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Murphy v. CIGNA Companies

Court of Workers Compensation of Montana

October 15, 1998

DANIEL MURPHY Petitioner
v.
CIGNA COMPANIES Respondent/Insurer for DARIGOLD FARMS Employer.,

          Submitted: September 28, 1998

          FINDINGS OF FACT, CONCLUSIONS OF LAW AND JUDGMENT

          MIKE McCARTER JUDGE

         Summary: A 73-year old claimant receiving permanent total disability benefits following severe 1979 back injury requested coverage of chiropractic treatment. Insurer denied, arguing treatments were maintenance care and not covered. Medical testimony indicated claimant reached maximum medical improvement in 1987 and will never return to pre-injury status. Chiropractic treatments were being administered on an as-needed basis when claimant suffered flare-ups. Chiropractor conceded treatments provided only temporary relief and that flare-ups were inevitable.

         Held: Under section 39-71-704, MCA (1979), claimant must establish that chiropractic care is "such other treatment as may be approved by the division for the injuries sustained." Administrative rules provided that workers' compensation pays for treatment necessary to return the patient to preclinical status or establish a stationary status, but does not pay for "a regime designed to provide the optimum state of health while minimizing recurrence of the clinical status." Under Synek v. State Compensation Mutual Ins. Fund, WCC No. 9401-6989, Order on Appeal (August 26, 1994), aff'd 272 Mont. 246, 900 P.2d 884 (1995), chiropractic treatments providing only temporary relief and not restoring claimant to either a preclinical or stationary status are not compensable. This case falls within that rule. Petition dismissed.

         Topics:

Constitutions, Statutes, Regulations and Rules: Montana Code: section 39-71-704, MCA (1979). A 73-year old claimant receiving PTD benefits following severe 1979 back injury sought coverage of chiropractic treatment on as-needed basis for flare-ups of back condition. Chiropractor testified flare-ups were inevitable and treatments provided only temporary relief. WCC followed Synek v. State Compensation Mutual Ins. Fund, WCC No. 9401-6989, Order on Appeal (August 26, 1994), aff'd 272 Mont. 246, 900 P.2d 884 (1995), which applied section 39-71-704, MCA, and ARM 24.29.2003 and -2004, to find not compensable chiropractic treatments providing only temporary relief and not restoring claimant to either a preclinical or stationary status.
Benefits: Medical Benefits: Chiropractors. A 73-year old claimant receiving PTD benefits following severe 1979 back injury sought coverage of chiropractic treatment on as-needed basis for flare-ups of back condition. Chiropractor testified flare-ups were inevitable and treatments provided only temporary relief. WCC followed Synek v. State Compensation Mutual Ins. Fund, WCC No. 9401-6989, Order on Appeal (August 26, 1994), aff'd 272 Mont. 246, 900 P.2d 884 (1995), which applied section 39-71-704, MCA, and ARM 24.29.2003 and -2004, to find not compensable chiropractic treatments providing only temporary relief and not restoring claimant to either a preclinical or stationary status.
Physicians: Chiropractors. A 73-year old claimant receiving PTD benefits following severe 1979 back injury sought coverage of chiropractic treatment on as-needed basis for flare-ups of back condition. Chiropractor testified flare-ups were inevitable and treatments provided only temporary relief. WCC followed Synek v. State Compensation Mutual Ins. Fund, WCC No. 9401-6989, Order on Appeal (August 26, 1994), aff'd 272 Mont. 246, 900 P.2d 884 (1995), which applied section 39-71-704, MCA, and ARM 24.29.2003 and -2004, to find not compensable chiropractic treatments providing only temporary relief and not restoring claimant to either a preclinical or stationary status.

         ¶1 The trial in this matter was held on September 28, 1998, in Missoula, Montana. Petitioner, Daniel Murphy (claimant), was present and represented by Mr. Rex Palmer. Respondent, CIGNA Companies (CIGNA), was represented by Mr. Leo S. Ward. A transcript of the trial has not been made.

         ¶2 Exhibits: Exhibits 1 and 2 were admitted without objection.

         ¶3 Witness and Deposition: Claimant was sworn and testified. The parties also submitted the deposition of Patrick R. Montgomery, D.C., for the Court's consideration.

         ¶4 Issue Presented: The sole issue presented by the petition is whether claimant is entitled to payment for continuing chiropractic treatments.

         * * * * *

         ¶5 Having considered the Pretrial Order, the testimony presented at trial, the demeanor and credibility of the witness, the deposition and exhibits, and the parties' arguments, the Court makes the following:

         FINDINGS ...


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