Crown Zellerbach Corp. v. LA. WORKMEN'S COMP. SECOND INJURY BD.
Docket: CA 84 1081
Court: Louisiana Court of Appeal; December 25, 1985; Louisiana; State Appellate Court
Crown Zellerbach Corporation appealed a judgment denying reimbursement from the Louisiana Workmen's Compensation Second Injury Fund for benefits paid to Lonnie Hall, Sr., who sustained a torn rotator cuff on January 27, 1982, while working. Hall, 59, developed a significant disability due to the injury and declined surgery, allegedly influenced by preexisting conditions, including diabetes. The corporation claimed that Hall's preexisting disabilities exacerbated his situation, making the resultant disability from the shoulder injury more severe.
After a hearing, the Louisiana Workmen's Compensation Second Injury Board found insufficient evidence that Hall's preexisting conditions affected his decision against surgery. The trial court upheld this finding, and the appeal was subsequently affirmed, confirming that the evidence did not demonstrate a merger of Hall's preexisting diabetes with his shoulder injury to warrant reimbursement under LSA-R.S. 23:1371 and 23:1378. The statutes stipulate that for an employer to seek reimbursement, they must prove that a preexisting permanent partial disability existed and that it materially affected the outcome of a subsequent injury. The court concluded that Crown Zellerbach failed to establish these necessary elements.
Plaintiff argues that the trial court erred in ruling that Mr. Hall did not have preexisting diabetes, which the defendant admitted in their response to the petition, constituting a judicial confession under LSA-C.C. art. 1853. This admission negates the need for the plaintiff to provide further evidence of Mr. Hall's diabetes. The plaintiff also claims the trial court should have acknowledged that the defendant had knowledge of Mr. Hall's preexisting condition, as outlined in LSA-R.S. 23:1378(A) and (F). Testimony indicated that information about Mr. Hall's diabetes was in his personnel file, though it was unclear if someone with hiring authority had seen it. Nevertheless, the defendant did not contest the plaintiff's supposed knowledge of the condition.
The court needed to determine if the preexisting diabetes merged with Mr. Hall’s rotator cuff tear. The plaintiff suggested that Mr. Hall declined surgery for his rotator cuff due to his diabetes, but Mr. Hall did not testify. The trial court noted the plaintiff failed to demonstrate the severity of Mr. Hall's diabetes, which would be critical in assessing its impact on his surgical decisions. Medical experts testified that they lacked firsthand knowledge of the extent of Mr. Hall's diabetes, and the trial court emphasized that age and other conditions were significant factors in the medical reports.
Dr. Daniel S. Sinclair, who examined Mr. Hall, indicated that while he explained the risks and benefits of surgery to Mr. Hall, the final decision was left to him. Dr. Sinclair characterized the surgical outcomes for rotator cuff repairs as generally poor, stressing the associated risks, particularly for a 60-year-old with diabetes and other health issues. He advised that if Mr. Hall could manage his pain and function adequately without surgery, it might be better to avoid the procedure, highlighting that diabetes would elevate the surgical risks, including complications from anesthesia and healing issues.
Dr. Roger P. Blitz, an orthopedic surgeon, assessed Mr. Hall and indicated that he would have recommended surgery if not for Mr. Hall's prior medical issues. He advised Mr. Hall to consult his family physician regarding the surgery. Dr. Blitz noted that rotator cuff surgery often has suboptimal outcomes, leading to a determination that evidence does not support the claim that Mr. Hall's diabetes influenced his decision to decline surgery. No evidence was presented to indicate that diabetes affected the severity of the rotator cuff tear or the potential for surgical repair. It was only suggested that recovery might be prolonged due to diabetes. Dr. Sinclair added that surgery does not guarantee a return to normal shoulder function, and even a healthy individual might not benefit from the procedure.
The court agreed with the defense that a causal connection between Mr. Hall's preexisting condition and the injury must be established, demonstrating that the combined effect of both injuries resulted in a significantly greater disability than the second injury alone. The existing record did not indicate such a merger, leading the court to affirm the trial court's denial of Mr. Hall's claim, with costs of the appeal assigned to him.
The excerpt also references Louisiana statutory requirements regarding employer notifications and appeal processes related to workers' compensation.
