Taylor v. TOMMIE'S NOVELTY GAMING, LLC

Citations: 978 So. 2d 1213; 2008 WL 725117Docket: 43,104-WCA

Court: Louisiana Court of Appeal; March 19, 2008; Louisiana; State Appellate Court

SummaryOriginalCytator Case TreatmentBackward CitatorAnalysis

EnglishEspañolSimplified EnglishEspañol Fácil

The case of Gregory M. Taylor v. Tommie's Novelty Gaming, L.L.C. and Bridgefield Casualty Insurance Company involves the appeal of a workers' compensation judge's (WCJ) ruling, which was remanded by the Louisiana Supreme Court. The Supreme Court directed the continuation of Taylor's claim for benefits and the employers' insurers' reconventional demands against him for fraud. Upon remand, Taylor moved to dismiss his claim and the case entirely, which the WCJ granted despite objections from the employer and one insurer. 

The case originated from two work-related injuries: the first on November 9, 2000, resulting in neck surgery, for which U.S. Specialty Insurance Company paid $40,432.12 in benefits. After returning to work, Taylor claimed a second injury on September 14, 2001, when Bridgefield Casualty Insurance Company was now the carrier. Both insurers asserted claims for forfeiture of benefits, citing Taylor's fraudulent statements in violation of La. R.S. 23:1208. 

During the original trial, Taylor was the sole witness, and following extensive examination and cross-examination, his credibility was questioned. After a motion for involuntary dismissal was made by US Specialty based on Taylor's lack of credibility and false assertions, the WCJ ruled in favor of the defendants, granting the involuntary dismissal and ordering restitution for the benefits paid and litigation costs. The appellate court found the WCJ erred in granting Taylor's dismissal, thus reversing the decision.

The court affirmed the Workers' Compensation Judge's (WCJ) involuntary dismissal in part while also reversing and affirming restitution judgments in Taylor v. Tommie's Gaming. The Louisiana Supreme Court later reversed the WCJ's procedural ruling on involuntary dismissal, determining that it was premature under La. C.C.P. art. 1672(B) because the plaintiff was not allowed to complete his case presentation before the motion was considered. Consequently, the lower court judgments were reversed, and the case was remanded for the plaintiff to present additional evidence. Following a trial date set for May 21, 2007, Taylor's counsel withdrew, and Taylor subsequently filed a pro se motion to dismiss his claim, which was granted with prejudice by the OWC, while Bridgefield's reconventional demand was dismissed without prejudice. The appellants contested the dismissal of their reconventional demand, asserting it was a compulsory demand under La. C.C.P. arts. 1031 and 1061. Additionally, La. R.S. 23:1208 governs the forfeiture of benefits for false statements made to obtain benefits, detailing associated criminal penalties, civil penalties, and conditions for forfeiture, emphasizing that benefits are forfeited if the employee is found to have willfully attempted to defraud the system without needing to show employer prejudice.

Exclusive jurisdiction over disputes under the workers' compensation act, including employer claims for overpayment of benefits, is held by the OWC judge, as established in La. R.S. 23:1310.3(E). The issue of a claimant's entitlement to benefits based on willful false statements is closely tied to the effective management of workers' compensation claims, per Clarendon Nat'l Ins. Co. v. Weston. If an incidental demand is filed before a plaintiff's motion to dismiss the principal action, the dismissal does not impact the incidental action, which must be adjudicated separately according to La. C.C.P. art. 1039. In the case at hand, the WCJ did not provide a legal foundation for dismissing the reconventional claims by Tommie's and Bridgefield. While the plaintiff, Taylor, can voluntarily dismiss his claim for benefits, he failed to cite legal authority to dismiss the reconventional action. The Louisiana Supreme Court's remand reinstated the parties in an ongoing trial, necessitating the continuation of the reconventional demands despite the dismissal of the principal action, as per La. C.C.P. art. 1039. The dismissal of the reconventional action by Tommie's and Bridgefield was deemed improper, leading to the reversal of the OWC's judgment. Consequently, all appeal costs are assigned to Gregory M. Taylor. REVERSED. US Specialty did not appeal the dismissal of its reconventional demand.