FROM THE OFFICE OF WORKERS' COMPENSATION, DISTRICT 02, PARISH OF RAPIDES, NO. 14-00992. JAMES BRADDOCK, WORKERS' COMPENSATION JUDGE.
Robert L. Beck, III, Law Offices of Robert L. Beck, Jr., LLC, Alexandria, LA, COUNSEL FOR PLAINTIFF-RELATOR: Tracy Bowie.
Matthew R. Richards, Johnson, Rahman & Thomas, Baton Rouge, LA, COUNSEL FOR DEFENDANTS-RESPONDENTS: Westside Habilitation Center, Inc. and Louisiana Workers' Compensation Corporation.
Court composed of Sylvia R. Cooks, John D. Saunders, Jimmie C. Peters, Marc T. Amy, and J. David Painter, Judges. Amy, J., dissents and assigns written reasons.
[14-617 La.App. 3 Cir. 1]
Relator, Tracy Bowie (Bowie), seeks supervisory writs from the judgment of
May 15, 2014, from the Office of Workers' Compensation (OWC), which found that " Defendants carried their burden of proving that they complied with the requirements of La. Rev. Stat. 23:1201.1(A) and are therefore entitled to a Preliminary Determination hearing with respect to the controversion of the compensability of the alleged left knee injury suffered by the Claimant as a result of the work accident of May 10, 2013, and with respect to the medical treatment that has been requested for the alleged left knee injury." For the following reasons, we grant the writ and reverse the ruling of the Workers' Compensation Judge (WCJ). The matter is remanded to the OWC for further proceedings in accordance with this opinion.
FACTS AND PROCEDURAL HISTORY
Bowie was employed by Westside Habilitation Center, Inc. (Westside) and allegedly suffered a work-related accident on May 10, 2013, when she attempted to restrain a combative patient. Westside was insured by Louisiana Workers' Compensation Corporation (LWCC).
Bowie allegedly suffered injuries to her knees and lower back, and she began receiving benefits on May 23, 2013. The weekly checks were mailed to 2120 Memorial Drive, Alexandria, Louisiana, until such time as Bowie became represented by counsel. Thereafter, the checks were sent to her attorney. LWCC initially paid for Bowie's reasonable and necessary medical expenses, including treatment for her left knee. However, on February 3, 2014, in a letter to Bowie's attorney, LWCC advised that they would no longer be paying for any expenses related to her left knee. LWCC advised Bowie that it considered the left knee problems to be a pre-existing medical condition that was not compensable. A [14-617 La.App. 3 Cir. 2] " Notice of Payment, Modification, Suspension, Termination of Medical Benefits" (the Notice) was sent to Bowie through her attorney on February 3, 2014. Bowie filed a Notice of Disagreement just four days later wherein she noted that she disagreed with the Notice because the work-related accident of May 10, 2013, aggravated her pre-existing left knee injury. Then, on February 14, 2014, Bowie filed a disputed claim for compensation, Form 1008.
Westside and LWCC (hereinafter collectively referred to as " Defendants" ) filed an answer to the 1008 and requested a preliminary determination on the issue of suspension of benefits with respect to the left knee injury. Bowie then filed a rule to show cause to determine whether defendants were entitled to a preliminary determination pursuant to La.R.S. 23:1201.1. Following a hearing on the rule, the WCJ found that Defendants were entitled to a preliminary determination hearing. Bowie timely applied for a writ with this court, and proceedings in the court below were stayed.
In the writ application, Bowie argues that the WCJ committed legal error in concluding that LWCC did not have to prove its compliance with La.R.S. 23:1201.1(A)-(E) and that the WCJ committed legal and manifest error in concluding that LWCC was entitled to a preliminary determination under La.R.S. 23:1201.1 after LWCC failed to present competent evidence or elicit testimony that the Notice of Payment was sent to Bowie as required by La.R.S. 23:1201.1(A)(2). For the reasons that follow, we agree. The writ is granted based on our finding that Westside and LWCC are not entitled to a preliminary determination due to the failure to comply with the statutory provisions of La.R.S 23:1201.1. Thus, the WCJ's ruling is hereby reversed, and the matter is remanded to the Office of Workers'
Compensation for further proceedings consistent with this opinion.
[14-617 La.App. 3 Cir. 3] DISCUSSION
Louisiana Revised Statutes 23:1201.1 reads, in pertinent part:
A. Upon the first payment of compensation or upon any modification, suspension, termination, or controversion of compensation or medical benefits for any reason, including but not limited to issues of medical causation, compensability of the claim, or issues arising out of R.S. 23:1121, 1124, 1208, and 1226, the ...