La. Stat. Ann. § 23:1201

Section 23:1201(F)(2) permits penalties and attorney fees for untimely benefits unless the claim is reasonably controverted or nonpayment resulted from conditions beyond the employer’s control; reasonable controversion requires a valid reason or evidence supporting denial of benefits.

Jones v. Gilbert Southern Corp. · filed 2004-08-31(F)(2)

La. R.S. 23:1201 F provides for the imposition of penalties and attorneys fees against the employer when indemnity or medical benefits 'due to the claimant are not paid timely, unless 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. Brown v. Texas-La Cartage, Inc., 98-1063, p. 9 (La.12/1/98), 721 So.2d 885, 890; Barbarin v. TLC Home Health, 02-1054, p. 9 (La.App. 5th Cir.4/29/03), 845 So.2d 1199, 1206. The question is 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.” Brown, 98-1063 at 9, 721 So.2d at 890; Barbarin, 02-1054 at 9, 845 So.2d at 1206. ... The evidence here was contradictory as to whether the Defendant was informed about the incident prior to the claim being filed and whether the injury was employment related. Although we do not find manifest error in the workers’ compensation judge’s finding that a work-related accident did occur, the facts support a reasonable basis for the claim to be controverted. Thus, the trial judge was manifestly erroneous in awarding penalties and attorney’s fees and we will reverse, that part of the judgment.

Section 23:1201(F) imposes a penalty for unpaid compensation or medical benefits unless the claim is reasonably controverted or the nonpayment results from conditions beyond the employer’s or insurer’s control.

Royals v. Town of Richwood · filed 2004-08-18(F)

Penalties are stricti juris and should be imposed only when the facts clearly negate good faith and just cause in connection with the refusal to pay. ... In this case we find no manifest error in the WCJ's imposition of a penalty. ... RMI should have investigated this claim further, but failed to do so before denying benefits. This is particularly important as the interview by Beverly Smith with Royals clearly showed an accident the day before. This first accident was totally ignored by Jenkins.

Section 23:1201(F)(2) permits penalties and attorney fees when the employer’s delay in providing medical benefits was not beyond its control and the claim was not reasonably controverted.

Sims Rachal v. Good Neighbor Glass, Inc. · filed 2004-03-03(F)(2)

An employer may escape liability for its delays in providing medical benefits if (1) its nonpayment stemmed from conditions over which the employer had no control, or (2) the employer reasonably controverted the employee's right to such compensation or medical benefits.

Section 23:1201(E) requires timely payment of workers’ compensation medical benefits, and failure to pay can trigger the statute’s penalty provision.

Abate v. City of Abbeville · filed 2002-10-02(E)

Regarding the remaining medical benefits, the evidence supports the finding that, under the laws of workers’ compensation, medical benefits remained unpaid. Furthermore, we conclude that LWCC and the City did not prove the amount paid, by submitting affirmative evidence, at trial. Therefore, it did not extinguish the claim. Accordingly, we find no error in the determination that the City failed to pay Mr. Abate’s medical expenses, which brings it under the penalty provision of La.R.S. 23:1201. The decision of whether to award penalties and attorneys’ fees is a factual determination and should not be disturbed on appeal unless clearly wrong.15 Thus, we affirm the attorney’s fees and penalties incurred for failing to timely pay medical benefits, as well as the attorney’s fees and penalties for failure to pay weekly indemnity benefits.

Subsection (F) imposes penalties and reasonable attorney fees for unpaid workers’ compensation or medical benefits unless the claim was reasonably controverted or nonpayment resulted from conditions beyond the employer’s or insurer’s control.

Sterling v. Asplundh Tree Expert Co. · filed 2003-10-01(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.” ... We find no manifest error in the WCJ’s finding that Asplundh did not reasonably controvert Sterling’s claim. Therefore, we affirm the WCJ’s award of penalties and attorney fees.

Subsection (F)(2) permits an employer to avoid penalties for delayed medical benefits when nonpayment resulted from conditions beyond its control or when it reasonably controverted the employee's entitlement.

Carter v. Wal-Mart Stores, Inc. · filed 2002-06-26(F)(2)

"An employer may escape liability for its delays in providing medical benefits if: (1) its nonpayment stemmed from conditions over which the employer had no control, or (2) the employer reasonably controverted the employee's right to such compensation or medical benefits. La. R.S. 23:1201(F)(2)." ... "Therefore, the workers' compensation judge found that the defendant-appellant failed to reasonably controvert the claim of Mr. Carter. We agree."

An employer may avoid penalties for delayed medical benefits when the delay resulted from conditions beyond its control or it reasonably controverted the employee's entitlement.

Palmer v. Schooner Petroleum Services · filed 2002-12-27(F)(2)

"An employer may escape liability for its delays in providing medical benefits if: (1) its nonpayment stemmed from conditions over which the employer had no control, or (2) the employer reasonably controverted the employee's right to such compensation or medical benefits. La.R.S. 23:1201(F)(2)." ... However, after a thorough reading of the record and taking into consideration our finding that Palmer sustained an injury as a result of a work-related accident, we find that the WCJ was correct in assessing the defendants with a $2,000 penalty although not in accord with her rulings on the other issues in this case.

Section 23:1201(F) requires penalties and attorney fees for untimely indemnity or medical benefits unless the claim was reasonably controverted or nonpayment resulted from conditions beyond the employer's control.

Howard v. HOLYFIELD CONST., INC. · filed 2004-07-14(F), (F)(2)

However, La. R.S. 23:1201(F) provides for the imposition of penalties and attorney 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. Brown v. Texas-La Cartage, Inc., 98-1063, (La.12/1/98), 721 So.2d 885, 890. The question is 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." Brown, supra at 890.

Subsection (F)(2) permits penalties for failure to pay or furnish workers' compensation benefits unless the claim was reasonably controverted or the nonpayment resulted from conditions beyond the employer's or insurer's control.

Adams v. Bayou Steel Corp. · filed 2002-04-10(F)(2)

Under LSA-R.S. 23:1201(F)(2), penalties are assessed against either the employer or the insurer for failure to commence payment of benefits, but 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. ... Because the claim was not reasonably controverted, Adams is entitled to penalties and attorney fees under LSA-R.S. 23:1201. ... Because the need for such surgery was not reasonably controverted as we have found above, failure to approve surgery within sixty days of March 14 results in the imposition of penalties and attorney fees.

The 60-day payment period in subsection (E) triggers penalties but does not eliminate the employer's ultimate liability for medical expenses, while subsection (F) requires the employee to prove entitlement to penalties and permits avoiding them when the employer reasonably controverts the claim with sufficient factual or medical support and a valid reason for withholding benefits.

Johnson v. Johnson Controls, Inc. · filed 2004-05-12(E), (F)

La. R.S. 23:1201(E) provides that, "Medical benefits payable under this Chapter shall be paid within sixty days after the employer or insurer receives written notice thereof." However, this section is part of a penalty statute, and the 60-day provision is a trigger for penalties, not to the employer's ultimate liability for medical expenses. Therefore, we find no error in the OWC's award for the amount of the unpaid medical bills as part of its judgment, even without written demand for payment. ... In the case sub judice, Johnson alleges that her employer failed to pay benefits, which would be governed by La. R.S. 23:1201(F). Pursuant to that statute, 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. ... Penalties are stricti juris and should be imposed only when the facts clearly negate good faith and just cause in connection with the refusal to pay.

Section 23:1201(F) governs penalties and attorney fees for failure to commence or continue timely benefit payments, but it does not authorize penalties when an employer discontinues benefits that were initially paid timely.

Crochet v. Barbera Chevy-Chrysler Co., Inc. · filed 2005-06-29(F)

During the pertinent time period in this case, the applicable statutory authority for assessing an employer with penalties and attorney fees depended on whether the employer failed to commence payment of benefits in a timely fashion or discontinued benefits that had been timely paid. ... In this case, it was undisputed that Barbera Chevy-Chrysler initially commenced paying Clint Crochet's workers' compensation benefits timely, as required by La. R.S. 23:1201, and therefore, penalties and attorney fees could not be awarded in favor of Clint Crochet under La. R.S. 23:1201(F).

Section 23:1201(F)(2) requires penalties and attorney fees for untimely medical-benefit payments unless the claim was reasonably controverted or nonpayment resulted from conditions beyond the employer’s control.

Smith v. Morris & Dickson · filed 2006-03-01(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." The employer is subject to the payment of penalties and attorney fees for the failure to timely pay medical benefits unless the claim is reasonably controverted or the nonpayment results from conditions over which the employer had no control. La. R.S. 23:1201(F)(2).

Section 23:1201 requires adequate written notice of medical charges before penalties and attorney fees may be imposed for untimely payment.

Gioe v. Albach Co. · filed 2006-09-20(E), (F)

An award of penalties and attorney fees is not appropriate when there is no evidence that the employer or its insurer received a proper breakdown of charges for a claimant's medical treatment.

Section 23:1201(F) requires penalties and attorney fees when an employer or insurer fails to timely pay benefits, unless the claim is reasonably controverted or nonpayment resulted from conditions beyond its control.

Johnson v. Louisiana Container Co. · filed 2002-10-02(F)

Louisiana Revised Statutes 23:1201(E) requires that "[m]edical benefits payable under this Chapter shall be paid within sixty days after the employer or insurer receives written notice thereof." Subsection (F) further states that failure to comply with this Section "shall result in the assessment of a penalty ... together with reasonable attorney fees for each disputed claim."

Section 23:1201(F)(2) permits penalties and attorney’s fees for failing to authorize medical treatment unless the claim is reasonably controverted; the statute also permits them when continued benefits are not timely paid, subject to the stated exceptions.

Ranel v. McDonald's · filed 2003-11-05(F)(2), (F)

Unless the claim is “reasonably controverted,” a penalty and attorney’s fees can be imposed for failure to authorize medical treatment. La.R.S. 23:1201(F)(2); Authement, 840 So.2d 1181. ... Louisiana Revised Statute 23:1201 authorizes the award of both penalties and attorney’s fees if continued benefits are not paid timely. ... When the claim is “reasonably controverted,” or the nonpayment results from conditions over which the employer and insurer have no control, penalties and attorney’s fees are not available. Id.

