La. Stat. Ann. § 23:1201

Section 1201(F) penalizes an employer for failing to consent to an employee’s selection or change of treating physician when consent is required by § 23:1121, not merely for failing to authorize a specialist; an actual physician selection must be made.

Jeffers v. Kentucky Fried Chicken · filed 2009-04-01(F)

This is in keeping with the statutory scheme. La.R.S. 23:1201(F) imposes a penalty for the failure of the employer “to consent to the employee’s request to select a treating physician or change physicians when such consent is required by R.S. 23:1121.” Section 1201 does not impose a penalty for failing to authorize a specialist, but rather for failing to consent to the employee’s selection of a treating physician. For the employer to fail to consent to the employee’s selection of a treating physician, it stands to reason that an actual selection must be made. Consent for an initial treating physician of a given specialty is not required by La.R.S. 23:1121. See Apeck Constr., Inc. v. Bowers, 03-486 (La.App. 3 Cir. 12/10/03), 862 So.2d 1087, writ denied, 04-459 (La. 4/23/04), 870 So.2d 301.

Section 23:1201(F) permits penalties and attorney fees when an employer fails to consent to an employee’s request to select or change a treating physician when consent is required under § 23:1121, including when the request is resolved through an expedited summary proceeding.

Scott v. Packaging Corporation of America · filed 2018-07-05(F)

Furthermore, pursuant to La.R.S. 23:1201(F), penalties and attorney‟s fees may be imposed “for failure to consent to the employee‟s request to select a treating physician or change physicians when such consent is required by [La.]R.S. 23:1121.” Youngblood v. Covenant Sec. SVC, LLC, 11-2382, p. 12 (La.App. 1 Cir. 12/21/12), 112 So.3d 233, 241, writ denied, 13-0200 (La. 3/8/13), 109 So.3d 363. ... Accordingly, we find that the WCJ did not err in denying PCA‟s exception of unauthorized use of summary proceedings.

Section 23:1201(F) allows penalties and attorney fees for unpaid benefits, but § 23:1201(F)(2) bars them when the employer or insurer reasonably controverts the claim.

Ledford v. New Orleans Saints · filed 2009-04-29(F), (F)(2)

La. R.S. 23:1201(F) provides for assessment of a penalty and attorney fees where the employer or insurer has refused or failed to pay benefits due. However, the penalty and attorney fees do not apply if the claim is reasonably controverted. La. R.S. 23:1201(F)(2). 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) avoids penalties and attorney fees when an employer or insurer reasonably controverts the claim, meaning it has some valid reason or evidence for denying benefits.

J.P. Morgan Chase v. Louis · filed 2009-05-13(F)(2)

Failure to provide payment of benefits will result in a penalty and attorney fee “unless the claim is reasonably controverted or if such nonpayment results from conditions over which the employer or insurer had no control.” ... The phrase “reasonably controvert” means that the defendant must have “some valid reason or evidence on which to base his denial of benefits.” ... On close review, we are constrained to find that Chase reasonably controverted this claim by providing a bona fide dispute as to Ms. Louis’s entitlement to benefits. ... Chase offered factual and medical evidence commensurate with Ms. Louis’s showing; in so doing, it reasonably controverted the claim under R.S. 23:1201 F(2) and negated the penalty and attorney fee.

Section 23:1201(F)(2) provides that penalties and attorney fees are not warranted when a workers’ compensation claim is reasonably controverted.

McCallister v. Fabricators · filed 2011-09-14(F)(2)

Regarding Mr. McCallister’s argument that the workers compensation judge erred in failing to award penalties and attorney fees for the benefits found to be due, we find no manifest error in the workers compensation judge finding that the claim for benefits was reasonably controverted, such that penalties and attorney fees were not warranted, in accordance with La. R.S. 23:1201 F(2).

Section 23:1201(F)(2) subjects an employer to penalties and attorney fees for untimely payment unless the claim is reasonably controverted or nonpayment resulted from conditions beyond the employer’s control.

Creole Steel, Inc. v. Stewart · filed 2012-03-07(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.” Bourgeois v. Brown’s Deli & Mkt., Inc., 09-290, p. 7 (La.App. 3 Cir. 10/14/09), 21 So.3d 1072, 1077. A WCJ’s decision on whether to award penalties and attorney fees is subject to great discretion which will not be disturbed absent an abuse of discretion. Briscoe v. McNeese State Univ., 11-872 (La.App. 3 Cir. 12/7/11), ___ So.3d ___.

Section 23:1201 permits attorney-fee awards in workers’ compensation matters, but an award is not warranted when the claim is reasonably controverted.

Noe v. Basile Police Department · filed 2012-11-07

In this case, although Mr. Noe successfully prosecuted his appeal, we find that the employer reasonably controverted his claim and that Mr. Noe would not be entitled to attorney fees under La.R.S. 23:1201. Accordingly, we decline to award attorney fees for work done on appeal.

Section 23:1201(F)(2) bars penalties and attorney fees when a claim is reasonably controverted, but permits them when the employer's failure to pay is not justified by a reasonable investigation.

Bordelon v. Key Energy Services, LLC · filed 2014-05-07(F)(2)

Except as otherwise provided in this Chapter, failure to provide payment in accordance with this Section . . . shall result in the assessment of a penalty in an amount up to the greater of twelve percent of any unpaid compensation or medical benefits, or fifty dollars per calendar day for each day in which any and all compensation or medical benefits remain unpaid or such consent is withheld, together with reasonable attorney fees for each disputed claim; however, the fifty dollars per calendar day penalty shall not exceed a maximum of two thousand dollars in the aggregate for any claim . . . . ... (2) This Subsection shall not apply if the claim is reasonably controverted or if such nonpayment results from conditions over which the employer or insurer had no control. ... Because the defendant did not reasonably controvert this claim, attorney’s fees and penalties are appropriate. ... Simply, Key Energy had a positive drug screen and relied upon that drug screen exclusively. Given the surrounding circumstances as permissibly determined by the workers’ compensation judge, we find no manifest error in its imposition of penalties and attorney fees.

Section 23:1201(f) allows penalties and attorney’s fees when an employer fails to pay or authorize workers’ compensation benefits unless the claim is reasonably controverted.

Villatoro v. Deep South BH & R Enterprises, LLC · filed 2016-12-07(f)

Under La. R.S. 23:1201(f), an employer may be liable for penalties and attorney’s fees for his failure to authorize medical treatment except where the claim is reasonably controverted. ... We find that the factual information presented by defendants in this case establish that they had a reasonable basis to believe that compensation benefits were not due to Ms. Villatoro. Under these circumstances, we find that the claim was reasonably controverted, and thus the workers’ compensation judge erred in assessing penalties and attorney’s fees on this issue. We accordingly reverse the judgment insofar as it awards Ms. Villatoro penalties and attorney’s fees for defendants’ failure to pay indemnity benefits and medical expenses to her.

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

Henderson v. Pavy · filed 1996-05-15(F)(2)

However, penalties and attorney's fees cannot be assessed when the claim is reasonably controverted. La.R.S. 23:1201(F)(2).

Section 23:1201(E) permits statutory penalties for untimely benefit payments unless the employee's right to benefits was reasonably controverted.

Alleman v. Fruit of the Loom-Crowley · filed 1997-03-05(E)

A claimant may recover statutory penalties if an employer fails to timely pay benefits unless the employee's right to those benefits has been reasonably controverted. ... We conclude that the hearing officer was not clearly wrong in determining that the need for benefits was reasonably controverted. In light of Miniex' testimony that the claimant did not present a work release and that the initial report from Dr. Marx did not indicate that the claimant could not work, we find that the defendant's delay in providing benefits was reasonable.

Section 23:1201(F)(2) requires a determination that the employer or insurer acted arbitrarily and capriciously and that the claim was not reasonably controverted before attorney’s fees may be awarded.

Executive Chiropractic Services v. Louisiana Workers' Compensation Corp. · filed 1999-01-27(F)(2)

... the trial court erred when it awarded attorney’s fees, without a determination that the actions of LWCC were arbitrary and capricious and the claims were not reasonably controverted. ... La.R.S. 23:1201(F)(2).

Subsection F(2) exempts an employer or insurer from penalties when the claim is reasonably controverted or nonpayment results from conditions outside its control.

Jackson v. Domtar Industries, Inc. · filed 1999-04-07(F)(2)

F. Failure to provide payment in accordance with this Section shall result in the assessment of a penalty in an amount equal to twelve percent of any unpaid compensation or medical benefits or fifty dollars per calendar day, whichever is greater, for each day in which any and all compensation or medical benefits remain unpaid.... (2) This Subsection shall not apply if the claim is reasonably controverted or if such nonpayment results from conditions over which the employer or insurer had no control.... Regarding the issue of penalties, the reasonableness of Defendant's controversion of Plaintiff's claim turns on whether, at the time Plaintiff's benefits were reduced, it possessed factual or medical information sufficient to "reasonably counter" that presented by Plaintiff.... Based upon the physician's releases previously discussed, coupled with the jobs it tendered to Plaintiff, we find that it did possess such information. Accordingly, we find no error in the workers' compensation judge's decision against awarding penalties.

Section 23:1201(F) imposes penalties and attorney fees for unpaid compensation, but § 23:1201(F)(2) exempts an employer or insurer that reasonably controverts the claim or lacks control over the nonpayment.

Leger v. A-1 Nursing Registry · filed 1999-04-28(F), (F)(2)

In order for Defendants to not have to pay penalties and attorney fees they must have "reasonably controverted" the claim as required in LSA-R.S. 23:1201(F)(2). ... Defendants' evidence does not reasonably controvert Plaintiff's claim. The workers' compensation judge committed clear legal error in not awarding penalties.

Section 23:1201 requires penalties and attorney fees for untimely benefit payments unless the claim was reasonably controverted or nonpayment resulted from conditions beyond the employer's or insurer's control; reasonable controversion requires a nonfrivolous legal dispute or factual or medical information that reasonably counters the claimant's evidence.

Baker Hughes, Inc. v. Ardoin · filed 2000-02-02(F)(2)

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. ... We find nothing in the record which would reasonably controvert Ardoin's claim.

Section 23:1201 permits penalties and attorney fees when an employer fails to provide medical benefits unless the claim was reasonably controverted, which requires a nonfrivolous dispute or sufficient factual and medical information to counter the claimant’s evidence.

Gay v. Georgia Pacific Corp. · filed 1999-12-22(F)(2)

Having decided that the current version of La. R.S. 23:1201 governs this dispute, we turn to Georgia Pacific's claim that it reasonably controverted the need for an MRI. To determine whether a 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. ... With nothing but this conclusory report to rebut Dr. Martinez' opinion, the WCJ was not clearly wrong in finding that the employer did not reasonably controvert Gay's need for the MRI. Because the award was made for the employer's failure to provide the MRI and not merely for unwarranted delay in utilization review, the remedies provided by Section 1201 were proper.

Section 23:1201(F)(2) does not impose penalties for delayed treatment approval when the claims are reasonably controverted.

Alley v. PERINI/O & G INDUSTRIES · filed 2009-05-13(F)(2)

The WCJ was manifestly erroneous in assessing penalties for the delay in approval of treatment of incontinence and the removal of the ANS unit as these claims were reasonably controverted. See La. R.S. 23:1201(F)(2).

