James Lynch v. a Door Works, Inc.

STATE OF LOUISIANA

COURT OF APPEAL, THIRD CIRCUIT

11-414

JAMES LYNCH

VERSUS

A DOOR WORKS, INC.

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APPEAL FROM THE
OFFICE OF WORKERS’ COMPENSATION, DISTRICT 03
PARISH OF CALCASIEU, NO. 08-05111
HONORABLE CHARLOTTE L. BUSHNELL,
WORKERS’ COMPENSATION JUDGE

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JAMES T. GENOVESE
JUDGE

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Court composed of John D. Saunders, J. David Painter, and James T. Genovese,
Judges.

AFFIRMED AND RENDERED.

Kathleen W. Will
Briney Foret Corry
413 Travis Street
Suite 200
Post Office Drawer 51367
Lafayette, Louisiana 70505-1367
(337) 237-4070
COUNSEL FOR DEFENDANT/APPELLANT:
A Door Works, Inc.

Mark Zimmerman
4126 Lake Street
Lake Charles, Louisiana 70605
(337) 474-1644
COUNSEL FOR PLAINTIFF/APPELLEE:
James Lynch

GENOVESE, Judge.

In this workers’ compensation case, employer, A Door Works, Inc. (Door

Works), appeals a judgment of the workers’ compensation judge (WCJ) rendered

in favor of its former employee, James Lynch. Mr. Lynch has answered the

appeal, seeking attorney fees for legal work done on appeal. For the following

reasons, we affirm and award $3,500.00 in attorney fees on appeal.

FACTUAL AND PROCEDURAL BACKGROUND

Mr. Lynch was employed with Door Works from October 27, 2007, until

March 6, 2008. Mr. Lynch states that while working on December 12, 2007, he

began feeling discomfort in his abdomen. Mr. Lynch claims that he initially

believed his discomfort was simply a stomach cramp, and he continued working.

Over the course of the next few days, however, and specifically after straining to

lift a door on December 15, 2007, Mr. Lynch claims that his abdominal discomfort

became more painful.

On December 17, 2007, Mr. Lynch reported his injury to Joy Abshire, part-

owner of Door Works. Mr. Lynch sought medical treatment at Sulphur Urgent

Care and was evaluated by Dr. Dwayne Helms. He was diagnosed as having a

hernia. Dr. Helms referred Mr. Lynch to Sulphur Surgical Care, where he was

evaluated by Dr. A. Kent Seale. According to Dr. Seale’s medical report,

Mr. Lynch had “an incarcerated hernia two fingers above the umbilicus,” and

“surgical repair” was recommended.

Mrs. Abshire reported Mr. Lynch’s injury to Summit Claims (Summit), the

workers’ compensation administrator for Door Works. Summit commenced an

investigation into Mr. Lynch’s claim purportedly due, in part, to Mrs. Abshire’s

report that Mr. Lynch stated he had been diagnosed as having a hernia years earlier

and, in part, because Mr. Lynch allegedly reported to his sister, also an employee

at Door Works, that his injury was to his lower back. Surgery to repair

Mr. Lynch’s hernia was not authorized pending Summit’s investigation. From

December 20, 2007, until March 6, 2008, Mr. Lynch worked in a light duty

capacity at Door Works.

Mr. Lynch filed a Disputed Claim for Compensation on June 6, 2008,

asserting that he was wrongfully denied medical treatment and seeking indemnity

benefits, penalties, and attorney fees based on Door Works’ failure to reasonably

controvert his claim. On August 26, 2008, Door Works answered Mr. Lynch’s

claim, denying that his injury was job-related. Door Works then filed a

reconventional demand, asserting that Mr. Lynch committed workers’

compensation fraud pursuant to La.R.S. 23:1208.

At the September 1, 2010 trial, the parties stipulated: (1) that Mr. Lynch

worked for Door Works from October 27, 2007 through March 6, 2008; (2) that

from December 20, 2007 through March 6, 2008, he worked in a light duty

capacity; (3) that no indemnity benefits were paid subsequent to March 6, 2008;

(4) that except for some initial medical expenses, no other medical expenses have

been paid; (5) that no hernia surgery recommended by Dr. Seale has been

authorized or paid; and (6) that Mr. Lynch’s average weekly wage was $662.95.

At the close of testimony, the matter was taken under advisement. Oral reasons for

judgment were rendered on November 29, 2010. Therein, the WCJ found that

Mr. Lynch sustained an accident within the course and scope of his employment

during the week of December 11, 2007, and December 15, 2007, which caused him

injury, thus making that injury compensable under the workers’ compensation

statute. The WCJ denied Door Works’ reconventional demand and granted

Mr. Lynch’s request for penalties and attorney fees. The WCJ awarded a

$2,000.00 penalty for failure to pay indemnity benefits, a $2,000.00 penalty for
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failure to pay medical benefits, and $14,000.00 in attorney fees. A written

judgment was rendered in accordance with these findings.

Door Works has filed a suspensive appeal, claiming that the following

findings made by the WCJ are not supported by the record, are manifestly

erroneous, and require reversal: (1) that Mr. Lynch sustained a hernia as a result of

an accident arising out of the course and scope of his employment with Door

Works; (2) that Mr. Lynch did not commit workers’ compensation fraud pursuant

to La.R.S. 23:1208; (3) that Mr. Lynch is entitled to workers’ compensation

benefits available to him under Louisiana’s Workers’ Compensation Act; and (4)

that Mr. Lynch is entitled to penalties and attorney fees for Door Works’ failure to

pay indemnity benefits and medical expenses. Mr. Lynch has answered Door

Works’ appeal, requesting additional attorney fees for work done on this appeal.

