84 Lumber Company v. Hon. Allen M. Babineaux

STATE OF LOUISIANA
COURT OF APPEAL, THIRD CIRCUIT

04-620

84 LUMBER COMPANY AND LUMBERMEN’S
MUTUAL CASUALTY COMPANY

VERSUS

HONORABLE ALLEN M. BABINEAUX, IN HIS
CAPACITY AS CURATOR FOR INTERDICT, RANDALL
MARKS, NURSING CORPORATION OF AMERICA, INC.,
NURSING AMERICA, INC., OLSTEN-KIMBERLY QUALITY
CARE, BLUE CROSS AND BLUE SHIELD OF MISSISSIPPI
(d/b/a TRISPAN HEALTH SERVICES), CENTERS FOR
MEDICARE AND MEDICAID SERVICES, U.S. DEPARTMENT
OF HEALTH AND HUMAN SERVICES, JIM LETTEN, U.S.
ATTORNEY FOR THE EASTERN DISTRICT OF THE UNITED
STATES OF AMERICA, TOMMY THOMPSON, DIRECTOR OF
THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES,
OUR LADY OF LOURDES REGIONAL MEDICAL CENTER, INC.
AND OPELOUSAS GENERAL HOSPITAL

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APPEAL FROM THE
FIFTEENTH JUDICIAL DISTRICT COURT
PARISH OF LAFAYETTE, NO. 2003-3333
HONORABLE KRISTIAN EARLES, DISTRICT JUDGE

**********

OSWALD A. DECUIR
JUDGE

**********

Court composed of Sylvia R. Cooks, John D. Saunders and Oswald A. Decuir,
Judges.

AFFIRMED.

Philip E. Roberts
Roy, Bivins, Judice
P. O. Drawer Z
Lafayette, LA 70502
(337) 233-7430
Counsel for Defendant/Appellee:
Our Lady of Lourdes Regional Medical Center, Inc.

Hugh B. Exnicios, Jr.
Exnicios Legal Center
247 Exnicios Drive
Folsom, LA 70437
(985) 796-8300
Counsel for Defendant/Appellee:
Honorable Allen M. Babineaux, in his capacity as Curator for
Interdict, Randall Marks

James B. Letten
Attorney at Law
501 Magazine Street, Suite 210
New Orleans, LA 70130
(504) 680-3000
Counsel for Defendant/Appellee:
U.S. Attorney General’s Office
for the Eastern District of Louisiana

James Steven Gates
Morrow, Morrow, et al.
P. O. Drawer 1787
Opelousas, LA 70571
(337) 948-4483
Counsel for Defendant/Appellee:
Nursing America, Inc.
Nursing Corporation of America, Inc.

Donald Wayne Washington
Attorney at Law
300 Fannin Street, Room #3201
Shreveport, LA 71101
(318) 262-6618
Counsel for Defendant/Appellee:
U.S. Attorney General’s Office
for the Western District of Louisiana

Lawrence B. Frieman
Juge, Napolitano, Guilbeau, Ruli, Frieman & Whiteley
3838 N. Causeway Boulevard, Suite 2500
Metairie, LA 70002
(504) 831-7270
Counsel for Plaintiffs/Appellants:
Lumbermen's Mutual Casualty Company
84 Lumber Company

Nicholas Gachassin III
The Gachassin Law Firm
P. O. Box 80369
Lafayette, LA 70598-0369
(337) 235-4576
Counsel for Defendant/Appellee:
Opelousas General Hospital

Agent C.T. Corporation System
Agent for Service
8550 United Plaza Blvd
Baton Rouge, La 70809
Counsel for Defendant/Appellee:
Olsten-Kimberly Quality Care

Services Center of Medicare and Medicaid
7500 Security Blvd.
Baltimore, MD 21244-1850
Counsel for Defendant/Appellee:
Center of Medicare and Medicaid Services

Tommy Thompson
Director of U.S. Department of Health & Human Services
200 Independences Avenue SW
Washington, DC 20530-0001
Counsel for Defendant/Appellee:
Tommy Thompson

Gentiva Health Services, Inc.
3 Huntington Quadrangle
2 South
Melville, NY 11747-8943
Counsel for Defendant/Appellee:
Gentiva Health Services, Inc.

