Case Name: Presley Carl MUSE, Plaintiff-Appellee, v. SENTRY INSURANCE COMPANY et al., Defendants-Appellants
Court: Louisiana Court of Appeal
Jurisdiction: Louisiana
Decision Date: 1972-08-04
Citations: 269 So. 2d 609
Docket Number: No. 3900
Parties: Presley Carl MUSE, Plaintiff-Appellee, v. SENTRY INSURANCE COMPANY et al., Defendants-Appellants.
Judges: Before FRUGÉ, HOOD and DOMEN-GEAUX, JJ.
Reporter: Southern Reporter, Second Series
Volume: 269
Pages: 609–618

Head Matter:
Presley Carl MUSE, Plaintiff-Appellee, v. SENTRY INSURANCE COMPANY et al., Defendants-Appellants.
No. 3900.
Court of Appeal of Louisiana, Third Circuit.
Aug. 4, 1972.
Rehearing Denied Sept. 13, 1972.
Dissenting Opinion Sept. 18, 1972.
Writ Refused Oct. 26, 1972.
Stafford, Pitts & Bolen, James A. Bolen, Jr., Alexandria, for defendants-appellants.
Kramer & Kennedy by Bernard Kramer, Alexandria, for plaintiff-appellee.
Before FRUGÉ, HOOD and DOMEN-GEAUX, JJ.

Opinion:
FRUGÉ, Judge.
This is an appeal from a workmen's compensation suit wherein plaintiff, Presley Carl Muse, was awarded compensation under LSA-R.S. 23:1221(4) (p) for the loss of the senses of taste and smell. Plaintiff has answered the appeal asking for a declaration of total and permanent disability due to traumatic neurosis. The only question before this court is whether and to what extent plaintiff is entitled to compensation based on an injury admittedly received while on the job. We amend to award total and permanent disability benefits on the basis of traumatic neurosis. Therefore, we pretermit questions of recovery under LSA-R.S. 23:1221(4) (p).
At the time of his injury Mr. Muse, a 25-year-old married man, was employed as a dry cleaner by Alexandria Steam Laundry in Alexandria, Louisiana. On July 13, 1970, while at work, he was attacked by a fellow worker and beaten viciously about the face and head. His head was beaten against a brick wall and when pushed to the ground he hit his head upon a concrete floor. Mr. Muse was rushed to the emergency room of Baptist Hospital where he was admitted as a patient.
He remained in an unconscious or semiconscious state for four days, vomiting profusely and occasionally vomiting up quantities of blood. When his wife saw him on the day of the attack she testified, "Well he didn't even know me — they had a pan beside of his head and he was spitting up black, clotted looking blood . . .". Upon regaining consciousness he was informed that he had come close to dying. Muse was discharged after seven days.
Plaintiff was first seen by Dr. Albert L. Rayburn, a general practitioner, who treated him on the day of the injury and during his stay in the hospital. Dr. Rayburn was not called at trial but his report was placed in the record.
He examined plaintiff for physical injury only and diagnosed his problem as a slight depressed skull fracture with cerebral concussion. Plaintiff complained of headaches the entire time he was in the hospital and when seen on July 27, 1970, was still complaining of headaches. Neurological and funduscopic examinations were negative. Dr. Rayburn admitted that as of this last visit he could not determine whether there was any permanent damage.
On August 3, 1970, Mr. Muse was seen by two neuro-psychiatrists, Dr. W. Sidney Easterling and Dr. Davidson H. Texada. Dr. Texada was called at trial by defendant, but both Dr. Easterling's and Dr. Tex-ada's reports were placed in the record.
Plaintiff was first seen by Dr. Easter-ling who recorded complaints of frequent mild to severe headaches in the frontal and left temporal regions. These headaches were "somewhat relieved" by aspirin. Plaintiff was described as cooperative.
Dr. Easterling stated that at this time it was too early to be definite about plaintiff's prognosis. He sent plaintiff to Dr. Texada (practicing at the same address) for "future neurological evaluation". His main concern at this time was a blood clot.
Dr. Texada saw the plaintiff on August 3 and August 14, December 2 and December 16, of 1970; and January 4, January 14, and July 21, of 1971. At trial Dr. Tex-ada admitted that the only thing he looked for on August 3 was a blood clot. His written report of that date shows that plaintiff complained of headaches. At that time the diagnosis was acute closed head injury. On August 14, Dr. Texada saw plaintiff only briefly in order to inform him that the findings of an electro-en-cephalogram were normal.