Section 23:1201(F) authorizes penalties and attorney fees for untimely payment or provision of workers’ compensation benefits, including failure to commence vocational rehabilitation, unless the claim is reasonably controverted under subsection (F)(2).

Boone v. Mid-State Marketing · filed 2004-03-03(F), (F)(2)

Both La. R.S. 23:1201(F) and La.R.S. 23:1201.2 are penal in nature and provide for imposition of penalties and attorney fees to discourage indifference and undesirable conduct by employers and insurers. See Williams, 737 So.2d 41. ... Thus, if sham rehabilitation subjects one to attorney fees and penalties, then failure to provide rehabilitation also subjects one to penalties and attorney fees. ... Thus, a failure to authorize treatment can result in the imposition of penalties and attorney fees except when the claim is reasonably controverted. La.R.S. 23:1201(F)(2); Authement, 840 So.2d 1181.

Section 23:1201(F)(2) permits penalties and attorney fees for failure to authorize treatment unless the claim is reasonably controverted.

Thomas v. Westaff, Inc. · filed 2004-05-12(F)(2)

In Authement v. Shappert Eng’g, 02-1631(La. 2/25/03), 840 So.2d 1181, the supreme court recognized that failure to authorize comes under La.R.S. 23:1203(A). Under La.R.S. 23:1203(A), the employer is obligated to “furnish all necessary drugs, supplies, hospital care and services, medical and surgical treatment, and any nonmedical treatment recognized by the laws of this state as legal.” La.R.S. 23:1203(A). Thus, a failure to authorize treatment can result in the imposition of penalties and attorney fees except when the claim is reasonably controverted. La. R.S. 23:1201(F)(2); Authement, 840 So.2d at 1187.

Section 23:1201 requires penalties and attorney fees for specified workers’ compensation violations, including untimely benefit payments or failure to authorize treatment, unless the claim is reasonably controverted.

Floyd Boone, Jr. v. Mid-State Marketing · filed 2004-03-03(F), (F)(2)

“Moreover, Louisiana Revised Statutes 23:1201 provides that penalties and fees shall be awarded if an appropriate violation occurs and is proven.” ... “Both La.R.S. 23:1201 (F) and La.R.S. 23:1201.2 are penal in nature and provide for imposition of penalties and attorney fees to discourage indifference and undesirable conduct by employers and insurers. See Williams, 737 So.2d 41.” ... “Thus, a failure to authorize treatment can result in the imposition of penalties and attorney fees except when the claim is reasonably controverted. La.R.S. 23:1201(F)(2); Authement, 840 So.2d 1181.”

Section 23:1201(F)(2) permits penalties and attorney fees for an untimely failure to authorize medical treatment.

Vincent v. Napa Auto Parts and Supply · filed 2004-06-23(F)(2)

In this case, the failure to authorize an appointment with Dr. Cobb for six weeks was not prompt. We, therefore, assess a penalty of $2,000.00 and an attorney fee of $3,500.00 pursuant to La.R.S. 23:1201(F)(2).

Section 23:1201(F) permits penalties and attorney fees when an employer or insurer fails to provide medical benefits or payment, including by failing to authorize treatment, unless the claim is reasonably controverted.

Authement v. Shappert Engineering · filed 2003-02-25(F)

Based on this language, a penalty and attorney fee can be imposed for the failure to authorize treatment except where "the claim is reasonably controverted." ... Thus, we conclude that a failure to authorize treatment can result in the imposition of penalties and attorney fees except when the claim is reasonably controverted. Depending on the circumstances, a failure to authorize treatment is effectively a failure to furnish treatment. ... After the employer unconditionally authorized examination by Dr. Dehne, the refusal to prepay the charge was a "failure to provide payment." LSA-R.S. 23:1201(F).

Section 23:1201(F) permits penalties and attorney fees for untimely payment of benefits or medical expenses, including a failure to authorize treatment, unless the claim is reasonably controverted or nonpayment resulted from conditions beyond the employer's or insurer's control.

Stelly v. Health South Rehabilitation · filed 2003-07-02(F)

Under Section 1201(F), both penalties and attorney fees may be awarded for the failure to provide timely payment of benefits or medical expenses, unless, as provided in Section 1201(F)(2), the claim is "reasonably controverted or if such nonpayment results from conditions over which the employer or insurer had no control." "Depending on the circumstances, a failure to authorize treatment is effectively a failure to furnish treatment" that can result in the imposition of penalties and attorney fees. Authement, 840 So.2d at 1187. "[I]n order to reasonably controvert a claim, the defendant must have some valid reason or evidence upon which to base his denial of benefits." Brown, 721 So.2d at 890.

Section 23:1201(A) treats a failure to authorize reasonable and necessary medical treatment as a failure to furnish treatment, while § 23:1201(F)(2) bars penalties and attorney fees when the claim is reasonably controverted.

Latigue v. Christus St. Patrick Hosp. · filed 2003-12-17(A), (F)(2)

Thus, a failure to authorize treatment can result in the imposition of penalties and attorney fees except when the claim is reasonably controverted. ... This failure to authorize amounted to a failure to furnish treatment under La.R.S. 23:1201(A). ... However, La.R.S. 23:1201(F)(2) states, in part, that the penalty and attorney fee provisions "shall not apply if the claim is reasonably controverted." Based on this language, a penalty and attorney fee can be imposed for the failure to authorize treatment except where the claim is reasonably controverted.

Section 23:1201 authorizes penalties and attorney fees for untimely payment or authorization of claims, but its penalty provision does not apply when the claim is reasonably controverted.

Travelers Insurance Co. v. Reliable Home Health Care, Inc. · filed 2003-09-17(F)

La. R.S. 23:1201 provides for penalties and attorney fees for the failure to timely pay or authorize claims. It also provides that “[t]his Subsection shall not apply if the claim is reasonably controverted ...”

Section 23:1201(F)(2) permits nonpayment of workers’ compensation benefits when the claim is reasonably controverted or nonpayment results from conditions beyond the employer’s or insurer’s control.

Wilkerson v. Wal-Mart Stores, Inc. · filed 2003-12-30(F)(2)

An employer’s failure to authorize a medical procedure for an employee [sotherwise eligible to receive workers’ compensation is deemed to be the failure to furnish compensation benefits, thereby triggering the penalty provisions of the Louisiana Workers’ Compensation Act. Failure to furnish benefits is permissible only when the claim has been “reasonably controverted or if such nonpayment results from conditions over which the employer or insurer had no control.” La. R.S. 23:1201(F)(2).

Section 23:1201 F treats an employer's refusal to authorize necessary medical treatment as a failure to furnish benefits subject to penalties, unless the claim was reasonably controverted or nonpayment resulted from conditions beyond the employer's or insurer's control.

Thompson v. the Animal Hosp. · filed 2004-12-15(F)(2)

An employer's failure to authorize a medical procedure for an employee otherwise eligible to receive worker's compensation is deemed to be the failure to furnish compensation benefits, thus triggering the penalty provisions of R.S. 23:1201. ... In the event of refusal to provide medical benefits, as distinguished from the termination of such benefits, the "reasonably controverted" standard of R.S. 23:1201 F applies.

Section 23:1201(E) and (F)(2) allow penalties and attorney fees for untimely benefits unless the claim was reasonably controverted, permit one penalty for a single ongoing violation involving delayed medical payments, and do not require a new demand or sixty-day wait for each refill of an accepted prescription.

Sigler v. Dressers rand/coastal Chemical · filed 2004-12-29(E), (F)(2)

Louisiana Revised Statutes 23:1201(F)(2) provides for the payment of penalties and attorney fees for the failure to provide payment of benefits unless the claim is reasonably controverted or the failure to pay results from conditions over which the employer had no control. ... While Dresser Rand clearly violated its obligation under La.R.S. 23:1201 by failing to immediately pay all outstanding medical expenses after the claim was no longer reasonably controverted, we find no error in the WCJ’s decision to “ferret out” the penalties by concluding that Dresser Rand’s violation was a single, ongoing one resulting in only one penalty award under the circumstances of this case. ... We do not find that La.R.S. 23:1201 requires a demand letter and allows a sixty-day wait for each refill of a prescription already accepted as compensable by the employer.

Section 23:1201(F) permits penalties and attorney fees when an employer fails to provide workers’ compensation or medical benefits, including by refusing to authorize necessary treatment, unless the claim is reasonably controverted.

Roberts v. Thibodaux Healthcare Center · filed 2006-03-24(F)

Thus, a failure to authorize a treatment, including a surgical treatment, can be considered a failure to furnish treatment resulting in the imposition of penalties and attorney fees under La. R.S. 23:1201(F), unless the claim is reasonably controverted.

Section 23:1201(F)(2) bars penalties and attorney’s fees when an employer reasonably controverts a claim or when nonpayment results from conditions beyond the employer’s or insurer’s control.

Capdeville v. Winn-Dixie Store 1473 · filed 2006-03-01(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.” ... The phrase “reasonably controverted,” . . . mandates a different standard. In general, one can surmise from the plain meaning of the words making up the phrase “reasonably controvert” that in order to reasonably controvert a claim, the defendant must have some valid reason or evidence upon which to base his denial of benefits. ... Winn Dixie has presented no evidence nor a valid reason for its failure to authorize the treatment, nor has it presented any evidence showing that its failure to authorize the treatment was due to conditions beyond its control.

Section 23:1201(F)(2) excuses an employer from penalties and attorney's fees only when it reasonably controverts the claim or the nonpayment results from conditions beyond its control.

Capdeville v. WINN-DIXIE STORE NO. 1473 · filed 2006-03-01(F)(2)

After reviewing the record, we find the workers' compensation judge clearly wrong in denying Capdeville's request for penalties and attorney's fees, as a result of Winn Dixie's failure to authorize Dr. Pearce's recommended treatment. Winn Dixie has already either agreed to or been ordered to authorize the treatment by Dr. Pearce on three different occasions. The present judgment by the workers' compensation judge is the fourth time this matter has been addressed. Winn Dixie has presented no evidence nor a valid reason for its failure to authorize the treatment, nor has it presented any evidence showing that its failure to authorize the treatment was due to conditions beyond its control.

