La. Stat. Ann. § 23:1201
Payment of compensation and penalties: the cases that interpreted this section
1,281 citing cases reviewed of 2,465 in the citation index: 1,083 interpreted the section (annotated below), 198 cited it only in passing. Cases filed after 2026-06-29 may not have been reviewed yet.
Have a situation under La. Stat. Ann. § 23:1201?
These notes show how courts have ruled. Ask about your specific facts and see which of these rulings apply, with citations you can check.
Later changes in law
Changes after the earliest notes below. A note stating a rule one of these changed is marked "Law changed since".
- 1983-07-01 Acts 1983, 1st Ex. Sess., No. 1 revised § 23:1201’s payment and late-penalty framework; current subsections (B) and (F)(2) use a 14-day first-installment deadline and reasonable controversion. Source
- 1993-01-01 Acts 1992, No. 1003 extended § 23:1201 penalties to late medical-benefit payments. Source
- 1995-06-29 Acts 1995, No. 1137 extended the medical-payment deadline to 60 days and added daily alternatives to the flat 12% late-payment and 24% final-judgment penalties. Source
- 2003-02-25 Authement v. Shappert Engineering held that an unjustified failure to authorize necessary treatment, including required prepayment on its facts, can support § 23:1201(F) penalties and fees. Source
- 2003-08-15 Acts 2003, No. 1204 changed § 23:1201(F)’s penalty formula from an amount equal to the greater measure to an assessment up to that amount and set an $8,000 merits-hearing cap. Source
- 2003-08-15 Acts 2003, No. 1204 added refusal to consent to a required treating-physician choice or change to § 23:1201(F)’s penalty grounds. Source
- 2003-08-15 Acts 2003, No. 1204 repealed § 23:1201.2 and placed penalties and attorney fees for arbitrary discontinuance in § 23:1201(I). Source
- 2003-08-15 Acts 2003, No. 1204 added § 23:1201(J)’s one reasonable attorney-fee award per merits hearing and res judicata rule for preceding conduct. Source
- 2009-01-01 Acts 2008, No. 415 redesignated the Title 22 insurance-law cross-reference in § 23:1201(I), now § 22:1892(C), without changing its substance. Source
- 2010-05-11 Acts 2010, No. 3 permitted electronic transfers, including direct deposit and debit cards, under § 23:1201(A)(2) and repealed the former mail-payment provision in § 23:1201.1. Source
- 2012 Acts 2012, No. 860 added “except as otherwise provided in this Chapter” to § 23:1201(F) and replaced former subsection (H)’s immediate office notice with a payment-notice and preliminary-determination process. Source
- 2013-07-01 Acts 2012, No. 652 split § 23:1201(E): non-electronic medical bills remain due within 60 days of written notice, while complete electronic bills are due within 30 days. Source
- 2013-08-01 Acts 2013, No. 337 moved and revised payment, modification, and suspension notices into § 23:1201.1, including a seven-business-day cure protection for a compliant payor. Source
- 2024-07-01 Acts 2024, No. 423 replaced the one-year delictual prescriptive period with two years prospectively for delictual actions arising after July 1, 2024. Source
Timely payment and penalties for workers compensation benefits
Section 23:1201 ties compensation-payment timing to the times and places wages were payable and permits the parties to agree to a longer interval, up to one month, without court approval.
Cole v. Sears, Roebuck & Co. · filed 1980-10-08
We find no merit in appellant’s argument that the agreement of the parties that compensation be paid monthly rather than weekly, pursuant to Section 1201, somehow deprives plaintiff-appellee of the benefit of Section 1333. Under Section 1201 payments of compensation are paid as near as may be, at the times and places as wages were payable to the injured employee before the accident. Plaintiff was paid his wages weekly, therefore he was to be paid compensation weekly. He and his employer agreed, subsequent to rendition of the 1976 judgment, that the weekly compensation installments would be accumulated and paid monthly.Read the full opinion on CourtListener →
Section 23:1201(F)(2) excuses penalties and attorney fees only when the employer or insurer reasonably controverts the claim or the nonpayment results from conditions beyond its control.
Ardoin v. GROCERY · filed 2002-04-17(F)(2)
In order to reasonably controvert a workers' compensation claim, an employer must have factual or medical information of such a nature that it reasonably counters that provided by claimant. ... The Defendant presents no evidence whatsoever which reasonably controverts the fact that Ms. Ardoin suffered a work-related accident. ... Under these circumstances, we are compelled to find that the WCJ committed manifest error in failing to provide penalties and attorney fees.Read the full opinion on CourtListener →
Section 23:1201 requires statutory penalties when covered workers’ compensation benefits are not timely paid.
Pierce v. City of Abbeville · filed 1992-06-24
We agree that, under the mandate of La.R.S. 23:1201, penalties should be awarded on the $3,521.21 of back benefits paid by defendant to plaintiff prior to trial and on the award of temporary total benefits of $398.94 for the period of November 28, 1988.Read the full opinion on CourtListener →
Law changed since Acts 1995, No. 1137 (effective June 29, 1995) added the $50-per-day alternative, capped at $2,000, to the former flat 12% late-payment penalty; the earlier rate can govern older injuries.
Section 23:1201(B) and (E) sets deadlines for workers' compensation installments and imposes a twelve-percent penalty for untimely payment unless a statutory exception applies, including reasonable controversion.
Martin Lumber P'ship. v. La. Ins. Guar. Ass'n · filed 1988-11-09(B), (E)
The award of statutory penalties in worker's compensation cases is governed by La.R.S. 23:1201(B, E), which provides in pertinent part as follows: ... Again, the test in determining whether Martin is entitled to statutory penalties involves a subjective determination as to the reasonableness of LIGA's failure to pay benefits and, on the facts before us, is not properly determined by a motion for summary judgment.Read the full opinion on CourtListener →
Law changed since Acts 1992, No. 1003 (effective January 1, 1993) extended the late-payment penalty to medical benefits; the prior exclusion remains relevant to injuries governed by the earlier law.
Section 23:1201 authorizes penalties for nonpayment of weekly workers' compensation benefits, but not for failure to pay medical expenses.
Dubois v. Diamond M Co. · filed 1990-02-12(E)
The trial court clearly erred in awarding penalties provided by R.S. 23:1201[3]. This statute provides only for the recovery of penalties for non-payment of the weekly compensation benefits described therein and does not allow for the imposition of penalties for failure to pay medical expenses.Read the full opinion on CourtListener →
Section 23:1201(A) requires compensation payments to be made as nearly as possible when and where the employee’s wages were paid before the injury, but permits the parties to agree to payment intervals of up to one month without the Director’s approval.
Ringo v. Hawco Manufacturing · filed 1991-06-27(A)
The act requires that payments be made as nearly as possible to the time and place of payment of the employee’s wages prior to the injury, but allows for a longer interval by agreement (up to one month) without the approval of the Director. La. R.S. 23:1201(A).Read the full opinion on CourtListener →
Section 23:1201 provides penalties when an employer or compensation insurer fails to make timely compensation payments.
Libasci v. Longo · filed 1992-02-13(E)
La.R.S. 23:1201 provides for penalties when an employer or compensation insurer fails to make timely compensation payments. For the reasons mentioned above, we cannot say the trial court erred in failing to assess penalties for Commercial’s failure to pay the admittedly incorrect amount recommended by the OWC A, instead of paying the correct amount, $212.34 per week.Read the full opinion on CourtListener →
Law changed since Acts 1983, 1st Ex. Sess., No. 1 (effective July 1, 1983) replaced the old demand/arbitrary nonpayment framework; current § 23:1201(B) sets a 14-day first-installment deadline and (F)(2) uses reasonable controversion for late-payment penalties.
Section 23:1201 permits penalties and attorney fees for nonpayment of compensation only when the failure to pay was arbitrary, capricious, or without probable cause.
Krouse v. Parnell, Inc. · filed 1971-05-25
The claim for penalties and attorneys’ fees is based on La.R.S. 23:1201, which requires that the failure to pay workmen’s compensation must have been arbitrary, capricious or without probable cause. We do not think this is a proper-case for the imposition of penalties. Gan-dy’s insurer had paid Krouse for 100 weeks, which was all the law required for the loss of an eye. The question of whether or not the employee was entitled to further benefits depended primarily upon the doctors’ reports. All medical information furnished to United States Fidelity indicated Krouse was able to return to his former occupation. Under these circumstances we think the lower court erroneously held the actions of either Gandy, United States Fidelity or Parnell in refusing to make further compensation payments were arbitrary or capricious.Read the full opinion on CourtListener →
Subsection (B) makes the first workers' compensation installment due 14 days after the employer learns of the employee's injury.
Martin v. Midas Muffler Shop · filed 1988-11-30(B)
The first installment of worker's compensation is payable and due on the 14th day after the employer has knowledge of the employee's injury. La.R.S. 23:1201(B).Read the full opinion on CourtListener →
Section 23:1201(E) permits penalties and attorney fees when workers’ compensation benefits are arbitrarily and capriciously denied.
Troutman v. Hart · filed 2003-04-02(E)
La. R.S. 23:1201(E) allows for an award of penalties and attorney fees to a workers’ compensation claimant that has been arbitrarily and capriciously denied benefits.Read the full opinion on CourtListener →
Section 23:1201(D) makes permanent-partial-disability installments due on the thirtieth day after the employer or insurer receives a medical report notifying it of the disability, with all compensation then due payable that day.
Dordain v. Anthony Seafood & Lobster House · filed 2003-11-05(D)
Installment payments payable pursuant to La. R.S. 23:1221(4) shall become due on the thirtieth day after the employer or insurer receives a medical report giving. notice of the permanent partial disability on which date all such compensation then due shall be paid.Read the full opinion on CourtListener →
Section 23:1201(F) permits penalties and reasonable attorney fees for an employer’s failure to pay compensation, but they are not awarded when the employer reasonably seeks judicial resolution of a close factual dispute.
Moore v. Pitt Grill · filed 2004-03-24(F)
Under La.R.S. 23:1201(F), an employer’s failure to pay compensation results in the assessment of a penalty as well as reasonable attorney fees for the disputed claims. ... In this matter Pitt Grill relied on opinions from their expert witnesses, and, while we find that Ms. Moore has met her burden of proving that her injury could have resulted from the workplace accident, the WCJ found she had not. The issue before us has enough merit that we are unable to say the defendants were unreasonable in seeking judicial review. Therefore, we are unwilling to award penalties or attorney fees in this matter.Read the full opinion on CourtListener →
Law changed since Acts 2024, No. 423 (effective July 1, 2024) replaced the one-year delictual period with two years for actions arising after that date; the prior one-year period continues to govern earlier delictual claims.
Section 23:1201(F) authorizes penalties and attorney fees for nonpayment of workers’ compensation benefits, but claims for those remedies are subject to a one-year delictual prescriptive period.
Craig v. Bantek West, Inc. · filed 2004-09-17(F)
Such is not the case with a fault-based claim for penalties and attorney fees pursuant to La. R.S. 23:1201(F), where the facts must clearly negate good faith and just cause in connection with an employer's refusal to pay workers' compensation benefits. ... Thus, we find no error in the application of the one-year prescriptive period set forth in Article 3492 to Mr. Craig's claims herein for penalties and attorney fees.Read the full opinion on CourtListener →
Section 23:1201(F)(2) bars attorney fees when the employer reasonably controverts the claim with sufficient factual and medical information.
Masters v. Fontenot · filed 2004-02-04(F)(2)
Dr. Goldware’s opinion is sufficient to reasonably controvert the claim. Therefore, attorney fees are not payable under La.R.S. 23:1201(F).Read the full opinion on CourtListener →
Section 23:1201(F) permits penalties and attorney fees when an employer or insurer fails to comply with the statutory payment schedules.
Lanclos v. Coastal Food, LLC. · filed 2004-07-07(F)
La.R.S. 23:1201(F) provides that penalties and attorney’s fees may be imposed when an employer or its insurer fails to comply with the payment schedules outlined in the various subsections of La.R.S. 23:1201.Read the full opinion on CourtListener →
Section 23:1201(F)(2) imposes penalties on an employer or insurer that withholds compensation or medical benefits without evidence sufficient to reasonably controvert the employee’s entitlement.
Town of Grand Isle v. Eschette · filed 2002-05-29(F)(2)
Pursuant to La. R.S. 23:1201(F)(2), an employer or insurer is liable for penalties for withholding benefits without evidence to "reasonably controvert" the employee's right to compensation and medical benefits. ... Having reviewed the record, we cannot say Grand Isle behaved in an arbitrary and capricious manner.Read the full opinion on CourtListener →
Section 23:1201(F) imposes a penalty when an employer fails to reasonably controvert an employee’s entitlement to benefits, but the penalty does not apply to a non-frivolous legal dispute.
Manino v. Ten (10) Minute Oil Change · filed 2002-08-21(F)
La. R.S. 23:1201(F) provides for a penalty when it is established that the employer failed to reasonably controvert the employee’s entitlement to benefits. Construing the phrase “reasonably controvert,” the Louisiana Supreme Court held it means “the defendant must have some valid reason or evidence upon which to base his denial of benefits.” Brown v. Texas-La. Cartage, Inc., 98-1063 (La.12/1/98), 721 So.2d 885, 890. This penalty provision does not apply when the employer “engaged in non-frivolous legal dispute.” Id. Given this was a “non-frivolous legal dispute” over the reverse offset calculation, the WCJ thus did not err in refusing to impose a penalty.Read the full opinion on CourtListener →
Section 23:1201(F)(2) allows a workers’ compensation claimant to recover penalties and attorney fees when benefits are withheld without reasonably controverting the claim.
Mitchell v. Winnfield Holding Corp. · filed 2003-12-17(F)(2)
Likewise, we find LWCC could have inquired from their insured about Mr. Mitchell’s part-time as well as full-time employment. Additionally, Ms. Robinson could have obtained the advice of counsel before interpreting the provisions of the workers’ compensation act on her own. Under the circumstances, we find Mr. Mitchell is entitled to penalties and attorney fees for LWCC’s failure to reasonably controvert his claim.Read the full opinion on CourtListener →
Section 23:1201(F)(2) permits penalties and attorney fees when the employer and insurer did not controvert entitlement to benefits and further medical information was needed to determine the claimant’s condition.
