Assistant's false statement in applying for unemployment doesn't end comp
Case name: Fontenot v. State of Louisiana, No. 2012-CA-1265 (La. Ct. App. 04/02/13).
The Louisiana Court of Appeal held that the state did not meet its burden of showing that an assistant forfeited his workers' compensation benefits by making false statements to obtain and maintain benefits.
What it means:
In Louisiana, a worker's benefits can be forfeited when he willfully makes a false statement of representation for the purpose of obtaining benefits.
An administrative assistant for the state department of health and hospitals was injured while in the course and scope of his employment. When he received workers' compensation benefits, he signed a certification indicating that he understood and would comply with the obligation of notifying the state's insurer of any and all employment, including unemployment compensation. However, the state did not provide him with the required forms for his monthly earnings and certificate of compliance setting forth the penalties for workers' compensation fraud. The assistant's employment ended, and he continued to receive workers' compensation benefits. He also applied for unemployment compensation benefits. The state terminated his workers' compensation benefits when it learned that he was receiving unemployment compensation benefits. The state asserted that he made false statements in order to obtain and maintain workers' compensation benefits so his benefits should be terminated. The Louisiana Court of Appeal held that he did not forfeit his workers' compensation benefits.
The court found that the state did not meet its burden of showing that the assistant forfeited his workers' compensation benefits. While he did make false statements when he told the office of unemployment security that he was not receiving workers' compensation benefits, his false statements were made for the purpose of obtaining unemployment compensation benefits and not workers' compensation benefits. The assistant never made a false statement to the state regarding his receipt of unemployment compensation benefits.
The court noted that the state advised him to apply for unemployment compensation benefits when he was terminated. The court said that the state should have advised the assistant that he would not receive both unemployment compensation benefits and workers' compensation benefits at the same time. The state also should have notified its adjuster to apply credits during any period unemployment compensation benefits were received.
The court found that the assistant was entitled to $10,000 in attorney's fees based on the time, energy, and efforts expensed by his attorney.
Read more at the WorkersComp Forum homepage.
July 15, 2013
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