Legal Definitions

1010 Form Required For Company To Cover Medical Expenses in Workers Compensation

Published on: October 27, 2023 | By Berniard Law Firm

photo_old_old_recording_0-scaled While workers’ compensation is intended to compensate injured workers, there are a number of procedural requirements with which an injured worker must comply in order for his or her company to cover the medical treatments. This case illustrates the importance of complying with procedural requirements and submitting all required paperwork.

While working for Circle K Stores, Melody Smith went to a Capitol One bank located in Lafayette, Louisiana. Before Smith reached the bank to make the night deposit, she was robbed by a person who crashed his truck into the rear end of Smith’s car and shot at her two times. He then smashed her window and took the deposit bag from her.

Smith injured her knee, back, and neck in the incident. Circle K paid Smith workers’ compensation benefits following the incident. However, the parties disagreed about treatment for Smith’s injured knee. Smith filed a Form 1008 under La. R.S. 23:1034.2(F)(1) against Circle K, claiming it had failed to pre-authorize her evaluation for her knee injury with her selected physician.

Worker Entitled To Unpaid Compensation Owed Him Under Contract

Published on: October 26, 2023 | By Berniard Law Firm

business_signature_contract_962355-scaled One frequent use of contracts is to establish how much someone will be paid for specified work. Clear contractual language can help prevent disputes down the road. What happens if you do not receive all the compensation to which you are entitled under your contract?

Clifton Franklin and Fountain Group Adjusters signed a contract where Franklin would provide Fountain with insurance adjusting services related to claims from Superstorm Sandy. The contract outlined how Franklin would be compensated by Fountain. Franklin claimed Fountain wanted him to sign a second contract because it could not find the first contract. While the second contract set Franklin’s compensation at 75% rather than the 65% in the initial contract, Franklin only asserted claims for the original 65% commission.

Claims One employed Franklin during this time. Fountain also signed a contract with Claims One. Although Franklin received some compensation from Fountain, he filed a lawsuit against Fountain, claiming he had not been fully compensation.

Prior Mistake Does Not Waive Insurer’s Defense In Subsequent Claim

Published on: October 24, 2023 | By Berniard Law Firm

supreme_court_building_washington_3_9-scaled If you are in a car accident and your insurance pays your claim, you likely expect the same thing will happen if you are subsequently in a similar accident. What happens if your insurer paid your prior claim, but tries to deny a subsequent claim?

Brandon Forvendel was injured in a car accident. When the accident occurred, he was driving a car he owned and was insured by State Farm. Forvendel had uninsured motorist coverage. After the accident, Forvendel recovered under his uninsured motorist policy.

When the accident occurred, he was living with his mother, who also had insurance through State Farm. Forvendel also tried to recover under his mother’s uninsured motorist policy, which had higher policy limits. State Farm denied his attempt to recover under both his and his mother’s policies under the anti-stacking provisions in La. R.S. 22:1295(1)(c). Forvendel then filed a lawsuit against State Farm.

Who Is Covered By A Settlement Agreement Release?

Published on: October 23, 2023 | By Berniard Law Firm

writing_write_person_paperwork-scaled A settlement agreement can be an efficient way of resolving a claim and receiving compensation without a lengthy trial process. However, it is essential to understand what a settlement agreement does and does not cover to avoid surprises down the road if you later try to bring related lawsuits against other parties.

Kerry Maggio was injured in a car accident when he was hit by a vehicle driven by James Parker, who worked for Sandwich Kings. Brenda Parker owned the vehicle, which was insured by the Louisiana Farm Bureau. Maggio filed a lawsuit against James Parker, Sandwich Kings, and their insurers.

Maggio signed a settlement agreement and release of all claims with Brenda Parker and the Louisiana Farm Bureau. Neither James Parker nor Sandwich Kings was specifically mentioned in the release. Sandwich Kings and its insurer filed a summary judgment motion, arguing Maggio’s release applied to them because it released “all other persons” who were or might be liable for his injuries from the accident.

Hospital Not Liable For Negligent Transportation During Hurricane Katrina

Published on: October 22, 2023 | By Berniard Law Firm

hurricane_bob_1991_cyclone-scaled Over a decade after Hurricane Katrina, we have almost all heard of the difficult choices hospitals faced while trying to care for patients. This case involves a patient who was allegedly injured while being evacuated from a New Orleans hospital during Hurricane Katrina.