Butler v. New Orleans Paddlewheels · filed 2003-12-10(F)(2)
In the present case, the claimant’s entitlement to penalties and attorney’s fees was not controverted by the employer and insurer pursuant to La. R.S. 23:1201. Further medical information was required to make an exact determination of the claimant’s condition. We cannot say that the trial court was clearly wrong in finding that the employer and insurer acted arbitrarily and capriciously in refusing to pay benefits to the claimant, and in refusing to allow the claimant to undergo additional testing and to be examined by a specialist.Read the full opinion on CourtListener →
Section 23:1201(F) places the burden on a claimant to prove entitlement to penalties for an employer’s untimely refusal or failure to pay workers’ compensation benefits, while an employer and insurer can avoid penalties and attorney fees by reasonably controverting the claim with factual and medical evidence.
Landry v. Furniture Center · filed 2006-01-11(F)
Under La.R.S. 23:1201(F), a claimant in a workers’ compensation claim has the burden of proving his entitlement to statutory penalties for the employer’s refusal or failure to timely pay workers’ compensation benefits. To avoid the imposition of penalties and attorney fees, the employer and its insurer must provide factual and medical evidence to reasonably controvert a workers’ compensation claim.Read the full opinion on CourtListener →
Law changed since Acts 2003, No. 1204 changed § 23:1201(F) from a penalty equal to the greater statutory measure to an assessment up to that measure; the former formula did not leave the same amount discretion.
Subsection (F) requires the greater of a 12% penalty on unpaid compensation or a $50-per-day penalty, subject to the statutory cap, while Subsection (J) permits only one reasonable attorney fee for multiple violations at a merits hearing.
Richard v. Machine Specialty & Mfg. · filed 2006-02-01(F), (J)
Under La.R.S. 23:1201(F), Mr. Richard is entitled to the greater of twelve percent of any unpaid compensation or fifty dollars per day for each day the claim remains unpaid, with the fifty-dollar per day penalty subject to a $2,000.00 cap. ... Recognizing that, under La.R.S. 23:1201(J), Mr. Richard is entitled to only one attorney fee for multiple violations, we increase the attorney fee awarded by the WCJ from $3,750.00 to $5,250.00 (an increase of $1,500.00) to reflect preparation and participation for the first hearing on the issue of prescription.Read the full opinion on CourtListener →
Section 23:1201(F) requires a penalty for failure to pay workers’ compensation benefits unless the employer reasonably controverts the claim or lacked control over the nonpayment; a claim is reasonably controverted only when the employer has not engaged in a frivolous dispute or has sufficient factual or medical information to counter the claim.
Hunter v. Alliance Compressors · filed 2006-06-21(F), (F)(2)
The failure to pay SEB, according to La.R.S. 23:1201(F), "shall result in the assessment of a penalty in an amount up to the greater of twelve percent of any unpaid compensation or medical benefits, or fifty dollars per calendar day for each day in which any and all compensation or medical benefits remain unpaid. . . ." The fifty dollars per calendar day penalty is limited to a maximum of two thousand dollars in the aggregate for any claim. La.R.S. 23:1201(F). The penalty for such a violation, consequently, must be assessed unless the employer reasonably controverts the employee's claim or proves that it had no control over the nonpayment. ... An injured worker's claim is considered reasonably controverted when a court determines that the employer or insurer has not engaged in a frivolous legal dispute or that the employer or insurer possessed factual and/or medical information sufficient to reasonably counter that presented by the injured worker.Read the full opinion on CourtListener →
Law changed since Acts 2012, No. 652 (effective July 1, 2013) limited § 23:1201(E)’s 60-day medical-payment rule to providers not using electronic billing; a complete electronic medical bill is due within 30 days.
Section 23:1201 requires indemnity payments on the same schedule as the employee’s wages, requires the first installment of specified disability or death compensation by the fourteenth day after notice of injury or death, and requires medical benefits within sixty days after written notice; its 2003 amendment authorizing multiple penalties subject to an $8,000 cap is substantive and applies prospectively only, while the penalty exception applies when the claim is reasonably controverted.
Maricle v. Sunbelt Builders, Inc. · filed 2005-11-02(A), (B), (E), (F), and (F)(2)
Louisiana Revised Statutes 23:1201(E) provides that medical benefits “shall be paid within sixty days after the employer or insurer receives written notice thereof.” ... Louisiana Revised Statute 23:1201 makes it clear that “[p]ayments of compensation under this Chapter shall be paid as near as may be possible, at the same time and place as wages were payable to the employee before the accident . . . . ” ... The initiation of indemnity benefits is governed by La.R.S. 23:1201(B) which provides that “[t]he first installment of compensation payable for temporary total disability, permanent total disability, or death shall become due on the fourteenth day after the employer or insurer has knowledge of the injury or death, on which date all such compensation then due shall be paid.” ... For the same reasons set forth in our prior decisions applying paragraph (J) of La.R.S. 23:1201, we hold that the amendment to La.R.S. 23:1201(F), providing for an award of multiple penalties subject to an $8,000.00 cap, is a change in the law and must be given substantive effect. Louisiana Civil Code Article 6 provides that substantive laws apply prospectively only and cannot be given retroactive effect in the absence of contrary legislative expression. Since the cap on the amount of penalties which may be awarded was not in existence when the actions occurred in the present case, we find that the WCJ did not err in awarding penalties in excess of $8,000.00.Read the full opinion on CourtListener →
Section 23:1201(A) requires indemnity benefits to be paid on the same schedule as the employee’s wages.
Maricle v. Sunbelt Builders, Inc. · filed 2005-11-02(A)
Thus, a claimant who is paid on a weekly basis is entitled to receive indemnity benefits the same way he receives his paycheck.Read the full opinion on CourtListener →
Subsection (B) makes the first compensation installment due 14 days after the employer knows of the disabling injury, while subsection (F) permits penalties and attorney’s fees for untimely payment unless the nonpayment was beyond the employer’s or insurer’s control or the claim was reasonably controverted.
Payne v. Orleans Parish School Bd. · filed 2006-03-02(B), (F)
La. R.S. 23:1201(B) provides that the first installment of compensation benefits for temporary total disability, permanent total disability, or death shall become due the fourteenth day after the employer has knowledge of the injury giving rise to disability. La. R.S. 23:1201(F) further provides that if an installment of benefits is not timely paid within the 14 day period, "there shall be added to such unpaid installment a penalty of ... twelve percent thereof ... unless such nonpayment results from conditions over which the employer or insurer had no control," or unless "the employee's right to such benefits has been reasonably controverted by the employer."[1] Both penalties and attorney's fees are recoverable under La. R.S. 23:1201(F) if the employer or insurer fails to commence payments of compensation benefits timely or to pay continued installments timely (or to pay medical benefits timely) unless the claim is reasonably controverted.Read the full opinion on CourtListener →
Subsection (F) places the burden on the claimant to prove entitlement to penalties for an employer's refusal or failure to timely pay workers' compensation benefits, while the employer and insurer avoid penalties and attorney fees by reasonably controverting the claim with factual and medical evidence.
Lebert v. McNeese State University · filed 2006-02-01(F)
Under La.R.S. 23:1201(F), a claimant in a workers' compensation case has the burden of proving his entitlement to statutory penalties for the employer's refusal or failure to timely pay workers' compensation benefits. To avoid the imposition of penalties and attorney fees, the employer and its insurer must provide factual and medical evidence to reasonably controvert a workers' compensation claim.Read the full opinion on CourtListener →
Section 23:1201 permits penalties when workers' compensation benefits are denied without reasonable controversion, assessed by whether the employer or insurer had sufficient factual and medical information to counter the claimant's evidence.
Hosli v. Rent-A-Center, Inc. · filed 2007-04-11
The penalty provisions of Louisiana Revised Statute section 23:1201 are invoked if workers' compensation benefits are denied and the employer or his insurer did not reasonably controvert the employee's right to compensation. The test to determine whether the employee's right has been reasonably controverted turns on whether the employer or his insurer had sufficient factual and medical information to reasonably counter the factual and medical information presented by the claimant.Read the full opinion on CourtListener →
Section 23:1201 authorizes a penalty when an employer fails to pay workers’ compensation benefits that are due.
Cotten v. First Fleet · filed 2007-05-02
Mr. Cotton further asks that a penalty be awarded for the non-payment of benefits for that period. We agree that a penalty is due under the provisions of La.R.S. 23:1201. Therefore, we assess Defendants with a penalty in the amount of $1,000.00 for failure to pay the benefits due for August 5 through August 8, 2004.Read the full opinion on CourtListener →
Section 23:1201 permits a penalty for the nonpayment of workers’ compensation benefits due for a particular period.
Cherry Cotton v. First Fleet · filed 2007-05-02
Plaintiff further asks that a penalty be awarded for the non-payment of benefits for that period. We agree that a penalty is due under the provisions of La.R.S. 23:1201. Therefore, we assess Defendants with a penalty in the amount of $1,000.00for failure to pay the benefits due for the week of April 5 through April 11, 2004.Read the full opinion on CourtListener →
Section 23:1201 authorizes a penalty when an employer fails to pay workers’ compensation benefits that are due.
Cotton v. First Fleet · filed 2007-05-02
We agree that a penalty is due under the provisions of La.R.S. 23:1201.Read the full opinion on CourtListener →
Subsections (B) and (C) require temporary total disability and supplemental earnings benefits to be paid by the fourteenth day after the employer or insurer knows of the injury or compensable earnings.
Smith v. KINDER RETIREMENT AND REH. CENTER · filed 2007-04-04(B) and (C)
More specifically, payments for temporary total disability benefits are due on the fourteenth day after the employer or insurer has knowledge of the injury, and supplemental earnings benefits are due on the fourteenth day after the employer or insurer has knowledge of the compensable supplemental earnings. La.R.S. 23:1201(B) and (C).Read the full opinion on CourtListener →
Section 23:1201(F) requires penalties for an employer’s failure to properly pay benefits unless the claim was reasonably controverted or resulted from conduct beyond the employer’s or insurer’s control.
Trahan v. City of Crowley · filed 2007-10-03(F)
Pursuant to La.R.S. 23:1201(F), penalties shall be awarded for an employer’s failure to properly pay benefits unless the claim is reasonably controverted or resulted from conduct over which the employer or insurer had no control. In order to reasonably controvert a claim, the employer must have some valid reason or evidence upon which to base its denial of benefits. ... We find that the City did not reasonably controvert this claim. Therefore, we award Trahan a $2,000.00 penalty and will assess attorney fees for the City’s improper calculation of the AWW. ... Based upon these factual findings of the WCJ, we find that the City did not have a reasonable basis upon which to controvert the claim. Accordingly, we award Trahan a $2,000.00 penalty and will assess attorney fees for the City’s improper reduction of SEB.Read the full opinion on CourtListener →
Section 23:1201(F) requires a penalty and attorney fees when workers’ compensation benefits are not timely paid or are unreasonably suspended without a valid defense.
Elie v. Sears, Roebuck & Co. · filed 2006-09-27(F)
Therefore, the WCJ erred in failing to impose a $2,000.00 penalty and $2,000.00 in attorney fees under La.R.S. 23:1201(F).Read the full opinion on CourtListener →
Section 23:1201(F) authorizes a penalty up to the greater of twelve percent of unpaid compensation or medical benefits or fifty dollars per day, subject to the subsection’s $2,000 aggregate daily-penalty limit and $8,000 maximum for penalties imposed at a merits hearing.
Trahan v. TURNER INDUSTRIES, INC. · filed 2008-12-10(F)
As cited above, La.R.S. 23:1201(F) requires that a penalty should be assessed "in an amount up to the greater of twelve percent of any unpaid compensation or medical benefits, or fifty dollars per calendar day for each day in which any and all compensation benefits remain unpaid...." (Emphasis added). Given the figures involved, it appears that the claimant's argument has merit insofar as the penalty for the nonpayment of indemnity benefits exceeds the two thousand dollar figure. We note that La.R.S. 23:1201(F) imposes a penalty of "twelve percent of any unpaid compensation." Therefore, we impose a penalty of twelve percent of the indemnity payments beginning on September 26, 2006, until paid. However, the total amount of penalties imposed, inclusive of the $2,000.00 imposed for failure to provide medical benefits, shall not exceed the statutory cap of $8,000.00.Read the full opinion on CourtListener →
Law changed since Same change as noted above.
Section 23:1201 requires indemnity compensation to begin within fourteen days after knowledge of the injury, medical benefits to be paid within sixty days after written notice, and permits penalties and attorney fees for nonpayment unless the claim is reasonably controverted.
Weaver v. Southern Erectors, Inc. of Florida · filed 2010-12-08(B), (E), and (F)
The WCJ’s award of penalties is vague. It appears that these two penalties were for the defendants’ failure to timely commence indemnity payments, a requirement of La.R.S. 23:1201(B), and to timely pay for the initial medical bills, a requirement of La.R.S. 23:1201(E).Read the full opinion on CourtListener →
Section 23:1201 makes an employer liable for penalties for withholding compensation and medical benefits without reasonably controverting the claim, and requires the first installment of compensation within fourteen days after the employer or insurer knows of the claimant’s injury or death.
Benoit v. Turner Industries Group, LLC · filed 2011-05-04(B)
An employer is liable for statutory penalties for withholding benefits without evidence to “reasonably controvert” the employee’s right to compensation and medical benefits. La.R.S. 23:1201. Section 1201(B) provides a specific time requirement for the first installment of compensation to be paid. Specifically, it provides that the first installment is due on the fourteenth day after the employer or insurer has knowledge of the claimant’s injury or death.Read the full opinion on CourtListener →
Law changed since Same change as noted above.
Subsection (E) requires medical benefits to be paid within sixty days after written notice; subsection (F) authorizes a penalty for failure to timely pay a compensable amount; and subsection (G) adds a penalty when an award under a final, nonappealable judgment is unpaid for thirty days, with the per-day penalty capped at $3,000.
Burke v. Venture Transport Logistics, LLC · filed 2014-01-22(E), (F), and (G)
Defendant’s timely authorized a prescription for Multag prescribed by Dr. Jeffrey Chen on May 18, 2011, pursuant to La.R.S. 23:1201(E), which requires “[m]edical benefits payable under this chapter shall be paid within sixty days after the employer or insurer receives written notice thereof.” ... The WCJ found Defendants failed to timely pay the Lafayette General Medical Center bills for services rendered on December 30 and 31, 2010, within the sixty day period required by La.R.S. 23:1201(E). ... Since Defendants paid the bills fourteen days after the sixty day due date, the WCJ awarded penalties of $700.00 pursuant to La.R.S. 23:1201(F), failure to pay an amount compensable under the law. ... We agree with the WCJ’s decision to impose the penalty pursuant to La.R.S. 23:1201(F). We find the award of statutory penalties in the amount of $700.00 is not manifestly erroneous. ... This Court finds the defendant violated the provision of Louisiana Revised Statute 23:1201-G by failing to pay the UMC bill for dates of service October 8 and 13, 2009, and January 8, 2010. Accordingly, the Court awards a Three Thousand Dollar penalty. ... We cannot say that his findings are clearly wrong and affirm his ruling on this issue.Read the full opinion on CourtListener →
Law changed since Same change as noted above.
