Mendez v. Transit Mgmt. of Se. La., Inc.

335 So.3d 387

Jose MENDEZ

v.TRANSIT MANAGEMENT OF SOUTHEAST LOUISIANA, INC.

NO. 21-CA-228

Court of Appeal of Louisiana, Fifth Circuit.

December 22, 2021

COUNSEL FOR PLAINTIFF/APPELLANT, JOSE MENDEZ, John B. Fox

COUNSEL FOR DEFENDANT/APPELLEE, TRANSIT MANAGEMENT OF SOUTHEAST LOUISIANA, INC., Denise M. Ledet, New Orleans, LA

Panel composed of Judges Marc E. Johnson, Robert A. Chaisson, and Hans J. Liljeberg

JOHNSON, J.

Appellant, Jose Mendez, seeks review of the Office of Workers’ Compensation Court District 7, Jefferson Parish's March 10, 2021 judgment finding that he failed to establish that his neck complaints were caused, aggravated, or accelerated by an October 4, 1993 workplace accident and denying workers’ compensation benefits for his neck injuries. For the reasons that follow, we affirm the judgment of the trial court.

FACTS AND PROCEDURAL HISTORY

Mr. Mendez claims that, on October 4, 1993, while working as a sheet metal technician at appellee's, Transit Management of Southeast Louisiana, Inc., ("TMSEL"), Carrollton Station in New Orleans, he injured his lower back and neck at work when squatting to lift a large iron die to use on a machine. Mr. Mendez reported the accident at that time and has received workers’ compensation benefits as a result of this accident.

On November 19, 2019, Mr. Mendez requested approval of a cervical MRI in connection with his continued complaints of neck pain. TMSEL denied this request, contending that Mr. Mendez injured only his lower back as a result of the accident and his cervical spine complaints are unrelated to the October 4, 1993 work accident and therefore non-compensable. TMSEL further argues that the appropriate amount of workers’ compensation benefits have already been paid to and on behalf of Mr. Mendez in accordance with the Louisiana Workers Compensation Act ("LWCA").

Mr. Mendez then filed a Disputed Claim for Compensation on March 10, 2020 with the Office of Workers’ Compensation ("OWC"), District 7. Mr. Mendez alleged that he was entitled to approval of the cervical MRI because the neck injury was related to his October 4, 1993 accident at work and also asserted a claim for penalties and attorney's fees because TMSEL declined to approve the requested medical treatment.

TMSEL filed an answer on April 29, 2020, alleging that Mr. Mendez's claim had prescribed and he had been "afforded all medical and indemnity benefits to which he is entitled." TMSEL also averred that any and all disability alleged by Mr. Mendez was a result of a pre-existing condition which has resolved, and "any injuries allegedly sustained by the plaintiff were the result of his own willful intent to injury herself (sic) and/or intoxication and, as such, recovery herein is barred." In the alternative, TMSEL alleged that Mr. Mendez did not provide proper notice of his injury, as required by the LWCA. It also alleged Mr. Mendez's claim did not comply with the provisions of La. R.S. 23:1314 of the LWCA and, therefore, was premature and subject to dismissal. TMSEL asserted that Mr. Mendez's claims were not brought upon reasonable grounds and prayed for judgment in its favor and against Mr. Mendez for the entire cost of the proceedings pursuant to La. R.S. 23:1310.9 of the LWCA.