Subsection (F)(2) authorizes penalties and attorney fees for failure to timely pay medical benefits unless the claim is reasonably controverted or the nonpayment results from conditions beyond the employer’s control.

Angelle v. Oilfield · filed 2005-12-30(F)(2)

Furthermore, La.R.S. 23:1201(F)(2) provides for an award of penalties and attorney fees for the failure to timely pay medical benefits unless the claim is reasonably controverted or the nonpayment results form conditions over which the employer had no control. ... We find that Taylor Oilfield was unreasonable in failing to authorize the EMG/ NCV studies. ... However, Angelle is entitled to a penalty for Taylor Oilfield’s refusal to authorize the testing requested by Dr. Heard.

Section 23:1201(F) permits penalties and attorney fees for failure to authorize treatment when the claim is not reasonably controverted; the court affirmed such an award for the refusal to authorize the claimant’s treating physician.

Wall v. Avoyelles Correctional Center · filed 2006-02-01(F)(2)

Inasmuch as the record establishes that Dr. Nanda was never provided with the claimant's medical records and never had a chance to examine either those records or the claimant, we can neither say the claim was reasonably controverted nor that the WCJ was clearly wrong in awarding the claimant penalties and attorney's fees for the defendant's failure to authorize treatment by Dr. Nanda.

Subsection (F) provides penalties and reasonable attorney’s fees for an employer’s failure to consent to an employee’s treating-physician selection, but subsection (F)(2) bars those awards when the claim is reasonably controverted.

Scallon v. Boise Cascade Corporation · filed 2005-11-02(F)(2)

La.R.S. 23:1201(F) directs that an employer’s failure to consent to an employee’s request to select a treating physician shall result in the assessment of a penalty which shall not exceed a maximum of two thousand dollars for any claim, together with reasonable attorney’s fees. However, if the claim is reasonably controverted by the employer, penalties and attorney’s fees shall not be awarded. La. R.S. 23:1201(F)(2). ... We conclude that Boise Cascade reasonably controverted Mr. Scallon’s claim.

Section 23:1201(F) permits penalties and attorney fees for untimely payment of benefits or medical expenses and for failure to authorize treatment, unless the claim is reasonably controverted or nonpayment results from conditions beyond the employer’s or insurer’s control.

Wall v. Avoyelles Correctional Center · filed 2006-02-01(F)

Under Section 1201(F), both penalties and attorney fees may be awarded for the failure to provide timely payment of benefits or medical expenses, unless, as provided in Section 1201(F)(2), the claim is “reasonably controverted or if such nonpayment results from conditions over which the employer or insurer had no control.” “Depending on the circumstances, a failure to authorize treatment is effectively a failure to furnish treatment” that can result in the imposition of penalties and attorney fees. Authement, 840 So.2d at 1187. “[I]n order to reasonably controvert a claim, the defendant must have some valid reason or evidence upon which to base his denial of benefits.” Brown [v. Texas-LA Cartage, 98-1063, (La. 12/1/98), 721 So.2d 885], 890.

Section 23:1201(F) specifically governs penalties for an employer’s failure to authorize a treating physician and provides penalties and attorney fees in place of the general constructive-contempt remedy.

Jackson v. M.R. Pittman, LLC · filed 2009-02-11(F)

Thus, while we agree that La. R.S. 23:1310.7 regarding constructive contempt could deal with the problem presented by Gray’s conduct, we find that [12under the facts and circumstances of this case, La. R.S. 23:1201(F) specifically deals with this situation. ... Also, this specific statute provides for the award of attorney’s fees, unlike the general contempt statute which does not.

Section 23:1201(F) subjects an employer or insurer to penalties and attorney fees for failing to pay benefits or authorize necessary medical treatment unless the claim is reasonably controverted or nonpayment was beyond its control.

Armand v. Denton-James, L.L.C. · filed 2009-02-04(F)

An employer’s failure to authorize a necessary medical procedure is deemed to be a failure to furnish the benefits required by La.R.S. 23:1203, and failure to authorize such treatment subjects the employer to the sanctions of La.R.S. 23:1201(F).

Section 23:1201(E) authorizes penalties and attorney fees when an employer fails to authorize required pain-management treatment.

Duplechain v. Town of Church Point · filed 2012-12-19(E)

Given the deference we must afford the WCJ in its ruling, we find no error in the WCJ‟s determination that Church Point was liable for penalties and attorney fees pursuant to La.R.S. 23:1201(E) for failing to authorize pain management, nor do we find an abuse of discretion in the amount of the penalty or in the amount of the attorney fees awarded.

Section 23:1201(F) requires an employer or insurer that reverses a denial of necessary medical treatment to inform the injured worker or prescribing physician; failing to do so can subject it to sanctions.

Foy v. Amerisafe Risk Services, Inc. · filed 2013-03-20(F)

Thus, the question before us is whether Pryor’s actions constitute authorization of necessary medical procedures under La.R.S. 23:1201(F). ... Clearly, that someone else has to have knowledge of the grant of authority or power, or it will not be exercised, making that grant of power fruitless. Moreover, La.R.S. 23:1201 pertains to the duties owed to the injured worker. Failure by an employer or insurer to inform either the injured worker or the prescribing physician of its decision to reverse a denial of necessary medical treatment is a breach of that duty.

Section 23:1201 requires timely authorization of medical treatment and permits a penalty for noncompliance; the court upheld a $2,000 penalty despite the employer’s argument that a four-day delay capped the penalty at $200.

Kinard v. New Iberia Wastewater Treatment Facility · filed 2013-04-03(E), (F)

“In the alternative, Defendants argue that even if the treatment was not timely authorized, the maximum penalty should be $200.00 pursuant to La.R.S. 23:1201(F) because authorization was given four days past the period provided in La.R.S. 23:1201(E). ... Thus, we find no manifest error in the imposition of the $2,000.00 penalty with regard to the authorization of treatment by Dr. Blackburn.”

Section 23:1201 permits penalties when an insurer lacks a reasonable basis to believe compensation is not due and fails to pay the first installment within fourteen days after learning of the injury.

Levatino v. Domengeaux and Wright, PLC · filed 1992-01-02

The assessment of penalties is proper under La.R.S. 23:1201 when the insurer does not have a reasonable basis to believe that compensation benefits are not due and fails to pay the first installments fourteen days after the insurer has knowledge of the injury.

Section 23:1201(F) requires penalties and attorney fees for late benefit payments unless the claim was reasonably controverted or nonpayment was beyond the employer's or insurer's control.

Johnson v. Transerve · filed 2002-02-27(F)(2)

La.R.S. 23:1201 clearly provides 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.

Section 23:1201(F) requires penalties and reasonable attorney fees for failure to provide compensation benefits unless the claim was reasonably controverted or nonpayment was beyond the employer’s or insurer’s control.

Bolton v. Mike Fleming Const. · filed 2002-12-11(F)

Failure to provide compensation benefits shall result in the assessment of a penalty 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. La. R.S. 23:1201(F). 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. ... The record shows that the plaintiff paid the plaintiff's medical expenses at Work Kare and paid for some of the plaintiff's visits to Dr. Bicknell. ... Under these circumstances, we do not find that the WCJ was manifestly erroneous in denying the plaintiff's claim for penalties and attorney fees.

Section 23:1201 permits penalties and attorney fees for untimely unpaid benefits unless the employer reasonably controverts the claim; a non-frivolous dispute or factual or medical evidence reasonably countering the claim is sufficient.

Tate v. Cabot Corp. · filed 2002-07-03

If the employer had some valid reason or evidence upon which to base its denial of benefits, then it has reasonably controverted the claim, thereby avoiding the imposition of penalties and attorney's fees. Id. To determine whether Mr. Tate's claim has been reasonably controverted, we "must ascertain whether the employer or his insurer 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 he refused to pay all or part of the benefits allegedly owed." ... In the end, this evidence was insufficient to counter Mr. Tate's proof of entitlement to benefits and medical expenses. However, we concede that even with possession of updated medical records, it was reasonable for Cabot to determine that Mr. Tate's post-accident injuries were neither new nor aggravations of preexisting injuries. We believe that the available medical information, along with Cabot personnel's exposure to Mr. Tate's comments prior to the unwitnessed accident, reasonably countered the factual and medical information presented by Mr. Tate. After thorough review of the record, therefore, we are satisfied that though Cabot's evidence is somewhat tenuous, it has reasonably controverted Mr. Tate's claim. Therefore, neither penalties nor attorney fees are warranted.

Subsection (F)(3) requires penalties and reasonable attorney fees for failing to pay compensation unless the claim was reasonably controverted or nonpayment resulted from circumstances beyond the employer’s or insurer’s control.

Feild v. General Motors Corp. · filed 2002-09-18(F)(3)

Failure to provide compensation benefits shall result in the assessment of a penalty 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. La. R.S. 23:1201 F(3). To meet this standard, the employer must have some "valid reason or evidence upon which to base his denial of benefits." Brown v. Texas-LA Cartage, 98-1063 (La.1/15/99), 721 So.2d 885.

Section 23:1201(F) requires penalties and reasonable attorney fees for nonpayment unless the claim is reasonably controverted or the nonpayment resulted from conditions beyond the employer's control.

Lee v. Schumpert · filed 2003-01-29(F)

Failure to provide payment in accordance with the workers' compensation act shall result in the assessment of a penalty and reasonable attorney fee; however, these are not assessed if the claim is reasonably controverted or the failure to pay results from conditions over which the employer had no control. ... A claim is reasonably controverted when the employer produces factual or medical information of such a nature that it reasonably counters the claimant's evidence.

Section 23:1201(E) permits penalties for nonpayment of compensation unless the nonpayment was beyond the employer's or insurer's control or the employee's entitlement was reasonably controverted.

