Case Title: McALEAR v McKEE GEN FIRE LIFE

Citation: 

Docket Number: 

State: montana

Court: Montana Supreme Court

Date: 1976-12-30T00:00:00Z

Document:
No. 13287 I N T H E S U P R E M E C O U R T O F T H E STATE O F MONTANA RICHARD L. McALEAR, Claimant and Appellant, A R T H U R G. M c K E E AND C O M P A N Y , EMPLOYER, and G E N E R A L ACCIDENT FIRE AM) LIFE A S S U R A N C E CORPORATION, Respondents and Insurers Appeal from: Workers' Compensation Court-Silver B o w County Honorable William E. Hunt, Judge presiding. Counsel of Record: For Appellant : Allen L. McAlear argued, Bozeman, Montana For Respondent : Henningsen, Purcell and Genzberger, Butte, Montana James E. Purcell argued, Butte, Montana Submitted: October 13, 1976 Decided: -- DEC 34 -- 1 9 7 6 : ? p Q " Filed: l,j E bc u 0 ?,27E. M r . Chief J u s t i c e James T. Harrison delivered t h e Opinion of t h e Court. This is a n appeal from t h e Workers' Compensation Court wherein defendant i n s u r e r was ordered t o pay p l a i n t i f f , Richard L. McAlear, $614.40 p a r t i a l d i s a b i l i t y . The f a c t s are: O n October 21, 1974, while employed a s a c a r p e n t e r by defendant McKee, McAlear suffered a broken elbow. It w a s not disputed t h a t t h e i n j u r y a r o s e o u t of and i n t h e scope of h i s employment. Neither are t h e medical r e p o r t s which state McAlear suffered a 15% permanent l o s s of extension i n t h a t elbow as a r e s u l t of t h i s i n j u r y questioned. Immediately a f t e r t h e i n j u r y McAlear w a s examined by D r . E l l i s of Anaconda, Montana, and t h e r e a f t e r r e f e r r e d t o D r . Whitfield of Dillon, Montana and D r . Losee of Ennis, Montana. From October 21, 1974,to January 20, 1975, McAlear was physically incapable of working and received $137 per week t e m - porary t o t a l d i s a b i l i t y from defendant i n s u r e r . On January 20, 1975, D r . Losee released M c A l e a r t o r e t u r n t o work and McAlear advised defendant i n s u r e r of t h i s release. A t t h a t t i m e t e m - porary t o t a l d i s a b i l i t y b e n e f i t s w e r e discontinued. McAlear then began t o seek employment, l i s t i n g h i s name with t h r e e union l o c a l s . However, no employment was a v a i l a b l e and he remained unemployed u n t i l June 1, 1975. During t h e period from h i s r e l e a s e by D r . Losee, January 2 0 , 1975, u n t i l May 2, 1975, McAlear continued t o s e e D r . Whit- f i e l d , receiving a w r i t t e n r e l e a s e from him on May 2 , 1975. O n April 23, 1975, defendant i n s u r e r o f f e r e d a p a r t i a l d i s a b i l i t y award of $1,394.40 t o McAlear f o r t h e conceded permanent i n j u r y t o h i s elbow. The b a s i s of t h a t award was s t a t e d t o be t h a t an American Medical Association guide t o evaluating i n j u r i e s i n t e r p r e t e d 15% l o s s of extension t o elbow equivalent t o 8-1/3% l o s s of t h e arm; t h a t l o s s of an arm e n t i t l e s one t o 280 weeks of benefits under the Workers' Compensation Laws; therefore 8-1/3% of 280 weeks (23.24 weeks) at a rate of $60 per week equals $1,394.40. Defendant insurer enclosed $780 with this offer to , bring the benefits current to April 21, 1975, and advised McAlear that if such a final settlement was agreeable the remaining $614.40 ' would be paid. McAlear rejected this offer and filed a claim with the Workers' Compensation Court seeking an extension of the total temporary disability from January 20, 1975, to May 2, 1975, and partial disability beginning May 2, 1975, for 2 / 3 of his wage loss at a maximum rate of $60 per week for 280 weeks. The Workers' Compensation Court's final determination was in accord with defendant insurer's offer ordering the re- maining $614.40 paid to McAlear. Two issues are presented for our review: 1) Whether the Workers' Compensation Court erred in refusing to extend the temporary total disability from January 20, 1975, to May 2, 1975? 