Searching over 5,500,000 cases.

Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.

TG v. Montana Schools Group Insurance Authority

Court of Workers Compensation of Montana

January 25, 2018

TG Petitioner

          Submitted: June 7, 2017




         While Petitioner was working as an aide at a high school, a special needs student hit her, and then hit and pinched her two days later, leaving bruises. Petitioner did not seek nor require medical treatment for her bruises, although, after they resolved, she reported increased neck and arm pain to her medical providers. The attacks caused PTSD, and aggravated her preexisting anxiety, depression, and pseudoseizures, resulting in her inability to work. Petitioner asserts that she suffered compensable physical injuries, and compensable physical-mental injuries in the attacks.


         Respondent is entitled to summary judgment on Petitioner's claims. Petitioner did not suffer compensable physical injuries in the attacks. Although she had bruising, she neither sought nor required medical treatment for her bruises, which resolved without any resulting disability. While Petitioner's treating physician for her fibromyalgia diagnosed increased neck and arm pain as a result of the attacks, his diagnosis was based entirely on Petitioner's subjective complaints of pain and was not substantiated by objective medical findings. Petitioner did not suffer compensable psychological injuries in the attacks. Petitioner's anxiety, depression, and PTSD are mental-mental conditions, and her pseudoseizures are a mental-physical condition. Neither mental-mental nor mental-physical conditions are compensable under the Workers' Compensation Act.

         ¶ 1 Respondent Montana Schools Group Insurance Authority (MSGIA) moves for summary judgment on the grounds that Petitioner TG did not suffer a compensable physical injury, and on the grounds that TG's anxiety, depression, and posttraumatic stress disorder (PTSD) are mental-mental conditions and that her pseudoseizures are a mental-physical condition, neither of which is compensable under the Workers' Compensation Act. TG opposes the motion, arguing that the evidence shows she suffered a physical injury, and physical-mental injuries.


         ¶ 2 TG worked as a paraprofessional in a special needs classroom for Helena Public Schools.

         Preexisting Conditions¶ 3 Before the incidents at issue in this case, TG had several preexisting conditions, including fibromyalgia, anxiety, panic attacks, depression, and pseudoseizures.

         ¶ 4 On June 16, 2015, TG saw Allen M. Weinert, MD, to follow up on her "fibromyalgia with diffuse body pain." Dr. Weinert noted:

She has put in for a job transfer to work with younger students [as] she relates that some of the disabled students that she works with in high school are quite violent and she has suffered injuries because of this. She relates that she does develop anxiety and panic attacks because of these exposures. She still has multiple fibromyalgia tender points, but is dealing with this with consistent exercise.

         TG also complained of low-back pain. On physical examination, Dr. Weinert noted, inter alia, mildly and moderately reduced range of motion in her neck and shoulders, and "diffuse tender points" in her neck and upper back. Dr. Weinert continued her prescriptions, which included trazodone, Ultram, Neurontin, bupropion, Xanax, and Maxalt.

         ¶ 5 On September 18, 2015, TG went to the ER because she had five episodes of seizure-like activity. The ER physician thought that TG may have been having anxiety and panic attacks.

         ¶ 6 On September 23, 2015, TG saw Bryan Hilborn, DC. Dr. Hilborn noted slightly to moderately limited range of motion in her cervical, thoracic, and lumbar areas. Dr. Hilborn treated her with chiropractic adjustments.

         ¶ 7 On September 29, 2015, TG saw Katy J. Wessel, DO, for her seizure-like activity. Dr. Wessel witnessed an episode. Dr. Wessel noted that TG did not have tonic-clonic movements and thought it could be a pseudoseizure. However, Dr. Wessel was not convinced TG was having a panic attack. Thus, Dr. Wessel referred TG to neurology. Dr. Wessel restricted TG from driving because "if she had an episode like she had in our clinic today while driving, she would surely get in an accident."

         Workplace Incidents

         ¶ 8 On October 7, 2015, a special needs student hit TG. On the Accident/Incident Report, TG wrote that the student "started to hit and kick. He hit me in the face and knocked my glasses off my face." She checked the boxes stating her face and hands were injured in the incident. She suffered bruising from this incident.

         ¶ 9 The following day, MSGIA denied liability for this claim on the grounds that the "information currently available to this office indicates you have not sought medical treatment in relation to your 10/7/2015 claim. Based on this, we must respectfully deny your claim as it does not meet the requirements for a compensable injury under the Montana Workers' Compensation Act."

         ¶ 10 On October 9, 2015, the student again became violent with TG. On the Accident/Incident Report, TG wrote that the student first hit her with an open hand in the gym. The student then slapped another student. Thus, TG decided to remove him from the gym. As they walked to the classroom, the student hit her again in the head, stomach, and breasts. The student also pinched her. TG could not get the student off her, and yelled for help. Three coworkers rescued her. TG reported injuries to her shoulder, upper arms, forearm, upper back, and lower back. She suffered bruising from this incident.

         ¶ 11 On October 13, 2015, MSGIA denied liability for this claim on the grounds that TG did not seek medical treatment for her alleged injuries.

