Higginbotham v. Stoltze-Connor Lumber Co.

810 P.2d 295, 248 Mont. 161, 48 State Rptr. 372, 1991 Mont. LEXIS 98
CourtMontana Supreme Court
DecidedApril 23, 1991
Docket90-077
StatusPublished
Cited by1 cases

This text of 810 P.2d 295 (Higginbotham v. Stoltze-Connor Lumber Co.) 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
Higginbotham v. Stoltze-Connor Lumber Co., 810 P.2d 295, 248 Mont. 161, 48 State Rptr. 372, 1991 Mont. LEXIS 98 (Mo. 1991).

Opinion

JUSTICE WEBER

delivered the Opinion of the court.

The Workers’ Compensation Court denied rehabilitation benefits under § 39-71-1023, MCA (1987), to James Greg Higginbotham, claimant. Claimant appeals, contending that he was entitled to *162 rehabilitation benefits during the course of the review procedure provided by statute. We reverse.

The principal issue is whether, under § 39-71-1023, MCA (1987), an insurer must pay total rehabilitation benefits to a worker during the review by the rehabilitation panel and the Department.

On September 14, 1987, claimant injured his back in a compensable work-related injury. Liability was accepted by Stoltze-Connor Lumber Co., his self-insured employer, herein referred to as insurer. In December 1987, claimant underwent a laminectomy and required subsequent surgical intervention. Claimant’s physician concluded that claimant had reached maximum healing on September 16,1988, and gave him a permanent impairment rating of 10 percent of the whole man.

The Insurer notified the Division of Workers’ Compensation that it had chosen Crawford Rehabilitation Services (Crawford) as its designated rehabilitation provider on March 17,1989. The rehabilitation counselor selected by Crawford prepared a rehabilitation evaluation report in which he determined that claimant could not return to the j ob he held at the time of injury, but that claimant’s age, education, work experience, and physical condition made him vocationally capable of entering the job market without retraining as a surveyor’s assistant or electronics technician. Claimant did not return to work in any capacity.

As a result of the determination that claimant had reached medical stability and was released to return to the open labor market by his treating physician, the insurer reduced his benefits from temporary total disability benefits to permanent partial disability benefits. Claimant’s permanent partial disability benefits were equal to one-half of his temporary total disability benefits.

Claimant wrote the Division stating that he thought the reduced benefits were inadequate, that he was not qualified for return to work in the options designated by the rehabilitation counselor, that he was not guaranteed future gainful employment, and that he desired to be retrained. Claimant argued that he was entitled to have a rehabilitation panel review the determination and requested a contested case hearing.

In the contested case hearing, the hearing examiner for the Department of Labor and Industry described the issue as:

“The issue to be determined is whether the return to work options identified by Claimant’s rehabilitation counselor are appropriate, and whether he is entitled to total compensation benefits.”

*163 The hearing examiner concluded that the mandatory rehabilitation process had not been followed, that the statutes mandated a rehabilitation panel review and a Department determination prior to termination of total rehabilitation benefits, and, ordered the payment of total rehabilitation benefits to the claimant pending the completion of that review.

Upon appeal, the Workers’ Compensation Court affirmed the determination that the review procedure by the rehabilitation panel and the Department was required under § 39-71-1015(3), MCA (1987). The court reversed the order which required payment of total rehabilitation benefits, and in part stated:

‘We find nothing in any section of the rehabilitation provisions which imposes on an insurer any total disability or total rehabilitation benefit liability once maximum healing is reached and a job market is identified for a claimant by a designated rehabilitation provider. The only risk to an insurer under these circumstances is that, on appeal or at a hearing, the labor market or jobs identified by the rehabilitation provider are found to be in error. Unfortunately for a disabled worker, that requires proof which can only be obtained at additional expense, which if claimant is receiving no benefits will be difficult to obtain.

“Unfortunately, the result is that the Hearing Examiner abused his discretion, and indeed established a nonexistent standard to transform ‘eligibility’ to ‘entitlement’ for purposes of benefit payments... We reverse that portion of the Order directing the payment of total rehabilitation benefits because the Hearing Examiner abused his discretion and erred as a matter of law, given the evidence presented at the hearing.”

The claimant appeals from that order.

I.

The Vocational Rehabilitation Provisions of the Workers’ Compensation Act were substantially revised in 1987. A review of those sections pertinent to this case follows.

Under § 39-71-1011, MCA (1987), a disabled worker is defined as follows:

“(2) ‘Disabled worker’ means one who has a medically determined restriction resulting from a work-related injury that precludes the worker from returning to the work the worker held at the time of the injury.”

*164 Both parties agree that claimant meets this statutory definition of a “disabled worker.”

Section 39-71-1012, MCA, sets forth the rehabilitation goal and options:

“(1) The goal of rehabilitation services is to return a disabled worker to work, with a minimum of retraining, as soon as possible after an injury occurs.
“(2) The first appropriate option among the following must be chosen for the worker:
“(a) return to the same position;
“(b) return to a modified position;
“(c) return to a related occupation suited to the claimant’s education and marketable skills;
“(d) on-the-job training;
“(e) short-term retraining program (less than 24 months);
“(f) long-term retraining program (48 months maximum); or “(g) self-employment.
“(3) Whenever possible, employment in a worker’s local job pool must be considered and selected prior to consideration of employment in a worker’s statewide job pool.”

This section emphasizes that a minimum of retraining is desired, with the primary aim being the return of the disabled worker to work as soon as possible. It also allows consideration of employment in a statewide pool as well as a local job pool.

Section 39-71-1014, MCA, in pertinent part states:

“(1) Rehabilitation services are required for disabled workers and may be initiated by:
“(a) an insurer by designating a rehabilitation provider and notifying the division;

In this case, the insurer notified the Division of its choice of a rehabilitation provider on March 17, 1989, 6 months after claimant reached maximum healing.

Section 39-71-1015, MCA, with regard to evaluation and return to work provides:

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Cite This Page — Counsel Stack

Bluebook (online)
810 P.2d 295, 248 Mont. 161, 48 State Rptr. 372, 1991 Mont. LEXIS 98, Counsel Stack Legal Research, https://law.counselstack.com/opinion/higginbotham-v-stoltze-connor-lumber-co-mont-1991.