Tag: injury

Is timing everything where workers compensation benefits are forfeited based on fraud? It depends…

In Moran v. Rouse’s Enterprises, LLC, 19-2392019(La. App.5 Cir. 12/26/19)- – – So. 3d – – -, the Louisiana Fifth Circuit held that there is a forfeiture of all benefits when a worker’s compensation claimant commits fraud, regardless of when the fraudulent conduct occurs. The court declined to follow opinions from the First and Third Circuits concluding otherwise.

In Moran, the claimant obtained treatment for injuries to her back, right knee, and right shoulder after a slip and fall at work for Rouses supermarket. In her deposition, the claimant Moran testified that she experienced knee pain only once before her fall; it was “years ago” and not “serious.” Moran also claimed that she experienced no prior shoulder or back pain. However, medical records established:

•             Complaints of knee pain on at least 8 separate occasions between 2012 and the job injury;

•             Complaints of right knee, right wrist, and back pain after a slip and fall in 2013; and

•             A right shoulder impingement diagnosis 2 months before the on-the-job accident.

Rouses and its workers compensation carrier affirmatively alleged a violation of La. R.S. 23:1208, Louisiana’s workers compensation fraud statute, following the claimant’s deposition. Paragraphs “A” and “E” of section 1208 provide in pertinent part:

A.            It shall be unlawful for any person… to willfully make a false statement or representation… for the purpose of obtaining or defeating any benefit or payment under…this Chapter.    

***

E.            Any employee violating this Section shall… forfeit any right to compensation benefits under this Chapter.

As part of their fraud defense, the defendants specifically denied responsibility for all worker’s compensation benefits, i.e. benefits that that might have otherwise been due both before and after the fraudulent deposition testimony.

Following trial, the workers compensation judge determined that Moran carried her burden of proving the occurrence of on-the-job injury and disability. Nevertheless, the trial court also ruled that the claimant made false statements for the purpose of obtaining workers compensation benefits in violation of section 1208, thereby forfeiting the right to both the pre and post-deposition benefits that she was claiming.

On appeal, Moran argued that the forfeiture requirement of section 1208 applies prospectively only. Moran cited opinions from the Louisiana First and Third Circuits. After addressing the statute and the case law, the Moran court affirmed the decision of the workers compensation judge finding that the forfeiture of benefits provided for in of Section 1208 is clear and unambiguous. The opinion states that “…if the legislature had intended to limit the application … it would have clearly expressed that in the statute.”

There are no Louisiana Supreme Court opinions which specifically address whether the Section 1208 forfeiture applies retroactively or prospectively only. Given the defined split in the Louisiana appellate courts, the issue is ripe for consideration by the state’s highest court.


Ed is a Keogh Cox partner who litigates Worker’s Compensation, automobile and premises liability as well as subrogation claims. He is an avid runner and enjoys traveling with his wife Jennifer and their three children.

Limitation of Liability under the LPLA: Can Internet Retailers be Manufacturers?

The Louisiana Products Liability Act (“LPLA”) contains the exclusive theories of recovery against a manufacturer for damages caused by its product. The term “manufacturer” within the LPLA includes “the seller of a product who exercises control over or influences a characteristic of the design, construction, or quality of the product that causes damage.” The rapid growth of e-commerce raises a unique question – how do we classify internet retailers?

Internet retailers generally act as a middleman for third party manufacturers and online consumers. In this respect, they are not technically “sellers” as defined by the LPLA because they typically do not have control over the design or construction of the products they sell. Nevertheless, the proper categorization of internet retailers may become important when someone is injured by a product, as was the case in State Farm Fire and Casualty Company v. Amazon.com, Inc., 2019 WL 5616708 (Miss. N.D. 10/31/19) — F.Supp.3d —.

In State Farm Fire and Casualty Company v. Amazon.com, Inc., two hoverboards purchased through Amazon caught fire inside a Mississippi home and the home was destroyed. In considering Amazon’s possible liability, the Mississippi Court asked whether Amazon was a “service provider” or a “marketplace.” In Mississippi, a finding that Amazon was a “service provider” would insulate it from the claim. However, if Amazon acted as a “marketplace,” it could be exposed by the common law to a negligent failure-to-warn claim. The Mississippi Court held that, because Amazon operated as a marketplace, the claim against it could go forward.

If similar facts arose in Louisiana, could Amazon or similar retailers be exposed under the LPLA? If an internet retailer established policies that forced a “true” manufacturer to negatively alter product quality, would the LPLA provide a remedy?  For example, if an internet retailer sets a price ceiling, this artificial figure, especially if unreasonably low, might pressure a manufacturer to lower product safety. Is setting a price range the exercise of enough control or influence over the “design, construction, or quality of a product” to render internet retailers subject to suit under the LPLA? That is a question likely to be answered in cases to come.