Warren v. H & W Steel Erectors Inc. · filed 1990-10-16(E)

An assessment of penalties is proper for the nonpayment of compensation benefits unless nonpayment results from conditions over which the insurer or employer had no control or unless the employee's right to such benefits had been "reasonably controverted". La.R.S. 23:1201 E. ... However, after Dr. Kirgis diagnosed a herniated disc and Drs. Kirgis and Connolly recommended surgery in a report dated December 5, 1986, defendants' failure to resume payments of benefits was arbitrary and capricious. ... Therefore, we impose the statutory penalty on each worker's compensation payment that became due after February 28, 1987, when plaintiff's unemployment benefits ceased. The trial court's judgment is amended accordingly.

Section 23:1201(E) permits penalties unless the employer or insurer proves that nonpayment was beyond its control or that it reasonably controverted the employee's right to benefits.

Kennedy v. Commercial Union Ins. Co. · filed 1990-12-12(E)

To avoid an award of penalties, the employer must show that nonpayment resulted from conditions over which it or the insurer had no control, or that it, or the insurer, has reasonably controverted the employee's right to benefits. ... Gomer Tire Services and Commercial Union Insurance Company are cast with penalties pursuant to La.R.S. 23:1201(E), with legal interest from date of judicial demand until paid, and with all costs of this appeal.

Section 23:1201(F) requires penalties and attorney fees when an employer untimely pays compensation benefits, unless the claim was reasonably controverted or nonpayment resulted from conditions beyond the employer's or insurer's control.

Thomas v. Wal-Mart · filed 2003-05-09(F)

Pursuant to La. R.S. 23:1201(F), a workers' compensation claimant is entitled to penalties and attorney fees if an employer fails to timely pay compensation benefits unless the claim is reasonably controverted or such nonpayment results from conditions over which the employer or insurer had no control.

Section 23:1201(F)(2) requires penalties and attorney fees for nonpayment of workers’ compensation benefits unless the claim was reasonably controverted or the nonpayment resulted from conditions beyond the employer’s or insurer’s control.

Simon v. Natchitoches Parish School Board · filed 2004-02-04(F)(2)

La.R.S. 23:1201(F)(2) provides for the imposition of penalties and attorney fees unless “the claim is reasonably controverted or if such nonpayment results from conditions over which the employer or insurer had no control.” We find nothing in the record to suggest that the School Board’s failure to pay indemnity benefits for the period from October 1, 2002 through November 25, 2002 resulted from conditions over which the School Board had no control, nor do we find that Simon’s claim was reasonably controverted.

Section 23:1201 permits penalties and attorney fees when an employer or insurer fails to reasonably controvert a workers’ compensation claim, meaning it lacks a nonfrivolous legal dispute or sufficient factual or medical information to counter the claimant’s showing.

Marjorie Lane Miller v. Christus St. Patrick Hospital · filed 2004-04-21

To determine whether the claimant’s right has been reasonably controverted, thereby precluding the imposition of penalties and attorney fees under La. R.S. 23:1201, a court must ascertain whether the employer or his insurer 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.

Section 23:1201(F)(2) allows penalties and reasonable attorney fees for unpaid benefits unless the claim was reasonably controverted or nonpayment resulted from conditions beyond the employer’s or insurer’s control.

Bradley v. ConAgra Poultry Co. · filed 2003-04-30(F)(2)

Louisiana Revised Statute 23:1201(F)(2) provides for the payment of penalties and reasonable attorney fees for nonpayment of benefits unless "the claim is reasonably controverted or ... such nonpayment results from conditions over which the employer or insurer had no control." ... "[T]o determine whether the claimant's right has been reasonably controverted, thereby precluding the imposition of penalties and attorney fees under La. R.S. 23:1201, a court must ascertain whether the employer or his insurer 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."

Subsection (F) requires penalties and attorney fees when an employer or insurer fails to timely pay benefits, unless the claim is reasonably controverted or the nonpayment resulted from conditions beyond its control.

Russell v. Snelling Personnel · filed 2003-05-09(F)

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. La. R.S. 23:1201(F); Brown v. Texas-LA Cartage, Inc., 98-1063, p. 8 (La.12/01/98), 721 So.2d 885, 890. The supreme court in Brown stated that in order to reasonably controvert a claim, the defendant must have some valid reason or evidence upon which to base his denial of benefits. Thus, to determine whether the claimant's right has been reasonably controverted, thereby precluding the imposition of penalties and attorney fees under La. R.S. 23:1201, a court must ascertain whether the employer or his insurer 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, 98-1063 at p. 9, 721 So.2d at 890.

Section 23:1201(F)(2) allows penalties and attorney fees for withheld workers’ compensation benefits unless the employee’s right to compensation was reasonably controverted.

Mitchell v. Winnfield Holding Corp. · filed 2003-12-17(F)(2)

The rule is well-settled that a workers' compensation claimant is entitled to penalties and attorney fees if benefits are withheld. To avoid the imposition of penalties and attorney fees an employee's right to compensation has to be reasonably controverted. La.R.S. 23:1201(F)(2).... [T]he proper method to calculate his AWW would be to give him credit for an eighty hour work week for the pay period ending May 16, 1993. Mr. Ben's wages were not reasonably controverted but withheld because of miscalculations and the failure of LWCC to acquire written payroll records from Cal Chlor at the time of the accident.

Section 23:1201 permits penalties and attorney fees for untimely payment of benefits unless the claim is reasonably controverted or nonpayment resulted from circumstances beyond the employer’s control.

Thibodeaux v. National Oilwell, Inc. · filed 2003-10-01

The Workers’ Compensation Act provides for the assessment of penalties and attorney fees for failure to pay benefits timely unless the claim for benefits is reasonably controverted or unless the failure to pay results from circumstances over which the employer had no control.

Subsection (F) imposes penalties and attorney fees when an employer fails to timely pay workers’ compensation benefits without reasonably controverting the claim.

Doyle v. Pepsi Bottling Group, Inc. · filed 2007-05-02(F)

Based on this evidence, we find that the trial court could have concluded that Pepsi did not reasonably controvert Doyle’s claim insofar as Doyle’s medical records indicated that the onset of pain occurred while and/or after he performed his work duties. Because the trial court found that Pepsi did not thoroughly investigate the claim before denying it, and the record supports this view, the workers’ compensation judge’s imposition of penalties and attorney’s fees was not manifestly erroneous.

Section 23:1201(F) permits penalties and reasonable attorney fees against an employer or insurer that fails to timely pay benefits unless the claim was reasonably controverted or nonpayment resulted from conditions beyond its control.

Hamilton v. Compass Group USA/Morrison · filed 2007-11-27(F)

La. R.S. 23:1201(F) provides for the assessment of a penalty and reasonable attorney fees against the employer or insurer for the failure to timely commence or timely continue paying benefits unless the claim is reasonably controverted or if the nonpayment results from conditions over which the employer or insurer had no control.

Section 23:1201(F)(2) requires an employer that denies a workers’ compensation claim to have a valid reason or evidence supporting the denial to avoid penalties and attorney fees.

Quinn v. Vidalia Apparel · filed 2010-12-08(F)(2)

The reasonably controverted standard requires the employer have some valid reason or evidence upon which to base its denial of benefits.

Section 23:1201(F)(2) requires penalties and attorney fees for untimely payment of medical benefits unless the claim is reasonably controverted or nonpayment results from conditions beyond the employer’s or insurer’s control.

Vita v. City of Lake Charles · filed 2012-12-12(F)(2)

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.” Failure to pay timely subjects the employer to penalties and attorney fees unless the claim is reasonably controverted or nonpayment results from conditions over which the employer had no control. La.R.S. 23:1201(F)(2). “A claim is reasonably controverted when the employer or insurer produces factual or medical information that reasonably counters the claimant’s evidence.” ... For these reasons, we find that the City did not reasonably controvert this claim. Therefore, we reverse the WCJ’s judgment denying Ms. Vita’s request for penalties and attorney fees and render judgment in favor of Ms. Vita assessing the City with a $2,000.00 penalty and $5,000.00 in attorney fees.

Section 23:1201(F) bars penalties and attorney fees when an employer reasonably controverts a claim by presenting a nonfrivolous legal dispute or factual or medical information that counters the claimant’s evidence.

Rogel v. Dollar General Corp. · filed 2013-12-11(F)

In general, one can surmise from the plain meaning of the words making up the phrase “reasonably controvert” that in order to reasonably controvert a claim, the defendant must have some valid reason or evidence upon which to base his denial of benefits. Thus, to determine whether the claimant’s right has been reasonably controverted, thereby precluding the imposition of penalties and attorney fees under La. R.S. 23:1201, a court must ascertain whether the employer or his insurer 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.

Section 23:1201(E) requires penalties unless the employee's right to compensation or medical benefits was reasonably controverted; reliance on the employer supervisor's testimony and the heightened burden of proof did not reasonably controvert the claim here.

Dupre v. Industrial Garment & Supply of LA · filed 1995-05-03(E)

Penalties shall be added unless the employee's right to compensation or medical benefits has been reasonably controverted. La.R.S. 23:1201(E). ... In any event, we do not find reliance on Ms. Cole's testimony concerning a prior complaint *198 of pain at Quality Manufacturing and the enhanced burden of proof in a case such as this sufficient grounds to reasonably controvert the evidence presented by Ms. Dupre. ... Thus, we affirm the award of penalties and attorney fees.

Section 23:1201(F)(2) denies statutory penalties when the employer or insurer reasonably controverts the employee's right to benefits.

Aymond v. RJ Jones & Sons · filed 1996-11-20(F)(2)

Statutory penalties are recoverable whenever an employer or insurer fails to timely pay benefits unless the employee's right has been reasonably controverted. La.R.S. 23:1201(F). ... The hearing officer then awarded penalties and attorney's fees based solely on the defendants' failure to conduct additional investigation into the claimant's true medical situation. A majority of this panel has concluded that this factual determination is not clearly wrong and has a reasonable basis in the record, especially in view of the employer's continuing duty to determine the claimant's true medical condition. Accordingly, a majority of the members of this panel conclude that the hearing officer's award of statutory penalties and attorney's fees must be affirmed.

