Miles v. Pinecrest Developmental Ctr.
| Decision Date | 07 November 2012 |
| Docket Number | No. 12–396.,12–396. |
| Citation | 101 So.3d 1077 |
| Parties | Linda MILES v. PINECREST DEVELOPMENTAL CENTER. |
| Court | Court of Appeal of Louisiana — District of US |
OPINION TEXT STARTS HERE
Brian D. Cespiva, Attorney at Law, Alexandria, LA, for Defendant Appellant, Pinecrest Developmental Center.
Maria Anna Losavio, Losavio Law Firm, Alexandria, LA, for Plaintiff Appellee, Linda Miles.
Court composed of JOHN D. SAUNDERS, ELIZABETH A. PICKETT, and JAMES T. GENOVESE, Judges.
[3 Cir. 1]In this workers compensation appeal, Pinecrest Developmental Center appeals Claimant's awards for permanent total disability benefits, statutory penalties, and attorney fees. We affirm the judgment and award Claimant $5,000 for attorney fees in connection with defending this appeal.
Ms. Linda Miles was employed as an LPN at Pinecrest Development Center when, on April 17, 2000, she was injured in the course and scope of her employment. Ms. Miles received workers compensation benefits for 524 weeks until May 2, 2010, when Defendant discontinued her compensation benefits, prompting Ms. Miles filed this claim seeking reinstatement of her benefits.
On October 5, 2011, Claimant and her son testified at her hearing as did adjuster Lisa Vincent, an employee of FARA Insurance Services, on behalf of Defendant. In addition, voluminous medical depositions, records, and reports were introduced into the record. These items included not only medical exhibits submitted by Claimant and Defendant, but an Independent Medical Examination report submitted by a specialist to whom Claimant was referred prior to the hearing.
Following submission of post-trial memoranda, the workers compensation judge ruled in favor of claimant, finding her eligible for reinstatement of benefits, penalties and attorney fees, citing among other evidence the testimony of treating psychologist James Quillin, Ph.D., and the report of the third party Independent Medical Examiner to whom Ms. Miles had been referred by the workers compensation judge.
Defendant assigns several errors on appeal. Defendant cites a combination of legal and manifest error in finding Claimant's injury compensable under [3 Cir. 2]La.R.S. 23:1021(8)(d). It also cites manifest error on the part of the workers compensation judge in finding that Claimant established by clear and convincing evidence that she is permanently and totally disabled given the relatively minor physical injury she had sustained more than ten years earlier and in finding that it had acted arbitrarily and capriciously when it terminated her benefits.
We first examine the legal error alleged by Defendant. A compensable injury is required before a claimant can collect temporary total disability benefits, supplemental earnings benefits, or permanent total disability benefits of the type awarded by the WCJ in this case. La.R.S. 23:1221.
Defendant claims that the workers compensation judge should not have awarded benefits, citing La.R.S. 23:1021(8)(d), recited below in its statutory context (emphasis added):
§ 1021. Terms defined
As used in this Chapter, unless the context clearly indicates otherwise, the following terms shall be given the meaning ascribed to them in this Section:
....
(8)(a) “Injury” and “personal injuries” include only injuries by violence to the physical structure of the body and such disease or infections as naturally result therefrom. These terms shall in no case be construed to include any other form of disease or derangement, however caused or contracted.
....
(c) Mental injury caused by physical injury. A mental injury or illness caused by a physical injury to the employee's body shall not be considered a personal injury by accident arising out of and in the course of employment and is not compensable pursuant to this Chapter unless it is demonstrated by clear and convincing evidence.
(d) No mental injury or illness shall be compensable under either Subparagraph (b) or (c) unless the mental injury or illness is diagnosed by a licensed psychiatrist or psychologist [3 Cir. 3]and the diagnosis of the condition meets the criteria as established in the most current issue of the Diagnostic and Statistical Manual of Mental Disorders presented by the American Psychiatric Association.
