Occupational Disease: Proximate Cause

Polk v. Planet Insurance Co., 287 Mont. 79, 951 P.2d 1015 (1997) In light of the occupational disease proximate cause requirement, set out at section 39-71-408, MCA, and the aggravation statute, section 39-71-706, MCA, occupational aggravations of preexisting non-occupational diseases are compensable, as are occupational diseases which are aggravated by non-occupational factors. The test for compensability under the OD Act is whether occupational factors significantly aggravated a preexisting condition, not whether occupational factors played the major or most significant role in causing a particular disease. As long as an occupational exposure substantially aggravated a pulmonary condition, claimant is entitled to pro rata compensation for his disease. The DOL hearing examiner, and the WC Court, erred in basing their decision on medical opinions by physicians who operated under the mistaken assumption that occupational irritants had to be the major factor causing a pulmonary condition for claimant to receive compensation.
Burglund v. Liberty Mutual Fire Ins. Co., 286 Mont. 134, 950 P.2d 1371 (1997) Supreme Court affirmed WCC determination that cause of claimant's current back-related disability was 1984 injury and not occupational disease insurer claimed arose after claimant returned to work. Claimant met his burden of establishing a clear connection between his current condition and the 1984 injury through physician's testimony. Insurer did not prove causation through occupational disease where doctor could not determine with any precision what effect claimant's resumed work had on his condition, testified claimant's low back condition would have deteriorated even if he had not resumed his UPS duties, and testified that post-injury work was not a substantial cause of the degeneration.

Clapham v. Twin City [10/16/12] 2012 MTWCC 34 Where Petitioner’s treating physician  opined that his work was the fourth in importance of five factors which contributed to his degenerative disk disease, the Court concluded that Petitioner’s work was not the “leading cause” as set forth in § 39-71-407(13), MCA.

Johnson v. Liberty Northwest Ins. Corp. [07/01/09] 2009 MTWCC 20 Where the Court found that Petitioner’s employment exposure to asbestos clearly exceeded his non-employment exposure, and the Court found the treating physician’s opinion that Petitioner’s exposure to asbestos during his years at Stimson was sufficient to cause his asbestos-related disease, the Court concluded that Petitioner suffers from an occupational disease as a result of his employment under the proximate causation test as set forth in Kratovil and pursuant to § 39-72-408, MCA.