Trispan Health Services

Blue Cross Blue Shield of MS

John Ashcroft
U.S. Attorney General
950 Pennsylvania Ave. NW
Washington, DC 20530-0001
Counsel for Defendant/Appellee:
Department of Health & Human Resources

DECUIR, Judge.

This lawsuit stems from a workers’ compensation claim filed by Randall Marks

against his employer, 84 Lumber Company, and its insurer, Lumbermen’s Mutual

Casualty Company. After final judgment was rendered in the compensation

proceedings, 84 Lumber and Lumbermen’s Mutual filed the instant action in district

court against Marks and numerous health care providers seeking reimbursement of

medical expenses paid to or on behalf of Marks pursuant to his workers’

compensation claim. The trial court maintained Marks’ exception of res judicata and

dismissed the suit against all defendants. For the following reasons, we affirm the

dismissal of the plaintiffs’ petition.

Essentially, in the prior proceedings, the workers’ compensation judge

determined that Marks had sustained a work-related accident which caused a head

injury and resulted in disabling depression. He found temporary, total disability and

specifically awarded medical benefits for the treatment of depression. The workers’

compensation judge further ruled that Marks had not met his burden of proving with

clear and convincing evidence that the injury caused further physical problems:

[T]he court denies the remaining claims, including the
compensability of Mr. Marks’ syncope or fainting spells. Marks has had
more than twenty-four thousand documented spells, and wears a helmet
which was prescribed to prevent head injury when he falls. He falls
without protecting himself, and many of the doctors were persuaded at
one point in time that the falls were genuine. Some experts continued
to believe the falls are not feigned. However, the court finds
overwhelming evidence that there is no physical basis for the syncope
spells, and that the weight of the evidence establishes that the falls are
conscious and deliberate, and therefore that aspect of the claim will be
denied.

The decision of the Office of Workers’ Compensation was affirmed at Marks

v. 84 Lumber Co., 00-322 (La.App. 3 Cir. 10/11/00), 771 So.2d 751.

The present case involves a claim for reimbursement of medical benefits

expended for the diagnosis and treatment of Marks’ syncope episodes, a cause of

action ordinarily addressed in an administrative forum by a workers’ compensation

judge. Therefore, we first address the obvious question of whether the trial court had

jurisdiction over the subject matter of this action. This issue was raised by Marks

among other exceptions and was briefly addressed and overruled by the trial court.

In this appeal, it is raised by appellee, Opelousas General Hospital, in support of its

position that the dismissal of all health care providers was proper. We discuss the

jurisdictional question first, as a determination that the district court did not have

subject matter jurisdiction will end our review. La.Code Civ. Proc. art. 3; DeHaven

v. DeHaven, 412 So.2d 537 (La.1982); Landrum v. Board of Com'rs of the Orleans

Levee Dist., 95-1591 (La.App. 4 Cir. 11/27/96), 685 So.2d 382.

Subject matter jurisdiction may be raised at any stage of litigation or may be

recognized by a court on its own motion. La. Code Civ. Proc. art. 925; Nerness v.

Christian Fidelity Life Ins. Co., 98-1827 (La. App. 3 Cir. 4/21/99), 733 So.2d 146.

The workers’ compensation statute specifically grants exclusive jurisdiction to the

workers’ compensation courts of all claims or disputes arising under that statute. La.

R.S. 23:1310.3(E) provides:

Except as otherwise provided by R.S. 23:1101(D) and 1378(E),
the workers' compensation judge shall be vested with original, exclusive
jurisdiction over all claims or disputes arising out of this Chapter,
including but not limited to workers' compensation insurance coverage
disputes, employer demands for recovery for overpayment of benefits,
the determination and recognition of employer credits as provided for in
this Chapter, and cross-claims between employers or workers'
compensation insurers for indemnification or contribution.

