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Surveillance video, exaggeration of symptoms fails to demonstrate fraud
In Louisiana, video surveillance of a worker performing activities he claimed he was unable to does not trigger a forfeiture of benefits because the worker's doctor was aware he performed the activities.
Case name: Harrell v. Brookshire Grocery Co., No. 11-108 (La. Ct. App. 09/07/11). Ruling: The Louisiana Court of Appeal held that a worker was entitled to temporary total disability benefits and medical expenses.
Summary: An overnight stocker for a grocery store was working when a coworker's foot was run over by a forklift. The stocker put the coworker into a wheelchair and lifted him into a coworker's car. The stocker claimed that he felt a pop followed by burning and tingling in his back as he lifted his coworker. He resumed his work, thinking the pain would go away. He claimed that he notified store managers about his injury. Six days later, he sought treatment for back, groin, and neck pain. The store began paying indemnity benefits and medical expenses and began surveillance of the worker. Later, the store terminated benefits. The stocker sought to have his benefits reinstated, payment for a wheelchair and behavioral pain management expenses, and penalties and attorney's fees. The Louisiana Court of Appeal held that the stocker was entitled to temporary total disability benefits and medical expenses. The court determined that the stocker suffered injuries as a result of a workplace accident. The stocker suspected that something was wrong with his back immediately after he lifted the coworker and informed store managers shortly afterward. He also sought treatment. The store argued that surveillance videos showed that the stocker was "lying" about the extent of his injury. Although the stocker exaggerated his symptoms and the video showed him doing activities he claimed to be unable to do, the court found the stocker's actions did not amount to a showing of fraud that would result in a forfeiture of benefits. The stocker's doctor said he was aware that the stocker performed yardwork and horseback riding. A dissenting judge opined that the stocker grossly misinterpreted the truth with the intent of obtaining or prolonging his entitlement to benefits. The judge found it "especially troubling" that the stocker included family members in his perpetration of fraud, where he was seen walking with ease at one moment and "pretending" to struggle with pain the next. Read more at the WorkersComp Forum homepage. October 20, 2011 Copyright 2011© LRP Publications |
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