Lionel Favret was admitted to the hospital in New Orleans, Louisiana where he was diagnosed with a bone disease and back pain. He was treated with antibiotics and underwent back surgery. He faced a difficult recover and while in the ICU, Favret had to be resuscitated on two different occasions.

He was moved out of the ICU into a unit for surgery patients when Hurricane Katrina hit. Hospital employees carried Favret down several stories of stairs into the parking garage where he was eventually evacuated after over a day. When he arrived at the new hospital, he was diagnosed with fractures in his back and an infection. He underwent another back surgery.

Presumption of Negligence in Rear-End Accidents Does Not Always Lead To Summary Judgment Victory

Published on: October 20, 2023 | By Berniard Law Firm

car_racing_crash_accident-scaled Under Louisiana law, there is a presumption the driver of a car that rear-ends another car acted negligently. However, this presumption of negligence can be overcome in certain situations, such as if the driver of the vehicle that was rear-end shifted lanes soon before the accident.

While Tammy Bloxham was stopped at a red light in her car, she was hit from behind by Andy Gibbs Jr. At the time of the accident, Gibbs was driving a tractor-trailer owned by 31 Energy. Bloxham filed a lawsuit against Gibs, 31 Energy, and 31 Energy’s insurer. Bloxham argued 31 Energy had been negligent in hiring Gibbs and not inspecting its vehicle’s brakes. The defendants filed a summary judgment motion, claiming Bloxham had not reported this claim in her pending bankruptcy. Bloxham also filed a summary judgment motion, claiming Gibbs was liable under La. R.S. 32:81 A and the presumed negligence of the driver of a following vehicle who hits the rear of another vehicle.

The trial court granted Bloxham’s summary judgment motion given the presumption that a following driver who rear ends another vehicle is negligent. The court held this applied even if Bloxham had changed lanes immediately before the accident. The defendants filed an appeal.

Can an Independent Contractor collect Workers’ Compensation Benefits?

Published on: October 19, 2023 | By Berniard Law Firm

labor_farmer_village_work The distinction between independent contractors and employees has always been something of a balancing test. This distinction becomes vital in workers’ compensation issues, where employees generally enjoy peace of mind with workers’ compensation in the event of an injury, whereas independent contractors usually do not. But are there some cases where an independent contractor can collect workers’ compensation benefits? The answer to this question is illustrated in the following appeal from the New Orleans Office of Workers’ Compensation.

Federico Espinoza Martinez and four others were hired by Jaroslov Rames to lower a washer/dryer combination unit to the first floor of an apartment building. During the lowering of the unit, Mr. Martinez received a laceration on his hand when one of the ropes used snapped. Despite a broken rope and cut hand, Mr. Martinez and the others completed the job. Afterward, Mr. Rames drove Mr. Martinez to the emergency room, paying five hundred dollars to ensure proper treatment was administered. Mr. Martinez later attempted to collect his pay from Mr. Rames. Mr. Rames informed him that he had deducted the five-hundred-dollar emergency room fee from Mr. Martinez’s check and planned to deduct the remainder of the hospital fee from his future earnings.

Mr. Martinez filed a claim for workers’ compensation benefits he believed Mr. Rames owed him. The issue was heard by the Office of Workers’ Compensation (henceforth “OWC”), and it was found that Mr. Martinez was not an employe of Mr. Rames, but rather an independent contractor. Benefits were denied based on this finding. Mr. Martinez appealed, maintaining that the OWC failed to apply the manual labor exception outlined in La. R.S. 23:1021(7). The OWC found the manual labor exception did not apply to the set of facts, denying benefits again for Mr. Martinez.

Is Delaying An Examination Under Oath A Lack of Cooperation In A Homeowner’s Insurance Claim?

Published on: October 2, 2023 | By Berniard Law Firm

house_architecture_brick_door_0-scaled In order to recover under a homeowner’s policy, there are many requirements with which you must comply. One common requirement is providing the insurer with requested documentation and undergoing an examination under oath where the insurer can ask questions and gather information relevant to the claim. What happens if a homeowner delays undergoing an examination under oath?

