Case Name: Wesley J. HEBERT, Plaintiff and Appellee, v. LOFFLAND BROTHERS and Travelers Insurance Company, Defendants and Appellants
Court: Louisiana Court of Appeal
Jurisdiction: Louisiana
Decision Date: 1978-10-13
Citations: 363 So. 2d 969
Docket Number: No. 6680
Parties: Wesley J. HEBERT, Plaintiff and Appellee, v. LOFFLAND BROTHERS and Travelers Insurance Company, Defendants and Appellants.
Judges: Before CULPEPPER, DOMENGEAUX, and CUTRER, JJ.
Reporter: Southern Reporter, Second Series
Volume: 363
Pages: 969–974

Head Matter:
Wesley J. HEBERT, Plaintiff and Appellee, v. LOFFLAND BROTHERS and Travelers Insurance Company, Defendants and Appellants.
No. 6680.
Court of Appeal of Louisiana, Third Circuit.
Oct. 13, 1978.
Caffery, Duhe & Davis, Jerry A. Oubre, New Iberia, for defendants and appellants.
Landry, Watkins, Cousin & Bonin, Jacob D. Landry, New Iberia, for plaintiff and appellee.
Before CULPEPPER, DOMENGEAUX, and CUTRER, JJ.

Opinion:
DOMENGEAUX, Judge.
This is a workmen's compensation case in which the trial judge awarded plaintiff benefits for total and permanent disability, plus penalties and attorney's fees. Defendants are Loffland Brothers, the employer, and Travelers Insurance Company, the insurer. They appeal only that portion of the judgment which awards penalties and attorney's fees.
The issues are:
(1) Whether plaintiff is entitled to statutory penalties and attorney's fees because of failure to reinstate benefits (La.R.S. 22:658); and
(2) If so, was the award of attorney's fees in the amount of $2,500.00 excessive?
Plaintiff worked as a derrick man on an oil rig. He sustained extensive injuries on January 9, 1974, when he fell some fifteen or twenty feet. These injuries included trauma to the head, which induced unconsciousness, a broken arm, several broken ribs, a fractured scapula, lacerations to the head and arm, and back injuries. All of plaintiff's injuries, except those to the back, ultimately healed. Consequently, the issues involving penalties and attorney's fees revolve around the back injury.
Plaintiff was seen and treated medically from the time of the accident. He returned to work with his employer as a floorhand (roughneck) on July 2, 1974. Although the jobs of derrick man and floorhand are different, both require strenuous activity. At the time of his return to work, his maximum compensation benefits were terminated by Travelers.
After working a few months as a floor-hand, plaintiff complained of persistent pain in his back, and, in November 1974, when an opening came up on another rig, plaintiff was assigned the job of a motorman. This is a lighter type work than that which he had been performing.
On May 13, 1975, the rig on which plaintiff was employed was stacked, and plaintiff lost his job. About two weeks subsequent to the layoff, plaintiff was offered a job as a floorhand by his employer, but he refused, stating that he was unable to do this type of work because of pain in his back. Plaintiff instituted this suit on March 15, 1976, and, based on subsequent medical developments, which will be discussed hereinafter, defendant, Travelers, reinstated compensation on July 1, 1976, and paid all arrearages.
Plaintiff was treated by Dr. Ethel Smith from the time of the accident until July 2, 1974, when she certified plaintiff as being able to return to his regular duties. He was seen by Dr. Fred C. Webre, an orthopedic surgeon, on April 24,1974, primarily for difficulties in the right knee, and the doctor reported generally that there was no particular problem with the knee and that there was no reason to believe that plaintiff would have any type of impairment in that connection. Doctor Webre saw plaintiff again on September 30, 1974, and reported that the lower back showed a transverse of the L-2 vertebrae on the right, which was apparently split in an old injury. The doctor was unsure as to whether this was caused by the injury of January 9, 1974. He did think, however, that plaintiff should continue to work as he had been doing. Doctor Webre saw plaintiff again on November 14, 1974, and plaintiff complained that, although he was continuing his work, he was doing so with difficulty and pain. Doctor Webre thought that the lower back was clear, but recognized that plaintiff appeared to have legitimate difficulties. The doctor also thought that, inasmuch as plaintiff was continuing to work, he should begin wearing a back brace in order to alleviate difficulties experienced on the job. Plaintiff returned to Doctor Webre on December 16, 1974. This was after plaintiff had changed his job to that of motorman and during the time in which plaintiff was wearing the recommended back brace. At that time Doctor Webre suggested that plaintiff continue his employment and try to wean out of the back brace in time. The doctor indicated that there were no specific findings upon which a diagnosis of disc herniation could be made.
On March 17, 1975, a myelogram was performed on plaintiff by Doctor Brendon Miles, a radiologist, at the request of Doctor Webre. This resulted in negative findings. On April 17, 1975, Doctor Webre reported that plaintiff had returned to work after the myelography and thought that there was no need for further orthopedic treatment.
