Defendant, a medical facility, initially filed three disputed claims against Employer with the Office of Workers’ Compensation (OWC) because they had not been paid for medical services rendered. Employer argued they had not received notice of any treatment before the claims were filed. The medical facility voluntarily dismissed its claims with prejudice prior to the hearing. Employer then filed a lawsuit in state district court against the medical facility alleging that Defendant’s prior claims were frivolous, and seeking sanctions and attorney fees. Defendant filed an exception of lack of subject matter jurisdiction, arguing that Employer’s suit should have been filed in the OWC because Employer’s claim arose out of workers’ compensation disputes. The district court found it had jurisdiction and denied the exception.
Decedent was a retired firefighter with the Jefferson Parish Fire Department. He passed away on May 5, 2013. On January 7, 2015, his widow filed a disputed claim for compensation seeking death benefits pursuant to La. R.S. 23:1231. Plaintiff alleged that her husband filed a workers’ compensation claim in 2004 for which he received benefits until the time of his death. She further alleged that he suffered a heart attack on the date of his death, and the coroner amended the death certificate in October 2014 to reflect that the cause of death was the heart attack.
Claimant allegedly injured his lower back while working as a laborer for the company he owned. Claimant filed a claim with his workers’ compensation carrier, and while some medical benefits were paid, Carrier denied authorization of lumbar epidural injections and paid no wage benefits. Claimant contacted Carrier to inquire about the denial of these benefits, and the adjuster took a recorded statement from Claimant. Claimant admitted to having a minor prior back injury and denied ever being involved in any motor vehicle accidents. Carrier thereafter approved the medical treatment and began paying temporary total disability benefits.
Plaintiffs’ father was killed in an unwitnessed work accident when he was caught in a pinch point while operating a lift truck. An investigation revealed that the decedent had traces of marijuana in his blood and urine. Plaintiffs filed a disputed worker’s compensation claim for death benefits. Defendant answered the suit and filed a motion for summary judgment raising the intoxication defense provided in La. R.S. 23:1081, which establishes employers’ various defenses to worker’s compensation claims. Defendant argued that the death benefits were forfeited due to the intoxication, which triggered the statutory presumption that the intoxication caused the accident. Plaintiffs opposed the motion arguing that the deposition testimony of multiple coworkers showed that the decedent appeared to be normal prior to the accident. The worker’s compensation judge granted the motion and dismissed Plaintiffs’ claim. Plaintiffs appealed.
Claimant slipped and fell at work injuring her back and hip on November 26, 2011. Employer accepted the claim and paid indemnity benefits from May 15, 2013 through October 16, 2013. Claimant thereafter filed a Disputed Claim for Compensation seeking indemnity benefits, medical treatment, penalties, and attorney fees. At trial, it was found that Claimant’s initial physician found no basis to restrict her work activity. Further, Claimant testified that she was able to work for 18 months following the accident by using medication. It wasn’t until Claimant began seeing another physician that she was restricted from work. The worker’s compensation judge found that Claimant failed to present any evidence of a significant change in her circumstances from when she saw the first doctor until she was restricted from work. In regard to medical treatment, the Medical Director determined that lumbar epidural steroid injections (LESI) were not medically necessary. However, the judge found that the Medical Treatment Guidelines reflect that the injections proposed by Claimant’s second physician were accepted and well-established procedures for treating chronic pain disorders. The judge ruled that Claimant was entitled to LESI therapy, but was not entitled to indemnity benefits, penalties, or attorney fees. Both parties appealed.
Claimant was awarded permanent partial disability benefits. Claimant later applied for and was awarded Social Security disability benefits. Employer sought an order to offset the workers’ compensation benefits paid by Employer in the amount of $115.52 per week, pursuant to La. R.S. 23:1225(A). Claimant did not dispute Employer’s entitlement to an offset. However, she contended that Employer should deduct the court approved attorney fees of $65.81 per week. The workers’ compensation judge agreed with Claimant and ordered an offset of $49.71 per week. Employer appealed.