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Major v. State Compensation Insurance Fund

Court of Workers Compensation of Montana

November 15, 1996

JAMES MAJOR Petitioner
v.
STATE COMPENSATION INSURANCE FUND Respondent/Insurer for MONTANA MAJOR WINDOW Employer.

          PARTIAL SUMMARY JUDGMENT

          Mike McCarter JUDGE

         Summary: Self-employed window salesman/installer elected sole proprietor coverage in workers' compensation insurance policy. He declared monthly wages of $900 for purposes of the election. After suffering an injury, claimant alleged he was limited in job duties and wanted wage supplement benefits based on loss of post-injury business earnings rather than declared $900 monthly earnings.

         Held: Section 39-71-118(2)), MCA (1989), provides that "all weekly compensation benefits must be based on elected wages...." Section 39-71-703(1)(b)(i), MCA (1989), which governs wage supplement benefits, states that a worker must be "compensated in weekly benefits." Under the plain language of the statutes, all weekly benefits, including wage supplement benefits, must be based on the amount elected. Thus, $900 is claimant's time-of-injury wage for purposes of wage supplement benefits.

         Topics:

Constitutions, Statutes, Regulations and Rules: Montana Code Annotated: section 39-71-118(2), MCA (1989). Where sole proprietor who elected coverage declared monthly earnings at $900 for policy purposes, insurer properly refused to base wage supplement benefits on loss of post-injury earnings rather than declared wages. Section 39-71-118(2)), MCA (1989), provides that "all weekly compensation benefits must be based on elected wages...." Section 39-71-703(1)(b)(i), MCA (1989), which governs wage supplement benefits, states that a worker must be "compensated in weekly benefits." Under the plain language of the statutes, all weekly benefits, including wage supplement benefits, must be based on the amount elected.
Constitutions, Statutes, Regulations and Rules: Montana Code Annotated: section 39-71-703(1)(b)(i), MCA (1989). Where sole proprietor who elected coverage declared monthly earnings at $900 for policy purposes, insurer properly refused to base wage supplement benefits on loss of post-injury earnings rather than declared wages. Section 39-71-118(2)), MCA (1989), provides that "all weekly compensation benefits must be based on elected wages...." Section 39-71-703(1)(b)(i), MCA (1989), which governs wage supplement benefits, states that a worker must be "compensated in weekly benefits." Under the plain language of the statutes, all weekly benefits, including wage supplement benefits, must be based on the amount elected.
Benefits: Permanent Partial Benefits: Generally. Where sole proprietor who elected coverage declared monthly earnings at $900 for policy purposes, insurer properly refused to base wage supplement benefits on loss of post-injury earnings rather than declared wages. Section 39-71-118(2)), MCA (1989), provides that "all weekly compensation benefits must be based on elected wages...." Section 39-71-703(1)(b)(i), MCA (1989), which governs wage supplement benefits, states that a worker must be "compensated in weekly benefits." Under the plain language of the statutes, all weekly benefits, including wage supplement benefits, must be based on the amount elected.

         The issue presently before the Court involves a matter of statutory interpretation. Specifically, the parties ask the Court to determine whether the amount of coverage a sole proprietor elects pursuant to section 39-71-118(2), MCA (1989), as the basis for weekly compensation benefits, is the sole proprietor's "actual wages" for the purpose of determining wage supplement benefits under section 39-71-703(b)(i), MCA (1989).

         Stipulated Facts

         The parties have stipulated to the following facts:

1. On August 16, 1989, the Petitioner was self-employed as a window salesman/installer. On September 15, 1989, the Petitioner had purchased workers' compensation insurance from the State Fund and elected coverage for himself. The Petitioner's declared monthly wages were $900.00. (Exhibit No. 1, Coverage Declaration Sheet and Exhibit No. 2, Owner or Partner Endorsement.)
2. On October 16, 1989, the Petitioner suffered an injury while in the course and scope of his employment. He was paid temporary total disability benefits at the rate of $138.08 per week from October 24, 1989, through June 14, 1991, when his injuries reached maximum medical healing and he returned to work. (Exhibit No. 3, Claim for Compensation.)
3. On February 25, 1994, the Petitioner was given a 9% impairment rating and paid 45 weeks of permanent partial disability benefits at the rate of $138.08 per week. (Exhibit No. 4.February 25, 1994 correspondence from Dr. Laidlaw.)
4. Petitioner returned to his self-employment venture in June of 1991. Due to his injury he is now limited in the job duties he can perform. He is no longer able to work as an installer. Petitioner alleges that as a ...

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