Van Daveer v. Stauffer Chemical Co. ( 1982 )

1 0 81-228
4.
IN THE SUPREME COURT OF THE STATE OF MONTANA
1982
JOHN C. VAN DAVEER,
Claimant and Respondent,
STAUFFER CHEMICAL COMPANY, Employer,
and NATIONAL UNION FIRE INSURANCE
COMPANY OF PITTSBUHG, Insurer,
Defendants and Appellants.
Appeal from: Workers' Compensation Court
Honorable William Hunt, Judge presiding
Counsel of Record:
For Appellants:
James P. Harrington argued, Butte, Montana
For Respondent :
Keefer and Roybal, Biilings, Montana
Neil S. Keefer argued, Biliings, Montana
Submitted: June 21, 1982
Decided: September 9, 1982
Filed: "Ski-' .I ~982
M r . J u s t i c e John C. Harrison delivered t h e Opinion o f the
Court.
T h l s a p p e a l a r i s e s from a J u l y 25, 1 9 8 0 judgment of
t h e W o r k e r s ' C o m p e n s a t i o n C o u r t i n w h i c h J o h n C. Van D a v e e r ,
the claimant, was awarded additional temporary total
d i s a b i l i t y b e n e f i t s , a n i n d e m n i t y award f o r d i m i n i s h e d e a r n -
i n g c a p a c i t y , p e n a l t y f o r l a t e payment, and a t t o r n e y f e e s .
The e m p l o y e r ' s r e q u e s t f o r r e h e a r i n g was d e n i e d by o r d e r o f
A p r l l 1 6 , 1981.
On S e p t e m b e r 2 4 , 1978, Van Daveer, w h i l e working a
summer job as a switchman for S t a u f f e r Chemical Company,
f e l l f r o m a r a i l r o a d c a r and w a s c r u s h e d b e t w e e n t h e c a r a n d
a brick wall. Van D a v e e r s u s t a i n e d a c o l l a p s e d l u n g , six
fractured ribs, and numerous o t h e r internal injuries. He
u n d e r w e n t s u r g e r y and was h o s p i t a l i z e d i n i n t e n s i v e care f o r
a t l e a s t a week.
A f t e r t h e i n j u r y , Van D a v e e r d i d n o t i n t e n d t o r e t u r n
to Stauffer but rather planned to return to school to
complete h i s degree. He discussed t h i s intention with Dr.
Bartlett, t h e only medical expert testifying i n t h e case.
On January 4, 1979, Dr. Bartlett released Van Daveer to
r e s u m e " f u l l , n o r m a l a c t i v i t i e s and d u t i e s . "
Van Daveer returned to school in January 1979 f o r
wlnter quarter and testified that he continued to suff6r
irom extreme pain. I n mid-February Van D a v e e r d e v e l o p e d a
hernia at the s i t e of the original incision. Corrective
s u r g e r y was performed March 23, 1979, and Bartlett again
r e l e a s e d Van Daveer f o r f u l l a c t i v i t y a s o f May 1, 1 9 7 9 .
Van D a v e e r g r a d u a t e d f r o m Montana S t a t e U n i v e r s i t y i n
c i v i l e n g i n e e r i n g i n August 1 9 7 9 and c u r r e n t l y i s employed
wit.h t h e Mont.ana Power Company a s a n e n g i n e e r .
At the time of the accident, Van Daveer was paid
$7.53 per hour for fort-y hours per week. His temporary
total rate was $188 per week and his maximum permanent
p a r t i a l rat.e was $94 p e r week.
Van D a v e e r p r o p e r l y g a v e S t a u f f e r n o t i c e o f h i s claim
and filed f o r compensation. N a t i o n a l Union F i r e I n s u r a n c e
Company a c c e p t - e d l i a b i l i t y f o r Van D a v e e r ' s i n j u r y , p a i d a l l
medical payments due, and paid weekly temporary t-otal
disability benefits t-hrough February 25, 1979. National
then terminated a l l c o m p e n s a t i o n and c l a i m e d a n o v e r p a y m e n t
o f $ 9 6 6 . 8 6 f o r p a y m e n t s made b e t w e e n J a n u a r y 3 a n d F e b r u a r y
25, 1 9 7 9 .
National r e i n s t . it u t e d temporary tot.al d i s a b i l i t y
payments on March 21, 1979, at the time of the hernia
problem. It continued payments through Flay 1, 1979,
deducting the claimed overpayment and making payment of
$161.14 o n S e p t e m b e r 28, 1 9 7 9 .
