Narrative Opinion Summary
In this workers' compensation case, the appellant, an employee of a major home improvement company, contested the Office of Workers' Compensation (OWC) judge's decision to uphold the employer's exception of prescription under La. R.S. 23:1209(C). The employee suffered an injury in 2006, received substantial benefits, and entered into a partial settlement in 2012. However, disputes regarding medical coverage remained unresolved, pending Medicare Set Aside (MSA) approval. In 2015, the employee filed a disputed claim for compensation and a motion to compel a medical examination, which the employer countered with a prescription exception, citing a lapse of over three years without medical claims following the last payment. The employee argued that the doctrine of contra non valentum should apply because ongoing settlement discussions misled him into delaying his claim. The court reviewed the evidence, including correspondence indicating the employer's refusal to settle the medical claim in 2015, and determined that the doctrine was inapplicable. Consequently, the appellate court affirmed the OWC judge's ruling, finding no manifest error in the factual findings, thus concluding the claim was prescribed. The judgment maintained that the employee bore his own appeal costs, and the employer's exception of prescription was upheld.
Legal Issues Addressed
Burden of Proof in Prescription Exceptionssubscribe to see similar legal issues
Application: The burden was on the employer to prove that the claim was prescribed, which it successfully demonstrated.
Reasoning: Typically, the movant must prove their case, and if evidence is presented at the hearing, the district court's factual findings are assessed under a manifest error standard.
Doctrine of Contra Non Valentumsubscribe to see similar legal issues
Application: The doctrine was deemed inapplicable because the employer's actions did not prevent the employee from filing a timely claim.
Reasoning: The OWC judge ruled that the doctrine of contra non valentum, which serves as an exception to prescription rules, did not apply to the case at hand.
Effect of Unapproved Settlements on Prescriptionsubscribe to see similar legal issues
Application: The court held that an unapproved settlement does not interrupt the prescription period.
Reasoning: It concluded that such a settlement is not binding until judicially approved, leading to the upholding of the OWC's decision regarding the employer’s exception of prescription.
Workers' Compensation Prescription under La. R.S. 23:1209(C)subscribe to see similar legal issues
Application: The claim was prescribed because the employee did not request medical treatment or submit bills for over three years following the last payment.
Reasoning: Giorlando had not requested medical treatment or bills for over three years prior to his claim, thus rendering it prescribed under La. R.S. 23:1209(C).