Section 23:1201(F) requires penalties and reasonable attorney fees for unpaid compensation or medical benefits unless the employer reasonably controverts the claim, meaning it has a valid reason or evidence supporting its denial.

Koenig v. Christus Schumpert Health System · filed 2009-05-13(F)

The employer’s failure to provide payment of compensation or medical benefits owed shall result in the assessment of a penalty and reasonable attorney fees, unless the employer has reasonably controverted the claim. La. R.S. 23:1201(F). ... In order to reasonably controvert a claim, the | ^defendant must have some valid reason or evidence upon which to base the denial of benefits. ... On the issue of imposition of penalties, we find that they are warranted for the employer’s failure to pay wage benefits to the claimant after she plainly suffered an on-the-job accident which prevented her from continuing to perform her job. Because the employer failed to reasonably controvert the claim, an award of $2,000 is warranted for this claim. However, we find that penalties are not warranted as to the payment of the costs of the claimant’s surgery. While it was obvious that the claimant suffered a work-related aggravation of her preexisting condition, the medical evidence was less clear as to its treatment. Since the surgery had already been scheduled and it appeared to be essentially the same procedure, the employer refused to pay for it. We find that under the facts of this case, this action did not rise to the level of failing to reasonably controvert the claim and therefore, no penalties are appropriate for this claim.

Section 23:1201(F)(2) withholds penalties when an employer reasonably controverts a claim or nonpayment results from conditions beyond its control.

Bourgeois v. Brown's Deli & Market, Inc. · filed 2009-10-14(F)(2)

An employer is required to furnish reasonable and necessary treatment to its injured employee. Failure to pay medical benefits results in the imposition of a penalty; however, the penalty is not imposed if the claim is reasonably controverted or if nonpayment results from conditions over which the employer or insurer 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. Davis v. Jones Baldwin Music Co., 27,545 (La.App. 2 Cir. 11/1/95), 662 So.2d 803.

Section 23:1201(F)(2) bars penalties and attorney fees when a claim is reasonably controverted or nonpayment results from conditions beyond the employer's control; an employer must investigate and assess the facts before denying benefits.

Doucet v. National Oilwell Varco Fluid Control · filed 2013-05-22(F)(2)

Further, “[t]o avoid the imposition of penalties and attorney fees for the nonpayment of benefits, the employer has a continuing obligation to investigate, to assemble, and to assess factual information before denying benefits.”

Subsection (F)'s penalties and attorney-fee provisions do not apply when a claim is reasonably controverted.

Deloach v. Fara Insurance Services · filed 2014-12-10(F)(2)

However, La.R.S. 23:1201(F)(2) also provides that “[t]his subsection shall not apply if the claim is reasonably controverted[.]” Where a claim has been reasonably controverted, the imposition of penalties and attorney fees under La.R.S. 23:1201 is precluded.

Section 23:1201 bars penalties and attorney fees when an employer reasonably controverts a workers’ compensation claim; a claim is reasonably controverted only when the employer has a non-frivolous legal dispute or factual or medical information that reasonably counters the claimant’s supporting information.

Hayward v. Boh Bros. Construction Co. · filed 2015-03-25

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 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 the benefits allegedly owed.

Subsection (F)(2) exempts an employer or insurer from penalties and attorney fees when the claim is reasonably controverted or nonpayment resulted from conditions beyond its control.

Arrant v. Wayne Acree Pls, Inc. · filed 2017-05-02(F)(2)

La. R.S. 23:1201(F) governs the assessment of penalties and award of attorney fees for an employer’s or insurer’s failure to authorize medical treatment. ... La. R.S. 23:1201(F)(2) states that 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, ... In order to reasonably controvert a claim, the defendant must have some valid reason or evidence upon which to base the denial of benefits. ... Reasonably controverting a claim means that the employer or insurer has sufficient factual and medical information to reasonably counter that provided by the claimant. ... Based upon this record, we cannot conclude that the WCJ was manifestly erroneous in determining that Aeree and LWCC had not reasonably controverted the second MRI request.

Section 23:1201(F)(2) precludes penalties and attorney’s fees when an employer reasonably controverts a workers’ compensation claim.

Jackson v. Family Dollar Stores of La. Inc. · filed 2018-10-24(F)(2)

Penalties and attorney's fees, however, are precluded if the claim is “reasonably controverted.” La. R.S. 23:1201(F)(2).

Under the reasonably-controverted standard, an employer must have sufficient factual and medical information to counter the claimant’s information and must propose a defense with a sound basis in fact or law to avoid statutory penalties and attorney fees.

Allen v. Louisiana Wood Moulding Corp. · filed 1998-01-23(E)

In testing for a "reasonably controverted" claim under former Section 1201(E), the jurisprudence provides that a claim is reasonably controverted if the employer (or insurer) had sufficient factual and medical information to reasonably counter the factual and medical information presented by the claimant. ... Thus, in order to avoid penalties and attorney fees under the "reasonably controverted" test, the employer must propose a defense having a sound basis in fact or in law.

Section 23:1201(F)(2) imposes a penalty for unpaid workers’ compensation benefits unless the claim is reasonably controverted or nonpayment resulted from conditions beyond the employer’s control.

Nowlin v. Breck Const. Co. · filed 1998-06-24(F)(2)

Failure to pay such benefits shall result in the imposition of a penalty; however, the penalty is not imposed if the claim is reasonably controverted or if nonpayment results from conditions over which the employer or insurer had no control. La. R.S. 23:1201 F(2). ... Under the circumstances, however, we prefer to treat this claim as one for failure to furnish benefits, thus invoking the "reasonably controverted" standard. R.S. 23:1201 F(2); see also, Allen v. Louisiana Wood Moulding Corp., 29,947 (La.App. 2 Cir. 1/23/98), 706 So.2d 636. ... The failure to produce the evidence central to the denial of the claim amounts to an absence of factual or medical information to counter the claimant's position.

Section 23:1201(F)(2) permits penalties and attorney fees to be withheld when the employer reasonably controverted the claim or nonpayment resulted from conditions beyond the employer's control.

Odom v. International Paper Co. · filed 1999-05-05(F)(2)

As recently set forth by our supreme court in Brown, supra, to determine whether a 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. Id. at 890.

Under § 23:1201(F), penalties and attorney fees for nonpayment do not apply when the employer or insurer reasonably controverts the claim, meaning it produces factual or medical information that reasonably counters the claimant's evidence.

Nunn v. CBC Services, Inc. · filed 2000-01-26(F)(2)

This argument has merit. Since 1995, amendments to La. R.S. 23:1201 and 23:1201.2 have assigned the standard of "arbitrary and capricious" to cases where the employer or insurer discontinues the payment of benefits. ... Thus it does not apply to the instant case. The applicable statute, La. R.S. 23:1201 F, provides in pertinent part: ... (2) This Subsection shall not apply if the claim is reasonably controverted or if such nonpayment results from conditions over which the employer or insurer had no control. A claim is reasonably controverted when the employer or insurer produces factual or medical information of such a nature that it reasonably counters the claimant's evidence.

Section 23:1201(E) permits penalties for unpaid compensation when the employer has not reasonably controverted the employee’s entitlement to benefits.

Ruf v. Photographers · filed 1990-10-11(E)

In the past, courts have refused to award penalties and attorney's fees when there has been a bona fide factual dispute. However, that is not the case here. We find that Mr. DeMoss, as the only living party to the oral contract of employment and as an eyewitness to the conditions of Mr. Ruf's work environment on the day he died, was fully aware of all factors and information necessary to determine plaintiff's entitlement to benefits.

Section 23:1201(F)(2) permits penalties for unpaid compensation when the employer has not reasonably controverted the claim.

Rideaux v. St. Landry Parish School Bd. · filed 1998-04-08(F)(2)

Based on the lack of information available to the defendant after Dr. Anders revoked his approval of the available positions, and doubt as to whether Mrs. Rideaux would have been qualified to perform these positions, we conclude that the workers' compensation was not clearly wrong in finding that this matter was not reasonably controverted. Therefore, we find no error in the award of penalties.

Section 23:1201 permits penalties and attorney's fees for untimely payment of benefits unless the claim was reasonably controverted; a nonfrivolous coverage dispute can preclude those awards.

Petticrew v. Abacus Capital Corp. · filed 2007-12-11

Thus, it is impossible to find that the claim was not reasonably controverted. ... Therefore, we set aside the award of penalties and attorney fees, having concluded that the OWC clearly erred in awarding them.

Section 23:1201 caps the penalties assessed against an employer at $8,000.

Mitchell v. Artcrete, Inc. · filed 2009-12-09

Because the WCJ previously assessed a penalty of $2,000 against Artcrete for failing to timely pay Mitchell’s physical therapy expenses and because La.R.S. 23:1201 limits penalties against employers to $8,000, we hold that Artcrete must pay a maximum of $8,000 in penalties to Mitchell.

Section 23:1201(E) requires penalties when an employee's right to benefits has not been reasonably controverted.

Thomas v. Union Tank Co. · filed 1994-12-07(E)

Whenever an employee's right to benefits has not been reasonably controverted, penalties shall be added. La.R.S. 23:1201(E). ... We do not find that Union Tank made a reasonable effort to ascertain Thomas' exact medical condition at the time benefits were terminated. Therefore, we find that Thomas' right to benefits was not reasonably controverted and that the termination of benefits was arbitrary, capricious, and without probable cause. ... Therefore we find no error in the trial court's award of statutory penalties and attorney fees.

Section 23:1201(F) requires an employer to reasonably controvert a workers’ compensation claimant’s right to benefits to avoid penalties, based on whether it has sufficient factual and medical information to counter the claimant’s information.

Burns v. Interstate Brands Corp. · filed 2010-02-03(F)

In order to avoid the imposition of penalties, an employer must reasonably controvert the workers’ compensation claimant’s right to benefits. La. R.S. 23:1201(F). The test to determine if the employer has fulfilled its duty is whether the employer or his insurer had sufficient | ¡¿actual and medical information to reasonably counter the factual and medical information presented by the claimant.

Section 23:1201(F)(2) bars penalties and attorney’s fees for untimely benefit payments when the claim is reasonably controverted or nonpayment resulted from conditions beyond the employer’s or insurer’s control.

Faulkner v. Better Services, Inc. · filed 2011-05-24(F)(2)

La.R.S. 23:1201 is the applicable statute in determining whether an employer should be assessed penalties and attorney’s fees for failure to timely pay indemnity or medical benefits. La.R.S. 23:1201(F)(2), however, provides that such penalties and attorney’s fees for failure to pay timely “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.” 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 v. Texas-LA Cartage, Inc., 98-1063 (La.12/1/98), 721 So.2d 885, 890. ... Because of the absence of documentation for nine months after the accident and Ms. Faulkner’s initial inconsistency in identifying the date of the current injury, we find that the claim was reasonably controverted. Accordingly, we reverse the judgment awarding penalties and attorney’s fees.

Subsection (I) bars penalties and attorney fees when an employer reasonably controverts the claim; the court affirmed denial of penalties after finding sufficient medical evidence supported the employer's position.

