Rothell v. City of Shreveport

Citations: 626 So. 2d 763; 1993 WL 431215Docket: 25,182-CA

Court: Louisiana Court of Appeal; November 30, 1993; Louisiana; State Appellate Court

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Roy Rothell, a retired Deputy Fire Chief of Shreveport, filed a workers' compensation claim after suffering a heart attack and undergoing bypass surgery, asserting his heart and lung conditions were occupational diseases under the Heart and Lung Act (R.S. 33:2581). After a hearing, the officer ruled in favor of the City, finding the City had successfully rebutted the presumption that Rothell’s heart condition was work-related. 

Key findings included that Rothell had a long history of heart and lung disease, attributed to several risk factors: a 20-year smoking history, hypertension, hypercholesterolemia, a family history of cardiovascular issues, and being male over 55. Although stress from his role might have aggravated his hypertension, it was deemed a minor factor in heart attack development. The hearing officer concluded that all major risk factors stemmed from Rothell's lifestyle and heredity, not his employment as a firefighter. 

Rothell also appealed a denial for reduction of appeal costs. The Heart and Lung Act states that any heart or lung disease developing during employment in classified fire service is considered work-related, granting affected employees rights equivalent to those suffering from an occupational disease.

A prima facie presumption exists that any disease or infirmity, particularly heart or lung disease, developed during a firefighter's employment if it manifests after five years of tenure. This presumption, established by LSA-R.S. 33:2581, shifts the burden of proof to the employer to demonstrate that the disease was not caused by the nature of the firefighter's work. The employer must provide affirmative evidence to rebut this presumption, which is generally considered difficult to overcome. The claimant is not required to prove that employment was the sole cause of the heart injury; it suffices to show that it was a contributing, accelerating, or aggravating factor.

In the case of Rothell, who served as a firefighter for over 42 years, his heart disease did not manifest in the early years of his employment. Therefore, the legal question focuses on whether the City of Shreveport successfully rebutted the statutory presumption of causation. Testimonies from expert witnesses, including Dr. Robert C. Hernandez and cardiologist Dr. Jim Haisten, indicated that the stress associated with Rothell's job likely accelerated his hypertension and contributed to his cardiac event, despite Dr. Hernandez acknowledging that the heart attack could have occurred regardless of his occupation.

Dr. Hernandez's December 7, 1990, response indicated that Mr. Rothell's hypertension significantly contributed to his atherosclerotic cardiovascular disease and heart attack, exacerbated by occupational stress related to his roles as an Administrator and Fire Fighter. Both Dr. Hernandez and Dr. Haisten acknowledged Rothell's pre-existing heart disease and the potential impact of workplace stress on his risk factors. In contrast, Dr. Thomas Allen Brown, a cardiologist for the City of Shreveport, testified that he did not believe stress caused Rothell's heart attack, citing his unfamiliarity with firefighting duties and the lack of evidence linking stress to the development of atherosclerosis. Although he recognized that stress aggravates hypertension, Dr. Brown attributed Rothell's heart disease primarily to personal health factors, including severe hypertension, high cholesterol, a history of smoking, and age. Nonetheless, he could not completely dismiss the role of stress from Rothell's job. The hearing officer's ruling that the City rebutted the presumption of work-related causation was deemed erroneous. Consequently, Rothell was awarded $279 per week in workers' compensation benefits and coverage for medical expenses. Additionally, Rothell claimed penalties and attorney's fees due to the City’s refusal to pay benefits, which could be justified if the employer had sufficient evidence to contest the claim, as established in relevant case law.

A claimant is entitled to attorney fees if benefits are denied arbitrarily, capriciously, or without probable cause, as outlined in LSA-R.S. 23:1201.2 and relevant case law, including Green v. Jackson Rapid Delivery Service, Inc. Under LSA-R.S. 23:1201 E, if compensation installments are not paid within the specified period, a penalty of 12% is added unless nonpayment is due to uncontrollable conditions. The statute also states that if an insurer or employer fails to pay claims within 60 days of written notice and such failure is deemed arbitrary, capricious, or without probable cause, they must pay reasonable attorney fees for claim collection. The case involves a determination of whether the City of Shreveport had reasonable grounds to contest Rothell's claim for compensation and medical expenses. To rebut the presumption that Rothell's atherosclerosis and subsequent heart attack were work-related, the employer must present evidence that employment did not contribute to the condition. Previous rulings, such as McKenzie, clarify that the employer bears the burden of proof in these situations. In the current case, claims manager Robert A. Marts handled Rothell's claim but did not formally deny it and did not make payments. Marts was aware of Rothell's claim by December 1990 and received pertinent medical reports in early 1991, before relying on a report from Dr. Brown in August 1991 to inform his decisions.

Dr. Brown's report indicated that while Rothell's cardiovascular disease was influenced by various factors, it did not rule out employment as a contributing factor to the atherosclerosis leading to his myocardial infarction. Prior to receiving this report on August 14, 1991, the City of Shreveport lacked justification for failing to comply with LSA-R.S. 23:1201 E regarding nonpayment of benefits. The City did not demonstrate that its nonpayment was due to uncontrollable circumstances, and after receiving Dr. Brown's report, it had no reasonable basis to deny that Rothell's employment contributed to his injury. Consequently, Rothell was found entitled to statutory penalties under LSA-R.S. 23:1201 E, and the City was deemed arbitrary and capricious in its failure to pay the claim within sixty days, lacking any supporting medical evidence. Rothell is also entitled to reasonable attorney's fees.

The judgment of the administrative hearing officer was reversed, with the City ordered to pay Rothell medical expenses and workers' compensation benefits of $267.00 per week starting July 31, 1990, along with legal interest on past due amounts. The City must also pay penalties as per LSA-R.S. 23:1201 E and $3,000 in attorney's fees, with appeal costs assessed against the City. A subsequent amendment corrected an error in the weekly compensation amount to $267.00, as per the parties' stipulation at trial, while all other rehearing requests were denied. The summary of legal precepts regarding causation in heart-related worker injuries was also included.