Section 23:1201(E)(1) requires medical benefits to be paid within 60 days after written notice, while subsection (F) provides penalties and attorney fees for untimely payment or withheld consent to a treating-physician choice, subject to statutory caps.
Arrant v. Wayne Acree PLS, Inc. · filed 2015-04-15(E)(1), (F)
The trial court’s finding that the LWCC provided timely authorization for Mr. Arrant to be examined by his choice of neurosurgeon is not manifestly erroneous.Read the full opinion on CourtListener →
Section 23:1201 requires the first TTD installment within 14 days after the employer or insurer learns of the injury, imposes penalties and reasonable attorney fees for untimely payment, and excuses those sanctions when the claim is reasonably controverted or nonpayment was beyond the payer’s control.
Tingle v. Page Boiler, Inc. · filed 2016-01-13(B), (F), and (F)(2)
The first installment of compensation payable for TTD is due on the 14th day after the employer or insurer has knowledge of the injury. La. R.S. 23:1201 B. Failure to provide this payment results in the assessment of a penalty of 12% of the claim or $50 per day unpaid, whichever is greater, but capped at $2,000 for each disputed claim, together with reasonable attorney fees. La. R.S. 23:1201 F. However, the penalty and attorney fee is not assessed if the claim is reasonably controverted • or if the nonpayment results from circumstances over which the employer or insurer had no control. La. R.S. 23:1201 F(2). To find that the employer or insurer reasonably controverted a claim, the WCJ must find that the payer “engaged in a nonfrivolous legal dispute or possessed factual and/or medical information to reasonably counter the factual and medical information presented by the claimant throughout the time he refused to pay all or part of the benefits allegedly owed.” Brown v. Texas-LA Cartage Inc., 98-1063 (La.12/1/98), 721 So.2d 885; Morris v. Rent-A-Center Inc., 43,191 (La.App. 2 Cir. 4/30/08), 981 So.2d 257.Read the full opinion on CourtListener →
Section 23:1201(E) requires medical benefits to be paid within sixty days after written notice, and the court applied subsection (D) to uphold penalties for an employer's failure to reasonably controvert a mileage-reimbursement claim.
Ebarb v. Boise Cascade Co. · filed 2016-07-13(E), (D)
The failure to provide medical treatment equates to a failure to provide medical benefits pursuant to La.R.S. 23:1201(E), which requires the payment of medical benefits within sixty days after written notice is received by the employer. ... Considering the evidence presented by Ms. Ebarb, which contained the number of miles she traveled for each appointment with Dr. Nunley, we find' that she presented sufficient evidence to substantiate her claim. Furthermore, Boise Cascade received notice of Ms. Ebarb’s request for reimbursement on June 2, 2014, and it had no knowledge or information with which to controvert her claim until August 18, 2014. Thus, we find that it was reasonable for the WCJ to find that Boise Cascade failed to reasonably controvert Ms. Ebarb’s claim; and we affirm the WCJ’s award of penalties and attorney fees pursuant to La.R.S. 23:1201(D).Read the full opinion on CourtListener →
Section 23:1201(F) authorizes penalties for underpayment of workers’ compensation benefits when the employer fails to reasonably controvert the claim.
Leblanc v. Wal-Mart Stores, Inc. · filed 2015-11-04(F)
The WCJ’s award of $2000.00 in penalties, pursuant to La R.S. 23:1201(F), for the underpayment of TTD benefits is affirmed.Read the full opinion on CourtListener →
Section 23:1201(G) imposes penalties and attorney fees when an award under a final, nonappealable judgment remains unpaid for thirty days, but not when nonpayment results from conditions beyond the employer's control.
Ortega v. Cantu Servs., Inc. · filed 2018-05-02(G)
A final, nonappealable judgment includes a workers' compensation settlement agreement, and triggers La.R.S. 23:1201(G) upon court approval and entry into judgment. Williamson v. Liberty Mut. Ins. Co. , 12-148 (La.App. 3 Cir. 6/6/12), 92 So.3d 1218. ... Therefore, the WCJ did not err in concluding that Appellees were not required to pay Ms. Ortega the settlement funds prior to CMS approval of the MSA funding. Additionally, because we conclude nonpayment was the result of conditions over which the employer had no control, the WCJ did not err in denying statutory penalties and attorney fees, in this case, for Appellees' failure to pay the funds within thirty days of the final and nonappealable judgment.Read the full opinion on CourtListener →
Section 23:1201 requires penalties when installment supplemental earnings benefits are not paid within fourteen days after the employer or insurer knows they are due, unless the nonpayment was beyond its control or the employee’s right to benefits was reasonably controverted.
Miller v. Roger Miller Sand, Inc. · filed 1994-11-30(C), (E)
Statutory penalties shall be awarded if the employer or insurer fails to pay supplemental earnings benefits to the claimant within fourteen days after the employer or insurer has knowledge that compensable supplemental earnings benefits are payable, unless (1) such nonpayment results from conditions over which the employer or insurer has no control, or (2) the employer or insurer has reasonably controverted the employee's right to such compensation or medical benefits. La.R.S. 23:1201.[8] Defendants do not claim, nor do the facts support the argument that disability benefits were not paid for reasons beyond the employer's or insurer's control. Therefore, we must determine whether the employee's right to disability benefits has been reasonably controverted by the employer or insurer. We find that it has not.Read the full opinion on CourtListener →
Law changed since Acts 1995, No. 1137 (effective June 29, 1995) added the $50-per-day alternative, capped at $2,000, to the former flat 12% late-payment penalty; the earlier rate can govern older injuries.
Section 23:1201(B) and (E) authorizes a 12% penalty on unpaid workers’ compensation installments and medical expenses when the employer has not reasonably controverted the claim.
Frelow v. Mills · filed 1994-12-07(B) & (E)
To avoid the imposition of penalties, an employee's right to compensation has to be reasonably controverted. La.R.S. 23:1201(E). Given the facts, medical and otherwise, known by Jeanerette Mills, did it have "sufficient factual and medical information to reasonably counter the factual and medical information presented by the claimant?" Guillory v. Soloco, Inc., 570 So.2d 139, 144 (La.App. 3d Cir.1990) quoting Chellette v. American Guarantee and Liability Insurance, Inc., 480 So.2d 363, 367 (La.App. 3d Cir.1985). We think not.Read the full opinion on CourtListener →
Section 23:1201(E) requires penalties for nonpayment of workers’ compensation benefits unless the nonpayment was caused by conditions beyond the employer’s or insurer’s control or the employee’s entitlement was reasonably controverted.
Lacava v. Albano Cleaners · filed 1995-04-07(E)
An assessment of penalties for nonpayment of compensation benefits is proper unless the nonpayment results from conditions over which the employer or insurer |7have no control or unless the employee’s right to such benefits has been reasonably controverted. La.R.S. 23:1201 E; Westley v. Land & Offshore, 533 So.2d 995, 997 (La. App. 1st Cir.1988).Read the full opinion on CourtListener →
Subsection (E) governs the penalty for benefits unpaid without an order, while subsection (F) provides 24% or $100-per-day penalties for judgment benefits not timely paid after a final, nonappealable judgment, and avoiding those penalties requires an unconditional tender.
Meche v. Foremost Management Corp. · filed 1995-10-04(E), (F)
Thus, Meche was not, and is not, entitled to 12% penalties for failure to pay benefits "without an order" under La.R.S. 23:1201(E). ... If payment of benefits under the terms of a judgment is not made within thirty days of when it is due, Meche is entitled to 24% penalties or $100.00 per day, whichever is greater, but payment is not due until after the judgment becomes final and nonappealable. La.R.S. 23:1201(F). The statute makes it very clear that the "penalty-free" time in which a defendant has to make payment is held in abeyance by an appeal. This is implicit in the words "final, nonappealable judgment," and explicit in the phrase "unless the order [of the hearing officer] is appealed as provided by law." Thus, penalties did not even come into play until after the judgment of this court became final and nonappealable under the rules of civil procedure. ... However, we agree that the hearing officer abused her discretion and that Meche is entitled to penalties under 23:1201(F) for not making payment timely after this court's judgment became final. Houston General's tender, as discussed above, was clearly conditional. No unconditional tender was ever made; thus, timely tender has never been made. To avoid penalties, there must be an unconditional tender.Read the full opinion on CourtListener →
Law changed since Acts 2003, No. 1204 changed § 23:1201(F) from a penalty equal to the greater statutory measure to an assessment up to that measure; the former formula did not leave the same amount discretion.
Section 23:1201(E) imposes a penalty of 12% of unpaid benefits or $50 per day, whichever is greater, when benefits are not paid within the statutory time period.
Miller v. City of New Orleans · filed 1995-12-14(E)
A penalty of 12% of unpaid benefits or $50 per day, whichever is greater, is imposed on benefits not paid within the statutory time period. La.R.S. 23:1201(E).Read the full opinion on CourtListener →
Section 23:1201(E) imposes a penalty for an employer's failure to begin paying compensation within 30 days after benefits are due, unless the claim was reasonably controverted.
Carrier v. Debarge's College Junction · filed 1996-01-24(E)
An employer who fails to commence payment of compensation within 30 days after benefits are due is penalized 12% of the outstanding benefits, unless the employee's claim has been reasonably controverted. La.R.S. 23:1201(E).Read the full opinion on CourtListener →
Law changed since Same change as noted above.
Section 23:1201(E) imposed the greater of a twelve-percent penalty or a $50-per-day penalty capped at $2,000 for unpaid compensation or medical benefits, unless nonpayment was reasonably controverted or caused by circumstances beyond the employer's control.
Perrodin v. St. Landry Parish School Bd. · filed 1996-05-22(E)
At the time of the conduct giving rise to the claim for penalties and attorney fees, La.R.S. 23:1201(E) provided for either (1) a twelve percent penalty on any unpaid compensation or medical benefits or (2) a penalty of fifty dollars per calendar day in which any compensation or medical benefits remained unpaid, not to exceed $2,000.00 in the aggregate, whichever penalty was greater, unless the employer or insurer reasonably controverted the claimant's right to the disputed amount or showed that nonpayment was due to conditions beyond their control. ... We agree with the hearing officer that the School Board reasonably controverted Perrodin's claim to any total disability payments, whether TTD or SEB at zero earnings base, and was not arbitrary and capricious in refusing to pay these benefits. However, we find no justification in the record for the seven month lapse in all compensation payments. ... We find that Perrodin is entitled to a penalty of $2,000.00 for the untimely payment of $1,215.00 and attorney fees of $700.00 for the prosecution of this portion of her claim.Read the full opinion on CourtListener →
Law changed since Acts 1995, No. 1137 (effective June 29, 1995) added the $50-per-day alternative, capped at $2,000, to the former flat 12% late-payment penalty; the earlier rate can govern older injuries.
Section 23:1201(E) requires a 12% penalty for nonpayment of workers' compensation benefits unless the employer or insurer reasonably controverted the employee's right to benefits.
Watkins v. Asphalt Associates, Inc. · filed 1996-12-04(E)
La.R.S. 23:1201(E) directs the hearing officer to assess a 12% penalty for nonpayment unless the employer or the insurer "reasonably controverted" the employee's right to benefits. A claim is reasonably controverted if the employer or the insurer had sufficient factual and medical information to reasonably counter the factual and medical information presented by the employee. Woolsey v. Cotton Bros. Bakery Co., Inc., 535 So.2d 1119 (La.App. 2 Cir.1988), writ denied, 537 So.2d 1168 (La.1989). ... The medical testimony detailed in the previous section of this opinion shows the divergence of expert medical opinion even on the diagnostic test results generated in the course of treating Watkins. In light of these circumstances, we find no error in the conclusion of the hearing officer that Asphalt Associates was not arbitrary and capricious in terminating Watkins' weekly worker's compensation benefits.Read the full opinion on CourtListener →
Law changed since Same change as noted above.
Section 23:1201(E) requires a twelve-percent penalty on unpaid workers’ compensation benefits that are not timely paid and permits the penalty when an employer arbitrarily and capriciously withholds or terminates benefits.
Livings v. LANGSTON COMPANIES · filed 1996-12-05(E)
The hearing officer noted in the reasons for judgment that Langston did not commence the indemnity payments until July 24, 1992, over two months after the accident and well beyond the fourteen day deadline set by La.R.S. 23:1201(B). A workers' compensation claimant is entitled to penalties and attorney's fees when an employer acts arbitrarily and capriciously in either terminating or withholding benefits without probable cause. Langston's arbitrary and capricious failure to comply with the statute warrants the assessing of penalties. Accordingly, we assign to Langston a penalty of 12 percent of the unpaid benefits from May 11, 1992 to July 24, 1992 provided in La.R.S. 23:1201(E), thus amending the judgment of the hearing officer which failed to do so.Read the full opinion on CourtListener →
Section 23:1201 requires workers' compensation penalties for unpaid benefits unless the claim was reasonably controverted or the nonpayment resulted from conditions beyond the employer's or insurer's control.
Spencer v. Gaylord Container Corp. · filed 1997-05-28(E.)
Consequently, the "arbitrary and capricious" standard no longer applies to an award of penalties in a workers' compensation matter. Therefore, when payment is not made in accordance with La. R.S. 23:1201, penalties are imposed unless the employer or its insurer has "reasonably controverted" the compensation claim[12] or unless "such nonpayment results from conditions over which the employer or insurer had no control."Read the full opinion on CourtListener →
Law changed since Acts 1995, No. 1137 (effective June 29, 1995) added a $100-per-day alternative and attorney fees to the former 24% penalty for an unpaid final judgment; the older formula can govern earlier injuries.
Subsection (F) imposed a 24% penalty on compensation unpaid more than 30 days after a final, nonappealable judgment, and the later daily-penalty and attorney-fee amendment did not apply to this injury.
Martin v. Elmwood Medical Center · filed 1998-01-27(F)
At the time of plaintiff's injury on December 3, 1992, the worker compensation statutes provided for a penalty of twenty-four percent of the judgment in the event of an employer's arbitrary and capricious failure to pay that judgmentand it did not provide for any attorney fees. La. R.S. 23:1201(F), as amended by Acts 1989, No. 24, supra. The subsequent amendment, which provided for a daily penalty of $100,00 and not to exceed $3,000.00 and which gave a claimant attorney fees was not enacted until after the plaintiff's accident in this case and, therefore, does not apply in this case.Read the full opinion on CourtListener →
Law changed since Acts 2003, No. 1204 changed § 23:1201(F) from a penalty equal to the greater statutory measure to an assessment up to that measure; the former formula did not leave the same amount discretion. Acts 2003, No. 1204 expressly allowed multiple § 23:1201 penalties at a merits hearing, subject to an $8,000 total cap; the old one-maximum-for-all-benefits rule is limited to earlier law.