Jose Mendez Versus Transit Management of Southeast Louisiana, Inc. · filed 2021-12-22(I)

Under La. R.S. 23:1201(I), when an employer fails to pay workers’ compensation benefits, penalties and attorney fees shall be assessed if the employer did not reasonably controvert the claim.

Subsection (F) penalties and attorney fees are unavailable where the employer presents a non-frivolous legal dispute; the court reversed penalties because the underlying death-benefit questions were close issues of first impression.

Latashia v. Perez, Both Individually and on Behalf of Unborn Child of Travis Chiokai (Deceased) v. Irby Construction Company · filed 2020-01-29(F), (F)(2)

Thus, the judgment of WCJ awarding Ms. Perez and Avery penalties and attorney fees is reversed.

Former § 23:1201(E) imposed penalties for untimely payment, but not when the employee’s right to compensation or medical benefits was reasonably controverted by the employer.

Joseph v. Elmwood Medical Center · filed 1998-06-30(E)

Therefore, under former La.R.S. 23:1201 E penalties were imposed when the employer failed to pay timely but were not assessed when the “employee’s right to such compensation or medical benefits ha[d] been reasonably controverted by the employer[.]”

Section 23:1201 permits penalties and attorney fees for untimely workers’ compensation benefits unless the employer reasonably controverts the claim.

Ardoin v. Firestone Polymers, LLC · filed 2009-12-30(F)

If the employer fails to timely pay workers’ compensation benefits, the employee is entitled to penalties and reasonable attorney fees unless the employee’s claim is reasonably controverted.

Section 23:1201(E) makes penalties for untimely compensation payments turn in part on whether the employer reasonably controverted the employee's right to compensation, rather than on an arbitrary-and-capricious standard.

Dubois v. Louisiana Forest Industries · filed 1998-12-09(E)

The defendant is correct that the arbitrary and capricious standard is not the proper standard to be applied in determining whether an award of penalties should be made. Rather, as set forth in former La.R.S. 23:1201(E), whether an award of penalties should be made turns in part on whether the employer reasonably controverted the employee's right to compensation. However, this argument is hypertechnical because it appears from the workers' compensation judge's reasons for judgment that, while she did not use the phrase "reasonably controverted," she found that the defendant had not reasonably controverted Dubois's right to the compensation at issue. Therefore, we reject the defendant's argument in that regard.

Subsection (F) avoids penalties when an employer reasonably controverts a workers’ compensation claimant’s right to benefits, requiring sufficient factual and medical information to counter the claimant’s factual and medical information.

Burns v. Interstate Brands Corporation · filed 2010-02-03(F)

In order to avoid the imposition of penalties, an employer must reasonably controvert the workers’ compensation claimant’s right to benefits. La.R.S. 23:1201(F). 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. Brown v. Texas-La. Cartage, Inc., 98-1063 (La.12/1/98), 721 So.2d 885; Thibodeaux v. L.S. Womack, Inc., 94-1375 (La.App. 3 Cir. 4/5/95), 653 So.2d 123.

When a health care provider prevails on a fee-payment claim, § 23:1201(F)(4) permits penalties and reasonable attorney fees paid directly to the provider, and those claims accrue only after the underlying payment claim is adjudicated.

Central La. Ambulatory Surgical Center,(edith Hilborn) v. Rapides Parish School Board · filed 2010-07-28(F)(4)

The statute, therefore, provides that the medical provider’s claims for penalties and attorney fees are separate and distinct from that of the injured employee and do not accrue until the medical provider’s underlying claim for payment is adjudicated. Because the health care provider cannot seek an award of statutory penalties and attorney fees from a defendant employer/insurer until the health care provider prevails on his claim for payment of his fee, that cause of action had not yet accrued at the time of trial.

Section 23:1201(F)(4) treats a health care provider’s claims for penalties and attorney fees as separate from the injured employee’s claims, accruing only after the provider prevails on its underlying claim for payment.

Central La. Ambulatory Surgical Center, (Vicky Lacour) v. Rapides Parish School Board · filed 2010-07-28(F)(4)

The statute, therefore, provides that the medical provider’s claims for penalties and attorney fees are separate and distinct from that of the injured employee and do not accrue until the medical provider’s underlying claim for payment is adjudicated. Because the health care provider cannot seek an award of statutory penalties and attorney fees from a defendant employer/insurer until the health care provider prevails on his claim for payment of his fee, that cause of action had not yet accrued at the time of trial.

Section 23:1201(F)(4) provides that a health care provider's claims for penalties and attorney fees arise only after the provider prevails on its claim for payment, so they do not accrue before adjudication of that underlying claim.

Central La. Ambulatory Surgical Center, (David Nardin) v. Rapides Parish School Board · filed 2010-07-28(F)(4)

The statute, therefore, provides that the medical provider’s claims for penalties and attorney fees are separate and distinct from that of the injured employee and do not accrue until the medical provider’s underlying claim for payment is adjudicated. Because the health care provider cannot seek an award of statutory penalties and attorney fees from a defendant employer/insurer until the health care provider prevails on his claim for payment of his fee, that cause of action had not yet accrued at the time of trial.

Section 23:1201(F)(4) makes a health care provider’s claim for statutory penalties and reasonable attorney fees accrue only after the provider prevails on the underlying fee-payment claim, and limits recovery to one penalty or attorney fee.

Central La. Ambulatory Surgical Center, (Bridget Huie) v. Payless Shoesource, Inc. · filed 2010-07-28(F)(4)

The statute, therefore, provides that the medical provider’s claims for penalties and attorney fees are separate and distinct from that of the injured employee and do not accrue until the medical provider’s underlying claim for payment is adjudicated.

Section 23:1201(F)(4) makes a health care provider’s claims for penalties and attorney fees separate from the injured employee’s claims, accruing only after the provider prevails on its underlying fee claim.

Central La. Ambulatory Surgical Center (Travis Villemarette) v. Gilchrist Construction Co. · filed 2010-07-28(F)(4)

The statute, therefore, provides that the medical provider’s claims for penalties and attorney fees are separate and distinct from that of the injured employee and do not accrue until the medical provider’s underlying claim for payment is adjudicated. Because the health care provider cannot seek an award of statutory penalties and attorney fees from a defendant employer/insurer until the health care provider prevails on his claim for payment of his fee, that cause of action had not yet accrued at the time of trial.

Section 23:1201(F)(4) permits a health care provider who prevails on a fee-payment claim to receive penalties and reasonable attorney fees directly, with no more than one penalty or attorney fee, and those claims accrue only after adjudication of the fee claim.

Central La. Ambulatory Surgical Center (Tammy Tyler) v. Rapides Parish School Board · filed 2010-07-28(F)(4)

In the event that the health care provider prevails on a claim for payment of his fee, penalties as provided in this Section and reasonable attorney fees based upon actual hours worked may be awarded and paid directly to the health care provider. This Subsection shall not be construed to provide recovery of more than one penalty or attorney fee. The statute, therefore, provides that the medical provider’s claims for penalties and attorney fees are separate and distinct from that of the injured employee and do not accrue until the medical provider’s underlying claim for payment is adjudicated. Because the health care provider cannot seek an award of statutory penalties and attorney fees from a defendant employer/insurer until the health care provider prevails on his claim for payment of his fee, that cause of action had not yet accrued at the time of trial.

Section 23:1201(F)(4) makes a health care provider’s claim for penalties and reasonable attorney fees separate from the injured employee’s claim, accruing only after the provider prevails on its underlying fee claim.

Central La. Ambulatory Surgical Center (Forrest Robinson) v. Rapides Parish School Board · filed 2010-07-28(F)(4)

The statute, therefore, provides that the medical provider’s claims for penalties and attorney fees are separate and distinct from that of the injured employee and do not accrue until the medical provider’s underlying claim for payment is adjudicated.

Section 23:1201(F)(4) makes a health care provider’s claim for penalties and attorney fees separate from the injured employee’s claim and provides that it does not accrue until the provider prevails on its underlying fee claim.

Central La. Ambulatory Surgical Center (Dwight Tennie) v. Rapides Parish School Board · filed 2010-07-28(F)(4)

The statute, therefore, provides that the medical provider’s claims for penalties and attorney fees are separate and distinct from that of the injured employee and do not accrue until the medical provider’s underlying claim for payment is adjudicated. Because the health care provider cannot seek an award of statutory penalties and attorney fees from a defendant employer/insurer until the health care provider prevails on his claim for payment of his fee, that cause of action had not yet accrued at the time of trial.

Section 23:1201(F)(4) provides that a healthcare provider’s claim for penalties and attorney fees accrues only after the provider prevails on the underlying underpayment claim, which prescribes three years after the last payment.

Touro Infirmary v. Wm. B. Reily & Co., Inc. · filed 2010-07-28(F)(4)

Under the plain language of La. R.S. 28:1201(F)(4), a provider’s claim for attorneys’ fees does not arise until after the provider has prevailed on the underlying claim for underpayment. The claim for underpayment does not prescribe until three years after the last payment.

A healthcare provider’s claim for penalties and attorney fees under § 23:1201(F)(4) arises only after the provider prevails on the underlying underpayment claim, and it is timely when that underlying claim is timely within three years after the last payment.

Touro Infirmary v. Lowes New Orleans Hotel Corp. · filed 2010-07-28(F)(4)

Under the plain language of La. R.S. 23:1201(F)(4), a provider’s claim for attorneys’ fees does not arise until after the provider has prevailed on the underlying claim for underpayment. The claim for underpayment does not prescribe until three years after the last payment. See La. R.S. 23:1201(F)(4). In the instant case, the underlying claim for underpayment was filed less than two years after the last payment was made. It is axiomatic that prescription does not begin to run on a claim until it has accrued. See Orlando v. E.T.I., 2007-1433 (La. 12/12/08), 15 So.3d 951. When claims for penalties and attorney fees accompany the claims for benefits, if the underlying claims have not prescribed, neither have the claims for attorney fees and penalties.

Section 23:1201(F)(4) makes a healthcare provider’s claim for penalties and attorney fees arise only after the provider prevails on the underlying underpayment claim, so the claim is timely while the underlying claim remains within its prescriptive period.

Touro Infirmary v. Silocaf of New Orleans · filed 2010-07-28(F)(4)

Under the plain language of La. R.S. 23:1201(F)(4), a provider’s claim for attorneys’ fees does not arise until after the provider has prevailed on the underlying claim for underpayment. The claim for underpayment does not prescribe until three years after the last payment. See La. R.S. 23:1201(F)(4).

Section 23:1201(F)(4) provides that a healthcare provider’s claim for penalties and attorney fees accrues only after the provider prevails on the underlying underpayment claim, which prescribes three years after the last payment.

Touro Infirmary v. Emeril's Homebase, L.L.C. · filed 2010-07-28(F)(4)

Under the plain language of La. R.S. 23:1201(F)(4), a provider’s claim for attorneys’ fees does not arise until after the provider has prevailed on the underlying claim for underpayment. The claim for underpayment does not prescribe until three years after the last payment. See La. R.S. 23:1201(F)(4). In the instant case, the underlying claim for underpayment was filed less than two years after the last payment was made. It is axiomatic that prescription does not begin to run on a claim until it has accrued. See Orlando v. E.T.I., 2007-1433 (La.12/12/08), 15 So.3d 951. When claims for penalties and attorney fees accompany the claims for benefits, if the underlying claims have not prescribed, neither have the claims for attorney fees and penalties.

