Vincent v. NAPA AUTO PARTS AND SUPPLY

879 So. 2d 301, 3 La.App. 3 Cir. 295, 2004 La. App. LEXIS 1599, 2004 WL 1398568
CourtLouisiana Court of Appeal
DecidedJune 23, 2004
Docket2003-295
StatusPublished
Cited by1 cases

This text of 879 So. 2d 301 (Vincent v. NAPA AUTO PARTS AND SUPPLY) 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
Vincent v. NAPA AUTO PARTS AND SUPPLY, 879 So. 2d 301, 3 La.App. 3 Cir. 295, 2004 La. App. LEXIS 1599, 2004 WL 1398568 (La. Ct. App. 2004).

Opinion

879 So.2d 301 (2004)

Thomas VINCENT
v.
NAPA AUTO PARTS AND SUPPLY.

No. 2003-295.

Court of Appeal of Louisiana, Third Circuit.

June 23, 2004.

*302 Robert Dean Hoover, Baton Rouge, LA, for Defendant/Appellee, NAPA Auto Parts and Supply.

Eugene A. Ledet, Jr., Rivers, Beck, Dalrymple & Ledet, Alexandria, LA, for Plaintiff/Appellant, Thomas Vincent.

Court composed of ULYSSES GENE THIBODEAUX, C.J., SYLVIA R. COOKS, BILLIE COLOMBARO WOODARD, ELIZABETH A. PICKETT, and BILLY HOWARD EZELL, Judges.

THIBODEAUX, Chief Judge.

In this workers' compensation matter, Thomas Vincent appeals a judgment denying him penalties and attorney fees against his employer, NAPA Auto Parts and Supply. Mr. Vincent claims that the workers' compensation judge erred in denying these awards for his employer's alleged failure to timely authorize an appointment with his doctor of choice and to authorize a diagnostic examination.

*303 The workers' compensation judge was manifestly erroneous. We reverse and award a penalty of $2,000.00 each for the failure to authorize an appointment with Mr. Vincent's physician of choice and for the failure to authorize a diskogram. We also award attorney fees of $10,000.00 for work at both trial and appellate levels. The provision of these benefits was not prompt and was not reasonably controverted. La.R.S. 23:1203 and 23:1201(F)(2).

I.

FACTS

On May 7, 2001, Mr. Vincent was involved in a work-related accident while employed by NAPA Auto Parts. He began receiving workers' compensation benefits shortly thereafter. Following his injury, Mr. Vincent was treated by several physicians, including a chiropractor and two neurosurgeons. However, his pain failed to resolve. On September 26, 2001, counsel for Mr. Vincent sent a request to see Dr. John Cobb, an orthopedic specialist, to Myrna Cannon, the claims supervisor working on Mr. Vincent's case for NAPA's insurer. The letter was received on October 2, 2001. An appointment with Dr. Cobb was then authorized on November 14, 2001.

Dr. Cobb examined Mr. Vincent on December 10, 2001. He recommended that a diskogram be performed upon Mr. Vincent. His report and the request for the diskogram were received by Ms. Cannon on January 10, 2002. In February, Blake Stevens, the vocational rehabilitation specialist assigned to Mr. Vincent's case, began to try to schedule an exam for a second opinion. Mr. Vincent was not seen for the second opinion until August 13, 2002, by Dr. Robert Po, who agreed with the diagnosis made by Dr. Cobb and the need for a diskogram. After a consultation with Mr. Stevens, a licensed vocation rehabilitation counselor, in which he was told of the possible dangers involved in a diskogram, which include paralysis, Mr. Vincent decided to forego the test and seek another means of diagnosis, specifically a repeat of an earlier MRI. Two weeks prior to the trial on this matter, Mr. Vincent changed his mind and became willing to undergo the diskogram. Authorization for the test was approved the day of trial.

