Benefits: Rehabilitation Benefits: In General

MONTANA SUPREME COURT DECISIONS
Henry v. State Fund, 1999 MT 126 The Occupational Disease Act violates the equal protection clause of the Montana Constitution in failing to provide rehabilitation benefits to occupationally diseased workers. In a case involving a herniated disk, the Court sees on rational basis for treating workers who are injured over one work shift differently from workers who are injured over two work shifts. Providing rehabilitation benefits to workers covered by the WCA, but not to workers covered by the ODA, is not rationally related to the legitimate governmental interest of returning workers to work as soon as possible after they have suffered a work-related injury.
 
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 determining eligibility for rehabilitation benefits.
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.  Since § 39-71-1006, MCA, already takes the workers’ age into consideration to determine eligibility for benefits, the Court finds no rational basis for automatically terminating rehabilitation benefits upon retirement eligibility, pursuant to § 39-71-702, MCA.  This automatic termination bears no rational relationship to a legitimate governmental interest and violates equal protection as guaranteed by Art. II, § 4, Mont. Const.
Stancil v. MHA Workers' Compensation Trust [12/06/07] 2007 MTWCC 51 Where Petitioner’s employer appropriately placed him in transitional employment following his post-injury return to the workplace, Petitioner demonstrated the ability to perform the essential job functions of the position and was personally and professionally qualified to perform the position, and eventually accepted the position on a permanent basis, the Court held that Petitioner did not suffer an actual wage loss when he was discharged from his employment as a result of behavioral issues. Therefore, Petitioner is not entitled to PPD or rehabilitation benefits.
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.
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).
Lalum v. Safeco Ins. [3/19/01] 2001 MTWCC 11 Where claimant=s immediate post-injury jobs include higher paying light-duty positions which have never been medically disapproved, there is no wage loss and therefore no entitlement to rehabilitation benefits. 
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.
Beyl v. Liberty NW 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.
Patrick v. State Compensation Insurance Fund [4/4/00] 2000 MTWCC 20 Where insurer essentially limited the rehabilitation evaluation to the gathering of information to support the insurer's prior conclusion claimant suffered no wage loss, the evaluation was woefully inadequate and fell far short of the "careful assessment of the worker's realistic and reasonable prospects for obtaining employment" or the "further assessment of the realistic wages he or she is likely to earn" required by this Court in Leastman v. Liberty Mutual Fire. Ins. Co., 1999 MTWCC 2. So that the insurer would not take advantage of its unreasonable delay in creating and implementing a rehabilitation plan, claimant awarded retroactive temporary total disability benefits. Penalty and attorneys' fees also awarded. (After decision, parties settled and presented a Stipulated Judgment to the Court, which then issued its Order Nunc Pro Tunc For Entry of Judgement and Dismissal with Prejudice, Patrick v. State Compensation Insurance Fund, 2000 MTWCC 20A.)
Huffman v. Twin City Fire Ins. Co. [11/16/98] 1998 MTWCC 83 A 48-year old driver in the movie and television industry hurt his shoulder while working on the production of Lonesome Dove in Montana. Although he worked immediately after his injury at a minimal wage loss, the reduction in his lifting capacity from heavy to medium has caused him to lose the ability to work in higher paying jobs. Where he has proven a wage loss and suggested the possibility of retraining in other aspects of entertainment industry work, claimant may be entitled to rehabilitation benefits, but the insurer has not developed a rehabilitation plan and claimant has not provided details regarding a plan, most importantly, whether his suggestion is reasonable given his education and experience and likelihood of finding new work that would minimize his wage loss. Therefore, the matter is referred back to a rehabilitation provider for evaluation and development of a plan.
Huffman v. Twin City Fire Ins. Co. [11/16/98] 1998 MTWCC 83 The fact that a claimant has returned to a job other than the time-of-injury job upon reaching MMI does not necessarily terminate the claimant's eligibility for rehabilitation benefits where the evidence indicates claimant has in fact suffered a wage loss. While the legislature intended a quick return to work, that does not foreclose entitlement to rehabilitation benefits without consideration to whether retraining will improve claimant's position in the job market, even though he might be able to obtain some employment without retraining. Denying rehabilitation benefits to disabled workers who find immediate employment upon reaching MMI would also discourage an early return to work and would force workers to remain idle in cases where the insurer disputes their entitlement to rehabilitation benefits.
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.
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.
Henry v. State Fund [5/13/98] 1998 MTWCC 42 The failure of the Occupational Disease Act to provide rehabilitation benefits to occupationally diseased workers does not violate the equal protection clause of the Montana or United States Constitutions. Note: the WCC was overruled in this conclusion in Henry v. State Fund, 1999 MT 126.
Carlson-Owens v. Liberty NW [4/28/97] 1997 MTWCC 27 Under section 39-71-1006, MCA (1995), claimant without wage loss is not entitled to rehabilitation benefits.
Gates v. Liberty Northwest Ins. Co. [2/13/96] 1995 MTWCC 114A Prior WCC conclusion that worker unable to return to time-of-injury job was entitled to at least 8 weeks of rehabilitation benefits applied only to worker who is unable to return to the job on account of his injury.
Gates v. Liberty Northwest Ins. Co. [2/13/96] 1995 MTWCC 114A Designation of a vocational rehabilitation provider under section 39-71-2001, MCA (1993) does not necessarily mean particular benefits will flow to claimant, but is the first step necessary if there is "a dispute as to whether an injured worker can return to the job the worker held at the time of injury." Payment of rehabilitation benefits commences after filing of the rehabilitation plan with the DOL.
Gates v. Liberty NW Ins. Co. [2/13/96] 1995 MTWCC 114A Under section 39-71-2001(2), MCA (1993), entitlement to rehabilitation benefits commences after a rehabilitation plan is filed with the department.
Gates v. Liberty NW Ins. Co. [12/29/95] 1995 MTWCC 114 If a rehabilitation plan calls for immediate return to work, the time for measuring wage loss is at the time when the eight weeks of rehabilitation benefits specified in section 39-71-2001(3), MCA (1993), are exhausted. If at that time the claimant has been unable to secure employment despite his best good faith efforts, his post-injury wage is zero and his entitlement to permanent partial disability benefits shall be computed accordingly. If a plan calls for retraining, then a reasonable time must be allowed for claimant to find work upon completion of the plan, at a minimum eight weeks, before wage loss is assessed.
Yarde v. Liberty Northwest [9/7/95] 1995 MTWCC 69 Where claimant’s ability to work in public settings was limited by her pre-existing allergies, her plan to retrain as a medical transcriptionist, a profession that can be pursued at home or in a non-public office, was reasonable and necessary as part of her rehabilitation following a back injury that prevented return to her time-of-injury job. Even though other jobs existed that she could perform without retraining, it was “hit or miss” whether she would be able to function in the public workplaces required by those jobs.