Case Name: Robert L. ASHWORTH, Plaintiff-Appellant, v. ELTON PICKERING, INC., et al., Defendants-Appellees
Court: Louisiana Court of Appeal
Jurisdiction: Louisiana
Decision Date: 1978-07-11
Citations: 361 So. 2d 940
Docket Number: No. 6559
Parties: Robert L. ASHWORTH, Plaintiff-Appellant, v. ELTON PICKERING, INC., et al., Defendants-Appellees.
Judges: Before CULPEPPER, DOMENGEAUX, WATSON, FORET and CUTRER, JJ.
Reporter: Southern Reporter, Second Series
Volume: 361
Pages: 940–948

Head Matter:
Robert L. ASHWORTH, Plaintiff-Appellant, v. ELTON PICKERING, INC., et al., Defendants-Appellees.
No. 6559.
Court of Appeal of Louisiana, Third Circuit.
July 11, 1978.
Baggett, McCall, Singleton & Ranier, Homer C. Singleton, Jr., Lake Charles, for plaintiff-appellant.
Raggio, Farrar, Cappel & Chozen; Frederick L. Cappel, Lake Charles, for defendants-appellees.
Before CULPEPPER, DOMENGEAUX, WATSON, FORET and CUTRER, JJ.

Opinion:
FORET, Judge.
This is a workmen's compensation suit involving the issues of whether the plaintiff, Robert L. Ashworth, has sustained a compensable injury and whether he has a permanent total disability as a result of the injury. Also at issue is whether the defendant, Rockwood Insurance Company, the compensation insurer of the plaintiff's employer, Elton Pickering, Inc., discontinued compensation payments arbitrarily, capriciously, or without just cause, thereby entitling the plaintiff to penalties and attorney fees.
The plaintiff appeals from the judgment awarding him benefits for permanent partial, not total, disability, and denying him statutory penalties and attorney's fees. The defendants have answered the appeal, seeking a reversal of the trial court's conclusion that the plaintiff sustained a com-pensable injury and that the plaintiff is presently disabled.
The facts concerning the plaintiff's employment, the accident and injury, are brief and not in dispute. On December 31, 1975, the plaintiff suffered dizziness, choking, shortness of breath, and pain in his chest and left arm while acting in the course and scope of his employment as a log cutter for Elton Pickering, Inc. Some of his difficulties were noticed by fellow employees. The following morning the plaintiff went to the West Calcasieu-Cameron Hospital where he was seen by Dr. C. M. Smith, who diagnosed the difficulty as congestive heart failure and began treatment as an out-patient for that condition. After retaining the plaintiff in the hospital for three days, Dr. Smith was of the opinion that the hard labor performed by the plaintiff on December 31, 1975, helped bring on the heart failure.
Subsequently, the plaintiff was examined by Dr. Buttross, cardiologist, who concluded the plaintiff suffered from coronary heart disease with angina pectoris resulting from coronary atherosclerosis. Dr. Buttross did not dispute Dr. Smith's conclusion as to the plaintiff's condition on or about December 31, 1975. He was of the opinion that further strenuous activity by the plaintiff would precipitate additional angina attacks.
Dr. Woodard examined the plaintiff on November 30 of 1976, and his diagnosis was artheriosclerotie heart disease. He agreed that strenuous physical exertion by the plaintiff would cause angina attacks.
Mr. Ashworth attempted to return to work as a log cutter after a period of treatment, but exertion produced chest pains, forcing him to quit. Since that occasion he has not returned to any gainful employment. The plaintiff is illiterate and has no other work experience.
The trial court found that the plaintiff sustained an'accident and injury within the meaning of the workmen's compensation law on December 31, 1975, and that there was a legal causal connection between that accident and injury and his disability. The court primarily relied upon Bertrand v. Coal Operators Casualty Company, 253 La. 1115, 221 So.2d 816 (1968). After reviewing the record and the jurisprudence, we find no reversible error in the trial court holding on this issue.