Section 23:1201(E) requires an employer to reasonably controvert a claimant's right to compensation to avoid penalties, judged by whether it had sufficient factual and medical information to counter the claim.

Hodges v. Quail Tools, Inc. · filed 1998-03-06(E)

A workers' compensation claimant is entitled to penalties and attorney's fees if benefits are withheld or terminated arbitrarily, capriciously, or without reasonable cause by the employer. ... To avoid the imposition of penalties, an employer must reasonably controvert the claimant's right to compensation. ... The test to determine if the employer has fulfilled its duty 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.

Section 23:1201(E) imposes a penalty for untimely payment of compensation, but the penalty does not apply when the employer reasonably controverts the employee's right to benefits.

Archbold v. Maxicare Health Plans, Inc. · filed 1998-12-16(E)

Thus, penalties are assessed if compensation or medical benefits are not timely paid; however, this rule does not apply where the employer reasonably controverts the employee's right to the benefits.

Section 23:1201(F)(2) does not bar penalties and attorney fees when the employer or insurer failed to timely pay benefits and the claim was not reasonably controverted or the nonpayment was not beyond its control.

Jackson v. Quikrete Products, Inc. · filed 2002-04-17(F)(2)

An employee has the burden of proving entitlement to statutory penalties and attorney fees for the employer's failure to timely pay workers' compensation benefits. La. R.S. 23: 1201F;[4]Parfait v. Gulf Island Fabrication, Inc., supra. La. R.S. 23:1201F(2) provides for penalties and attorney fees unless the claim is "reasonably controverted." ... In the present case, the claimant's entitlement to penalties and attorney fees was not controverted by the employer and insurer pursuant to La. R.S. 23:120-1203. ... The workers' compensation judgment also awarded attorney fees. The emergency room medical report showed that Jackson sustained an injury. It was a work-related injury. The trial court was not clearly wrong in finding that the employer and insurer acted arbitrarily and capriciously in refusing to pay benefits to the claimant and refusing to allow the claimant to be examined by a physician of his choice.

Subsection (F) subjects an employer to penalties and attorney fees for failing to pay benefits and expenses required by subsections (A) through (E), unless the claim is reasonably controverted or the failure resulted from circumstances beyond the employer’s control.

Istre v. International Maintenance Co., LLP · filed 2004-02-04(F)

Under La.R.S. 23:1201(F), the employer is subject to penalties and attorney fees for the failure to pay benefits and expenses as outlined in La.R.S. 23:1201(A) through (E), unless the claim is reasonably controverted or the failure to pay results from circumstances beyond the employer’s control. ... On the record before us, we find no error in the workers’ compensation judge’s conclusion that IMC failed to reasonably controvert this claim.

Subsection (F)(2) bars penalties and attorney fees when the claim was reasonably controverted or nonpayment resulted from conditions beyond the employer’s or insurer’s control.

Strother v. Guinn Oilfield Services · filed 2004-03-03(F)(2)

An employee is not entitled to penalties and attorney fees for the employer’s failure to pay benefits timely when the employer or insurer reasonably controverted the employee’s claim for benefits, or when the nonpayment resulted from conditions over which it had no control. Thus, if the employer or insurer had a valid reason for its denial of benefits, the WCJ should assess neither penalties nor attorney fees under La.R.S. 23:1201.

Section 23:1201(F) requires penalties and attorney fees for untimely benefit payments unless the claim is reasonably controverted or nonpayment results from conditions beyond the employer’s or insurer’s control.

Allen v. Schneider National Bulk Carriers · filed 2004-10-26(F)(2)

Initially we observe that the arbitrary and capricious standard no longer applies in this context. ... In Brown, 721 So.2d at 889, the court concluded that a lesser standard is appropriate when assessing penalties and attorney fees in cases where the employer has failed to timely pay benefits, concluding that La. R.S. 23:1201 unambiguously states 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.” ... To reasonably controvert a claim, an employer must have some valid reason or evidence upon which to base the denial of benefits.

Section 23:1201(G) imposes a penalty and reasonable attorney fees when an award under a final, nonappealable judgment remains unpaid for more than thirty days, unless the nonpayment resulted from conditions beyond the employer’s control.

Halker v. American Sheet Metal · filed 2005-03-16(G)

Upon conclusion of this time period, La.R.S. 23:1201(G) provides thirty days for payment of the judgment, and also provides penalties and attorney fees for failure to pay timely. Therefore, appellant had until February 10, 2004 to pay the judgment. ... In the present case, the judgment provided all the necessary information for the appellant to determine the correct amounts owed. Therefore, based on an analysis of the facts and the jurisprudence, we believe that penalties and attorney fees are indeed warranted in this situation as the payment was completely under the appellant’s control.

Section 23:1201(F) permits penalties and attorney fees for untimely indemnity or medical benefits unless the claim is reasonably controverted or nonpayment resulted from conditions beyond the employer's control.

Russell v. Orleans Parish School Bd. · filed 2006-05-17(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). ... The phrase "reasonably controverted," mandates a different standard. In general, one can surmise from the plain meaning of the words making up the phrase "reasonably controvert" that in order to reasonably controvert a claim, the defendant must have some valid reason or evidence upon which to base his denial of benefits. Thus, to determine whether the claimant's right has been reasonably controverted, thereby precluding the imposition of penalties and attorney fees under La. R.S. 23:1201, a court must ascertain whether the employer or his insurer 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.

Section 23:1201(E) imposes a penalty for unpaid compensation or medical benefits, but the penalty does not apply when the employee’s right to payment was reasonably controverted.

Scherer v. Interior Plant Design · filed 1998-10-28(E)

We find no manifest error in the workers' compensation judge's determination that the employer presented a "reasonable controversion" of Mr. Scherer's claim and acted in a reasonable manner. The evidence presented indicates IPD was reasonable in its conversion of Mr. Scherer's benefits from TTD to SEB, as Mr. Scherer appears to be capable of engaging in employment, and, furthermore, he did not prove his incapacity by clear and convincing evidence. Additionally, although IPD did contest its responsibility for certain medical expenses, it was reasonable in doing so, as issues of causation regarding Mr. Scherer's HIV condition did exist. In summary, we affirm the workers' compensation judge's denial of penalties and attorney's fees.

Section 23:1201 is strictly construed as a penal statute, and payment penalties and attorney fees do not apply when the employer reasonably controverts the compensation claim.

Fortenberry v. CR Bard, Inc. · filed 2002-10-16(F)(2)

Because La. R.S. 23:1201 is penal in nature, we are confined to a strict and narrow construction of it in determining whether an award of a penalty is appropriate. ... In this case, Ms. Phillips did not file her Disputed Claim for Compensation with the Office of Workers' Compensation until September 25, 2000, a year after the death of Mr. Fortenberry. Further, we find Bard reasonably controverted the claim for workers' compensation in its argument that Mr. Fortenberry was out of the course and scope of his employment at the time of his death. Accordingly, we cannot say that the hearing officer was manifestly erroneous or clearly wrong in denying Ms. Phillips penalties and attorney's fees.

Subsection (F) provides for attorney-fee and penalty awards when the claim is not reasonably controverted.

Vanvliet v. Kansas · filed 2002-09-11(F)

La. R.S. 23:1201(F) provides the basis for an award of attorney’s fees and penalties. This provision, however, is inapplicable if the claim is reasonably controverted.

Section 23:1201(E) does not impose penalties when nonpayment was beyond the employer’s or insurer’s control or the employee’s right to benefits was reasonably controverted.

Westley v. Land & Offshore · filed 1988-10-12(E)

An assessment of penalties is proper for the nonpayment of compensation benefits unless the 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. La.R.S. 23:1201 E.

Section 23:1201 provides penalties when an employer or insurer denies payment and the employee's entitlement to benefits is not reasonably controverted.

Keyes v. Rockwood Ins. Co. · filed 1987-02-04

La.R.S. 23:1201 provides payment of penalties when the employer or insurer denies payment and the employee's right to such benefits is not "reasonably controverted."

When an employee’s right to workers’ compensation benefits is reasonably controverted by the employer, the penalties under § 23:1201(E) do not apply.

Gaspard v. State ex rel. Department of Revenue & Taxation · filed 1987-04-08(E)

Under La.R.S. 23:1201(E) whenever the employee’s right to worker’s compensation benefits has been reasonably controverted by the employer, the penalties set forth therein shall not apply. ... The amount of work-related stress Mr. Gaspard actually experienced was a fact reasonably in dispute in this case. ... Also, this factual dispute gave the State a basis upon which to controvert Mr. Gaspard’s claim under La.R.S. 23:1201.

Section 23:1201(E) does not impose its penalty when the employee’s right to benefits has been reasonably controverted, and the claimant bears the burden of proving entitlement to the penalty.

Breshears v. Security Guard Service, Inc. · filed 1988-12-20(E)

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. ... A claimant seeking statutory penalties has the burden of proving his entitlement thereto. Cf. Chiasson v. Lafourche Parish Council, 449 So.2d 110 (La.App. 1st Cir.1984). The trial court found there was a bona fide dispute between the parties and denied the claim for statutory penalties. After reviewing the record, we cannot say this factual finding is clearly wrong.

Section 23:1201(E) relieves an employer from penalties when disability benefits are withheld or terminated because the employee's entitlement was reasonably controverted, but it does not eliminate liability for benefits the employee proves are owed.

Steele v. Winn-Dixie Louisiana, Inc. · filed 1990-04-11(E)

Under La.R.S. 23:1201, payments for disability benefits which have been withheld or terminated by an employer because entitlement to these benefits has been reasonably controverted, relieves that employer of penalties for failure to pay. However, it does not absolve them from liability for such payments when the worker shows at trial that he is entitled to the benefits, Wills v. Solida Construction Co., 543 So.2d 1365 (La.App. 2nd Cir.1989).

Section 23:1201(F) does not impose penalties or attorney fees when the employer reasonably controverts the claim, including by litigating a close factual or legal question.