Van D a v e e r c l a i m e d h e was e n t i t l e d t o t e m p o r a r y t o t a l
p a y m e n t s f r o m t h e d a t . e o f h i s i n j u r y t o August. 1, 1 9 7 9 , and
t o a f u r t h e r I1indemnit.y a w a r d . "
The case was s u b m i t - t e d t-o t h e W o r k e r s ' Compensat i o n
Court on the pretrial order and briefs of counsel. The
court concluded that Van Daveer would not have been
physically fit to return t o h i s old job with St.auffer on
J a n u a r y 3 , 1 9 7 9 , and t . h a t h e was e n t i t - l e d t o t e m p o r a r y tot-a1
disability b e n e f i t - s from t h e d a t e of injury t o August 1,
1979.
The c o u r t . f u r t h e r c o n c l u d e d t h a t r e s i d u a l e f f e c t s o f
Van Daveer's injury limited h i s abi1it.y t o o b t a i n c e r t a i n
einployment a s an engineer in the open labor market., and,
therefore, h e was e n t . i t l e d t o a n " i n d e m n i t . ~ a w a r d " of 100
weeks.
The court computed temporary total compensation
b e n e f i t s f r o m S e p t e m b e r 24, 1 9 7 8 , t o A u g u s t 1, 1 9 7 9 , a t $ 1 8 8
per week, less the amount already paid, for a total of
$4,162.86. To that figure, the court added a 20 p e r c e n t
penalty for delay or refusal t.o pay compensation which
amounted t o $832.57. In addition, t h e " i n d e m n i t y award" o f
100 weeks a t $94 p e r week t o t a l e d $9,400. Each of these
a m o u n t s w a s t o be p a i d i n a lump sum.
S t a u f f e r and N a t i o n a l p e t i t i o n e d f o r r e h e a r i n g . The
p e t i t i o n was d e n i e d A p r i l 1 6 , 1 9 8 1 , and t h i s a p p e a l e n s u e d .
Four i s s u e s a r e b e f o r e t h i s Court on review:
1. W h e t h e r t h e c o u r t ' s award o f a d d i t i o n a l t e m p o r a r y
total compensation benefits was supported by substantial
evidence?
2. Whether t h e c o u r t ' s i n d e m n i t y award w a s s u p p o r t e d
by s u b s t a n t i a l e v i d e n c e ?
3. Whet.her t h e c o u r t ' s imposition of a penalty was
s u p p o r t e d by s u b s t a n t i a l e v i d e n c e ?
4. Whether the court erred in awarding attorney
fees?
AODITIOhAL BENEFITS
The f i r s t i s s u e t o b e c o n s i d e r e d i s w h e t h e r t h e r e is
substantial evidence t.o support the award of additional
disability benefits. If there is substantial evidence to
support t h e Workers' Compensation Court, t ~ h i sC o u r t c a n n o t
overturn that decision. H o l t o n v . S t o l t z e ( 1 9 8 1 ) , - Mont .
National argues the court's award of additional
disability benefits was arbitrary and unsupported by
substantial evidence. National points to t.he pretrial
stipulation which states: "Thereafter, defendant.-insurer
reinstituted temporary total disability payments on March
21, 1 9 7 9 when C l a i m a n t a g a i n became d i s a b l e d b e c a u s e o f a
h e r n i a problem . . ." (Emphasis added.)
National argues t-hat t h i s s t i p u l a t i o n , in a d d i t i o n t o
Dr. B a r t l e t t - l s f u l l m e d i c a l r e l e a s e o f Van D a v e e r o n J a n u a r y
4, 1979, p r e c l u d e s a f i n d i n g of d i s a b i l i t y bet-ween J a n u a r y
a n d March 2 1 , 1 9 7 9 .
The c o u r t c o n c l u d e d t - h a t s i n c e a h e r n i a i s c a u s e d by
exertion, if the original surgery incision was herniating
from t h e d a i l y a c t i v i t i e s a s s o c i a t e d w i t h a t t e n d i n g s c h o o l ,
it could n o t h a v e b e e n s u f f i c i e n t l y h e a l e d t.o h a v e a l l o w e d
Van D a v e e r t o r e t u r n t o h i s j o b a t S t a u f f e r i n J a n u a r y .
Dr. Bartlett testified that he knew, a t t h e t i m e he
r e l e a s e d Van D a v e e r f o r r e t u r n t.o w o r k , t h a t Van D a v e e r d i d
n o t i n t e n d t o ret-urn t o h i s job a t S t a u f f e r . Bartlett also
s t a t - e d h e was n o t f a m i l i a r w i t h t h e A m e r i c a n M e d i c a l Asso-
ciat-ion Rating Guides because he d i d n o t o f t e n make those
d e t - e r r n i n a t i o n s a n d h i s e x a m i n a t i o n o f Van D a v e e r was o f the
n a t u r e of a follow-up:
.o
t
S o , b a s i c a l l y , D o c t o r , would i t b e f a i r
s t a t e t h a t , r e a l l y , a t no t i m e d i d you
e v e r s i t down w i t h him and g o t h r o u g h t h e j o b
t h a t he had a t S t a u f f e r - and s a y , ' A l l r i g h t ,
you c a n g o d o t h i s t o d a y o r y o u c a n d o i t
next week'?
