OWC Does not Have Jurisdiction: 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
Category: Personal Injury
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Case Dismissed Because Not Presented to Review Board: Plaintiff filed suit against a hospital when he developed an infection following spine surgery. Defendant filed an exception of prematurity, arguing that it was a qualified healthcare provider under the Medical Malpractice Act (MMA) and that Plaintiff’s claims had not yet been presented to a medical review panel. The district court granted the exception as to all of Plaintiff’s allegations with the exception of the allegation that Defendant failed to properly maintain and service all equipment utilized in the sterilization process. On a supervisory writ, the Louisiana Supreme Court found that Plaintiff’s
How Long to File for Death Benefits in Occupational Disease Cases: 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
Fax Filing Petition Interrupts Prescription: Plaintiff was injured on a city bus on May 1, 2013. He attempted to file suit on the one-year anniversary by facsimile filing on May 1, 2014. Multiple attempts were made, but Plaintiff received an error code each time due to a busy signal. The Clerk of Court received the fax the following morning, and stamp filed the petition on May 2, 2014. Defendants filed an exception of prescription pointing out that the petition was filed more than one year after the alleged injury. Plaintiff opposed the exception, arguing that he first attempted to fax file the
Damages Granted for Willful False Statements: 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
Employer’s Intoxication Defense Defeated: 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
Indemnity Limited with Continued Work by Claimant: 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
What can be Deducted when Calculating SSDI Offset: 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. Pursuant to 42 U.S.C. § 424(a), any month an individual,
Situs and Status Tests for Rail Yard Workers: Claimant worked for Employer for twenty years when he became aware that his exposure to workplace noise had caused hearing loss. He brought a claim under the Longshore Act. He argued that although he worked as a trackman operating switching engines, he sometimes worked on a track near a shipping channel and was a member of the longshoreman’s union, thus, he was a longshoreman under the Act. Employer controverted the claim on the grounds that Claimant never worked on, over, or adjacent to navigable waters. Employer further argued that switching cars was
“Vessel” is not Limited to Vessels Engaged in Commerce: Plaintiff was injured while aboard Defendant’s pleasure yacht in 2011. In 2015, Plaintiff filed a negligence based lawsuit in federal court. Defendant filed a motion to dismiss on the grounds that the statute of limitations for a maritime tort barred the claim. Plaintiff argued that the maritime statute of limitation did not apply because his case was not maritime in nature since he was aboard a pleasure yacht rather than a seagoing vessel. The court found that Defendant satisfied both the locality and nexus tests, and because admiralty jurisdiction was established the three-year