Lanoue v. All Star Chevrolet · filed 2003-11-07(F)(2)

As for the claimant's request for penalties and attorney fees pursuant to La. R.S. 23:1201(F), we find that the imposition of the same is not warranted under the facts of this case, because the claimant's request for workers' compensation benefits was reasonably controverted by All Star Chevrolet. An employer should not be liable for penalties or attorney fees for taking a close factual or legal question to court for resolution.

Section 23:1201(F)(2) bars penalties and attorney’s fees when the workers’ compensation claim is reasonably controverted.

Jenkins v. Roy O. Martin Lumber, Inc. · filed 2004-03-03(F)(2)

La.R.S. 23:1201 provides for the imposition of penalties and attorney’s fees in the event workers’ compensation benefits are not provided. La.R.S. 23:1201(F)(2) indicates, however, that the penalties and attorney’s fees “shall not apply if the claim is reasonably controverted.” ... Our review of the record confirms this absolute failure to investigate, even after information indicating that the injury was an aggravation of the previous work-related injury. Therefore, we find this assignment to be without merit.

Section 23:1201(F)(2) bars penalties and attorney fees when the employer or insurer reasonably controverts the claim or nonpayment results from conditions beyond its control.

Spells v. Extreme Nissan · filed 2004-09-01(F)(2)

Penalties and attorneys’ fees are due for failure to timely pay a claim, unless the claim “is reasonably controverted or if such nonpayment results from conditions over which the employer or insurer had no control.” La. R.S. 23:1201(F)(2). An employer is not subject to statutory penalties and attorneys’ fees if it had a “reasonable basis” to object to the payment of benefits. Angulo v. ATH Painters and Construction, Inc., 1998-2363, p. 4 (La.App. 4 Cir. 5/5/99), 733 So.2d 1222, 1227, citing Dean v. K-Mart Corp., 97-2850 (La.App. 4 Cir. 7/29/98), 720 So.2d 349. The fact that an employer refuses to pay workers’ compensation benefits when it denies liability does not warrant the imposition of penalties and attorneys’ fees, even if the facts adduced at trial show that the employer was liable. Id. We believe reasonable cause existed for nonpayment. We note especially the fact that there was a serious dispute between the parties as to the application of the law regarding independent contractors. We further note that the trial judge denied appellants benefits and dismissed their suit on the basis that Aaron Spells was an independent contractor. Under these circumstances we cannot say that the failure to pay is “arbitrary, capricious, or without probable cause.” As such, we find that the trial judge did not err in refusing to award penalties and attorneys’ fees.

Section 23:1201 precludes penalties and attorney fees when the employer or insurer reasonably controverts the claimant’s right by presenting a nonfrivolous legal dispute or factual or medical information that reasonably counters the claim.

Doumite v. Kvhp - Fox 29 · filed 2004-10-20

[T]o determine whether the claimant’s right has been reasonably controverted, thereby precluding the imposition of penalties and attorney fees under La. R.S. 23:1201, a court must ascertain whether the employer or his insurer 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.

Section 23:1201(F) requires penalties and attorney fees for failure to timely pay benefits unless the claim was reasonably controverted; whether the claim was reasonably controverted is a factual question focused on whether the employer had an objective reason to deny benefits.

Autin v. Wal-Mart · filed 2004-10-29(F)

Louisiana Revised Statute 23:1201(F) establishes that penalties and attorney fees for failure to timely pay benefits shall be assessed unless the claim is reasonably controverted. We conclude that the WCC did not err in finding that Wal-Mart failed to reasonably controvert the claim. The Louisiana Supreme Court made it perfectly clear that in a workers’ compensation action, the determination of whether an employer should be cast with penalties -and attorney fees is a question of fact. Authement v. Shappert Engineering, 02-1631, p. 12 (La.2/25/03), 840 So.2d 1181, 1188. The crucial inquiry in making this determination is whether.the employer Chad an objective reason to deny benefits. Id.

Section 23:1201 makes penalties and attorney fees unavailable when nonpayment is reasonably controverted or results from conditions beyond the employer's or insurer's control, and the version in effect when benefits were withheld governs.

McGuyer v. Fidelity & Cas. Co. of NY · filed 2005-03-02(F)(2)

On this record, the claim for the bed was reasonably controverted and the WCJ's decision denying penalties and attorney fees is not clearly wrong.

Paragraph F permits penalties and attorney fees for failure to provide payment unless the employer or insurer reasonably controverts the claim.

Young v. Christus Schumpert Medical Center · filed 2005-05-11(F)

Under either standard, the WCJ did not abuse his discretion in denying penalties and attorney fees. At the very least, Schumpert reasonably controverted Young's demand for complete reimbursement. The legal dispute was not frivolous as the jurisprudence in this circuit and elsewhere was not dispositive of the issue.

Section 23:1201 precludes penalties and attorney fees when an employer reasonably controverts a workers’ compensation claim by asserting a non-frivolous legal dispute or possessing factual or medical information that reasonably counters the claimant’s evidence.

Bordelon v. Cox Communications · filed 2005-05-31

When an employer has failed to pay benefits, the proper standard for review of that decision is whether the employer reasonably controverted the claim. Brown v. Texas-LA Cartage, Inc., 98-1063 (La.12/1/98), 721 So.2d 885. A claim for workers’ compensation is reasonably controverted if the employer has some valid reason or evidence upon which to base his denial of benefits. Thus, to determine whether the claimant’s right to benefits has been reasonably controverted, thereby precluding the imposition of penalties and attorney fees under La. R.S. 23:1201, a court must ascertain whether the employer or his insurer 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 he refused to pay all or part of the benefits allegedly owed. Brown v. Texas-LA Cartage, Inc., supra. Although the Workers’ Compensation Act is to be liberally construed in regard to benefits, penal statutes, such as the statutes awarding penalties and attorney fees, are to be strictly construed. Williams v. Rush Masonry, Inc., 98-2271 (La.6/29/99), 737 So.2d 41.

Section 23:1201(F) permits penalties and attorney fees for an employer’s failure to authorize an employee’s requested medical treatment, unless the claim is reasonably controverted under subsection (F)(2).

Nelson v. Windmill Nursery of Louisiana · filed 2005-09-23(F), (F)(2)

Based upon the clear language of the statute, a penalty and attorney fee can be imposed for this failure to authorize treatment except where the claim is reasonably controverted. ... Therefore, LSA-R.S. 23:1201 F(2) is inapplicable to exclude the penalties under LSA-R.S. 23:1201 F.

Section 23:1201(F) requires penalties and attorney fees for untimely payment of benefits unless the claim was reasonably controverted or nonpayment resulted from circumstances beyond the employer's or insurer's control.

Romero v. Garan's, Inc. · filed 2006-04-19(F)

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. La.R.S. 23:1201(F); Brown v. Texas-LA Cartage, Inc., 98-1063 (La.12/01/98), 721 So.2d 885. ... Although we do find that Romero's back treatment is compensable, there was a serious question and issue of causation relative to her back problem which we find was reasonably controverted by Garan.

Section 23:1201(F)(2) excuses mandatory penalties when the employer reasonably controverts the employee’s claim, while subsection F provides for penalties and attorney fees when benefits are not paid as required.

Miller v. Christus St. Patrick Hospital · filed 2012-10-24(F)(2)

Subsection F of that statute mandates that a penalty be assessed when payment is not provided in accordance with the other subparts and allows for attorney fees to be assessed as well. An employer can escape the mandatory penalties only when it reasonably controverts the employee‘s claim. La.R.S. 23:1201(F)(2).

Section 23:1201 bars penalties and attorney fees when the employer or insurer reasonably controverts the claim through a nonfrivolous legal dispute or factual or medical information that counters the claimant’s evidence.

Joseph v. JE Merit Constructors, Inc. · filed 2002-06-21

Thus, to determine whether the claimant's right has been reasonably controverted, thereby precluding the imposition of penalties and attorney fees under La. R.S. 23:1201, a court must ascertain whether the employer or his insurer 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. Medical evidence, in the form of Dr. Kilroy's medical reports and deposition testimony, in addition to Ms. Joseph's failure to disclose the alleged injuries to her shoulder and neck to the doctors at OLOL, Dr. Kilroy or initially to Dr. Rauchwerk, constitutes factual and medical information that reasonably counters that presented by Ms. Joseph.

Section 23:1201 bars penalties when the employee's entitlement to compensation benefits was reasonably controverted; otherwise, penalties may attach for untimely payment after the employer or insurer knew of a compensable injury.

Frazier v. Conagra, Inc. · filed 1989-11-01

La.R.S. 23:1201 provides, in pertinent part, that whenever the employee's right to compensation benefits has been reasonably controverted by the employer or his insurer, the penalties shall not apply. Under La.R.S. 23:1201 if the nonpayment 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 will attach if payment of said benefits is not timely after the employer or its insurer had knowledge of a compensable injury. 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?

Section 23:1201(E) permits statutory penalties when an employer fails to pay or terminates workers' compensation benefits without a reasonably controverted basis.

Anthony v. Georgia Pacific Corp. · filed 1991-10-18(E)

As to Georgia-Pacific's third assignment of error, the assessment of penalties for non-payment of benefits is governed by La.R.S. 23:1201(E). Georgia-Pacific relies on the "reasonably controverted" language of this section in arguing that the trial court abused its discretion in awarding penalties. ... Given these letters, we cannot find that the trial judge abused his discretion, in rejecting Georgia-Pacific's "reliance" on any reports in its possession, and, in awarding penalties against Georgia-Pacific. ... Further, the defendant knew, by medical information in its possession, that Anthony was at least partially disabled and has never denied this. The courts have repeatedly held that there is no justification for terminating benefits where the employer has such knowledge and information. ... Accordingly, we find no abuse of discretion in the trial court's assessment of statutory penalties.

Section 23:1201(E) avoids penalties when the employer or insurer shows that nonpayment resulted from conditions beyond its control or reasonably controverted the employee's right to benefits.

