 |
 |
to fill out a simple form to connect to Personal Injury Lawyers in your area.
|
|
|
|
|
Fornea v. Norwell Equipment Co.11/8/2002
CUSSION
Appellants first complain that the WCJ erred in failing to find that Mr. Fornea made false statements for the purpose of obtaining benefits. Specifically, they assert that the evidence established that Mr. Fornea fell off of a motorcycle on August 6, 2000, but did not report the motorcycle incident to his treating physician or American, and therefore, he should be denied benefits under La. R.S. 23:1208.
In order to establish a claim that an employee has forfeited his benefits pursuant to Section 1208, the following requirements must be met: (1) there is a false statement or representation, (2) it is willfully made, and (3) it is made for the purpose of obtaining or defeating any payment or benefit. The issue of whether an employee forfeited his workers' compensation benefits by willfully making false statements in order to obtain benefits is one of fact, which may not be reversed on appeal absent manifest error. Bibbins v. Sonny's Pizza, Inc., 2001-1524, pp. 4-5 (La. App. 1 Cir. 6/21/02), 822 So.2d 79, 82. Thus, in order to overturn a factual determination of a WC], this court must find from the record that a reasonable factual basis does not exist for the finding and the record establishes that the finding is clearly wrong. Saucier v. Dynasty Transportation, Inc., 2001-0847, p. 4 (La. App. 1 Cir. 5/10/02), 818 So.2d 943, 945-46, writ denied, 021613 (La. 9/30/02), 825 So.2d 1198.
Obviously, in rejecting the Section 1208 defense, the WC] believed Mr. Fornea and his wife's testimony regarding the fall from the steps, despite the confusion in the medical records. The WCJ simply made a credibility determination, and we cannot say that the WC] was clearly wrong in failing to find that Mr. Fornea made a misrepresentation for the purpose of obtaining benefits.
Next, appellants contend that the WCJ erred in awarding continued benefits, asserting that Mr. Fornea failed to prove a causative link between his work accident and ongoing disability and medical treatment. They assert that the August 6t" accident caused Mr. Fornea's condition to deteriorate to the point that surgery was considered.
Determinations of disability and the length of disability are factual findings. Reviewing courts must afford great weight to the trier of fact's disability determinations, which may not be disturbed in the absence of manifest error. Herrell v. Tempo Personnel, 633 So.2d 690, 692 (La. App. 1 Cir. 1993), writ denied, 94-0236 (La 3/18/94), 635 So.2d 1101.
The record abundantly supports the WCJ's finding that Mr. Fornea sustained a spinal injury at work, which rendered him temporarily totally disabled. Dr. Lea's testimony established that Mr. Fornea complained of back pain from the time of the work injury and beyond. Dr. Lea initially suspected a joint injury and treated him based on that suspicion for some time. However, when Mr. Fornea's condition did not improve, Dr. Lea ordered the MRI, which revealed the spinal injury. Furthermore, as noted earlier, the WCJ did not believe that Mr. Fornea injured himself in a subsequent motorcycle accident. Appellants simply failed to establish another causative explanation for Mr. Fornea's back injury, and thus have not provided a basis upon which to reverse the WCJ's disability determination.
CONCLUSION
Based on the foregoing, the judgment appealed from is affirmed. All costs of this appeal are assessed to appellants.
AFFIRMED.
|