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Taylor v. State Compensation Insurance Fund

Court of Workers Compensation of Montana

October 21, 1994




         The matter before the Court is the Petitioner's Motion for Summary Ruling. The motion requests the Court to enter summary judgment determining that petitioner suffered an industrial injury on March 4, 1991.

         Procedural Background

         The Petition for Hearing in this matter was filed on June 2, 1994. It alleges that the petitioner, Edwin Taylor, was injured in an industrial accident on March 4, 1991, while he was working for the Montana Department of Highways. It further alleges that the Department's insurer, the State Compensation Insurance Fund (State Fund), accepted liability for the accident and thereafter paid petitioner temporary total disability benefits. Finally, apropos to the present matter, the petition alleges that in April 1994, the State Fund notified petitioner that it was terminating benefits because "the State of Montana is of the opinion that Mr. Taylor did not suffer a disabling injury." (Petition ¶ VIII.) The State Fund admits that it initially accepted liability but affirmatively alleges that the claim was fraudulent. (Response at 1-3.)

         The Petitioner's Motion for Summary Ruling and a supporting brief were filed on July 14, 1994. Respondent submitted a brief opposing summary judgment. Both parties have submitted numerous exhibits in support of their arguments and the State Fund has submitted several affidavits. The parties filed a number of depositions with the Court.

         The Court held a hearing on the petitioner's motion on September 22, 1994. Following argument by counsel, the parties requested and were given time to submit additional briefs. The Court received those briefs and the motion is ready for decision.


         While the rules of the Workers' Compensation Court provide that the time for filing a motion "for summary ruling" shall be fixed by a scheduling order, the Court has adopted no other rules applicable to motions for summary judgment. However, in recent decisions it has applied Rule 56, Mont.R.Civ.P., to summary judgment motions. E.g., Steve Wood v. Montana School Groups Ins. Authority, WCC 9401-6986, Order Granting Partial Summary Judgment (August 12, 1994); State Compensation Ins. Fund v. Frank Richter, WCC. No. 9308-6367, Order Denying Summary Judgment (March 4, 1994). It will continue to do so.[1]

         Rule 56 (c), Mont.R.Civ.P., provides that summary judgment "shall be rendered forthwith if the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law." See also First Security Bank v. Vander Pas, 250 Mont. 148, 152, 818 P.2d 384 (1991). When appropriate, summary judgment encourages judicial economy by eliminating unnecessary trial, delay and expense. Wagner v. Glasgow Livestock Sale Co., 22 Mont. 385, 389, 722 P.2d 1165, 1168 (1986). However, there truly must be a complete absence of any genuine issue of fact. Kober v. Stewart, 148 Mont. 117, 122, 417 P.2d 476 (1966). Summary judgment is not "a substitute for trial if a factual controversy exists." Reaves v. Reinbold, 189 Mont. 284, 288, 615 P.2d 896, 898 (1980). If there is any doubt as to the propriety of summary judgment, the motion must be denied. Rogers v. Swingly, 206 Mont. 306, 310, 670 P.2d 1386 (1983).

         Initially, the moving party bears the burden of showing an absence of material fact; the burden then shifts to the opposing party to present evidence of a material and substantial nature raising a genuine issue of fact. Cole v. Flathead County, 236 Mont. 412, 416, 771 P.2d 97, 100 (1989). The evidence, both in support and in opposition to the motion, must be sworn evidence in the form of affidavits, depositions, and answers to interrogatories, and is limited to "such facts as would be admissible in evidence." Rule 56 (e), Mont.R.Civ.P. Thus, inadmissible evidence cannot be considered.

         Petitioner's motion was initially supported only by the documents attached to his motion. One of the documents is the claim form which is routinely admitted. The other documents, with one exception, are copies of medical records which are routinely admissible unless the opposing party specifically objects to the records. Respondent has not objected to the attachments to petitioner's motion, and has also attached copies of medical records to its own response. The claim form and the medical records will therefore be considered. The Social Security disability determination, attached to petitioner's motion, is inadmissible and will not be considered.

         According to his Petition, petitioner suffered an industrial injury while he was picking up traffic cones in Bozeman:

EDWIN TAYLOR was injured in the course and scope of his employment as a truck driver for the State of Montana, Department of Highways, Bozeman Division on March 4, 1991. On that date he was picking up traffic cones on Main Street in Bozeman, Montana. He had tar and gravel stuck to the bottom of his boots, he stumbled because of the build-up on his boots while carrying five (5) safety cones. He fell into the fender on the air compressor hitting his head, neck and shoulder then fell to the pavement landing on his hips and back.

         (Petition, ¶ I.) Petitioner was the only person present when the alleged accident occurred. He argues that the lack of witnesses, the employer's failure to question the claim when it was first presented, and the medical evidence conclusively show that an accident in fact occurred. He points out that he was hospitalized for several days following the accident and has been repeatedly diagnosed as suffering from back problems.

         Initially, the fact that the alleged accident was not witnessed by others is not conclusive evidence. Neither is the fact that the employer did not initially question petitioner's report of the accident. Fraud may be proved by other evidence, including circumstantial evidence and the admissions of the party accused of the fraud. Similarly, the medical records are not conclusive or unrebuttable. The fact that petitioner may suffer from a genuine medical condition does not conclusively prove that the medical condition arose from an industrial accident. The records in this case do not identify conclusive, objective manifestations of an injury occurring on March 4, 1991. While petitioner sought treatment at the emergency room, ...

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