"A. I d i d n ' t d o t h a t and had no i n t e n t i o n o f
doing t h a t . What I mean by t.he p h y s i c a l
f i t n e s s o f him was h e w a s a b l e t o p e r f o r m
n o r m a l a c t i v i t i e s as s t a t e d i n my l e t t - e r . I
d i d n o t go t h r o u g h and d o a d i s a b i l i t y
e x a m i n a t i o n on him. I wasn't requested to.
I w a s g i v i n g a follow-up."
Van D a v e e r t e s t i f i e d h e e x p e r i e n c e d p a i n i n h i s h i p s
and c h e s t a f t e r J a n u a r y 1 9 7 9 w h i c h i m p a i r e d h i s movement and
would have prevented his return t o work a t S t a u f f e r . He
s t a t e d he b e l i e v e d he c o u l d n o t have r e t u r n e d t o S t a u f f e r ,
i f h e had e v e r i n t e n d e d t o d o s o , u n t i l A u g u s t 1, 1 9 7 9 .
W f i n d t h e c o u r t ' s d e t e r m i n a t i o n of temporary t o t a l
e
disability p a y m e n t s d u e Van D a v e e r f r o m t h e d a t e o f injury
t o A u g u s t 1, 1 9 7 9 , t o be s u p p o r t e d b y s u b s t a n t i a l e v i d e n c e .
INDEMNITY AWARD
I n h i s p e t i t i o n f o r a h e a r i n g Van D a v e e r r e q u e s t e d a n
"indemnity award," but did not specify the statute under
w h i c h h i s r e q u e s t was made. The W o r k e r s ' C o m p e n s a t i o n C o u r t
f o u n d t h a t he s u f f e r s from r e s i d u a l e f f e c t s of his injury
w h i c h would " l i m i t h i s a b i l i t y t o o b t a i n c e r t a i n employment
as an engineer in the open l a b o r market" and, therefore,
made a n " i n d e m n i t y award o f 1 0 0 w e e k s . "
This Court recently upheld a f i n d i n g of 40 p e r c e n t
d i s a b i l i t y of the whole man by the Workers' Compensation
Court. Holton v. Stoltze, supra. There, two p h y s i c i a n s
gave the claimant d i s a b i l i t y ratings--one 1 0 p e r c e n t and t h e
other 15 percent. The court, after considering the
claimant's age, education, work experience, pain and
disability, actual wage loss and loss of future earning
capacity, found a 40 percent disability. Based on that
determination, the court awarded claimant 200 weeks of
b e n e f i t s a t $ 4 5 p e r week.
Here, t h e c o u r t made no f i n d i n g o f a percentage of
d i s a b i l i t y of t h e w h o l e man or o f a n y member o f t h e body.
In fact, it did not specify any basis for its 100-week
determination, nor d i d it specify the s t a t u t e under which
t h e award was made. W e f i n d such an unexplained det-ermina-
t.ion t o be arbitrary, and w e return this question to t h e
W o r k e r s ' C o m p e n s a t i o n C o u r t f o r more c o m p l e t e f i n d i n g s .
PENALTY
The next i s s u e on review is whether a 20 percent
p e n a l t y f o r u n r e a s o n a b l e d e l a y a u t h o r i z e d b y s e c t i o n 39-71-
2907, MCA, w a s warranted here.
National paid Van Daveer temporary total payments
from t h e d a t e o f i n j u r y through February 25, 1979, s t o p p i n g
t h e payments a f t e r r e c e i v i n g D r . Bartlet.tls medical r e l e a s e .
Van D a v e e r ' s h e r n i a s u r g e r y and s u b s e q u e n t r e c o v e r y r e q u i r e d
additional temporary t-otal payments. National made the
payments f r o m March 1, 1 9 7 9 t h r o u g h May 1, 1 9 7 9 , when D r .
B a r t l e t t a g a i n g a v e Van D a v e e r a m e d i c a l r e l e a s e . Since Dr.
Bart1et.t had originally released Van Daveer for work on
J a n u a r y 5, 1 9 7 9 , N a t i o n a l c l a i m e d a n o v e r p a y m e n t . o f $ 9 6 6 . 8 6
for payments made into February. It subtracted this
o v e r p a y m e n t f r o m p a y m e n t s d u e f r o m March t h r o u g h May and o n
S e p t e m b e r 28, 1 9 7 9 , p a i d Van Daveer t.he $161.14 r e m a i n d e r .