LAW AND DISCUSSION

The standard of review applied in workers’ compensation cases to a WCJ’s

finding of fact is the “manifest error–clearly wrong” standard. Dean v. Southmark

Constr., 03-1051, p. 7 (La. 7/6/04), 879 So.2d 112, 117. The court of appeal may

not set aside the findings of the WCJ “unless they are found to be clearly wrong in

light of the record reviewed in its entirety.” Id. (quoting Alexander v. Pellerin

Marble & Granite, 93-1698, pp. 5-6 (La. 1/14/94), 630 So.2d 706, 710). “[E]ven

where the appellate court is convinced it would have weighed the evidence

differently if it had been sitting as trier, the court of appeal may not reverse if the

factfinder’s findings are reasonable in light of the record reviewed in its entirety.”

Winford v. Conerly Corp., 04-1278, pp. 15-16 (La. 3/11/05), 897 So.2d 560,

569-70.

Louisiana Revised Statutes 23:1021(1) defines an “accident” as an

“unexpected or unforeseen actual, identifiable, precipitous event happening
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suddenly or violently, with or without human fault, and directly producing at the

time objective findings of an injury which is more than simply a gradual

deterioration or progressive degeneration.” In order to secure workers’

compensation benefits, the employee must prove the existence of a work-related

accident and that the accident is causally related to the complained of disability.

Dousay v. Dousay Floor Covering, 07-195 (La.App. 3 Cir. 9/12/07), 966 So.2d

677, writ denied, 07-2023 (La. 12/7/07), 969 So.2d 639.

In determining that Mr. Lynch’s injury was compensable under the workers’

compensation statute, we note that the WCJ was particularly persuaded by the

medical evidence corroborating Mr. Lynch’s testimony and that the WCJ was not

convinced by the testimony of his employer and co-workers who disputed

Mr. Lynch’s injury claim. In oral reasons for judgment, the WCJ reached the

following conclusion:

Mrs. Abshire testified that claimant was a good and
orderly worker. Furthermore, he had no problems doing
his job, nor did he complain of pain. Although there
seems to be some confusion as to whether claimant
injured his back or his injuries resulted from a pre-
existing hernia, claimant was placed on light duty until
March 2008.

....

None of the workers working the job with the
claimant confirmed that the claimant was injured on the
job. However, there is no indication that the claimant
sustained a hernia at dinner or elsewhere after work hours.
Instead, the medical evidence supports that the claimant,
Mr. Lynch, has a ventral hernia/acute onset after lifting.
Therefore, the [c]ourt finds that even if claimant has a
previous hernia, he was able to work his job satisfactorily
until the Target incident.

Based on the evidence presented, the [c]ourt finds
that the claimant, James Lynch, is entitled to workers’
compensation benefits available to him under the
Workers’ Compensation Act. Proof is sufficient to show
that there is a causal relationship between claimant’s
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hernia and the work accident. The claimant has
established, by a preponderance of the evidence, that the
injuries he suffered were caused as he installed rolling
steel doors in the Target Store in Lafayette. The
corroborative testimony supports the claimant’s position
from a medical standpoint. Furthermore, the accident was
reported[,] claimant was sent to the doctor, and he was
placed on light duty. The conflicting testimony of
claimant’s co-workers lead to more questions than real
answers. As a result, the [c]ourt finds the claimant did not
commit workers’ compensation fraud[,] but, instead, he
proved a work[-]related accident by a preponderance of
the evidence. . . .

Although there is contradictory and disputed evidence with regard to

Mr. Lynch’s version as to how and when his injury occurred, we conclude that the

WCJ clearly articulated a reasonable basis for its decision to rule in favor of

Mr. Lynch, and we cannot say that such a finding is manifestly erroneous or

clearly wrong.

Moreover, it is well established that “[a] worker’s preexisting condition does

not bar his or her recovery under the workers’ compensation laws because an

employer takes the worker as he finds him or her. An abnormally susceptible

worker is entitled to no less protection under the workers’ compensation statute

than a healthy worker.” Halker v. Am. Sheet Metal, 03-678, pp. 3-4 (La.App. 3

Cir. 12/10/03), 861 So.2d 740, 743 (citations omitted) (quoting Baker v. Conagra

Broiler Co., 93-1230, p. 8 (La.App. 3 Cir. 5/4/94), 640 So.2d 494, 498, writ

denied, 94-1435 (La. 9/23/94), 642 So.2d 1289). It is important to note that prior

to the week of his alleged injury, Mr. Lynch exhibited no problems working. It is

reasonable to conclude that the events of that week may have caused Mr. Lynch’s

hernia or, at the very least, may have aggravated his preexisting hernia. In either

event, Mr. Lynch would not be precluded from receiving workers’ compensation

benefits.

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The factual conclusions reached by the WCJ are reasonable and are

supported by the evidence. After thoroughly reviewing the evidence in the record

and considering the WCJ’s detailed reasons for judgment, we find that the WCJ

was not manifestly erroneous or clearly wrong in her determination that Mr. Lynch

met the requisite burden of proof for entitlement to workers’ compensation benefits

and that Door Works failed to prove fraud on the part of Mr. Lynch. We also find

no error in the WCJ’s determination that Mr. Lynch is entitled to penalties and

attorney fees for Door Works’ failure to pay indemnity benefits and medical

expenses.

Answer to Appeal

The WCJ awarded Mr. Lynch attorney fees. Mr. Lynch requests additional

attorney fees for work done on this 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). Having affirmed the judgment of the WCJ, we

award $3,500.00 for attorney fees on appeal.

DECREE

For the foregoing reasons, the judgment of the WCJ is affirmed in all

respects. We award Mr. Lynch $3,500.00 in attorney fees for work done on this

appeal. All costs of this appeal are assessed against A Door Works, Inc.

AFFIRMED AND RENDERED.

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