Subsection (F)(4) allows a prevailing health care provider to recover statutory penalties and reasonable attorney fees directly, with those claims accruing only after adjudication of the provider’s underlying payment claim; subsection (F)(2) does not apply when the claim was reasonably controverted.

Musculoskeletal Institute of Louisiana v. McDonald's Corp. · filed 2010-09-22(F)(4), (F)(2)

According to the statute, the health care provider’s claims for penalties and attorney fees are separate and distinct from those of the injured employee and do not accrue until the health care provider’s underlying claim for payment is adjudicated. ... We find that Rollins reasonably controverted Musculoskeletal’s claim in the instant case.

For a health care provider’s payment claim, the penalty is subject to the reasonably controverted limitation, but the attorney-fee award based on actual hours worked is not.

Agilus Health (Kenneth McKeithen) v. Dresser, Inc. · filed 2010-11-17(F)(4)

While the WCJ’s discretion to award the twelve percent penalty under La.R.S. 23:1201(F)(4) is still subject to the “reasonably controverted” requirement of La.R.S. 23:1201(F)(2), the attorney fee award is not.

Section 23:1201(F)(4) allows a prevailing health care provider to recover a penalty and reasonable attorney fees based on actual hours worked; the penalty is subject to the reasonably-controverted limitation, but the attorney-fee award is a separate recovery not subject to that limitation.

Agilus Health (James Wilbanks) v. Dresser, Inc. · filed 2010-11-17(F)(4)

With regard to a health care provider’s claim, an award of anything over the amount owed is subject to the WCJ’s discretion, although that discretion is limited to some extent by the “reasonably controverted” requirement of La.R.S. 23:1201(F)(2). ... While the WCJ’s discretion to award the twelve percent penalty under La.R.S. 23:1201(F)(4) is still subject to the “reasonably controverted” requirement of La.R.S. 23:1201(F)(2), the attorney fee award is not.

Section 23:1201(F)(4) allows a prevailing health care provider to receive a penalty and reasonable attorney fees based on actual hours worked; the penalty remains subject to the reasonably controverted requirement, but the attorney-fee award does not.

Agilus Health (Albert Atwood, Jr.) v. Dresser, Inc. · filed 2010-11-17(F)(4)

While the WCJ’s discretion to award the twelve percent penalty under La.R.S. 23:1201(F)(4) is still subject to the “reasonably controverted” requirement of La.R.S. 23:1201(F)(2), the attorney fee award is not.

When a health care provider prevails on a claim for payment, the statute permits penalties and attorney fees based on actual hours worked, but bars recovery of more than one penalty or attorney fee.

Thomas Medical Group, Apmc (Eric Brewton) v. Stine, LLC · filed 2010-12-08(F)(4)

In the event that the health care provider prevails on a claim for payment of his fee, penalties as provided in this Section and reasonable attorney fees based upon actual hours worked may be awarded and paid directly to the health care provider.

For a health care provider's claim, the twelve-percent penalty is discretionary and subject to the reasonably controverted defense, while a separate reasonable attorney-fee award based on actual hours worked is not subject to that defense.

CLASC.(LIGGINS) v. Rapides Parish Sch. Bd. · filed 2011-10-24(F)(2), (F)(4)

The initial paragraph of La.R.S. 23:1201(F) provides that the mandatory penalty available to a claimant is comprised of two parts: (1) a percentage of the unpaid compensation subject to a maximum amount, and (2) a reasonable attorney fee. With regard to a health care provider's claim, an award of anything but the amount owed is subject to the WCJ's discretion, although that discretion is limited to some extent by the "reasonably controverted" requirement of La.R.S. 23:1201(F)(2). Additionally, while La.R.S. 23:1201(F)(4) refers to the award of "penalties," we interpret that to mean only the statutory penalty provided for in La.R.S. 23:1201(F).[1] That is to say, the WCJ is vested with discretion to impose the twelve percent penalty as provided for by the statute and/or a separate "reasonable attorney fee based upon actual hours worked." La.R.S. 23:1201(F)(4). Thus, while the WCJ's discretion to award the twelve percent penalty is still subject to the "reasonably controverted" requirement of La.R.S. 23:1201(F)(2), the attorney fee award is not as the obvious intent of the statutory scheme is to award an attorney fee similar to that awarded in an open account collection action. Given the small nature of the amount normally at issue, any other interpretation would make the attempted collection by the health care provider a financially infeasible proposition. Thus, we find no error in the WCJ's award of attorney fees to CLASC.

Section 23:1201(F)(4) permits a prevailing health care provider to recover a discretionary penalty and reasonable attorney fees based on actual hours worked, with the penalty subject to the reasonably controverted requirement in Section 23:1201(F)(2) but the attorney-fee award not.

Agilus Health (Wilbanks) v. Dresser, Inc. · filed 2011-10-27(F)(4) and (F)(2)

The initial paragraph of La.R.S. 23:1201(F) provides that the mandatory penalty available to a claimant is comprised of two parts: (1) a percentage of the unpaid compensation subject to a maximum amount, and (2) a reasonable attorney fee. With regard to a health care provider's claim, an award of anything over the amount owed is subject to the WCJ's discretion, although that discretion is limited to some extent by the "reasonably controverted" requirement of La.R.S. 23:1201(F)(2). In the matter before us, the WCJ awarded the $2,000.00 statutory penalty provided in the general language of La. R.S. 23:1201(F), as allowed in La.R.S. 23:1201(F)(4), and awarded a $3,000.00 attorney fee "for the work done" by Agilus' attorneys. That is to say, the attorney fee award was awarded, not as a penalty as provided for in the general language of La.R.S. 23:1201(F), but for the actual work performed as allowed under La.R.S. 23:1201(F)(4). While the WCJ's discretion to award the twelve percent penalty under La.R.S. 23:1201(F)(4) is still subject to the "reasonably controverted" requirement of La.R.S. 23:1201(F)(2), the attorney fee award is not.

Section 23:1201(F)(4) permits a prevailing health care provider to receive one penalty and reasonable attorney fees based on actual hours worked; the penalty remains subject to the reasonably-controverted limitation in § 23:1201(F)(2), while the fee does not.

Agilus Health (Atwood) v. Dresser, Inc. · filed 2011-10-27(F)(4), (F)(2)

While the WCJ’s discretion to award the twelve percent penalty under La.R.S. 23:1201(F)(4) is still subject to the “reasonably controverted” requirement of La.R.S. 23:1201(F)(2), the attorney fee award is not.

Section 23:1201(F)(4) permits penalties and reasonable attorney fees directly to a health care provider that prevails on a fee claim, unless the payment dispute was reasonably controverted; the payer must have an articulable and objective reason to deny payment.

Iberia General Hospital v. St. Mary Sugar Cooperative, Inc. · filed 2016-11-02(F)(4)

[U]nder [La.R.S.] 23:1201(F)(4) (“[F]ailure to provide payment in accordance with this Section . . . shall result in the assessment of a penalty . . . together with reasonable attorney fees for each disputed claim. . . . Penalties shall be assessed in the following manner: . . . (4) In the event that the health care provider prevails on a claim for payment of his fee, penalties as provided in this Section and reasonable attorney fees based upon actual hours worked may be awarded and paid directly to the health care provider. . . .”). ... The crucial inquiry in determining whether to impose penalties and attorney fees is whether the payor had an articulable and objective reason to deny payment at the time it took action. ... Therefore, we affirm the WCJ’s imposition of penalties and attorney fees against St. Mary and LUBA who failed to demonstrate an “articulable and objective reason to deny payment at the time it took action.”

For a health-care provider’s payment claim, § 23:1201(F)(4) permits a discretionary statutory penalty subject to the reasonably-controverted limitation in § 23:1201(F)(2), while the reasonable attorney-fee award based on actual hours worked is not subject to that limitation.

Central La. Ambulatory Surgical Center (Lorraine Bryant) v. Rapides Parish School Board · filed 2010-11-03(F)(2), (F)(4)

That is to say, the WCJ is vested with discretion to impose the twelve percent penalty as provided for by the statute and/or a separate “reasonable attorney fee based upon actual hours worked.” La.R.S. 23:1201(F)(4). Thus, while the WCJ’s discretion to award the twelve percent penalty is still subject to the “reasonably controverted” requirement of La.R.S. 23:1201(F)(2), the attorney fee award is not as the obvious intent of the statutory scheme is to award an attorney fee similar to that awarded in an open account collection action. Given the small nature of the amount normally at issue, any other interpretation would make the attempted collection by the health care provider a financially infeasible proposition. Thus, we find no error in the WCJ’s award of attorney fees to CLASC.

For a health care provider's payment claim, § 23:1201(F)(4) permits a separate reasonable attorney-fee award based on actual hours worked, while the statutory penalty remains subject to § 23:1201(F)(2)'s reasonably controverted exception.

Central La. Ambulatory Surgical Center (Lawrence Liggins v. Rapides Parish School Board · filed 2010-11-03(F)(2), (F)(4)

The initial paragraph of La.R.S. 23:1201(F) provides that the mandatory penalty available to a claimant is comprised of two parts: (1) a percentage of the unpaid compensation subject to a maximum amount, and (2) a reasonable attorney fee. ... Additionally, while La.R.S. 23:1201(F)(4) refers to the award of “penalties,” we interpret that to mean only the statutory penalty provided for in La.R.S. 23:1201(F). ... Thus, while the WCJ’s discretion to award the twelve percent penalty is still subject to the “reasonably controverted” requirement of La.R.S. 23:1201(F)(2), the attorney fee award is not as the obvious intent of the statutory scheme is to award an attorney fee similar to that awarded in an open account collection action. ... Thus, we find no error in the WCJ’s award of attorney fees to CLASC.

Section 23:1201(F)(4) permits a separate reasonable attorney-fee award for a health care provider, while the statutory penalty remains subject to the reasonably-controverted limitation in § 23:1201(F)(2).

Central La. Ambulatory Surgical Center (Mary Cryique) v. Rapides Parish School Board · filed 2010-11-03(F)(2), (F)(4)

That is to say, the WCJ is vested with discretion to impose the twelve percent penalty as provided for by the statute and/or a separate “reasonable attorney fee based upon actual hours worked.” La.R.S. 23:1201(F)(4).

Section 23:1201(F)(4) permits a separate reasonable attorney-fee award for a health care provider, while the statutory penalty remains subject to the reasonably-controverted limitation in § 23:1201(F)(2).

Central La. Ambulatory Surgical Center (Katherine Arnold) v. Rapides Parish School Board · filed 2010-11-03(F)(2), (F)(4)

That is to say, the WCJ is vested with discretion to impose the twelve percent penalty as provided for by the statute and/or a separate “reasonable attorney fee based upon actual hours worked.” La.R.S. 23:1201(F)(4).

For a health care provider’s successful fee claim, § 23:1201(F)(4) permits a reasonable attorney fee based on actual hours worked even when the statutory penalty is unavailable because the claim was reasonably controverted under § 23:1201(F)(2); the penalty itself remains subject to that limitation.