Fuss v. Ins. Co. of NA and Valor [4/8/04] 2004 MTWCC 34 Where the claimant has been determined to suffer from an occupational disease, the insurer at risk at the time of the determination continues to be liable for the condition unless it wholly resolves and the recurrence of the condition is the result of factors unrelated to his employment.
State Fund v. Carl Murray [4/6/04] 2004 MTWCC 33 The fact that the claimant's recreational activities may have contributed to his preexisting bilateral knee condition does not preclude a finding of an occupational disease where the evidence establishes that the claimant's work significantly and materially aggravated his underlying condition. Affirmed Montana State Fund v. Murray, 2005 MT 97
State Fund v. Carl Murray [4/6/04] 2004 MTWCC 33 The Montana Occupational Disease Act does not require that occupational exposures be the principal or substantial cause of the condition, only that the "occupational factors significantly aggravated a preexisting condition." 39-72-408, MCA (1971-1999); Polk v. Planet Ins. Co., 287 Mont. 79, 951 P.2d 1015 (1997). Affirmed Montana State Fund v. Murray, 2005 MT 97
State Fund v. Carl Murray [4/6/04] 2004 MTWCC 33 Aggravations of preexisting conditions are compensable under the Montana Occupational Disease Act. 39-72-706, MCA (1989-2003). Affirmed Montana State Fund v. Murray, 2005 MT 97
Christensen v. Rosauer's Supermarket, Inc. [10/28/03] 2003 MTWCC 62 Where the Court found claimant incredible, and the medical opinion supporting her claim for benefits was based on her incredible history of events, she has not proven that her work as a cook caused her herniated disk and resulting disability and medical treatment.
B. v. Northwest Healthcare [7/28/03] 2003 MTWCC 52 Foot condition involving swelling and pain suffered by nursing home housekeeper was not caused by employment where her condition was inconsistent with any trauma, even repetitive trauma, occurring at work and where she suffered a long history of fibromyalgia and other medical conditions, including prior swelling in her legs.
Watkins v. State Fund [2/22/02] 2002 MTWCC 11 Where claimant presented no medical testimony that he suffered from an occupational disease proximately causing his condition, his occupational disease claim must fail.
Liberty Mutual v. Griner [11/09/01] 2001 MTWCC 58 In cases where claimant suffered a prior work-related injury or occupational disease involving the condition, a subsequent insurer is liable for an aggravation of the prior condition if and only if the subsequent work exposure was different from or in excess of ordinary, everyday activities typically occurring outside the job. § 39-72-408(4), MCA (1997).
Liberty Mutual v. Griner [11/09/01] 2001 MTWCC 58 Where medical testimony establishes that heavy labor caused harm the proximate cause requirement of the Occupational Disease Act is satisfied. § 39-72-408 (1997).
LaFournaise v. State Fund [8/14/01] 2001 MTWCC 42 In evaluating medical opinions concerning causation under the Occupational Disease Act, 39-72-408, MCA (1997), the Department of Labor must consider the substance of the opinions rather than the use of precise, statutory language, and determine whether the substance of the opinions satisfy the statutory criteria even though not couched in the precise terms of the statute.
Romero v. Liberty Mutual & State Fund [1/29/01] 2001 MTWCC 5 Where condition develops over a period of years as a natural progression and result of an earlier workers' compensation injury, even though part of the progression occurred during subsequent employment it does not constitute an occupational disease and is the responsibility of the insurer for the earlier injury since the progression was not fairly traceable to the subsequent employment and is not a natural incident of the work or business. 39-72-408, MCA. [Note: The Supreme Court affirmed the WCC decision in Romero v. Liberty Mutual Fire Ins. Co., 2001 MT 303N (a non-citeable decision.)]
Polk v. Planet Ins. Co. [2/26/97] 1997 MTWCC 6 WCC affirmed DOL hearing officer's decision that medical panel correctly determined claimant was not entitled to compensation for occupational exposure. [Note: the WCC decision was reversed by the Supreme Court in Polk v. Planet Insurance Co., 287 Mont. 79, 951 P.2d 1015 (1997), on the ground that physicians rendering an opinion on occupational disease causation misunderstood the appropriate standard.]
Burglund v. Liberty Mutual Fire Insurance Co. [8/29/96] 1996 MTWCC 60 UPS driver and insurer disputed whether claimant's current disability was result of 1984 back injury and following surgery or occupational disease resulting from claimant's return to work. Based on medical testimony, Court found condition was result of earlier injury. Physician's testimony left no doubt that claimant's 1991 surgery, and thus his 1984 injury, are substantial and material factors in claimant's current disability. WCC was persuaded claimant's continued employment may have hastened the degenerative process, but was not persuaded it substantially or materially did so. Most importantly, physician testified that even had claimant not returned to a labor intensive job, his degenerative condition would have ultimately progressed and that the current condition is consistent with a natural progression of the underlying condition. (Note: WCC decision affirmed by Supreme Court in Steven K. Burglund v. Liberty Mutual Fire Ins. Co., 286 Mont. 134, 950 P.2d 1371 (1997).)
Erickson v. Champion International [3/12/96] 1996 MTWCC 23 WCC reversed and remanded DOL decision that claimant did not suffer from an occupational disease where the decision rested on the opinion of a doctor who applied an incorrect understanding of the law. The doctor opined that claimant's knee condition was not an occupational disease because not all mill workers develop similar knee conditions, ignoring the settled principle that an employer takes a worker as it finds him, making the fact that non-susceptible or non-predisposed workers would not be affected by working conditions irrelevant to a determination whether an occupational disease exists in a particular worker.
Erickson v. Champion International [3/12/96] 1996 MTWCC 23 The fact that claimant's underlying condition would ultimately have been totally disabling due to a natural progression of an underlying condition does not preclude compensation where the disability was hastened by a work-related injury or conditions.
Shorten v. State Comp. Ins. Fund [12/22/95] 1995 MTWCC 110 From the fact that claimant may have suffered from carpal tunnel syndrome it does not follow that her syndrome was the consequence, in whole or in part, of occupational factors. She had a prior history of hand problems, her job involved less repetitive hand motion than she claimed, and the medical evidence did not establish a causal connection.