GENOVESE, Judge.
Lott Oil Company, Inc. (Lott Oil) has suspensively appealed a judgment which awarded its employee, Roland Sorile, workers' compensation benefits for an unwitnessed accident and injury sustained while in the course and scope of his employment. Mr. Sorile has answered the appeal, alleging trial court error in denying his claim for penalties and attorney fees and seeking additional attorney fees for defending the appeal.
Mr. Sorile, a fuel truck operator for Lott Oil, alleges that he injured his back on February 26, 2013, while on the job. There were no witnesses to the accident. Mr. Sorile filed a Disputed Claim for Compensation Form (1008) on March 25, 2013, seeking indemnity benefits, medical expenses, penalties, and attorney fees. On April 2, 2013, Lott Oil answered, denying the occurrence of a work accident and/or that any injury or disability was causally related to his employment and claiming that Mr. Sorile willfully made false statements for the purpose of obtaining benefits, thereby forfeiting benefits pursuant to La.R.S. 23:1208 and La.R.S. 23:1208.1.
The case was tried on June 19, 2014, after which the WCJ took the matter under advisement and accepted post-trial memoranda. On August 25, 2014, the WCJ issued oral reasons for judgment, ruling that Mr. Sorile had proven the occurrence of a work accident and that he sustained a compensable injury as a result thereof. Mr. Sorile was awarded temporary total disability (TTD) benefits from February 28, 2013, through July 25, 2013, supplemental earning benefits (SEB) thereafter based upon a zero earning capacity, and was entitled to ongoing medical benefits. The WCJ ruled that Blue Cross Blue Shield was entitled to recover the full value of its lien. Mr. Sorile's claims for attorney fees and penalties, however, were denied. The WCJ ruled that Mr. Sorile did not commit fraud and denied Lott Oil's claims that Mr. Sorile willfully made false statements for the purpose of obtaining benefits. Judgment was signed September 10, 2014. Lott Oil has filed a suspensive appeal.
Lott Oil assigns the following errors for our review:
The supreme court set forth the law relative to a workers' compensation claimant's burden of proof for an unwitnessed accident and the appellate standard of review thereof in Marange v. Custom Metal Fabricators, Inc., 11-2678, pp. 6-8 (La.7/2/12), 93 So.3d 1253, 1257-58 (per curiam):
Lott Oil's first three assignments of error dispute the WCJ's findings that Mr. Sorile experienced a work accident, sustained a back injury, and is entitled to workers' compensation benefits. Lott Oil argues that the evidence reflects that Mr. Sorile reported experiencing an injury at home and that he specifically denied to co-workers and medical personnel being injured on the job. Lott Oil further contends that Mr. Sorile only conjured a tale of being injured at work on March 12, 2013, when the neurological surgeon made him realize that he had a significant back injury that would entail both substantial medical expenses and loss of income.
According to Mr. Sorile's testimony, on February 26, 2013, he unloaded diesel at Shop-A-Lot 6 in Leesville, Louisiana. He explained that he felt burning in his back when he picked up a hose in order to drain the diesel out of the line. Mr. Sorile had his wife apply Bengay, a topical analgesic, to his back that evening. Mr. Sorile did report to work the next day, although he was still in pain. That evening, Mr. Sorile again had his wife apply Bengay to his back. According to Mr. Sorile, he awoke early on February 28, 2013, and got out of bed to use the restroom. Suddenly, his back pain became severe making it too painful to walk. He stated he lowered himself to the floor and crawled back to his bed. Mr. Sorile called his co-worker, Anthony Guillory, to ask who was on call because he would not be reporting to work. Contrary to Mr. Guillory's testimony, Mr. Sorile disputes that he told Mr. Guillory anything about his back during that telephone conversation.
Mr. Sorile also called Randall Cook, Lott Oil's transportation supervisor, to inform him he would not be reporting to work. Contrary to Mr. Cook's testimony, Mr. Sorile disputes that he said anything about his back during that telephone conversation.
Soon thereafter, Mr. Sorile was taken to the Emergency Room of Rapides Regional Medical Center by his wife. Mr. Sorile was evaluated by Brandi Peacock, a nurse practitioner. Contrary to Ms. Peacock's testimony, Mr. Sorile recalled reporting that the onset of his severe back pain, not his injury, occurred at home. He denies telling Ms. Peacock that he fell and injured himself at home. Mr. Sorile was diagnosed with sciatica, given a steroid injection and pain medication, and released with instructions to follow up with his primary care physician.
Mr. Sorile then called Mr. Cook again. He told Mr. Cook he had sciatica and that he needed to see his primary care physician.
The next day, March 1, 2013, Mr. Sorile sought treatment from his primary care physician, Dr. Amy Griffin, at Griffin Family Medicine Clinic. Mr. Sorile was evaluated by Elizabeth Robichaux, a physician's assistant. Similar to what he reported at the emergency room, he told her that the onset of his severe back pain occurred at home. Ms. Robichaux ordered an MRI of Mr. Sorile's lumbar spine at Central Louisiana Surgical Hospital, which was performed on March 5, 2013. Mr. Sorile was notified on March 6, 2013, that his MRI indicated the possibility of two herniated discs.
