Occupational Disease: Subsequent Disease

Cornelius v. Lumbermen's Underwriting Alliance [04/27/12] 2012 MTWCC 13 Since the Court determined Petitioner suffered a work-related, permanent, and material aggravation of an underlying work-related condition, the Court concluded that the insurer at risk at the time of the aggravation was now liable for Petitioner’s condition and is therefore liable for her medical benefits from the date she filed her occupational disease claim forward.

Grande v. Montana State Fund [06/17/11] 2011 MTWCC 15 Section 39-71-407(2)(a), MCA, provides for the compensability of an aggravation to an underlying condition caused by an injury, but does not contain any language providing for the compensability of an aggravation caused by an OD.  Although the word “aggravation” does not appear in the statutory definition of “occupational disease” at § 39-71-119(2)(d), MCA, the statutory requirement that the work-related aspect of an occupational disease be the “major contributing cause” would be meaningless if permanent aggravations of underlying conditions can no longer be considered occupational diseases even if work-related factors are the major contributing cause of the condition.
Tinker v. Montana State Fund [07/07/08] 2008 MTWCC 33 Although the same insurer was at risk for both Petitioner’s alleged industrial injury and his alleged subsequent occupational disease, the facts of Petitioner’s case remain the same regardless of whether it was a single insurer or not. Where no evidence indicates Petitioner ever reached MMI from his industrial injury, any subsequent progression is attributable to the initial injury. Petitioner therefore does not have a viable occupational disease claim.
Faulkner v. Hartford Underwriters Ins. Co. [04/24/07] 2007 MTWCC 15 Under the 2005 version of the Workers’ Compensation Act, the Court does not need to determine whether Petitioner’s occupational disease is related to the January 2000 injury or is a new distinct occupational disease unrelated to the 2000 injury. The Court only needs to determine whether the events that occurred during Petitioner’s employment at N.E.W. were the “major contributing cause” of his occupational disease in relation to other factors.
Fuss v. Ins. Co. of NA and Valor [4/8/04] 2004 MTWCC 34 An insurer liable for an occupational disease is not liable for a subsequent new and different disease. However, where a claimant is diagnosed with an occupational disease, the insurer at risk at the time of that diagnosis is liable for, and continues to be liable for, the disease even though the disease is materially aggravated by the claimant's continued work for the same employer.
Fuss v. Ins. Co. of NA and Valor [11/25/03] 2003 MTWCC 68 An insurer liable for an occupational disease is not liable for a subsequent new and different disease. However, where a claimant is diagnosed with an occupational disease, the insurer at risk at the time of that diagnosis is liable for, and continues to be liable for, the disease even though the disease is materially aggravated by claimant's work for the same employer and the aggravation occurs during a subsequent insurer's watch.
Abfalder v. Nationwide Mutual Fire Ins. [5/30/02] 2002 MTWCC 29 Where an occupational disease is based upon repetitive trauma, the occupational disease is continuing. A "new" occupational disease based on a continuation of the same sort of repetitive trauma does not begin merely because claimant may have been pronounced at maximum medical improvement. [Note: The Supreme Court affirmed this decision in Travelers Indemnity Company of Illinois v. Nationwide Mutual Fire Insurance Company (Abfalder), 2003 MT 180.]  
American Alernative Ins. Group v. Sung Sorenson & MSGIA [9/19/00] 2000 MTWCC 60 Two successive insurers of school district moved for summary judgment arguing that janitor's 1997 OD claim was barred by doctrine of collateral estoppel or res judicata where OD claim filed in 1996 was denied by DOL based on OD panel examination and claimant did not request a hearing on that denial. Court denied motion for summary judgment where claimant raised triable issues of material fact regarding whether her work following her 1996 claim materially aggravated her condition or she suffers from a new condition.
Liberty NW Ins. v. Champion International [6/25/96] 1996 MTWCC 45 Based on the "last injurious exposure" language of section 39-72-303(1), MCA, in Caekaert v. State Compensation Insurance Fund, 268 Mont. 105, 885 P.2d 495 (1994), the Montana Supreme Court extended the subsequent injury rule to a subsequent occupational disease for which the initial insurer was liable. This case turns on whether claimant, a millwright who injured his back in 1992, materially and significantly aggravated his condition by subsequent work at the same mill under a different employing entity, with a different insurer. If his current condition were merely a recurrence resulting from his 1992 injury, or merely the result of a natural progression of his preexisting condition, then the first insurer would remain liable. The Court was persuaded, however, by testimony of two doctors and the claimant, that his subsequent work caused material and significant deterioration of his low-back condition and caused his disability. (Note: this decision was affirmed by the Montana Supreme Court in Liberty Northwest v. Stimson Lumber Company, 285 Mont. 76, 945 P.2d 433 (1997) (No. 96-368).
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.