Court: Louisiana Court of Appeal; June 1, 2016; Louisiana; State Appellate Court
The claimant, Corey Lamartiniere, experienced a work-related injury in 2007 while employed by Boise Cascade and initially received temporary total disability (TTD) benefits. However, these benefits were terminated by the employer due to an alleged violation of La.R.S. 23:1208. After a hearing, the workers’ compensation judge rejected the employer's claim but reinstated TTD benefits from the termination date. An appellate panel later reversed this reinstatement, concluding that the claimant was not entitled to TTD benefits beyond the date of the May 16, 2013 hearing. The Louisiana Supreme Court partially granted a writ application, remanding the case to determine if the claimant was entitled to supplemental earnings benefits (SEB), but ultimately upheld the denial of TTD benefits.
On remand, the appellate panel found the record sufficient to consider SEB benefits but noted that the claimant did not provide testimony regarding his ability to work, leading to a conclusion that he did not meet the burden of proof for SEB benefits. The Supreme Court denied the claimant’s subsequent writ application.
In August 2015, Lamartiniere filed a new claim asserting that the employer had not paid wage benefits or authorized medical treatment, citing injuries from the 2007 accident. The employer responded with an exception of res judicata, claiming that the previous decisions denying TTD and SEB benefits precluded the current claim. The workers' compensation judge upheld the res judicata exception but denied the employer’s motion for sanctions. The claimant appealed, and the ruling was affirmed, with the employer’s request for sanctions also denied.
The employer sought sanctions against the claimant for filing a claim without sufficient legal or factual basis, arguing for costs and attorney’s fees. Additionally, the employer filed an exception of prematurity, claiming the claimant's request for medical treatment was premature, as no requests had been made since the May 16, 2013 trial. Following a hearing on October 12, 2015, the workers’ compensation judge upheld the exception of res judicata, denying the employer’s motion for sanctions, and granted the exception of prematurity, dismissing the claimant’s medical benefits claim while allowing for future claims. The claimant appealed, arguing that the judge erred by granting res judicata before trial, thereby denying him the opportunity to present evidence of a change in condition and disability. He also contested the judge's interpretation of La.R.S. 23:1310.8, which he believed improperly barred his entitlement to indemnity benefits indefinitely due to a previous judgment. The employer countered the appeal, asserting that the judge was correct in denying sanctions. During the hearing, the employer reiterated that the prior judgment precluded the claimant's current claim, but the claimant maintained that he was entitled to demonstrate changes in circumstance affecting his eligibility for benefits post-May 2013. The trial court ultimately sustained the res judicata exception based on previous rulings regarding indemnity and disability benefits, indicating that the law, while harsh, must be adhered to. The res judicata effect of prior judgments is typically reviewed for manifest error, but if no factual determinations are made, it is a question of law reviewed de novo.
The trial court's ruling was determined to be a legal decision rather than a factual one, as it did not make any factual findings. The employer's exhibits presented were solely relevant court rulings, leading to a de novo standard of review. The trial court's ruling is upheld. Under La.R.S. 13:4231, res judicata applies when a valid and final judgment is conclusive between the same parties regarding all causes of action arising from the same transaction, depending on whether the judgment favors the plaintiff or defendant. In workers’ compensation cases, La.R.S. 23:1310.8(A)(1) grants workers’ compensation judges continuing jurisdiction to modify previous findings upon application and contradictory hearing, particularly when there is a change in circumstances. La.R.S. 23:1310.8(B) allows for the review of awards based on changes in conditions, enabling the judge to adjust compensation after due process. However, La.R.S. 23:1310.8(E) establishes that a judgment denying benefits becomes res judicata after the claimant exhausts appeal rights. The claimant's argument centers on whether indemnity benefits owed due to changed circumstances can be modified under Paragraph B, or if the issue is res judicata under Paragraph E, particularly in light of previous rulings regarding TTD benefits. The case of Olivier v. Olivier Builders is cited, demonstrating that modification applications fall under La.R.S. 23:1310.8 parameters, as the court found no error in the trial court’s decision to modify TTD benefits based on the claimant’s ability to return to work.
Louisiana Revised Statutes 23:1310.8(B) allows for the modification of prior compensation awards, but in this case, a final appellate judgment denied SEB benefits following a hearing on May 16, 2013. Consequently, no existing award remained to modify under La.R.S. 23:1310.8(B). Jurisprudence prior to the statute's 1999 enactment confirms that a prior award is necessary for its application. The court also dismissed the claimant’s argument that the judgments were only applicable until the May hearing, emphasizing that entitlement to disability benefits was determined post-trial. Thus, the trial court correctly applied res judicata under La.R.S. 23:1310.8(E), upholding the denial of the claimant's claim.
In response to an appeal, Boise Cascade argued that the workers’ compensation judge wrongly denied its request for sanctions under La.Code Civ. P. art. 863. This article mandates that all pleadings be signed by an attorney or the party, certifying that they are not presented for improper purposes and are supported by evidence. If the certification is violated, sanctions may include reimbursement for reasonable expenses incurred. Appellate courts review trial court decisions on sanctions for manifest error and examine the specifics of imposed sanctions for abuse of discretion. After review, the appellate court found no manifest error in the trial court's denial of sanctions, supporting the employer’s claim that the petition was frivolous given the clear application of La.R.S. 23:1310.8(E) and prior judgments.
Paragraph E states that a judgment denying benefits is res judicata, but the record indicates that the argument regarding the statute's applicability to this judgment has merit, given that it included an initial award of benefits. Current jurisprudence on La.R.S. 23:1310.8(E) does not specifically address this situation. Consequently, the employer's position is deemed without merit.
The ruling of the workers' compensation judge is affirmed, and Boise Cascade’s request for sanctions under La.Code Civ. P. art. 863 is denied. Costs of the proceedings are to be shared equally between claimant Corey Lamartiniere and employer Boise Cascade. The judgment is affirmed, and the employer's answer to the appeal is denied.
Chief Judge Thibodeaux concurs and provides written reasons. La.R.S. 23:1208(A) makes it unlawful to willfully provide false statements to obtain or defeat benefits, with specified penalties including forfeiture of benefits. The employer did not challenge the judgment portion reinstating Lamartiniere’s right to recover Temporary Total Disability (TTD) benefits for the period between his termination and the trial date, leaving that ruling intact.
The employer submitted several exhibits related to the case, including past opinions and judgments regarding Lamartiniere’s entitlement to benefits. The claimant submitted three exhibits in opposition to the res judicata exception but did not introduce them at the hearing or request their admission as a proffer. These exhibits included correspondence regarding the re-initiation of benefits and the employer’s refusal to do so, along with a court ruling excerpt.
The applicable law for a workers' compensation case is determined by the law in effect at the time of the injury. As established in Frith v. Riverwood, Inc., the relevant statute, Paragraph E of La.R.S. 23:1310.8, applies only to injuries occurring after its enactment in 1999. Since the injury in question occurred in 2007, Paragraph E and relevant case law are applicable. However, in Jeanise v. Cannon, the claimant was denied Supplemental Earnings Benefits (SEBs) as he did not provide evidence of his current pain level or ability to work, failing to demonstrate entitlement to SEBs due to a disability that prevents him from earning at least ninety percent of his pre-injury wages. Consequently, the request for SEBs is denied, along with any claim for Temporary Total Disability (TTD) benefits beyond the trial date.
