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.

Neisinger v. New Hampshire Ins. Co.

Supreme Court of Montana

November 19, 2019

MICHAEL NEISINGER, Petitioner and Appellee,
v.
NEW HAMPSHIRE INS. CO., Respondent and Appellant.

          Submitted on Briefs: March 20, 2019

          APPEAL FROM: Montana Workers' Compensation Court, WCC No. 2017-4143 Honorable David M. Sandler, Presiding Judge

          For Appellant: Kelly M. Wills, Carrie L. Garber, Shea A.B. Sammons, Wills Law Firm, PC, Missoula, Montana

          For Appellee: Thomas J. Murphy, Murphy Law Firm, Great Falls, Montana

          For Amicus Montana State Fund: Kevin Braun, Nick Mazanec, Special Assistant Attorneys General, Montana State Fund, Helena, Montana

          For Amici Montana Municipal Interlocal Authority and Montana Schools Group Insurance Authority: Oliver H. Goe, Leo S. Ward, Kasey R. Kimball, Browning, Kaleczyc, Berry & Hoven, P.C., Helena, Montana

          OPINION

          JAMES JEREMIAH SHEA JUSTICE

         ¶1 New Hampshire Insurance Company (New Hampshire) appeals from an Order of the Workers' Compensation Court (WCC) reversing in part and affirming in part the Montana Department of Labor and Industry (DLI) Order Directing Medical Examination.

         ¶2 We address the following issues:

Issue One: Whether Neisinger's complaints of anxiety and insomnia provide a basis to require a psychiatric examination pursuant to § 39-71-605, MCA, before it is established that the complaints are related to his workers' compensation claim.
Issue Two: Whether New Hampshire must authorize Neisinger to see a psychiatrist or psychologist who will evaluate him and provide treatment if necessary before it can obtain a psychiatric examination pursuant to § 39-71-605, MCA.

         ¶3 We affirm in part, reverse in part, and remand for further proceedings consistent with this Opinion.

         PROCEDURAL AND FACTUAL BACKGROUND

         ¶4 On May 27, 2015, Michael Neisinger was injured in the course of his employment when a high-pressure stream of water hit his left thigh and knocked him off a platform. Neisinger suffered several injuries to his left leg, including a rupture of his quadriceps tendon.

         ¶5 New Hampshire provides workers' compensation insurance for Neisinger's employer. New Hampshire accepted liability for Neisinger's left leg injury. Neisinger sought treatment for his injury with Dr. John Ortiz and Dr. James Elliot.

         ¶6 On June 15, 2016, Neisinger underwent a medical examination pursuant to § 39-71-605, MCA, (§ 605 exam) with Dr. Joseph Erpelding, an orthopedist retained by New Hampshire. Dr. Erpelding determined that Neisinger was at maximum medical improvement (MMI) for his leg injuries and assigned a five percent whole person impairment rating. On August 18, 2016, Dr. Elliot agreed with Dr. Erpelding's opinion that Neisinger had reached MMI and that Neisinger should limit his use of stairs and ladders and should avoid squatting.

         ¶7 On October 26, 2017, Neisinger returned to Dr. Elliot and reported an increase in left knee pain. Dr. Elliot noted that (1) Neisinger presented with knee pain since his leg surgery, and (2) Neisinger had a recent event at a grocery store where his knee gave out, resulting in severe pain. Dr. Elliot concluded Neisinger needed additional medication to control his pain and referred Neisinger to Dr. S. Dante Oriente, a pain management specialist. Dr. Elliot requested pre-authorization for Neisinger to be seen by a pain management doctor.[1] New Hampshire authorized the referral to a pain management specialist and, on February 8, 2018, Neisinger saw Dr. Oriente for pain management. Dr. Oriente assessed Neisinger, and in his treatment plan for Neisinger stated:

This is a case of a [] male being seen in clinic for chronic left knee pain status post left quadriceps surgical repair and chronic low back pain radiation down left leg greater than right. [Neisinger] also complains of anxiety disorder with sleep disturbance for which I recommended psychologist/psychiatrist referral.

         ¶8 In response to Dr. Oriente's recommendation that Neisinger undergo a psychological or psychiatric evaluation, New Hampshire declined to authorize such a referral. Instead, on February 12, 2018, New Hampshire scheduled a § 605 exam with Dr. ...


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.