Employer fails to show clerk willfully refused to comply with weight loss
Amerisure Insurance Co. v. Jones, No. 2012 CA 1267 (La. Ct. App. 06/14/13).
Ruling: The Louisiana Court of Appeal held that a clerk was compliant with the weight loss rehabilitation offered to him, so his benefits were not reduced.
What it means: In Louisiana, a worker's refusal to accept rehabilitation deemed necessary by the workers' compensation judge will result in a 50 percent reduction in weekly compensation.
Summary: A warehouse clerk who weighed 600 pounds injured his back while lifting some pallets. He received treatment for his back pain, including medication and physical therapy. When that treatment was unsuccessful, the clerk was given a prescription for a weight loss program.
Later, the employer disputed compensation, alleging that the clerk failed to comply with his prescribed rehabilitation to lose weight and requested that his indemnity benefits be reduced retroactive to the date the weight loss program had been prescribed. Alternatively, the employer requested that any future benefits be conditioned on the clerk's participation with the recommended rehabilitation of weight loss. The Louisiana Court of Appeal declined to reduce the clerk's benefits.
A state statute provides that a worker's refusal to accept rehabilitation as deemed necessary by the workers' compensation judge will result in a 50 percent reduction in weekly compensation. The court found that the WCJ did not find that weight loss rehabilitation was necessary. The court pointed out that the prescription for weight loss was requested by the clerk, and his health care providers acquiesced.
The court also found that the clerk was cooperative and complaint with the weight loss rehabilitation offered to him. The employer presented medical evidence that the clerk's injury should have resolved within a few months of the accident and his pain symptoms persisted due to his morbid obesity. The clerk stated that he had been overweight since childhood and that he was compliant with his weight loss plan. The employer failed to show that he willfully refused to comply with the prescribed rehabilitation for weight loss.
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August 30, 2013
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