GENOVESE, Judge.
In this workers' compensation case, Defendant/Employer, Dolgencorp, LLC, doing business as Dollar General (hereafter Dollar General),
On September 2, 2008, Ms. Alpizar, who was employed by Dollar General as an assistant manager of its Merryville, Louisiana store, tripped over a box and injured her right knee and lower back. On December 29, 2010, Ms. Alpizar filed a disputed claim for compensation, alleging that Dollar General denied a doctor-recommended MRI and claiming entitlement to SEB, penalties, and attorney fees. She filed an amended disputed claim for compensation on August 10, 2011, alleging that Dollar General denied doctor-recommended physical therapy and claiming entitlement to penalties and attorney fees.
In its answer, Dollar General admitted that Ms. Alpizar was injured in the course and scope of her employment and that it paid her indemnity benefits from December 2008 through December 2009; however, Dollar General averred that Ms. Alpizar's "current problems with her back and right knee are not related to the alleged work accident." Dollar General further alleged that Ms. Alpizar had "voluntarily terminated her employment[.]"
This matter was tried on March 4, 2013, after which the Workers' Compensation Judge (WCJ) took the matter under advisement and accepted post-trial memoranda. On May 20, 2013, the WCJ rendered
As previously stated, there is no dispute that Ms. Alpizar injured her right knee and back while in the course and scope of her employment with Dollar General. She initially saw her primary care physician, Dr. Larry Brown, and nurse practitioner, Anita Drake, at Newton Family Clinic. For her right knee, Ms. Alpizar was treated by Dr. J. David DeLapp. In March 2009, Dr. DeLapp performed a partial lateral meniscectomy and chondroplasty on Ms. Alpizar's right knee. On March 24, 2009, Dr. DeLapp released Ms. Alpizar to "return to work without restrictions concerning her knee only[.]" For her back, Ms. Alpizar was initially treated by Dr. Richard Francis. On September 25, 2009, Dr. Francis performed a lumbar laminectomy and discectomy at L-3, L-4, and L-5 on Ms. Alpizar. On December 17, 2009, Dr. Francis found that Ms. Alpizar had reached "maximum medical improvement" and released her from his care, stating she could "return[] to the workforce in a full duty capacity." It is at this point that Dollar General contends its responsibility for Ms. Alpizar's ailments ceases. Ms. Alpizar, on the other hand, insists that she was unable to return to the workforce when Dr. Francis released her in December 2009, just two months after a multi-level back surgery. She alleges that her medical treatment post-December 2009 is Dollar General's continuing responsibility because she had not fully recovered from her September 2, 2008 work accident.
Ms. Alpizar testified that she continued to experience pain after her release by Dr. Francis in December 2009, and returned to the Newton Family Clinic. On April 5, 2010, an FCE was ordered to determine whether she was physically able to work. The FCE, performed on August 13, 2010, found that Ms. Alpizar was capable of performing light-duty, sedentary work only on a part-time basis. We find it noteworthy that when Dr. DeLapp released Ms. Alpizar in March 2009, he did state, relative to her right knee, that she may not tolerate being released without restrictions and that an FCE may ultimately be necessary.
On November 22, 2010, Ms. Alpizar saw Dr. Clark Gunderson, an orthopedic surgeon. He recommended a lumbar MRI, a right-knee replacement, and opined that she was incapable of working in any capacity. Ms. Alpizar returned to Dr. Francis on June 16, 2011. Dr. Francis assessed Ms. Alpizar as having "[c]hronic low back and right lower extremity pain" and "right lumbar radiculopathy." He, like Dr. Gunderson in November 2010, recommended "[a]n MRI study of the lumbar spine with and without contrast as well as lower extremity electroneurographic studies[.]"
