Gaines v. Home Care Solutions, LLC.
| Citation | 192 So.3d 794 |
| Decision Date | 06 April 2016 |
| Docket Number | No. 2015–CA–0895.,2015–CA–0895. |
| Parties | Deborah GAINES v. HOME CARE SOLUTIONS, LLC. |
| Court | Court of Appeal of Louisiana (US) |
Ryan Jude Hughes, Law Offices of Robert T. Hughes and Ryan J. Hughes, New Orleans, LA, for Plaintiff/Appellee.
Nathan L. Schrantz, Nathan L. Schrantz, LLC, New Orleans, LA, for Defendant/Appellant.
(Court composed of Judge DENNIS R. BAGNERIS, SR., Judge TERRI F. LOVE, Judge MAX N. TOBIAS, JR. ).
, Judge.
In this workers' compensation case, the defendant, Home Care Solutions, LLC (“Home Care”), appeals a judgment of the Office of Workers' Compensation (“OWC”) rendered in favor of the plaintiff, Deborah Gaines (“Ms.Gaines”). The OWC found Ms. Gaines met her burden of proving that (1) she had suffered a work-related accident resulting in a back injury and (2) the back injury rendered her temporarily totally disabled entitling her to weekly compensation and medical benefits. On appellate review, we affirm the OWC's judgment, finding Ms. Gaines presented clear and convincing evidence that she is entitled to temporary total disability benefits, past medical expenses, and “expenses for future reasonable and necessary medical treatment related to her work-related back injury.”
On April 8, 2013, Ms. Gaines was employed by Home Care as a caregiver. While attending to her duties that day caring for a Home Care client, Ms. Gaines claims that she was bitten on the right leg by the client's dog, a Scottish Terrier. The dog bite caused Ms. Gaines to jump backwards in a twisting motion resulting in injuries to her right leg and back. After reporting the accident to Home Care the following day, Ms. Gaines was directed to Concentra Medical Center (“Concentra”) for treatment for the dog bite to her leg. She was treated at Concentra for her leg injury on two separate occasions, April 9, 2013, and April 15, 2013, and was thereafter discharged to return to work without restrictions. Ms. Gaines contends that she repeatedly advised her employer of ongoing back pain resulting from the dog-bite accident. However, because the onset of her back pain did not manifest itself until several days following the accident, Home Care denied that a work-related accident caused Ms. Gaines' alleged back injury and, consequently, denied indemnity and medical benefits to her.
Ms. Gaines commenced this action on April 8, 2014, by filing a disputed claim for compensation (Form 1008) against Home Care seeking to recover indemnity benefits and medical expenses resulting from her work-related back injury. Home Care answered the petition averring that Ms. Gaines did not sustain an “accident” within the meaning of the Louisiana Workers' Compensation Act, while within its employ resulting in a back injury.
Trial proceeded against Home Care on March 9, 2015, at which time the parties stipulated to the following: (1) Ms. Gaines was employed with Home Care as a caregiver at the time the dog-bite incident occurred on April 8, 2013; and (2) on April 8, 2013, Ms. Gaines was earning an average weekly wage of $564.94, with a corresponding workers' compensation rate for temporary total disability benefits of $376.25 per week.
Two witnesses were called at trial, Ms. Gaines and Elliot Steven LeNormand, Jr. (“Mr. LeNormand”). The parties introduced into evidence the medical records of Dr. Henry Evans (“Dr. Evans”) at Louisiana Medical Center, Louisiana Health Solutions, Ochsner Hospital, Concentra, Touro Infirmary, and documents relating to an outstanding Medicaid lien in the amount of $275.53.
Ms. Gaines testified that on the date of the accident, she was in the process of bringing the Home Care client a snack when the client's dog grabbed onto her right thigh and bit her, causing her to jump backwards in a twisting motion. Ms. Gaines stated that she immediately felt a stinging sensation on her leg where the dog bit her and, a few days later, felt pain in her back. According to Ms. Gaines, she reported the accident to Shelly Green (“Ms.Green”) at Home Care the following day on April 9, 2013, and was directed to Concentra, where she was treated for the dog-bite injury to her right leg. She was scheduled for a follow-up appointment one week later.