The parties stipulated that Claimant sustained back, neck, and other injuries while acting in the course and scope of her employment, and Defendant neither claims that the workers compensation judge could not have found claimant entitled to benefits under La.R.S. 23:1201(8)(c), nor that Ms. Miles' mental injury or illness was not diagnosed by a licensed psychologist under La.R.S. 23:1201(8)(d). Rather, Defendant's claim hinges on whether that diagnosis met criteria established in the most current issue of the Diagnostic and Statistical Manual as required by the same provision.
The record contains references to DSM Axes I–III, hallmarks of the Diagnostic and Statistical Manual of Disorders. For example, psychologist William Lowe, Ph.D., to whom Claimant was referred by the Office of Workers Compensation on October 19, 2010, made specific diagnoses with respect to DSM Axis I (chronic depressive disorder), Axis II (passive dependent and others), and Axis III (morbid obesity, diabetes, chronic pain and others).
Therefore, we find no merit to this argument.
Next we turn to Defendant's allegations that the workers compensation judge committed manifest error in finding that Claimant had established by clear and convincing evidence that she is permanently and totally disabled given the relatively minor physical injury she had sustained more than ten years earlier.
It is well settled that the standard of review applied in workers' compensation cases is the “manifest error-clearly wrong” standard. Dean v. Southmark Constr., 03–1051, p. 7 (La.7/6/04), 879 So.2d 112, 117.
[3 Cir. 4]Accordingly, the findings of the OWC will not be set aside by a reviewing court unless they are found to be clearly wrong in light of the record viewed in its entirety. Alexander [ v. Pellerin Marble & Granite, 93–1698 (La.1/14/94) ], 630 So.2d [706,] 710. Where there is conflict in the testimony, reasonable evaluations of credibility and reasonable inferences of fact should not be disturbed upon review, even though the appellate court may feel that its own evaluations and inferences are as reasonable. Robinson v. North American Salt Co., 02–1869 (La.App. 1 Cir.2003), 865 So.2d 98, 105. The court of appeal may not reverse the findings of the lower court even when convinced that had it been sitting as the trier of fact, it would have weighed the evidence differently. Robinson, 865 So.2d at 105. The determination of whether injury occurred in the course and scope of employment is a mixed question of law and fact. Winkler v. Wadleigh Offshore, Inc., 01–1833 (La.App. 4 Cir. 4/24/02), 817 So.2d 313, 316 (citing Wright v. Skate Country, Inc., 98–0217 (La.App. 4 Cir. 5/12/99), 734 So.2d 874).
Minor v. J & J Carpet, Inc., 10–45, pp. 2–3 (La.App. 3 Cir. 6/2/10), 40 So.3d 434, 436–437.
By the same token, we would be remiss were we not to acknowledge Defendant's point that the manifest error rule can only go so far.
There is no legitimate conflict in testimony where documents or objective evidence so contradict the witness's story, or the story presented by the witness is so internally inconsistent or implausible on its face, that a reasonable fact-finder could not give credence to the witness's testimony. Faced with such circumstances, the court of appeal may find manifest error or clear wrongness even in a finding purportedly based upon a credibility determination.
Henderson v. Nissan Motor Corp., 2003–606 (La.2/6/04), 869 So.2d 62, 68–69 ().
The record evidence in this case, however, does not warrant or permit our departure from the general rule.
Defendant stipulates that Claimant suffered a work-related accident and injuries for which it paid benefits for ten years, but now maintains that her injuries did not rise to the level of being permanently totally disabling. Rather, Defendant [3 Cir. 5]suggests that Claimant's inability or refusal to return to work is attributable to malingering.
The record does contain such evidence. Defendant's expert, Dr. Rennie Culver, M.D., Ph.D., concluded that no work restrictions were warranted from a psychiatric perspective, sentiments essentially echoed by another Defense expert, Dr. Thomas Staats, a neuropsychologist. Additionally, as Defendant notes, in 2011 Claimant's pain specialist,...
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