Injury and Accident: Subsequent Injury

Harrison v. Liberty Northwest Inc. Corp. [04/01/08] 2008 MT 102 The insurer liable for the claimant’s first injury was liable for a second injury the claimant sustained while working for a subsequent employer where a physician testified unequivocally that the claimant’s first injury and evolving degenerative spinal condition were the causes of the second injury.
Paterson v. Montana Contractor Compensation Fund, 1999 MT 158 Substantial evidence supported WCC's determination that construction worker seeking TTD had reached maximum medical healing prior to non-work related aggravation of back condition, relieving the insurer of liability for compensation or medical benefits caused by the nonwork-related aggravation pursuant to section 39-71-407(5), MCA (1993).
Paterson v. Montana Contractor Compensation Fund, 1999 MT 158 Substantial evidence supported WCC's determination that non-work related injury aggravating back condition was a permanent aggravation where opinion of single physician testifying at trial was not seriously disputed at the time of trial.

McNamara v. MHA Workers' Compensation Reciprocal [05/25/16] 2016 MTWCC 5 Although an aggravation of a preexisting condition is an injury, claimant’s industrial injury was a minor aggravation of her underlying condition and did not cause her need for surgery, since her treating surgeon testified that her injury only made her condition “a little worse,” and no treatment was “directly necessary” for it.

Newlon v. Teck American Inc. (Formerly Cominco) [05/08/14] 2014 MTWCC 12 While evidence regarding two industrial injuries Petitioner suffered in the 1970s was sparse, the Court concluded that he must have reached MMI for those injuries prior to suffering a new injury in 1991 because he continued to work in his time-of-injury position for approximately 15 years and no evidence indicated that he did not reach MMI in between.  The Court therefore reasoned that Petitioner’s current problems would be attributable to the 1991 industrial accident.

Newlon v. Teck American Inc. (Formerly Cominco) [05/08/14] 2014 MTWCC 12 Even though the same insurer was at risk for Petitioner’s initial industrial injury and his subsequent alleged injuries, this does not remove the claim from the usual analysis used by the courts in determining whether a subsequent injury is considered a new injury for liability purposes.  The key question is whether Petitioner reached MMI from the earlier injury prior to suffering the later injury.