Further neurological examinations were conducted on December 2, 1970, and plaintiff was given Fiorinal for his headaches. These headaches continued and on December 16, Dr. Texada prescribed Talwin — it did not give plaintiff relief. On January 4, 1971, Dr. Texada placed plaintiff on Equagesic in an effort to curb these headaches but to no avail. On January 13, 1971, the headaches were continuing but no neurological abnormalities could be found. In his written report of January 21, 1971, Dr. Texada stated:
"This patient has continued to complain of headaches since the head injury this past summer. No medication has been of any value."
Dr. Texada described the plaintiff as intellectually limited but cooperative.
On July 21, 1971, after suit had been filed, Dr. Texada again saw plaintiff and submitted a report to defendant's attorneys based on that examination. In this report Dr. Texada stated that plaintiff complained of occasional headaches directly related to periods of exertion or overheating. These pains were controlled by ordinary analgesics. Dr. Texada testified in court that there was never any indication of traumatic neurosis on any of the examinations conducted by him. However, Dr. Texada never conducted any psychiatric examinations — all of his tests were of a neurological nature designed to discover objective symptomatology. The only mention of traumatic neurosis ever made in any of his reports was the denial of the existence of such a condition in his last report (July 21, 1971). It is interesting to note that this single mention of neurosis was made without benefit of a supporting psychiatric examination and only after Dr. Texada had been put on the spot by recommending plaintiff's return to work and defendant, relying thereon, had ceased paying benefits and been sued on this claim' — -an infirmity apparently overlooked by Dr. Texada. Dr. Texada admitted in court that his finding of no traumatic neurosis was based solely upon his reading of a written report by Dr. James H. Phillips wherein Dr. Phillips had stated that plaintiff did suffer from traumatic neurosis.
The report and sworn deposition of Dr. James Harper Phillips were introduced into evidence by plaintiff. Dr. Phillips, a medical doctor with a speciality in psychiatry, graduated from medical school in 1959 and has specialized in psychiatry for one and a half years.
In response to direct questions on cross examination he stated that his examination was more than adequate to support his diagnosis or he would not have made it.
Dr. Phillips set forth the following basic definition of traumatic neurosis:
"Traumatic neurosis is an emotional disorder that occurs most often in a basically emotionally dependent person following rather severe emotional or physical trauma."
Dr. Phillips explained that people who become very dependent on meaningful people in their lives and who, through a lack of intellectual ability have difficulty in handling their anxiety, are prime candidates for traumatic neurosis, especially if they are confronted with a life-threatening situation.
The manner in which trauma works on such a person to produce neurotic pain was set forth by Dr. Phillips thusly:
". . . a person who is basically emotionally dependent, they are in need of emotional support, and especially a person like this, like this man (referring to plaintiff), who has a limited intellectual ability to cope with stress of any type, lives in a rather insecure situation, and they are able to cope with it fairly well until some trauma comes along. This heightens their feeling of insecurity and uncertainty, and then any time they are in a position . . . not any time, but frequently when they are in a position of emotional stress, or physical stress, where they feel less capable of coping with it, they are likely to develop anxiety. Anxiety, or tension, as many people call it, can result in a rather severe headache, and the headache serves as an unconscious manifestation of the conflict, and it serves as an escape route. It offers them a way to get away from their conflict. . . . This is involuntary." (Comment added).
Of Mr. Muse, Dr. Phillips said, ". . . his basic personality is the type that we most often see in the traumatic neurosis, . He had the pre-morbid personality for a traumatic neurosis ." Dr. Phillips enlarged upon these statements by saying that the plaintiff had such an intense emotional dependency on his parents that he lived in a trailer in their back yard even after seven and one- half years of marriage. Also, plaintiff is of lower than average intellectual ability,
It was Dr. Phillips' firm opinion that plaintiff's headaches are due to traumatic neurosis. As to the causal relationship between the neurosis and the attack, Dr. Phillips stated:
"In my opinion the traumatic neurosis that he demonstrated when I saw him was the result of a combination of his preexisting personality and the precipitating event of July 13 when he was traumatized, with some additional sort of 'nailing on the lid', . . . occurring when he woke up to be told how close to dying he came. . . . Whether it was physically life-threatening was unimportant. Emotionally to him it was."
Dr. Phillips stated that at the time of the visit, plaintiff was disabled and that due to the fact that plaintiff's low intellectual capability made him a poor candidate for psychotherapy, his prognosis for the immediate future was not good. The doctor stated that this neurosis and the resultant recurrence of symptoms (headaches) is a persistent problem, and that if plaintiff is placed in any situation of stress until he has regained a great deal of his stability, the neurosis will result in a ". precipitating headache, or some symptom". For these reasons, Dr. Phillips does not believe that plaintiff will be able to resume his old job or any job that has any stress associated with it. This disability could last for an undeterminable period of time. (Plaintiff was still having headaches at the time of the trial).
