Opinion ID: 1789638
Heading Depth: 1
Heading Rank: 3

Heading: Claim for Death Benefits

Text: Ms. Jonise continues to argue her claim for death benefits is not prescribed. She maintains alternate dates for the beginning of the prescriptive period apply and thus her claim for death benefits was timely filed. [1] We disagree and find Ms. Jonise's claim for death benefits is prescribed for the reasons below. LSA-R.S. 23:1231 through LSA-R.S. 23:1255 set forth the provisions relating to compensation for the death of an employee. Pursuant to LSA-R.S. 23:1231, death benefits are recoverable only if an employee's death occurs within two years of the last treatment resulting from the accident by personal injury or occupational disease upon which the claim is based. [2] This two year time period is neither a prescriptive nor peremptive period. Rather, it is a condition precedent to the accrual of the right of action for the dependents. H. Alston Johnson, III, 14 Louisiana Civil Law Treatise, Workers' Compensation Law and Practice, § 302, at 6 (1994). Thus, if an employee's death occurs within two years of his or her last treatment resulting from the work related accident, the employee's dependents have a right of action for death benefits pursuant to LSA-R.S. 23:1231. See Tran v. Avondale Shipyards, Inc., 95-542 (La. App. 5th Cir.11/15/95), 665 So.2d 507; Estate of Bell v. Timber, 28,333 (La.App. 2nd Cir.05/08/96), 675 So.2d 284. The prescriptive period for a dependant's claim for death benefits is generally provided by LSA-R.S. 23:1209(A) when the employee's death resulted from a personal injury by accident. This statute provides in part: In case of personal injury, including death resulting therefrom, all claims for payments shall be forever barred unless within one year after the accident or death the parties have agreed upon the payments to be made under this Chapter, or unless within one year after the accident a formal claim has been filed as provided in Subsection B of this Section and in this Chapter. Where such payments have been made in any case, the limitation shall not take effect until the expiration of one year from the time of making the last payment, except that in cases of benefits payable pursuant to R.S. 23:1221(3) this limitation shall not take effect until three years from the time of making the last payment of benefits pursuant to R.S. 23:1221(1), (2), (3), or (4). LSA-R.S. 23:1209(A) requires that in order for a dependent to preserve his or her right to death benefits, he or she must enter into an agreement on such benefits with the decedent's employer or employer's workers' compensation insurer within at least a year of the employee's death or file a claim for such benefits with the office of workers' compensation within a year of the employee's accident which resulted in death. However, jurisprudential interpretation on this statute holds that a dependent has one year from the employee's death to file a claim for death benefits. While we have implicitly sanctioned this jurisprudence in our prior decisions, we now do so explicitly. In Hoy v. T.S. Grayson Lumber Co., 15 La.App. 176, 130 So. 651 (La.App. 2nd Cir.1930), the court aptly stated why the general prescriptive period then in existence should be interpreted as providing that a dependent has one year from the employee's death, not accident, to file a claim for death benefits: Counsel for defendant contends that plaintiffs action is barred under the letter of the law. His contention is that, in all cases where dependents were entitled to compensation under the act, they must bring their action for such within one year from the date of the accident, or be forever barred. We do not think so. To hold that, under section 31 of the act, suits by dependents are barred by one year from the date of the accident, would be in effect to hold that in some cases, at least, they could not recover at all. To illustrate: Suppose an employee received an injury in the course of his employment which produced death one hour before the expiration of one year. The act provides that dependents are entitled to compensation where death ensues within one year after the accident. In such cases, the dependent widow for the benefit of herself and minor children, if she had any, or the dependent mother, as the case may be, would have just one hour in which to bring suit or be forever barred. Or to reduce the proposition to an absurdity, let us suppose that death occurred five minutes previous to the expiration of the year. In such case, it would be impossible for a widow or a mother to bring suit within one year. They would therefore have a right without a remedy. The act gives dependents a right and a remedy, and their remedy is to bring their action within one year from the date of the death and not from the date of the accident. Their cause of action arises, not from the accident itself, but from death, caused by the accident. They have no cause or right of action unless death ensues and none until then. Id. at 651-52. In Martin v. Anheuser-Busch, Inc., 534 So.2d 4 (La.App. 4th Cir. 1988), the court made a similar observation. The court noted LSA-R.S. 23:1209(A) provides that a claim for death benefits prescribes one year after an employee's accident; however, LSA-R.S. 23:1231, as it then existed, permitted a dependent to file a claim for death benefits for up to two years following the employee's accident resulting in death. When read pari materia, the court observed, in some cases these two statutes could lead to the anomalous result that a dependent's claim for death benefits is prescribed pursuant to LSA-R.S. 23:1209(A) before the claim comes into existence pursuant to LSA-R.S. 23:1231. [3] The court found such a result is absurd and illogical. Thus, in Martin, the court found, as the court did in Hoy, that a dependent has one year from the employee's death to file a claim for death benefits, notwithstanding the statute's reference to accident. In keeping with this line of jurisprudence, we hold, when no agreement is reached between the parties on death benefits within at least a year of the employee's death and the employee's death resulted from a personal injury by accident, a claim for death benefits must be filed within one year of the employee's death or else it is prescribed pursuant to LSA-R.S. 23:1209(A). Our interpretation of LSA-R.S. 23:1209(A) is in accord with the consistent jurisprudence of the lower courts holding, e.g., Tran, supra ; Estate of Bell, supra , and also properly furthers the beneficial purposes of the Workers' Compensation Act. Moreover, our interpretation is more consistent with the treatment of claims for death benefits when the employee's death resulted from an occupational disease. LSA-R.S. 23:1031.1(F), as amended by 2001 La. Acts 1189, § 1, provides that a dependent has one year from the date of the employee's death, or one year from the date the dependent has reasonable grounds to believe the employee's death resulted from an occupational disease, to file a claim for death benefits. [4] In the present case, Ms. Jonise has never alleged that she and defendants entered into an agreement on death benefits. Thus, her claim for death benefits, which was filed on August 3, 1999, is prescribed on its face because it was filed more than a year after Mr. Jonise's death, which occurred on July 30, 1998. When a workers' compensation claim is prescribed on its face, the burden is upon the claimant to show the running of prescription was suspended or interrupted in some manner. See Causby v. Perque Floor Covering, 97-1235 (La.01/21/98), 707 So.2d 23, 25. Ms. Jonise claims prescription was interrupted because she was lulled into a false sense of security by a August 28, 1998 letter written by a LWCC claims adjuster. In the letter, the adjuster requested Ms. Jonise execute several attached medical authorizations so LWCC could obtain Mr. Jonise's medical records. The letter also stated that no determination can be made at this time on the cause of Mr. Jonise's death and whether compensation is properly due. We find the August 28, 1998 letter in no way lulled Ms. Jonise into a false sense of security. The letter did not present any offers or waive prescription. The letter merely requested medical authorizations and indicated LWCC was investigating the cause of Mr. Jonise's death. Under these circumstances, we find prescription was not interrupted. Therefore, because Ms. Jonise filed her claim for death benefits more than a year after Mr. Jonise died and has failed to establish prescription was interrupted, we conclude her claim is prescribed pursuant to LSA-R.S. 23:1209(A).