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Failure to investigate technician's claim triggers penalties
In Louisiana, a worker who files a claim for benefits after stating that he was not seeking benefits should prompt an employer to investigate, rather than deny the claim.
Case name: Green v. National Oilwell Varco, No. 10-1041 (La. Ct. App. 04/27/11). Ruling: The Louisiana Court of Appeal held that a technician was entitled to medical benefits, indemnity benefits, penalties, and attorney's fees.
Summary: A lead service technician for an oil company was breaking down a motor with a coworker when a part pressured up and struck him in the groin, causing him to fly backwards and land on his back. The technician immediately felt pain all the way down his leg and he urinated on himself. His groin began to swell, and he told his supervisor and the facility manager that he could not work. He was terminated two weeks after his injury. The technician saw a number of doctors due to pain until he could not afford to do so. He told a nurse case manager that he was not under workers' compensation. The nurse closed his file because he could not give her information. The technician also told an insurance adjuster that he was not pursuing workers' compensation, and he was being treated for an unrelated matter. One month later, he filed a claim for benefits. The Louisiana Court of Appeal held that the technician was entitled to medical benefits, indemnity benefits, penalties, and attorney's fees. The court found that the technician was entitled to past medical expenses, as they were related to treatment for his work-related injury. The court noted that the company "turned its back" on the technician even though he consistently sought medical treatment for his work-related injury. The technician's termination two weeks after his injury limited his ability to pay for adequate medical care. The court also found that he was entitled to indemnity benefits because he continued to suffer from substantial pain. In arguing that the technician should not be entitled to attorney's fees and penalties, the company asserted that it denied the claim because the technician told multiple people that he was not pursuing treatment under workers' compensation. The court disagreed, finding that the technician's filing of a claim should have prompted the company to investigate despite what he may have indicated. The company did not "reasonably controvert" the claim, entitling him to penalties and attorney's fees. Read more at the WorkersComp Forum homepage. June 16, 2011 Copyright 2011© LRP Publications |
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