In addressing jurisdictional questions which arise under this statute, the courts

distinguish between matters arising within the context of the workers’ compensation

laws and cases which merely relate to a compensation claim. In Broussard, Bolton,

Halcomb & Vizzier v. Williams, 01-0219 (La. App. 3 Cir. 10/3/01), 796 So.2d 791,

a fee dispute between two attorneys who represented a workers’ compensation

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claimant was found to be outside the jurisdiction of the OWC. In Covington v. A-

Able Roofing, Inc., 95-1126 (La.App. 3 Cir. 3/6/96), 670 So.2d 611, the court found

the OWC did not have subject matter jurisdiction in a case involving the Business

Corporation Law, La.R.S. 12:1 et seq. By contrast, this court in Ellender’s Portable

Bldgs, Inc. v. Cormier, 00-1724 (La. App. 3 Cir. 6/6/01), 787 So.2d 601, held the

OWC has jurisdiction over a petition to nullify a compensation settlement. Similarly,

in Lee v. M & O, Inc., 00-1497 (La. App. 3 Cir. 2/28/01), 782 So.2d 124, writ denied,

01-1253 (La. 6/15/01), 793 So.2d 1249, an employer’s action to recoup an

overpayment of benefits was held to be within the jurisdiction of the OWC.

Nunez v. Loomis Fargo & Co., 00-2519 (La. App. 4 Cir. 1/23/02), 807 So.2d

1063, writ denied, 02-0574 (La. 5/24/02), 816 So.2d 307, was a third party tort suit

in which a compensation carrier intervened to recover compensation and medical

benefits paid and a credit for future payments. The fourth circuit held the district

court did not have jurisdiction to determine the issue of future credits, “a matter that

arises out of the Worker’s Compensation Act, and not merely a question that

tangentially relates to worker’s compensation in general.” 00-2519, p. 14, 807 So.2d

at 1070-71.

Specifically when faced with an employer’s suit to recover benefits previously

paid to a claimant as a result of the claimant’s fraudulent acts, the courts have found

the workers’ compensation judge to have exclusive jurisdiction, based on the current

statutory language providing for such. See, Our Lady of the Lake Regional Medical

Center v. Helms, 98-1931 (La.App. 1 Cir. 9/24/99), 754 So.2d 1049, 1052-1053, writ

denied, 99-3057 (La. 1/7/00), 752 So.2d 863. The second circuit cited Our Lady of

the Lake with approval and held:

An employer, under the quasi contractual obligation of unjust
enrichment, is entitled to recover benefits wrongly paid as the result of

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fraud. Where one is unjustly enriched at the impoverishment of another,
without cause, the value of that enrichment must be restituted. Our
Lady of the Lake, supra, citing Minyard v. Curtis Products, Inc., 251 La.
624, 205 So.2d 422 (1967); and La. C.C. arts. 2298 and 2299.
Accordingly, the 1997 amendment does not change the law
substantively, but only sets forth that the Office of Workers’'
Compensation has jurisdiction to award a reimbursement of benefits.

Yarnell Ice Cream Co. v. Allen, 33,020 (La.App. 2 Cir. 5/10/00), 759 So.2d 1066,

1071, writ recalled, 00-1520 (La. 1/17/01), 777 So.2d 472. Subsequently, in Allen

v. Fireman’s Fund Ins. Co., 36,606 (La. App. 2 Cir. 11/6/02), 830 So.2d 1120, writ

denied, 02-2981 (La. 2/14/03), 836 So.2d 114, the second circuit again held the

OWC, not the district court, has jurisdiction to resolve disputes arising out of this

state’s compensation laws. See also, Yarnell Ice Cream Co. V. Allen, 38,262 (La.

App. 2 Cir. 3/3/04), 867 So.2d 969.

The instant case involves issues arising under the workers’ compensation laws,

including such questions as the claimant’s right to diagnostic testing, and the medical

distinction between his compensable depression and his non-compensable fainting

syndrome. We find the workers’ compensation court has exclusive jurisdiction of the

controversy presented herein. Consequently, because the trial court was without

jurisdiction to hear the case before it, the judgment dismissing the proceedings in

favor of all defendants, albeit on other grounds, is affirmed.

Costs of this appeal are assessed to the plaintiffs.

AFFIRMED.

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