Mr. Sorile next saw a neurological surgeon, Dr. Gregory Dowd, on March 12, 2013. According to Mr. Sorile, when asked by Dr. Dowd's physician's assistant how he injured himself, not when the onset of his severe pain occurred, he revealed the incident of February 26, 2013.
On March 14, 2013, Mr. Sorile spoke via telephone to Jerry Arnold, Lott Oil's risk and safety manager, to report his work
Mr. Sorile explained at trial that he hoped he had simply pulled a muscle in his back and that it would quickly heal. He reported having back pain in the past — in 2004 and 2008 — for which he saw Dr. William McBride. Dr. McBride diagnosed him with muscle strain and/or pulled back muscles and prescribed anti-inflammatory pain medication. Mr. Sorile recalled his back pain being alleviated shortly thereafter. Mr. Sorile testified that he did not immediately report a work accident to Lott Oil because he believed the back pain he began to experience on February 26, 2013, was from a pulled muscle and that it, too, would go away, just as it had done twice before.
Dr. Dowd testified, via deposition, that on March 12, 2013, he evaluated Mr. Sorile and reviewed his MRI. Mr. Sorile reported the manner in which he injured his back as occurring at work while handling a fuel hose. According to Dr. Dowd:
On April 16, 2013, Dr. Dowd performed "a L5-S1 microdiscectomy, and a left L4-5 far lateral microdiscectomy."
Mrs. Sorile testified that she applied Bengay to her husband's lower back on two consecutive evenings before his lower-back pain became severe, and she ultimately had to bring him to the emergency room on the morning of February 28, 2013. Mrs. Sorile denied that Mr. Sorile injured himself by falling at their home.
Dr. McBride corroborated Mr. Sorile's testimony relative to his treatment for pulled back muscles in both 2004 and 2008. According to Dr. McBride, he saw Mr. Sorile once for each of the two instances, wherein he complained of experiencing lower back pain.
The WCJ found Mr. Sorile to be sincere and credited the testimonies of Peggy Sorile, Dr. McBride, and Dr. Dowd for corroborating Mr. Sorile's version of events. In his oral reasons, the WCJ elaborated:
After thoroughly reviewing the evidence in the record, being mindful of the WCJ's reasons for judgment, and applying the correct standard of review, we find that the WCJ's factual conclusions that Mr. Sorile proved a work accident and resultant compensable work-related back injury are reasonably supported by the evidence. The testimonies of Peggy Sorile, Dr. McBride, and Dr. Dowd established Mr. Sorile's veracity. While there was considerable conflicting and contradictory evidence which supported Lott Oil's position, the WCJ chose to believe Mr. Sorile and accept his position in this case. Though it is a close call, we cannot say that the WCJ was manifestly erroneous or clearly wrong. There are definitely two permissive views supported by the evidence.
Lafayette Steel Erector, Inc. v. Constance, 13-1367, p. 3 (La.App. 3 Cir. 4/16/14), 137 So.3d 1251, 1256-57. Thus, we find no merit to Lott Oil's contentions that the WCJ erred in finding that Mr. Sorile met his burden of proving a work accident, that he sustained a compensable work-related injury, and that he was entitled to workers' compensation benefits.
In its fourth assignment of error, Lott Oil contends that the WCJ erred in finding that Mr. Sorile did not violate La.R.S. 23:1208 and La.R.S. 23:1208.1. Louisiana Revised Statutes 23:1208 provides, in pertinent part:
For an employer to prevail under La.R.S. 23:1208, it must prove "`(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 benefit or payment.'" Dugas v. AutoZone, Inc., 12-727, p. 4 (La.App. 3 Cir. 12/5/12), 103 So.3d 1271, 1275, writ denied, 13-45 (La. 2/22/13), 108 So.3d 775 (quoting Burnett v. Vector Elec. & Controls, Inc., 10-81, p. 4 (La.App. 3 Cir. 6/2/10), 40 So.3d 477, 480 (quoting Resweber v. Haroil Constr.
Louisiana Revised Statutes 23:1208.1 provides:
For an employer to prevail under La.R.S. 23:1208.1, it must prove "`(1) an untruthful statement; (2) prejudice to the employer; and (3) compliance with the notice requirements of the statute.'" Dugas, 103 So.3d at 1275 (quoting Burnett, 40 So.3d at 482 (quoting Jeffers v. Kentucky Fried Chicken, 08-1380, p. 12 (La.App. 3 Cir. 4/1/09), 7 So.3d 812, 820, writ denied, 09-956 (La. 6/19/09), 10 So.3d 738)).