Crowley v. City of Lafayette · filed 1992-06-26(E)

The award of statutory penalties in worker's compensation cases is governed by La.R.S. 23:1201(B, E). In order to avoid an award of penalties, the employer must demonstrate that non-payment resulted from conditions over which it or the insurer had no control, or that it or the insurer has reasonably controverted the right to benefits. La.R.S. 23:1201(E). The employee's right to such benefits will be deemed reasonably controverted if the employer or insurer had a reasonable basis for believing that medical expenses and compensation benefits were not due the employee. Guidry v. United Furniture Distributors, 544 So.2d 100 (La.App. 3d Cir.1989). The question of whether amended La.R.S. 23:1103 should be applied retroactively, thus, allowing the City a credit for future worker's compensation regardless of the itemization of the award to Crowley, is a reasonable basis for the City to refuse payment of compensation benefits to Crowley. Thus, we conclude the trial court erred in assessing penalties against the City.

Section 23:1201(F)(2) does not impose late-payment penalties when the claim is reasonably controverted or nonpayment results from conditions beyond the employer's or insurer's control.

Sneed v. RTA/TMSEL · filed 2004-02-25(F)(2)

We conclude that the defendant paid all outstanding medical bills in a timely manner.

Section 23:1201(F)(2) bars penalties and attorney fees when the employer or insurer reasonably controverts the claim, judged by whether the known factual and medical information provided a reasonable basis to believe benefits were not due.

Goodman v. Manno Electric, Inc. · filed 2002-11-08(F)(2)

Penalties are not to be assessed when the employee's right to such benefits has been reasonably controverted by the employer or insurer. ... 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. ... Manno knew of the shoveling incident that occurred while Goodman was employed with Manno, prior to Goodman's filing of the disputed claim for compensation. Based on this fact, the WCJ concluded that Manno did not reasonably controvert Goodman's claim for indemnity and medical benefits. We find no error with the WCJ's conclusion.

Section 23:1201(E) excuses penalties when nonpayment results from circumstances beyond the employer's control or when the right to benefits has been reasonably controverted.

Cormier v. Lafayette Parish School Bd. · filed 1987-06-03(E)

The assessment of penalties is proper under the 1983 revision of the worker's compensation laws when the insurer does not have a reasonable basis to believe that medical expenses and compensation are not due and fails to pay the first installments of compensation fourteen days after the employer knows of the injury and resulting loss of income. ... The assessment of penalties will be made under the aforementioned circumstances unless the employer failed to pay the benefits because of circumstances beyond his control or because the right to benefits has been reasonably controverted. La.R.S. 23:1201(E). ... Defendant, in good faith, refused plaintiff the benefits. We will not penalize defendant under these circumstances and find that defendant had a reasonable basis to believe that compensation was not due to plaintiff. As such, we affirm the portion of the trial court judgment denying plaintiff penalties.

Section 23:1201 bars penalties and attorney fees when the employer or insurer reasonably controverts the claimant’s right to benefits through a nonfrivolous legal dispute or countervailing factual or medical information.

McCall v. Wal-Mart Stores, Inc. · filed 2003-03-05

To determine whether the claimant's right has been reasonably controverted, thereby precluding the imposition of penalties and attorney fees under La. R.S. 23:1201, a court must ascertain whether the employer or his insurer 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.

Section 23:1201(F)(2) permits reasonable controversion only when the employer has sufficient factual and medical information to justify denying benefits.

Benandi v. Louisiana Pacific Corp. · filed 2000-05-03(F)(2)

The record unmistakably shows there was no medical evidence to reasonably controvert Benandi’s right to medical benefits.

Section 23:1201(F)(2) permits reasonable controversion only when the employer has sufficient factual or medical information to counter the employee’s claim.

Landry v. Physicians Practice Management · filed 2001-04-04(F)(2)

A claim is reasonably controverted if the employer has sufficient factual or medical information to reasonably counter the factual and medical information presented by the employee.

Section 23:1201 requires penalties and attorney fees for untimely benefit payments unless the claim was reasonably controverted by a nonfrivolous dispute or sufficient factual or medical information.

Holley v. Tate & Lyle · filed 2001-08-15(F)

Thus, to determine whether the claimant’s right has been reasonably controverted, thereby precluding the imposition of penalties and attorney fees under La. R.S. 23:1201, a court must ascertain whether the employer or his insurer 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.

Section 23:1201(E) is penal in nature and must therefore be strictly construed.

Terro v. WMCO, INC. · filed 1993-05-05(E)

The cited statutes are penal in nature and must be strictly construed.

Section 23:1201(E) requires an employer to avoid penalties by showing that nonpayment resulted from conditions beyond its control or that it reasonably controverted the benefits claim, while § 23:1201(B) makes the first installment of specified disability or death compensation due 14 days after the employer or insurer knows of the injury or death.

Gaspard v. Dresser Industrial Valve of Dresser Industries, Inc. · filed 1989-04-19(E), (B)

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 or insurer has knowledge of the injury or death, on which date all such compensation then due shall be paid.

Section 23:1201(F) imposes penalties for untimely workers’ compensation payments unless the employer or insurer reasonably controverted the claimant’s entitlement or nonpayment resulted from circumstances beyond its control.

Arnold v. Wal-Mart · filed 2003-11-05(F)

Based upon our examination of the record, we find that the workers’ compensation judge erred in employing the “arbitrary and capricious” standard in his evaluation of Mr. Arnold’s claims. ... In our opinion, this $200 in benefits was paid late, thereby triggering La.R.S. 23:1201 and the “reasonably controverted” standard. ... Accordingly, we remand the portion of this matter related to the two insufficient payments to the Office of Workers’ Compensation for calculation of penalties pursuant to La.R.S. 23:1201(F).

Section 23:1201(F) permits penalties and attorney's fees for untimely indemnity or medical benefits unless the claim is reasonably controverted or nonpayment resulted from conditions beyond the employer's control; reasonable controversion requires a valid reason or evidence supporting denial.

Blanchard v. Rental Service Corp., USA · filed 2006-02-21(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.

Penalties and attorney fees are precluded only when the employer or insurer has factual or medical information that reasonably counters the claimant’s information throughout the period it refuses to pay benefits.

Jackson v. St. Francis Cabrini Hospital · filed 2006-02-01

“[T]o determine whether the claimant’s right has been reasonably controverted, thereby precluding the imposition of penalties and attorney fees under La. R.S. 23:1201, a court must ascertain whether the employer or his insurer . . . 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.”

Subsection (F) places on a workers’ compensation claimant the burden of proving entitlement to statutory penalties for an employer’s refusal or failure to timely pay benefits.

James B. Doyle, Jr. v. Pepsi Bottling Group, Inc. · filed 2007-05-02(F)

“Under La.R.S. 23:1201(F),6 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.”

Subsection (F)(2) avoids penalties for nonpayment only when the claim is reasonably controverted, which requires a valid reason or evidence supporting denial of benefits.

Porter v. Pellerin Construction Co. · filed 2007-04-11(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.

Section 23:1201(F)(2) bars penalties and attorney fees when an employer or insurer reasonably controverts a workers' compensation claim, meaning it has factual or medical information, or a non-frivolous legal dispute, that reasonably counters the claimant's evidence.

Brown v. Guide Corporation · filed 2007-05-09(F)(2)

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. ... The court must determine whether the employer "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 he refused to pay all or part of the benefits allegedly owed." ... We agree with the WCJ that the "short period between claimant's commencement of employment and her symptoms provides defendant with a reasonable basis to deny her claim." Guide's denial was not frivolous and we find no evidence of a lack of good faith and just cause in its actions.

Section 23:1201(F)(2) authorizes penalties and attorney fees when an employer or insurer fails to reasonably controvert a workers’ compensation claim.

Chassion v. Cingular Wireless · filed 2006-11-02(F)(2)

In its second assignment or error, Cingular argues that the WCJ erred in awarding penalties and attorney fees, contending that it reasonably controverted the claim under La.R.S. 23:1201(F)(2) by hiring Dr. Hutcheson to perform an ergonomic analysis. ... We find no error in this reasoning, given the emphasis that the jurisprudence places on medical evidence in occupational disease cases. Accordingly, the award of penalties and attorney fees is affirmed.

Subsection (F) imposes penalties and attorney fees for untimely workers’ compensation payments unless the employer reasonably controverts the claim with an articulable and objective reason to deny benefits.

Baca v. Natchitoches Parish Hospital · filed 2007-02-07(F)

Under La.R.S. 23:1201(F)[1], 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. The employer must have an “articulable and objective reason to deny benefits at the time it took the action.” ... Nonetheless, Dr. Goodman’s answer to the questionnaire and the notation in Baca’s medical records that Baca’s injury resulted from playing volleyball, gave the Hospital an “articulable and objective reason to deny benefits at the time it took the action.” Landry, 920 So.2d at 311 (quoting Authement v. Shappert Eng., 02-1631 (La. 2/25/03), 840 So.2d 1181, 1188). Therefore, we find no manifest error in the workers’ compensation judge’s determination that the Hospital reasonably controverted Baca’s claim and that the assessment of penalties and attorney’s fees for the failure to pay Baca’s medical bills was unwarranted.

Section 23:1201(F) subjects an employer to penalties and attorney fees when it fails to reasonably controvert an employee’s claim.

Wilczewski v. Brookshire Grocery Store · filed 2009-01-28(F)

An employer is subject to penalties and attorney’s fees should it fail to reasonably controvert an employee’s claim.

Section 23:1201(F) requires penalties for late workers’ compensation payments unless the employee’s entitlement was reasonably controverted or nonpayment resulted from conditions beyond the employer’s or insurer’s control.

Arnold v. Wal-Mart Stores, Inc. · filed 2003-11-05(F)

Based upon our examination of the record, we find that the workers' compensation judge erred in employing the "arbitrary and capricious" standard in his evaluation of Mr. Arnold's claims. The record indicates that on two occasions, Mr. Arnold's compensation checks were $100 short, and, within a month of these occurrences, when the mistake was brought to Wal-Mart's attention, it immediately mailed Mr. Arnold a check for the difference. In our opinion, this $200 in benefits was paid late, thereby triggering La.R.S. 23:1201 and the "reasonably controverted" standard. It is clear from the record that Mr. Arnold received regular benefits checks, and, as such, they were never "discontinued."

