Summary of a Recent
Judicial Development in
Labor

Denial of Motion for Independent Medical Examination of Injured Employee

Walt McCarter
National AgLaw Center Research Associate

Summary of Decision

In Smith v. Pilgrim's Pride Corp., 4 So. 3d 983, 2009 WL 474066 (La. Ct. App. 2009), the Louisiana Court of Appeals held that an employee was entitled to workers' compensation benefits and medical treatment because her injuries were work-related, and also ruled that the employer's motion for continuance to obtain an independent medical examination and motion to recuse the workers' compensation judge had been properly denied.

Background

A Pilgrim's Pride ("Pilgrim's") processing plant employee who was diagnosed with bilateral carpal tunnel syndrome brought this action against Pilgrim's to recover for her injuries. Id. at *1. Her doctor recommended surgery on her shoulder, but upon Pilgrim's request, she got a second opinion; that doctor found impingement of her left shoulder but did not recommend surgery, and Pilgrim's therefore refused to pay for shoulder surgery. Id. The employee's doctor again recommended surgery, and the employee filed a claim for compensation seeking reimbursement for mileage, payment of medical bills, penalties, and attorney fees. Id. Pilgrim's moved for a continuance and sought a state-appointed independent medical examination to determine "whether the claimant's shoulder pain was related to her employment and whether surgery was medically necessary." Id. The workers compensation judge denied the motion and scheduled a visit to the processing plant to observe the claimant's workplace. Id. Pilgrim's then moved to recuse the judge on the grounds that he had become an advocate for the claimant and a witness in the matter, but the judge denied that motion as well. Id. at *2. The judge ruled that the claimant's injury was work-related and that she was entitled to have the recommended surgery, and also awarded her $2,000 in penalties and $7,000 in attorney fees, finding that "Pilgrim's denial of medical treatment was arbitrary and unreasonable." Id. The workers' compensation chief judge affirmed denial of the recusal motion and rendered judgment in favor of the claimant, and Pilgrim's appealed. Id.

Arguments

Pilgrim's argued that the workers' compensation judge erred in failing to grant a continuance and order an independent medical examination, because the independent examination was necessary given previous conflicting medical opinions. Id.

Analysis and Holdings

The court concluded that Pilgrim's should have sent the claimant back to get a another second opinion after her doctor recommended surgery the second time, but instead denied treatment based on the assertion that the injury was not related to her job duties. Id. Moreover, the court noted that Pilgrim's had already been granted a continuance to obtain additional medical depositions, but had failed to depose the two physicians that examined the claimant to address the issue of causation. Id. The court therefore determined that Pilgrim's had failed to show evidence of a dispute concerning the claimant's injuries, so the judge's denial of its motion to schedule an independent examination was not erroneous. Id. at *3. The court further held that the evidence supported the judge's finding that the injuries were work-related, and therefore the claimant was entitled to compensation benefits and medical treatment. Id. at *4.

Regarding penalties and attorney fees, the court explained that "[t]he employer's failure to provide payment of compensation or medical benefits owed shall result in the assessment of a penalty and reasonable attorney fees, unless the employer has reasonably controverted the claim," meaning that "the employer must have sufficient factual or medical information to reasonably counter the evidence provided by claimant." Id. The court found that Pilgrim's had failed to reasonably controvert the claim, and therefore held that the penalties and attorney fee awards were proper. Id. at *5. Lastly, the court affirmed the decision to deny Pilgrim's motion for recusal, finding that that the inspection of the facility did not make the workers' compensation judge a witness and that "Pilgrim failed to satisfy its burden of proving actual bias on the part of the [judge] that prevented a fair trial." Id. at *6.

The case was decided on February 25, 2009.