Plaintiff was examined by Dr. Stuart Phillips, an orthopedic surgeon, on June 11, 1975. On July 3, 1975, plaintiff's attorney mailed to defendant Travelers a copy of Doctor Phillips' report, which indicated that plaintiff was unable to return to his prior occupations of either derrickman or motorman and which estimated plaintiff's disability at ten percent. On August 13, 1975, plaintiff's attorney received a letter from defendant Travelers requesting an examination of plaintiff by Dr. H. R. Soboloff, a third orthopedic surgeon. On August 26, 1975, plaintiff's attorney refused an examination by Doctor Soboloff, but suggested a re-examination by Doctor Webre. On September 22,1975, the appointment for re-examination by Doctor Webre was not kept by plaintiff on advice of his counsel. On November 18,1975, plaintiff's attorney furnished a report by Dr. Richard W. LeBlanc, a fourth orthopedic surgeon, which indicated that plaintiff was unable to participate in heavy manual labor.
As indicated above, plaintiff instituted this suit on March 15, 1976. On May 6, 1976, Doctor Webre re-examined plaintiff pursuant to a Court Order. This report, which was received by Travelers' adjuster in the middle of May, 1976, showed that plaintiff had a disc injury. Doctor Webre, from his examination of plaintiff, and a review of the x-rays and a discogram which had been performed by Doctor LeBlanc, concluded that plaintiff had an abnormality at the lumbo-sacral disc space, and therefore recommended that the lumbo-sacral disc space should be explored and evacuated. Shortly after this report, as previously mentioned, Travelers paid all past due benefits and continued to pay maximum benefits thereafter.
When a workmen's compensation insurer fails to make payments within sixty days after receipt of proof of loss and such failure is found to be arbitrary, capricious, or without probable cause, the insurer is subject to a penalty, in addition to the amount of the loss, of twelve percent damages on the total amount of the loss, together with all reasonable attorney's fees for the prosecution and collection of such loss. La.R.S. 22:658. Thus, the substantial issue presented on this appeal is whether Travelers' failure to resume compensation benefits prior to July 1,1976, was arbitrary, capricious, or without probable cause.
Appellants place reliance on Doctor Webre's report of April, 1975, which indicated that plaintiff was able to work, and the fact that plaintiff failed to keep his appointment for re-examination with Doctor Webre on September 22, 1975. It is now settled that an employer may not terminate the payment of compensation benefits to a disabled employee solely because the employee fails to report for a medical examination arranged by the employer. Green v. Liberty Mutual Insurance Company, 184 So.2d 801 (La.App. 3rd Cir. 1966), and Richardson v. Weitz Company, 202 So.2d 361 (La.App. 1st Cir. 1967).
Generally, the termination of compensation benefits by an insurer, based on competent medical reports or evidence, is not arbitrary, capricious, or without probable cause within the meaning of the compensation statute. However, the existence of conflicting medical reports may not, under all circumstances, justify the nonpayment of benefits, either by discontinuance or failure to reinstate. For example, our Supreme Court in the case of Walker v. Gaines P. Wilson & Son, Inc., 340 So.2d 985 (La.1976), stated:
"[I]f subsequent to an initial optimistic report, an insurer receives medical information indisputably showing disability at a subsequent date, the insurer may not blindly rely upon the early report and solely on its basis avoid penalties for arbitrary non-payment of compensation benefits indisputably due a disabled workman." [Citations omitted]
The evidence shows that following plaintiff's refusal to report for re-examination by Doctor Webre, Travelers made no further requests or demands and made no further investigation of the claim until after suit was filed in March of 1976. It is undisputed that in November of 1975, Travelers had in its possession two reports of competent physicians indicating that plaintiff was disabled. The only contrary information which Travelers had at that time was the report of Doctor Webre of April, 1975, some seven months old, which indicated that plaintiff could work. The defendants knew that plaintiff had been wearing a brace for the last six months in which he worked. They should have known that even Doctor Webre must have been concerned about plaintiff's physical condition, inasmuch as he had ordered the myelogram performed on plaintiff in March, 1975. Appellants' reliance on Doctor Webre's report of April, 1975, is unwarranted under the circumstances present in this suit. Of significance in this overall picture is the fact that Doctor Webre, as early as November 14, 1974, recognized that plaintiff appeared to have legitimate back difficulties and recommended that he wear a back support at a time when he was performing the less strenuous work of a motorman. The defendant Travelers should have conducted further medical investigations of plaintiff's condition, particularly after receiving a second report by a qualified orthopedic surgeon showing disability. Only the filing of suit in March of 1976, caused Travelers to take the necessary action in bringing a rule before the District Court to require plaintiff to be re-examined by Doctor Webre.
We feel that the rationale in Walker, supra, applies here, and we consequently conclude that attorney's fees were properly awarded by the District Judge.
Concerning the issue of the exces-siveness of attorney's fees, it is well settled that the amount awarded therefor is left largely to the discretion of the trial court. Artigue v. Louisiana Farm Bureau Mutual Insurance Company, 339 So.2d 880 (La.App. 3rd Cir. 1976). We note that the trial judge properly took into consideration the degree of skill and amount of work involved; the number of court appearances; the number of depositions taken; the amount of office work; and the length of time spent in court. Our review of the record indicates that the amount awarded by the trial court as attorney's fees was not unreasonable.
For the reasons assigned, the judgment appealed from is affirmed. The costs of this appeal are assessed to appellants.
AFFIRMED.
CULPEPPER, J., dissents and assigns written reasons.