Section 23:1201 requires the first compensation installment within fourteen days after notice of injury and imposes the greater of a 12% penalty or $50 per late day, capped at $2,000, with one maximum penalty for all compensation benefits.
Lejeune v. Integrated Health Service · filed 1998-12-09(F)
La.R.S. 23:1201 provides the manner in which compensation benefits are to be made to employees. An employee’s first installment of compensation is to be paid no later than fourteen days after the employer has notice of the injury. ... The failure to pay benefits results in the assessment of a penalty in the amount of 12% of the unpaid compensation or $50.00 per calendar day an installment is late, whichever is greater, not to exceed $2,000.00. La.R.S. 1201(F). ... An employee is entitled to one maximum penalty of $2,000.00 for an employer’s or insurer’s failure to timely pay any and all compensation benefits.Read the full opinion on CourtListener →
Law changed since Acts 2012, No. 652 (effective July 1, 2013) limited § 23:1201(E)’s 60-day medical-payment rule to providers not using electronic billing; a complete electronic medical bill is due within 30 days.
The statute requires compensation benefits to be paid within 14 days and medical benefits within 60 days after notice, and requires penalties and attorney fees for untimely payment unless the claim was reasonably controverted or the nonpayment was beyond the employer's control.
Fisher v. Lincoln Timber Co. · filed 1999-01-24(B), (E), and (F)
The employer or insurer must pay all compensation benefits due the injured employee within 14 days of the notice of the injury and loss. ... All medical benefits must be paid within 60 days after the employer or insurer receives written notice thereof. ... Failure to pay such benefits shall result in the impositions of a penalty, together with reasonable attorney fees for each disputed claim. ... However, such penalties and attorney fees shall not be assessed if the claim is reasonably controverted or if such nonpayment results from conditions over which the employer or insurer had no control. ... Where the fact of late payment is uncontradicted and an employer fails to show that the late payment resulted from conditions over which he had no control, an award of penalties and attorney fees is mandated. ... The statute clearly requires payment within the specified time period, thus preventing the employee from being burdened with possibly having to pay a bill he incurred but which should not be his responsibility.Read the full opinion on CourtListener →
Section 23:1201 requires timely compensation payments and imposes penalties and attorney fees for noncompliance, subject to the reasonably controverted-claim exception.
Ricaud v. Holloway Sportswear, Inc. · filed 1999-05-26(A), (F), and (F)(2)
Despite Defendant’s act to remedy its calculation error and reimbursement to Plaintiff shortly after its initial payment, we find that Defendant clearly violated La.R.S. 23:1201 A which provides: ... An interval of more than one month must be approved by the director.Read the full opinion on CourtListener →
Law changed since Acts 1995, No. 1137 (effective June 29, 1995) added the $50-per-day alternative, capped at $2,000, to the former flat 12% late-payment penalty; the earlier rate can govern older injuries.
Section 23:1201(E) requires an employer or insurer to pay workers' compensation benefits within fourteen days after notice of the injury and loss, subject to statutory exceptions, and imposes a twelve-percent penalty for untimely payment.
JE Merit Constructors, Inc. v. Hickman · filed 2000-03-01(E)
The employer or its insurer must pay benefits within 14 days of notice of the injury and loss; failure to pay timely subjects the liable party to a penalty of 12 percent, "unless such nonpayment results from conditions over which the employer or insurer had no control" or "the employee's right to such benefits has been reasonably controverted by the employer or his insurer." La.R.S. 23:1201 E; Barton v. Wausau Ins. Co., 545 So.2d 1248 (La.App. 2d Cir.1989). ... In the matter before us, the hearing officer sanctioned Defendant $2,000.00 in penalties and awarded to Plaintiff attorney's fees in the amount of $3,000.00 for the handling of this issue. Finding the hearing officer's sanctions appropriate, adequate and not manifestly erroneous, we affirm.Read the full opinion on CourtListener →
Section 23:1201(E) and (F) authorize penalties when an employer or insurer fails to timely provide medical benefits, including by failing to timely authorize necessary surgery.
George v. Guillory · filed 2000-11-02(E)(F)
Penalties are made available to employees under La.R.S. 23:1201. Penalties under La.R.S. 23:1201 are properly awarded when an employer or an insurer fails to pay medical benefits in a timely fashion. See La.R.S. 23:1201(E)(F). "The penal provisions of this state's workers' compensation act are applied not only against employers who untimely pay weekly benefits, but also against employers who fail to timely deliver competent medical attention. Savoy v. McDermott, Inc., 520 So.2d 888 (La.App. 3 Cir.1987); Dupre v. Sterling Plate Glass & Paint Co., 344 So.2d 1060 (La.App. 1 Cir.), writ denied, 347 So.2d 246 (La.1977)." Foster v. Liberty Rice Mill, 96-438, p.13 (La.App. 3 Cir. 12/11/96); 690 So.2d 792, 800. This court has found an award of penalties proper for an employer's failure to timely authorize a request for surgery. See Skipper v. Acadian Oaks Hosp., 00-67 (La.App. 3 Cir. 5/3/00); 762 So.2d 122; Foster, 96-438; 690 So.2d 792. Here, LWCC failed to timely authorize a surgery needed by Mr. George, thereby failing to provide medical benefits due to him. At trial, LWCC failed to reasonably controvert Mr. George's request for surgical authorization. Accordingly, we find that the trial court properly awarded penalities against LWCC under La.R.S. 23:1201. Therefore, we find that the trial court's award of penalties was proper.Read the full opinion on CourtListener →
Section 23:1201(F) requires the employee to prove entitlement to statutory penalties for the employer's failure to timely pay workers' compensation benefits.
Figueroa v. Hardtner Medical Center · filed 2002-01-25(F)
Regarding a claim under Section 1201(F), an employee has the burden of proving her entitlement to statutory penalties for the employer's failure to timely pay workers' compensation benefits. ... As such, we cannot say that claimant met her burden of proving that Hardtner's payments were untimely as provided by La. R.S. 23:1201(F).Read the full opinion on CourtListener →
Subsections (A) and (E) require timely payment of indemnity and medical benefits, and untimely payment supports penalties unless the claims were reasonably controverted.
Carradine v. Regis Corporation · filed 2010-11-03(A), (E)
The facts clearly establish that Regis did not pay either of these claims within the time limits required by La.R.S. 23:1201(A) and (E).Read the full opinion on CourtListener →
Penalty amounts
Law changed since Same change as noted above.
Section 23:1201(E) imposes a 12% penalty on an employer or insurer that fails to pay benefits within the applicable statutory period, but the penalty is not warranted when the refusal to pay has a reasonable basis.
Coley v. Wilson Oil Co., Inc. · filed 1993-06-09(E)
La.R.S. 23:1201(E) provides for the imposition of a 12% penalty against an employer or insurer for its failure to pay benefits within the applicable statutory time period. ... Considering these facts and the closeness of the issue as to whether a 1987 accident occurred, USF & G had a reasonable basis to refuse to pay compensation benefits and medical expenses. Accordingly, the trial court's imposition of penalties and attorney's fees was not warranted.Read the full opinion on CourtListener →
Law changed since Same change as noted above.
Section 23:1201 can entitle a workers' compensation claimant to a 12% penalty and attorney's fees when the insurer arbitrarily and capriciously delays payment of medical expenses.
Nork v. Aetna Insurance Co. · filed 1986-10-13
The sole issue presented in this appeal is whether defendant was arbitrary and capricious in delaying payment of $284.00 medical expenses, thereby entitling plaintiff to recover a 12% penalty and attorney’s fees under La.R.S. 23:1201, et seq. The trial court ruled that it was not. We affirm.Read the full opinion on CourtListener →
Section 23:1201 requires penalties and attorney's fees when an employer improperly calculates and pays workers' compensation benefits at an incorrect indemnity rate.
Pauley v. Wal-Mart Stores, Inc. · filed 2003-06-04
However, we do find manifest error with regard to its failure to pay the correct indemnity rate to Pauley from the date it commenced payment of benefits through August 13, 2001. Pauley received $123.90 per week in compensation benefits rather than $173.34 per week. In its brief, Wal-Mart states that Pauley "admitted that he knew that [it] was cutting back on hours because the store's payroll was too high." This is not a valid reason for failing to pay him at the correct rate. Pauley had no control over the number of hours Wal-Mart gave him each week, rather, this rested entirely within its control. Therefore, we find that the workers' compensation judge erred in failing to award him penalties and attorney's fees for Wal-Mart's miscalculation of his workers' compensation benefits. La.R.S. 23:1201. Accordingly, we award Pauley $2,000 in penalties and $5,000 in attorney's fees.Read the full opinion on CourtListener →
Section 23:1201 permits penalties when an employer’s unreasonable vocational rehabilitation leads it to reduce a claimant’s benefits.
Chelette v. Riverwood International USA, Inc. · filed 2003-04-30(F)
For these reasons, we find Riverwood was arbitrary and capricious in reducing Ms. Chelette's benefits, and hold that penalties are warranted. Therefore, we affirm the judgment of the trial court assessing $2,000.00 in penalties to Riverwood.Read the full opinion on CourtListener →
Section 23:1201(G) caps the $100-per-day penalty at $3,000 but does not cap the alternative 24% penalty.
Bordelon v. Inland Industrial Contractors · filed 2002-03-06(G)
We conclude that the $100.00 per day penalty provided for therein is limited to $3,000.00, but the 24% penalty is not.Read the full opinion on CourtListener →
Subsection (F) mandates the applicable penalty amounts under the provision.
Colonial Nursing Home v. Bradford · filed 2002-12-30(F)
The penalty amounts are mandated by La.R.S. 23:1201(F); and it was not error for the WCJ to enforce this provision.Read the full opinion on CourtListener →
Subsection (F) authorizes penalties and attorney fees when an employer fails to timely pay workers' compensation benefits.
Jackson v. Conagra Poultry Co. · filed 2003-03-05(F)
We further find Ms. Jackson is entitled to both penalties and attorney fees for ConAgra's failure to timely pay benefits pursuant to La.R.S. 23:1201(F). We award penalties in the amount of $2,000.00 and attorney fees in the amount of $5,000.00 for work done at the trial and in this appeal.Read the full opinion on CourtListener →
Section 23:1201 authorizes penalties and attorney fees when an employer fails to pay benefits without reasonably controverting the claim, and those penal provisions are strictly construed.
Gaspard v. Dollar General Corp. · filed 2003-04-02
Penalties and attorney fees do not automatically result from an employer’s erroneous failure to pay benefits. ... The statutes only authorize such penalties and attorney fees where the employer does not reasonably controvert the claim. ... A review of the record supports our conclusion that Dollar General did not reasonably controvert Ms. Gaspard’s assertion that it unreasonably failed to pay for prescribed medications. ... Therefore, pursuant to La. R.S. 23:1201, we award Ms. Gaspard $2,000.00 in penalties, attorney fees of $3,000.00 for work done at trial and attorney fees of $2,000.00 for work done on this appeal.Read the full opinion on CourtListener →
Section 23:1201(E) requires penalties for nonpayment unless the employer reasonably controverts the employee’s right to benefits, which requires sufficient factual and medical information to counter the claimant’s information; reliance on a worthless labor-market survey did not meet that standard.
Federated Rural Electric v. Simmons · filed 1990-10-03(E)
On the other hand, penalties will be assessed against the employer for failure to pay benefits unless the employee’s right to such benefits has been reasonably controverted by the employer or his insurer. La.R.S. 23:1201(E). The test to determine whether the employer (insurer) has reasonably controverted the employee’s rights to benefits is whether the employer or his insurer had sufficient factual and medical information to reasonably counter the factual and medical information presented by the claimant. ... In December of 1987, before a decision on the declaratory judgment could be obtained, plaintiff unilaterally reduced benefits. The action was taken based upon the labor market survey conducted by Durlacher. For reasons discussed above, this Court is persuaded that Durlacher’s survey is patently without value. To rely upon it is arbitrary, capricious and without probable cause. The information contained in it does not reasonably controvert the employee’s right to benefits. For this reason the court awards both penalties and attorney’s fees for this unwarranted reduction. ... The 12% statutory penalties are assessed only on the amounts due because of the December 1987 reduction. ... We find no clear error in the trial court’s evaluation of Durlacher’s report or its conclusion that it was arbitrary and capricious to rely thereon in unilaterally reducing defendant’s benefits irrespective of how they characterized the benefits owed defendant.Read the full opinion on CourtListener →
Section 23:1201(F) requires a penalty for late payment of workers' compensation benefits, with the maximum penalty applying when payment is delayed for the period specified by the statute, unless the claim was reasonably controverted or another statutory exception applies.
Belaire v. Don Shetler Olds Buick Chevrolet · filed 2003-06-04(F)
The workers' compensation judge assessed Don Shetler a $1,500 penalty for the failure to timely pay the first installment of indemnity benefits. Don Shetler noticed the mistake on its own, not at the urging of Belaire or his counsel, and immediately paid the delinquency. It is evident that Don Shetler failed to make the payment as a result of its own carelessness. Therefore, given the mandatory nature of the penalty provision provided by La.R.S. 23:1201(F), we affirm the assessment of penalty for this mistake. However, we must amend the assessment and award $2,000 in penalties because the payment was due in September and not paid until April, thus requiring the maximum penalty under the statute.Read the full opinion on CourtListener →
Law changed since Same change as noted above.
Subsection (B) makes the first installment of compensation due on the fourteenth day after notice of injury and resulting lost income, while subsection (E) imposes a 12% penalty for untimely unpaid installments unless the nonpayment was beyond the employer's or insurer's control or the employee's entitlement was reasonably controverted.
