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LaPlant v. State Compensation Insurance Fund

Court of Workers Compensation of Montana

November 24, 1999

FRANCIS D. LaPLANT Petitioner
v.
STATE COMPENSATION INSURANCE FUND Respondent/Insurer for JAMES TALCOTT CONSTRUCTION Employer

          Submitted: November 16, 1999

          ORDER DENYING MOTION FOR SUMMARY JUDGMENT

          MIKE MCCARTER JUDGE

Summary: In 1987, claimant submitted a claim for compensation to State Fund for an elbow injury occurring in July 1986. State Fund failed to accept or deny the claim within 30 days. The claim then languished for 12 years until claimant filed the present petition. On motion for summary judgment, citing section39-71-606, MCA (1985) and Haag v. Montana Schools Group Ins. Authority, 274 Mont. 109, 906 P.2d 693 (1995), claimant argues State Fund is liable, without proof of disability or causal relationship, for medical benefits for a wide range of conditions (medical bills submitted relate to ribs, knees, lumbar, cervical, neck, hands, low back, wrists, and chest) and for compensation benefits for all periods of unemployment since the elbow injury.

         Held: Motion denied. Section 39-71-606, MCA (1985) and Haag put State Fund in the position of having accepted the elbow injury claim. This does not mean State Fund is liable for compensation benefits without proof of disability and a causal relationship to the accident, or for all medical bills without proof of a causal relationship to the elbow injury.

         Topics:

Constitutions, Statutes, Regulations and Rules: Montana Code: 39-71-606, MCA (1985). Where State Fund failed to accept or deny a 1987 claim within thirty days, under section 39-71-606, MCA (1985) and Haag v. Montana Schools Group Ins. Authority, 274 Mont. 109, 906 P.2d 693 (1995), it is in the same position as though it had accepted the claim. State Fund is not, however, liable for a wide range of medical bills without proof of a causal relationship to the claimed elbow injury, nor for compensation benefits during all periods of unemployment without proof of disability and causal relationship of disability to the "accepted" claim.

Cases Discussed: Haig v. Montana Schools Group Ins. Authority, 274 Mont. 109, 906 P.2d 693 (1995). Where State Fund failed to accept or deny a 1987 claim within thirty days, under section 39-71-606, MCA (1985) and Haag v. Montana Schools Group Ins. Authority, 274 Mont. 109, 906 P.2d 693 (1995), it is in the same position as though it had accepted the claim. State Fund is not, however, liable for a wide range of medical bills without proof of a causal relationship to the claimed elbow injury, nor for compensation benefits during all periods of unemployment without proof of disability and causal relationship of disability to the "accepted" claim.
Causation: Medical Condition. Where State Fund failed to accept or deny a 1987 claim within thirty days, under section 39-71-606, MCA (1985) and Haag v. Montana Schools Group Ins. Authority, 274 Mont. 109, 906 P.2d 693 (1995), it is in the same position as though it had accepted the claim. State Fund is not, however, liable for a wide range of medical bills without proof of a causal relationship to the claimed elbow injury.
Claims: Acceptance. Where State Fund failed to accept or deny a 1987 claim within thirty days, under section 39-71-606, MCA (1985) and Haag v. Montana Schools Group Ins. Authority, 274 Mont. 109, 906 P.2d 693 (1995), it is in the same position as though it had accepted the claim. State Fund is not, however, liable for a wide range of medical bills without proof of a causal relationship to the claimed elbow injury, nor for compensation benefits during all periods of unemployment without proof of disability and causal relationship of disability to the "accepted" claim.

         ¶1 The matter before the Court is the petitioner's motion for summary judgment. The motion has been briefed and orally argued.

         Introduction

         ¶2 Petitioner (claimant) seeks benefits with respect to an injury he suffered on July 1, 1986. He submitted a claim for compensation to the insurer, State Compensation Insurance Fund, in January 1997. (Ex. 1 of Exhibits to State Compensation Insurance Fund's Brief in Opposition to Petitioner's Motion for Summary Judgment.) In that claim he described his industrial accident as follows:

I feel [sic] off a cement wall about 8-9 feet high backwards and landed on my elbows. About a week later I reinjured by [sic] elbows when I was pounding posts and hit my ...

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