39-71-1006, MCA

MONTANA SUPREME COURT DECISIONS

Caldwell v. MACo Workers' Compensation Trust [07/11/11] 2011 MT 162 The categorical denial of rehabilitation benefits to those claimants who are eligible for social security retirement violates the Equal Protection Clause of the Montana Constitution.  An older claimant’s entitlement to rehabilitation benefits will be limited by consideration of his age, residual physical capacities, and vocational interests under § 39-71-1006(1)(c), MCA.

 
MONTANA WORKERS' COMPENSATION COURT DECISIONS
Caldwell v. MACo Workers' Compen. Trust [07/07/10] 2010 MTWCC 24 Automatically terminating rehabilitation benefits upon an injured worker’s eligibility for retirement subverts the governmental objective of the workers’ compensation system set forth at § 39-71-105(3), MCA, since § 39-71-1006, MCA, already takes a worker’s age into consideration in forming a rehabilitation plan.

Caldwell v. MACo Workers' Compen. Trust [07/07/10] 2010 MTWCC 24 Rehabilitation benefits are meant to assist only workers who will return to work.  Section 39-71-1006, MCA, takes the workers’ age into consideration to determine eligibility for benefits.  Therefore, the Court finds no rational basis for automatically terminating rehabilitation benefits upon retirement eligibility.

Markovich v. Liberty Northwest [06/14/07] 2007 MTWCC 21 On its face, § 39-71-1006, MCA, provides for up to 104 weeks of biweekly rehabilitation benefits. It does not create an entitlement to a full 104 weeks of benefits.
[1995] Kapor v. Liberty Mutual [3/14/03] 2003 MTWCC 22 Under 1995 law, claimant must begin a rehabilitation program within 78-weeks of reaching MMI. However, for the section to apply, the claimant must be eligible for benefits. Where claimant is not eligible at the time of MMI the period begins to run when she becomes eligible. 39-71-1006, MCA (1995).
[1995] Kapor v. Liberty Mutual [3/14/03] 2003 MTWCC 22  Where the claimant is eligible for rehabilitation benefits but the insurer notifies claimant of her entitlement to permanent partial disability benefits, including wage-loss benefits, without mention of rehabilitation benefits, the notice implicitly represents that the claimant is not entitled to rehabilitation benefits since wage-loss benefits are expressly tied to claimant's completion of a rehabilitation program, 39-71-703(8), MCA (1995). In light of that representation, claimant should be allowed to present evidence which may give rise to an estoppel from asserting the 78-week limitation period of section 39-71-1006(5), MCA.
[1997] McCoy v. Benefis Healthcare [11/19/02] 2002 MTWCC 59 Rehabilitation benefits are payable during semester breaks where the claimant is pursuing a college degree under a rehabilitation plan prepared by the vocational consultant designated by the provider. Section 39-71-1006, MCA (1997), which governs rehabilitation benefits provides for payment of those benefits during "the period specified in the rehabilitation plan," and the period contemplated by the statute is a calendar period not a chopped up series of periods defined by actual class attendance.
[1997] Petersen v. Liberty Mutual Fire Ins. [4/28/01] 2001 MTWCC 49 Claimant is not entitled to rehabilitation benefits where she has rejected a plan proposed by the insurer's vocational consultant and has not presented any alternative plan. 39-71-1006, MCA (1997).
[1997] Delaney v. Hartford [3/1/01] 2001 MTWCC 10 Claimant who has a significant impairment rating, who cannot return to his time-of-injury job or any other job at his time-of-injury employer, and who has a wage loss is entitled to rehabilitation benefits under section 39-71-1006, MCA (1997). Pursuant to the rehabilitation statutes, a rehabilitation plan must be prepared and implemented.
[1997] Dale J. Beyl v. Liberty Northwest Ins. Corp. [12/21/00] 2000 MTWCC 75 Under 1997 law, a claimant who does not suffer a rateable impairment is not entitled to rehabilitation benefits.
[1995] Kemp v. Montana Contractor Compensation Fund [6/4/98] 1998 MTWCC 46 Claimant argued section 39-71-1006, MCA (1995) was unconstitutional in that it denied him due process through judicial review of a rehabilitation decision and represented an unconstitutional delegation of authority to a private party. WCC rejected the constitutional challenge. On its face, the statute does not prohibit the parties from petitioning the WCC when a dispute arises over a rehabilitation decision. Even if the section did prohibit review, the remedy would be to strike down the denial of judicial review, not to invalidate the statute in its entirely. As shown by prior decisions of the WCC, this Court has entertained and decided rehabilitation questions.
[1995] Leastman v. Liberty Mutual Fire Ins. Co. [1/6/99] 1999 MTWCC 2 Claimants with permanent partial disability are entitled to a rehabilitation plan where statutory criteria are met, even if completion of the plan requires delay in return to work.
[1995] Leastman v. Liberty Mutual Fire Ins. Co. [1/6/99] 1999 MTWCC 2 Section 39-71-1006, MCA (1995) requires more than a theoretical exercise and recitation of job assessments to meet rehabilitation requirements. The statute requires a careful assessment of the worker's realistic and reasonable prospects for obtaining employment and a further assessment of the realistic wages he or she is likely to earn. That assessment must compare realistic job prospects and wages without further education or retraining with realistic job prospects and wages if the worker participates in retraining and/or further education which is consistent with his or her "age, education, training, work history, residual physical capacities and vocational interests." If there is a reasonable prospect that retraining or further education will result in significantly higher wages, then the plan must provide for such. Here, the analysis performed by the insurer's vocational consultants was inadequate, but the record leads the WCC to conclude claimant's plan for education in computer science will expand his job market and significantly increase his wages. Because the insurer's plans were inadequate, claimant will be allowed to proceed with his plan. 104 weeks of rehabilitation benefits were ordered, along with penalty and attorneys fees based on the insurer's unreasonable hardening of its position toward payment of any benefits after claimant refused to acquiesce to its inadequate plan.

[1995] Leastman v. Liberty Mutual Fire Ins. Co. [1/6/99] 1999 MTWCC 2 Contrary to the insurer's argument, section 39-71-1006, MCA (1995) does not vest unfettered discretion in either the insurer or the rehabilitation provider to require claimant to accept rehabilitation advice; claimant is entitled to petition the WCC, as he has done, for a determination of his entitlement to rehabilitation benefits.

[1995] Kemp v. Montana Contractor Compensation Fund [8/17/98] 1998 MTWCC 63 Section 39-71-1006, MCA (1995) requires actual wage loss as a result of an injury as a prerequisite to entitlement to rehabilitation benefits. If a wage loss exists, the section requires development of a rehabilitation plan and approval or disapproval by the insurer. While the Court ultimately has jurisdiction to resolve a dispute over a rehabilitation plan, or to compel the insurer to follow statutory procedures relating to development of a plan, those questions are properly deferred until resolution of the threshold question, whether claimant has a wage loss. Request that Court approve a specific plan is dismissed as premature.
[1995] Carlson-Owens v. Liberty NW [4/28/97] 1997 MTWCC 27 Claimant without wage loss is not entitled to rehabilitation benefits under 1995 statute.