Robert W. Keene, branch manager for the General
Adjustment Bureau, testified via deposition that a f t e r the
S e p t e m b e r p a y m e n t , Van D a v e e r was owed n o t h i n g f u r t h e r .
The c o u r t s u b s e q u e n t l y made F i n d i n g of F a c t No. 20:
"The p o s i t - i o n o f t h e i n s u r a n c e c a r r i e r t h a t
c l a i m a n t is e n t i t l e d t o a b s o l u t - e l y n o t h i n g
c o n s t i t u t e s a d e l a y o r r e f u s a l t o p a y compen-
s a t . i o n b e n e f i t s s o a s t o e n t i t - l e c l a i m a n t t.o
a 20% p e n a l t y a s p r o v i d e d by s e c t i o n 39-71-
2907, MCA."
In h i s deposition, Keene stated that he based his
position that Van Daveer was not entitled t.o further
payments on D r . B a r t l e t t ' s medical r e l e a s e .
The p e n a l t y is a u t h o r i z e d f o r " u n r e a s o n a b l e d e l a y o r
r e f u s a l t o pay." S e c t i o n 39-71-2907, MCA. The p e n d l t y i s
not, however, intended to e l i m i n a t e t h e r i g h t of an i n s u r e r
t o assert a l e g i t i m a t e defense. S t e f f e s v. 93 L e a s i n g Co.,
Inc. ( 1 9 7 8 ) , 1 7 7 Mont. 83, 580 P.2d 450.
B a s e d on t h e f a c t s i n t h i s c a s e , w e f i n d t h e c o u r t ' s
i m p o s i t i o n o f t h e 20 p e r c e n t p e n a l t y u n s u p p o r t e d b y s u b s t a n -
t l a l evidence.
"The triggering event for the purpose of awarding
p e n a l t i e s f o r u n r e a s o n a b l e d e l a y or r e f u s a l t o p a y compensa-
t l o n is t h e i n s u r e r ' s r e c e i p t of medical v e r i f i c a t i o n of a
compensable injury." Holton v. S t o l t z e ( l 9 8 1 ) , - Mont .
,
- 637 P.2d 1 0 , 1 3 , 38 S t .Rep. 1835, 1838.
Here, rather than a verification of compensable
injury, the insurer received medical v e r i f i c a t i o n t h a t Van
Daveer w a s r e c o v e r e d and c a p a b l e o f returning t o f u l l duty
a s o f May 1, 1 9 7 9 .
Although, based on d e p o s i t i o n s t a k e n nearly a year
later, the court determined Van Daveer' s temporary total
d i s a b i l i t y payments should have extended beyond that date,
we find it w a s n o t u n r e a s o n a b l e for the i n s u r e r t o r e l y on
the m e d ~ c a l releases. We therefore reverse the court's
i m p o s i t i o n o f a 20 p e r c e n t p e n a l t y .
ATTORNEY FEES
I n s u r e r 1s entire argument that attorney fees were
i m p r o p e r l y awarded is b a s e d on t h e p r e m i s e t h a t Van D a v e e r
s h o u l d n o t p r e v a i l on t h e o t h e r i s s u e s b e f o r e t h e C o u r t .
The c o u r t a w a r d e d a t t o r n e y f e e s . S e c t i o n 39-71-611,
MCA, p r o v i d e s f o r such a n award: "In the event an i n s u r e r
d e n i e s l i a b i l i t y f o r a claim f o r compensation o r t e r m i n a t e s
compensation b e n e f i t s and the claim is later adjudged
c o m p e n s a b l e by t h e w o r k e r s ' compensation judge o r on a p p e a l ,
the i n s u r e r s h a l l p a y r e a s o n a b l e c o s t s and a t - t o r n e y s ' f e e s
a s e s t a b l i s h e d by t h e w o r k e r s ' compensation c o u r t . "
Here, the insurer did not deny 1iabilit.y but did
t e r m i n a t e cornpensat-ion b e n e f i t s on a claim which h a s been
upheld as compensable. We, therefore, a f f inn t h e c o u r t ' s
award o f r e a s o n a b l e c o s t s and a t t o r n e y f e e s .
We remand this case to the Workers' Compensation
Court f o r a c t i o n i n accordance with t h i s opinion.
Justices
Mr. J u s t i c e F r a n k B. M o r r i s o n c o n c u r r i n g :
I concur i n p a r t , and d i s s e n t i n p a r t . T h i s case need n o t
b e remanded as c l a i m a n t is n o t e n t i t l e d to a n i m p a i r e d e a r n i n g
c a p a c i t y award. The r e c o r d c o n t a i n s a t o t a l l a c k o f e v i d e n c e to
s u p p o r t a f i n d i n g t h a t c l a i m a n t s u f f e r e d a 20% l o s s o f e a r n i n g
capacity. The f o l l o w i n g e v i d e n c e b e a r s upon t h a t q u e s t i o n .
