Borja v. Fara St. Bernard Parish Gov’t

Claimant Richard Borja, was employed by St. Bernard Parish Government (“St. Bernard”) as a firefighter. In March of 2004, claimant filed a disputed claim for compensation alleging that he had injured his right knee and right thumb in an accident in 2002, and he also alleged he had an occupational disease. He described his injuries on the 2004 disputed claim for compensation as a “torqued knee” and “Heart and Lung,” indirectly referencing the Fireman’s Heart and Lung Act. After the accident, the claimant began receiving maximum workers’ compensation benefits, which continued until St. Bernard terminated them one year later. In the meantime, claimant had taken disability retirement in January 2003. The disputed claim form was filed within one year of the termination of the benefits. St. Bernard ultimately admitted that claimant had sustained an injury to his right knee, but disputed any thumb injury as well as any heart and lung claims as being related to his employment, stating that it did not know about the injuries, or that alternatively, they were prescribed. While St. Bernard conceded the claimant had been receiving the maximum benefits from the date of the accident until January 2003, it also maintained that because the claimant voluntarily retired in that month, he had removed himself from the workforce and was no longer entitled to future workers’ compensation benefits. Throughout the 2004 litigation, claimant had consistently argued that his heart and lung conditions were related to his employment. The dispute eventually went to mediation, which resulted in a compromise that claimant would receive back compensation payments in two lump sums, bringing him current to 2008, and that he would receive weekly indemnity benefits which were the maximum claimant could receive at that time. By October 2008, claimant moved dismiss the 2004 litigation noting “that this matter has been settled in full.” By 2013, St. Bernard, identifying the claimant’s benefits as Supplemental Earnings Benefits (“SEBs”), gave notice that it would terminate SEBs effective August 27, 2013, on the basis that he would have received the full 520 weeks of payments. In November 2013, claimant filed another disputed claim for compensation citing “knees, heart and lung” as his injuries. Specifically, he described his 2002 injury to the knee. St. Bernard filed exceptions of prescription and res judicata. A workers’ compensation judge granted the exception of res judicata for the knee injury, and granted the exception of prescription as to the claim under the “Heart and Lung Statute.” On appeal, a majority of the court of appeal affirmed in an unpublished opinion. After its review, the Supreme Court found the lower courts erred in concluding the claimant’s request for medical benefits under the heart and lung statute had prescribed because claimant timely filed his 2013 disputed claim asserting permanent and total disability as a result of his heart and lung condition. The Court reversed the court of appeal’s judgment affirming the workers’ compensation judge’s rulings sustaining the exception of prescription and the exception of res judicata. View "Borja v. Fara St. Bernard Parish Gov't" on Justia Law