Physicians: Conflicting Evidence

MONTANA SUPREME COURT DECISIONS

Ford v. Sentry Casualty Company, 2012 MT 156 In weighing the conflicting opinions of medical experts, the Montana Supreme Court gave less weight to the lone contrary opinion, noting that he appeared to not take the findings of another expert into account, and failed to document or cite any objective findings specific to his examination of Petitioner, relying instead on generalizations about his past experiences with other patients.

EBI/Orion Group v. Blythe, 1998 MT 90 As a general rule, the opinion of a treating physician is accorded greater weight than the opinions of other expert witnesses. However, a treating physician's opinion is not conclusive. To presume otherwise would quash the role of the fact finder in questions of an alleged injury. The WCC, as the finder of fact, is in the best position to assess witnesses' credibility and testimony. In this case, WCC did not err in finding the testimony of a nationally known expert on neuropsychology more persuasive and a better explanation for all the evidence presented in the case than the testimony of a treating physician.
EBI/Orion Group v. Blythe, 1998 MT 90 As a general rule, the opinion of a treating physician is accorded greater weight than the opinions of other expert witnesses. However, a treating physician's opinion is not conclusive. To presume otherwise would quash the role of the fact finder in questions of an alleged injury. The WCC, as the finder of fact, is in the best position to assess witnesses' credibility and testimony. In this case, WCC did not err in finding the testimony of a nationally known expert on neuropsychology more persuasive and a better explanation for all the evidence presented in the case than the testimony of a treating physician.
 
WORKERS' COMPENSATION COURT DECISIONS

Koch v. Employers' Ins. Group [04/30/12] 2012 MTWCC 14 Where an IME physician disregarded the objective medical finding of a herniated disk because he believed the claimant exaggerated her complaints of pain, the Court did not find the physician’s causation opinions to be entitled to great weight.

Bjorgum v. Montana State Fund [12/30/11] 2011 MTWCC 29 Although the conflicting testimony of two physicians was credible, one physician’s testimony was more persuasive and therefore entitled to greater weight. The less persuasive physician interpreted a CT scan differently than others who examined it, and gave opinion testimony at odds with peer-reviewed publications. The more persuasive physician had greater credentials including an extensive list of published articles.

Sherwood v. Watkins & Shepard Trucking [02/15/11] 2011 MTWCC 4 Where one physician saw Petitioner over a long duration of time but had not seen Petitioner in over a year, during which time Petitioner’s dependency on pain medication significantly increased, the Court gave greater weight to the opinion of another physician who had seen Petitioner less frequently but more recently.

Petritz v. Montana State Fund [06/10/10] 2010 MTWCC 17 The claimant suffered a myocardial infarction.  His treating physician is a board-certified interventional cardiologist who specializes in angioplasty.  A neurologist who is not board-certified in any specialty and who never examined the claimant disagreed with the treating physician’s opinion as to the cause of the claimant’s myocardial infarction.  The Court concluded that the treating physician’s opinion is entitled to greater weight, not only because he is the treating physician, but because he is more qualified than the other physician both through his training and educational background and because he actually examined the claimant.
Barnea v. Ace American [12/21/08] 2007 MTWCC 58 Where the opinions of two physicians conflict as to whether Petitioner’s neck was injured during an industrial accident, the Court finds more persuasive the opinion of the doctor who is not only entitled to more weight because he is Petitioner’s treating physician, but also because the Court finds his credentials more significant.
Davis v. Ins. Co. of PA [8/20/01] 2001 MTWCC 45 The testimony of tumor expert, with over 30 years experience and who is well versed in current medical research and literature as to cause of a brain tumor, is more persuasive than the testimony of far less qualified physicians.
Munroe v. MT Electric & Telephone Pool [8/16/01] 2001 MTWCC 43 Where physician recommended surgery at three levels of claimant's spine and opined the surgery was related to a relatively minor 1997 industrial accident, his opinions are unpersuasive. He failed to review and consider claimant's extensive medical records and history. The claimant's statements to him regarding her history of pain were inaccurate in important respects and his opinions were contradicted by four other physicians, including two who had treated claimant for a longer period of time and three who had similar surgical experience.

McKay, Sr. v. City of Choteau [3/4/99] 1999 MTWCC 20 Police officer appealed Department of Labor hearing officer's decision he did not suffer from occupational disease resulting from alleged exposure to carbon monoxide in patrol car. Substantial evidence supports the hearing officer's determination, including the decision to credit the conclusions of the physician with specific expertise in carbon monoxide poisoning over those of other physicians.

Durham v. State Fund [12/1/98] 1998 MTWCC 87 Court was not persuaded by evidence of treating physician, a family practitioner, that claimant could not work due to fatigue and difficulty concentrating, where opinion was based largely on claimant's subjective reports, which Court found were exaggerated.
McGillis v. State Fund [11/2/98] 1998 MTWCC 79 The parties' dispute over an impairment rating under the 1995 WCA was resolved in the insurer's favor based upon the Court's finding that the particular testimony of two chiropractors was not persuasive in comparison to the testimony provided by two medical doctors. The Court was not required to reach the question whether either chiropractor was statutorily authorized to render an opinion on impairment.
Lockhart v. New Hampshire Ins. Co. [12/11/97] 1997 MYWCC 67 Parties disputed whether claimant's wrist condition resulted entirely from deterioration of Silastic lunate implant he received fifteen years earlier, or whether his hammering in construction job caused fragmentation in implant or surrounding bone. WCC was persuaded an injury occurred, based upon: claimant's credible testimony that he had no wrist pain until the incident at issue, the treating physician was more familiar with claimant's condition than the IME physician (who performed hundreds of IMEs a year for insurance companies), and another physician's reference to a "fragment" on an x-ray supports the treating physician's analysis.
EBI/Orion Group v. Michael S. Blythe [6/20/97] 1997 MTWCC 39 On remand from the Supreme Court, see EBI/Orion Group v. Blythe, 281 Mont. 50, 931 P.2d 38 (1997)(Blythe I), the WCC disregarded the opinion of an IME psychologist not licensed to practice in Montana, but nevertheless continued to credit the opinion of a nationally-known expert in neuropsychology over that of the treating physician in light of all the evidence in the record, including evidence relating to claimant's credibility. Because the treating physician accepted claimant's statements, his opinion depended on claimant's credibility, which the Court, not the physician, was required in the final instance to evaluate.
Byun v. Montana Schools Group Ins. Auth. [06/21/95] 1995 MTWCC 50 Where the conflict in medical opinion is based in large part on philosophical differences regarding the occurrence and etiology of thoracic outlet syndrome, but no detailed evidence concerning the medical reasons for the dispute in this particular case have been provided, it is difficult to evaluate the opposing positions. Given the record, the opinion of the treating physician must be given the greater weight.
Frisbie v. Champion International Corporation [02/10/95] 1995 MTWCC 13 Though treating physician believed claimant’s pain was disabling and that his injury may have exacerbated his drinking problem, the Court found more convincing the testimony of two other physicians who believed claimant was capable of working, one noting non-organic pain behavior. This was based on the greater expertise of the latter two doctors and on the Court’s observation of one of the doctor’s testimony. A treating physician’s opinion is not conclusively presumed to be correct; if it were, the factual inquiry conducted by the Court would be superfluous.

Where one physician saw Petitioner over a long duration of time but had not seen Petitioner in over a year, during which time Petitioner’s dependency on pain medication significantly increased, the Court gave greater weight to the opinion of another physician who had seen Petitioner less frequently but more recently.