At trial, Dollar General defended its refusal to authorize Dr. Gunderson's lumbar MRI by asserting that Dr. Francis was Ms. Alpizar's treating physician and that she had been released from his care to return to work on December 17, 2009. It also took issue with the April 2010 prescription from the Newton Family Clinic for Ms. Alpizar to have an FCE because it was signed by a nurse practitioner and not a doctor. Dollar General also contends that Ms. Alpizar voluntarily terminated her employment because, after Dr. Francis released her in December 2009, she did not contact Dollar General about returning to work. Therefore, Dollar General considered the ailments experienced by Ms. Alpizar after December 2009 as being unrelated to her September 2, 2008 work accident. Relative to Ms. Alpizar's request to see Dr. Gunderson, Ms. Alpizar's
In his extensive oral reasons for judgment, the WCJ ruled in favor of Ms. Alpizar, as set forth in the following significant excerpt:
Judgment in this matter was signed on May 23, 2013, whereby: (1) Ms. Alpizar was "awarded supplemental earnings benefits, at a zero earning rate, from December 1, 2009 forward"; (2) Ms. Alpizar was "awarded a $2,000.00 penalty for [Dollar General]'s failure to institute SEBs as of December 21, 2009"; (3) Ms. Alpizar's "request for a change in orthopedic surgeons from Dr. Richard Francis to Dr. Clark Gunderson [was] granted"; (4) Ms. Alpizar's "request for a functional capacities evaluation was reasonable"; (5) Dollar General was "assessed a $2,000.00 penalty for failing to grant that request"; (6) "attorney[] fees in the amount of $13,000.00 [were] awarded to [Ms. Alpizar]'s counsel"; and, (7) Ms. Alpizar was "awarded the costs associated with the litigation and the FCE ... in the total amount of $2,279.89." Dollar General appeals.
Dollar General sets forth four assignments of error:
Ms. Alpizar has answered Dollar General's appeal, seeking an additional award of attorney fees for work done on appeal.
Poissenot v. St. Bernard Parish Sheriff's Office, 09-2793, p. 6 (La.1/9/11), 56 So.3d 170, 174.
Dollar General contends that the WCJ erred in awarding SEB to Ms. Alpizar from December 2009 forward and in awarding the $2,000.00 penalty for its failure to institute SEB. On appeal, Dollar General argues:
The law pertaining to SEB was recently set forth by our supreme court in Poissenot, 56 So.3d at 174-75 (footnote omitted):
A review of the record reveals that the WCJ relied upon the trial testimony of Ms. Alpizar in awarding SEB and a $2,000.00 penalty. At trial, Ms. Alpizar explained that her duties as assistant manager entailed opening and/or closing the store,
According to Ms. Alpizar, after the accident, she "did a little bit of light duty [work] for a couple of days[,]" but the manager informed her that Dollar General didn't have light duty work. In December 2008, Dollar General began paying Ms. Alpizar temporary total disability benefits which it terminated in December 2009. Ms. Alpizar offered the August 2010 FCE performed and the November 2010 opinion of Dr. Gunderson to further support her position that she is entitled to SEB from the date of termination, December 2009.
The WCJ found that Ms. Alpizar proved by a preponderance of the evidence that her disability was causally connected to her September 2008 work injury. Dollar General contends that the evidence offered by Ms. Alpizar to establish her entitlement to SEB is insufficient. However, other than Dr. Francis' December 17, 2009 opinion, Dollar General offered no evidence that Ms. Alpizar was not entitled to SEB.
After a thorough review of the record and relevant jurisprudence, and considering the credibility findings by the WCJ, we find that the extensive oral reasons for judgment adequately explain and support its decision with respect to Ms. Alpizar's entitlement to SEB. The WCJ found no evidence that Dollar General ever offered Ms. Alpizar anything other than "precisely what she did before she was injured." It is evident that the WCJ considered Dr. Francis' December 2009 medical opinion unpersuasive. The WCJ further found Ms. Alpizar credible in her assertions at trial that her knee and back pain made it impossible for her to work. In finding Ms. Alpizar entitled to SEB, it is clear that the WCJ accepted her testimony as to her physical ability, or lack thereof, as well as the findings of the FCE and Dr. Gunderson, which corroborated her claim that she was entitled to SEB due to her inability to earn ninety percent or more of her average pre-injury wage. Thus, we find no manifest error in the WCJ's award of SEB to Ms. Alpizar.
Dollar General also urged that the WCJ erred in finding that Ms. Alpizar was entitled to treatment from Dr. Gunderson. Dollar General particularly took issue with the fact that Ms. Alpizar's formal request was not made until June 2011, seven months after she saw Dr. Gunderson in November 2010. Dollar General contends that it fulfilled the requirements of La.R.S. 23:1121(B)(1), which states "[t]he employee shall have the right to select one treating physician in any field or specialty." Dollar General argues that it fulfilled its statutory obligation under La.R.S. 23:1121(B)(1) since Ms. Alpizar chose to see Dr. Francis,
An employer's duty to furnish medical expenses is governed by La.R.S. 23:1203(A), which provides, in pertinent part:
The WCJ found "good and sufficient reason" for Ms. Alpizar's request to change orthopedic surgeons from Dr. Francis to Dr. Gunderson. Dollar General's challenge of the medical necessity for a change in Ms. Alpizar's orthopedic surgeons is purely argument, not evidence. The evidence, however, reflects that Dr. Francis opined that Ms. Alpizar was able to return to the workforce two months after her back surgery. Further, her request for an FCE was rebuffed by Dollar General, which relied upon the opinion of Dr. Francis. Considering these facts and circumstances, it is both reasonable and understandable that Ms. Alpizar would choose not to return to Dr. Francis and would seek to change her orthopedic surgeon. Hence, we disagree with Dollar General's assertion that the WCJ erred in approving Ms. Alpizar's request for a change in orthopedic surgeon.
