39-71-105, MCA

MONTANA SUPREME COURT DECISIONS

Wright v. Ace American, 2011 MT 43, 359 Mont. 332, 249 P.3d 485 In this case, the objective of the Workers’ Compensation Act would more likely be served by following the course of treatment recommended by a doctor whose services were not authorized by the insurer than by continuing an authorized course of pain management that had so far not succeeded.

Wright v. Ace American, 2011 MT 43, 359 Mont. 332, 249 P.3d 485 Where a physician qualified as a treating physician when he first saw the claimant but no longer qualified at the time of trial due to the expiration of his Montana license, the Workers’ Compensation Court could consider the opinion and diagnoses offered by that physician.  To do otherwise would be absurd and contrary to § 39-71-105, MCA.

State Farm v. Bush Hog, 2009 MT 349, 353 Mont. 173, 219 P.3d 1249 [10/21/09] The objective of the WCA is to provide no-fault, wage loss benefits to the worker who suffers work-related injuries.  This system fails to the extent that the employer refuses to provide workers’ compensation insurance for his employee in accordance with the WCA.  If this employer were then allowed to seek indemnity or contribution from a third party to reduce the damages he owes to the injured employee, the employer has no incentive to comply with the WCA.  Cost/benefit should not inform the employer’s decision to not purchase workers’ compensation insurance.  If the employer chooses to roll the dice and loses, his recompense should be a financially painful experience.
Gamble v. Sears, 2007 MT 131, 337 Mont. 354, 160 P.2d 537 Given the underlying policy of the WCA, the employer/insurer’s contention that any failure to comply with the authorization rule (§ 39-71-1101, MCA) eliminates entitlement to medical benefits mandated under the WCA must be rejected. Categorical imposition of this penalty based solely on a mere failure to obtain authorization could lead to absurd outcomes wherein an injured worker is deprived of coverage to which he is entitled. Such a consequence is not only unjust, but it conflicts with the WCA’s underlying purposes of ensuring medical benefits for work-related injuries without regard to fault.

[1999] Mathews v. Liberty Northwest Ins. Corp., 2003 MT 116 The public policy underlying the Workers' Compensation Act generally, and as set out in section 39-71-105, MCA (1999), is violated when an employer offers to pay a worker a higher wage on the condition that the worker present an independent contractor exemption at the time of hire.

 
WORKERS' COMPENSATION COURT DECISIONS

Gerber v. Montana State Fund [03/28/13] 2013 MTWCC 9 The declared legislative objectives of the WCA of providing wage-loss benefits that bear a relationship to actual wages lost and returning a worker to work as soon as possible after the worker has suffered a work-related injury or disease (§§ 39-71-105(1)&(2), MCA) are thwarted by Petitioner’s interpretation of § 39-71-744(1), MCA: that the legislature intended for him to receive wage-loss benefits while incarcerated, incapable of earning a wage, and incapable of returning to work.

Goble v. Montana State Fund [03/28/13] 2013 MTWCC 8 The declared legislative objectives of the WCA of providing wage-loss benefits that bear a relationship to actual wages lost and returning a worker to work as soon as possible after the worker has suffered a work-related injury or disease (§§ 39-71-105(1)&(2), MCA) are thwarted by Petitioner’s interpretation of § 39-71-744(1), MCA: that the legislature intended for him to receive wage-loss benefits while incarcerated, incapable of earning a wage, and incapable of returning to work.

Marjamaa v. Liberty Northwest Ins. Co. [07/03/12] 2012 MTWCC 23 While periods of idleness are correctly included in average weekly wage calculations under § 39-71-123(3), MCA, the resulting average weekly wage must nonetheless comport with the policy of § 39-71-105(1), MCA, and bear a reasonable relationship to the actual wages lost.

Marjamaa v. Liberty Northwest Ins. Co. [07/03/12] 2012 MTWCC 23 In order to bear a reasonable relationship to actual wages lost, an average weekly wage calculation cannot include extraordinary events such as a prolonged absence from work due to an industrial injury.  In this instance, including four months of lost work due to an industrial injury would have artificially lowered Petitioner’s average weekly wage.