Jesse and Dena McCartney’s house was destroyed in a fire. They filed a claim with Shelter Mutual Insurance, who issued their homeowner’s policy. Their policy required that they cooperate with the insurer, including answering questions under oath and submitting proof of loss. The McCartneys filed a lawsuit against Shelter for refusing to pay them anything.

Shelter filed a summary judgment motion, arguing the McCartneys had not provided the required requested information and had refused to submit to an examination under oath. The McCartneys claimed they had not refused to cooperate with the investigation and had submitted documentation and recorded statements. They also claimed they had only postponed the examination under oath, not refused it. They noted Shelter had requested an examination under oath more than sixty days after the McCartneys submitted their proof of loss, which was after the time by when Shelter was required to pay them or make a settlement offer. The trial court granted Shelter’s summary judgment motion, explaining the McCartneys had voided their policy by not submitting to an examination under oath. The McCartneys filed an appeal.

No Hostile Work Environment Where Employer Took Remedial Actions

Published on: October 1, 2023 | By Berniard Law Firm

usps_mcveytown_pa_17051-scaled No one should have to deal with sexual harassment in the workplace. If you are dealing with sexual harassment at work and you report it to your employer, you hope they will act on your report. How do actions taken by your employer affect your ability to recover for sexual harassment in court?

Shelita Tucker worked for UPS in Port Allen, Louisiana for three years. One of the subordinates she managed was Larry McCaleb. Tucker claimed McCaleb sexually harassed her for about two years. His alleged sexual harassment involved inappropriate touching. Soon after the incident with the inappropriate touching, Tucker reported what had happened to the business manager. McCaleb was taken out of service while the investigation was ongoing. The next day, Tucker filed a complaint with the UPS Compliance Line. She subsequently also filed a report with the local police department.

The next week, Tucker was on a scheduled vacation. While she as on vacation, UPS investigated the matter and suspended McCaleb. When McCaleb was allowed to return to work, UPS took corrective action including meeting with McCaleb, counseling him about proper behavior and relevant policies, and prohibiting him from going near Tucker. McCaleb was also convicted of battery and sentenced to 90-days in jail. Tucker reported McCaleb never talked to or touched her again. The one-time McCaleb entered her work area, she reported it and UPS addressed it. Tucker claimed she still felt unsafe at work because McCaleb also worked at the facility. However, she said she was still about to perform her job. She claimed McCaleb would stare at her as she walked in or out of work.

Louisiana Jury Did Not Err In Apportioning Fault For Car Crash

Published on: September 8, 2023 | By Berniard Law Firm

rim_tire_wheel_round-scaled In the heart of Lafayette Parish, Louisiana, tragedy struck on Interstate 10 as a routine drive turned fatal. Arthur Huguley, behind the wheel of a tractor-trailer for AAA Cooper Transportation, found himself in a situation that would forever alter the lives of those involved. A blown-out tire, a series of events, and a wrongful death lawsuit brought forth by Curley Mouton’s surviving family members set the stage for a courtroom drama that unfolded with unexpected twists. In the end, a jury assigned fault, but the defendants, Huguley, AAA Cooper, and their insurer, were not ready to accept the verdict without a fight. This article explores the intricacies of their appeal, shedding light on the compelling arguments presented and the complexities of apportioning fault in a tragic accident.

Arthur Huguley was driving a tractor-trailer in Lafayette Parish, Louisiana, on Interstate 10 while working for AAA Cooper Transportation (“AAA Cooper”). Huguley heard a bang and worried he might have blown out a tire. While performing a maneuver to see if he had blown out a tire, the tire that had blown out came apart and flew into the air. Curley Mouton was driving in a truck behind Huguley when debris from the tire started flying through the air. The debris hit Mouton’s truck, causing him to hit a guardrail, flip over, and crash. Mouton died in the crash.

Mouton’s surviving spouse and son filed a wrongful death lawsuit against Huguley, AAA Cooper, and their insurer. A jury found in favor of Mouton’s family and assigned 10% fault to Huguley and 90% to AAA Cooper for putting a defective tire on its truck. The defendants appealed, claiming the jury had erred in its ruling.