Central La. Ambulatory Surgical Center (Donna Boss) v. Rapides Parish School Board · filed 2010-11-03(F)(2) and (F)(4)

The initial paragraph of La.R.S. 23:1201(F) provides that the mandatory penalty available to a claimant is comprised of two parts: (1) a percentage of the unpaid compensation subject to a maximum amount, and (2) a reasonable attorney fee. With regard to a health care provider’s claim, an award of anything but the amount owed is subject to the WCJ’s discretion, although that discretion is limited to some extent by the “reasonably controverted” requirement of La.R.S. 23:1201(F)(2). Additionally, while La.R.S. 23:1201(F)(4) refers to the award of “penalties,” we interpret that to mean only the statutory penalty provided for in La.R.S. 23:1201(F). ... Thus, while the WCJ’s discretion to award the twelve percent penalty is still subject to the “reasonably controverted” requirement of La.R.S. 23:1201(F)(2), the attorney fee award is not as the obvious intent of the statutory scheme is to award an attorney fee similar to that awarded in an open account collection action. Given the small nature of the amount normally at issue, any other interpretation would make the attempted collection by the health care provider a financially infeasible proposition. Thus, we find no error in the WCJ’s award of attorney fees to CLASC.

Section 23:1201(F)(4) permits a separate attorney-fee award to a health care provider even when the statutory penalty is reversed.

Central La. Ambulatory Surgical Center (Edith Cripps) v. Rapides Parish School Board · filed 2010-11-03(F)(4)

We conclude that the WCJ may impose an award of attorney fees as an item of recovery separate from the penalty issue.

Subsection (B) makes the first installment of temporary total, permanent total, or death compensation due on the fourteenth day after the employer or insurer knows of the injury or death.

Massingill v. Dunham Price Group, L.L.C. · filed 2010-05-05(B)

We find no merit in the defendant’s argument. According to La.R.S. 23:1201(B), “[t]he first installment of compensation payable for temporary total disability . . . shall become due on the fourteenth day after the employer or insurer has knowledge of the injury[.]” Thus, we find no error in the workers’ compensation judge’s determination that payment was due on May 4, 2007. Accordingly, the defendant’s argument regarding receipt versus transmission is irrelevant at this time because under either interpretation of the law, the payment was untimely.

Subsection (F) does not authorize an award of postage, mileage, or copying costs as litigation expenses.

Udell Lejeune, Jr. v. State of Louisiana, Dotd · filed 2010-06-02(F)

Nothing in La.R.S. 23:1201(F) provides for an award of such costs, and we decline to expand the statutory benefit beyond which the legislative language allows.

Section 23:1201(F)(4) allows a health care provider to recover penalties and reasonable attorney fees directly after prevailing on its underlying claim for payment; those claims accrue only when that claim is adjudicated.

Central La. Ambulatory Surgical Center (Carmen Lacour) v. Rapides Parish School Board · filed 2010-07-28(F)(4)

In the event that the health care provider prevails on a claim for payment of his fee, penalties as provided in this Section and reasonable attorney fees based upon actual hours worked may be awarded and paid directly to the health care provider. This Subsection shall not be construed to provide recovery of more than one penalty or attorney fee. The statute, therefore, provides that the medical provider’s claims for penalties and attorney fees are separate and distinct from that of the injured employee and do not accrue until the medical provider’s underlying claim for payment is adjudicated. Because the health care provider cannot seek an award of statutory penalties and attorney fees from a defendant employer/insurer until the health care provider prevails on his claim for payment of his fee, that cause of action had not yet accrued at the time of trial.

For a healthcare provider, a claim for penalties and attorney fees arises only after the provider prevails on the underlying underpayment claim, and it is timely when the underlying claim remains within its three-year prescriptive period.

Touro Infirmary v. Fisk Corp. · filed 2010-07-28(F)(4)

Under the plain language of La. R.S. 23:1201(F)(4), a provider’s claim for attorneys’ fees does not arise until after the provider has prevailed on the underlying claim for underpayment. The claim for underpayment does not prescribe until three years after the last payment. See La. R.S. 23:1201(F)(4).

Section 23:1201(F)(4) makes a health care provider’s penalty and attorney-fee claims separate from the injured employee’s and delays accrual until the provider prevails on its underlying fee claim.

Central La. Ambulatory Surgical Center (Patricia Harmson) v. Rapides Parish School Board · filed 2010-07-28(F)(4)

The statute, therefore, provides that the medical provider’s claims for penalties and attorney fees are separate and distinct from that of the injured employee and do not accrue until the medical provider’s underlying claim for payment is adjudicated.

For a health care provider's successful underpayment claim, the reasonably controverted limitation applies to penalties but not to discretionary attorney fees.

Central La. Ambulatory Surgical Center,(edith Hilborn) v. Rapides Parish School Board · filed 2010-10-20(F)(2), (F)(4)

In the event that the health care provider prevails on a claim for payment of his fee, penalties as provided in this Section and reasonable attorney fees based upon actual hours worked may be awarded and paid directly to the health care provider.

Section 23:1201(F)(4) incorporates the reasonably controverted limitation in subsection (F)(2) for penalties, but attorney fees remain discretionary and are not subject to that limitation when a health care provider prevails on an underpayment claim.

Central La. Ambulatory Surgical Center, (Vicky Lacour) v. Rapides Parish School Board · filed 2010-10-20(F)(2) and (F)(4)

The phrase “as provided in this Section” of La.R.S. 23:1201(F)(4) encompasses the “reasonably controverted” standard of La.R.S. 23:1201(F)(2) as it applies to an award of penalties. The award of reasonable attorney fees has no such restriction. That is, once a health care provider prevails on an underpayment claim, the award of attorney fees is discretionary and is not subject to the “reasonably controverted” limitation.

Section 23:1201(F)(4) makes penalties subject to the reasonably controverted limitation in § 23:1201(F)(2), but attorney-fee awards to a prevailing health care provider are discretionary and not subject to that limitation.

Central La. Ambulatory Surgical Center, (David Nardin) v. Rapides Parish School Board · filed 2010-10-20(F)(2) and (F)(4)

The phrase “as provided in this Section” of La.R.S. 23:1201(F)(4) encompasses the “reasonably controverted” standard of La.R.S. 23:1201(F)(2) as it applies to an award of penalties. The award of reasonable attorney fees has no such restriction. That is, once a health care provider prevails on an underpayment claim, the award of attorney fees is discretionary and is not subject to the “reasonably controverted” limitation.

For a prevailing health care provider's underpayment claim, § 23:1201(F)(4) permits discretionary reasonable attorney fees without the reasonably-controverted limitation that applies to penalties under § 23:1201(F)(2).

Central La. Ambulatory Surgical Center (Travis Villemarette) v. Gilchrist Construction Co. · filed 2010-10-20(F)(2), (F)(4)

The phrase “as provided in this Section” of La.R.S. 23:1201(F)(4) encompasses the “reasonably controverted” standard of La.R.S. 23:1201(F)(2) as it applies to an award of penalties. The award of reasonable attorney fees has no such restriction. That is, once a health care provider prevails on an underpayment claim, the award of attorney fees is discretionary and is not subject to the “reasonably controverted” limitation.

For a health care provider's successful fee claim, § 23:1201(F)(4) makes penalties subject to the reasonably-controverted exception in (F)(2), but attorney-fee awards discretionary and not subject to that limitation.

Central La. Ambulatory Surgical Center (Tammy Tyler) v. Rapides Parish School Board · filed 2010-10-20(F)(2), (F)(4)

The phrase “as provided in this Section” of La.R.S. 23:1201(F)(4) encompasses the “reasonably controverted” standard of La.R.S. 23:1201(F)(2) as it applies to an award of penalties. The award of reasonable attorney fees has no such restriction. That is, once a health care provider prevails on an underpayment claim, the award of attorney fees is discretionary and is not subject to the “reasonably controverted” limitation.

Section 23:1201(F)(4) incorporates the reasonably-controverted limitation in Subsection (F)(2) for penalties, but that limitation does not apply to discretionary attorney-fee awards once a health care provider prevails on an underpayment claim.

Central La. Ambulatory Surgical Center (Patricia Harmson) v. Rapides Parish School Board · filed 2010-10-20(F)(2), (F)(4)

The phrase “as provided in this Section” of La.R.S. 23:1201(F)(4) encompasses the “reasonably controverted” standard of La.R.S. 23:1201(F)(2) as it applies to an award of penalties. The award of reasonable attorney fees has no such restriction. That is, once a health care provider prevails on an underpayment claim, the award of attorney fees is discretionary and is not subject to the “reasonably controverted” limitation.

Section 23:1201(F)(4) allows penalties and reasonable attorney fees for a prevailing health care provider, but the reasonably controverted limitation in § 23:1201(F)(2) applies only to penalties, not attorney fees.

Central La. Ambulatory Surgical Center (Forrest Robinson) v. Rapides Parish School Board · filed 2010-10-20(F)(2) and (F)(4)

La.R.S. 23:1201(F)(2) states that “[t]his 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.” The phrase “as provided in this Section” of La.R.S. 23:1201(F)(4) encompasses the “reasonably controverted” standard of La.R.S. 23:1201(F)(2) as it applies to an award of penalties. The award of reasonable attorney fees has no such restriction. That is, once a health care provider prevails on an underpayment claim, the award of attorney fees is discretionary and is not subject to the “reasonably controverted” limitation.

Section 23:1201(F)(4) makes the reasonably controverted limitation applicable to penalties, but attorney fees for a health care provider that prevails on an underpayment claim are discretionary and not subject to that limitation.

Central La. Ambulatory Surgical Center (Dwight Tennie) v. Rapides Parish School Board · filed 2010-10-20(F)(2), (F)(4)

The phrase “as provided in this Section” of La.R.S. 23:1201(F)(4) encompasses the “reasonably controverted” standard of La.R.S. 23:1201(F)(2) as it applies to an award of penalties. The award of reasonable attorney fees has no such restriction. That is, once a health care provider prevails on an underpayment claim, the award of attorney fees is discretionary and is not subject to the “reasonably controverted” limitation.

Section 23:1201(F)(4)'s penalty award incorporates the reasonably controverted limitation in Subsection (F)(2), but that limitation does not restrict discretionary attorney-fee awards to a health care provider that prevails on an underpayment claim.

Central La. Ambulatory Surgical Center (Carmen Lacour) v. Rapides Parish School Board · filed 2010-10-20(F)(2), (F)(4)

The phrase “as provided in this Section” of La.R.S. 23:1201(F)(4) encompasses the “reasonably controverted” standard of La.R.S. 23:1201(F)(2) as it applies to an award of penalties. The award of reasonable attorney fees has no such restriction. That is, once a health care provider prevails on an underpayment claim, the award of attorney fees is discretionary and is not subject to the “reasonably controverted” limitation.

Section 23:1201(F)(4) makes a health care provider’s penalty and attorney-fee claims separate from the injured employee’s and accruing only after the provider prevails on the fee claim, while subsection (F)(2) bars those awards when the claim is reasonably controverted.