Breaux v. Travelers Ins. Co. · filed 1988-05-11(B), (E)
The award of statutory penalties in worker's compensation cases is governed by La.R.S. 23:1201(B, E), which provides in pertinent part as follows: ... "B. The first installment of compensation payable for temporary total disability, permanent total disability, or death shall become due on the fourteenth day after the employer has knowledge of the injury or death and resulting loss of income, on which date all such compensation then due shall be paid. ... E. If any installment of compensation payable without an order is not paid within the time period provided in Subsections (B), (C), or (D) of this Section, there shall be added to such unpaid installment a penalty of an amount equal to twelve percent thereof, which shall be paid at the same time as, and in addition to, such installment of compensation, unless such nonpayment results from conditions over which the employer or insurer had no control. Whenever the employee's right to such benefits has been reasonably controverted by the employer or his insurer, the penalties set forth in this Subsection shall not apply. ..." (Emphasis ours). ... Considering the closeness of the issues presented in this case, we find that Travelers had a reasonable basis for controverting plaintiff's demand for further compensation. Accordingly, we will reverse that portion of the trial court's judgment awarding penalties in favor of plaintiff.Read the full opinion on CourtListener →
Section 23:1201(F)(2) bars penalties and attorney fees when the employer or insurer reasonably controverts the claim, or when nonpayment results from conditions outside its control.
Schindler v. ORLEANS REGIONAL SEC. · filed 2003-12-03(F)(2)
(2) This Subsection shall not apply if the claim is reasonably controverted or if such nonpayment results from conditions over which the employer or insurer had no control. ... After reviewing the evidence in the record, we cannot say the workers' compensation judge erred in assessing a $2,000.00 penalty against the LWCC and awarding Schindler attorney fees for failing to reasonably controvert the claim.Read the full opinion on CourtListener →
Law changed since Same change as noted above.
Section 23:1201 makes installment benefits due 14 days after the employer or insurer knows they are owed and imposes a 12% penalty for late payment unless the claim was reasonably controverted.
Valley v. American Ins. Co. · filed 1987-06-26(C), (E)
Installment benefits pursuant to La.R.S. 23:1221(3) are due on the 14th day after the employer or insurer has knowledge of the compensable supplemental earnings benefits. La.R.S. 23:1201 C. If such benefits are not paid when due a penalty of 12% of the unpaid amount due shall be assessed against the employer or insurer and added to the unpaid amount due unless, (1) the nonpayment results from conditions over which the employer or insurer had no control; or (2) the employee's right to benefits has been reasonably controverted by the employer or his insurer. La.R.S. 23:1201 E. ... Considering the record evidence including all correspondence between counsel for plaintiff and the representative of American, as well as the medical reports, we find that American reasonably controverted plaintiff's claim for benefits after March 4, 1984. A finding that American reasonably controverted plaintiff's claim logically precludes a finding that it acted in an arbitrary or capricious manner or without probable cause. We feel the trial court's finding to the contrary was clearly wrong.Read the full opinion on CourtListener →
Law changed since Same change as noted above.
Section 23:1201(E) imposes a 12% penalty on untimely benefit payments unless the employer or insurer reasonably controverts the employee's entitlement, but later medical evidence of disability can make the insurer liable for penalties going forward.
Slate v. Travelers Ins. Co. · filed 1990-02-07(E)
La.R.S. 23:1201(E) authorizes the imposition of a twelve percent penalty on any untimely payment of benefits, unless the employer or insurer reasonably controverts the employee's right to such benefits. ... Although Travelers initially reasonably controverted plaintiff's entitlement to compensation, this action should not protect it against future penalties pursuant to La.R.S. 23:1201(E) in light of the latter developments in this case.Read the full opinion on CourtListener →
Law changed since Same change as noted above.
Section 23:1201(E) imposes a 12% penalty for late payment unless nonpayment was beyond the employer or insurer’s control or the claimant’s entitlement was reasonably controverted; reasonable controversion depends on the factual and medical information known to them.
Chelette v. American Guar. & Liability Ins., Inc. · filed 1985-12-11(E)
Under the new workers' compensation provisions, the employer and/or insurer escapes the payment of statutory penalties if non-payment results from conditions over which the employer or insurer had no control, or if the latter can "reasonably controvert" the employee's right to medical and compensation benefits. If non-payment did not result from conditions over which the employer or insurer had no control or if the employer or insurer is not able to reasonably controvert the employee's right to such benefits, then penalties attach if payment of said benefits does not take place by the fourteenth day after the employer or his insurer had knowledge of the compensable injury. ... Using this definition along with a plain reading of the statute, we conclude that the following test is applicable: given the facts, medical and otherwise, known to the employer or his insurer, did the employer or insurer have a reasonable basis to believe that medical expenses and compensation benefits were not due the employee. Stated another way, did the employer or his insurer have sufficient factual and medical information to reasonably counter the factual and medical information presented by the claimant. This test requires a close analysis of each workers' compensation case.Read the full opinion on CourtListener →
Law changed since Same change as noted above.
Section 23:1201(E) imposes a 12% penalty on an unpaid compensation installment unless the nonpayment was beyond the employer’s or insurer’s control or the employee’s right to benefits was reasonably controverted.
Watson v. Amite Mill. Co., Inc. · filed 1990-04-10(E)
"The assessment of penalties is governed by La.R.S. 23:1201(E) which provided as of October 20, 1983: ... Therefore, the only inquiry with respect to penalties is whether Mr. Watson's right to benefits has been reasonably controverted by the defendant. ... [G]iven the facts, medical and otherwise, known to the employer or his insurer, did the employer or insurer have a reasonable basis to believe that medical expenses and compensation benefits were not due the employee. Stated another way, did the employer or his insurer have sufficient factual and medical information to reasonably counter the factual and medical information presented by the claimant. This test requires a close analysis of each workers' compensation case. ... The evidence indicates that the defendant did not have sufficient factual and medical information to reasonably believe that compensation and medical expenses were not due. ... Therefore, based on the medical evidence of Mr. Watson's condition, it was unreasonable for the defendant to terminate his benefits. ... In light of the foregoing, it was manifest error for the trial court not to award statutory penalties and that judgment is hereby modified to include them."Read the full opinion on CourtListener →
Section 23:1201(F) requires the penalty for unpaid compensation to be the greater of 12% of the unpaid amount or $50 per calendar day, subject to the statutory cap then in effect, unless the claim was reasonably controverted under § 23:1201(F)(2).
Cormier v. LOUISIANA SOUTHWEST SCRAP · filed 2004-12-01(F)(2), (F)
Since the statute requires the award of the higher penalty, we remand to the workers' compensation judge for calculation of 12% of the back compensation owed as the record is not clear concerning the time period for calculation.Read the full opinion on CourtListener →
Section 23:1201(F) permits a penalty up to the greater of twelve percent of unpaid compensation or $50 per calendar day, but the amount awarded remains within the workers’ compensation judge’s discretion.
Johnson v. Wal-Mart Stores, Inc. · filed 2012-02-08(F)
However, the imposition of penalties falls within the WCJ’s discretion.Read the full opinion on CourtListener →
Who may recover a late-payment penalty
Section 23:1201(F) permits either the employee claimant or the health care provider, but not both for the same late payment, to recover a penalty, and bars the penalty when nonpayment results from conditions beyond the employer’s or insurer’s control.
Russo v. Sewerage & Water Board of New Orleans · filed 2002-03-06(F)(2), (F)(3)-(4)
Moreover, sub-subsection (4) does not state that only health care providers can recover a penalty for late payment of the health providers fees. ... The net result of these statutory amendments is that either the employee claimant or the health care provider, but not both as to the same late payment, may recover a late payment penalty. ... Consequently, if there is no claim by the health care provider so that the health care provider is not seeking a late payment penalty, then the claimant employee may seek the late payment penalty. If there is a claim by the health care provider, so that the health care provider might be awarded a late payment penalty, then the employee claimant may not seek the penalty. In short, only one penalty may be recovered, as per the last section of sub-subsection (4), and the employee claimant may seek that penalty unless the health care provider seeks it. ... The WCJ found that, because the S & WB decided to turn the medical bills over to the outside company, the late payment was not due to conditions over which the S & WB had no control. We agree and add that, based upon the record, there is no reason apparent that the S & WB could not keep track of the time that the outside company had the bills so that the S & WB could require their return in time to pay them within 60 days.Read the full opinion on CourtListener →
Section 23:1201(E) strictly limits penalty liability to the employer or its insurer, so an entity that is not an insurer is not liable for the penalties.
Bowens v. General Motors Corp. · filed 1992-11-30(E)
In interpreting La.R.S. 23:1201(E) and La. R.S. 23:1201.2, we bear in mind that it is "the universally recognized rule of law that statutes imposing penalties must be strictly construed and every doubt must be resolved against the imposition of the penalty." Tichenor v. Tichenor, 190 La. 77, 181 So. 863, 864 (1938); Gros v. LeBlanc, 304 So.2d 49 (La.App. 1st Cir.1974). We are unable to say, under a strict construction of La.R.S. 23:1201(E) and La.R.S. 23:1201.2, that LIGA is an insurer for purposes of penalties and attorney fees. Accordingly, we hold that LIGA is not liable for penalties and attorney fees, either as a covered claim or as a result of its own actions.Read the full opinion on CourtListener →
Multiple penalties for multiple violations
Subsection (F) provides penalties and reasonable attorney fees when an employer or insurer fails to timely pay benefits without a reasonable controversion or an excuse beyond its control, and permits penalties for separate violations.
Frank v. Kent Guidry Farms · filed 2002-05-08(F)
Louisiana courts have consistently held that failure to authorize a medical procedure for an employee eligible to receive workers' compensation is deemed to be a failure to furnish compensation benefits, thereby triggering the penalty provisions of the Louisiana Workers' Compensation Act. ... Penalties and attorney fees shall be awarded if the employer or the insurer fails to timely pay benefits due claimant, unless the claim is reasonably controverted or such nonpayment results from conditions over which the employer or insurer had no control. ... Louisiana Revised Statute 23:1201(F)(1) provides that the penalty and attorney fees shall be assessed against either the employer or the insurer, depending upon fault. ... Because there were multiple violations in this case, Mr. Frank is entitled to receive multiple penalties as requested.Read the full opinion on CourtListener →
Subsection (F) permits multiple penalties for separate violations involving unpaid compensation or medical benefits and provides for the greater of a 12-percent penalty or $50 per day, subject to the statutory cap, plus reasonable attorney fees.
Montgomery v. Orleans Parish School Board · filed 2004-06-02(F)
The actual amount of the medical bills is not relevant to the penalties and attorney fees assessed. The relevant issue is the delay in the payment of the medical bills.Read the full opinion on CourtListener →
Section 23:1201(F) permits one penalty for each distinct violation of the statute.
Boudreaux v. Bellsouth Telecommunications · filed 2003-03-11(F)
Based on our conclusion that claimant is entitled to multiple penalties, we amend the judgment to award one penalty for each of defendants’ three violations of La. R.S. 23:1201(F).Read the full opinion on CourtListener →
Section 23:1201(F) provides multiple penalties for multiple violations involving compensation and medical-benefit claims.
Roque v. Shell Beach Trucking · filed 2003-05-07(F)
Defendants' first assignment of error asserts the WCJ erred in imposing multiple penalties. We disagree. The Louisiana Supreme Court recently settled this issue finding "La.R.S. 23:1201(F) provides multiple penalties for multiple violations of compensation and medical benefits claims."Read the full opinion on CourtListener →
Subsection (F) permits separate penalties for multiple violations, but each penalty corresponds to a distinct claim for specific benefits rather than to every individual bill arising from one violation.
White v. Shop Rite · filed 2002-04-03(F)
After considering our conflicting rulings, we choose to adhere to our ruling in Haynes, allowing for multiple penalties for multiple violations regarding indemnity and medical benefits claims. ... In keeping with Haynes and Gay, we have examined the exhibits submitted and have attempted to group the untimely and/or unpaid bills into “claims,” i.e., specific demands for particular benefits.Read the full opinion on CourtListener →
Subsection F permits separate penalties for distinct unpaid compensation and medical-benefit violations, including each of the five violations asserted in this case.
Moore v. City of New Orleans · filed 2003-01-29(F)
La. R.S. 23:1201 F is penal in nature and, therefore, must be strictly construed. ... A reasonable interpretation of the 1995 amendment is that the legislature intended to clarify that separate penalties could be awarded for both unpaid compensation and medical benefit claims. The statute as amended in 1995 makes no provision that a separate penalty is available for every single violation of the act. ... In Fontenot v. Reddell Vidrine Water District, XXXX-XXXX, XXXX-XXXX, XXXX-XXXX (La.1/14/03), 836 So.2d 14, the Louisiana Supreme Court interpreted the penalty provision of La. R.S. 23:1201 F to allow for multiple penalties for multiple violations regarding indemnity and medical benefits claims. In the case at bar, we find the trial court erred in its determination of that which plaintiff is entitled to recover as penalties. We hold that plaintiff is entitled to recover a penalty, as provided for in La. R.S. 23:1201 F, for each of the five violations that plaintiff has asserted.Read the full opinion on CourtListener →
Section 23:1201(F) provides multiple penalties for multiple violations involving compensation and medical-benefit claims.
Fontenot v. Reddell Vidrine Water District · filed 2003-01-14(F)
We find the appellate court properly interpreted the provisions of this statute in favor of finding that LA.REV.STAT. ANN. § 23:1201(F) provides multiple penalties for multiple violations of compensation and medical benefits claims.Read the full opinion on CourtListener →
Section 23:1201 permits multiple penalties, but a further penalty is not warranted when the later denial of treatment is reasonably controverted.
Phillips v. Diocese of Lafayette · filed 2004-03-24
Although the supreme court concluded in Fontenot v. Reddell Vidrine Water District, 02-439, 02-442, 02-478 (La. 1/14/03), 836 So.2d 14, that multiple penalties are recoverable under La.R.S. 23:1201, we find that a second penalty is not appropriate in this case.Read the full opinion on CourtListener →
Law changed since Acts 2003, No. 1204 added § 23:1201(J), allowing only one reasonable attorney-fee award against the employer or insurer for violations addressed at one merits hearing.
Before subsection J took effect, Section 23:1201(F) allowed multiple penalties and attorney-fee awards for multiple violations involving compensation and medical benefits.
Smith v. Roy O. Martin Lumber Co. · filed 2004-04-14(F)
The Louisiana Supreme Court in Fontenot v. Reddell Vidrine Water Dist., 02-439, 02-442, 02-478 (La.1/14/03), 836 So.2d 14, found La.R.S. 23:1201(F) provides multiple penalties and attorney fees for multiple violations of compensation and medical benefits claims. ... Since the denial of benefits and failure to pay medical expenses occurred prior to the enactment of subsection J, the WCJ did not err in making multiple awards of attorney fees.Read the full opinion on CourtListener →
Section 23:1201(F) allows separate penalties for multiple failures to pay compensation or medical benefits, measured by the greater of 12% of unpaid benefits or $50 per day, subject to the statutory maximum in effect when the benefits were denied.