         ¶ 12 TG continued to work until the Thanksgiving holiday, but did not return thereafter.

         Medical Treatments Following the Workplace Incidents

         ¶ 13 On December 8, 2015, TG saw Nicole C. Clark, MD. Dr. Clark - who had previously treated TG for "significant anxiety and headaches" - noted, "This is a 55-year-old woman with episodes that are likely nonepileptic events related to her anxiety." Dr. Clark also noted: "She has still been having significant anxiety. She has been attacked by students several times at work and she is fearful of being attacked again. She has taken medical leave off work right now bc she feels that she is unable to deal with that environment." Dr. Clark also noted, "At the end of her visit she tells me that she is scared to go back to work and everyday she is supposed [to] go to work she gets nauseous and throws up just thinking about going back with that student who recently attacked her."

         ¶ 14 On December 9, 2015, TG returned to Dr. Wessel because she was suffering from severe depression. Dr. Wessel wrote:

She was attacked at work again by a student as she teaches the special needs kids. She says it occurred in the end of Oct. sometime. She did an accident report at the school, but she does still have to work in the same classroom with him. When it occurred, the kid chased her and pushed her up against a wall and was hitting her and pinching her. She says he started out in the gym and she ran and he caught her. She says she has not been able to go back to work since Thanksgiving as she has been sick and felt anxious to the point of vomiting and is unable to go to work.

         Dr. Wessel also noted, "She has a long-standing history of anxiety and it has been extremely severe to her at times in her life to the point she is unable to work which is where she is currently."

         ¶ 15 On December 9, 2015, Dr. Wessel wrote a letter taking her off work as a result of her psychological conditions, and opining that the cause of TG's PTSD was the attacks:

Please allow [TG] to take medical leave due to her severe anxiety and depression. We are in the process of attempting to get it under better control. Please be willing to work with her as to when she will be able to return. In my professional opinion, she is also suffering from some post traumatic stress from some incidents that have occurred on the job.

         ¶ 16 On December 21, 2015, TG returned to Dr. Weinert. Dr. Weinert noted:

[TG] is a . . . school aide who returns for follow up of diffuse body pain with fibromyalgia with increased symptoms of neck and left arm pain since suffering an assault at work. The patient relates in late October she was attacked by a student who hit her about the [sic] and arms causing bruising. She denies any concussion. She relates suffering emotional trauma from this and began to develop what she describes as "seizures." [They] seemed to be worse before she went to school and her primary care physician diagnosed her with PTSD and she has been off of work since November 23. She does have an appointment with a psychiatrist on January 6. The patient still relates a great deal of discomfort in the posterior neck and left arm. She denies any numbness or weakness in the arms. She has seen a neurologist for seizures and relates that one of her medical providers did describe her events as pseudoseizures. The patient relates that [they] seemed to be triggered by thoughts of going to work and she relates that she developed diarrhea and nausea and vomiting as well as diffuse body shaking.

         Dr. Weinert's physical examination was in all material ways identical to his physical examination on June 16, 2015: he noted mildly and moderately reduced range of motion in her neck and shoulders, and diffuse tender points in her neck and shoulder areas. While TG told Dr. Weinert she suffered bruising in the attacks, he noted, "No ecchymosis is evident about the shoulders or arms." Dr. Weinert's impressions included: "Fibromyalgia with diffuse tender points with recent exacerbation of neck and left arm pain related to an assault at work which appears to be soft tissue in nature"; depression and anxiety; and probable pseudoseizures. Dr. Weinert discontinued TG's prescription for Ultram because it lowers seizure threshold, and replaced it with a low dose of Norco. He refilled TG's prescriptions for Neurontin and trazodone. He did not make any other changes to her prescriptions.

         ¶ 17 On December 23, 2015, TG saw Elize Cline, NP. TG had undergone an EEG, which was normal. Cline noted, "her 'seizure' events described do not sound epileptic in nature as her eye movements are not abnormal, maintains consciousness and able to hear voices during events, is able to lower herself to the ground, and the pre-event shaking is not typical of seizures." Cline also noted, "She self-reports high anxiety, stress and 'PTSD' diagnosed by her [primary care physician] as the cause for many of her shaking events." Cline also noted, "She often has the episodes accompanied by extreme nausea and vomiting just before she leaves for work in the morning. She is very nervous about work as she has been assaulted many times by students."

         ¶ 18 On January 7, 2016, TG saw Connie O'Connor, MD, a psychiatrist. Dr. O'Connor noted that TG was having the seizure-like activity "once a month until she was 'attacked' by a student in October. She now has them once a week[, ] especially when she thinks about going back to work." Dr. O'Connor understood that TG had been attacked by the student five times. Dr. O'Connor also noted that TG has "anxiety daily triggered by thoughts about going back to work, " and, "[s]he has flashbacks twice a day and she avoids going back to school or talking about being attacked." Dr. O'Connor diagnosed TG with recurrent major depressive disorder, posttraumatic stress ...

Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.