At the January 8, 2021 trial, Mr. Mendez's counsel rested his case after submitting the following into evidence: neurosurgeon Dr. Cuong Bui's report dated May 1, 2018; Dr. Bui's opinion letter dated May 25, 2018; Dr. Bui's report dated November 19, 2019; and the April 6, 2016 conference report of Dr. Troy Beaucoudray, a neurologist who specializes in pain management. Dr. Bui opined that the cervical disc herniation at C6-7 revealed by a prior cervical MRI performed on March 19, 2018 "could be responsible for neck and arm pain." After an examination on May 1, 2018, Dr. Bui found that Mr. Mendez may benefit from surgery.¹ On September 25, 2018, Dr. Bui opined that Mr. Mendez's need for the cervical surgery was "more likely than not related to the [October 4, 1993] job accident." Mr. Mendez returned to Dr. Bui on November 19, 2019 with complaints of worsening neck pain radiating to both shoulders. Dr. Bui wished to get an updated cervical MRI before proceeding with any possible treatments, as the disc "could also conceivably gotten better". TMSEL also denied the request for an updated cervical MRI, determining that the proposed diagnostics and treatment were not related to the October 4, 1993 accident. Mr. Mendez stressed in his post-trial memorandum that he first complained of neck pain to Dr. Richard Meyer, an orthopedist, on July 22, 1994, seven months after the accident; so, his current neurosurgeon, Dr. Bui, was "satisfied that the job injury ... caused plaintiff's neck injury." Mr. Mendez also pointed out that Dr. Beaucoudray, a specialist in neurology and pain management, found that "Mr. Mendez's diagnoses as they relate to his work injury from 1993 include [...] cervical and lumbar radiculopathy."

TMSEL's counsel also offered and introduced four exhibits into the record at trial: the certified medical records of TMSEL's choice of neurosurgeon, Dr. Najeeb Thomas; the certified medical records of TMSEL's choice of pain management physician, Dr. Joseph Crapazano; the November 13, 2020 Dr. Bui deposition transcript; and the certified medical records of Dr. Bui. TMSEL's choice of neurosurgeon and pain management physician, Doctors Najeeb Thomas and Joseph Crapanzano, respectively, both determined that Mr. Mendez's pain complaints were not related to the work accident where the cervical herniation first appeared on diagnostic testing on June 25, 2007. Counsel for TMSEL argued that the matter was purely a medical issue and asked that the court take the matter under advisement on the medical records and the briefs. In its post-trial memorandum, TMSEL argued that Mr. Mendez was not entitled to authorization of the cervical MRI as both Dr. Thomas and Dr. Crapanzano determined that Mr. Mendez's neck pain complaints were related to his psoriatic arthritis and not the October 1993 accident. TMSEL asserted there was a previous judicial determination that the psoriatic arthritis was not related to the work accident, and Mr. Mendez's treating neurosurgeon determined that his neck pain was caused by a cervical herniation not present on any diagnostic testing until fourteen years after the work accident occurred.

In its March 10, 2020 judgment, the trial court found that Mr. Mendez "failed to carry his burden to establish that his neck complaints were caused, aggravated or accelerated by" the October 4, 1993 accident and his claims for workers’ compensation medical benefits were denied as non-compensable pursuant to La. R.S. 23:1031(A)² . The trial court also denied Mr. Mendez's claim for penalties and attorney's fees pursuant to La. R.S. 23:1201³ , having found TMSEL reasonably controverted his right to workers’ compensation benefits related to his neck injury, including the authorization of Dr. Bui's request to perform a cervical MRI. In her reasons for judgment, the trial judge opined that the opinions of Dr. Bui and Dr. Beaucoudray were less credible than the physicians who treated Mr. Mendez within the first fourteen years of his accident and concluded that the "totality of the evidence demonstrates that any neck issues from which Mr. Mendez suffers are not related to the 1993 work accident."

ASSIGNMENT OF ERROR

Mr. Mendez avers that the trial court committed error when it found that his neck complaints were not related to his October 4, 1993 accident at work.

TMSEL counters that the court placed greater weight on the opinions of Dr. Thomas in 2015, Dr. Crapanzano in 2019, and also Dr. Paul Hubbell⁴ , a pain management specialist, in 2011. Each of those physicians attributed Mr. Mendez's neck complaints to his psoriatic arthritis, instead of the work-related accident. TMSEL also argued that trial court's decision was reasonable considering the objective diagnostic evidence presented, even though Mr. Mendez reported to Dr. Bui that he began experiencing neck pain immediately after the 1993 accident and that he first complained of neck injuries to his then treating orthopedist, seven months after the accident occurred.

LAW AND ANALYSIS

Factual determinations in workers’ compensation cases are subject to the manifest error or clearly wrong standard of appellate review. Downs v. Chateau Living Ctr. , 14-672 (La. App. 5 Cir. 1/28/15), 167 So.3d 875,...