2) Whether the Workers' Compensation Court erred in its partial disability award? This being one of the first appeals from the Workers' Compensation Court we refer to Skrukrud v. Gallatin Laundry Co., Inc., decided by this Court on December , 1976, Mont . - I - P. 2d -' - St.Rep. , wherein we stated: " * * * The law as it applied to judicial review of Workmen's Compensation Division decisions prior to July 1, 1975 is well summarized in Miller v. City of Billings, Mont. , 555 P.2d 747, 749, 33 st. Rep. 984, 986: "'The findings and decision of the Workmen's Compensation Division are presumed to be correct and if supported by credible evidence must be affirmed. Section 92-822, R.C.M. 1947 (since repealed); Birnie v. United States Gypsum Co., 134 Mont. 39, 44, 328 P.2d 133; Hurlbut v . Vollstedt Kerr Co., Mont. 538 P.2d 344, 347, 32 St.Rep. 752, 755. The d i s t r i c t c o u r t must a f f i r m t h e Division order i f t h e evidence does n o t c l e a r l y preponderate a g a i n s t its findings. Becktold v. Ind. A c c . Bd., 137 Mont. 119, 125, 350 P.2d 383; Stordahl v. Rush Implement Co., 148 Mont. 13, 417 P.2d 95; 3 Larson's Workmen's Compensation Law, S 80.20. Section 92-834, R.C.M. 1947 ( i n e f f e c t i n 1966, but s i n c e r e p e a l e d ) , provided t h e d i s t r i c t c o u r t , may upon good cause shown admit a d d i t i o n a l evi- dence. Section 92-835, R.C.M. 1947 ( i n e f f e c t i n 1966, but s i n c e r e p e a l e d ) , provided t h a t i f t h i s a d d i t i o n a l evidence i s s u b s t a n t i a l , t h e d i s t r i c t c o u r t may be j u s t i f i e d i n reversing t h e Division even though t h e evidence adduced before t h e Division c l e a r l y preponderates i n favor of its order. Murphy v. I n d u s t r i a l Accident Board, 93 Mont. 1, 16 P.2d 705; Hurlbut v. V o l l s t e d t Kerr Co., supra. "'Where t h e appeal t o t h e d i s t r i c t c o u r t i s heard only on t h e D i v i s i o n ' s c e r t i f i e d record o r when t h e d i s t r i c t c o u r t permits a d d i t i o n a l evidence t o be introduced t h a t i s not important o r adds nothing new t o t h e case, t h e c o u r t i s bound by t h e same r u l e of appeal which a p p l i e s where t h e appeal is heard only on t h e c e r t i f i e d record and t h e Division i s e n t i t l e d t o a presumption t h e c a s e was decided c o r r e c t l y . Kelly v. West Coast Construction Co., 106 Mont. 463, 78 P.2d 1078; McAndrews v . Schwartz, 164 Mont. 402, 523 P.2d 1379; Erhart v. Great Western Sugar Co., Mont. 546 P.2d 1055, 33 St.Rep. 302.' "See a l s o : Kimball v. Continental O i l Co., Mont . I 550 P.2d 912, 33 St.Rep. 517. "Under t h e law a s it now e x i s t s , t h i s Court d i r e c t l y reviews t h e d e c i s i o n of t h e workers' c o u r t , s e c t i o n 92-852(2), R.C.M. 1947. The workers' c o u r t proceedings a r e a d m i n i s t r a t i v e i n n a t u r e and quasi- j u d i c i a l , s e c t i o n s 92-852 (1) and 82A-1016, R.C.M. 1947. The appropriate scope of t h i s C o u r t ' s review should be no d i f f e r e n t than it was under former l a w as expressed i n t h e above c i t e d cases; t h a t is, workers' c o u r t d e c i s i o n s w i l l not be over- turned i f t h e r e i s s u b s t a n t i a l evidence t o support its f i n d i n g s and