City of Jennings v. Deshotel

• Decision Date: 02 February 2000
• Docket Number: No. 99-1232.,99-1232.
• Citation: 758 So.2d 269
• Parties: CITY OF JENNINGS v. Tommy R. DESHOTEL.
• Court: Court of Appeal of Louisiana — District of US

758 So.2d 269

CITY OF JENNINGS v. Tommy R. DESHOTEL.

No. 99-1232.

Court of Appeal of Louisiana, Third Circuit.

February 2, 2000.

Writ Denied April 20, 2000.

Christopher R. Philipp, Jamison & Philipp, Lafayette, LA, Counsel for Plaintiff/Appellant.

Kevin L. Camel, Cox, Cox & Filo, Lake Charles, LA, Counsel for Defendant/Appellee.

Court composed of Judge HENRY L. YELVERTON, Judge JIMMIE C. PETERS, Judge MARC T. AMY.

AMY, Judge.

The City of Jennings filed a claim with the Office of Workers' Compensation seeking a determination as to whether an employee's heart condition was work-related and, thus, compensable under workers' compensation. The employee answered and asserted a claim for unpaid medical bills relating to the treatment of the alleged heart condition as well as penalties and attorney's fees. The workers' compensation judge determined that the heart condition was work-related and granted the employee's demand for all medical bills arising out of treatment for the heart condition and assessed penalties and attorney's fees against the City. For the following reasons, we affirm.

Factual and Procedural Background

Thomas R. Deshotel has been employed with the City of Jennings Fire Department since 1966. He has been serving as chief of the fire department since 1986. In 1993, Deshotel began experiencing a sensation in his heart which he described as "skipping of a beat." On referral from his family physician, Deshotel met with Dr. Miguel Depuy, a cardiologist, on December 22, 1993. After initial evaluation and testing, Dr. Depuy determined that Deshotel was experiencing arrhythmia, more specifically, symptomatic premature ventricular and atrial heartbeats. Dr. Depuy prescribed a beta blocker to decrease the frequency of the premature beats, recommended a change in diet, and an annual stress test. From the date of the initial diagnosis, Deshotel has continuously taken the prescribed medication and received an annual stress test from Dr. Depuy.

Until October of 1997, the City, through its workers' compensation administrator, paid for Deshotel's treatment with Dr. Depuy. Thereafter, the City transferred all claims for payment of medical bills to the City's health and accident insurer. On February 6, 1998, the City filed a claim with the Office of Workers' Compensation (OWC) seeking a determination as to whether Deshotel's arrhythmia was related to any compensable accident or occupational disease which would entitle him to payment under the workers' compensation laws. The City also sought reimbursement from Deshotel for payment of medical bills relating to the treatment of his heart condition. Deshotel answered and asserted a claim for unpaid medical bills and penalties and attorney's fees.

After a hearing on the merits, the workers' compensation judge determined that Deshotel's arrhythmia was work-related and compensable under workers' compensation. The workers' compensation judge found that La.R.S. 33:2581, commonly referred to as the Heart and Lung Act, establishes a prima facie presumption, in favor of a classified fireman, that a heart condition is work-related once he proves that he suffers from a heart disease or infirmity and that it has developed after the first five years of employment. The workers' compensation judge concluded that Deshotel had proved his entitlement to the presumption. Moreover, she determined that the City had not proved by affirmative evidence that Deshotel's employment could not have contributed to his heart condition and, accordingly, did not rebut the statutory presumption of causation. The workers' compensation judge rendered judgment in favor of Deshotel for payment of all medical treatment related to his heart condition and penalties and attorney's fees.

The City appeals from that ruling and asserts the following assignments of error:

1. The trial court committed manifest error when it determined that Deshotel suffered from a "disease or infirmity of the heart" which triggered the prima facie presumption provided by La. R.S. 32:2581.

2. The trial court committed manifest error and misinterpreted the law in finding that Jennings did not introduce sufficient evidence to rebut the prima facie presumption [of] causation provided by La. R.S. 32:2581.

3. The trial court committed manifest error in awarding penalties and attorney's fees for Jennings controversion of its liability for medical expenses where all of Deshotel's medical expenses had been paid for by Jennings (either as workers' compensation medical benefits or under the health and accident insurance which was fully funded by the City with no deductible amount to the employee).