Central Louisiana Ambulatory Surgical Center, Inc. v. Payless Shoesource, Inc. · filed 2010-10-20(F)(4), (F)(2)

The statute, therefore, provides that the medical provider’s claims for penalties and attorney fees are separate and distinct from that of the injured employee and do not accrue until the medical provider’s underlying claim for payment is adjudicated. Because the health care provider cannot seek an award of statutory penalties and attorney fees from a defendant employer/insurer until the health care provider prevails on his claim for payment of his fee, that cause of action had not yet accrued at the time of trial. ... Louisiana Revised Statutes 23:1201(F)(2) provides that penalties and attorney fees “shall not apply if the claim is reasonably controverted or if such nonpayment results from conditions over which the employer had no control.” ... While we find that the PPO contracts in these cases did not have legal effect for *698the rate reductions applied, we find that the Employers did have “articulable and objective” reasons to reduce the payments to CLASC at the time that the Employers took that action. ... In the ten consolidated eases, while we find that the Employers underpaid CLASC due to their reliance upon the PPO contracts, we find that the OWC manifestly erred in imposing penalties and attorney fees against the Employers, and we reverse.

Section 23:1201(F)(4) permits a health care provider to recover a statutory penalty and reasonable attorney fee; the penalty remains subject to subsection (F)(2)'s reasonable-controversion limitation, but the attorney-fee award does not.

Central La. Ambulatory Surgical Center (Veltz) v. Rapides Parish School Board · filed 2010-10-20(F), (F)(2), and (F)(4)

That is to say, the WCJ is vested with discretion to impose the twelve percent penalty as provided for by the statute and/or a separate “reasonable attorney fee based upon actual hours worked.”

When a health care provider prevails on a fee claim, subsection (F)(4) permits a statutory penalty and separate reasonable attorney fee, but the attorney-fee award is not subject to subsection (F)(2)'s reasonable-controversion limitation.

Central La. Ambulatory Surgical Center (Shedrick) v. Rapides Parish School Board · filed 2010-10-20(F)(2), (F)(4)

That is to say, the WCJ is vested with discretion to impose the twelve percent penalty as provided for by the statute and/or a separate “reasonable attorney fee based upon actual hours worked.”

Section 23:1201(F)(4) permits a prevailing health-care provider to recover a statutory penalty and separate reasonable attorney fee, with the reasonable-controversion limitation applying to the penalty but not the attorney fee.

Central La. Ambulatory Surgical Center (Patricia) v. Rapides Parish School Board · filed 2010-10-20(F)(4)

That is to say, the WCJ is vested with discretion to impose the twelve percent penalty as provided for by the statute and/or a separate “reasonable attorney fee based upon actual hours worked.”

Section 23:1201(F)(4) permits a medical provider to seek penalties and attorney fees on an underlying underpayment claim; those ancillary claims remain timely when the underlying benefit claim has not prescribed.

Tulane University Hospital & Clinic v. Lockheed Martin Corp. · filed 2011-06-29(F)(4)

Consequently, plaintiffs claim for penalties and attorneys’ fees is also timely. This Court has stated that pursuant to La. R.S. 23:1201(F)(4), “[w]hen claims for penalties and attorney fees accompany the claims for benefits, if the underlying claims have not prescribed, neither have the claims for attorney fees and penalties.”

Section 23:1201(F)(4) authorizes penalties and direct reasonable-attorney-fee awards to a health care provider prevailing on its fee claim, and subsection (F)(2)'s reasonably-controverted limitation does not restrict that fee award.

Lake Charles Memorial Hospital (Stephen Babin) v. Rapides Parish School Board · filed 2010-11-17(F)(2), (F)(4)

In the event that the health care provider prevails on a claim for payment of his fee, penalties as provided in this Section and reasonable attorney fees based upon actual hours worked may be awarded and paid directly to the health care provider.

Section 23:1201 permits a health care provider who prevails on a claim for payment of its fee to receive statutory penalties and reasonable attorney fees directly, and the attorney-fee award is not limited by subsection (F)(2)'s reasonable-controversion standard.

Lake Charles Memorial Hospital v. Hobby Lobby · filed 2010-11-17(E), (F)(2), (F)(4)

In the event that the health care provider prevails on a claim for payment of his fee, penalties as provided in this Section and reasonable attorney fees based upon actual hours worked may be awarded and paid directly to the health care provider.

Section 23:1201(F)(4) permits a prevailing health care provider to recover penalties and reasonable attorney fees based on actual hours worked, but does not allow recovery of more than one penalty or attorney fee.

Thomas Medical Group, Apmc v. Stine, LLC · filed 2010-12-08(F)(4)

Louisiana Revised Statute 23:1201(F)(4) allows a health care provider to collect an attorney fee based on the actual hours worked.

When a health care provider prevails on a fee-payment claim, penalties and reasonable attorney fees based on actual hours may be awarded, but the statute does not permit more than one penalty or attorney fee.

Thomas Medical Group, Apmc v. Stine, LLC · filed 2010-12-08(F)(4)

Given these circumstances, we cannot say that the WCJ erred in awarding a single penalty to Thomas.

Section 23:1201(F) allows penalties and attorney fees in the stated circumstances, while § 23:1201(F)(4) allows a prevailing health care provider direct reasonable attorney fees based on actual hours worked; here, the provider’s failure to submit a fee petition documenting those hours supported denial of the fee award.

Lake Charles Memorial Hospital (Isom T. Roy) v. City of Lake Charles · filed 2011-12-07(F)(4)

In this case, counsel for Lake Charles Memorial Hospital failed to provide a fee petition setting out the hours actually worked.

When a health care provider prevails on a claim for payment, § 23:1201(F)(4) permits penalties and reasonable attorney fees based on actual hours worked to be paid directly to the provider.

Roy v. City of Lake Charles · filed 2011-12-07(F)(4)

In the event that the health care provider prevails on a claim for payment of his fee, penalties as provided in this Section and reasonable attorney fees based upon actual hours worked may be awarded and paid directly to the health care provider. ... In this case, counsel for Lake Charles Memorial Hospital failed to provide a fee petition setting out the hours actually worked. The workers’ compensation judge did not abuse his discretion in declining to award the requested attorney fees.

Section 23:1201(F)(4) permits a health care provider's penalties-and-attorney-fees claim to remain timely when it accompanies an underlying medical-benefit claim that has not prescribed, using the same prescriptive period.

St. Tammany Parish Hospital v. Trinity Marine Products, Inc. · filed 2012-02-16(F)(4)

We agree with the rationale of the Fourth Gircuit — if a health care provider makes a claim for penalties and attorney fees under La. R.S. 23:1201(F)(4), which accompanies a claim for the payment of his fee, if the underlying claim has not prescribed, then neither has the claim for penalties and attorney fees. Thus, the applicable prescriptive period for a health care provider’s claim for penalties and attorney fees is the same prescriptive period that is applicable to its underlying claim for medical benefits.

Subsection (F)(4) permits a health care provider who prevails on a fee claim to recover penalties and reasonable attorney fees directly; its penalties incorporate the reasonably controverted standard in Subsection (F)(2), but its attorney-fee award is not restricted by that standard.

LAFAYETTE BONE & JOINT CLINIC(CHARLES POOLE, JR.) VERSUS GUY HOPKINS CONSTRUCTION CO., INC. · filed 2015-10-21(F)(4), (F)(2)

Louisiana Revised Statutes R.S. 23:1201(F)(4) affords a health care provider who prevails on a claim for a payment of his fee with “penalties as provided in this Section,” which necessarily encompasses the “reasonably controverted standard” of La.R.S. 23:1201(F)(2). ... We have recognized that an award of attorney fees under La.R.S. 23:1201(F)(4) is not restricted by the “reasonably controverted” standard of La.R.S. 23:1201(F)(2).

For a health care provider's payment claim, the statutory penalty is subject to the reasonably controverted requirement, but a separate reasonable attorney-fee award based on actual hours worked is not.

Central La. Ambulatory Surgical Center (Miah Armstrong) v. Rapides Parish School Board · filed 2010-11-03(F)(2), (F)(4)

Thus, while the WCJ’s discretion to award the twelve percent penalty is still subject to the “reasonably controverted” requirement of La.R.S. 23:1201(F)(2), the attorney fee award is not as the obvious intent of the statutory scheme is to award an attorney fee similar to that awarded in an open account collection action.

For a health-care provider's payment claim, § 23:1201(F)(4) permits a separate reasonable attorney-fee award based on actual hours worked; the twelve-percent penalty remains subject to the reasonably controverted limitation in § 23:1201(F)(2).

Central La. Ambulatory Surgical Center (Janet Daniels) v. Rapides Parish School Board · filed 2010-11-03(F)(2), (F)(4)

That is to say, the WCJ is vested with discretion to impose the twelve percent penalty as provided for by the statute and/or a separate “reasonable attorney fee based upon actual hours worked.” La.R.S. 23:1201(F)(4). Thus, while the WCJ’s discretion to award the twelve percent penalty is still subject to the “reasonably controverted” requirement of La.R.S. 23:1201(F)(2), the attorney fee award is not as the obvious intent of the statutory scheme is to award an attorney fee similar to that awarded in an open account collection action.

Section 23:1201(F)(2) authorizes penalties and attorneys’ fees when an employer fails to commence benefits, unless the claim was reasonably controverted or the failure resulted from conduct beyond the employer’s or insurer’s control.

Bell v. Mid City Printers, Inc. · filed 2010-12-22(F)(2)

In instances where the employer fails to commence payment of benefits, penalties and attorneys’ fees are authorized under La. R.S. 23:1201(F)(2), unless the claim is reasonably controverted, or resulted from conduct over which the employer or insurer had no control.

Section 23:1201(A) requires compensation payments to be made as nearly as possible at the same time and place as the employee's pre-injury wages, so weekly-paid employees receive SEBs weekly.

Carmouche v. Kraft Foods · filed 2011-04-13(A)

“Payments of compensation . . . shall be paid as near as may be possible, at the same time and place as wages were payable to the employee before the accident.” La.R.S. 23:1201(A). Despite the fact that SEBs are calculated by determining the employee’s average monthly wages, if an employee is paid weekly, his SEBs are to be paid weekly.

Section 23:1201(F) mandates penalties and attorney fees for unexcused nonpayment or underpayment, while subsection (B) requires the first installment fourteen days after notice of injury but does not require an individualized payment schedule thereafter.

Mulvihill v. Jefferson Parish Hospital Service District No. 2 · filed 2013-03-13(F), (B)

While the hearing officer’s decision to award or refuse penalties and attorney fees is a matter of great discretion, the plain text of La. R.S. 23:1201(F) mandates the penalties and attorney fees against a defendant when it fails to pay in accordance with this section of law unless the defendant either reasonably controverted the payments or had no control over the payments not being made. ... Under the plain text of the law, a claimant seeking penalties and attorney fees under La. R.S. 23:1201(F) does not need to prove that payments due were arbitrarily or capriciously underpaid. Such penalties are mandated when a party fails to pay in accordance with La. R.S. 23:1201 without a valid excuse. ... This statute proscribes that an employer pay an employee’s workers’ compensation benefits at the time and place where it typical pays its employees’ wages. It does not mandate, as claimant contends, that the employer begin a series of payment dates exclusive to an individual injured worker.

