LAFAYETTE BONE & JOINT CLINIC (CHARLES MORRIS), ET. AL.
v.
LOUISIANA UNITED BUSINESS SIF, ET. AL.
No. WCA 15-283
Court of Appeals of Louisiana, Third Circuit
October 21, 2015
APPEAL FROM THE OFFICE OF WORKERS' COMPENSATION - # 4 PARISH OF LAFAYETTE, NO. 08-23957 SHARON MORROW, WORKERS' COMPENSATION JUDGE
Jeffrey C. Napolitano Juge, Napolitano, Guilbeau, Ruli & Freiman COUNSEL FOR DEFENDANTS-APPELLEES: LUBA Casualty Insurance Company Wallace Wiltz Concrete, Inc.
Thomas A. Filo Cox, Cox, Filo, Camel & Wilson, L.L.C. COUNSEL FOR PLAINTIFFS-APPELLANTS: Louis C. Blanda MD Lafayette Bone & Joint Clinic
Lawrence C. Billeaud Attorney at Law COUNSEL FOR PLAINTIFFS-APPELLANTS: Louis C. Blanda MD Lafayette Bone & Joint Clinic
Court composed of Elizabeth A. Pickett, Phyllis M. Keaty, and David Kent Savoie, Judges.
DAVID KENT SAVOIE JUDGE
This is one of two workers' compensation matters now before us involving an identical dispute between a health care provider and an employer/workers' compensation insurer over reimbursement for physician-dispensed medication provided in connection with the employee's authorized office visits with his treating physician. The two matters were tried together, but never consolidated, and they were appealed separately.
1
After trial, the workers' compensation judge (WCJ) limited the health care provider's reimbursement for the medication to $750.00 under La.R.S. 23:1142, finding that the medication was not authorized. The WCJ also denied the health care provider's claim for penalties and attorney fees.
For the following reasons, we amend the judgment to award reimbursement for the medication in the full amount charged, reverse the judgment in part, and award the health care provider penalties and attorney fees.
FACTUAL AND PROCEDURAL BACKGROUND
The facts in this case are largely undisputed. In April 2008, Charles Morris was injured in the course and scope of his employment with Wallace Wiltz Concrete, Inc. (Wallace Wiltz). According to the WCJ's ruling, LUBA Casualty Insurance Company (LUBA)
2 was Wallace Wiltz's workers' compensation self-insured fund, and later insurer. Mr. Morris was treated by Dr. Louis Blanda with Lafayette Bone and Joint Clinic for work-related injuries.
On June 5, 2008, LUBA sent Dr. Blanda a letter indicating generally that it would no longer provide reimbursement for...
