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Tanner v. International Maintenance Corp.

Citations: 602 So. 2d 1133; 1992 WL 163548Docket: CA 91 1362

Court: Louisiana Court of Appeal; June 29, 1992; Louisiana; State Appellate Court

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In the case of Glenn Tanner v. International Maintenance Corporation, the Court of Appeal of Louisiana addressed an appeal concerning a judgment that awarded compensation benefits to Tanner for temporary total disability and medical expenses, while denying penalties and attorney's fees. The court reversed the compensation award but affirmed the medical and prescription expenses. 

Tanner, a pipefitter for IMC, sustained a foot injury on May 17, 1990, when a steel door fell on his foot. He reported the injury immediately and initially received first aid without seeing a doctor. Following continued pain, Tanner visited Dr. Thibodeaux on May 21, who allowed him to return to work on light duty. Over the following months, Tanner saw several doctors, including Dr. Fraiche and Dr. Griffith, who diagnosed a soft tissue injury and recommended light duty work with restrictions on standing and walking. Despite undergoing various treatments, including a walking cast, Tanner's complaints of pain were deemed disproportionate to his physical injuries, and no objective symptoms were found.

Tanner later sought further treatment from Dr. Adatto, who also found no objective evidence to support Tanner's complaints. Tanner's ongoing dissatisfaction with his condition and treatment continued to be noted. The court ultimately concluded that while Tanner was entitled to medical expenses, the evidence did not support his claim for temporary total disability benefits.

Tanner returned to Dr. Adatto's office on December 5, 1990, after an evaluation by Dr. Palmer, who had conducted EMG and nerve conduction studies supporting Tanner's complaints. Dr. Adatto deemed Tanner totally disabled until a definitive diagnosis and treatment plan were established but acknowledged that his assessment was based on Tanner's previous role as a pipefitter. He indicated that Tanner could perform sedentary work if a light-duty position was available and considered himself Tanner's treating physician, with plans for a follow-up appointment on January 11, 1991.

Dr. Palmer first examined Tanner on October 15, 1990, diagnosing him with possible superficial nerve injury and tarsal tunnel syndrome. Subsequent tests revealed Tanner did not have tarsal tunnel syndrome but exhibited neuropathy, which required further study of the opposite leg to assess accident-related causes. Additional tests performed on December 3, 1990, showed Tanner was anemic and had a vitamin B-12 deficiency, leading Dr. Palmer to recommend a Schilling Test to check for pernicious anemia, which had not yet been completed by trial time. Dr. Palmer concluded that Tanner had a pre-existing undiagnosed neuropathy complicating his foot injury, but expected recovery within two to three months with vitamin therapy. She advised against climbing or working at heights but placed no restrictions on sedentary work.

Tanner’s supervisors indicated that IMC offered him light-duty work in a 'seal room,' where he could observe machinery while seated and with his foot elevated. Tanner claimed he could only wear supportive tennis shoes and therefore could not accept the job due to a supposed requirement for safety boots. However, IMC's supervisors confirmed that Tanner was permitted to work in tennis shoes, as the safety boot requirement was waived for him in that area. Tanner earned $9.91 per hour in the 'seal room,' slightly higher than his pre-accident wage of $9.66 per hour, with his last full workday being July 11, 1990. IMC communicated the availability of the 'seal room' position and the waiver of the safety boot requirement, encouraging Tanner to return to work.

Tanner filed a claim for benefits on July 13, 1990, after not returning to work following an accident. He was employed as a marshall at Louisiana State University and was paid for supervising a plumbing job after the incident. A trial on December 20, 1990, resulted in a judgment favoring Tanner, ordering IMC to pay for temporary total disability (TTD) and medical expenses. IMC appealed, raising three errors: 

1. The hearing officer improperly applied evidentiary rules regarding the burden of proof.
2. TTD benefits were granted for over six months without applying rules for Supplemental Earnings Benefits (SEB).
3. An award for medical expenses was made for unnecessary treatment related to the litigation.

In response to the first assignment of error, IMC contended that the hearing officer misapplied the burden of proof, which is on the claimant to establish the work-related nature of the accident, its causation of injury, and the resulting disability. The officer concluded Tanner met this burden. Under LSA-R.S. 23:1221(1), the claimant must prove temporary total disability by clear and convincing evidence, demonstrating physical inability to work, a standard made more stringent by amendments effective January 1, 1990. Although the claimant can show an accident occurred and injury sustained by a preponderance of evidence, without clear and convincing proof of inability to engage in any employment, the claim for TTD benefits cannot succeed. LSA-R.S. 23:1031 A affirms that employees suffering personal injury by accident during employment are entitled to compensation under specified conditions.

The statute outlines the requirements for a claimant to qualify for coverage under the Workers' Compensation Act. An employee must meet the criteria established by LSA-R.S. 23:1031 to be eligible for medical and/or disability benefits (LSA-R.S. 23:1203 and LSA-R.S. 23:1221). For temporary total disability benefits, the claimant must provide clear and convincing evidence of inability to engage in any employment, as specified in LSA-R.S. 23:1221(1). The court found that the hearing officer incorrectly applied a preponderance of the evidence standard instead of the required clear and convincing evidence standard regarding Tanner's claim of physical inability to work.

Upon reviewing the evidence, including lay and expert testimonies, it was determined that Tanner did not meet his burden of proof. Medical opinions unanimously indicated that he was capable of performing sedentary work during the period for which he sought disability benefits. Additionally, IMC had suitable work available for Tanner within his medical restrictions. Tanner's claim of being unable to wear safety boots was contradicted by testimony from IMC supervisors, who confirmed that the boot requirement was waived for him.

Consequently, the court concluded that Tanner was not totally disabled as defined by the statute and reversed the hearing officer's decision to award temporary total disability benefits. Regarding additional claims, the court opted not to address the duration of benefits exceeding six months, as well as IMC's assertion about the hearing officer's failure to apply supplemental earnings benefit rules, noting Tanner's earnings would not have decreased had he accepted IMC's job offer. Finally, the court found the hearing officer erred in awarding medical expenses that were not for necessary treatment but rather for litigation preparation, clarifying that necessary medical expenses are only covered if proven by a preponderance of the evidence following a work-related injury.

Tanner sustained an injury to his right foot from a work-related accident and is entitled to necessary medical expense payments. IMC paid for visits to Drs. Thibodeaux, Fraiche, and Griffith, claiming fulfillment of their obligation. However, IMC disputes the reimbursement of expenses related to visits to Drs. Adatto and Palmer, arguing these were for evaluation and litigation rather than necessary medical services. According to LSA-R.S. 23:1203, employers are not required to cover expenses from physicians consulted at the request of the employee's attorney for evaluation purposes. Citing Price v. Fireman's Fund Insurance Company, the court acknowledges this limitation but finds that the expenses for diagnosing Tanner's condition are necessary and reimbursable. Consequently, the hearing officer's award of disability benefits to Tanner is reversed, although the judgment is affirmed regarding other medical expenses. Appeal costs are shared equally between the parties. There are noted discrepancies regarding the date of the accident, but both parties agree an on-the-job accident occurred. The judgment prevails over the written reasons for judgment when discrepancies arise.