conclusions." W e t u r n now t o t h e f i r s t i s s u e . The s t a t u t e s which govern a r e s e c t i o n 92-701.1, R.C.M. 1947, which s t a t e s : " * * * Total temporary d i s a b i l i t y b e n e f i t s s h a l l be paid f o r t h e d u r a t i o n of t h e worker's temporary d i s a b i l i t y . " and s e c t i o n 92-439, R.C.M. 1947, which d e f i n e s temporary t o t a l d i s a b i l i t y as: " * * * a condition r e s u l t i n g from an i n j u r y a s defined i n t h i s a c t t h a t r e s u l t s i n t o t a l l o s s of wages and e x i s t s u n t i l t h e injured workman i s a s f a r r e s t o r e d as t h e permanent c h a r a c t e r of t h e i n j u r i e s w i l l permit." - - - ( ~ m p h a s i s added.) Therefore, temporary t o t a l d i s a b i l i t y ceases when t h e workman's physical condition i s as f a r r e s t o r e d a s t h e permanent c h a r a c t e r of t h e i n j u r i e s w i l l permit. When t h e claimant has reached t h i s s t a g e i n h i s healing process temporary t o t a l d i s a b i l i t y ceases, and p a r t i a l d i s a b i l i t y begins i f t h e r e is permanent p a r t i a l im- pairment. The record shows t h a t D r . Losee r e l e a s e d McAlear as of January 20, 1975. Furthermore McAlear himself c a l l e d and informed defendant i n s u r e r t h a t he w a s released t o r e t u r n t o work on Jan- uary 20, 1975. D r . Whitfield, i n w r i t t e n correspondence, s t a t e d t h a t McAlear might have been a b l e t o r e t u r n t o work i n January but t h a t an o f f i c i a l w r i t t e n r e l e a s e w a s n o t signed by D r . Whitfield u n t i l May 2 , 1975. McAlear f u r t h e r t e s t i f i e d t h a t he w a s seeking work through t h r e e union l o c a l s from January 20, 1975, t h e d a t e of D r . Losee's release, u n t i l June 1, 1975, when he obtained em- ployment, and t h a t t h e only reason f o r h i s unemployment during t h i s period was t h e u n a v a i l a b i l i t y of any employment. Considering t h i s evidence and t h e l a w governing temporary t o t a l d i s a b i l i t y , w e w i l l not r e v e r s e t h e holding of t h e Workers' Compensation Court on t h i s i s s u e , s i n c e w e f a i l t o f i n d any d e n i a l of p l a i n t i f f ' s s u b s t a n t i a l r i g h t s a s s p e c i f i e d i n s e c t i o n 82-4216, R.C.M. 1947. Next, w e are asked t o review t h e Workers' Compensation Court's p a r t i a l d i s a b i l i t y award. I n t h e beginning, w e note t h a t t h e r e are two d i s t i n c t types of p a r t i a l d i s a b i l i t y b e n e f i t s which a claimant may seek, such being t h e s i t u a t i o n on t h e d a t e of McAlear's i n j u r y . A claimant may e l e c t a d i s a b i l i t y b e n e f i t under s e c t i o n 92-703.1, R.C.M. 1947, o r an indemnity b e n e f i t under s e c t i o n 92-709, R.C.M. 1947. The d i s t i n c t i o n between t h e s e two b e n e f i t s is t h a t s e c t i o n 92-703.1 bases t h e b e n e f i t upon a c t u a l l o s s of earning c a p a c i t y r e s u l t i n g from t h e i n j u r y , whereas s e c t i o n 92-709 awards compensation r e g a r d l e s s of earnings t o compensate f o r p o s s i b l e l o s s of earning c a p a c i t y i n t h e f u t u r e . Jones v . Glac. General Assurance Co., 145 Mont. 326, 400 P.2d 888. Applying t h i s d i s t i n c t i o n t o t h e c a s e a t hand, t h e r e s u l t is t h a t McAlear w a s e n t i t l e d t o elect one of two awards, depend- ing upon t h e record e s t a b l i s h e d before t h e Workers' Compensation Court . 