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Further benefits denied over misrepresentation of injury

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Louisiana

A worker who fell at an office supply store while running a work errand misrepresented her injury, an appeals court in Louisiana ruled Wednesday in affirming a workers compensation court judgment that held her employer was right to deny her additional workers compensation benefits.

Debra White was working for Washington Inventory Services Inc. in 2016 when she injured her elbow and knees in the fall, an injury that she sought treatment for and was awarded workers comp benefits, according to documents in Debra White v. WIS International, filed in the Court of Appeal of Louisiana, Third District, in New Orleans.

Ms. White eventually added additional injuries to her claim, including back and shoulder pain, and requested indemnity for a longer duration on several occasions, filing paperwork for attorney’s fees based on her claim that she had not been paid part of the indemnity owed to her, according to documents.

As part of her recovery, she was treated by several physicians and had surgery. Doctors also noted in her file a history of knee surgeries, a car accident, arthritis, among other ailments documents in several pages of court documents. Her employer eventually denied additional benefits, alleging she had misrepresented her injury and additions to her claim.

At issue before a workers compensation court in 2019 was Ms. White's entitlement to indemnity from the date of the accident, whether the additional medical treatment Ms. White sought with respect to her right shoulder, knees, neck and back, as well as treatment for pain management, were causally related to the 2016 fall, whether Washington Inventory Services was liable for penalties and attorney fees for failing to approve the requested medical treatment, and whether Ms. White made intentional misrepresentations in violation of state law, thereby forfeiting her claims, according to documents.

A workers compensation judge ruled in favor of the employer, deliberating on a history of prior accidents, injuries and surgeries — some undisclosed in her original claim.

“So these failures on behalf of Ms. White and these denials of the injury in the 2006 motor vehicle accident and denial of injuries to her shoulders in the 2015 automobile accident, denials of chronic back pain, repeatedly disagreeing with her various medical records about complaints of injuries or pain problems in those areas, and the number of times including her expression on her face convinced this Court that this was not inadvertent. This was, in fact, willful, deliberate, intentional,” the judge wrote.

In affirming, the appeals court ruled that the “record reasonably supports the WCJ's findings with respect to Ms. White's lack of credibility and intentional misrepresentations in violation of (state law); therefore, we find no error in WCJ's denial of Ms. White's claims.”

 

 

 

 

 

 

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