 |
 |
to fill out a simple form to connect to Personal Injury Lawyers in your area.
|
|
|
|
|
Authement v. Wal-Mart9/26/2003
Matherne, Dr. Michael Haydel, or Dr. Guidry in her review of Ms. Authement's file. Moreover, she acknowledged she had no information to suggest that Ms. Authement had sustained any injury to her neck either before or after the July 5, 2001 incident.
After a thorough review of the record herein, we cannot say that Wal-Mart had an articulable and objective reason for discontinuing Ms. Authement's benefits. Wal-Mart paid medical and indemnity benefits to Ms. Authement for approximately eight months before discontinuing same. Wal-Mart was aware of Ms. Authement's diagnosis as well as her treating physician's recommendation for surgery. Based on the information known to Wal-Mart concerning Ms. Authement's medical status, there was no reasonable basis for Wal-Mart's discontinuance of her benefits, thus warranting the imposition of attorney fees pursuant to La. R.S. 23:1201.2. Accordingly, the award of $2,000.00 for attorney fees under these circumstances is affirmed.
MEDICAL EXPENSE OFFSET
In its final assignment of error, Wal-Mart contends the workers' compensation judge erred in failing to rule on whether Wal-Mart was entitled to the medical expense offset pursuant to La. R.S. 23:1212. Wal-Mart asserts that it specifically pled the entitlement to the medical expense offset and was thus, entitled to same. We disagree. It is well settled that an employer is entitled to a credit against medical expenses pursuant to La. R.S. 23:1212, which states, in pertinent part, as follows:
ayment by any person or entity, other than a direct payment by the employee, a relative or friend of the employee, or by Medicaid or other state medical assistance programs of medical expenses that are owed under this Chapter, shall extinguish the claim against the employer or insurer for those medical expenses. ... If the employee or the employee's spouse actually pays premiums for health insurance, either as direct payments or as itemized deductions from their salaries, then this offset will only apply in the same percentage, if any, that the employer of the employee or the employer of his spouse paid the health insurance premiums.
However, La. R.S. 23:1212 is not a self-operative provision. In order for an employer or insurer to avail himself of the credit for payment, it must set forth the extinguishment of the claim as an affirmative defense and submit evidence at trial showing payment of a certain amount of the employee's medical expenses by a person or entity other than the employee or a relative or friend of the employee, thereby proving the amount of the credit. Gentile v. Baton Rouge General Medical Center, 95-0348 (La. App. 1 Cir. 11/9/95), 665 So.2d 422, 430. Our review of the instant record reveals no such evidence was introduced by Wal-Mart. Thus, Wal-Mart is not entitled to a medical expense credit or setoff pursuant to La. R.S. 23:1212. This assignment of error is without merit.
JUDICIAL INTEREST
In her appeal, Ms. Authement assigns error to the judge's failure to award judicial interest below. Pursuant to La. R.S. 23:1201.3(A), " ny compensation awarded and all payments thereof directed to be made by order of the workers' compensation judge shall bear judicial interest from the date compensation was due until the date of satisfaction." Thus, an award of legal interest is not discretionary with the workers' compensation judge. Gregory v. Interim Personnel Of North Louisiana, 30,808, p. 3 (La. App. 2 Cir. 8/25/98), 717 So.2d 291, 293. A workers' compensation claimant is entitled to legal interest on past workers' compensation benefits from the due date of each payment, until paid, and on penalties and attorney fees from the date of judicial dema
Page 1 2 3 4 5 6 7 8 9 Louisiana Personal Injury Attorneys
Personal Injury Lawyers
|
| |
to fill out a simple form to connect to Personal Injury Lawyers in your area.
|
|