Narrative Opinion Summary
This workers’ compensation case involves Boise Cascade Company's appeal against a judgment from the Office of Workers’ Compensation (OWC) in favor of the claimant, who sustained a lower back injury while working. The OWC determined the claimant's Average Weekly Wage (AWW) to be $704.17 and imposed penalties totaling $8,000 on Boise for miscalculations and delays in Temporary Total Disability (TTD) benefits and medical treatment authorizations, as well as $15,500 in attorney fees. Boise contested the AWW calculation and penalties, asserting that the termination of TTD benefits was justified based on medical advice and that it was an aggrieved party entitled to appeal medical treatment authorizations. The Workers' Compensation Judge (WCJ) upheld the AWW calculation, penalties, and attorney fees, affirming that the cessation of TTD was arbitrary and capricious. Boise's appeal regarding medical treatment authorizations was rejected, leading to further penalties. The court also awarded the claimant additional attorney fees for the appeal. The judgment was affirmed, and costs of the appeal were assigned to Boise Cascade Company.
Legal Issues Addressed
Appeals Process for Medical Treatment Authorization under La.R.S. 23:1203.1subscribe to see similar legal issues
Application: Boise Cascade Company's Form 1009 appeal regarding the authorization of a discogram and lumbar surgery was rejected after the Medical Director deemed the treatments necessary.
Reasoning: The adjuster acknowledged that no new information warranted another appeal. Mr. Davis contends this was a delay tactic by Boise.
Attorney Fees on Appealsubscribe to see similar legal issues
Application: The court granted Mr. Davis additional attorney fees for the appeal after successfully defending the WCJ's judgment.
Reasoning: The court granted Mr. Davis's request, awarding him $8,500.00 in additional attorney fees for the appeal work.
Calculation of Average Weekly Wage under La.R.S. 23:1021subscribe to see similar legal issues
Application: The Workers' Compensation Judge (WCJ) determined the Average Weekly Wage (AWW) to be $704.17 by excluding the week of January 15, 2012, due to a power outage affecting work and including the prior full week.
Reasoning: The WCJ ultimately calculated an AWW of $704.17 by including the prior full week instead.
Penalties for Failure to Provide Compensation under La. R.S. 23:1201subscribe to see similar legal issues
Application: The Workers' Compensation Judge (WCJ) imposed penalties on Boise Cascade Company for failing to pay Temporary Total Disability (TTD) benefits and authorize medical procedures.
Reasoning: Mr. Davis was awarded penalties totaling $10,000 for various failures by Boise to pay TTD and authorize medical procedures.
Penalties for Unjustified Discontinuation of Benefits under La. R.S. 23:1201(I)subscribe to see similar legal issues
Application: The court found Boise Cascade's termination of TTD benefits to be arbitrary and capricious, affirming a $4,000 penalty against the maximum of $8,000 allowed.
Reasoning: The court found the $4,000 penalty awarded to Mr. Davis for the discontinuation of Temporary Total Disability (TTD) benefits to be reasonable and affirmed that part of the judgment.