STEPHEN T. GARCIA Petitioner
UNINSURED EMPLOYERS' FUND/JULIE MANIACI Respondent/Insurer for PROFESSIONAL HEALTH PLANNING Employer.,
Submitted: April 23, 1998
FINDINGS OF FACT, CONCLUSIONS OF LAW AND
An employer challenged the determination of the Uninsured
Employers' Fund that an office manager injured in an
automobile accident over the lunch hour was acting within the
course and scope of employment. Employee claimed she was
running an errand specifically authorized by the employer.
After carefully considering the conflicting testimony of the
employee and employer, the WCC is unable to make the
subjective judgment whether one was more credible than the
other. The Court thus turned to the question of burden of
proof, finding that where an uninsured employer files a
petition to challenge a UEF determination, the petition is in
the nature of an action for declaratory judgment. The burden
of proof is thus properly placed on the UEF, which would bear
that burden if it commenced its own action to obtain
reimbursement from the employer. Thus, the WCC held the UEF
is not entitled to indemnification from the employer.
Proof: Burden of Proof: Generally. Where an
uninsured employer files a petition in the WCC to challenge
the UEF's determination that a claimant is entitled to
benefits and that it must reimburse the UEF, the action is in
the nature of an action for declaratory judgment and the
burden of proof is properly with the UEF, which would have
that burden if it sought to collect reimbursement from
petitioner. [Note: Although the WCC decision was
affirmed on appeal in Garcia v. Uninsured Employers'
Fund, 1999 MT 35N, an unpublished, nonciteable opinion,
the Supreme Court did not reach the issue of burden of
Witnesses: Credibility. After carefully
considering the conflicting testimony of two witnesses, the
WCC was unable to make the subjective judgment whether one
was more credible than the other and decided the case based
on its determination of the burden of proof.
This matter was tried on April 23, 1998 in Bozeman, Montana.
The petitioner, Stephen T. Garcia, was present and was
represented by Mr. William Dean Blackaby. The Uninsured
Employers' Fund was represented by Mr. Robert J.
Campbell. Ms Julie Maniaci Brennan was present and
Exhibits: Exhibits 1 through 18 were admitted
Witnesses: Stephen T. Garcia, Julie Maniaci Brennan,
Charles Edquest and Bernadette Rice testified at trial. The
parties also submitted depositions of Charles Edquest, Julie
Maniaci, Bernadette Rice, Merle Bouma, D.C., and Curt Kurtz,
M.D. for the Court's consideration.
Issues: The parties state the issues as follows:
1. Was the claimant acting in the course and scope of her
employment when she was involved in a motor vehicle accident
on November 10, 1995?
2. Has the UEF met its obligation under 39-71-502 and
39-71-503(1) by paying only "proper" benefits,
managing medical and indemnity benefits appropriately and
operated in "good faith" in managing the claim?
(Pre-trial Order at 3.)
Having considered the testimony at trial, the demeanor and
credibility of the witnesses, the exhibits, the depositions
submitted for the Court's consideration, and the
arguments of the parties, the Court makes the following:
Stephen T. Garcia (Garcia) is an independent agent for group
health benefits plans. Since 1991 he has based his business
in Bozeman, Montana.
On November 1, 1995, Julie Maniaci (Maniaci) began working
for Garcia. (Maniaci has since remarried and changed her last
name to Brennan. She is also referred to as Julie T. Murphy
and Julie Foster in the exhibits. Her changes of name are the
result of remarriages.)
Maniaci's job title was office manager and her duties
included answering the telephones, filing, bookkeeping, and
general management of the office. She worked 8:00 a.m. to
5:00 p.m., with one hour for lunch. She was paid for 40 hours
a week, so she was not paid during her lunch hour.
On Friday, November 10, 1995, Maniaci left Garcia's
office at approximately noon. She drove to Wendy's and
had lunch. Lunch consumed approximately half an hour. Maniaci
then reentered her car and within two blocks of Wendy's
was involved in a car accident.
Although she did not immediately seek medical care, claimant
was shaken up in the accident. She returned to Garcia's
office to work the afternoon but left work a half hour early.
On Monday, November 13, 1995, Maniaci sought medical care
from her family physician, Dr. Curt Kurtz. (Ex. 10 at 2.) She
reported the accident to him and complained of left-side pain
in the neck and thoracic region with radiating pain into her
left shoulder. Dr. Kurtz diagnosed cervical and thoracic
On November 13, 1995, Maniaci also obtained massage therapy
for "lumbar & cervical discomfort - for
sprain." (Ex. 12.) She received additional massage
therapy on November 15, 1995.
Maniaci did not work Monday or Tuesday, November 13 and 14,
1995. She returned to work November 15 and worked for
approximately another month. She was then off work for more
than a year and a half.
One or two weeks after the auto accident, Maniaci decided to
pursue a workers' compensation claim with regard to her
accident. She learned that Garcia did not have workers'
compensation insurance and filed a claim with the UEF. The
UEF accepted liability for the claim.
The UEF paid Maniaci temporary total disability benefits from
December 19, 1995 through June 8, 1997. On June 8, 1997,
claimant returned to work with another employer.
Since the accident, claimant has been treated by Dr. Kurtz,
two chiropractors, a ...