A Matter of Control of a Bike Results in No Liability under the LPLA

A Louisiana man logged onto eBay. To save some money, he bought a used racing bicycle. While riding this bike through his neighborhood, he noticed an unlevel section of the roadway and attempted a “bunny hop” over the gap in the pavement. The front wheel disconnected when he landed. The cyclist lost control and flipped over the handlebars, sustaining serious injuries. He later filed suit against Specialized, the manufacturer of the bicycle, under the Louisiana Products Liability Act (“LPLA”). See Delahoussaye v. Boelter, — So.3d—, 2019-0026 (La. App. 1 Cir. 11/15/19).

The evidence in Delahoussaye showed that the bike was missing its “secondary retention device,” which keeps the wheel from disengaging if the “quick release” on clamp on the front fork is not engaged properly. Also, no warnings were found on the bike. Based upon this evidence, the cyclist claimed Specialized should be liable because the bike was defective; unreasonably dangerous in its design, construction, and manufacture; and inadequate in its instructions and warnings.

To recover from a manufacturer under the LPLA, a plaintiff must show that the product (here, the bike) was unreasonably dangerous at the time it left the manufacturer’s control. Photographs of the bike showed a light, silver spot on the bike where the secondary retention device had been located. This confirmed that the secondary retention device was removed after it originally was manufactured. Evidence also showed that warning stickers originally on the bike had been removed.

These changes were made after Specialized lost control of the bike. Because the bike was not defective when the product left Specialized’s control, Specialized, as the bike’s manufacturer, could not be liable under the LPLA for injuries the plaintiff sustained when he lost control of the bike. In short, this case came down to a matter of control.


Reynolds LeBlanc is a partner at Keogh Cox. His practice areas include commercial litigation, personal injury claims, appeals, and other matters. Reynolds is a former teacher, who in his free time plays music and perpetually talks himself into training for his next marathon.

Throw Me Something Mister? Liability for Mardi Gras Krewes

As part of the unique aura that surrounds Mardi Gras in South Louisiana, the expression “Laissez les bons temps rouler” is forever linked to the spirit of the season. The Cajun French phrase meaning “Let the good times roll” captures the eccentric soul of Carnival. However, it might be difficult to let the good times roll after being struck by a bag of beads hurled from the second deck of float. If the spectator suffers a severe injury as a result, who is liable? Does the injured party have any recourse against the person who threw the beads? Against the Mardi Gras krewe organizers?

The Fourth Circuit Court of Appeal held that spectators assume the risk of injury when attending a parade. Citron v. Gentilly Carnival Club, Inc., 14-1096 (La. App. 4 Cir. 4/15/15), 165 So.3d 304. The foundation of the decision was based on the Mardi Gras Immunity Statute, La. R.S. 9:2796, which has two parts: (1) creates broad immunity for krewes which sponsor parades; and (2) states that anyone who attends such a parade “assumes the risk of being struck by any missile whatsoever which has been traditionally thrown, tosses or hurled by members,” which include, but are not limited to: beads, cups, doubloons, and many other things.

To impose liability on a krewe, there must be evidence of the krewe’s—as opposed to its member’s—gross negligence. Palmer v. Zulu Soc. Aid & Pleasure Club, Inc., 09–0751 (La. App. 4 Cir. 3/1/10), 63 So.3d 131 (emphasis added). Furthermore, a carnival krewe or organization may not be vicariously liable for its members’ acts. To the contrary, Louisiana jurisprudence has rejected the argument that a krewe is vicariously liable for its members’ acts. Kibble v. B.P.O. Elks Lodge No. 30, 640 So.2d 267, 269 (La. App. 4th Cir. 1993).

The Mardi Gras Immunity Statute imposes an extremely high burden of proving the “loss or damage was caused by the deliberate and wanton act or gross negligence” of the krewe or organization. Gross negligence has been defined as the “entire absence of care” and an “extreme departure from ordinary care or the want of even scant care.” Ambrose v. New Orleans Police Department Ambulance Service, 93–3099 (La. 7/5/94), 639 So.2d 216. In calculating whether an act was grossly negligent in the context of Mardi Gras Immunity Statute, the Citron court considered several factors: (1) the weight of the object thrown, (2) the distance the object was throw, and (3) the manner in which the object was thrown. Citron, 165 So.3d at 317.

Ultimately, the statute absolves krewes from liability for injuries caused by objects thrown to parade spectators, except in extreme and unusual circumstances. Therefore, be alert during parades this Mardi Gras season and Laissez les bons temps rouler.


Cole Frazier joined Keogh Cox as an associate in 2019 after working at the firm as a law clerk during law school. He earned his J.D. and Diploma in Comparative Law from Louisiana State University, Paul M. Hebert Law Center. During his time at LSU Law, he also studied comparative law at Jean Moulin Lyon 3 University in Lyon, France. Cole received his Bachelor’s degree in Business Administration with a concentration in Pre-law from Nicholls State University in 2015. He was elected to the Southland Conference all-academic team twice as a member of the Nicholls State football program.

