In the recent workers’ compensation case of Spillman v. Career Adventures, Inc., the Louisiana Second Circuit Court of Appeal upheld the decision of the workers’ compensation judge. The court found that the Employee forfeited his right to workers’ compensation benefits by selectively choosing not to answer questions regarding his past medical history in a pre-employment questionnaire.

Spillman v. Career Adventures, Inc. – BACKGROUND

In May of 2018, Employee, Michael Spillman, applied for a position with Employer, Career Adventures. Mr. Spillman was given an extensive pre-employment questionnaire, which included several questions asking if Mr. Spillman had ever been diagnosed with any of the 52 conditions listed on the page. Mr. Spillman falsely selected “no” for each item listed despite being diagnosed with COPD, hypertension, bipolar disorder, depression, and ADHD.

A separate section of the questionnaire inquired as to whether Mr. Spillman had ever been restricted by a physician and the reasons behind any restrictions. Contrary to the above, the section provided several blanks for which the employee was to write in their answer. Mr. Spillman declined to answer several of these questions, which, if he had, would have disclosed an array of injuries, including a prior foot injury, gunshot wound to the upper left leg, and surgery to his right shoulder.

He additionally omitted the fact that he was currently taking fourteen types of medications, which included muscle relaxers, stimulants, and opioid pain medications.

On April 5, 2019, Mr. Spillman was welding when he began to experience a burning pain in his left elbow. At the trial on the matter, the Workers’ Compensation Judge (WCJ) denied Mr. Spillman’s claim, in part, on the basis that he forfeited entitled to benefits by failing to truthfully answer Employer’s medical questionnaire under La. R.S. 23:1208.1.

FORFEITURE UNDER LA R.S. 23:1208.1

Under La. R.S. 23:1208.1, the failure of the employee to truthfully answer questions regarding prior conditions or disabilities shall result in the forfeiture of benefits if the failure to answer directly relates to the medical condition at issue or affects the employer’s ability to receive reimbursement from the Second Injury Fund.

Upon appeal, the court was tasked with determining whether Mr. Spillman’s failure to answer the pre-employment questionnaire satisfied the elements articulated in La. R.S. 1208.1. Contrary to the WCJ, who found that Mr. Spillman forfeited his benefits solely based upon his affirmative denial of his pre-existing conditions in the first section, the court found that due to Mr. Spillman’s selectivity in not answering questions that would have revealed his pre-existing conditions, the entire questionnaire, including the information that would have been solicited from the provisions he failed to answer, were relevant to whether La. R.S. 1208.1 was satisfied.

When considering the questionnaire in its entirety, the court found that Mr. Spillman’s misrepresentations satisfied both elements of the foregoing provision. First, the court determined that Mr. Spillman’s failure to answer the questionnaire truthfully undoubtedly affected the Employer’s ability to seek reimbursement under the Second Injury Fund, as Mr. Spillman’s subsequent elbow injury would have reasonably entitled the Employer to make a claim for same. With respect to the direct relation prong, the court found that Mr. Spillman’s prior right shoulder injury was directly related to his elbow injury given the close proximity of the extremities and frequent simultaneous usage of the two.

Therefore, the decision of the WCJ was upheld and Mr. Spillman forfeited his right to workers’ compensation benefits.