DEPOSITION OF CLAIMANT:
(PP* 16, 17, 1 8 )
"Q. Now, w h a t t y p e o f work d o you d o a l l d a y
now a t t h e p r e s e n t t i m e ?
"A. L i k e I s a i d , most o f t h e week, a t l e a s t 35
h o u r s i s d e s k work, i s d e s i g n work. And 5 h o u r s
a week i s f i e l d work, which i n v o l v e s t r a v e l i n g
and i n s p e c t i n g .
"Q. Your d e g r e e from Bozeman i s i n C i v i l
E n g i n e e r i n g , is t h a t c o r r e c t ?
"A. Correct.
"Q. You a r e employed by t h e Montana Power
Company a s a n e n g i n e e r ?
"A. Correct.
"Q. And you a r e f a m i l i a r , a r e you J o h n , w i t h
t h e t y p e o f work t h a t c i v i l e n g i n e e r s d o ?
"A. Yes, I am.
"Q. You are a b l e , I t a k e i t , t o d o y o u r p r e s e n t
job, is t h a t c o r r e c t ?
"A. T h a t ' s correct.
"Q. A r e t h e r e some c i v i l e n g i n e e r i n g j o b s t h a t
y o u f e e l t h a t you would be u n a b l e to d o ?
"A. The area I would l i m i t m y s e l f t o would b e ,
i n f a c t , i f I was t o h a v e a j o b t h a t r e q u i r e d a
g r e a t d e a l of t r a v e l i n g p o s s i b l y heavy
construction .
"Q. Can you t e l l t h e r e a s o n f o r t h a t o p i n i o n ?
"A. I would s a y t h a t I would be h e s i t a n t to d o
something l i k e t h a t because I r e a l l y haven't
t r i e d to t e s t t h e f u l l c a p a b i l i t i e s of my p h y s i -
c a l w e l l b e i n g as f a r a s c o m p l e t e h e a l i n g from
t h e i n j u r i e s . And I w o u l d n l t w a n t to j e o p a r d i z e
m y s e l f or a n y b o d y e l s e i n s u c h a s i t u a t i o n w h e r e
I m i g h t g e t h u r t s a y i f I was to be i n t h e
p r o x i m i t y o f h e a v y c o n s t r u c t i o n and s o m e t h i n g d i d
h a p p e n and I was c a l l e d on t o d o s o m e t h i n g t h a t
r e q u i r e d some h e a v y p h y s i c a l r e s p o n s e .
"Q. A r e t h e r e a n y a c t i v i t i e s t h a t you c a n ' t do
now t h a t you c o u l d d o b e f o r e y o u r i n j u r y ?
"A. N o t t h a t I know o f . I h a v e n 1t t r i e d a l o t
of things afterwards."
A t p a g e 36 o f t h e d e p o s i t i o n t h e c l a i m a n t gave t h e
f o l l o w i n g r e s p o n s e s to q u e s t i o n s propounded on c r o s s - e x a m i n a t i o n :
Q . I mean i n t h e f i e l d of c i v i l e n g i n e e r i n g
i t s e l f . Okay, p u t t i n g a s i d e t h e q u e s t i o n o f
w h e t h e r t h e r e was a n a c c i d e n t i n v o l v i n g h e a v y
e q u i p m e n t and you b e i n g a r o u n d and c a l l e d t o
l i f t a v e h i c l e o f f o f somebody or s o m e t h i n g l i k e
t h a t , b u t j u s t i n your f i e l d a l o n e of c i v i l
e n g i n e e r i n g , t h e r e is n o t h i n g t h a t r e q u i r e s a n y
f u n c t i o n s t h a t you c a n ' t p e r f o r m , is t h e r e ?
"A. The o n l y area I would q u e s t i o n myself i n
d o i n g is p o s s i b l y i f I was on a l a r g e i n s p e c t i n g
j o b w h i c h would r e q u i r e m e to d o a l o t o f
climbing f o r a long period of t i m e .
"Q. O t h e r t h a n t h a t , t h e p e r f o r m a n c e , t h e r e is
n o t h i n g you c o u l d c o n c e i v e o f t h a t you c o u l d n ' t
d o , is t h e r e ?
The d e p o s i t i o n o f t h e t r e a t i n g p h y s i c i a n was a d m i t t e d .
Dr. J o h n D. B a r t l e t t g a v e t h e f o l l o w i n g t e s t i m o n y :
"Q. Okay, a t t h e t i m e t h a t you examined him on
J a n u a r y 4 , 1 9 7 9 , d i d you form a n o p i n i o n , b a s e d
upon a r e a s o n a b l e d e g r e e o f m e d i c a l c e r t a i n t y ,
a s t o w h e t h e r he had a n y i m p a i r m e n t o r d i s a b i -
l i t y from t h i s a c c i d e n t a t S t a u f f e r C h e m i c a l
Company?