Section 23:1201(A) requires indemnity payments to be made as nearly as possible at the same time and place as during employment, unless the parties agree to a longer interval.

Jones v. Dunham Price, Inc. · filed 2012-10-03(A)

Dun-ham/Gray argues that the statute also provides that a longer interval may be substituted by agreement. Unfortunately, while Jones acquiesced in Dunham/Gray’s two-week payment schedule, Dunham/Gray has not demonstrated the existence of an agreement between the parties. Accordingly, we find no error in the award of penalties by the workers’ compensation judge.

Section 23:1201(A) requires compensation payments to be made as nearly as possible at the same time and place that wages were payable before the accident, and the claimant must provide evidence allowing that timing and place to be measured.

Kibodeaux v. Cajun Bag and Supply Co. · filed 1999-06-02(A)

Accordingly, the workers' compensation judge and this court are left with no frame of reference by which we can measure whether the payments met the requirements of La.R.S. 23:1201(A) that benefit payments are to be made "as near as may be possible, at the same time and place as wages were payable to the employee before the accident...." Therefore, we agree with the trial judge that Kibodeaux failed to meet her burden of proving that payments were not made as near as may be possible at the same time and place as wages were payable to her before the accident.

Section 23:1201(I) imposes a penalty of up to $8,000 and a reasonable attorney fee when an employer or insurer arbitrarily, capriciously, or without probable cause discontinues payments due under the Workers' Compensation Act, including court-ordered payments after judgment.

Tidwell v. Premier Staffing, Inc. · filed 2013-10-30(I)

Clearly, La.R.S. 23:1201(I) applies “at any time” Premier discontinued the court ordered payments for “compensation benefits” and “all reasonable and necessary medical treatment.”

Section 23:1201 permits multiple penalties for separate violations, but the court reversed a subsection (I) penalty because the dispute concerned denial of surgery rather than discontinuance of benefits, while affirming the subsection (F) penalty and one attorney-fee award under subsection (J).

Ralph Stretzinger Versus Claims Management, Inc. and Wal-Mart · filed 2019-12-11(F), (I), (J)

We do not believe that the facts of this case support an award under Subsection (I) and find that the OWC manifestly erred in awarding penalties under that Subsection.

Section 23:1201 imposes a continuing obligation to pay all compensation and medical benefits due and within the specified time, permits multiple penalties for multiple violations, and requires a valid reason or evidence to reasonably controvert a claim.

Eleazar Rivera Salgado Versus Tri-Parish Roofing & Home Improvements · filed 2020-05-27(F)

La. R.S. 23:1201 imposes a twofold continuing obligation on the employer: (1) to pay all compensation and medical benefits due, and (2) to pay for compensation and medical benefits within the time limit specified.

Subsection (F)(2) requires penalties for improperly paid benefits unless the claim is reasonably controverted or the conduct was beyond the employer’s or insurer’s control; subsection (F) permits multiple penalties for multiple violations, subject to the statutory caps.

Carlos A. Juarez Versus Aj Lazo Construction, LLC, and Louisiana Construction and Industry Self Insurer's Fund (Lci) · filed 2023-09-20(F), (F)(2)

La. R.S. 23:1201(F)(2) provides that penalties and attorney’s fees for failure to properly pay benefits shall be assessed against an employer or insurer unless the claim is reasonably controverted or resulted from conduct over which the employer or insurer had no control.

Section 23:1201(A)(1) requires indemnity benefits to be paid as near as possible to the employee’s usual wage-payment time and place; subsection (G) concerns timely payment of lump-sum benefits, while subsection (I) governs discontinuance of due benefits and permits penalties up to $8,000.00 for multiple violations.

Lopez v. TOWN OF ZWOLLE · filed 2011-10-05(A)(1), (G), (I)

Louisiana Revised Statutes 23:1201 governs the time and place of payment of indemnity benefits: ... La.R.S. 23:1201(A)(1). ... We conclude the Town’s method of payment to Mr. Lopez violated the statute’s prohibition against “late” payments. ... Section (G) of the statute refers to the timely payment of lump sum benefits, not to the continued payment of presently owed benefits. Because neither party is arguing over the accrued lump sum benefits, section (G) of the statute does not apply. Instead, we find that section (I) of the statute, which concerns the discontinuance of payment of claims due, applies. Section (I) provides for penalties not to exceed $8,000.00 for multiple violations. Thus, we increase the Town’s penalties to $8,000.00, for the arbitrary and capricious termination of Mr. Lopez’s benefits.

Section 23:1201(C) makes installment supplemental earnings benefits due 14 days after the employer or insurer knows of the compensable benefits, while § 23:1201(F)(2) permits avoiding penalties and attorney fees when the claim was reasonably controverted or nonpayment resulted from conditions beyond the employer's or insurer's control.

Slade v. State ex rel. University of Louisiana at Monroe · filed 2011-11-09(C), (F)(2)

Louisiana law provides that installment benefits payable pursuant to R.S. |1023:1221(3) shall become due on the fourteenth day after the employer or insurer has knowledge of the compensable supplemental earnings benefits on which date all such compensation then due shall be paid. ... Failure to provide payment of benefits will result in a penalty and attorney fees “unless the claim is reasonably controverted or if such non-payment results from conditions over which the employer or insurer had no control.” ... The phrase “reasonably controverted” means that the defendant must have “some valid reason or evidence on which to base his denial of benefits.” ... The fact that defendant ultimately lost in summary proceedings is not necessarily determinative as to whether there was a valid reason to initially dispute the claim. We cannot say the WCJ abused her great discretion in denying statutory penalties and attorney fees, and, therefore, we decline to reverse her decision.

Section 23:1201(G) requires the greater of a 24-percent penalty on an unpaid final judgment or $100 per day after 30 days, subject to the $3,000 aggregate cap for the daily penalty.

McCallon v. Key Energy Services · filed 2021-12-15(G)

Workers’ compensation statutes providing for penalties and attorney fees, which are penal in nature, must be strictly construed. ... Louisiana Revised Statutes 23:1201(G) requires a penalty of an amount equal to twenty-four percent of the unpaid judgment or one hundred dollars per day for each day after thirty days the judgment remains unpaid, whichever is greater. ... As the daily penalty exceeds the penalty of $1,360.80 representing 24% of the unpaid judgment, we assess a penalty of $3,000.00 for failure to pay a final judgment in the form of weekly indemnity benefits from April 16, 2016 to June 21, 2016 pursuant to La.R.S. 23:1201(G).

Subsection G imposes penalties and reasonable attorney fees when an award under a final, nonappealable judgment remains unpaid more than thirty days, using the greater of twenty-four percent of the award or one hundred dollars per day, subject to the stated aggregate cap.

Borne v. St. John the Baptist Parish School Bd. · filed 1998-03-11(G)

In this case, we hold that the Order by the hearing officer is a judgment within the meaning of the statute. Under the law, the hearing officer was required to make certain findings before approving the payment. La. R.S. 23:1272. The Order of approval was not automatic. Further, this was a lump sum payment of benefits owed and not a contested matter. Since the Order is nonappealable under R.S. 23:1272, we find that the hearing officer did not err in finding that R.S. 23:1201 G applies.

Section 23:1201(G) applies to consent judgments and requires an unconditional payment of an award under a final, nonappealable judgment within thirty days; otherwise penalties and reasonable attorney fees may be imposed.

Trahan v. John F. Reggie, Inc. · filed 1998-10-07(G)

Therefore, as in Meche, penalties and attorney fees should have been awarded. The consent judgment was rendered and signed on August 14, 1997, and the defendants have not yet made an unconditional tender under the judgment. Therefore, under La.R.S. 23:1201(G), we award penalties of $3,000.00 and attorney fees of $3,000.00.

Section 23:1201(G) permits penalties and attorney's fees when an employer fails to authorize a court-ordered physician visit within thirty days after the workers' compensation judgment becomes final and nonappealable.

Perot v. Link Staffing Services · filed 1999-06-23(G)

Therefore, the defendant had until August 14, 1998 to lodge a suspensive appeal, and in the event that it did not, it had until September 14, 1998 to authorize Mr. Perot's visit to a physician of his choice, Dr. Michel Heard, without incurring La.R.S. 23:1201(G) sanctions.

Subsection (F) authorizes penalties and attorney fees when an employer fails to pay benefits required by a final judgment; the court upheld penalties where the employer paid only through an earlier date based on an erroneous interpretation of the judgment.

McCallon v. Key Energy Services, LLC · filed 2021-12-15(F)

Key Energy was obligated to pay benefits through June 21, 2016. On its own erroneous interpretation of this court’s judgment, it paid benefits only through April 16, 2016.

Section 23:1201 requires timely payment of medical bills and compensation, authorizes penalties for nonpayment subject to reasonable controversion, and applies a separate arbitrary-and-capricious standard to discontinued benefits.

Day v. Superior Derrick Services · filed 2011-02-02(E), (F), (B), and (I)

The burden of establishing that medical bills were not paid within sixty days of receipt lies upon the claimant seeking sanctions for failure to timely pay medical bills.

Section 23:1201(F) caps the total penalties imposed at a hearing on the merits at $8,000.

Bilquist v. Custom Craft Homes, Inc. · filed 2012-11-07(F)

Where the trial court did err, however, is in awarding Mr. Bilquist $10,000.00 in penalties. Mr. Bilquist’s attorney concedes that the maximum penalty allowed under the La. R.S. 23:1201(F) is $8,000.00. Therefore, we amend the judgment to set aside the $10,000.00 penalty and award $8,000.00 in penalties, the maximum allowed by law.

Whether an employer reasonably controverted a compensation claim so as to avoid penalties and attorney fees is a factual issue reviewed for manifest error; the court affirmed the award after finding the WCJ's determination reasonable.

Thibodeaux v. St. Mary Parish School Board · filed 2020-06-24(F)

Additionally, the WCJ' s determination that an employer has not reasonably controverted an employee' s compensation claim, so as to subject that employer to penalties and attorney' s fees pursuant to the Workers' Compensation Act, is a question of fact subject to the manifest error standard of review.

Section 23:1201 imposes statutory penalties when an employer or insurer withholds workers’ compensation benefits without evidence reasonably controverting the claimant’s right to compensation and medical benefits.

Borel v. Dynamic Offshore Contractors · filed 1995-04-05

The employer or insurer is liable for statutory penalties for withholding benefits without evidence to “reasonably controvert” the employees right to compensation and medical benefits. La.R.S. 23:1201. ... Once Dynamic’s insurer, The Gray Insurance Company, received the reports from Dr. Cobb and Dr. Lisenby, it should have conducted a further investigation. For example, it could have paid to have the MRI performed as Dr. Cobb requested and paid for Borel to continue his treatment with Dr. Cobb. Gray also admitted that it denied the MRI. because it felt that an accident had not occurred and that benefits were not owed. Once it received the decision of this court that Borel did suffer a compensable accident, Gray should have conducted a further investigation. We find that Gray was arbitrary and capricious in its denial of benefits and award penalties and attorney’s fees to Borel in accordance with La.R.S. 23:1201 as it read prior to the 1992 Amendment and 23:1201.2. Penalties are awarded in the amount of 12% of the unpaid benefits. Attorney’s fees are awarded in the amount of $3,500.

