Cenacle Retreat House v. Dubose

Citations: 888 So. 2d 409; 4 La.App. 5 Cir. 571; 2004 La. App. LEXIS 2922; 2004 WL 2720334Docket: No. 04-CA-571

Court: Louisiana Court of Appeal; November 29, 2004; Louisiana; State Appellate Court

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Regina Dubose appeals a workers’ compensation ruling in favor of Cenacle Retreat Home, which denied her claim for benefits. Dubose, hired as an office manager on a probationary basis in August 2001, had pre-existing shoulder and arm pain from a 1996 car accident and subsequent surgeries. Despite these conditions, which Cenacle was aware of, Dubose filed claims for injuries from two job-related accidents in late 2001. She was terminated in December 2001 due to poor performance and hostility toward her supervisor. Following another car accident in February 2002, which she claimed aggravated her previous injuries, Dubose initially received indemnity and medical benefits. However, these were terminated after Cenacle discovered her medical history and a vocational evaluation indicated job availability, leading them to conclude she was not disabled from a work-related injury. 

Cenacle subsequently filed a Disputed Claim for Workers’ Compensation, and Dubose requested reinstatement of benefits along with penalties and attorneys’ fees. The trial, held in December 2003, resulted in a judgment favoring Cenacle, as the workers’ compensation judge found Dubose had not proven a work-related accident or causation, and determined she had willfully misrepresented facts to obtain benefits, thus violating La. R.S. 23:1208. Dubose’s requests for penalties and attorney’s fees were denied. On appeal, she argues the judge erred in failing to recognize a compensable accident and causation, and in determining her misrepresentations constituted willfulness. The appellate court applies a manifest error standard of review, emphasizing that factual findings should not be disturbed if they are reasonable, even amid conflicting testimonies. The ruling indicates that a factfinder’s conclusions can only be overturned if they are manifestly erroneous or clearly wrong.

The appellate court is bound to uphold a judgment if the factfinder's findings are reasonable based on the record. La.R.S. 23:1021(1) defines an accident as an unexpected event that causes identifiable injuries, distinguishing it from gradual deterioration. Sister Pafco initially hired Dubose for a clerical position but offered her the role of office manager due to her impressive resume. Dubose had previously suffered injuries from a 1996 automobile accident, including Thoracic Outlet Syndrome (TOS), which required surgeries in 1998. Sister Pafco, understanding Dubose's medical history, was not concerned about her ability to perform the job. 

Dubose was placed on a three-month probation. In mid-October, she left for a family emergency but returned the following week. During a meeting that week, Dubose reported a shoulder injury sustained while trying to straighten a box of computer labels, claiming she fell against the wall. Sister Pafco disputed the proximity of the table to the wall and noted the absence of an accident report. Dubose did not report the injury at the time because she felt no immediate pain. 

On November 3, 2001, during a performance review, Dubose was informed of deficiencies in her work, but her probation was extended. On November 6, 2001, while assisting Sister Pafco with a ream of computer paper, Dubose experienced discomfort, which she later attributed to the incident. Although she felt pain radiating later that evening, she returned to work the next day without complaints.

Neither Dubose nor Sister Pafco filed an accident report following two work-related incidents. Dubose initially believed her pain would subside but sought emergency care on November 10, 2001, where she was diagnosed with a pinched nerve. She later applied for workers’ compensation benefits to cover her medical expenses, despite not missing work. On November 13, 2001, she submitted accident reports for both incidents but had to revise them multiple times due to incorrect dates, which Sister Pafco insisted on correcting. Dubose expressed frustration over the pressure to submit the reports quickly, particularly as she was left-handed and in pain while writing.

On November 28, Dubose submitted a time-off request for the October incident, and the following day, she provided the final versions of the injury reports. In these reports, she detailed injuries from both accidents, including pain radiating from her left shoulder to her arm and hand. On November 30, 2001, Dubose was terminated, with Sister Pafco citing Dubose’s hostility after seeking compensation and poor job performance as reasons for her dismissal, which was marked by unprocessed deposits leading to customer complaints.

Both Dubose and Sister Pafco acknowledged the October incident occurred when Dubose was injured while handling a box, though there was confusion over the date. The November incident was witnessed by Sister Pafco, but neither initially considered it significant enough to report. Although there were suspicions that Dubose’s motivation for reporting the incidents was linked to a poor performance evaluation, she did inform Sister Pafco about the October incident shortly after it occurred. The determination of whether the accidents caused a compensable injury was also a key issue, with Sister Pafco revealing that Dubose had been under chiropractic care when hired, contradicting earlier statements about her medical status.

Dr. Aida Blasini, Dubose’s treating physician, reported significant discomfort in Dubose's left shoulder, arm, and hand, for which she is on medications and receiving intravenous treatments. Although Dr. Blasini linked Dubose's pain to work-related incidents in late 2001, subsequent tests ruled out a recurrence of thoracic outlet syndrome (TOS) and other nerve-related issues. Orthopedic evaluations by Dr. Gordon Nutik and Dr. Richard Meyer indicated only minor trauma and soft tissue injuries, with MRI and electromyography results showing no notable clinical findings. Dr. Meyer later diagnosed cervical strain and cubital tunnel syndrome, but nerve conduction studies negated the cubital tunnel diagnosis. No definitive cause for Dubose's ongoing pain was identified by the time of the trial. 

Additionally, Dubose has a history of fibromyalgia, diagnosed by Dr. Warren Gottsegen post-surgeries in 1998, which is recognized as a chronic pain condition. Dr. Blasini agreed with this diagnosis and noted that mental stress or physical trauma could be contributing factors. Dubose also has post-traumatic stress syndrome allegedly linked to workplace events. Her pre-employment medical records indicate persistent symptoms in her left shoulder, arm, and hand following her surgeries. Treatment included consultations with various specialists and ongoing therapies. Following a February 2002 car accident, Dubose reported similar injuries but maintained at trial that they were distinct from her work-related injuries. Despite her claims of new pain from the work incidents, her medical records reflect a consistent pattern of chronic issues, undermining her assertions that the work incidents aggravated her condition.

Dubose's efforts to distinguish pain from work-related incidents compared to chronic injuries from accidents in 1996 and 2002 lack credibility. Her reliability was further undermined by her failure to disclose a 2001 automobile accident occurring four months before her employment and another accident two months after her termination. In a May 2002 statement to field adjuster Keith Catha, she repeatedly denied having any other automobile accidents since 1996, only revealing them during her deposition. Dubose attributed her memory lapse to medications causing drowsiness, despite the February 2002 accident being recent to her statement. Given the minor nature of the work-related incidents, her pre- and post-employment medical records, and her questionable credibility, the workers’ compensation judge was justified in concluding that Dubose did not demonstrate that her medical condition stemmed from the two incidents. Consequently, the issues of forfeiture of benefits and penalties are moot, and the denial of her claims for penalties and attorneys' fees is upheld. The judgment of the workers’ compensation judge is affirmed, with Dubose responsible for the appeal costs. The exact date of the first alleged injury, around October 22, 2001, was not definitively established, although it was linked to her absences around that time.