As earlier stated, we find the WCJ's extensive oral reasons for judgment adequately explain his decision allowing Ms. Alpizar to change orthopedic surgeons. Accordingly, we find no manifest error in the WCJ's ruling that Ms. Alpizar was entitled to treatment with Dr. Gunderson without approval, even though she had been released to return to work by Dr. Francis.
Dollar General contends that the WCJ erred in assessing penalties and attorney fees. Specifically, it argues the WCJ erred in finding that it failed to reasonably controvert Ms. Alpizar's claims and awarding: (1) a $2,000.00 penalty for failing to pay SEB; (2) a $2,000.00 penalty for refusing to authorize the FCE; and, (3) $13,000.00 for attorney fees.
Louisiana Revised Statutes 23:1201(F) authorizes penalties and attorney fees in situations where the employer failed to commence, or recommence, payment of benefits timely, to pay continued installments timely, or to pay medical benefits timely.
Lambert v. Brookshire Grocery Co., 06-1001, p. 11 (La.App. 3 Cir. 12/20/06), 945 So.2d 918, 927.
The WCJ found that Dollar General failed to reasonably controvert Ms. Alpizar's requests for SEB and a FCE. Again, the only evidence offered by Dollar General as to why it felt it was within its rights to deny Ms. Alpizar's requests is Dr. Francis' release. Dollar General also argued
After a thorough review of the record and relevant jurisprudence, and considering the credibility findings by the WCJ, we find no manifest error in the WCJ awarding a $2,000.00 penalty and $13,000.00 in attorney fees for failing to pay SEB and a $2,000.00 penalty for refusing to authorize the FCE.
The WCJ cast Dollar General with the costs associated with the litigation and the FCE. Dollar General asserts the WCJ erred in awarding reimbursement of the FCE because Ms. Alpizar failed to prove it was medically necessary.
The record reflects that a written demand, dated April 6, 2010, was sent to Dollar General based on the prescription written by Anita Drake, a nurse practitioner at Newton Family Clinic, on April 5, 2010. An authorization from Dollar General was not received; however, Ms. Alpizar had an FCE performed on August 13, 2010. The results substantiated Ms. Alpizar's complaints relative to her back. Dollar General continues to argue that it was error for the WCJ to attribute Ms. Alpizar's inability to work to her September 2008 work accident, and not her poor health, in general. While the medical records and testimony confirm that Ms. Alpizar did have health problems, Dollar General did not prove that her poor health did anything more than exacerbate her inability to work because of her proven injuries. We find no manifest error in WCJ's determination that medical necessity existed and in casting the costs of the FCE being against Dollar General.
Dollar General also asserts the WCJ erred in assessing it with the costs associated with the litigation. An appellate court reviews a WCJ's assessment of court costs under an abuse of discretion standard. Lambert, 945 So.2d 918. Given that Ms. Alpizar prevailed on her claims before the WCJ, we find no abuse of discretion in the WCJ's assessment of costs against Dollar General.
Ms. Alpizar requests additional attorney fees for work done on appeal. "The general rule is that an increase in attorney fees is usually allowed where the WCJ awarded a party attorney fees and that party is forced to and successfully defends an appeal, provided that the party properly requests such an increase." Simpson v. Lafayette Consol. Gov't, 09-816, p. 10 (La.App. 3 Cir. 2/3/10), 29 So.3d 727, 733, writ denied, 10-477 (La.4/30/10), 34 So.3d 292 (citing McKelvey v. City of Dequincy, 07-604 (La.App. 3 Cir. 11/14/07), 970 So.2d 682). Ms. Alpizar was awarded attorney fees by the WCJ. Having affirmed the judgment of the WCJ, we award Ms. Alpizar $3,500.00 in attorney fees for work done on appeal.
Accordingly, for the foregoing reasons, we affirm the May 23, 2013 judgment of the Office of Workers' Compensation in its entirety. Ms. Alpizar is awarded additional attorney fees of $3,500.00 for work performed on this appeal. All costs of this appeal are assessed against Defendant/Employer, Dolgencorp, LLC, doing business as Dollar General.