Section 23:1201(E) permits penalties for nonpayment of compensation unless the employer or insurer reasonably controverted the employee’s right to compensation or medical benefits, or nonpayment resulted from conditions beyond their control.

Davis v. Jones Baldwin Music Co. · filed 1995-11-01(E)

Penalties may be assessed for nonpayment of compensation unless nonpayment results from conditions over which the employer or insurer has no control[4] or if the employer or his insurer has reasonably controverted the employee's right to such compensation or medical benefits. La.R.S. 23:1201 E; Graham v. Georgia-Pacific Corp., 26,165 (La.App.2d Cir. 9/23/94), 643 So.2d 352. To reasonably controvert a claim, the employer and insurer must have sufficient factual and medical information to reasonably counter that provided by the claimant. Vernon v. Wade Correctional Institute, 26,053 (La.App.2d Cir. 8/19/94), 642 So.2d 684. ... *808 In light of this evidence, the hearing officer was not plainly wrong to find that the defendants did not reasonably controvert Davis's claim, and that their failure to pay benefits was arbitrary, capricious and without probable cause. The award of penalties and attorney fees will be upheld.

Section 23:1201(E) permits penalties when workers' compensation benefits are denied without sufficient factual and medical information to reasonably controvert the claimant's right to benefits, and the provision is strictly construed.

Ball v. Dawsey Corp. · filed 1995-11-28(E)

We recognize that La.R.S. 23:1201 is a penal statute and thus must be strictly construed. Lutz, supra. The statute provides for penalties when worker's compensation benefits are denied to a claimant and the employer did not "reasonably controvert" the claimant's right to the benefits. La.R.S. 23:1201(E). The question of whether the employer reasonably controverted the claim for benefits turns on whether the employer had "sufficient factual and medical information to reasonably counter the factual and medical information presented by the claimant." Ceasar v. Crispy Cajun Restaurant, 94-30 (La.App. 3d Cir. 10/5/94), 643 So.2d 471, 477, writ denied, 648 So.2d 931 (La. 1995). The defendant argues that it reasonably controverted the claimant's right to benefits and therefore the trial court erred in awarding a penalty under the statute. Essentially, the defendant's argument is that it presented a good faith defense to the claimant's request for benefits, namely that the claimant was not injured in the course and scope of his employment. The problem with defendant's argument is that, as discussed earlier, the trial court believed the claimant's testimony on this issue, as opposed to the defendant's. That is, the trial court believed the claimant's testimony that he was injured at work, that he told his supervisors of the accident, and that his employer took no steps to provide him with the required medical treatment and benefits. We have previously determined there to be no manifest error in the trial court's ruling on this issue. Therefore, we must conclude that the defendant had no factual basis on which to controvert the claimant's request for benefits. Moreover, Dr. Funk's testimony regarding the claimant's medical condition is uncontroverted. Thus, the defendant also lacked a medical basis to controvert the claim for benefits. Consequently, we find that the award of a penalty is justified in this case.

Section 23:1201(E) does not impose penalties when the employer's nonpayment is supported by a reasonable controversy and is not arbitrary or capricious.

Deris v. DHL Airways, Inc. · filed 1996-06-25(E)

We find no error in the hearing officer’s concluding a reasonable controversy existed over whether Deris, as a sole proprietor, was entitled to the benefits of successive employment in computing his wages. Thus, there is no error in his failure to award penalties. We also find no error in the hearing officer’s evidently finding that DHL was not arbitrary and capricious in computing the wages.

Section 23:1201 authorizes a penalty for underpaid workers’ compensation benefits when the employer cannot show that the calculation error was beyond its control or that the claimant’s entitlement was reasonably controverted.

Doucet v. Crowley Mfg. · filed 1997-04-30

Penalties and attorney's fees are proper for underpaying proper compensation benefits where the employer did not offer proof that the error in calculation of benefits was beyond its control or that claimant's right to such benefits was reasonably controverted. ... Accordingly, we assess a penalty of $2,000.00 for failure to correctly calculate the benefit from April 18, 1994, through the time the benefit was recalculated on December 15, 1995. La.R.S. 23:1201.

Section 23:1201 permits penalties for unpaid compensation or medical benefits only when the claim is not reasonably controverted, subject to the statute’s stated exceptions.

Gary v. Econo-Mart 10 · filed 1998-06-03(F)(2)

“Penalties for failure to provide worker’s compensation benefits are, of course, recoverable if the employee’s claim is not reasonably controverted. ... However, in view of the above-related factual background of this matter and our conclusion regarding the claimant’s failure to sustain the requisite burden of proof, we find no error in the denial of penalties and attorney’s fees.”

Section 23:1201's penalty provisions are governed by the law in effect when the medical benefits were denied, rather than the law in effect when the accident occurred.

Alexander v. Roy O. Martin Lumber Co. · filed 2001-05-09

However, after a thorough review of the applicable jurisprudence, the court in Skipper held that it was the law at the time of the denial of medical benefits which governed the imposition of penalties under La.R.S. 23:1201. We find the reasoning in Skipper to be applicable to the present issue.

Section 23:1201(F) permits a statutory attorney-fee award to cover reasonable work on all issues in the workers’ compensation litigation, even when penalties were awarded on only some issues.

Magbee v. Federal Express · filed 2012-12-12(F)

Mr. Magbee asserts that the award should be based on the efforts of his attorneys relative to all issues, including those issues for which he did not receive a penalty. We agree. ... Based on the supreme court’s holding in McCarroll, we find that the WCJ erred in awarding statutory attorney fees based only on the three issues for which penalties were awarded.

Section 23:1201(F) and (I) authorize attorney-fee awards in specified workers’ compensation circumstances, including nonpayment, failure to consent to physician selection or change when required, and arbitrary or capricious discontinuance of benefits without probable cause.

Our Lady of the Lake Regional Medical Center v. Mire · filed 2014-02-18(F) and (I)

The workers’ compensation law authorizes an award of attorney’s fees in certain instances, including where the employer fails to provide payment, fails to consent to the employee’s request to select a treating physician or change physicians when such consent is required, and discontinues benefits when such discontinuance is arbitrary and capricious or without probable cause.

Subsection (J) permits only one attorney-fee award for a hearing on the merits, even when multiple violations have occurred.

Musson Patout Automotive Group v. Maynard · filed 2021-01-27(J)

“Under La. R. S. 23:1201(J), only one award of attorney fees can be made in connection with a hearing on the merits, even when multiple violations have occurred.”

Section 23:1201(G)'s payment period for an award may be shortened by a final, court-approved settlement agreement, and penalties may be imposed for missing the agreed deadline.

Rapheal Guillory, Jr. v. R & R Construction, Inc. · filed 2018-03-14(G)

Here, the parties agreed to a deadline upon which settlement funds were payable, effectively amending the provisions of La.R.S. 23:1201(G). If there was no penalty or ramification for not complying with the agreement, that portion of the settlement agreement would be meaningless and unenforceable. As such, the workers’ compensation judge did not err in imposing penalties and attorney fees for Employer’s untimely tender of settlement funds, as the parties contractually agreed to shorten the time in which settlement funds were due, the agreement was not against public policy, the agreement was approved by the workers’ compensation judge, was placed on the record, and became final.

Section 23:1201(G) governs the employer’s post-final-judgment payment obligation and is penal in nature; parties may agree to shorten the payment period.

Guillory v. R&R Constr., Inc. · filed 2018-03-14(G)

Notably, LSA-R.S. 23:1201(G), which is penal in nature, concerns an obligation that arises because of the employer's conduct after a final judgment.

Section 23:1201(E) imposes statutory penalties for unpaid compensation or medical benefits unless the employer or insurer reasonably controverts the employee's entitlement, meaning it has a reasonable basis to believe the benefits are not owed.

Rochon v. Iberia Parish School Bd. · filed 1996-05-21(E)

La.R.S. 23:1201(E) subjects the employer or insurer to statutory penalties for any unpaid compensation or medical benefits, unless the employer or insurer reasonably controverts the employee's right to those benefits. "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 indemnity benefits were not due the employee." ... When we consider the length of time benefits were paid in this case and the total amount of medical expenses provided, we cannot conclude that the employer's reliance upon Dr. Shepherd's report was arbitrary and capricious or that such action subjected the employer to statutory penalties.

Subsection (E) permits separate penalties for delinquent compensation and medical benefits, so the statutory aggregate cap applies separately to each type of penalty.

Kendrick v. Bill Liberto Enterprises · filed 1997-06-18(E)

Consistent with our opinion in LeJeune v. Trend Services, Inc., 96-550 (La.App. 3 Cir. 6/4/97); 699 So.2d 95, we conclude that, at least for claims to be determined by the laws in force effective January 1, 1993, different penalties are to be assessed for delinquent payments of compensation and medical benefits. Our reasoning is that because penalties under La.R.S. 23:1201 are disjunctively due for arrearages in "compensation or medical benefits," an award is for either type that is delinquent; thus, it follows that each penal claim arises separately. Having stated as much, we hold that defendant is required to pay claimant separate penalties for each arrearages, for a total of $2,000.00 in penalties for its failure to timely pay claimant's medical expenses and an additional $1,100.00 for its failure to timely pay compensation benefits which claimant has not appealed, plus legal interest thereupon from the date of judicial demand until paid.

Section 23:1201(E) allows statutory penalties when an employer or insurer fails to pay benefits without reasonably controverting the claimant’s entitlement or without being prevented by conditions beyond its control.

Danzey v. Evergreen Presbyterian Ministries · filed 1995-06-07(E)

Statutory penalties are due only if the claimant's right to receive benefits has been reasonably controverted or nonpayment resulted from conditions over which the employer or insurer had no control.

Section 23:1201(E) provides penalties for an insurer’s unreasonable termination of workers’ compensation benefits before the claimant is released.

Despain v. Guichard Drilling Co. · filed 1994-03-02(E)

Given this medical history, we find that the insurer’s action in terminating benefits before Despain was released, prompted by one missed appointment, is subject to the penalties provided in §§ 23:1201 E and 23:1201.2.

The penalties and attorney's fees remedy is not exclusive when an employer intentionally and arbitrarily refuses lifesaving medical treatment knowing to a substantial certainty that the refusal will cause death.

Weber v. State · filed 1994-04-12(E)

We therefore conclude that the Legislature did not intend that the exclusive remedy of penalties and attorney's fees for an employer's intentional and arbitrary refusal to provide medical treatment to a compensation victim would encompass the situation where the employer knew to a substantial certainty that the refusal would cause death that would not otherwise have occurred.

Section 23:1201(E) requires the statutory penalty for untimely compensation payments, assessed against the employer or insurer at fault.

Warren v. Progressive Healthcare Providers · filed 1995-10-18(E)

Therefore, we find that Progressive was arbitrary and capricious and that Warren is entitled to penalties in the amount of $500 and attorney fees in the amount of $500.

Section 23:1201(E) is penal in nature and permits recovery only when the facts negate probable cause for nonpayment.

Stevens v. Wal-Mart Stores, Inc. · filed 1995-11-01(E)

These provisions are penal in nature and must be strictly construed, allowing recovery only when the facts of the case negate probable cause for nonpayment.