Rivera v. M & R Cable Contractors, Inc. · filed 2004-12-15(F)
In Fontenot v. Reddell Vidrine Water District, 02-439, 02-478 (La. 1/14/03), 836 So.2d 14, rehearing granted in part on other grounds, 02-442, 01-478 (La. 4/21/03), 851 So.2d 917, the supreme court held that La.R.S. 23:1201(F) provides multiple penalties for multiple violations of compensation and medical benefits claims. ... M&R has not made any indemnity payments or medical benefits, and is, therefore, subject to more than one penalty. ... Furthermore, La.R.S. 23:1201(F) mandates a penalty of the greater of twelve percent of any unpaid compensation or medical benefits or fifty dollars a day for each day the benefits remain unpaid. ... We recognize that the law now provides for a ceiling on the maximum amount of penalties at $8,000. However, this maximum penalty provision was not added until 2003 by Acts 2003, No. 1204, § 1. ... Therefore, Juan is not subject to the maximum penalty limitation of $8,000.Read the full opinion on CourtListener →
Subsection (F) permits multiple penalties for multiple violations but does not authorize a separate penalty for each missed week of indemnity benefits, and its penalty provisions are strictly construed.
Taylor v. Hollywood Casino · filed 2006-06-28(F)
Statutory provisions permitting the assessment of penalties and attorney fees for nonpayment of workers' compensation benefits are penal in nature and must be strictly construed. ... The provisions of La. R.S. 23:1201(F) provide for multiple penalties for multiple violations of compensation and medical benefits. ... As this court recognized in Player v. International Paper Company, 39,254 (La. App.2d Cir.1/28/05), 892 So.2d 781, La. R.S. 23:1201(F) allows multiple penalties but does not contemplate that a claimant can be awarded a separate penalty for each missed week of indemnity benefits as occurred in the instant case. We amend the award of penalties for missed indemnity benefits to $2,000, the maximum allowed under these facts.Read the full opinion on CourtListener →
Subsection (F) authorizes multiple penalties when an employer commits multiple violations involving compensation and medical benefits claims.
Wyble v. Acadiana Preparatory School · filed 2007-05-02(F)
The provisions of La.R.S. 23:1201(F) provide for multiple penalties for multiple violations of compensation and medical benefits claims. ... But here the WCJ concluded that the School’s failure to pay medical benefits was an ongoing violation, which resulted in only one penalty award under the circumstances of the case. Finding no manifest error in this factual determination by the WCJ, we affirm the penalty award and decline to increase it on appeal.Read the full opinion on CourtListener →
Subsection (F) permits multiple penalties but caps the total penalties at $8,000, and the 2003 amendment applies prospectively.
Lambert v. Brookshire Grocery Co. · filed 2006-12-20(F)
In Maricle v. Sunbelt Builders, Inc., 05-398, p. 11 (La.App. 3 Cir. 11/2/05), 916 So.2d 1226, 1234, writ denied, 05-2506 (La.3/31/06), 925 So.2d 1261, this court explained that "Louisiana Revised Statute[s] 23:1201(F) was amended by the legislature by 2003 La. Acts No. 1204, § 1, to expressly provide for multiple penalties and to place a cap on the amount of penalties which may be awarded at $8,000.000 [sic]. The effective date of the legislative amendment was August 15, 2003." ... Given this evidence, we find the awarding of multiple penalties in excess of $8,000.00 clearly wrong. Accordingly, we reduce the total penalty award from $16,000.00 to $8,000.00.Read the full opinion on CourtListener →
Section 23:1201(F) permits multiple penalties for multiple violations, but a single ongoing failure to pay several weeks of indemnity benefits warrants only one penalty.
Ducote v. Louisiana Industries, Inc. · filed 2008-04-02(F)
What we are called upon to decide is the number of penalties which may be imposed for the nonpayment of indemnity benefits over a six-week period. ... We disagree with Mr. Ducote's interpretation of La.R.S. 23:1201(F). ... Based upon the foregoing, we find that the WCJ was legally correct in awarding Mr. Ducote a single penalty for the failure of Louisiana Industries to pay six weeks of indemnity benefits.Read the full opinion on CourtListener →
Section 23:1201(F) and (I) may each support penalties for the same conduct, but the same violation cannot receive duplicative penalties under both provisions.
Morris v. Cactus Drilling Company · filed 2008-04-30(F), (I)
Although penalties could be imposed under either section of the statute, to allow penalties under both sections of the statute would be to twice penalize a defendant for the same behavior. We do not believe this was the intent of the statute.Read the full opinion on CourtListener →
Subsection (F) permits separate penalties for separate violations, so multiple penalties may be imposed when an employer commits multiple distinct violations.
Burnett v. Village of Estherwood · filed 2009-12-09(F)
In this case, there were three separate mileage submissions which were either underpaid or paid late for different reasons. Multiple penalties for multiple violations are allowed by statute. See La.R.S. 23:1201(F). We agree with the WCJ in her finding that there were three separate acts in this case such that three separate penalties are warranted.Read the full opinion on CourtListener →
Section 23:1201 permits multiple penalties for multiple violations, with penalties and attorney fees triggered by an employer’s or insurer’s failure to comply with the statute’s procedures.
Cox v. Port Aggregates, Inc. · filed 2011-02-02
In Gay [v. Georgia Pacific Corp., 32,653 (La.App. 2 Cir. 12/22/99); 754 So.2d 1101,] this court decided that the triggering event for penalties and attorney fees is not the injury giving rise to the compensation claim, but instead is the employer’s or insurer’s failure to comply with the procedures set forth in La. R.S. 23:1201. Interpretation of “claim” as a specific demand for particular benefits (such as an operation) rather than as a general demand for benefits under the compensation laws is consistent with the Gay rationale. As in Gay, “to conclude otherwise would dilute the deterrent effect of these statutory provisions, which are not intended to make the worker ‘whole’ but rather to discourage specific conduct on the part of the employer.” ... In this case, it is undisputed that Defendants failed to reimburse Plaintiff for his medical and pharmacy bills, failed to approve physical therapy recommended by Dr. Gunderson, failed to approve x-rays and therapy recommended by Dr. Altimura, and failed to pay compensation benefits. Each of these incidents constitutes a “claim” as defined in the Haynes cases. Accordingly the trial court did not err in granting penalties in the amount of $6000.00.Read the full opinion on CourtListener →
Section 23:1201(E) requires timely payment of medical benefits, and § 23:1201(F) permits penalties and attorney fees for each violation, subject to an $8,000 aggregate maximum.
Johnson v. Conagra Poultry Company · filed 2012-03-21(E), (F)
In this case, Conagra admitted to thirteen violations of La.R.S. 23:1201(E). Each violation entitles Mr. Johnson to penalties and reasonable attorney fees pursuant to La.R.S. 23:1201(F). Based on Conagra‘s admission of guilt, we find that Mr. Johnson is entitled to a penalty based on each of the thirteen violations of La.R.S. 23:1201(E). However, since La.R.S. 23:1201(F) limits the maximum amount of penalties awarded pursuant to this section to $8,000.00, the WCJ‘s judgment is amended to increase the penalty awarded to Mr. Johnson from $2,000.00 to $8,000.00.Read the full opinion on CourtListener →
Section 23:1201(F) permits penalties and attorney fees when an employer fails to pay compensation or medical benefits without reasonably controverting the claim, but duplicative penalties for related failures should not be awarded separately.
Mallery v. Dynamic Industries, Inc. · filed 2012-03-14(F)
Nevertheless, we conclude that the WCJ erred in awarding Mallery a penalty for failing to authorize the cervical surgery recommended by Dr. Cobb and a separate penalty for failing to authorize post-surgical care and medical treatment for his neck, as those penalties are duplicative.Read the full opinion on CourtListener →
Section 23:1201(F) permits multiple penalties for multiple violations involving indemnity and medical benefits claims.
Haynes v. Fence · filed 2002-01-09(F)
After considering our conflicting rulings, we choose to adhere to our original ruling *235in Haynes, allowing for multiple penalties for multiple violations regarding indemnity and medical benefits claims. Thus, we affirm the decision of the original 13three-judge panel in this matter to amend the trial judgment to award Kenneth Haynes an additional $8,000.00 in penalties pursuant to La.R.S. 23:1201(F).Read the full opinion on CourtListener →
Section 23:1201(F) permits multiple penalties for multiple violations, but repeated late payments on one pharmacy account may constitute a single ongoing violation subject to one penalty.
Johnson v. Conagra Poultry Company · filed 2009-12-09(F)
Therefore, La.R.S. 23:1201(F) provides for “multiple penalties for multiple violations of compensation and medical benefits claims.” ... We find no error in the WCJ’s decision that the employer’s failure to timely pay bills Causey’s Pharmacy submitted was a single, ongoing violation. Sedgwick continued to make late, single, lump-sum payments toward the payment of the bill at Causey’s. Thus, we affirm the single penalty of $2,000.00.Read the full opinion on CourtListener →
Subsection (F) permits multiple penalties when an employer commits multiple separate violations.
James Burnett, Sr. v. Village of Esterwood · filed 2009-12-09(F)
In this case, there were three separate mileage submissions which were either underpaid or paid late for different reasons. Multiple penalties for multiple violations are allowed by statute. See La.R.S. 23:1201(F). We agree with the WCJ in her finding that there were three separate acts in this case such that three separate penalties are warranted.Read the full opinion on CourtListener →
Section 23:1201 permits multiple penalties for separate arbitrary and capricious violations by an employer or insurer.
Duvall v. St. Francis Cabrini Hospital · filed 2001-12-28
We agree with the holding in Haynes, and find that, in order to more effectively deter multiple infractions by employers and insurers, multiple penalties are appropriate.Read the full opinion on CourtListener →
Attorney fees—Factors governing amount
Section 23:1201(F) permits penalties and attorney fees when a workers' compensation claim is not reasonably controverted, but a nonfrivolous legal dispute can establish that the claim was reasonably controverted.
Critser v. Dillard's Department Stores, Inc. · filed 2002-12-20(F)
The purpose of the imposition of penalties and attorney fees in a workers’ compensation proceeding is to nudge the employer into making timely payments when there is no reasonable basis for refusing or delaying its obligation. ... To determine whether a claimant’s right has been reasonably controverted, thereby precluding the imposition of penalties under La. R.S. 23:1201, one of the factors used by the court is to determine whether the employer or his insurer engaged in a nonfrivolous legal dispute. ... Because Dillard’s was not attempting to relitigate an issue previously addressed by the supreme court, | fiwe find that Dillard’s actions were not frivolous litigation.Read the full opinion on CourtListener →
Subsection (F) authorizes attorney’s fees for failure to pay claims due under Subsections (A)–(E), but not for failure to provide vocational rehabilitation.
Maynard v. Grey Wolf Drilling · filed 2004-10-20(F)
Turning to the issue of attorney’s fees, reference to La.R.S. 23:1201(F) indicates the availability of attorney’s fees for failure to pay claims due under La.R.S. 23:1201(A)-(E). ... Thus, although we have concluded that the award of attorney’s fees for violations of La.R.S. 23:1201 was not an abuse of discretion, the failure to provide appropriate rehabilitation is not one of those which we have considered to be a suitable basis for the award.Read the full opinion on CourtListener →
Law changed since Acts 2003, No. 1204 repealed § 23:1201.2 and placed the remedy for arbitrary, capricious, or baseless discontinuance in § 23:1201(I); the older section-level exclusion of discontinuance no longer applies.
Section 23:1201(F) authorizes penalties and attorney fees for failure to provide benefits, including failure to authorize medical treatment or timely pay medical expenses, but not for mere discontinuation of benefits when the then-effective law assigns that issue to § 23:1201.2.
Hutchison v. Aldworth Co. · filed 2004-11-10(F)
Aldworth’s failure to authorize surgery and to make timely payment of medical expenses and transportation expenses is controlled by La. R.S. 23:1201. ... Under La. R.S. 23:1201, medical benefits are payable within sixty days after the employer receives notice. ... Thus, the WCJ properly awarded penalties of $2000 for the failure to authorize surgery and $2000 for the failure to pay medical expenses, medication expenses and transportation costs.Read the full opinion on CourtListener →
Section 23:1201(F) imposes penalties and reasonable attorney fees for unpaid compensation unless the claim was reasonably controverted or nonpayment resulted from conditions beyond the employer’s or insurer’s control, with penalties reserved for refusals lacking good faith and just cause.
Moore v. Conagra Poultry Co. · filed 2005-01-26(F)
We find no manifest error in the award of penalties and attorney fees in light of this record as a whole.Read the full opinion on CourtListener →
Section 23:1201(F) requires penalties and reasonable attorney fees for failure to provide compensation benefits unless the claim is reasonably controverted or nonpayment was beyond the employer’s or insurer’s control, while subsection (I)’s arbitrary, capricious, and without probable cause standard applies when benefits are terminated.
Thomas v. Casino Magic · filed 2005-05-11(F), (I)
Regarding a claim under La. R.S. 23:1201(F), an employee has the burden of proving his entitlement to statutory penalties for the employer's failure to timely pay workers' compensation benefits. To reasonably controvert a workers' compensation claim so as to avoid imposition of penalties and attorney fees, the employer and its insurer must provide sufficient factual and medical information to reasonably counter the evidence provided by the claimant. ... Here, the WCJ applied the incorrect statute when awarding penalties and attorney fees on the finding that Casino Magic acted arbitrarily or capriciously by failing to award compensation benefits to Thomas. However, pursuant to La. R.S. 23:1201(I) the standard of "arbitrary, capricious, and without probably cause" pertains to cases where the employer terminated claimant's benefits (discontinuance of benefits) and not to cases such as the instant case where there was a failure to provide compensation benefits. Pursuant to La. R.S. 23:1201(F), a failure to provide compensation benefits shall result in assessment of penalties and reasonable attorney fees unless the claim is "reasonably controverted" or nonpayment results from conditions over which the employer or its insurer had no control.Read the full opinion on CourtListener →
Subsection (J) is a substantive change that applies prospectively only, while subsection (F) requires workers’ compensation attorney-fee awards to be reasonable.
Metoyer v. Roy O. Martin, Inc. · filed 2005-03-23(J) and (F)
La.R.S. 23:1201(J) changes existing rights. Therefore, we find that it is substantive. ... Therefore, we find that La.R.S. 23:1201(J) has no effect on the awards of attorney’s fees made in this case. ... However, La.R.S. 23:1201(F) requires that awards of attorney’s fees be reasonable. ... We find the award of attorney’s fees, as outlined in the reasons for judgment to be justified and reasonable.Read the full opinion on CourtListener →
Section 23:1201(J) limits an employer or insurer to one reasonable attorney-fee award for conduct preceding a merits hearing, but that limitation does not apply retroactively to conduct predating the provision’s effective date.