"A. I f e l t t h a t he was p h y s i c a l l y f i t f o r d u t y ,
yes.
"Q. You f e l t t h a t h e w a s w i t h o u t a n y i m p a i r m e n t
o r disability?
"A. Yes ."
The o n l y t e s t i m o n y i n t h e r e c o r d to s u p p o r t a p e r m a n e n t
d i s a b i l i t y award is c l a i m a n t ' s t e s t i m o n y t h a t h e m i g h t l i m i t him-
s e l f i n h i s work from h a v i n g t o do a " g r e a t d e a l of t r a v e l i n g and
p o s s i b l y heavy c o n s t r u c t i o n . " T h e r e is n o t e v e n s e l f - s e r v i n g
t e s t i m o n y b y t h e c l a i m a n t t h a t s u c h a l i m i t a t i o n would i n a n y way
a f f e c t h i s a b i l i t y to e a r n i n t h e f u t u r e . Although it is p r e f e r -
a b l e t o c a l l a n e m p l o y e r , a s u p e r v i s o r , o r some e x p e r t w i t n e s s
to e s t a b l i s h t h a t p h y s i c i a l l i m i t a t i o n s af f e c t earning c a p a c i t y ,
some " s u b s t a n t i a l c r e d i b i l e e v i d e n c e " c o u l d be p r o v i d e d b y t h e
claimant himself. I n t h i s r e c o r d , even t h a t s u p p o r t for t h e
award i s l a c k i n g . In f a c t , the only medical evidence i n the
r e c o r d s u g g e s t s t h a t c l a i m a n t has n e i t h e r p h y s i c a l impairment nor
disability. I do not agree with the suggestion in the majority
o p i n i o n t h a t a medical f i n d i n g of p e r c e n t a g e of " d i s a b i l i t y of
t h e w h o l e man or o f a n y member o f t h e body" i s d e t e r m i n a t i v e of
a n i s s u e involving impaired earning c a p a c i t y . Nevertheless, the
m e d i c a l t e s t i m o n y i n t h i s r e c o r d , when viewed i n c o n j u n c t i o n w i t h
c l a i m a n t ' s t e s t i m o n y , d o e s n o t s u p p o r t t h e f i n d i n g o f a 20%
i m p a i r e d e a r n i n g c a p a c i t y and t h e r e f o r e t h e f i n d i n g s h o u l d be s e t
aside.
I d i f f e r w i t h t h e m a j o r i t y i n r e m a n d i n g t h i s case. The
c l a i m a n t s i m p l y f a i l e d i n h i s e f f o r t to p r o v i d e any e v i d e n c e o f
i m p a i r e d e a r n i n g c a p a c i t y and t h e r e f o r e t h a t a s p e c t o f c l a i m a n t ' s
case m u s t f a i l . The r e s u l t o f t h e m a j o r i t y o p i n i o n i s t o g i v e
c l a i m a n t a s e c o n d o p p o r t u n i t y to p r o v i d e e v i d e n c e n o t p r o d u c e d
initially. I know o f n o l e g a l s u p p o r t f o r s u c h a c t i o n .
I a g r e e w i t h t h e m a j o r i t y ' s p o s i t i o n on t h e b a l a n c e of
issues. Based upon c l a i m a n t ' s t e s t i m o n y t h e r e is some
" s u b s t a n t i a l c r e d i b l e e v i d e n c e " to s u p p o r t a n award o f t e m p o r a r y
t o t a l d i s a b i l i t y p a y m e n t s t o c l a i m a n t u n t i l A u g u s t 1, 1 9 7 9 .
However, i n l i g h t o f t h e t r e a t i n g p h y s i c i a n ' s finding t h a t
c l a i m a n t c o u l d r e t u r n t o work i n F e b r u a r y o f 1 9 7 9 , and n o t i c e
t h e r e o f t o t h e i n s u r e r , a p e n a l t y should n o t have been a s s e s s e d
a g a i n s t i n s u r e r f o r suspending temporary t o t a l payments.
I would a f f i r m t h e C o u r t ' s award o f a d d i t i o n a l t e m p o r a r y
t o t a l c o m p e n s a t i o n b e n e f i t s , a f f i r m t h e award o f c o s t s and a t t o r -
n e y f e e s , and m o d i f y t h e judgment to e x c l u d e t h e r e f r o m t h e award
f o r l o s s o f f u t u r e e a r n i n g c a p a c i t y and p e n a l t y .
.--,
Mr. Justice John C. Sheehy concurring in part and dissenting
in part:
I concur with the majority in the resolution of the
issues of temporary total disability payments, and attorney
fees. I disagree with and dissent from the majority opinion
insofar as it remands the indemnity award, and denies the
worker's right to a penalty in this case.