We, like the trial court, find Dr. Phillips' report ". . . imminently believable and . a lucid explanation of the nature of this type of neurosis . ."
The only other doctor to examine plaintiff was Dr. Joseph Villard. However, his testimony relates only to plaintiff's loss of smell and taste and therefore, will not be considered.
Defendant would have this court believe that there is a conflict in expert medical testimony between Doctors Texada and Phillips. Indeed, it would be of great inequitable benefit to defendant if we would so find, but we do not. Dr. Texada never performed a psychiatric examination on plaintiff. All of the examinations conducted by Dr. Texada were of a neurological variety designed solely to detect objective findings. Dr. Texada himself admitted that the basis of his July 21 determination was based not on examination conducted by himself but rather the report (not even the excellent deposition) of Dr. Phillips. Having conducted no psychiatric examination, we find that Dr. Texada was not in a position to have accurately evaluated plaintiff's condition. Unsubstantiated findings cannot be the equivalent of those well substantiated (especially true here in view of the fact that it was stated by counsel for defendant and substantiated by Dr. Phillips that an accurate psychiatric diagnosis must be based on a lengthy interview consisting of precisely formulated questions). Therefore, we find Dr. Phillips' testimony uncontradicted.
Defendant also wishes this court to employ a legal presumption against plaintiff arising out of his alleged failure to call several material witnesses (doctors) or explain their absence. Defendant states that in such a circumstance the presumption arises that the statements of each of these doctors would have been unfavorable to plaintiff. However, as defendant points out in his brief, the only inference that could be drawn would be in relation to plaintiffs claim for loss of smell and taste since these doctors (Dr. Easterling and Dr. Rayburn) examined plaintiff only for objective symptoms — one being certain fra-tures which, if found, would substantiate plaintiffs claim as to loss of these senten-ses. Therefore, no inference could possibly be drawn adversely to plaintiff's claim of disability due to traumatic neurosis.
In any event, had defendant alleged the extension of such inference to plaintiff's neurosis claim, our decision in Evers v. State Farm Mutual Automobile Ins. Co., 187 So.2d 217, 222 (La.App.3rd Cir., 1966), would be dispositive of the issue in plaintiff's favor.
"Although this unfavorable presumption is a factor to be considered with the other evidence in determining the true facts, it alone is not sufficient to outweigh or to overcome the positive, sworn testimony of the examining and treating physicians whose testimony was obtained and produced at the trial."
The bulk of "sworn testimony" produced at trial and relied upon by us in Evers, supra, was the sworn depositions of three doctors. Presently, we have the uncontradicted sworn deposition of an examining physician, Dr. Phillips, which heavily outweighs any possible adverse inference.
Louisiana allows awards of compensation for disability resulting from neurosis caused by an injury in the course of employment. Tate v. Gullett Gin Company & Liberty Mutual Ins. Co., 86 So.2d 698 (La.App. 1st Cir., 1956) and cases cited therein at p. 702. There is no necessity that there also be a physical disability. Harrell v. Delta Drilling Company, 251 So.2d 97, 100 (La.App. 3rd Cir., 1971); writs refused, 259 La. 896, 253 So.2d 221 (1971).
As to the matter of proof it is said that there should be a sound cause and good reason for the mental condition which superinduces a fear of pain in the individual strong enough to render him totally disabled. Mouton v. Gulf States Utilities Co., 69 So.2d 147 (La.App. 1st Cir., 1953); Stanford v. Long & Wolfe, 199 So. 608, (La.App. 1st Cir., 1941). In other words, the neurosis should be directly traceable to the accident. Lala v. American Sugar Refining Co., 38 So.2d 415 (La.App.Orl., 1949); Porter v. W. Horace Williams Co., 9 So.2d 60, 63 (La.App. 2nd Cir., 1942). We are convinced that the brutal attack suffered by plaintiff is sufficient in nature to produce the claimed neurosis, and that the attack is in fact, the cause of the neurosis.
It is also said that any claim based on traumatic neurosis must be substantiated by competent psychiatric opinion. Jackson v. International Paper Company, 163 So.2d 362 (La.App. 3rd Cir., 1964). We have previously held that the uncontradicted testimony of one psychiatrist based upon a single psychiatric interview is sufficient. Guidry v. Michigan Mutual Liability Company, 130 So.2d 513 (La.App. 3rd Cir., 1961). See also: Webber v. Wofford-Brindley Lumber Company, 113 So.2d 23 (La.App. 1st Cir., 1959). We, therefore, find Dr. Phillips' testimony sufficient to meet this requirement.
