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Wieglenda v. State Compensation Insurance Fund

Court of Workers Compensation of Montana

October 23, 1996

RUTH WIEGLENDA Appellant
v.
STATE COMPENSATION INSURANCE FUND Respondent.

          Submitted: September 10, 1996

          DECISION AND JUDGMENT

          MIKE McCARTER JUDGE.

         Summary: Although couched as an appeal of an administrative order, claimant's filing in the WCC is an attempt to invoke the Court's original jurisdiction to challenge the constitutionality of statutory and regulatory provisions permitting an insurer to deny coverage for "maintenance care" following an industrial injury. The Court addresses the constitutionality of sections 39-71-116 (13) and (16), MCA (1993), section 39-71-704 (f), MCA (1993), and ARM 24.29.2004.

         Held: Equal protection provisions are not applicable where the statutes and regulation at issue make distinctions in subject matter of benefits and do not distinguish between or among classes of persons. All persons covered by the WCA are subject to the exclusion regarding maintenance and palliative care. Under a substantive due process analysis, the provisions are lawful where enacted for a legitimate purpose. (Note: WCC was affirmed by the Supreme Court in an unpublished, nonciteable opinion, Wieglenda v. State Compensation Insurance Fund/Department of Labor and Industry, No. 97-045 (1997).)

         Topics:

Constitutions, Statutes, Regulations and Rules: Montana Code Annotated: section 39-71-704(1)(f), MCA (1993). Section 39-71-704(1)(f), MCA (1993), and other statutory and regulatory provisions, do not deny equal protection or due process by providing that an insurer is not required to furnish maintenance care. (Note: WCC was affirmed by the Supreme Court in an unpublished, nonciteable opinion, Wieglenda v. State Compensation Insurance Fund/Department of Labor and Industry, No. 97-045 (1997).)
Benefits: Medical Benefits: Maintenance Care. Section 39-71-704(1), MCA (1993), and other statutory and regulatory provisions, do not deny equal protection or due process by providing that an insurer is not required to furnish maintenance care. (Note: WCC was affirmed by the Supreme Court in an unpublished, nonciteable opinion, Wieglenda v. State Compensation Insurance Fund/Department of Labor and Industry, No. 97-045 (1997).)
Constitutional Law: Due Process: Substantive Due Process. Section 39-71-704(1), MCA (1993), and other statutory and regulatory provisions, do not deny equal protection or due process by providing that an insurer is not required to furnish maintenance care. (Note: WCC was affirmed by the Supreme Court in an unpublished, nonciteable opinion, Wieglenda v. State Compensation Insurance Fund/Department of Labor and Industry, No. 97-045 (1997).)
Constitutional Law: Equal Protection. Section 39-71-704(1), MCA (1993), and other statutory and regulatory provisions, do not deny equal protection or due process by providing that an insurer is not required to furnish maintenance care. (Note: WCC was affirmed by the Supreme Court in an unpublished, nonciteable opinion, Wieglenda v. State Compensation Insurance Fund/Department of Labor and Industry, No. 97-045 (1997).)
Physicians: Chiropractors. Section 39-71-704(1), MCA (1993), and other statutory and regulatory provisions, do not deny equal protection or due process by providing that an insurer is not required to furnish maintenance care. (Note: WCC was affirmed by the Supreme Court in an unpublished, nonciteable opinion, Wieglenda v. State Compensation Insurance Fund/Department of Labor and Industry, No. 97-045 (1997).)

         Introduction

         This is a so-called appeal from a decision of the Department of Labor and Industry (Department).

         The appellant herein, Ruth Wieglenda (claimant), petitioned the Department on April 11, 1996. The petition was in the form of a letter from claimant's attorney, Don Edgar Burris (Burris), accompanied by various exhibits. In relevant part, claimant, through Burris, alleged that the exclusion of maintenance and palliative medical care from covered medical expenses, § 39-71-704(1)(f), MCA (1993), is unconstitutional. The petition further alleged that the Department lacked jurisdiction over the constitutional challenge and requested that the Department dismiss the petition so claimant could appeal the constitutional issues to this Court. On May 20, 1996, a hearing officer of the Department obliged, finding that the Department indeed lacked jurisdiction over constitutional Issues. (Findings of Fact; Conclusions of Law; and Final Order.[1]) On June 19, 1996, claimant filed a Notice of Appeal with this Court, asking it to declare the exclusion unconstitutional.

         It is tempting to dismiss the present appeal out-of-hand. The Department granted the relief requested by claimant. While judicial review is available to examine the correctness of the decision below, or the sufficiency of the process below, § 2-4-704, MCA, claimant does not challenge the Department's decision or the manner in which it was reached. Judicial review is available to persons "aggrieved" by a final agency decision. § 2-4-702(1)(a), MCA. Claimant does not satisfy that prerequisite. Thus, if this matter is treated as an appeal, the Court must affirm the Department's decision, which claimant concedes is correct, and go no further. § 2-4-704(2), MCA.

         It is apparent, however, that the claimant seeks to invoke this Court's original jurisdiction to decide constitutional issues. Administrative agencies, including the Department of Labor and Industry, are powerless to declare a statute or administrative regulation unconstitutional. "A judicial body, not an administrative body, is the proper forum to decide constitutional questions . . . ." Schneeman v. Department of Labor and Industry, 257 Mont. 254, 259, 848 P.2d 504, 507 (1993) (citing Jarussi v. Board of Trustees, 204 Mont. 131, 135-36, 664 P.2d 316, 318 (1983)). The original jurisdiction of the Workers' Compensation Court is not limited to determining specific benefits; it extends to other matters which may affect benefits and encompasses requests for declaratory rulings in such matters. State ex rel. Uninsured Employers' Fund v. Hunt, 191 Mont. 514, 625 P.2d 539 (1981). Since claimant's constitutional attack on section 39-71-704(1)(f), MCA, ultimately affects her entitlement to medical benefits, this Court has original jurisdiction over her challenge and will treat her appeal as a petition for declaratory judgment. Respondent will not be affected by this treatment since it has responded to claimant's constitutional contentions and has assumed that those issues are properly before the Court.

         Constitutional Issues Raised by Claimant

         In her Notice of Appeal the claimant alleges:

The statutes (39-71-116(13) to (16), 39-71-704 and Med. Service Rule 24.29.2004 are unconstitutional on the grounds they deny due process and, equal protection of the law and, constitute cruel and unusual punishment. [Sic.]

         The Statutes and Rule at Issue

         The laws in effect at the time of the claimant's injury govern her right to benefits. Buckman v. Montana Deaconess Hospital, 224 Mont. 318, 321, 730 P.2d 380, 382 (1986). Both parties agree that claimant's injury occurred in 1994 and that the 1993 version of the Workers' Compensation Act (WCA) applies in this case.

         The 1993 statutes and administrative rule challenged by the claimant are as follows:

39-71-116 (13) "Maintenance care" means treatment designed to provide the optimum state of health while minimizing recurrence of the clinical status.
39-71-116 (16) "Palliative care" means treatment designed to reduce or ease symptoms without curing the underlying cause of the symptoms.
39-71-704. Payment of medical, hospital, and related services-fee schedules and hospital rates - fee limitation. (1) In addition to the compensation provided under this chapter and as an additional benefit separate and apart from compensation benefits actually provided, the following must be furnished:
(a) After the happening of a compensable injury and subject to other provisions of this chapter, the insurer shall furnish reasonable primary medical services for conditions resulting from the injury for those periods as the nature of the injury or the process of recovery requires.
(b) The insurer shall furnish secondary medical services only upon a clear demonstration of cost-effectiveness of the services in returning the ...

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