Claimant sustained an injury to his back, neck and shoulders while unloading a truck at work.  Employer and Carrier initially accepted the claim and paid Claimant indemnity and medical benefits.  During the pendency of the claim, Employer and Carrier retained a private investigator to conduct surveillance on Claimant.  Based upon the surveillance footage, Employer and Carrier suspended benefits and raised the fraud defense.  The claim proceeded to a trial, and the workers’ compensation judge found that Employer and Carrier failed to show that all of the elements of fraud were met, and awarded benefits to Claimant.  Employer and Carrier appealed this decision to the Louisiana First Circuit Court of Appeals.

Employer and Carrier challenged the workers’ compensation judge’s determination regarding whether Claimant committed fraud.  Video footage of Claimant obtained during surveillance demonstrated Claimant riding a bicycle to the grocery store and back home, washing an elliptical machine and then moving it into his home, and running various errands, including going to a doctor’s appointment.  Employer and Carrier maintained that Claimant made false statements to his physicians by misrepresenting the extent of the injurie he suffered.

Additionally, Employer and Carrier specifically alleged that Claimant drove to his doctor’s appointment after telling his physicians he had difficulty driving, then had another person sit in his car after he arrived at the doctor’s office to make it appear as if someone else drove him.  Claimant testified that he drove to the appointment with his child in the car, who had cancer.  Claimant further testified that he had his cousin meet him at the appointment to watch the child so the child did not have to risk infection by going into the doctor’s office.  Despite putting in his report that Claimant was alone, the private investigator subsequently admitted that there was a child present and had no explanation for the omission in his report.

Finding that the workers’ compensation judge made a reasonable finding based on the evidence, the Court of Appeals affirmed the decision awarding Claimant benefits.

Brown v. Alsco, Inc.