Finally, it is often stated that:
"When a compensation claim is predicated upon traumatic neurosis the court must proceed with utmost caution and exercise extreme care in view of the nebulous characteristics of such a condition. The evidence in cases of this nature should be scrutinized carefully and every precaution should be taken to protect employers and insurers against unjustified claims based on alleged men tal affections. On the other hand, the danger of denying recovery to a deserving claimant is equally as apparent, and must be guarded against." (Emphasis added). Jackson v. International Paper Company, 163 So.2d 362, 365 (La.App. 3rd Cir., 1964).
Of note also is the following statement:
"We adhere to the principle that great weight must necessarily be given to the statement of the claimant Where the diagnosis and opinion of the doctor as to the nature and extent of the injury must depend largely on subjective symptoms, if there is nothing in the record to doubt the veracity and honesty of the plaintiff." (Emphasis added). Dixon v. W. Horace Williams Co., 8 So.2d 724, 727 (La.App. 1st Cir., 1942);
and the principle set forth in Miller v. United States Fidelity and Guaranty Co., 99 So.2d 511, 516 (La.App. 2nd Cir., 1957):
"The principle that courts will stigmatize a claimant as a malingerer only upon positive and convincing evidence justifying such a conclusion is so well imbedded in our jurisprudence as to preclude the necessity for specific citations."
None of the doctors ever doubted that plaintiff had genuine headaches. (Dr. Texada even prescribed several medicines for them). All the doctors characterized the plaintiff as cooperative and Dr. Phillips specifically testified that he had extreme confidence in plaintiff's veracity. The trial court apparently had faith in plaintiff's truthfulness as it awarded recovery on the highly subjective complaints of loss of smell and taste. Plaintiff had never made a workmen's compensation claim before, and we like everyone else, have confidence in plaintiff's veracity.
We, therefore, find that plaintiff suffers from traumatic neurosis caused by a work-related injury. The trial court had also found this to be the case, but had not awarded compensation because it did not believe plaintiff was disabled thereby. This was error. Due to the fact that this condition prevents his return to any employment involving stress and that the duration of this disability is impossible of determination, we find that he is totally and permanently disabled. Porter v. W. Horace Williams Co., 9 So.2d 60, 63 (La.App. 2nd Cir., 1942). He is to be compensated accordingly. However, if for any reason his condition should improve in the future, defendant may seek a modification of this decree. Doucet v. Ashy Construction Co., 134 So.2d 665 (La.App. 3rd Cir., 1961).
Plaintiff's claim for penalties and attorney's fees is rejected.
"Mere failure to make payment does not subject an insurer to penalties and attorney's fees even though it may be later found that the payments were due. The failure to pay must be arbitrary, capricious, or without probable cause, and there must have been a demand for the payment. (Emphasis of court cited). Pharr v. Insurance Company of North America, 200 So.2d 365, 370 (La.App. 4th Cir., 1967).
In this case, compensation had been terminated on the basis of a doctor's report and suit followed without a demand for resumption of payments. The same is true of the case before us. After compensation benefits were stopped, plaintiff initiated suit without making ,a demand for payment.
For the reasons assigned, the judgment of the trial court is amended to award plaintiff compensation benefits on the basis of total and permanent disability subject to a credit in favor of defendants for all previous payments made. The record shows that at the time of the assault, plaintiff was earning $72.00 per week. Therefore, payments to him are to be at the rate of $46.80 per week for a period not to exceed 500 weeks. All costs of this appeal are assessed to defendant-appellant.
Amended and rendered.
HOOD, J., dissents being of the opinion that the judgment of the trial court is correct.
. Defendant also alleged that plaintiff's failure to call certain lay witnesses alleged to have seen the attack should create an inference that plaintiff was not hit and injured in the areas complained of. This allegation by defendant is also in furtherance of his rebuttal of plaintiff's claim for compensation for loss of smell and taste. Therefore, we find it unimportant to our decision but point out that we have previously held that such inference does not apply to the failure to call lay witnesses who observed the injury. See: Guidry v. Michigan Mutual Liability Company, 130 So.2d 513, 514 (La.App. 3rd Cir., 1961) and Stevens v. Dowden, 125 So.2d 234, 236 (La.App. 3rd Cir., 1960).