1) McAlear was e n t i t l e d t o proceed under s e c t i o n 92-709 whereby t h e Workers' Compensation Court could award, as compensa- t i o n f o r t h e p a r t i a l l o s s of use of h i s arm, t h e f u l l amount allow- a b l e under s e c t i o n 92-709 t h a t would r e s u l t i f t h e arm had been permanently l o s t , o r a proportionately less amount. Obie v. Obie Signs, Inc.,143 Mont. 1, 386 P.2d 68. Defendant i n s u r e r made i t s o f f e r pursuant t o t h i s approach and based upon t h e medical r e p o r t s of McAlear's doctors t h a t he sustained a 15% permanent l o s s of extension i n h i s elbow, o f f e r e d t h e following evidence. A n American Medical Association guide t o evaluating i n j u r i e s s t a t e d such a l o s s of extension i n t h e elbow was equivalent t o 8-1/3% l o s s of t h e arm. Therefore, t h e proportionate amount due w a s c a l c u l a t e d t o be $1,394.40 [280 weeks (100% l o s s of arm) x 8-1/3% ( a c t u a l l o s s of use i n t h i s case) x $60 per week ( t h e maximum weekly r a t e allowable a t t h e time of McAlear's i n j u r y ) ] . 2 ) The a l t e r n a t e b e n e f i t a v a i l a b l e w a s under s e c t i o n 92-703.1 which would allow McAlear a maximum of $60 per week f o r t h e maximum number of weeks under s e c t i o n 92-709 f o r t h e l o s s of an arm (280 weeks). However, t o be e l i g i b l e f o r such b e n e f i t s , McAlear w a s r e q u i r e d t o show a c t u a l l o s s of earning c a p a c i t y . The test t o determine l o s s of earning c a p a c i t y is t h a t a claimant must show t h e i n a b i l i t y t o o b t a i n employment due t o t h e i n j u r i e s . S h a f f e r v. Midland Empire Pack. Co., 127 Mont. 2 1 1 , 259 P.2d M c A l e a r f a i l e d t o f u l f i l l t h i s burden of proof. The testimony w a s uncontroverted t h a t t h e s o l e reason f o r M c A l e a r l s unemployment a f t e r January 20, 1975, was t h a t no employment was a v a i l a b l e . There w a s no showing by McAlear t h a t t h e r e d u c t i o n of h i s e a r n i n g s a f t e r g a i n i n g employment, a s compared t o h i s e a r n i n g s p r i o r t o h i s i n j u r y , was due t o h i s p h y s i c a l impairment. Nor w a s he, a t any t i m e , refused employment o r forced t o r e j e c t any o f f e r e d employment because of h i s p h y s i c a l impairment from t h e d a t e of h i s i n i t i a l r e l e a s e , January 20, 1975, u n t i l t h e t i m e of h i s hearing b e f o r e t h e Workers' Compensation Court. W e f i n d no grounds under s e c t i o n 82-4216, R.C.M. 1947, which would permit r e v e r s a l of t h e f i n a l d e c i s i o n of t h e Workers' Compensation Court. The Workers' Compensation Court awarded McAlear b e n e f i t s i n accord w i t h t h e defendant i n s u r e r ' s o f f e r under s e c t i o n 92-709, R.C.M. 1947, i n s t e a d of d i s a l l o w i n g any b e n e f i t s a t a l l f o r M c A l e a r l s f a i l u r e t o p u t f o r t h any evidence e n t i t l i n g him t o compensation under s e c t i o n 92-703.1, R.C. M. 1947. McAlearls contention is c o r r e c t t h a t a claimant can elect t o proceed under s e c t i o n 92-703.1 o r s e c t i o n 92-709 when seeking p a r t i a l d i s a b i l i t y b e n e f i t s . However, w e do n o t b e l i e v e t h a t t h e Workers' Compensation Court should be r e s t r a i n e d from making an award supported by t h e evidence when t h e claimant has made an i n c o r r e c t e l e c t i o n i n l i g h t of t h e evidence presented. The judgment i s affirmed. P Chief J u s t i c e W e concur: Judge, s i t t i n g in p l a c e of Mr. J u s t i c e Wesley C a s t l e s .