Minimal Force of an Impact Matters in Car Accident Litigation

For years, Louisiana plaintiffs attorneys have argued that the force of impact in an auto accident is not determinative of their clients’ injuries and should be afforded little, if any, weight. A recent decision out of the Louisiana First Circuit Court of Appeal does damage to that argument. In Jones v. Bravata, Jr. and The City of Baton Rouge, 2018 CA 0837 (La. App. 1 Cir. 5/9/19), the First Circuit upheld the trial court’s jury instruction on “force of impact” where photographs showed only minor damage and the defendant described the accident as a “bump.”

The accident occurred when a City employee rear-ended the plaintiffs’ vehicle. Liability was stipulated and the only question at trial was damages. Mrs. Jones alleged severe neck and back injuries. She began treatment with an orthopedist within a week of the accident and thereafter received five “relatively non-invasive surgical procedures” in lieu of a lumbar fusion surgery. The jury returned a verdict of $200,000, which included $150,000 in past medical expenses and $35,000 in future medical expenses, but awarded little for general damages. Mrs. Jones appealed the verdict, asserting that the trial court erred in instructing the jury on force of impact.

The “force of impact” jury instruction in dispute provided:

While the force of a collision may be considered in determining whether a person was injured by an accident and the extent of the injuries sustained, it should not be the only factor to consider in making such a determination. Even though the force of impact may be slight, it does not preclude an award of damages. However, in determining causation, you may consider the minimal nature of the accident.

In considering the plaintiff’s assignment of error, the First Circuit noted that Mrs. Jones was correct that no witness specifically testified that the accident was too minor to have caused her injuries. However, there was evidence in the record upon which the jury could have reached the conclusion that this was a minimal impact.

Common sense would appear to support a connection between the force of an impact and the injury one could be expected to suffer. The recent Jones decision allows defendants to promote this common sense argument. Where the claimed injuries are disproportionate to the forces involved, this argument can make the difference at trial.

John Grinton is a partner of the firm admitted in state, federal and appellate courts throughout Louisiana.  His practice focuses on commercial and construction litigation, representing insurance companies, architects, engineers, contractors and other businesses in all aspects of litigation.  His workers’ compensation practice includes representing clients in medical billing disputes, healthcare provider disputes, statutory/borrowing/special employer disputes, and court approved settlements. John has been involved in complex cases involving construction defect claims, breach of contract and negligence actions, insurance coverage issues, lender liability, securities litigation and personal injury matters. He has firsthand experience in jury trials and arbitration’s, as well as mediation, appellate briefing and oral argument.

The “Collateral Source Rule” & How it Can Cost (or Make) You Thousands – Part I

Imagine you are a defendant sued because you negligently injured someone in Louisiana.  In the accident, the plaintiff received extensive medical treatment. The health insurer paid $50,000 for medical costs even though the doctors billed $150,000 for the plaintiff’s care. The plaintiff was only out-of-pocket $500 for his health insurance deductible. What amount should you have to pay: $150,000, $50,000, or only $500?

The answer to this question is not so simple. You will certainly have to pay more than the plaintiff’s deductible, that much is clear. But whether you are required to pay the medical providers’ full rate of $150,000, the insurer’s discounted rate of $50,000, or some other amount for the medical services provided is a more complicated issue.

This blog is broken down in a two-part series. This installment will address the background of the collateral source rule and the public policy behind the rule.

What is the Collateral Source Rule?

The collateral source rule provides that a tortfeasor is generally not entitled to a credit for payments made to a plaintiff through “collateral sources,” i.e., sources not provided by the defendant. Under this rule, a tortfeasor’s exposure for damages should be the same regardless of whether or not the plaintiff purchased health insurance.

The collateral source rule permits the plaintiff to recover medical expenses in excess of the amounts actually paid by the plaintiff or their insurer. Critics therefore assert that the rule provides a “windfall” to the plaintiff that violates the goal of Louisiana tort law, namely to make the victim “whole.”  As applied, the rule can make the victim more than whole.

Origins of the Collateral Source Rule

To understand the collateral source rule, it helps to look at its origins. The rule in the United States at least dates back to the 1854 case The Propeller Monticello v. Mollison, 58 U.S. (17 How.) 152, 15 L.Ed. 68 (1854). In Propeller Monticello, two ships wrecked and one sank. The insurer of the ship that sank paid for the loss. The owner of the at fault ship asserted that the plaintiff had been fully compensated by the insurer’s payment and that it was therefore not obligated to pay for the damage. In rejecting this argument, the Propeller Monticello Court held the defendant was not a party to the insurance contract and could not reduce exposure by citing to the insurance available to the plaintiff.

Policies Behind the Collateral Source Rule

In Dep’t of Transp. & Dev. v. Kansas City S. Ry. Co., 846 So. 2d 734 (La. 5/20/03), the Louisiana Supreme Court detailed the public policy concerns that support the collateral source rule. According to the court, the policies in favor of the rule include:

i.  Fairness– a defendant should not gain an advantage from benefits provided to the plaintiff independent of any act of the defendant;

ii.  Deterrence– the rule provides a deterrence to negligent conduct; and,

iii.  Promotion of Insurance– victims could be dissuaded from purchasing insurance if that act could affect tort recovery.

So, how much do you owe: $50,000, $150,000, or some other amount? We’ll tell you in Part II of this blog.