The WCJ justified his denial of Lott Oil's fraud allegations against Mr. Sorile, stating:
Considering these reasons and the evidence before us, we find the factual conclusions of the WCJ are reasonable. We find no merit in Lott Oil's fourth assignment of error. Further, having found no merit to Lott Oil's fourth assignment of error, we need not address whether it was error for the WCJ not to order Mr. Sorile to pay restitution for fraudulent conduct.
Lastly, Lott Oil contends the WCJ "erred in finding that [it] was liable to Blue Cross Blue Shield for the entirety of its lien for medical benefits paid to or on behalf of [Mr.] Sorile." Having found the occurrence of a work accident, Lott Oil is responsible for Mr. Sorile's medical expenses. Thus, we find no merit in Lott Oil's contention that the WCJ erred in recognizing the lien of Blue Cross Blue Shield for the amount of medical benefits it paid to or on behalf of Mr. Sorile.
For the foregoing reasons, we affirm the judgment of the Office of Workers' Compensation in its entirety and do not consider Mr. Sorile's Answer to Appeal. All
PETERS, J., concurs in the result and assigns written reasons.
PETERS, J., concurring.
I join with the majority in the decision to affirm the judgment of the workers compensation judge (WCJ) awarding workers' compensation benefits to Ronald Sorile. Additionally, I concur in the result reached in rejecting Mr. Sorile's claim for penalties and attorney fees at the trial level as well as his claim for attorney fees for work performed on appeal. However, I do not agree with the manner of disposition of the claims raised by Mr. Sorile.
Mr. Sorile raised the issues of penalties and attorney fees by filing an answer to the appeal of Lott Oil Company, Inc. (Lott Oil). The majority refuses to consider the issues raised in the answer based on their interpretation of La.Code Civ.P. art. 2088(A). Specifically, the majority reaches the conclusion that the WCJ "became divested of jurisdiction over all matters on appeal" when it granted the appeal to Lott Oil on September 22, 2014. According to the majority, from that point forward, Mr. Sorile could only file his answer to the appeal in this court. I disagree with that analysis.
The majority quotes part of the first paragraph of La.Code Civ.P. art. 2088(A) in support of their rejection of Mr. Sorile's answer to the appeal. However, the language deleted is of critical importance in interpreting that Article. The full paragraph and the pertinent language that follows the quoted language reads:
(Emphasis added.)
Thus, clearly the WCJ had not lost jurisdiction to grant an appeal to Mr. Sorile.
In this case, however, Mr. Sorile did not seek an appeal of the WCJ judgment. Instead, he chose to file an answer to the appeal as provided for in La.Code Civ.P. art. 2133(A). Compliance with that Article requires no order from the trial court, and the Article provides in part that "[t]he answer filed by the appellee shall be equivalent to an appeal on his part from any portion of the judgment rendered against him in favor of the appellant and of which he complains in his answer." (Emphasis added.) The appellee "must file an answer to the appeal, stating the relief demanded, not later than fifteen days after the return day or the lodging of the record whichever is later." Id.
The record was lodged with this court on October 31, 2014; and the return date was set first for November 24, 2014, and finally for November 30, 2014. Mr. Sorile filed his answer into the record on September 30, 2014, or well within the fifteen-day outer limit set in La.Code Civ.P. art. 2133(A). Nothing in La.Code Civ.P. art. 2133(A) requires an appellee to wait until after the lodging of the record or the return date to file an answer to the appeal, and when the record was lodged with this court, Mr. Sorile's answer was lodged as a part of that record. It is significant to
Although I find that the majority erred in not considering Mr. Sorile's answer to appeal, my review of the record before us causes me to conclude that his request for penalties and attorney fees lacks merit and that the WCJ did not err in rejecting his claims in that regard. For those same reasons, I would reject his claim for an award of attorney fees for work performed on appeal. Thus, I concur in the ultimate result reached by the majority.
The record reflects that Lott Oil filed a Motion for Suspensive Appeal in the Office of Workers' Compensation (OWC) on September 22, 2014. The WCJ granted Lott Oil's appeal on September 23, 2014. At that time, in accordance with La.Code Civ.P. art.2088, the OWC became divested of jurisdiction over all matters on appeal. Subsequently, Mr. Sorile filed an Answer to Appeal in the OWC on September 30, 2014, relative to the WCJ's denial of his claim for penalties and attorney fees and he requests an award of additional attorney fees for defending Lott Oil's appeal. Thus, the Answer to Appeal filed on behalf of Mr. Sorile in the OWC was improvidently filed in the wrong tribunal and, thus, will not be considered. See also, Smoot v. Hernandez, 08-1121 (La.App. 3 Cir. 3/4/09), 6 So.3d 352; Kelly v. Boise Bldg. Solutions, 11-1116 (La. App. 3 Cir. 5/2/12), 92 So.3d 965, writs denied, 12-1173, 12-1209 (La. 10/8/12), 98 So.3d 851.