Discussion of the Merits

"In a workers' compensation case, as in other cases, the appellate court's review is governed by the manifest error or clearly wrong standard." Freeman v. Poulan/Weed Eater, 93-1530 (La.1/14/94); 630 So.2d 733, 737. Thus, we may not set aside the findings of fact of the workers' compensation judge, absent manifest error or unless they are clearly wrong. Id.

The Heart and Lung Act, La.R.S. 33:2581, states as follows:

Any disease or infirmity of the heart or lungs which develops during a period of employment in the classified fire service in the state of Louisiana shall be classified as a disease or infirmity connected with employment. The employee affected, or his survivors, shall be entitled to all rights and benefits as granted by the laws of the state of Louisiana to which one suffering an occupational disease is entitled as service connected in the line of duty, regardless of whether the fireman is on duty at the time he is stricken with the disease or infirmity. Such disease or infirmity shall be presumed, prima facie, to have developed during employment and shall be presumed, prima facie, to have been caused by or to have resulted from the nature of the work performed whenever same is manifested at any time after the first five years of employment.

Although the above provision is not specifically incorporated into the Workers' Compensation Act, La.R.S. 23:1021, et seq., the courts have held it applicable in workers' compensation cases. Meche v. City of Crowley, 96-577 (La.App. 3 Cir. 2/12/97); 688 So.2d 697, writ denied, 97-0632 (La.4/25/97); 692 So.2d 1088. Once an employee's heart disease or infirmity is determined to have been caused by or resulted from work performed as per La. R.S. 33:2581, questions of compensation are then decided pursuant to the Workers' Compensation Act. Id. See Saling v. City of New Orleans, 398 So.2d 1205 (La.App. 4 Cir.), writ denied, 401 So.2d 986 (La.1981).

Heart Disease or Infirmity

First, the City asserts that the workers' compensation judge was manifestly erroneous in determining that arrhythmia is a disease or infirmity under La.R.S. 33:2581. The City contends that before Deshotel is entitled to the legal presumption of causation, he must first prove that he in fact suffers from a disease or infirmity of the heart, which, it argues, Deshotel has failed to prove. The City asserts in its brief to this court that, "[d]espite extensive testing, Dr. Depuy has never been able to find any evidence of a heart disease or a heart defect." However, the City does not deny that Dr. Depuy diagnosed Deshotel with having an arrhythmia.

Dr. Depuy explained Deshotel's heart condition during his deposition. While being questioned by the City, Dr. Depuy stated:

Q. Was this arrhythmia clinically significant enough to be categorized as heart disease or a heart defect?

A. I would use the term benign or malignant arrhythmia to put this in a better perspective. A malignant arrhythmia is an arrhythmia that is produced by a heart disease that is significant enough that it can kill you. It can put your life at risk. You can die with a malignant arrhythmia.

The arrhythmia that Mr. Deshotel has falls into the category of a benign arrhythmia meaning that he can live with that. It may make you uncomfortable, which appears to have been his case, so I did prescribe medication for that, called Sectral. And I started him on that in 1994.

La.R.S. 33:2581 expressly covers "any disease or infirmity of the heart[.]" Emphasis added. The City's argument that the arrhythmia suffered by Deshotel does not fall under the Heart and Lung Act because it is not a disease or defect is incomplete. The workers' compensation judge found the arrhythmia to be an infirmity of the heart covered by La.R.S. 33:2581. The City relies solely on the testimony of Dr. Depuy. Though, Dr. Depuy would not classify the arrhythmia as a heart disease, he does recognize the arrhythmia as a heart irregularity which should be monitored annually and treated with medication. Upon review of this evidence presented at the hearing, we find no clear error in the workers' compensation judge's factual determination that Deshotel's condition constitutes an infirmity. Therefore, we find this assignment of error without merit.

Burden of Proof

Next, the City asserts that the workers' compensation judge misinterpreted the law regarding the burden of proof necessary to rebut the prima facie presumption of causation set forth in La.R.S. 33:2581. The City argues that the jurisprudence interpreting the statutory presumption has made the prima facie presumption of causation more onerous than legally required. Therefore, the City argues, the workers' compensation judge erroneously relied on the jurisprudence and subjected it to a higher burden of proof.

As explained previously, La.R.S. 33:2581 mandates that a heart "disease or infirmity shall be presumed, prima facie, to have developed during employment and shall be presumed, prima facie, to have been caused by or to have resulted from the nature of the work performed whenever same is manifested at any time after the first five years of employment." Furthermore the employment does not have to be the sole cause of the disease or infirmity. Rather, it is sufficient under the act if the...