Case Name: Annie Mae ARTHUR, Plaintiff, v. UNION UNDERWEAR COMPANY, INC., d/b/a Jeanerette Mills and CNA Insurance Company, Inc., Defendants
Court: Louisiana Court of Appeal
Jurisdiction: Louisiana
Decision Date: 1986-05-08
Citations: 492 So. 2d 873
Docket Number: No. 86-327
Parties: Annie Mae ARTHUR, Plaintiff, v. UNION UNDERWEAR COMPANY, INC., d/b/a Jeanerette Mills and CNA Insurance Company, Inc., Defendants.
Judges: Before GUIDRY, LABORDE and KING, JJ.
Reporter: Southern Reporter, Second Series
Volume: 492
Pages: 873–877

Head Matter:
Annie Mae ARTHUR, Plaintiff, v. UNION UNDERWEAR COMPANY, INC., d/b/a Jeanerette Mills and CNA Insurance Company, Inc., Defendants.
No. 86-327.
Court of Appeal of Louisiana, Third Circuit.
May 8, 1986.
On Rehearing Aug. 18, 1986.
Voorhies & Labbe, John P. Wolff, III, Lafayette, for defendants.
Porter & Fuselier, Donald R. Fuselier, New Iberia, for plaintiff.
Before GUIDRY, LABORDE and KING, JJ.

Opinion:
PER CURIAM.
WRIT DENIED:
The plaintiff, Annie Mae Arthur (hereinafter referred to as plaintiff), was an employee of the defendant, Union Underwear Company, Inc., d/b/a Jeanerette Mills (hereinafter referred to as defendant), who was allegedly injured during the course of her employment on March 23, 1984. Plaintiff subsequently filed a claim for worker's compensation benefits with the Louisiana State Office of Worker's Compensation (hereinafter referred to as the Office) in accordance with LSA-R.S. 23:1310.1. The office reviewed the matter and issued a recommendation, for defendant to pay worker's compensation benefits to plaintiff, which was received by both parties on or about June 25, 1984. On August 15, 1984 the Office issued a certificate indicating that neither party had timely rejected the recommendation of the Office and were therefore conclusively presumed to have accepted the recommendation of the Office, as provided in LSA-R.S. 23:1310.1. Thereafter defendant and its worker's compensation insurer, CNA Insurance Company, Inc. (hereinafter referred to as insurer), commenced paying worker's compensation benefits to plaintiff, in accordance with the recommendation of the Office. Subsequent thereto the defendant and its insurer ceased paying worker's compensation benefits to plaintiff. On March 25, 1985, the plaintiff filed suit against defendant and its insurer alleging that they had arbitrarily and capriciously stopped paying plaintiff's worker's compensation benefits. Plaintiff attached to her petition the original certificate from the Office indicating that neither party had rejected the Office's recommendation and were conclusively presumed to have accepted the recommendation.
Defendant and its insurer filed exceptions of prematurity, no right of action, no cause of action, and res judicata on the ground that plaintiff had failed to attach to her petition a certificate of rejection to the recommendation of the Office as required by LSA-R.S. 28:1811(0).
The trial court overruled all of the exceptions and defendant and its insurer have applied for a Writ of Certiorari from the denial of their exceptions.
The defendant and its insurer might have sought a modification of the recommendation of the Office by reapplying to the Office, under the provisions of LSA-R.S. 23:1331(C), before discontinuing payments to plaintiff but it chose not to do so. The defendant and its insurer cannot force the plaintiff to reapply to the Office for a determination of the issue of the right of the defendant and its insurer to cease payment of worker's compensation benefits to plaintiff nor can they attempt to defeat the plaintiff's legal action to enforce the benefits the Office had recommended, and they were conclusively presumed to have accepted, by claiming plaintiff had not first applied for and rejected a recommendation of the Office before filing suit. The defendant and its insurer may not unilaterally cease making payments of worker's compensation benefits, which under the administrative procedure of the Office they were obligated to pay, and then leave plaintiff without judicial recourse to seek enforcement of such payments. Irene Andrews v. Delta Downs, Inc., an unreported decision on application for supervisory writs bearing Number 85-842 on the Docket of this Court rendered on August 22, 1985.
For the reasons given above we find that the trial court was correct in overruling the exceptions of prematurity, no right of action, no cause of action, and res judicata filed by defendant and its insurer on the ground that plaintiff had failed to attach a certificate of rejection to her petition as required by LSA-R.S. 23:1311(C).