Searching over 5,500,000 cases.


searching
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.

Simpson v. Montana Municipal Interlocal Authority

Court of Workers Compensation of Montana

July 30, 2018

CHRISTOPHER SIMPSON Petitioner
v.
MONTANA MUNICIPAL INTERLOCAL AUTHORITY Respondent/Insurer

          Submitted: May 11, 2018.

          ORDER GRANTING RESPONDENT'S MOTION FOR SUMMARY JUDGMENT AND DENYING PETITIONER'S MOTION FOR SUMMARY JUDGMENT

          DAVID M. SANDLER JUDGE

         Summary: Respondent moved for summary judgment, arguing that Petitioner's claim for medical benefits is time-barred under the two-year statute of limitations at § 39-71-2905(2), MCA. In the alternative, Respondent asserts that Petitioner's medical benefits terminated under § 39-71-704(1)(f), MCA (2005), because he did not use them for 60 consecutive months. Petitioner moved for summary judgment, arguing that his claim is timely, and that there was not a 60-month period of time in which he did not use his medical benefits.

         Held: This Court granted summary judgment for Respondent. Petitioner's claim is time-barred under the two-year statute of limitations in § 39-71-2905(2), MCA. Respondent denied liability for all further medical treatment on Petitioner's right knee in 2009, but Petitioner did not petition this Court to decide the dispute until 2017, approximately six years after the statute of limitations ran.

         ¶ 1 Petitioner Christopher Simpson and Respondent Montana Municipal Interlocal Authority (MMIA) filed an Agreed Statement of Facts and 15 exhibits. They also filed cross motions for summary judgment. The parties dispute whether MMIA is liable for medical benefits for Simpson's right knee. Because this Court rules that Simpson's claim for medical benefits for his right knee is time-barred by the statute of limitations at § 39-71-2905(2), MCA, it does not address the issue of whether Simpson's medical benefits terminated under § 39-71-704(1)(f), MCA (2005).

         FACTS

         ¶ 2 Simpson is a longtime Officer with the Billings Police Department. In the spring of 2006, Simpson injured his right knee in the course of his employment. MMIA, the insurer for the City of Billings, accepted liability.

         ¶ 3 On April 19, 2006, Scott Ross, MD, performed an arthroscopy with removal of loose body and microfracture technique of the lateral femoral condyle at the patellofemoral joint of Simpson's right knee. Following the procedure, Dr. Ross concluded that Simpson was at maximum medical improvement (MMI) for his right-knee injury with a 0% impairment rating and released him to return to work with no restrictions. No future medical appointments or procedures were scheduled.

         ¶ 4 On February 27, 2007, MMIA sent Simpson a letter informing him that due to the inactivity in medical treatment his file was being closed, but that his medical benefits remained open. MMIA also informed Simpson that pursuant to § 39-71-704(1)(f), MCA (2005), his medical benefits would terminate if they were not used for 60 consecutive months. Lastly, MMIA clarified that any further medical treatment would require prior authorization.

         ¶ 5 On January 13, 2009, Simpson met with Michael Willis, MD, after experiencing pain and swelling in his right knee after jogging. Dr. Willis' impression was: "Right knee pain with history of patellofemoral degeneration, likely representing loose body." Dr. Willis recommended Simpson undergo an MRI of his right knee "to evaluate for loose body."

         ¶ 6 MMIA paid for the January doctor's visit because it had been authorized. However, via a letter dated March 17, 2009, MMIA notified Simpson that because Dr. Willis' records from January 13, 2009, stated that he began experiencing pain and swelling after jogging, it did not appear that his current injury was related to his work-related injury and MMIA was therefore "not liable for any future treatment directly or indirectly related to the diagnosis of right knee pain." MMIA's letter also stated, "no further treatment regarding your right knee pain is authorized." MMIA's letter concluded with instructions that if Simpson disagreed with its decision, he could petition the Department of Labor & Industry's Employment Relations Division for mediation.

         ¶ 7 Simpson testified that after receiving this letter, he understood that MMIA was "trying to" deny further liability for his right-knee injury. He also testified that he "believed" that MMIA was not going to authorize any further treatment for his right knee. When asked if he thought "there was any treatment that MMIA would offer . . . after you received this letter," Simpson answered: "Not without having to sue them."

          ¶ 8 On March 26, 2009, Dr. Willis sent a letter to MMIA stating that he thought Simpson's current symptoms were related to his original work injury and surgery.

         ¶ 9 On April 17, 2009, MMIA sent a letter to Dr. Willis denying his request for authorization for an MRI of Simpson's right knee. MMIA highlighted that Simpson had previously been placed at MMI and that it appeared that Simpson's current right-knee pain was related to Simpson's jogging. As authority for its denial of authorization, MMIA cited § 39-71-407(6), MCA, which states: "If a claimant who has reached maximum healing suffers a subsequent nonwork-related injury to the same part of the body, the workers' compensation insurer ...


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.