Daenen v. the Cajun Landing Restaurant · filed 2005-04-06(J)
In this case, the denial of benefits occurred prior to the effective date of this provision. ... We find La.R.S. 23:1201(J) does not prohibit multiple awards of attorney’s fees in this case.Read the full opinion on CourtListener →
Section 23:1201(J) permits only one reasonable attorney-fee award for a merits hearing and makes that award res judicata as to earlier conduct, but it does not apply retroactively to deny multiple fees for conduct predating its effective date.
Daenen v. Cajun Landing Restaurant · filed 2005-04-06(J)
We find La.R.S. 23:1201(J) does not prohibit multiple awards of attorney’s fees in this case.Read the full opinion on CourtListener →
Section 23:1201(F) and (J) bar penalties and attorney fees for conduct that preceded an earlier merits hearing when the prior award is res judicata as to those claims.
Metoyer v. Roy O. Martin, Inc. · filed 2004-12-01(F) and (J)
The January, June and July 1999 payments were claims which arose from conduct that preceded the August 9, 1999 hearing. Thus, La.R.S. 23:1201(F) and (J) preclude Ms. Metoyer from collecting penalties or attorney fees for those incorrect payments.Read the full opinion on CourtListener →
Section 23:1201(F) permits a penalty for an unpaid medical bill when the employer lacked a reasonable foundation for refusing payment, while § 23:1201(G) does not apply to an appealed judgment.
Lazaro v. New Orleans Brass · filed 2005-05-04(F), (G)
Since the judgment in the instant case has been appealed, this provision is inapplicable and Mr. Lazaro is not entitled to the penalties and attorney fees provided for by the statute.Read the full opinion on CourtListener →
Section 23:1201(G) applies when an award under a final, nonappealable judgment is not paid within thirty days.
Rodrigue v. Lafourche Parish School Board · filed 2005-05-06(G)
Initially, we note that La. R.S. 23:1201(G) clearly sets forth that an employer is liable for penalties and attorney fees if it does not pay an award payable under a final, nonappealable judgment within 30 days.Read the full opinion on CourtListener →
Section 23:1201(F) provides for an attorney-fee award when an employer fails to pay medical bills within the prescribed time, and the award is reviewed for abuse of discretion.
Adams v. Dependable Source Corp. · filed 2007-05-04(F)
Louisiana Revised Statute 23:1201 F provides for an attorney fee award for failing to pay medical bills within the time prescribed pursuant to 23:1201. The amount of the award is to be reviewed using the "abuse of discretion" standard.Read the full opinion on CourtListener →
Subsection (G) does not permit the employer’s degree of bad faith to be considered when determining the amount of attorney fees.
Sisk v. a P Supply Co. · filed 2009-01-21(G)
The degree of bad faith exhibited by the employer is not an appropriate factor in determining the amount of attorney fees to be awarded under La. R.S. 23:1201(G).Read the full opinion on CourtListener →
Section 23:1201(F) authorizes reasonable attorney fees; their amount depends on counsel’s skill and time, the size of the claim, and the recovery, without regard to the employer’s degree of bad faith.
Smith v. Quarles Drilling Co. · filed 2001-10-03(F)
The factors to be taken into account when fixing the amount of attorney fees to be awarded in a workers' compensation case are the degree of skill and ability exercised by the attorney, the amount of the claim, the amount recovered for the claimant, and the amount of time the attorney devoted to the case. Id. A court cannot take into consideration the degree of bad faith exhibited by the employer. Id. In determining whether the amount awarded by the court is abusively low, therefore, we must focus not on whether the employer lacked bad faith, as found by the workers' compensation judge, but on the other factors as set forth above.Read the full opinion on CourtListener →
Section 23:1201(F) allows reasonable attorney fees, but bad faith cannot be used to increase the amount awarded.
Desselle v. Oaks Care Center · filed 2002-04-24(F)
However, once the bad faith factor is extricated from the totality of jurispru-dentially-approved criteria and those factors listed in Rule 1.5 of the Rules of Professional Conduct, we conclude that ban award of $12,500 is appropriate to provide full compensation for the laudable work performed by the claimant’s attorney.Read the full opinion on CourtListener →
Section 23:1201(F) leaves the amount of a reasonable statutory attorney fee to the workers' compensation judge's discretion, subject to review for abuse of discretion.
Ardoin v. Kipling Korner Grocery · filed 2003-03-05(F)
Rather, our role is to determine whether the WCJ abused her discretion in setting a reasonable fee.Read the full opinion on CourtListener →
Section 23:1201(G) requires reasonable attorney fees when a final, nonappealable award is not timely paid unless a statutory exception applies, and permits the court to consider the employer’s bad faith in setting the fee amount.
Langley v. Petro Star Corp. of La. · filed 2000-12-29(G)
We now hold that the view expressed in Britton is the correct view and the court can take into consideration the degree of bad faith exhibited by the employer in determining the appropriate amount of attorneys' fees to be imposed. ... The question is not, then, whether an attorney fee should be imposed. That is automatic in the absence of one of the two factors listed above. The question is simply how much the attorney fee will be and what factors are to be considered in reaching that amount.Read the full opinion on CourtListener →
Section 23:1201(G) allows reasonable attorney fees for an unpaid final, nonappealable judgment, but the fee amount may not include a punitive factor based on the employer's degree of bad faith.
Langley v. Petro Star Corp. of La. · filed 2001-06-29(G)
We granted a writ of certiorari in this workers' compensation action to resolve a split among the circuit courts of appeal regarding the proper factors to be considered in fixing an award of reasonable attorney fees pursuant to La. R.S. 23:1201(G). For the reasons that follow, we hold that a court should not take into consideration the degree of bad faith exhibited by the employer in determining the appropriate amount of attorney fees to be awarded under the statute.Read the full opinion on CourtListener →
Timely payment of medical benefits
Section 23:1201 requires penalties and attorney fees for untimely payment of compensation or medical benefits unless the claim is reasonably controverted or nonpayment resulted from conditions beyond the employer's or insurer's control.
Champagne v. STATE, LOUISIANA STATE UNIV. · filed 2002-03-28(F)(2)
The unambiguous language of the statute clearly establishes that penalties and attorney fees for failure to timely pay benefits shall be assessed unless the claim is reasonably controverted or such nonpayment results from conditions over which the employer or insurer had no control. La. R.S. 23:1201.Read the full opinion on CourtListener →
Section 23:1201(B) sets the initial-payment deadline, while § 23:1201(F) imposes penalties for unpaid benefits unless the employer reasonably controverts the claim, and § 23:1201(F)(2) provides the corresponding reasonable-controversion exception for medical benefits.
Warren v. Maddox Hauling · filed 2002-12-04(B), (F), (F)(2)
Maddox Hauling began paying indemnity benefits on June 17, 2001; however, the first payment was due on the fourteenth day after the injury, June 10, 2001. ... Thus, the WCJ used La.R.S. 23:1201(F) to calculate his award for these untimely or not paid benefits. ... After reviewing the record in its entirety, we cannot say that the WCJ committed manifest error in awarding these penalties, as La.R.S. 23:1201 provides that the employer or insurer is liable for statutory penalties for withholding benefits without evidence to "reasonably controvert" the employee's right to compensation and medical benefits.Read the full opinion on CourtListener →
Section 23:1201(F) provides penalties and reasonable attorney fees for unpaid compensation or medical benefits, but penalties are not assessed when the employer reasonably controverts the claim.
Taylor v. State, Department of Public Safety & Corrections · filed 2002-03-28(F)
Penalties are not to be assessed when the employee’s right to such benefits has been reasonably controverted by the employer or insurer. ... We have thoroughly reviewed the record and the evidence in this case and conclude that the State’s failure to pay medical bills was not arbitrary, capricious, or unreasonable in light of the medical evidence that was present. Thus, Taylor was not entitled to penalties and attorney fees pursuant to La. R.S. 23:1201(F) and 23:1201.2.Read the full opinion on CourtListener →
Section 23:1201(F) permits penalties and attorney fees when indemnity or medical benefits are paid late, unless the claim was reasonably controverted or the nonpayment resulted from conditions outside the employer's or insurer's control.
Smith v. Hansen's Seafood Dock · filed 2002-12-11(F), (F)(2)
La. R.S. 23:1201 F provides for the imposition of penalties and attorneys fees when indemnity or medical benefits due to the claimant are not paid timely. However, under R.S. 23:1201 F(2), this does not apply if the claim is reasonably controverted or if such nonpayment results from conditions over which the employer or insurer had no control. ... Thus, the Defendants failed to show that the refusal for surgery - and the indemnity amounts were reasonably controverted. Thus, we find no manifest error in the awards for penalties and attorney’s fee awards.Read the full opinion on CourtListener →
Section 23:1201(F) requires penalties and reasonable attorney fees for unpaid compensation or medical benefits unless the claim was reasonably controverted or the nonpayment resulted from conditions beyond the employer’s or insurer’s control.
Cormier v. Sam Broussard Trucking Co. · filed 2002-05-08(F)(2)
F. Failure to provide payment in accordance with this Section shall result in the assessment of a penalty in an amount equal to twelve percent of any unpaid compensation or medical benefits or fifty dollars per calendar day, whichever is greater, for each day in which any and all compensation or medical benefits remain unpaid, together with reasonable attorney fees for each disputed claim; however, the fifty dollars per calendar day penalty shall not exceed a maximum of two thousand dollars in the aggregate for any claim.Read the full opinion on CourtListener →
Law changed since Acts 1995, No. 1137 (effective June 29, 1995) added the $50-per-day alternative, capped at $2,000, to the former flat 12% late-payment penalty; the earlier rate can govern older injuries.
Section 23:1201(E) imposes a twelve-percent penalty when an employer or insurer fails to timely pay compensation or medical benefits, unless the employee’s entitlement was reasonably controverted.
Galeano v. Taco Bell Corp. · filed 2003-02-25(E)
La. R.S. 23:1201(E), which sets out the penalty provision in question, provides for a twelve percent (12%) penalty on any compensation or medical benefit that the employer/insurer fails to timely pay, unless the employee's right to such compensation or benefit has been "reasonably controverted."Read the full opinion on CourtListener →
Section 23:1201's initial-payment penalty provision concerns untimely commencement and reasonable controversy, while the discontinuance provision—then § 23:1201.2 and replaced by subsections (I) and (J)—applies when a self-insured employer stops benefits that it timely began paying.
Longoria v. Brookshire Grocery Co. · filed 2003-12-19(I) and (J)
Section 1201 involves the employer's failure to timely commence payment of benefits, while Section 1201.2 involves the employer's discontinuance of benefits after timely commencement. Section 1201 applies penalties to employers and insurers alike, while Section 1201.2's penalty provision incorporates the penalties of La. R.S. 22:658 applicable only to insurers, and not self-insured employers. ... From our review of Brown and Williams v. Rush Masonry, which sorted out how these two penalty provisions of the Act apply, we find that the present situation, analogous to the one addressed in Williams v. Rush Masonry, requires the application of Section 1201.2 to address a self-insured employer's discontinuance of payments of medical benefits. To the contrary, the WCJ's ruling measured Brookshire's conduct under the reasonable controversy standard of Section 1201, and the $500 penalty awarded has no application to Brookshire under Section 1201.2.Read the full opinion on CourtListener →
Section 23:1201(F) imposes penalties and attorney's fees for untimely indemnity or medical benefits unless the claim is reasonably controverted or the nonpayment resulted from conditions outside the employer's or insurer's control.
Barbarin v. TLC Home Health · filed 2003-04-29(F), (F)(2)
La. R.S. 23:1201 F provides for the imposition of penalties and attorneys fees when indemnity or medical benefits due to the claimant are not paid timely. However, under R.S. 23:1201 F(2), this does not apply if the claim is reasonably controverted or if such nonpayment results from conditions over which the employer or insurer had no control. In order to reasonably controvert a claim, the Defendant must have some valid reason or evidence upon which to base the denial of benefits. Brown v. Texas-La Cartage, Inc., 98-1063, p. 9 (La.12/1/98), 721 So.2d 885, 890. Thus, the court must determine whether the Defendant engaged in a non-frivolous legal dispute or possessed factual and/or medical information to reasonably counter the factual and medical information presented by the claimant throughout the time which they refused to pay all or part of the benefits allegedly owed. Id.Read the full opinion on CourtListener →
Section 23:1201 requires a $50-per-day penalty for late medical-benefit payments, capped at $2,000 in the aggregate for any claim.
Ware v. Allen Parish School Bd. · filed 2003-09-24
That bill was paid two days late. La.R.S. 23:1201 provides that penalties for late payments of medical benefits shall be $50 per calendar day, not to exceed a maximum of $2,000 in the aggregate of any claim. In that regard, we reduce the penalty on the July 13th bill to $400 and on the January 12th bill to $100.Read the full opinion on CourtListener →
Subsection (F) permits penalties and attorney fees when an employer or insurer untimely fails to pay benefits or medical benefits, unless the claim is reasonably controverted.
Jackson v. Wal-Mart Stores, Inc. · filed 2004-02-10(F)
Penalties and attorney fees are recoverable under LSA-R.S. 23:1201(F) if the employer or insurer fails to commence payments of benefits timely or to pay continued installments or medical benefits timely, unless the claim is reasonably controverted. The statutes providing for imposition of penalties and attorney fees are to discourage indifference and undesirable conduct by employers and insurers, and are essentially penal in nature. Although the Workers' Compensation Act is to be liberally construed in regard to benefits, penal statutes are to be strictly construed.Read the full opinion on CourtListener →
Section 23:1201(F) requires penalties and reasonable attorney fees when an employer fails to pay owed workers’ compensation or medical benefits, unless the employer reasonably controverts the claim.
Lewis v. CHATEAU D'ARBONNE NURSE CARE CTR. · filed 2004-04-07(F)
The employer's failure to provide payment of compensation or medical benefits owed shall result in the assessment of a penalty and reasonable attorney fees, unless the employer has reasonably controverted the claim. ... Given these facts, the evidence of prior back pain was insufficient to reasonably controvert Lewis' claim for her ruptured disc. Under either statutory standard, reasonably controverted in La. R.S. 23:1201(F), or arbitrary, capricious, and without probable cause in La. R.S. 23:1201.2,[1] the penalties and attorney fees were properly awarded.Read the full opinion on CourtListener →
Section 23:1201(F) imposes penalties and reasonable attorney fees for unpaid compensation or medical benefits unless the claim is reasonably controverted or nonpayment arose from conditions beyond the employer or insurer's control.