The plaintiff contends on this appeal that he is permanently and totally disabled within the meaning of R.S. 23:1221, as amended by Act 583 of 1975. It is undisputed that the plaintiff has not returned to work since the termination of benefits by defendants on March 10,1977. The medical experts were in agreement that the plaintiff would be able to perform light work without pain or harm to his health. It is clear that he will never be able to do work requiring strenuous physical activity.
Prior to the amendment in 1975, R.S. 23:1221 was interpreted as meaning that a worker was deemed totally disabled if he was unable to do work of the same character as that which his training, education and experience qualified him to perform without unusual difficulty or danger. Lawless v. Steel Erectors, Inc., 254 La. 37, 222 So.2d 849 (1969).
The 1975 amendment, Act No. 583, to R.S. 23:1221 deleted the phrase "to do work of any reasonable character" and added "to engage in any gainful occupation for wages, whether or not the same or similar occupation as that in which the employee was customarily engaged when injured, and whether one for which the employee, at the time of the injury, was particularly fitted by reason of education, training, and experience."
The 1975 Legislature also changed the definition of partial disability. Partial disability is now defined as disability to perform the duties in which the worker was customarily engaged when injured, or duties of the same or similar character for which the worker was fitted by education, training, and experience. Clearly, this definition substantially encompasses the jurisprudential definition of permanent total disability prior to 1975.
Included in the 1975 amendment by Act 583, was an increase in the disability benefits. Rather than limiting permanent total disability benefits to 65% of wages for the period of disability and not beyond 400 weeks, the new law raises it to 66%% of wages and deletes the 400-week limitation. Similarily, the partial disability benefits were raised to 66%%, and the former 300-week limitation was raised to 400 weeks for accidents occurring in the first year under the new law with successive annual increases the next two years up to 450 weeks for injuries occurring after September 1, 1977. As amended, however, 1221(3) provides that if an employee secures other employment subsequent to the injury, then the worker's compensation would be computed on the basis of 66%% of the difference between wages earned at the time of injury and wages actually earned thereafter.
Clearly, the 1975 legislation had three primary purposes. First, it increased the compensation benefits for disabled workers. Second, it made the availability of benefits for total disability more restrictive. Third, it made relevant an analysis of the realistic effect on earning capacity.
There have been few judicial interpretations of the new law. Our brethren of the First Circuit Court of Appeal held in LeBlanc v. Commercial Union Assurance Company, 349 So.2d 1283 (La.App. 1 Cir. 1977), that partial disability includes a situation where an employee is unable to resume his former employment only because it involves working conditions hazardous to his health or welfare. The court found support for its holding in our firmly established jurisprudence that the workmen's compensation law is to be liberally construed to the end that its coverage will be extended to injured workmen to relieve them of the crushing economic burden of work-connected injuries by spreading such loss in the channels of commerce and industry. Also, it held that where the partially disabled worker actual ly earns income subsequent to the disabling injury, that amount must be deducted from the statutory compensation benefits. Thus, where the employee has subsequently earned wages equal to or greater than those earned at the time of injury, he is entitled to no compensation during the period such equal or greater wages are earned. It is clear that the court considered the economic and humanitarian purposes of the law in making its decision.
We first considered the effects of the 1975 amendment in Phillips v. Dresser Engineering Company, 351 So.2d 304 (La.App. 3 Cir. 1977). We upheld the trial court's holding that the legislature had no intention of requiring an injured worker who has not fully recovered from the injury to find employment and work in substantial pain. Thus, we recognized the inherent intent of the legislature to exclude an injured worker from total disability compensation only when he may reasonably engage in any gainful occupation.
In Kilbourne v. Armstrong, 351 So.2d 802 (La.App. 1 Cir. 1977), the First Circuit Court of Appeal again addressed the 1975 amendment. There the employee lost the use of his right hand. He had no technical training and only a third grade education. The plaintiff's counsel argued that because of these facts, there were very few jobs which the plaintiff was capable of performing. The court adopted the finding of the LeBlanc panel that the definition of partial disability was the disability to perform his usual or customary occupation, "but can engage in some other gainful employment for which he is fitted by education, training, or experience". Considering the plaintiff's admission that some jobs were available to him, our brethren, we think, correctly held that the plaintiff was only partially disabled. We agree with their interpretation of the new definition of partial disability. We find, however, that the facts of Kilbourne are distinguishable from the instant case.
In Cullivan v. Fish Engineering and Construction Company, Inc., 354 So.2d 597 (La.App. 3 Cir., 1977), we upheld the trial court's holding that the plaintiff, who suffered from a back injury, was permanently and totally disabled. There was testimony by an expert that there were light jobs available in Louisiana which the plaintiff could perform. Another witness, a physician, said that he recommended a return to the plaintiff's former occupation. The primary treating physician, however, indicated that the plaintiff was unable to perform the duties of those jobs, and the trial court gave more weight to his testimony which was buttressed by another physician's testimony. We held there was sufficient evidence to establish that the plaintiff was unable "to engage in any gainful occupation for wages". LSA-R.S. 23:1221(2).
Recently, we re-affirmed, our decision in Phillips, supra, that a worker is totally disabled if he is unable to pursue any gainful employment without experiencing substantial pain. Rachal v. Highlands Insurance Company, 355 So.2d 1355 (La.App. 3 Cir. 1978).
In the instant case, the testimony of the physician is that the plaintiff is able to return to light work. The trial court held that this is the only factor to be considered and thus the plaintiff had not established that he has a permanent total disability but that he had proven that he was partially disabled. The trial court committed reversible error in so holding.
It is undisputed that the plaintiff is illiterate and has no training or experience for the type of work which he is now physically able to perform. Given our agreement with the decision of the First Circuit as to the definition of partial disability, it is clear that he is unable "to engage in some other gainful employment for which he is suited by education, training, or experience", by virtue of his lack of education, training, or experience. Yet it would be illogical to hold that the plaintiff is entitled to no compensation given our prima facie conclusion that he suffered a compensable injury.
The underlying principle in the decisions discussed above is that the workmen's compensation law will be interpreted in a manner which takes into account the reasona bleness of requiring the disabled worker to return to employment, and the realistic earning capacity of the disabled worker. This was the primary intent of the legislature. Thus, when an employee can only work in substantial pain or at substantial risk to his health, our courts have held the worker entitled to either total disability compensation, Phillips and Rachal, supra, or partial disability compensation, LeBlanc, supra. Where the evidence indicates that the disabled worker has a realistic earning capacity by engaging in some gainful occupation, although not his former occupation for which he is suited by education, training, or experience, then he will be considered only partially disabled, Kilbourne, supra. If the evidence indicates that the employee is unable to engage in any gainful occupation, then the worker is entitled to total disability compensation, Cullivan, supra.
We conclude that the plaintiff is unable to engage in any gainful occupation. Unlike Kilbourne, the plaintiff has made no admission that there is work which he could perform. On the contrary, he has steadfastly contended that he is unable to engage in any gainful occupation. The testimony indicates that from a solely medical prospective the plaintiff could engage in some light jobs. The workmen's compensation law, however, is not based solely on a medical prospective. To do so would return us to the evil which the 1975 Legislature intended to eliminate by bringing into focus the reasonable earning capacity of the worker subsequent to the injury. The plaintiff has no reasonable ability to engage in any gainful occupation, in his physical condition. This is consistent with the legislative intent to bring into focus the economic realities of the situation. We make our decision without considering the plaintiff's education, training, or experience, but we note that the legislature was restrictive in the language it used in the 1975 amendment relating thereto. The amendment states:
"whether or not an occupation for which the employee, at the time of the injury was particularly fitted by reason of education, training, and experience." (Emphasis ours.)
Clearly, the inference is that if the employee could become qualified for an occupation by a reasonable degree of further education, training, or experience, then the lack of the particular education, training, or experience which is required is irrelevant. Conversely, we believe that the legislature intended that where an employee would become fit for any gainful occupation only by an unreasonable degree of further education, training, or experience, the extreme lack of education, training, or experience would be relevant to our analysis. As noted, however, we find that in the instant case, the plaintiff has no reasonable ability to engage in any gainful occupation based on his physical condition, without regard to his illiteracy and lack of training or experience.
PENALTIES AND ATTORNEY'S FEES
The trial court denied plaintiff penalties and attorney's fees which are authorized by LSA-R.S. 23:1201.2 where the employer arbitrarily, capriciously, or without just cause, fails to pay or discontinues payment of benefits.
The reason given by the trial court was that medical reports presented to the defendant insurer did not indicate that the plaintiff's heart problems were job-related. Furthermore, the plaintiff's written statement does not suggest that he had an "accident" while working for his employer, according to the trial court. We disagree, and find the trial court was manifestly erroneous.
The plaintiff's signed statement of April 1, 1976, indicates that Dr. Smith advised him that his pains were due to a heart attack which he had suffered. He informed his employer of this, and the employer indicated that he would turn in an injury report.
The insurance claims adjuster received a medical report from Dr. B. M. Woodard dated December 15, 1976. Dr. Woodard's report states the plaintiff gave the facts surrounding his accident on December 31, 1975, and that the physician who treated him the day following the "accident" later indicated that he had suffered a heart attack. Dr. Woodard's report concludes that the pain experienced by the plaintiff at the time of his examination of the plaintiff was "obviously the result of an anginal-type pain". There was no direct contradiction of the plaintiff's statement that he suffered a heart attack on December 31, 1975.
Clearly, this information strongly suggests "an accident" had occurred, especially when considering the nature of the plaintiff's work. Where the employee presents evidence of an accident and a following disability without any intervening cause, it is presumed that the accident caused the disability. Bertrand v. Coal Operators Casualty Co., supra.
Furthermore, the defendant-appellee states that the termination of benefits was based on Dr. Woodard's opinion that the plaintiff could return to some type of gainful employment. We agree that this case presented a difficult issue of the degree of the plaintiff's disability under the new law. The insurer, however, acted capriciously in completely terminating benefits since the evidence it had at the time clearly was insufficient to allow it to terminate benefits entirely. Had the insurer reduced the benefits consistent with the medical opinion that the plaintiff could return to light work, we might have reached a different conclusion. We feel that prior to stopping compensation payments under the facts of this case, it became incumbent upon the insurer to make a further investigation. Therefore, we find manifest error in the failure of the trial court to award penalties and attorney's fees. We think that attorney's fees in the amount of $4,000.00 should be awarded along with the statutory penalty of 12% of all past-due benefits until paid.
The trial court allowed plaintiff to recover payment of one medical bill in the amount of $152.50, and certain costs were assessed against the defendant. We affirm that part of the trial court decision.
For the above reasons, we hereby reverse that portion of the trial court judgment which failed to find that the plaintiff was permanently and totally disabled within the meaning of the compensation act, and do hereby order, adjudge and decree that plaintiff herein is entitled to workmen's compensation benefits for permanent and total disability at the rate of 66%% of his wages for as long as the said disability shall continue. We further reverse the trial court judgment denying penalties and attorney fees, and we hereby award attorney fees in the amount of $4,000.00, plus the statutory penalty of 12% per annum on all past-due workmen's compensation benefits, until paid.
In all other respects, we affirm the judgment of the trial court.
All costs of this appeal are assessed against the defendants.
AFFIRMED IN PART, REVERSED IN PART, AND RENDERED.
WATSON, J., concurs in the result, but would favor a remand for evidence on plaintiff's employment capabilities and possibilities.
CULPEPPER and DOMENGEAUX, JJ., dissents in part and concurs in part and will assign written reasons.