It distorts the record to say that there is no basis in
the evidence and in the findings and conclusions for the
indemnity award. (The indemnity award is for permanent partial
loss of earning capacity.)
At the outset, it is stated here as reinforcement that
when the Workers' Compensation Court is considering an
indemnity award, it need not consider as a determinative
fact that the employee is earning as much or more money as
he did before the injury. Fermo v. Superline Products
(1978), 175 Mont. 345, 574 P.2d 251. Of course, if loss of
earning capacity can be proven through an actual, post-injury
loss of earnings, that is an item for the Workers' Compensation
Court to consider. Walker v. H. F. Johnson, Inc. (1978), 180
Mont. 405, 591 P.2d 181. It was settled in Shaffer v.
Midland Empire Packing Co. (1953), 127 Mont. 211, 213-214, 259
P.2d 340, 342, that the test of whether an injured worker is
entitled to an indemnity award is not whether there has been
a loss of earnings or income caused by the injury, but
rather whether there has been a loss of earning capacity--a
loss of ability to earn in the open labor market.
The evidence in this case discloses that this injured
worker has sustained a loss of ability to earn in the open
labor market. This injury occurred when the employee,
working as a switch man, was crushed between a brick wall
and a moving train car. His injuries were found by the
Workers' Compensation Court to be: "blunt trauma to the
chest and abdomen; abrasion right lobe of liver; hemo-
peritoneum; contusion to left kidney with hematoma at base
of gallbladder; hemopneumothorax of right lung; [and] fractured
ribs 5 through 11 on the left." He was substantially and
seriously injured.
With respect to the worker's residual post-injury
difficulties, the Workers' Compensation Court made findings
that the worker has occasional discomfort on the left side
of his chest due to the nature of the healing of his ribs;
that when he sits for a long period of time, he experiences
tiredness in his back and pain in his legs. The court also
found that after his injury the worker received a degree in
civil engineering from Montana State University and is
employed as a civil engineer by the Montana Power Company.
However, the worker's opportunity to work as a civil engineer
is limited in that he can not accept a job that requires
a great deal of traveling or that is involved with heavy
construction. The claimant stated the reason for this limitation
is that he would not want to jeopardize himself or anybody
else in a situation where ". . . I might get hurt, say if I
was to be in the proximity of heavy construction and something
did happen and I was called on to do something that required
some heavy physical response." The pain and "bothersomeness"
in his rib cage is due to the fact that a couple of the
ribs have healed a little out of place and they protrude
farther from his chest than the other ribs. He has a continuing
dull pain in the chest.
On these findings, the Workers1 Compensation Court
concluded:
"The evidence clearly establishes that claimant
still suffers some residual effects from his
injury that would limit his ability to obtain
certain employment - - engineer in the open
as an
labor market. It appears that an indemnity
award of 100 weeks would be an appropriate
award in his case." (Emphasis added.)
We are required to view the evidence on appeal of a case
of this kind in the light most favorable to the prevailing
party. Hellickson v. Barrett Mobile Home Transport, Inc. (1973),
161 Mont. 455, 507 P.2d 523, 525. In considering such evidence
we should bear in mind these rules:
". . . We will not substitute our judgment for
that of the trier of fact, but rather will o n l y con-
s c c r whether substantial credible evidence supports
il-
the findings and conclusions. Those findings will
not be overturned by this court unless there is a
clear preponderance of t.vidcnce against them.
We will view the evidence in a light most favorable
to the prevailing party, recognizing that substantial
evidence may be weak or conflicting with other evidence,
yet still support the findings . . ." Cameron v.
Cameron (1978), 179 Mont. 219, 228, 587 P.2d 939,
945.
We owe a good deal of respect to the findings and con-
clusions adopted by the Workers' Compensation judge. Under
section 39-71-2905, MCA, he is given the power to fix and
determine any benefits to be paid and to specify the manner
of payment to a claimant. The Workers1 Compensation judge is
required in that same statute to make his determinations in
accordance with the law as set forth in Ch. 71 of Title 39,
MCA. Indemnity awards arise by virtue of the provisions of
sections 39-71-705 and -706, PICA. The latter section
provides that in all cases of permanent injury less than
total, the compensation for permanent partial disability
shall bear such relation as the disability bears, in this
case, to 500 weeks. By determining here that the claimant
was entitled to 100 weeks for his indemnity award, the
Workers1 Compensation Court impliedly found that he had
suffered a loss of 20 percent of earning capacity. The
record bears this out.
Although an estimate from a medical person as to the
percentage of total disability of an injured worker is
undoubtedly helpful to the Workers1 Compensation Court, I
find nothing in the law which requires the testimony of a
medical person as an absolute requisite for such an award.