Sherwood v. Watkins & Shepard Trucking [06/30/10] 2010 MTWCC 19 Where the Court found the claimant lacked credibility regarding his claim that he suffered new industrial injuries, the Court concluded the insurer for the claimant’s previous, accepted claim was liable for paying TTD benefits after an IME physician opined that the claimant could no longer continue in his time-of-injury occupation.
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.
Liberty v. Valor Re: Handel [01/30/08] 2008 MTWCC 7 Where the Court concluded that the claimant had not reached MMI from a previous industrial injury at the time he alleged his subsequent work activities aggravated his cervical condition, the insurer at risk at the time of the initial industrial accident is not relieved of liability.
Healy v. Liberty Northwest [10/23/07] 2007 MTWCC 43 Where Petitioner settled a workers’ compensation claim in December 2000 and subsequently returned to manual labor jobs and sought no medical treatment for his back for several years, and where he demonstrated an ability to lift and carry 110 pounds in September 2003 and continued to perform heavy-duty manual labor until an industrial accident in June 2005, the evidence weighs towards Petitioner’s claim that he reached MMI from his first industrial injury and that the June 2005 accident caused a permanent aggravation of the preexisting injury.
Hunter v. Hartford Ins. Co., 2007 MTWCC 13 [03/11/07] Where a subsequent knee injury arguably aggravated Petitioner’s preexisting knee condition, Respondent is liable for Petitioner’s knee injury because it failed to meet its burden of proving (1) Petitioner had not reached maximum medical healing with respect to his 1983 accident or (2) Petitioner’s 1998 accident did not permanently aggravate the underlying condition.
Leger v. Liberty Mutual Fire Ins. Co. [11/05/04] 2004 MTWCC 74 Where a nonwork-related incident satisfies the injury and accident definitions of section 39-71-119, MCA (1993), the incident constitutes a subsequent nonwork-related injury for purposes of section 39-71-407(5), MCA (1993).
Leger v. Liberty Mutual Fire Ins. Co. [11/05/04] 2004 MTWCC 74 Where a claimant suffers a subsequent nonwork-related injury to the same body part and the injury materially and permanently aggravates the preexisting condition involving that body part, the insurer liable for a prior injury to that same part is relieved from further liability for disability and treatment involving the body part. § 39-71-407(5), MCA (1993).
Brown v. Montana Contractor Comp. Fund [11/3/04] 2004 MTWCC 72 Where a claimant suffered a work-related low-back injury but thereafter reached maximum medical improvement and suffered a new, material injury or aggravation, the insurer for the first injury is relieved from further liability for the claimant's back condition.
Lockwood v. LIberty NW Ins. [3/2/04] 2004 MTWCC 21 Where the claimant reached MMI following a work-related patellar dislocation, and thereafter suffered a material, permanent aggravation of her patellar condition in a nonwork- related injury, the insurer for the work-related injury is relieved of further liability under section 39-71-407(5), MCA (1999).
MCCF v. Liberty NW and Rusco [7/30/03] 2003 MTWCC 54 In light of Abfalder v. Nationwide Mutual Fire Ins. Co., 2003 MT 180, this Court's prior holding in Liberty Northwest Ins. Corp. v. State Compensation Ins. Fund, 2001 MTWCC 56, ¶ 36, is overruled to the extent it conflicts with Afbalder and the decision in this case. Where a claimant arguably aggravates a preexisting injury in a subsequent work-related incident, and there is a dispute between insurers as to whether the subsequent injury is permanent or merely temporary, or whether it or the prior injury is the cause of the claimant's current condition and disability, or whether the claimant had reached maximum medical improvement, the insurer for the subsequent injury is liable for benefits "until it proves, or until another insurance company agrees, that it [the other company] should pay the benefits." Belton v. Carlson Transport, 202 Mont. 384, 658 P.2d 405, 409-10 (1983).
Stacks v. Travelers/State Fund [3/1/01] 2001 MTWCC 9 Under Belton v. Carlton Transport, 202 Mont. 384, 658 P.2d 405 (1983), and subsequent cases, including Perry v. Tomahawk Transp., 226 Mont. 318, 735 P.2d 308 (1987), when a subsequent injury has arguably aggravated a preexisting condition, the second insurer avoids liability for the aggravated condition only upon proving the claimant had not reached maximum medical healing with respect to his prior workers' compensation injury or that the second injury did not in fact permanently aggravate the underlying condition. The second insurer carried its burden of proving that claimant's back condition was only temporarily aggravated, but failed to prove that the neck condition was only temporarily aggravated.
Wayne V. Kelly v. State Compensation Insurance Fund [10/4/99] 1999 MTWCC 60 Claimant suffered a neck injury in 1986, and another neck injury in 1987. In a prior proceeding in the Workers' Compensation Court, and on appeal to the Supreme Court, it was held that claimant reached maximum medical healing prior to second injury, making claimant's status after the second injury the result of the second injury for workers' compensation purposes, under an extension of Belton v. Carlson Transport, 202 Mont. 384, 385-386, 658 P.2d 405, 406 (1983). Claimant now alleges his current deteriorated condition is a result of the 1986 injury. Insurer's motion for partial summary judgment on this issue granted. Res judicata applies, barring any present claim that claimant's post-1987 condition is attributable to the 1986 injury.
Paterson v. Montana Contractor Compensation Fund [6/22/98] 1998 MTWCC 55 Where claimant reached MMI on a minor back injury prior to suffering a permanent aggravation of his back condition in a nonwork-related incident, section 39-71-407(5), MCA (1993) relieved the insurer of liability for compensation and medical benefits following the nonwork aggravation. [Note: WCC decision affirmed in Paterson v. Montana Contractor Compensation Fund, 1999 MT 158.]
Briney v. Pacific Employers Insurance Co., 283 Mont. 346, 942 P.2d 81 (1997) Where physician testified that the most significant injury contributing to claimant’s current disability was the original injury for which the insurer was liable, WCC erred in concluding that insurer was relieved of liability due to subsequent exacerbations following MMI. Even though intervertebral disk had returned to its normal anatomical configuration, the deterioration of claimant’s condition and his present physical impairment was traced to the injury for which the insurer was liable.
Hamlin v. State Fund [12/29/95] 1995 MTWCC 113 Section 39-71-407(5), MCA (1993) relieves the insurer of liability for claimant’s knee condition following non-work related fall where he had reached MMI after knee surgery following industrial accident and the Court finds, as a matter of fact, that claimant did not suffer from instability of his knee following his first surgery and that his non-work related fall was not caused by a pre-existing work-related knee condition.
Ostwald v. Plum Creek Manufacturing [12/19/95] 1995 MTWCC 107  Belton is an exception to the more general rule that the employer and insurer take the worker as they find him and has not been extended to situations where no prior claim has been filed or where no insurer is already liable for the existing condition.
Cary v. Lumbermens Mutual Casualty Co. [7/7/95] 1995 MTWCC 56 Section 39-71-407(5), MCA (1993) relieves an insurer from further liability for claimant’s condition only if claimant’s nonwork-related injury amounted to a permanent aggravation of her condition. If the aggravation is permanent, then future disability and treatment is “caused” by the nonwork-related injury within the meaning of the statute. If the nonwork related incident caused only a temporary flare-up of symptoms of her underlying condition, further treatment and any future disability is still caused by the work related injury for which the insurer remains liable.
Liberty Northwest Ins. Corp. v. Bevis [04/17/95] 1995 MTWCC 28 Where treating physician testified convincingly that subsequent incident for which second insurer was at risk caused only a temporary aggravation of claimant’s back condition, the insurer with liability for that back condition must indemnify the second insurer for benefits that insurer paid under reservation of rights.

ANR Freight Systems, Inc. v. Garrett Freight Lines/Farmers Ins. Group and Thoreson [01/26/95] 1995 MTWCC 5 In dispute over whether insurer or self-insurer is liable for claimant’s present back condition, summary judgment would not be granted to self-insurer where its motion is based entirely on evidence from one doctor and discovery is not completed. Where dispute involves a series of injuries and/or aggravations, surgery, and various medical opinions, it is better resolved by careful analysis of medical opinions and medical history following trial, not by summary judgment.