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Mendoza v. Stewart & Associates12/26/2001
eral occasions, and which he did not disclose during treatment by his physicians, in discovery, or during the hearing until the information was elicited on cross-examination. The judge, without comment, found that he had the requisite intent and after our examination of the record as a whole we see no manifest error in such finding.
Here, Mr. Mendoza disclosed one incident which happened to him as a teenager playing basketball, which he apparently considered significant enough to mention, but failed to declare an automobile accident in which he injured his back approximately only four years prior to the work- related accident. In addition, he sought treatment for back pain on at least two other occasions of which he claimed to have no memory, yet recalled other medical problems which he disclosed, such as having tubes in his ears as a child, and having flu-like symptoms. In his defense, Mr. Mendoza avers that the injuries for which he sought treatment were insignificant and not remotely similar, and were not really "previous back problems." Mr. Mendoza has exhibited a pattern of forgetting to mention several problems, all relating only to his back, to a number of physicians treating him for an injury in on that portion of his body; of forgetting the occurrence of an automobile accident with injury to his back, both in his deposition as well as to the court. It is clear from the ruling that the court did not find Mr. Mendoza's testimony on this issue credible. Given the evidence presented, we cannot say the court was manifestly erroneous in finding that he intended to make willful misrepresentations in order to obtain benefits.
The false statements in question go to the heart of the issue of the causation and extent of Mr. Mendoza's present injuries, and cannot be considered either inadvertent or inconsequential. The consensus of medical opinion is that his symptoms could not be explained. Where the false statements are made specifically to obtain benefits, and thus to defraud the workers' compensation system, the benefits will be forfeited for the sole reason that the claimant has willfully and deliberately attempted to defraud the workers' compensation system, and no further requirements are to be imposed.
Because we agree that Mr. Mendoza forfeited his benefits under R.S.23:1208, State Farm was not arbitrary and capricious in denying benefits after May 26, 2000.
For the foregoing reasons the judgment is affirmed. Mr. Mendoza is assessed all costs of appeal.
AFFIRMED
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