In a workers’ compensation case before the Louisiana Fourth Circuit Court of Appeal, the court addressed whether an injured employee’s back pain was due to a work-related accident.
Deborah Gaines worked as a caregiver for Home Care. While working for a client, Ms. Gaines alleged she was bitten on her right leg by the client’s dog. This bite forced her to jump backward in a twisting motion, leading to injuries to her right leg and back. She reported the accident to Home Care the next day, and she was treated for the dog bite. While Ms. Gaines contended that she repeatedly informed her employer of her ongoing back pain from the dog bite accident, Home Care denied that a work-related accident caused her back injury. They denied her indemnity and medical benefits.
Ms. Gaines then filed a disputed claim for compensation in an effort to recover benefits and medical expenses. The case went to trial, and the Office of Workers’ Compensation found that Ms. Gaines carried her burden of proving she suffered a work-related accident, causing an injury to her back at the time the dog bit her. The court found she was temporarily totally disabled from employment and rendered judgment in favor of Ms. Gaines.
The court stated that Louisiana workers’ compensation laws require that an employee’s injury must have resulted from a work accident arising out of and in the course of employment. The rule of law regarding causation is that the employment causes the accident, the accident causes the injury, and the injury results in the disability.
While workers’ compensation laws are liberally interpreted in favor of the worker, it is the worker who bears the burden of proving the injury by a preponderance of the evidence.
First, Home Care contended that the court incorrectly found that Ms. Gaines proved an “accident” under the law. They argued that she proved she suffered an injury to her right leg when the dog bit her, but she did not show that the accident in fact caused her back injury. Home Care also contended that the medical records made clear that Ms. Gaines’ back pain was unrelated to the dog-bite accident.
The court stated the rule that a witness’ uncontradicted testimony should be accepted as true.
The court stated that Ms. Gaines’ testimony about the dog bite accident, and her claim of a back injury, was credible. She recalled stating to medical personnel that she twisted her back when the dog bit her. She also testified that she repeatedly complained to employees of her back pain, and she related the onset of her pain to the dog-bite accident. Furthermore, there was no evidence that Ms. Gaines suffered from a pre-existing back condition.
The court stated that based on the totality of the record, the lower court was not manifestly erroneous or clearly wrong in finding that Ms. Gaines’ back injury was a result of the work-related dog bite. This “accident” under the Louisiana Workers’ Compensation Act was found to have caused Ms. Gaines’ back injury.
Home Care also alleged that Ms. Gaines had not suffered a temporary total disability due to her back injury. The law requires that to prove entitlement to temporary total disability benefits, an employee must prove they are physically unable to engage in employment. Medical and lay testimony can prove disability.
Home Care contended that Ms. Gaines had not presented objective medical evidence of her back pain, and she was discharged and able to return to work without restriction after the dog bite.
The law holds that regarding the ultimate issue of whether the claimant can work, a court cannot base their determination of a claimant’s physical limitations solely on self-serving testimony. Louisiana law holds that injured workers may receive temporary total disability benefits from the date of their disabling injury until they show a change in status. Here, the appellate court stated the Office of Workers’ Compensation did not commit error in finding that Ms. Gaines proved she was medically incapable of performing employment.
After reviewing the medical records, the court stated that they reflected that Ms. Gaines received treatment for back pain from the dog-bite accident for about two months. The most recent medical findings had placed Ms. Gaines on a disabled, no-work status. Here, Home Care failed to present objective evidence challenging the contention that Ms. Gaines’ back injury rendered her temporarily totally disabled and unable to work.
Under Louisiana law, if the defendant does not present evidence that the employee was able to return to work, or that her physician released her to return to work, there is no ground for changing her status. Here, Home Care did not present evidence supporting a change in Ms. Gaines’ temporary total disability status. The court held there was no error in the lower court’s finding that Ms. Gaines was temporarily totally disabled and entitled to indemnity benefits. The court affirmed the award of past temporary total disability benefits for $39,130.00.
Regarding the award of medical expenses, the appellate court stated that the employer must furnish all necessary medical treatment caused by work-related injuries. In order to recover medical costs, a workers’ compensation claimant must prove, by a preponderance of the evidence, that the expenses are reasonably necessary for treating the work-related injury. It must be proven that the treatment is necessary and that there is a causal connection between the treatment and the work-related accident. The court affirmed the award of past and future medical expenses, to the extent they were medically necessary and related to Ms. Gaines’ back injury.
In conclusion, the court affirmed the Office of Workers’ Compensation’s finding that Ms. Gaines suffered a work accident and resulting back injury.
The workers’ compensation attorneys at Lavis Law provide legal guidance and representation to injured workers throughout Louisiana. We help individuals seeking compensation after suffering injuries in a work-related accident. We provide a free consultation, and our office can be reached by calling 866.558.9151.
More Blog Posts: