Opinion ID: 1677741
Heading Depth: 1
Heading Rank: 3

Heading: Disability Status

Text: A key to understanding disability status, suggested by a scholar in this area, is to recognize the two, often interwoven, ingredients that make up the disability concept: (i) disability in the medical or physical sense, as evidenced by obvious loss of members or by medical testimony that the claimant simply cannot make the necessary muscular movements and exertions; and (ii) inability or decreased ability to earn wages, which is a  de facto inability to earn wages, as evidenced by proof that claimant has not in fact earned anything. 4 Arthur Larson and Lex K. Larson, Larson's Workers' Compensation Law § 80.02 (2001). Although these two ingredients generally coexist, one may be present without the other. Id. The ultimate issue before us is the determination of plaintiff's disability status. The corollary issue is what factors, other than physical condition, can be considered when plaintiff claims to be totally, permanently disabled. Given that plaintiff is not employed, the controlling statutory provision is La.Rev.Stat. 23:1221(2)(c), which provides: For purposes of Subparagraph (2)(a) of this Paragraph, whenever the employee is not engaged in any employment or self-employment as described in Subparagraph (2)(b) of this Paragraph, compensation for permanent total disability shall be awarded only if the employee proves by clear and convincing evidence, unaided by any presumption of disability, that the employee is physically unable to engage in any employment or self-employment, regardless of the nature or character of the employment or self-employment, including, but not limited to, any and all odd-lot employment, sheltered employment, or employment while working in any pain, notwithstanding the location or availability of any such employment or self-employment. (Emphasis supplied.) The underscored, heightened standards were enacted in 1983 as part of the legislation tightening the scope of permanently, totally disabled status. These are difficult burdens for the worker, and the changes clearly reflect the intent that awards for total and permanent disability should be very unusual and that maximum awards for SEB for those `able to work' should also be rare. H. Alston Johnson, Bound in Shallows and Miseries: The 1983 Amendments to the Workers' Compensation Statute, 44 La. L.Rev. 669, 686 (1984). The phrase [`unaided by any presumption of disability'] is simply an additional statement of the difficulty of the employee's burden, and is largely superfluous in light of the `clear and convincing evidence' standard found elsewhere in section 1221. Id. at 687. Recently, we defined the standard of clear and convincing in the workers' compensation context as an `intermediate' standard falling somewhere between the ordinary preponderance of the evidence civil standard and the beyond a reasonable doubt criminal standard. Hatcherson v. Diebold, Inc., 00-3263 at p. 4 (La.5/15/01), 784 So.2d 1284 (citing Black's Law Dictionary 227 (5th ed.1979)). In finding these heightened standards satisfied in this case, the court of appeal acknowledged that generally the standard of appellate review in workers' compensation cases is manifest error. See Bruno v. Harbert International, Inc., 593 So.2d 357 (La.1992). Yet, the court of appeal felt that a  de novo  review was appropriate reasoning that the hearing officer was in legal error by restricting its consideration to only the physical component of plaintiff's status. [6] Based on its review of the record and consideration of a totality of factors, the court of appeal held: Mr. Comeaux is now fifty-eight years old and has reached maximum medical improvement. The Functional Capacity Evaluation, as well as the opinions of both physicians, indicate that Mr. Comeaux is unable to work but is encouraged to be as active as possible within the parameters of light and sedentary activities as tolerated. Coupled with Mr. Comeaux's physical deficiencies and his age, work experience and educational inadequacies, our review of the entire record reveals that Mr. Comeaux proved by clear and convincing evidence that he is permanently and totally disabled. 00-928 at p. 9, 773 So.2d at 904 (Emphasis supplied). Defendant contends this reasoning by the court of appeal is flawed because the statute mandates consideration of only plaintiff's physical condition. Defendant argues the totality of factors should only be considered when evaluating plaintiff's entitlement to supplemental earnings benefits.