Gundermann v. Montana State Fund [06/04/12] 2012 MTWCC 18 The language of § 39-71-123, MCA, recognizes the validity of using different calculation methods for different employment situations to arrive at a wage loss benefit that, pursuant to  § 39-71-105(1), MCA, bears a reasonable relationship to actual wages lost.  Where a seasonal employee worked for the same employer for 16 years, it is appropriate to use an average weekly wage calculation under § 39-71-123(3)(b), MCA, by taking the total earnings for the year prior to the injury divided by the number of weeks the wages were earned, including periods of idleness or seasonal fluctuations.  Because Petitioner was not idle during those weeks he worked for a second employer, those weeks should not be used in the calculation.

Leigh v. Montana State Fund [12/21/10] 2010 MTWCC 37 The average weekly wage calculation must be a reasonable relationship to the actual wages lost as mandated by § 39-71-105(1), MCA.  Where Respondent’s chosen calculation method created an artificially low average weekly wage and Petitioner’s suggested calculation method would have created a higher average weekly wage than his typical wages, the Court found that neither method met the reasonable relationship to wages lost required by § 39-71-105(1), MCA.
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.
Caldwell v. MACo Workers' Compen. Trust [07/07/10] 2010 MTWCC 24 The public policy set forth at § 39-71-105(3), MCA, pays no respect to the worker’s age or retirement eligibility.
Murphy v. Montana State Fund [03/09/10] 2010 MTWCC 6 Section 39-71-105(3), MCA, states that an objective of the workers’ compensation system is to return a worker to work as soon as possible.  Where the claimant requested a lump sum conversion of his PTD benefits and presented the Court with a feasible self-employment venture, the Court concluded that in addition to the financial soundness of the claimant’s business plan, the claimant, his family, and his community would benefit by his return to work both through tangible financial return and through the intangible benefits that gainful employment would provide.
Jones v. Albertsons [06/22/07] 2007 MTWCC 26  Nothing in the public policy expressed by § 39-71-105(1), MCA, can reasonably be construed to allow an insurer to require a claimant to forego the benefits of one claim in order to pursue the benefits of another.
Jones v. Albertsons [06/22/07] 2007 MTWCC 26 Section 39-71-105(4), MCA, states that this system must be designed “to minimize reliance upon lawyers and the courts to obtain benefits and interpret liabilities.” Where language in a proposed stipulated settlement, while appearing unenforceable to individuals who work within the workers’ compensation system, is clearly intended to dissuade a claimant from filing future claims, this Court will not approve the stipulation.
Sturchio v. Liberty [01/30/07] 2007 MTWCC 4 Section 39-71-105(1), MCA, mandates a reasonable relationship between benefits and actual wages lost, which the calculation methods found in § 39-71-123, MCA, are intended to achieve. Where a claimant has multiple concurrent employments, each employment is to be considered individually and the average weekly wage calculated by whatever method found in § 39-71-123, MCA, best maintains a reasonable relationship between benefits and actual wages lost.
Negethon v. Montana State Fund [12/14/06] 2006 MTWCC 40 This statute provides that benefits bear a reasonable relationship to actual wages lost. Since unemployment benefits are a benefit and not a wage, Petitioner traded one set of benefits for another and, as in a previous case, the Court held that unemployment benefits cannot be considered wages.
Negethon v. Montana State Fund [12/14/06] 2006 MTWCC 40 Workers' compensation benefits are not intended to make an injured worker whole, but are intended to assist a worker at a reasonable cost to the employer. While Petitioner asserts that $66.67 per week in benefits does not constitute "assistance," he ignores the medical benefits he has received, as well as potential future benefits he may receive should he be given an impairment rating.

[1999] Hanks v. Liberty Northwest [3/22/02] 2002 MTWCC 19The general intent of the Workers' Compensation Act to provide wage supplement and medical benefits to a worker suffering an occupational injury is qualified by the particular intent of the 30-day notice provision of section 39-71-603(1), MCA. (Affirmed in Hanks v. Liberty Northwest 2002 MT 334.)