In a Louisiana Third Circuit case, the court found that LWCC was not entitled to a preliminary hearing, due to failure to notify the claimant of initial payment. This was despite the fact that several weeks of indemnity payments were sent to the claimant’s home address in Alexandria. In testimony for the case, (Bowie v. Westside Habilitation Center Inc.) the adjuster was unable to explain why the notice of payment was sent to an address in Cheneyville when the claimant (Bowie) had identified her address as the one in Alexandria to which the payments were sent. LWCC terminated benefits when they determined that Bowie’s knee injury was the result of a pre-existing degenerative condition and not solely related to the circumstances of injury (restraining a violent patient.)
The workers’ comp judge ruled in LWCC’s favor, finding that the question of the notice of initial payment was “irrelevant, because the issue in dispute is a knee replacement.” The Third Circuit summarily disagreed and stated in their discussion that: “In this instance, the controversy is over the payment for treatment to Bowie’s left knee. However, Defendants must still comply with the requirements of La.R.S. 23:1201.1(A)(2) and (3). These provisions deal with the notice of initial payment. The evidence and testimony clearly showed that Defendants could not prove that the notice of initial payment was properly sent to Bowie.” The appellate court thus reversed and remanded the decision.
Read the decision here.
Read additional summary from WorkCompCentral here.