In November 2001, Mr. Vincent filed a complaint with the Office of Workers' Compensation seeking penalties and attorney fees, claiming that NAPA failed to timely authorize the visit to Dr. Cobb. The complaint was later amended to assert that NAPA failed to timely authorize the diskogram requested by Dr. Cobb.[1] After the hearing on the matter, the workers' compensation judge found that the appointment with Dr. Cobb was authorized within sixty days of the request, making the authorization timely.[2] Accordingly, he denied penalties and attorney fees on that claim. The workers' compensation judge *304 also found that NAPA was not unreasonable in seeking a second opinion as to the need for a diskogram and that the delay for the authorization was also not unreasonable based on Mr. Vincent's own initial refusal to have the diskogram performed. From this decision, Mr. Vincent appeals.

II.

ISSUES

We shall consider whether:

(1) the workers' compensation judge erred in finding that NAPA timely authorized the visit with Dr. Cobb;
(2) the workers' compensation judge erred in finding that NAPA complied with their obligation to provide prompt medical care with regards to the diskogram; and,
(3) the workers' compensation judge erred in failing to award penalties and attorney fees for the alleged violations.

III.

LAW AND DISCUSSION

A. Failure to Authorize Appointment With Physician of Choice

There is no factual dispute regarding the evidence on this issue. Mr. Vincent's attorney's letter to the adjuster requesting authorization to see Dr. Cobb was sent on September 26, 2001, and received by Ms. Cannon, the adjuster, on October 2, 2001. She reviewed the letter on October 3 and failed to communicate with Mr. Vincent's attorney until November 14, 2001— a lapse of six weeks. Ms. Cannon testified that she was familiar with Mr. Vincent's right to see Dr. Cobb and further acknowledged that he had not been seen by an orthopedist of his choice. Moreover, Ms. Canon did not question the accuracy of Mr. Vincent's medical records which she had in her possession.

Authement v. Shappert Engineering, 02-1631 (La.2/25/03), 840 So.2d 1181, 1186, concluded that "[b]ased on this language [La.R.S. 23:1201(F)(2)] a penalty and attorney fee can be imposed for the failure to authorize treatment except where `the claim is reasonably controverted.'" Authement further explained:

The employer is obligated to `furnish all necessary drugs, supplies, hospital care and services, medical and surgical treatment, and any nonmedical treatment recognized by the laws of this state as legal.' LSA-R.S. 23:1203(a). Thus, we conclude that a failure to authorize treatment can result in the imposition of penalties and attorney fees except when the claim is reasonably controverted. Depending on the circumstances, a failure to authorize treatment is effectively a failure to furnish treatment.

Id. at 1187. (Emphasis supplied).

Moreover, "[o]ne purpose of the workers' compensation statute is to promptly provide compensation and medical benefits to an employee who suffers injury within the course and scope of employment." Id. at 1186-87. (Emphasis supplied). In this case, the failure to authorize an appointment with Dr. Cobb for six weeks was not prompt. We, therefore, assess a penalty of $2,000.00 and an attorney fee of $3,500.00 pursuant to La.R.S. 23:1201(F)(2).

B. Failure to Authorize Diskogram

Dr. Cobb examined Mr. Vincent on December 10, 2001 and determined the need for a diskogram for which he requested authorization to perform. His request was received by the claims adjuster on January 10, 2002. Having received no response from NAPA, Mr. Vincent's attorney *305 wrote to the claims adjuster on February 25, 2002, to again request authorization for the diskogram. Dr. Po saw Mr. Vincent for a second opinion at NAPA's request on July 11, 2002. Dr. Po concurred with the need for a diskogram and informed Mr. Stevens, the vocational rehabilitation counselor, on August 13, 2002. Finally, in September 2002, Mr. Stevens called Mr. Vincent to discuss Dr. Po's findings. He summarized their conversation as follows:

I advised Mr. Vincent about the diskogram and [advised him that] it's a delicate procedure and if [it is] not performed adequately ...

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Bluebook (online)
879 So. 2d 301, 3 La.App. 3 Cir. 295, 2004 La. App. LEXIS 1599, 2004 WL 1398568, Counsel Stack Legal Research, https://law.counselstack.com/opinion/vincent-v-napa-auto-parts-and-supply-lactapp-2004.