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Willis Knighton Health System v. Sims

Court of Appeal of Louisiana, Second Circuit

June 24, 2015

WILLIS KNIGHTON HEALTH SYSTEM, Plaintiff-Appellee
v.
PRESTON SIMS, Defendant-Appellant

Appealed from the Office of Workers' Compensation, District 1W, Parish of Caddo, Louisiana. Docket No. 14-01607. Patrick F. Robinson, Workers' Compensation Judge.

JAMES CALDWELL, Counsel for Appellant.

LUNN, IRION, SALLEY, CARLISLE & GARDNER, By: Walter S. Salley, Counsel for Appellee.

Before BROWN, LOLLEY, and PITMAN, JJ.

OPINION

Page 802

[49,967 La.App. 2 Cir. 1] BROWN, CHIEF JUDGE

Claimant, Preston Sims, appeals from the judgment of the Office of Workers' Compensation in favor of Willis-Knighton Health System reducing his workers' compensation benefits by 50% for his failure to cooperate with an order of rehabilitation. For the following reasons, we affirm. Facts and Procedural Background

On October 17, 2006, Preston Sims sustained a back injury while in the course and scope of his employment with Willis-Knighton Health System (" WK" ) in Shreveport, Louisiana. Sims suffered a herniated disk at L5-S1. His treating physician, Dr. Eubulus Kerr (dual certified in orthopedic surgery and spine surgery), recommended lumbar surgery. Although paying indemnity benefits, WK refused to approve the surgery. After a trial on the matter, the Workers' Compensation Judge (" WCJ" ), on September 8, 2011, ordered WK to approve and pay for the surgery, as well as continue to pay indemnity benefits. On March 7, 2012, Sims underwent L4-5 and L5-S1 360-degree lumbar fusion, with placement of pedicle screws, followed by a right L5-S1 micro lumbar decompression.

On July 7, 2011, the WCJ signed an order of rehabilitation wherein Lenora Maatouk was named Sims' vocational rehabilitation specialist, Sims was ordered to " participate in an adult education program in order to obtain his GED as approved by Dr. Eubulus Kerr," and, further, Sims was ordered to move forward with the entrance exam for the adult education program.

After the order of rehabilitation was entered, Sims took the adult education program placement test twice--October 10, 2011, and February 4, [49,967 La.App. 2 Cir. 2] 2013--and the GED test twice--January 27, 2012, and November 8, 2013. Sims did not take any remedial classes prior to taking the GED exam and failed the exam on both occasions. Following the failure of his second GED exam, Ms. Maatouk informed Sims that in order for him to take the GED exam again (now named HiSET) he must take a new placement test, and she further directed that he enroll in remedial classes for approximately six to nine months prior to taking the exam again. Over several months, Ms. Maatouk tried to get Sims to enroll in the adult education classes to no avail.

On March 12, 2014, as a result of Sims' refusal to enroll in adult education classes, WK filed a disputed claim for compensation with the Office of Workers' Compensation seeking to reduce workers' compensation benefits being paid to Preston Sims by 50% for his failure to cooperate with the order of rehabilitation signed by the WCJ on July 7, 2011.

A hearing on WK's motion to reduce benefits was held on May 15, 2014. The WCJ deferred ruling on the motion at that time and instead ordered the appointment of an independent medical examiner, Dr. Carl Goodman. After receiving the medical report from Dr. Goodman, the WCJ ruled that WK was entitled to reduce Sims' weekly indemnity benefits by 50% retroactive to March 12, 2014. Based on this adverse ruling, Sims has appealed.

Discussion

La. R.S. 23:1226(B)(3)(c) ...


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