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A. Garcia Trucking & Produce, LLC v. Sandoval

Court of Appeals of Georgia, Fourth Division

March 8, 2019


          DILLARD, C. J., DOYLE, P. J., and MERCIER, J.

          MERCIER, JUDGE.

         Alleging that he sustained a back and leg injury while employed by A. Garcia Trucking and Produce, LLC ("Garcia Trucking"), Jose Sandoval filed a claim for workers' compensation benefits. An administrative law judge ("ALJ") awarded benefits, finding that Sandoval proved a compensable injury and that he gave proper notice of the injury to Garcia Trucking. The ALJ also assessed attorney fees and costs upon finding that Garcia Trucking's defenses of the claim were unreasonable, and assessed penalties against Garcia Trucking based on its failure to timely controvert Sandoval's claim. Garcia Trucking appealed to the Appellate Division of the State Board of Workers' Compensation (the "Board"), which adopted the ALJ's findings and award as to compensability and notice, but found that an assessment of attorney fees and costs was not warranted given the "conflicting evidence" and Garcia Trucking's "other defenses, which [the Board found] to have been closely contested on reasonable grounds." Sandoval appealed to superior court on the attorney fees issue. The superior court stated that the Board "has some discretion" in assessing fees and costs, but that such discretion is premised upon evidence to explain an employer's noncompliance with the statute; "Since the Board made no finding that [Garcia Trucking's] late controvert was with reasonable grounds, the Board erred in reversing the ALJ's award of assessed attorney fees and litigation costs." Garcia Trucking and its insurer, Guarantee Insurance Company, applied for discretionary review of the superior court's ruling regarding attorney fees. We granted the application. For the reasons that follow, we reverse.

         Pursuant to OCGA § 34-9-105 (c), the findings made by the members of the Board are, in the absence of fraud, conclusive. However,

the [superior] court shall set aside the decision if it is found that: (1) [t]he members acted without or in excess of their powers; (2) [t]he decision was procured by fraud; (3) [t]he facts found by the members do not support the decision; (4) [t]here is not sufficient competent evidence in the record to warrant the members making the decision; or (5) [t]he decision is contrary to law.

(Punctuation omitted.) In this case, the superior court based its decision on OCGA § 34-9-105 (c) (5).

         In reviewing a workers' compensation award, "this Court must construe the evidence in the light most favorable to the party prevailing before the [Board]." Laurens County Bd. of Educ. v. Dewberry, 296 Ga.App. 204, 205-206 (674 S.E.2d 73) (2009) (footnote omitted). And, "the findings of the [Board], when supported by any evidence, are conclusive and binding, and neither the superior court nor this [C]ourt may substitute itself as a factfinding body in lieu of the [Board]." The Medical Center, Inc. v. Hernandez, 319 Ga.App. 335 (1) (734 S.E.2d 557) (2012) (citation and punctuation omitted). Erroneous applications of law to undisputed facts, as well as decisions based on erroneous theories of law, are subject to de novo review. Renu Thri ft Store v. Fi gueroa, 286 Ga.App. 455, 456 (649 S.E.2d 528) (2007).

         The record shows that Sandoval worked for Garcia Trucking as a delivery truck driver. His duties included loading and unloading merchandise and driving the delivery truck. On October 29, 2014, approximately two and one-half years after he began work at Garcia Trucking, Sandoval injured his lower back and right leg while lifting a 50-pound box. Sandoval immediately told his supervisor (company owner Aureliano Garcia) about his injury and asked to see a doctor, but Garcia told him to go home and rest. Sandoval went home and missed two to three weeks of work due to the pain. Lacking the money to seek treatment from the authorized panel physicians, and/or not realizing that he could see the panel physicians, Sandoval went to a doctor at a clinic that provided medical treatment for people with low income. He returned to work until March 2015, when the pain became intolerable.

         P. B., who was employed as an accountant by a company associated with Garcia Trucking and who knew Sandoval through his employment, testified that Sandoval told her about his back pain sometime between May and August 2014. Sandoval had pain medication that came from Mexico, and P. B. agreed to give him injections of the medication when he needed them. P. B. began giving him injections in May or June 2014. According to P. B., Garcia knew that she was giving Sandoval injections for back pain.

         Garcia testified that he hired Sandoval as a favor to Sandoval's uncle, that Sandoval told him before he began working at Garcia Trucking that he had a "back problem," that he was giving himself injections of medication for pain, and that he could not begin work until the following week because he was "waiting on some injections[.]" Garcia testified that it was not unusual for Sandoval to miss work prior to October 2014 due to back pain. He added that Sandoval never reported an October 2014 work injury and "never said he got hurt." According to Garcia, had Sandoval told him of an injury, he would have sent Sandoval to a doctor.

         In April 2015, Sandoval filed a claim for income and medical benefits, alleging a compensable injury on October 29, 2014, and an alleged fictional new accident on March 13, 2015. He also sought continuing temporary total disability benefits from March 13, 2015, as well as attorney fees, costs and late payment penalties under OCGA §§ 34-9-108 (b) (1), (2), (4) and 34-9-221 (e). Garcia Trucking contended Sandoval failed to give it proper notice of the claim and that any back pain predated his employment.

         Following a hearing, the ALJ found that Sandoval was credible, that he met his burden of proving a compensable accident on October 29, 2014, resulting in injury and disability, and that Garcia Trucking had actual notice of the injury. The ALJ further found "the Employer's defense claiming the Employee failed to give notice of his injury to the Employer to be unreasonable" and concluded that this unreasonable defense served as a basis for the assessment of attorney fees and costs of litigation.[1]The ALJ also awarded penalties based on Garcia Trucking's failure to controvert Sandoval's claim within 21 days of learning about the injury on October 29, 2014.[2]Garcia Trucking appealed the ALJ's award to the Board.

         "After a review of the record as a whole, as well as the arguments presented," the Board concluded that the ALJ correctly ruled that Sandoval suffered a compensable injury on October 29, 2014, and informed Garcia Trucking about his injury, but found that the competent and credible evidence did not support the ALJ's finding that the employee was entitled to attorney fees:

We find that the preponderance of the competent and credible evidence shows that the Employer had sufficient and timely notice of a claimed back injury in that it had enough information within thirty days after October 29, 2014, to investigate whether the Employee's absence from work, subsequent return to work, and need for restricted work were related to a work injury. [Cit.] However, given the evidence, including conflicting evidence, regarding the extent and duration of the Employee's pre-existing back condition and in light of the Employer/Insured's other defenses, which we find to have ...

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