Ms. Gaines testified that on April 13, 2013, five days after the accident, she presented to the emergency room at Touro Infirmary, complaining of pain in her abdomen and lower back. A CT scan
of her abdominal cavity showed a small umbilical hernia and a cyst on her liver. After receiving prescriptions for pain medication, Ms. Gaines was instructed to follow-up with her primary care physician, Dr. Evans, in the next four to six days. Ms. Gaines testified that she specifically told the emergency room physician at Touro about the earlier dog-bite accident, relating the onset of her acute back pain to this incident, and that she advised the physician that she had a follow-up visit scheduled at Concentra for several days later.
Ms. Gaines returned to Concentra for her previously scheduled follow-up appointment on April 15, 2013, and testified that in addition to the right leg pain she was experiencing, she also complained to the treating physician at Concentra of the pain in her back, which she directly related to the dog-bite incident. Despite her complaints of back pain, the treating physician at Concentra discharged her to return to work that day with no restrictions.
According to Ms. Gaines, she continued to work for Home Care for a month following the accident performing the full duties of her position as a caregiver. During this time, she testified that she repeatedly informed her superior at Home Care, as well as a couple of her fellow employees, of her ongoing back problems, which she specifically related to the dog-bite accident.
Ms. Gaines further testified that on May 8, 2013, she followed up with Dr. Evans as previously instructed when she was discharged from the emergency room at Touro. Upon examination, Dr. Evans diagnosed Ms. Gaines with a lumbosacral sprain
, right buttock strain, and a laceration/contusion of the right lower thigh related to the dog-bite accident and determined that, as a result, she was incapacitated and disabled from working. She contends that she provided Home Care with documentation in the form of a work slip from Dr. Evans, stating that she was disabled from work because of “her injuries of 4/08/13.” Ms. Gaines testified that she continued to receive ongoing care and treatment from Dr. Evans for her low back pain and disability related to the dog-bite accident from May 2013 through the date of trial in March 2015, and asserted that Dr. Evans had not released her to return to work in any capacity during that time.1 Despite Dr. Evans having declared Ms. Gaines disabled from working due to the work accident, Home Care denied indemnity and medical benefits to her.
Ms. Gaines also testified that she was also treated for her low back pain from June 2013 through August 2013 by Dr. Boyd Helm (“Dr. Helm”) at Louisiana Health Solutions, which pain he related to the dog-bite accident. Dr. Helm diagnosed Ms. Gaines with a lumbar strain
and lumbar radiculopathy as a result of the accident and opined that her prognosis was “guarded.” He further concluded that Ms. Gaines was disabled from working during that time (June 2013 through mid-September 2013)2 and restricted her from heavy lifting and recommended limited bending.3
On February 6, 2014, approximately ten months following the dog-bite accident and nearly six months since her last treatment with Dr. Evans or Dr. Helm, Ms. Gaines presented to the emergency room at Ochsner Hospital where she complained of chronic pain to her lower back, in addition to pain associated with an abdominal hernia
.4 Specifically, Ms. Gaines complained of lower back pain since she twisted it while being bitten by a dog at work in April of the previous year. According to the Ochsner records in evidence, Ms. Gaines' physical examination and clinical history were consistent with a diagnosis of “lumbago,” otherwise referred to as pain in the lumbar region of the back. Ms. Gaines was treated with analgesics and discharged with a prescription for pain and instructions to follow up with her primary care physician.
Ms. Gaines testified at trial that she remains under the care and treatment of Dr. Evans and has not returned to work in any capacity since May 8, 2013, when he declared her to be disabled from working. Moreover, she testified that Home Care has refused to pay her indemnity benefits or medical expenses despite her ongoing disability caused by the work-related accident.
Mr. LeNormand, a registered nurse case manager for AM City Resources, testified on behalf of Home Care. He stated that he was the nurse case manager assigned to Ms. Gaines' claim and was charged with coordinating her medical care for the injuries she received as a result of the dog-bite accident. He stated that on April 9, 2013, he received a telephone call from Michelle Lenore at Home Care advising that its employee, Ms. Gaines, had suffered a dog bite. Arrangements were made for Ms. Gaines to be treated at Concentra. According to Mr. LeNormand, Concentra's records did not indicate to him that Ms. Gaines had suffered any back injury as a result of the dog-bite accident. Further, he stated that his first knowledge that Ms. Gaines was complaining of back problems that she related to the accident was in May 2013 when he received an email, relating to a request for workers' compensation information from Dr. Evans' office. Mr. LeNormand testified that he requested and obtained Ms. Gaines' medical records from Touro Infirmary and, to the best of his recollection, the records made no reference of a work-related injury to her back.
Following the trial, the OWC found that Ms. Gaines carried her burden of proving that she suffered a work-related accident causing injury to her back at the time...
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