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Taylor v. State3/28/2002
Parro, J., concurs.
Plaintiff, Benny Taylor (Taylor), filed a claim for workers' compensation benefits against his employer, the State of Louisiana Department of Public Safety and Corrections (the State). He alleged that the State was liable for medical bills he incurred during the course and scope of his training as a Louisiana state trooper in May of 1999. The adjuster with the Louisiana Office of Risk Management denied the claim. After a hearing, the Workers' Compensation judge (WCJ), Judge Pamela Moses-Laramore, of District 5 of the Office of Workers' Compensation Administration, rendered judgment in favor of Taylor and ordered the State to pay all medical bills, but denied Taylor's claims for penalties and attorney fees. Taylor appealed, claiming that the WCJ was manifestly erroneous in denying his claims for penalties and attorney fees. The State also appealed, claiming that the WCJ's ruling that the State pay Taylor's medical bills was erroneous.
BACKGROUND
On May 2, 1999, Taylor was a state police trainee with the Louisiana Department of Public Safety and Corrections. While running during the course of his training, Taylor had chest pains. He was taken to a hospital, where he was admitted, and tests were conducted. After a few days, Taylor was released, and he returned to the training academy. He completed his training and is now a state trooper.
Taylor made a workers' compensation claim for payment of his medical bills. The State denied the claim and refused to pay the medical bills on the basis that Taylor's chest pains were not covered under the workers' compensation act. The State concluded that there was "no clear and convincing evidence that the physical work stress was extraordinary and unusual in comparison to the stress experienced by the average employee in [Taylor's] occupation" as required under the workers' compensation act for heart-related injuries. Subsequently, Taylor's attorney sent a letter to the State contesting this decision. The State again denied the claims.
At the trial, Louisiana Office of Risk Management adjuster, Catherine Bourdet, testified that the medical records related to the claim, including the report of the cardiologist, were reviewed before the claim was rejected. She also indicated that during a telephone conversation with Taylor, he indicated that he had experienced diarrhea and vomiting the weekend before he suffered the chest pains. Her office initially concluded that Taylor's condition was heart-related or a perivascular problem and rejected the claim. After Taylor's attorney sent a letter on behalf of his client, Ms. Bourdet's office concluded that the flu and a pre-existing heart condition was the basis for Taylor's pains. She further testified that the subsequent denial was based on the determination that there was no accident and no injury which occurred as a result of an accident.
Taylor testified that he was aware he has a congenital heart murmur. He denied having chest pains in the past from exertional activity. Nor did health problems prevent him from entering the Coast Guard or the state police academy. Taylor explained that the running pace in his training was faster than the pace he was used to. When he returned home on a Friday after weeklong training, he had diarrhea, fever and chills. He took Imodium for the diarrhea and his symptoms disappeared before he returned to the academy on Sunday afternoon. Despite the medical history recorded in the emergency room records, Taylor denied he told doctors at the hospital that he had prior chest pains. Taylor's wife, Darleen, testified that she had never heard her husband complain of chest pains.
The WCJ found that there
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