There is no reason why the Workers' Compensation Court
cannot rely on the uncontroverted evidence of the claimant
as to the amount and character of his disability, from which
the Workers1 Compensation Court may draw a conclusion as to
the amount of indemnity award to which the claimant is
entitled. Section 39-71-706, MCA.
Taking into account that there is a different Workers'
Compensation judge now sitting than the one who heard and
determined this case, it appears quite unnecessary to me to
remand this case to the Workers1 Compensation judge for what
will be a ministerial act: his determination that the
injuries shown by the claimant amount to 20 percent of his
earning capacity.
I also disagree with the majority conclusion that this
claimant is not entitled to a penalty award based on the
actions of the insurer in connection with his claim. The
majority is substituting its opinion for that of the Workers1
Compensation judge upon entirely wrong factors. This is not
a case where the employer-insurer had a right to rely on medical
evidence so as to refuse - further compensation.
all
Section 39-71-2907, MCA, provides:
". . . The question of unreasonable delay or
refusal shall be determined by the workers'
compensation judge, and such a finding constitutes
good cause to rescind, alter, or amend any order,
decision, or award previously made in the cause
for the purpose of making the increase provided
herein. "
The Workers' Compensation Court concluded that "[tlhe
position of the insurance carrier that claimant - entitled
is
- absolutely nothing constitutes a delay or refusal to pay
to
compensation benefits . . ." (Emphasis added.) The record
supports this finding and conclusion.
A review of the whole record, not shown to have been made
by the majority, would indicate that there was an unreasonable
delay or refusal to pay compensation to the worker.
On March 9, 1979, Mr. Keene, branch manager of the
adjustment firm handling this case, wrote to the worker
stating that he had been overpaid for 36 days for a total of
$966.86, and demanding that Van Daveer repay that amount. This
was during the period of the worker's disability, which the
majority concurs is correctly computed.
On March 21, 1979, counsel for the worker wrote to Mr.
Keene advising him of the development of a hernia in the
long abdominal incision. In that letter, counsel advised Keene
that the overpayment could be deducted from the eventual
entitlement to the worker, and that this was a case where
there would be a claim over and above the temporary total
disability benefits.
On March 30, 1979, Keene wrote to counsel for the
worker stating that they were going to deny further compensation
by relying on the medical report of Dr. Bartlett that the
worker suffered no residual disability, although at that
time Keene had been advised that an operation for the hernia
had occurred.
-17-
On June 8, 1979, Dr. Bartlett wrote to Keene, stating
that he had last seen the worker on March 29, 1979, and that
he had released the worker for full duty as of May 1, 1979.
Dr. Rartlett also indicated that since he had not seen the
worker lately, he could give no further information at that
time.
On July 2, 1979, the worker's counsel wrote to the
adjustment firm stating that a claim would be made for an
indemnity award, and setting forth the amount of partial
disability then owed to the worker. The letter invited any
offer that the firm might make with respect to settling the
case. The insurer did not respond.
On August 23, 1979, Keene wrote to the Workers' Compensation
Division, asking for permission to pay the worker a temporary
total disability of 6 weeks, and to deduct therefrom the
overpayment of $966.86, leaving a net payment to the employee
of $161.14.
On September 28, 1979, Keene addressed a letter to
counsel for the worker stating that he had received a
letter from the Workers' Compensation Division authorizing
the deduction of the overpayment and that Reene had surrendered
a check in the sum of $161.14 "as final payment of compensation
benefits owing."
On February 7, 1980, the employee filed his petition
for a hearing to determine the compensation benefits to
which he was entitled. In that petition, he asked for an
indemnity award for prospective loss of earning capacity.
On April 30, 1980, the Workers' Compensation judge entered
a pretrial order, in which he noted the worker contended
he was entitled to an indemnity award for prospective loss
of earning capacity, and in which the employer contended
that the claimant had been paid all medical and compensation
benefits to which he was entitled.
The case was tried on depositions, all taken on the
same day. The claimant testified to his continuing disability.
Keene testified that based on medical reports and the further
testimony that day of the worker, he would still contend
that the worker was not entitled to one further penny as
compensation benefits.
Thus, nonths after the letter of September 28, 1979,
it was apparent that Keene still refused to change his mind,
and was relying on medical reports that obviously were not
pertinent to the present claimed condition of the worker.
The Workers' Compensation Court saw this as an unreasonable
delay or denial of compensation benefits. The record sustains
the court. When there is substantial evidence to support
the court's findings and conclusions, it is the duty of this
Court to affirm those findings. Walker v. H. F. Johnson,
supra.
I would affirm the Workers' compensation Court in
toto.
.
,
Mr. Chief Justice Frank I. Haswell:
I concur in the foregoing opinion of Mr. Justice Sheehy.
Chief Justice