and John E. Conery, Judges.

AFFIRMED IN PART AS AMENDED;

REVERSED IN PART; AND RENDERED.

Saunders, J., concurs in the result.

Michael B. Miller Jacqueline B. Manecke P. O. Drawer 1630 Crowley, LA 70527-1630 (337) 785-9500 COUNSEL FOR PLAINTIFF/APPELLEE:

Valerie Fabacher

Matthew P. Keating Christopher P. Ieyoub Plauche, Smith & Nieset, LLC P. O. Drawer 1705 Lake Charles, LA 70602-1705 (337) 436-0522 COUNSEL FOR DEFENDANT/APPELLANT:

Stine, Inc.

PETERS, J.

The defendant, Stine, Inc. (Stine), appeals from a judgment awarding the plaintiff, Valerie Fabacher, supplemental earnings benefits, multiple penalties, and attorney fees. The plaintiff answered this appeal, seeking additional attorney fees for work performed on appeal. For the following reasons, we affirm in part as amended, reverse in part, and render judgment.

DISCUSSION OF THE RECORD

On March 13, 2010, Mrs. Fabacher, who was employed by Stine in the Garden Center section of its Crowley, Louisiana store, sustained a work-related injury to her lower back. She was unloading Windsor wall blocks from a delivery truck when, midway through the unloading process, she experienced a burning sensation down her right leg. Mrs. Fabacher immediately reported the accident to her supervisor, Jeri Landry, but continued working until the end of her shift. She first obtained medical attention for her injury two days later when she saw her family physician, Dr. Carl J. Richard. Dr. Richard, a general practitioner who practices in Kaplan, Louisiana, diagnosed Mrs. Fabacher as suffering from sciatica of her right leg and restricted her from working indefinitely.

The next day, March 16, 2010, Stine arranged for Mrs. Fabacher to be seen by its physician, Dr. Yarmen Korab. Dr. Korab, a Crowley, Louisiana general practitioner, also diagnosed Ms. Fabacher as suffering from acute sciatica, in addition to low-back pain, and treated her with medication. When Mrs. Fabacher next saw Dr. Korab on March 30, 2010, her low-back pain had increased and she had begun to suffer weakness in her right leg. Dr. Korab ordered that a diagnostic MRI be obtained and excused Mrs. Fabacher from working through at least April 21, 2010. The MRI, which was performed on March 30, or the same day as the

follow-up visit, revealed a large disc herniation at the right, mediolateral aspect of L5-S1, with some effusion of the upper fragment noted interiorly. After reviewing these findings, on April 5, 2010, Dr. Korab recommended that Mrs. Fabacher see a neurosurgeon prior to any attempt to return to work. When her April 20, 2010, return visit reflected that her symptoms were unchanged, Dr. Korab recommended that she see a neurosurgeon as soon as possible.

Mrs. Fabacher acted on Dr. Korab‘s recommendation and obtained an appointment with Dr. Luiz C. de Araujo, a Lafayette, Louisiana neurosurgeon, on June 28, 2010. Dr. de Araujo‘s initial examination of Mrs. Fabacher caused him to conclude that her symptoms were consistent with a disc herniation at L5-S1. The March 30, 2010 MRI confirmed Dr. Araujo‘s initial diagnosis of a large disc herniation at that level, and he recommended that she treat the condition with physical therapy, anti-inflammatory medications, and muscle relaxants. Although Dr. de Araujo recommended that she not return to work, he agreed to release Mrs. Fabacher to light duty work at her request. However, in a June 28, 2010 letter to Dr. Richard, he stated that Mrs. Fabacher was not fit for duty.

Stine then scheduled Mrs. Fabacher for a second medical opinion (SMO)

with Dr. Ricardo R. Leoni, a Lafayette neurosurgeon, on July 15, 2010. Three days before the scheduled appointment with Dr. Leoni, Mrs. Fabacher saw Dr. de Araujo for a follow up visit. When she saw Dr. de Araujo on July 12, 2010, physical therapy had yet to be approved by Stine or its workers‘ compensation carrier. This failure to approve the recommended medical treatment created problems for Dr. de Araujo in addressing the complaints of his patient because he considered the physical therapy treatment a necessary next step before he could further evaluate Mrs. Fabacher.

Mrs. Fabacher failed to keep the July 15, 2010 appointment with Dr. Leoni, on the advice of her counsel, and Stine rescheduled it for August 17, 2010. After examining Mrs. Fabacher on that day, Dr. Leoni noted numbness in the S-1 distribution, weakness in the dorsiflexion of her foot, and an absent right ankle jerk. He suggested that he normally recommends microdiscectomy surgery for patients with those symptoms, and he expressed a concern that the lost function and weakness in Mrs. Fabacher‘s right foot might be permanent given the presence of the symptoms for several months. Finally, he expressed a belief that Mrs. Fabacher would reach maximum medical improvement (MMI) in three to four months. At the time he examined Mrs. Fabacher, Dr. Leoni was of the opinion she was capable of performing sedentary to light-duty work so long as that work did not require lifting of anything greater than ten to fifteen pounds.

Sometime after her July 12, 2010 visit to Dr. de Araujo, Mrs. Fabacher began receiving physical therapy treatments, and she responded well to those treatments. When she returned to Dr. de Araujo on September 13, 2010, he found that her condition was much improved in that she could walk and move much better than before. However, based on her occasional complaints of radicular pain, he recommended continued physical therapy for several more weeks.

When Mrs. Fabacher returned for an office visit on October 11, 2010, Dr. de Araujo found that his patient was virtually symptom free. Based on this finding, he released her to return to medium-duty work. On November 8, 2010, Dr. de Araujo responded to an October 27, 2010 letter from Martha Raines, a nurse care manager retained by Stine‘s workers‘ compensation administrator, Gallagher

Bassett Services, Inc. (Gallagher), wherein he asserted that he believed Mrs. Fabacher could perform the light-duty obligations of a customer coordinator.1 When Mrs. Fabacher returned to Dr. de Araujo on November 22, 2010, she had yet to return to work in any capacity, and she advised the doctor that she still suffered from occasional episodes of right-leg pain. Although Dr. de Araujo was still of the opinion that Mrs. Fabacher could return to work with restrictions, he did not believe she had reached her MMI level. He planned to reevaluate her approximately six weeks into her medium-duty work and, if she was doing well, to have her undergo a functional capacity evaluation in order to determine her work level. He still believed that at some point she would reach MMI, but did acknowledge that there was a possibility her condition would worsen. If it did, she would be a candidate for surgery.

During the early period of Mrs. Fabacher‘s medical treatment, and despite the uncontroverted findings of the doctors treating her, Stine did not begin timely paying workers‘ compensation benefits. Mrs. Fabacher first made demand on her employer for workers‘ compensation benefits and related expenses by correspondence from her attorney dated April 21, 2010. The next day, she filed a disputed claim for compensation citing Stine‘s failure to pay indemnity benefits and its refusal to authorize her referral to Dr. de Araujo by Dr. Korab. Based on the actions and/or inactions of Stine, she sought statutory penalties, attorney fees, and legal interest on the amounts that might be awarded to her. After receipt of a second demand letter from Mrs. Fabacher‘s attorney dated June 29, 2010, Stine finally responded by tendering payment for some claimed benefits. This came in

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