Major Workers’ Comp Appeals Court Win Upholds Workers’ Rights

Thanks in part to a case recently handled by workers’ compensation lawyer Tim Benedetto from our firm, workers in Louisiana who are injured on the job don’t have to explain other injuries that they don’t think are relevant to their cases—and they have more flexibility in the types of health care providers they can see.

The Louisiana Third Circuit Court of Appeal favored Tim’s arguments on behalf of his client, an employee of a staffing agency who injured his back at work. The ruling now applies to other workers in similar situations.

The company tried to say that the worker committed fraud by failing to report another, unrelated back injury that happened before the work incident. His employer also tried to disqualify the opinions of his medical providers in favor of a company doctor.

The company refused to pay benefits. But their arguments didn’t work.

Tim and his client won. And by extension, so did workers across Louisiana.

“Cases like this one push me to continue fighting when most others would give up,” said Tim, a member of the Workers’ Compensation, LLC, team of workers’ comp lawyers.

“Fighting against large companies that will make any excuse not to pay workers’ compensation benefits to an injured worker is the reason I do what I do.”

Keep reading for more about the case—and see how it could apply to you after a workplace injury.

Hurt at Work: How It Started

The case started when a Louisiana worker, Leroy Johnson, Jr., twisted his back and fell to the ground during work.

Mr. Johnson was working as a forklift operator at a jewelry manufacturer. But his direct employer was a staffing company, Lofton Staffing Services, Inc.

He was moving a pallet full of paper when the injury happened. Going around a corner, the pallet got stuck.

He jerked the handle to get the pallet loose—and felt a burning pain across his shoulders and middle back.

The pain made him collapse to the ground, landing on his side.

His supervisor sent him to a walk-in medical clinic, where they told him he had a muscle strain and sent him back to work with no restrictions or precautions.

But the pain didn’t stop. He had to get someone to drive him home that day.

The next day he went to the emergency room, where they did an x-ray and found a fractured rib.

Then he went to his primary health care provider, who said he can’t do full-duty work.

Because he was unable to work, he filed for lost wages pay under Louisiana workers’ comp.

Lofton Staffing rejected his benefits, based on the walk-in clinic saying Mr. Johnson could work.

Why You Can & Should Use Your Own Medical Provider after an Injury on the Job

Looking at a bigger point than just the facts of this particular case—this is an example of why you should choose your own medical providers for treatment of a job injury.

While it may be hard to avoid going to their clinic for the first treatment after your injury, you need to remember that the clinic where your employer sends you doesn’t put your needs first.

They easily can be biased in favor of getting you back to work so the company has the fewest costs and disruptions.

In Mr. Johnson’s case, Lofton picked on the fact that his primary care provider was a nurse practitioner, not a doctor—and that he got follow-up care from a chiropractor.

Lofton argued that since its medical doctor released Mr. Johnson back to full-duty work, that doctor’s opinion outweighed the nurse practitioner and chiropractor’s opinions because a medical doctor is more “specialized.”

So that was one of the two major points Mr. Johnson and his workers’ comp attorney Tim Benedetto had to fight.

And they prevailed.

The Third Circuit Court rejected the company’s argument and explained that a family nurse practitioner and chiropractor were qualified medical providers—and that denying benefits in this way ignored multiple other factors in the case.

Tim and Mr. Johnson also had to overcome a second major argument by Lofton—that a different injury disqualified him from benefits.

You Can’t Be Penalized for Not Reporting an Unrelated Injury

Lofton argued Mr. Johnson committed fraud when he failed to disclose an emergency room visit that occurred just a few days before his work accident.

Mr. Johnson had gone to the emergency room after pulling a muscle in his back while lifting one of his children.

He was back at work and feeling better within a few days without any lingering injuries.

Later, after his back injury at work, Lofton argued Mr. Johnson willfully misrepresented his past medical history by failing to mention the visit in his accident report and during a sworn statement.

But the Third Circuit rejected this argument, too, holding:

“Evidence in the record supports the (workers’ compensation judge’s) finding that Johnson did not think the incident resulting in his receipt of prescription medication to alleviate pain in a similar area from an emergency room visit was significant enough to disclose, that Johnson did not feel that the resulting pain from the previous incident was truly an injury, that Johnson’s symptoms from the incident and the work injury were different, that Johnson felt rushed to finish filling out fifteen pages of his employer’s incident paperwork, and did not realize the incident four days prior qualified as what the questions were asking him to reveal, and that Johnson understood questions asking about any injury did not mean any pain, rather than pain from a serious injury.”

It’s Worth It to Fight for Your Louisiana Workers’ Compensation Benefits

Workers’ comp is one of the most important economic protections you have if a job injury disrupts your work and your ability to keep earning a paycheck.

The replacement pay for lost wages and the coverage for medical care resulting from your injury can help you get through this interruption to your life on steady financial ground.

Workers’ comp claims aren’t about blaming anybody or finding who was at fault. They’re simply about helping when you’re hurt at work. And most employers in Louisiana must carry workers’ comp coverage.

If your employer puts up barriers to you getting the benefits you’re entitled to receive, like they did for Mr. Johnson, talk to the workers’ comp lawyers at Workers’ Compensation, LLC .

Because you know we’ll fight for you.

“This was a long and difficult process for me, but I was glad I had Tim Benedetto working on it,” Mr. Johnson said. “Tim Benedetto and Workers’ Compensation, LLC, did a hell of a job.”

(Case citation: Johnson v. Lofton Staffing Services, Inc., 21-761 (La. App. 3 Cir. 5/4/22), __ So. 3d __.)

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