Case name: Wright v. Cypress General Contractors, No. 11-238 (La. Ct. App. 10/05/11).
The Louisiana Court of Appeal held that a worker was entitled to a reinstatement of his indemnity and medical benefits, penalties, and attorney's fees.
What it means: In Louisiana, an employer asserting that a worker committed fraud by working while collecting benefits must show the worker was earning money and was capable of performing work.
Summary: A worker suffered a compensable injury to his left knee. He received indemnity and medical benefits. Later, the employer began to suspect that the worker was working. Through an Internet search, the workers' compensation adjuster learned that the worker was associated with a company that produced and sold custom goose calls. The employer hired a private investigator. The investigator purchased goose calls from a company owned by the worker's wife and received instructional videos depicting the worker. The worker, who had won goose calling world championships using calls that he had built, was also pictured on the company's website and sometimes handled the company's phone orders. The employer requested the worker to report his earnings, and he denied receiving wages or being involved in a business. The company terminated his benefits. The Louisiana Court of Appeal held that the worker was entitled to a reinstatement of his benefits, penalties, and attorney's fees.
The court found that the employer's discontinuation of the worker's benefits was "arbitrary and capricious" based on the investigation of his possible income-producing activities. The employer also failed to have the worker undergo vocational rehabilitation testing. The employer failed to show that the worker was capable of doing physical work or that he was earning money. Although the worker admitted that he helped make the goose calls, the company did not make any money.
Read more at the WorkersComp Forum homepage.
November 28, 2011
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