Section 23:1201(F) requires penalties and reasonable attorney fees for untimely payment of benefits unless the claim is reasonably controverted or nonpayment resulted from conditions beyond the employer’s or insurer’s control.

Thomason v. Wal-Mart Stores, Inc. · filed 2003-09-04(F)

La. R.S. 23:1201(F) provides for the assessment of a penalty and reasonable attorney fees against the employer or insurer for the failure to timely commence or timely continue paying benefits unless the claim is reasonably controverted or if the nonpayment results from conditions over which the employer or insurer had no control. La. R.S. 23:1201.2 provides for an assessment of attorney fees when an employer or insurer discontinues payments and the discontinuance was arbitrary, capricious, or without probable cause. See, generally, Williams v. Rush Masonry, 98-2271 (La.6/29/99), 737 So.2d 41, ... The unambiguous language of La. R.S. 23:1201 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. Unreasonably controverting a claim, which is the exception at issue in this case, requires action of a less egregious nature than that required for arbitrary and capricious behavior. Arbitrary and capricious behavior consists of willful and unreasoning action, without consideration and regard for facts and circumstances presented, or of seemingly unfounded motivation. Stated another way, such behavior arises from unrestrained exercise of the will or personal preference or lacks a predictable pattern. The phrase "reasonably controverted," on the other hand, mandates a different standard. In general, one can surmise from the plain meaning of the words making up the phrase "reasonably controvert" that in order to reasonably controvert a claim, the defendant must have some valid reason or evidence upon which to base his denial of benefits. Thus, to determine whether the claimant's right has been reasonably controverted, thereby precluding the imposition of penalties and attorney fees under La. R.S. 23:1201, a court must ascertain whether the employer or his insurer 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.

Section 23:1201(F) allows penalties and attorney fees for untimely benefit payments unless the employer reasonably controverts the claim, and subsection (F)(2) exempts a reasonably controverted claim.

Body Masters v. Fontenot · filed 2004-02-04(F)(2)

Louisiana Revised Statute 23:1201(F) provides that if benefits are not paid timely, penalties and attorney fees may be awarded, unless the claim is reasonably controverted. Louisiana Revised Statute 23:1201.2 provides for payment of penalties and attorney fees if benefits are discontinued, if such discontinuance is found to be “arbitrary, capricious, or without probable cause.” Since this case does not involve any discontinuance of benefits, but payment for a surgical procedure, we will analyze this case under La.R.S. 23:1201(F). ... Under La.R.S. 23:1201(F)(2), an employer will not be liable for penalties and attorney fees if the claim is reasonably controverted. ... The test to determine if an employer has reasonably controverted a claim for workers’ compensation benefits is whether the employer has sufficient factual and medical information to counter the claimant’s factual and medical information. ... Dr. Goldware’s opinion is sufficient to reasonably controvert the claim. Therefore, attorney fees are not payable under La.R.S. 23:1201(F).

Section 23:1201's penalty and attorney's-fee provisions are penal and strictly construed; penalties and fees are unavailable when the claim is reasonably controverted based on a valid, articulable, objective reason supported by an adequate investigation.

Crowson v. L & D Community Care · filed 2002-05-08

The penalty and attorney’s fee provisions of La.R.S. 23:1201 are penal in nature, and therefore, must be strictly construed.5 Under the statute, penalties and attorney’s fees are not owed if the claim is reasonably controverted. For this to occur, the “defendant must have some valid reason or evidence upon which to base his denial of benefits.”6 Furthermore, the employer must adequately investigate the claim and have both an articulable and objective reason for denying or discontinuing benefits.

Section 23:1201(E) does not support penalties when the employer's termination of compensation was reasonably controverted.

Champagne v. Martin Mills, Inc. · filed 1992-11-04(E)

Although the trial court determined that any benefit received by Champagne from the store, as co-owner, was not to be considered income, we do not find Martin Mills's action in terminating Champagne's compensation benefits, based upon its knowledge of plaintiff's co-ownership, arbitrary, capricious, or without probable cause. We find that Champagne's employment capability was reasonably controverted and find no error in the trial court's denial of penalties and attorney's fees. See La.R.S. 23:1201 E; La.R.S. 23:1201.2.

Section 23:1201(E) does not support penalties and attorney's fees when the employer reasonably controverted the claim based on the available medical evidence.

Garnier v. Orleans Parish School Bd. · filed 2002-07-31(E)

We likewise find unpersuasive Ms. Garnier's final argument that the WCJ erred in denying her request for attorney's fees and penalties pursuant to La. R.S. 23:1201(E) and/or R.S. 23:1201.2. Ms. Garnier cannot prevail under La. R.S. 23:1201(E) given the employer reasonably controverted her claim based on the evidence it had that her own physician had released her to return to work and that several health care providers had opined that she was exaggerating her symptoms.

Section 23:1201(F) authorizes penalties and attorney’s fees for untimely commencement of benefits unless the claim is reasonably controverted, while § 23:1201 addresses the timeliness of commencing and continuing benefit payments rather than their discontinuation.

Alphonso v. Bridge Terminal Transport · filed 2003-07-09(F)

In instances where the employer fails to commence payment of benefits, penalties and attorney’s fees are authorized under La. R.S. 23:1201 F, unless the claim is reasonably controverted. ... However, because the instant case involves discontinuation of benefits rather than failure to provide benefits, La. R.S. 23:1201.2, not La.R.S. 23:1201 F, applies.

Section 23:1201(F) applies when an employer or insurer fails to commence or timely pay workers' compensation benefits, and permits recovery of both penalties and attorney fees.

Killett v. Sanderson Farms · filed 2002-05-10(F)

In Williams v. Rush Masonry, Inc., 98-2271 (La.6/29/99), 737 So.2d 41, the Louisiana Supreme Court stated that La. R.S. 23:1201.2 applies only when an insurer or employer arbitrarily discontinues payment of benefits; La. R.S. 23:1201(F) applies only when there has been a failure to commence or pay benefits timely. ... The distinction drawn in the Williams case is significant because both penalties and attorney fees are recoverable under La. R.S. 23:1201(F), whereas only attorney fees are recoverable under La. R.S. 23:1201.2. Id. ... In the instant case, Ms. Killett does not argue that payments were not commenced or paid in a timely fashion. She received disability benefits until it was determined that she had carpal tunnel syndrome. The subsequent termination of her benefits is a discontinuance.

Section 23:1201(E) permits penalties and attorney's fees when an employer arbitrarily, capriciously, and without probable cause denies workers' compensation coverage, but denies them when the employer reasonably controverts the claim.

Savoy v. Cameron Parish School Bd. · filed 1988-02-03(E)

Under La.R.S. 23:1201(E) and 1201.2 penalties and attorney's fees are to be awarded to the claimant who is denied worker's compensation coverage when such denial was arbitrary, capricious and without probable cause. When an employer or his insurer reasonably controverts the claimant's right to worker's compensation benefits, the penalties and attorney's fees shall be denied.

Section 23:1201 authorizes penalties and attorney’s fees when an employer or insurer arbitrarily, capriciously, or without probable cause denies compensation benefits, but they are unavailable when the denial has a rational basis.

Hanover Ins. Co. v. Allstate Ins. Co. · filed 1989-11-15

La.R.S. 23:1201 and La.R.S. 23:1201.2 authorize the imposition of penalties and attorney's fees against an employer or insurer who arbitrarily, capriciously or without probable cause denies compensation benefits. The claimant is not entitled to penalties and attorney's fees if there exists a rational basis for an employer and its insurer to decline to pay benefits. ... We reverse the awards. Hanover was justified in refusing to pay benefits following the December 20, 1986, settlement by Woodruff without its consent thereto. Because Woodruff did not attempt to buy back his right to future compensation prior to instituting this suit, Hanover acted reasonably in terminating benefits and cannot therefore be cast with penalties and attorney's fees.

Section 23:1201 authorizes statutory penalties when an insurer fails to reasonably controvert the claimant's right to workers’ compensation benefits.

Domingue v. Hartford Ins. Co. · filed 1990-10-03

Statutory penalties were awarded under La.R.S. 23:1201 on the ground that the insurer did not reasonably controvert the claimant's right to benefits. Attorney's fees were awarded under La.R.S. 23:1201.2, based upon a finding that the conduct of the insurer was arbitrary and capricious. These findings were not manifestly wrong. See Aguillard v. Industrial Const. Co., Inc., 542 So.2d 774 (La.App. 3rd Cir.1989). We find no error in the award of penalties and attorney's fees.

Section 23:1201(E) authorizes penalties and attorney's fees when an employer or insurer arbitrarily and capriciously withholds workers' compensation benefits without reasonably controverting the claim.

Shelvin v. Waste Management, Inc. · filed 1991-05-22(E)

Waste Management and American Motorists contend the trial court erred in assessing them with penalties and attorney's fees under La.R.S. 23:1201 E and La.R.S. 23:1201.2. ... We find this "auditor's report" was not sufficient to reasonably controvert Shelvin's claim. Furthermore, we consider American Motorists' reliance upon the "auditor's report," when confronted with what the trial court termed "clear and convincing medical evidence" in Shelvin's favor, constitutes arbitrary and capricious conduct.

Section 23:1201 permits penalties and attorney's fees when an insurer arbitrarily and capriciously fails to pay compensation claims, but its penal provisions are strictly construed.

Landry v. Central Industries, Inc. · filed 1991-12-18

Under La.R.S. 23:1201 and 23:1201.2, an insurer who arbitrarily and capriciously fails to pay compensation claims may be liable for penalties and attorney's fees. However, these statutes are penal in nature and must be strictly construed so that employers are not penalized for taking close factual questions to court for resolution, and for relying on valid defenses. ... A worker is not entitled to statutory penalties and attorney's fees in a worker's compensation case where his employer relied upon competent medical advice in making the decision not to guarantee the payment of a recommended medical treatment. ... Guillory relied upon the competent medical advice of Dr. McDaniel to deny payment for both the PAC Program and the discogram. We cannot say that this reliance was arbitrary and capricious.