Gamble v. Sears

2007 MT 131, 160 P.3d 537, 337 Mont. 354, 2007 Mont. LEXIS 239
CourtMontana Supreme Court
DecidedJune 5, 2007
DocketDA 06-0172
StatusPublished
Cited by18 cases

This text of 2007 MT 131 (Gamble v. Sears) is published on Counsel Stack Legal Research, covering Montana Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Gamble v. Sears, 2007 MT 131, 160 P.3d 537, 337 Mont. 354, 2007 Mont. LEXIS 239 (Mo. 2007).

Opinion

JUSTICE COTTER

delivered the Opinion of the Court.

¶1 Sears Holdings Corporation appeals from the judgment of the Workers’ Compensation Court rescinding the settlement agreement in Mary Ann Gamble’s injury claim.

¶2 The Appellant raises the following issues for review:

¶3 (1) Did the court err in rescinding the parties’ settlement agreement?

¶4 (2) Did the court err in concluding that Gamble’s failure to comply with § 39-71-1101(2), MCA, did not absolve Sears of liability for the cost of medical treatment?

¶5 We affirm.

FACTUAL AND PROCEDURAL BACKGROUND

¶6 K-Mart Corporation (“K-Mart”) hired Mary Ann Gamble *357 (“Gamble”) in 1988 to work at its retail store in Great Falls, Montana. After working in several capacities at the store during the following years, Gamble was promoted to the position of manager of the housewares department in 1996. Thereafter, on May 16,1997, she was injured in an accident that occurred dining the course and scope of her employment.

¶7 As department manager, Gamble was required to lift and move pieces of furniture, appliances, and other items. Her injury occurred while she was moving a desk, weighing approximately 150 pounds, which was contained in a box. As she attempted to remove the box from a shelf, it fell onto the top of her head. She instantly experienced severe pain in her neck. Her left knee was also injured in this accident, eventually requiring surgery, but only her neck injury is at issue in this appeal. Gamble reported her injuries to K-Mart’s personnel department and filed an injury claim form that day. 1

¶8 During the period in which K-Mart employed Gamble, it was self-insured for workers’ compensation purposes. Thus, K-Mart accepted liability for Gamble’s injury claim and paid benefits accordingly. Sears Holdings Corporation (“Sears”) is the successor to K-Mart and has assumed liability for K-Mart’s workers’ compensation claims.

¶9 After the accident, Gamble experienced a number of symptoms including continuous pain in her neck, particularly at the base of her skull, a limited range of motion in her neck, severe headaches on a regular basis, as well as numbness and a burning sensation on the right side of her face. Additionally, the act of leaning forward-to pick up a piece of merchandise from the floor, for example-caused nausea and vomiting. The severity of Gamble’s condition caused her to frequently cut short her work shifts at the store. Ultimately, her symptoms did not subside until September of 2004 after she underwent surgery to fuse a fractured bone in her neck.

¶ 10 Although Gamble visited a chiropractor shortly after the accident, she did not seek additional medical treatment for a number of months, as she hoped her neck would heal on its own. Then, in the fall of 1997, after Gamble missed part of a day of work due to a particularly severe headache which brought on an extended bout of nausea and vomiting, her manager expressed concern over her frequent absence from work *358 and directed her to see a physician. Accordingly, in November of 1997, Gamble went to Dr. Jerry Speer, a board-certified family practitioner in Great Falls. Based on his examination, Dr. Speer believed Gamble was suffering from “a muscular rotational injury with underlying osteoarthritic problems.” He prescribed anti-inflammatory medication and referred Gamble to Dr. Dale Schaefer, a board-certified neurosurgeon.

¶11 After examining Gamble in December of 1997, Dr. Schaefer initially believed that she was suffering from a soft-tissue injury. Thus, he recommended pain medication and a course of physical therapy. Gamble completed six weeks of physical therapy and reported that it did not relieve her symptoms. As an additional diagnostic measure, Dr. Schaefer then ordered a cervical myelogram and CAT scan. After reviewing the films from these tests, Dr. Schaefer came to believe that Gamble was suffering from arthritic degenerative or spondylitic changes in her neck, rather than a soft-tissue injury, and therefore concluded that he could not offer treatment that would benefit her. Consequently, he released Gamble from his care, and she continued to see Dr. Speer.

¶12 In March of 1998, Gamble ceased working at K-Mart due to her persisting symptoms. Then, in September of 1998, she was examined by a panel of doctors at the request of the firm administering Gamble’s injury claim, Compensation Adjusters, Inc. In rendering its report, the panel diagnosed Gamble with, among other things, “multi-level cervical degenerative changes.” While the panel determined that this condition likely existed before her on-the-job injury, it also determined that “the occupational injury represents a significant and permanent aggravation” of her pre-existing degenerative condition. Further, the panel determined that Gamble had reached a maximum medical improvement plateau, but also noted that she could require further treatment. Finally, the panel assigned her a 5% whole-person impairment rating and determined that while continued work as the housewares department manager would be inappropriate, she “maybe able to return to a light duty vocational position with restrictions.” ¶13 In May of2001, the parties entered into an agreement that settled Gamble’s claims for disability and rehabilitation benefits under the Workers’ Compensation Act. At that time, the parties believed that Gamble’s condition had been properly diagnosed and that she had achieved maximum medical improvement, in accordance with the panel’s conclusion. However, the settlement agreement expressly reserved further medical benefits, apparently because the panel had *359 determined that Gamble could require further treatment. Yet, because Gamble was not diagnosed with a fracture at the time of settlement, the reservation of medical benefits did not extend to that condition. Shortly thereafter, the Department of Labor and Industry approved this settlement agreement.

¶14 In the years following the settlement of her claim, Gamble’s symptoms did not subside. During this time, Dr. Speer periodically prescribed pain medication and muscle relaxant medication. He also conducted testing which demonstrated that Gamble was not suffering from rheumatoid arthritis. Gamble treated with Dr. Speer until he ceased his full-time family practice in 2003. Then, in the summer of 2004, Gamble went to Dr. James Legan, who ordered new MRI testing. Based on the results, Dr. Legan determined that she was suffering from a fracture in her odontoid process, which is a part of the second vertebra of the neck. He then referred Gamble to Dr. Michael Dube, a board-certified orthopedic surgeon. Dr. Dube ordered a CAT scan in August of 2004. The results of that test clearly showed that Gamble was suffering from an odontoid fracture that had failed to heal properly. He recommended that Gamble undergo abone fusion surgery without delay, and informed her of the serious risks associated with such a procedure. Gamble agreed to undergo the procedure and Dr. Dube successfully performed surgery in September of 2004. Consequently, Gamble’s symptoms subsided dramatically.

¶15 Thereafter, Dr. Dube was presented with the results of an x-ray taken in March of 1998, less than a year after Gamble’s injury occurred.

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Bluebook (online)
2007 MT 131, 160 P.3d 537, 337 Mont. 354, 2007 Mont. LEXIS 239, Counsel Stack Legal Research, https://law.counselstack.com/opinion/gamble-v-sears-mont-2007.