Fox v. Reynolds Industrial Contractors, Inc.

Citations: 79 So. 3d 1140; 2011 La. App. LEXIS 1387; 2011 WL 5554825Docket: No. 46,695-WCA

Court: Louisiana Court of Appeal; November 15, 2011; Louisiana; State Appellate Court

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Willie Faye Fox appeals a summary judgment favoring Reynolds Industrial Contractors, which also included an exception of no cause of action. Reynolds appeals the denial of its exception of prescription. The court reverses the judgment granting the exception of no cause of action and affirms the denial of the exception of prescription, remanding the case. 

Fox was injured in January 1996 while employed as a secretary for Reynolds, which provided temporary total disability benefits until November 1997 and supplemental earnings benefits (SEB) until September 2001. After a series of disputed claims, a 2006 appeal resulted in an award of SEB for six weeks. In July 2007, Fox filed another claim for compensation, which led to the defendant asserting exceptions of prescription and res judicata. The workers’ compensation judge (WCJ) granted the exception of res judicata regarding medical benefits but did not rule on prescription. On appeal, the court affirmed the res judicata ruling but remanded the case for a determination on prescription, which was ultimately denied by the WCJ.

The WCJ later granted Reynolds' exception of no cause of action or, alternatively, summary judgment, suggesting it would simplify resolution. Fox argues this was erroneous, claiming her request for additional SEB due to a change in her medical condition constituted a valid cause of action. The court supports this assertion, stating that under LSA-R.S. 23:1310.8(B), the WCJ can review awards based on changes in conditions, confirming that Fox's claim to modify her compensation was valid. Thus, the WCJ's decision to grant the exception of no cause of action is deemed incorrect.

The defendant argues that the Workers' Compensation Judge (WCJ) incorrectly denied its exception of prescription, asserting that the claimant's second claim for compensation was filed over one year after the court's June 28, 2006 decision awarding benefits. Under LSA-R.S. 23:1310.8(D), claims to modify judgments awarding benefits are subject to the prescription periods outlined in LSA-R.S. 23:1209, which mandates that workers' compensation claims must be filed within one year from the last total disability payment and within three years for Supplemental Earnings Benefits (SEB). Prescription statutes favor maintaining actions rather than barring them. The modification statute aims to ensure claimants receive benefits throughout their disability while limiting employer liability to the disability duration.

The defendant contends the claimant was required to file for modification within one year post-Reynolds' decision. However, since SEB was awarded in Reynolds, the applicable period is three years according to Section 1209(A)(2). Therefore, the claimant's July 2007 modification claim was timely, rendering the defendant's argument without merit.

Regarding summary judgment, the claimant asserts that the WCJ erred in granting it, as a genuine issue of material fact about SEB entitlement exists despite no benefits being paid for over two years. Louisiana law allows SEB for employees unable to earn 90% of their pre-injury wage, with a maximum duration of 520 weeks. SEB can terminate after two years post-temporary total disability unless paid for at least 13 consecutive weeks during that period.

The defendant argues that the claimant's SEB entitlement has ceased due to the court's prior award of six weeks of SEB, which the defendant interprets as a denial of further benefits. However, this interpretation contradicts the court's earlier ruling permitting modification due to a change in condition. The defendant also claims the SEB award ended in mid-October 2000, leading to over two years without benefits by the July 2003 trial. However, the statutory language indicates that the two-year period starts after the last temporary total disability payment, which was November 1, 1997. Because SEB was paid until September 2001, the relevant two-year period extends from November 2001 to November 2003, meaning claimant's SEB eligibility did not terminate in July 2003, as four months remained in that period.

The court found that a second deposition of Dr. Kathleen Majors indicated the claimant's incapacity is permanent, contradicting the doctor's initial assessment of a temporary condition. This raises a genuine issue of material fact regarding the claimant's eligibility for Supplemental Earnings Benefits (SEB) for thirteen consecutive weeks from July to November 2003. The Workers' Compensation Judge (WCJ) erred in granting summary judgment, leading to a remand for trial to determine if the claimant is entitled to a modification of the prior benefits award. The court reversed the Office of Workers’ Compensation’s (OWC) judgment granting the defendant’s exception of no cause of action and the summary judgment, while affirming the denial of the defendant’s exception of prescription. Costs incurred in the OWC and on appeal are to be borne by the defendant, Reynolds Industrial Contractors.