Fontenot v. Pyramid Alloys, Inc. · filed 2004-05-12(F)
Subparagraph (2) of La.R.S. 23:1201(F) states: “This Subsection shall not apply if the claim is reasonably controverted or if such nonpayment results from conditions over which the employer or insurer had no control.” ... Whether the WCJ finds that an employer reasonably controverts a claim for benefits is a question of fact. ... We find no manifest error in the WCJ’s finding that Pyramid did not reasonably controvert Mr. Fontenot’s claim. Therefore, we affirm the WCJ’s award of penalties and attorney fees.Read the full opinion on CourtListener →
Section 23:1201(F) imposes penalties and attorney's fees when indemnity or medical benefits are not timely paid, unless the claim is reasonably controverted or nonpayment results from conditions beyond the employer's control.
Sarrio v. Stalling Const. Co. · filed 2004-05-26(F)(2)
La. R.S. 23:1201 F provides for the imposition of penalties and attorneys fees when indemnity or medical benefits due to the claimant are not paid timely. However, this does not apply if the claim is reasonably controverted, or if such nonpayment results from conditions over which the employer had no control. La.R.S. 23:1201 F(2). In order to reasonably controvert a claim, the Defendant must have some valid reason or evidence upon which to base the denial of benefits.Read the full opinion on CourtListener →
Section 23:1201(E) requires medical benefits, including mileage expenses incurred for medical treatment, to be paid within 60 days after written notice; once a documented request is submitted, the employer or insurer must show that it paid timely.
Jeanise v. Tommy Cannon D/B/A Rental World, Inc. · filed 2005-02-23(E)
It is well settled that travel expenses (mileage) incurred to seek medical treatment form part of a claimant’s medical expense claim. La.R.S. 23:1201(E); La.R.S. 23:1203(D); Milligan v. Bayou Vista Manor, Inc., 355 So.2d 569 (La.App. 3 Cir. 1978). Louisiana Revised Statute 23:1201(E) provides: "Medical benefits payable under this Chapter shall be paid within sixty days after the employer or insurer receives written notice thereof." Once Claimant submitted a documented request for payment of mileage, as was the case here, the burden shifted to the Defendant to show that the request was timely paid. The record reflects that more than sixty days elapsed after the Claimant had made these requests for payment.Read the full opinion on CourtListener →
Law changed since Acts 2012, No. 652 (effective July 1, 2013) limited § 23:1201(E)’s 60-day medical-payment rule to providers not using electronic billing; a complete electronic medical bill is due within 30 days.
Section 23:1201(E) requires medical benefits to be paid within 60 days after the employer or insurer receives written notice of the expense, and subsection (F) authorizes penalties and attorney fees for untimely payment unless an exception applies.
Thomas v. Sonic · filed 2006-06-09(E), (F)
La. R.S. 23:1201(E) provides that medical benefits payable under workers’ compensation shall be paid within sixty days after the employer or insurer receives written notice of the expense. ... Therefore, we find the workers’ compensation court was not manifestly erroneous or clearly wrong in concluding that Sonic failed to timely pay the Lakeview Regional bills in accordance with La. R.S. 23:1201.Read the full opinion on CourtListener →
Law changed since Same change as noted above.
Section 23:1201(E) requires the employer to pay medical benefits within 60 days after receiving written notice, and failure to do so can support penalties and attorney fees.
Farmer v. RAS Management Co., Inc. · filed 2007-06-20(E)
The employer failed to pay medical benefits within 60 days of written notice. La. R.S. 23:1201(E). The appellants were not penalized for challenging the surgery, but for not acknowledging the claim from its inception and even after investigating the claim, for failing to pay even for Farmer's visits to physical therapy. As such, we find no error in the trial court's award of penalties and attorney fees.Read the full opinion on CourtListener →
Law changed since Same change as noted above.
Section 23:1201 requires medical benefits to be paid within 60 days after written notice and permits a daily late-payment penalty, capped at $2,000 in the aggregate for any claim.
Barnes v. Plaquemines Parish Solid Waste · filed 2007-06-20(E), (F)
In the case of West Jefferson, on March 30, 2004, the workers’ compensation insurer received West Jefferson’s bill for the medical services that were rendered to Mr. Barnes, and the bill was paid on June 21, 2004. Thus, the bill was paid twenty-one days beyond the sixty-day payment period permitted by statute. The penalty for the late payment under La. 23:1201(F) should have been $50.00 per day for 21 days, or a total of $1,050.00. ... We, therefore, find that the workers’ compensation judge properly assessed a penalty in the maximum amount of $2,000.00 in connection with the nonpayment of Dr. Van Wormer’s bills.Read the full opinion on CourtListener →
Law changed since Same change as noted above.
Section 23:1201(E) requires medical benefits to be paid within sixty days after written notice, and subsection (F) provides for penalties and reasonable attorney fees when that requirement is violated.
Nash v. Aecom Technology Corp. · filed 2008-02-06(E), (F)
We also note La.R.S. 23:1201(E) provides that “[m]edical benefits payable under this Chapter shall be paid within sixty days after the employer or insurer receives written notice thereof.” (Emphasis added.) Violation of this section “shall result in the assessment of a penalty” as well as “reasonable attorney fees.” La.R.S. 23:1201(F). Although the WCJ did not base his decision on the failure to pay benefits within the sixty day period, we find appellants were in violation of this provision. ... Thus, penalties and attorney fees are appropriate under R.S. 23:1201(F).Read the full opinion on CourtListener →
Law changed since Same change as noted above.
Section 23:1201(E) requires medical benefits to be paid within sixty days after written notice, while § 23:1201(F)(2) excuses penalties and attorney fees when the claim is reasonably controverted or nonpayment results from conditions beyond the employer's control.
Ellis v. Resource Transportation · filed 2009-03-04(E), (F)(2)
Louisiana Revised Statutes 23:1201(E) provides: “Medical benefits payable under this Chapter shall be paid within sixty days after the employer or insurer receives written notice thereof.” However, the employer or insurer is not liable for penalties or attorney fees for failure to timely pay medical benefits when the claim has been reasonably controverted or the nonpayment results from conditions over which the employer had no control. La. R.S. 23:1201(F)(2). ... The Defendants were well over sixty days after the agreement had been reached before indicating that they needed additional information to pay the bills. ... We find no error in the workers’ compensation judge’s decision that penalties and attorney fees are appropriate in this matter.Read the full opinion on CourtListener →
Law changed since Same change as noted above.
Section 23:1201(E) requires medical benefits to be paid within sixty days after the employer or insurer receives written notice.
Gradney v. Louisiana Commercial Laundry · filed 2010-05-12(E)
Louisiana Revised Statutes 23:1201(E) provides: “[m]edical benefits payable under this Chapter shall be paid within sixty days after the employer or insurer receives written notice thereof.”Read the full opinion on CourtListener →
Law changed since Same change as noted above.
Section 23:1201(E) requires medical benefits to be paid within sixty days after written notice, while subsection (F) provides penalties for untimely payment; the court found no violation where timely approval or receipt of the bill was not disproved.
Romero v. Flowers Bakery Company of Lafayette, LLC · filed 2013-05-01(E), (F)
Therefore, there was no violation of La.R.S. 23:1201(F). ... Louisiana Revised Statutes Article 23:1201(E) states: “Medical benefits payable under this Chapter shall be paid within sixty days after the employer or insurer receives written notice thereof.” ... Without any evidence that this bill was presented any earlier, we cannot conclude that Flowers failed to timely pay Dr. Cobb’s bill within sixty days of its receipt. We find no error in the WCJ’s determination that Flowers was not liable for a penalty and attorney fees relative to Dr. Cobb’s bill pursuant to La.R.S. 23:1201(E).Read the full opinion on CourtListener →
Law changed since Same change as noted above.
Section 23:1201(E) requires medical benefits to be paid within 60 days after written notice, while subsection (F) provides penalties and attorney fees for a failure to pay as required.
Romero v. Flowers Baking Co. of Lafayette · filed 2013-05-01(E), (F)
Despite having been advised by BHN to deny the EMG/NCS, the record establishes that an approval of the EMG/ NCS was communicated to Dr. Hodges less than sixty days after receiving a request for said test. Therefore, there was no violation of La.R.S. 23:1201(F). ... Without any evidence that this bill was | ^presented any earlier, we cannot conclude that Flowers failed to timely pay Dr. Cobb’s bill within sixty days of its receipt. We find no error in the WCJ’s determination that Flowers was not liable for a penalty and attorney fees relative to Dr. Cobb’s bill pursuant to La.R.S. 23:1201(E).Read the full opinion on CourtListener →
Law changed since Same change as noted above.
Section 23:1201(E) requires medical benefits to be paid within sixty days after the employer or insurer receives written notice, and failure to reimburse covered expenses within that period can support penalties.
Daniel v. Point to Point Directional Drilling, Inc. · filed 2014-05-07(E)
The penalty and attorney fee provisions in La.R.S. 23:1201, at the time of Mr. Daniel’s work accident, provided in part: ... E. Medical benefits payable under this Chapter shall be paid within sixty days after the employer or insurer receives written notice thereof. ... Based on this finding, we further award Mr. Daniel an additional $2,000.00 in penalties based on Point to Point’s failure to reimburse him for the $4,500.00 co-pay within the sixty days allowed by La.R.S. 23:1201(E).Read the full opinion on CourtListener →
When providers do not use the specified electronic billing rules, § 23:1201(E)(1) requires medical benefits to be paid within 60 days after the employer or insurer receives written notice.
Washington v. Louisiana-I Gaming · filed 2014-12-23(E)(1)
Pursuant to La. R.S. 23:1201(E)(1), “medical benefits payable under this Chapter shall be paid within sixty days after the employer or insurer receives written notice thereof, if the provider of medical services is not utilizing the electronic billing rules and regulations provided. for in R.S. 23:1203.2.” No evidence in the record exists that claimant’s medical providers utilize such electronic billing. Therefore, at the time of trial, 60 days had not expired since Boomtown received notice of claimant’s medical claims. Therefore, we cannot find that Boomtown did not reasonably controvert claimant’s medicals.Read the full opinion on CourtListener →
Subsection (E)'s sixty-day period governs approval of requested medical treatment, and the court affirmed that the approval here was timely.
Romero v. Garan's, Inc. · filed 2014-08-06(E), (G)
Accordingly, since Garan’s approval of the radiofrequency facet-nerve ablation was timely, the judgment of the WCJ denying penalties and attorney fees based on Garan’s failure to authorize the requested procedure is affirmed.Read the full opinion on CourtListener →
Law changed since Acts 1995, No. 1137 (effective June 29, 1995) changed the medical-benefit payment period from 14 to 60 days; the earlier deadline can govern vested claims from older injuries.
For a 1993 accident, § 23:1201 required medical benefits to be paid within 14 days; the 1995 amendment allowing 60 days could not be applied retroactively because the 14-day entitlement was vested, and the statute authorized penalties for unpaid medical benefits.
Batiste v. Capitol Home Health · filed 1997-09-25(E) (F)
As might readily be observed, La.R.S. 23:1201(F), effective in 1995, clearly affords an employer 60 days to pay its employee's medical expenses. Therefore, the dispositive question is whether the 1995 amendment may be applied retroactively. ... We conclude that claimant's rights to have her medical bills timely paid within fourteen days rather than sixty constituted a vested constitutional right and therefore hold that the hearing officer properly declined to apply the 1995 amendment to her 1993 accident. ... However, effective January 1, 1993, there has been no question as to the law. ... La.R.S. 23:1201 was amended by Acts 1992, No. 1003, effective January 1, 1993 to provide for a penalty on any unpaid medical benefits. Previously the statute had provided only for a penalty on an unpaid installment of compensation. Therefore, we find no merit to defendant's alternate theory.Read the full opinion on CourtListener →
Law changed since Acts 2012, No. 652 (effective July 1, 2013) limited § 23:1201(E)’s 60-day medical-payment rule to providers not using electronic billing; a complete electronic medical bill is due within 30 days.
Section 23:1201(E) requires uncontroverted workers' compensation medical benefits to be paid within sixty days after the employer or insurer receives notice, but it does not set a deadline for a defense evaluation.
Beverly v. Boardwalk Const. · filed 2000-10-11(E)
Appellant contends that La.R.S. 23:1201(E) provides that LWCC had sixty days to decide whether to approve medical benefits. Appellant's interpretation of the statute is incorrect. La.R.S. 23:1201 deals with the payment of uncontroverted medical bills. Under that provision, medical benefits payable under workers' compensation must be paid within sixty days after the employer or insurer receives notice. This section is silent regarding the time frame in which a defense evaluation must take place.Read the full opinion on CourtListener →
Law changed since Same change as noted above.
Section 23:1201(E) gives an employer or insurer sixty days after written notice to pay medical benefits, while subsection (F) permits penalties when benefits are not timely paid without an articulable and objective reason for the nonpayment.
Mitchell v. ARTCRETE, INC. · filed 2010-11-03(E), (F)
Louisiana Revised Statutes 23:1201(F) allows for the imposition of sanctions against an employer who fails to timely pay medical benefits. Under La. R.S. 23:1201(E), medical benefits “shall be paid within sixty days after the employer or insurer receives written notice thereof.” ... As explained above, “[t]he crucial inquiry in determining whether to impose penalties and attorney fees on an employer is whether the employer had an articulable and objective reason to deny benefits at the time it took action.” ... The workers’ compensation judge found that it did not become clear to Arterete that it was obligated to pay for this prescription until judgment was executed. As explained above, the record supports the workers’ compensation judge’s finding in this regard, thus we cannot say it was error for the workers’ compensation judge to decline to award penalties.Read the full opinion on CourtListener →
Medical-benefit payment and reimbursement
Section 23:1201(F)(2) bars penalties and attorney’s fees when an employer reasonably controverts the compensation claim, including when it has valid factual information supporting denial of benefits.
Paul Thomas, Jr. v. Browning-Ferris, Inc. · filed 2004-03-31(F)(2)
Louisiana Revised Statute 23:1201(F) provides that penalties and attorney’s fees will be assessed against an employer who fails to timely provide compensation benefits or medical benefits to the injured employee. However, penalties and attorney’s fees will not be assessed if the employer reasonably controverted the injured employer’s claim or if the “nonpayment results from conditions over which the employer or insurer had no control.” La.R.S. 23:1201(F)(2). ... Based on the foregoing, we find that BFI did have valid factual information for denying Thomas’ claim. Accordingly, we find that the workers’ compensation judge erred in finding that it failed to reasonably controvert his claim. His judgment assessing BFI with penalties and attorney’s fees is reversed.Read the full opinion on CourtListener →
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