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Smith v. Montana State Fund

Court of Workers Compensation of Montana

October 10, 2017

DEBBRA SMITH Petitioner
v.
MONTANA STATE FUND Respondent/Insurer.

          Submitted: September 5, 2017

         APPEALED TO MONTANA SUPREME COURT - 10/10/17

          ORDER GRANTING RESPONDENT'S MOTION FOR SUMMARY JUDGMENT

          DAVID M. SANDLER JUDGE

         Summary: Respondent moves for summary judgment, arguing: (1) that Petitioner's claim for TTD or PTD benefits is time-barred; (2) that, in the alternative, she does not have sufficient evidence to prove that she is totally disabled as a result of her claim-related injuries; and (3) that her medical benefits are closed because Petitioner did not use them for 60 consecutive months. Petitioner opposes the motion on the grounds: (1) that she filed her Petition for Hearing within the statute of limitations; (2) that her head and neck problems are a result of claim-related injuries and have deteriorated to the point that she is now unable to work; and (3) that her medical benefits remain open because Petitioner received treatment during the relevant 60-month period.

         Held: Respondent's motion for summary judgment is granted because Petitioner's claim for TTD or PTD benefits is time-barred under the two-year statute of limitations set forth in § 39-71-2905(2), MCA. Because the issue of Petitioner's entitlement to TTD or PTD benefits is disposed of on statute of limitations grounds, this Court does not reach whether there is an issue of material fact as to her substantive entitlement to those benefits. Further, because Petitioner has neither asserted a claim for medical benefits in her Petition for Hearing, nor mediated that issue, this Court currently lacks jurisdiction to consider whether her medical benefits are closed.

          ¶ 1 Respondent Montana State Fund (State Fund) moves for summary judgment, arguing: that Petitioner Debbra Smith's claim for temporary total disability (TTD) or permanent total disability (PTD) benefits is time-barred; that, in the alternative, she does not have sufficient evidence to prove she is totally disabled due to her industrial injury; and that her medical benefits are closed because she did not use them for 60 consecutive months.

         ¶ 2 Smith opposes the motion on the grounds: that she filed her Petition for Hearing within the statute of limitations; that her head and neck problems are a result of claim-related injuries and have deteriorated to the point that she is now unable to work; and that her medical benefits remain open because she received treatment during the relevant 60-month period.

         FACTS

         ¶ 3 Smith fell on December 10, 2009, and suffered injuries at work, including her left shoulder.

         ¶ 4 On January 5, 2010, State Fund accepted liability for her left shoulder injury.

         ¶ 5 On December 18, 2010, Smith's treating physician, Larry Stayner, MD, determined Smith was at maximum medical improvement (MMI) and had no restrictions. He released her to return to work at her time-of-injury job.

         ¶ 6 On February 9, 2011, Smith resigned via an e-mail to her supervisor stating: "I hereby give my 2-week resignation, in that I can no longer perform my job duties sustained from injuries, caused by the State of Montana on 10 Dec 09."

         ¶ 7 On August 24, 2011, Smith sent an e-mail to State Fund stating,

What is State Fund prepared to do for me since the State of Montana's Department of Administration is responsible for my injuries sustained from a very bad fall on the raised floor of the ITSD's data center at the Mitchell Bldg., December 10, 2009?
I am not, and have not, been able to physically work since February 9, 2011.

         ¶ 8 On August 25, 2011, State Fund responded, and first indicated that medical benefits remained open. However, as to Smith's request for benefits for her alleged inability to work, State Fund denied liability:

As far as disability benefits, prior to your voluntary resignation, your employer committed to providing accommodations. Presently, your file reflects that your time-of-injury job has been approved by your treating physician, therefore you are not currently entitled to additional compensation benefits.

         State Fund also notified Smith that if she disagreed with its decision, she could notify it in writing and, thereafter, petition the Department of Labor & ...


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