Source: http://wcc.dli.mt.gov/G/Greene%20Findings.htm
Timestamp: 2019-04-21 07:06:36+00:00

Document:
Summary: In January 2000, claimant and his ex-wife were hired to manage the Alder Montana KOA Kampground. Claimant was the maintenance manager and his ex-wife assumed responsibility for the small convenience store. On April 7, 2000, claimant fell from a ladder and suffered a 50% compression fracture of the L1 vertebra and an ankle fracture. He continued to be paid and was allowed to return to work in a modified position doing such work as he felt physically able to do. Claimant's treating physician approved claimant's working in a sedentary to light capacity. The owner of the campground hired others to assist claimant.
On June 22, 2000, the claimant quit his modified position after his ex-wife was reprimanded for allowing drunken motorcyclists to camp at the campground. Thereafter, in April 2002 and May 2002, Dr. Sorini, a neurosurgeon to whom claimant was referred for back complaints, and Dr. Buehler, an orthopedic surgeon who was claimant's regular treating physician, found him totally incapable of working.
Claimant now seeks medical benefits for a L5-S1 spondylosis with Grade 1 spondylolisthesis, urging that while the condition was preexisting the industrial accident made it symptomatic. He also seeks temporary and/or permanent total disability benefits from June 22, 2000. The UEF, which assumed liability for the claimant's industrial accident since Alder KOA was uninsured, began paying total disability benefits as of April 2002. It seeks indemnification from Alder KOA.
(1) The industrial accident did not cause the claimant's L5-S1 condition or make it symptomatic. The condition was made symptomatic by claimant's subsequent fall at home. Therefore, the UEF and Alder KOA are not liable for the claimant's L5-S1 condition or for disability arising from that condition.
(3) Claimant has proved he is totally disabled as of April 2002, on account of back pain. The claimant's L1 compression fracture is a significant contributor to that pain and total disability. He is therefore entitled to total disability benefits as of April 2002.
(4) For purposes of determining the claimant's compensation rate, any back pay the claimant is entitled to on account of the employer's failure to comply with minimum wage and overtime pay requirements must be included.
(5) At the time of his industrial accident, claimant was working only part time, averaging no more than twenty-eight hours a week.
(6) The UEF is entitled to reimbursement from Alder KOA for both medical and compensation benefits paid to date and which may reasonably be paid in the future.
Injury and Accident: Aggravation: Generally. An insurer is responsible for treatment of a preexisting condition where the industrial accident makes a preexisting condition symptomatic, however, where the most credible medical evidence shows that the condition did not become symptomatic until six months after the industrial accident and became symptomatic immediately after a non-industrial accident, the insurer is not liable for the condition or for disability arising from the condition.
Constitutions, Statutes, Regulations, and Rules: Montana Code Annotated: 39-71-701(4), MCA (1999). Under section 39-71-701(4), MCA, a claimant is disqualified from TTD benefits so long as he is released to a modified position and the position is available. A claimant cannot bootstrap TTD entitlement by refusing the position or quitting the position without good cause.
Benefits: Temporary Total Disability Benefits. Under section 39-71-701(4), MCA, a claimant is disqualified from TTD benefits so long as he is released to a modified position and the position is available. A claimant cannot bootstrap TTD entitlement by refusing the position or quitting the position without good cause.
Constitutions, Statutes, Rules, and Regulations: Montana Code Annotated: 39-71-701(4), MCA (1999). Under section 39-71-701(4), MCA, a claimant is disqualified from TTD benefits so long as he is released to a modified position and the position is available. A claimant cannot bootstrap TTD entitlement by refusing the position or quitting the position without good cause.
Benefits: Temporary Total Disability Benefits. Where claimant who had been previously released to a modified position becomes physically unable to perform that position, he again becomes entitled to TTD benefits. § 39-71-701(4), MCA.
Constitutions, Statutes, Rules, and Regulations: Montana Code Annotated: 39-71-701(4), MCA (1999). Where claimant who had been previously released to a modified position becomes physically unable to perform that position, he again becomes entitled to TTD benefits. § 39-71-701(4), MCA.
Benefits: Temporary Total Disability Benefits. Where claimant is totally disabled on account of back pain and the industrial condition is a significant contributor to that pain, the claimant is entitled to TTD benefits.
Wages: Average Weekly Wage. For purposes of determining the claimant's compensation rate, any back pay the claimant is entitled to on account of the employer's failure to comply with minimum wage and overtime pay requirements must be included. § 39-71-123(1)(b), MCA (1999).
Constitutions, Statutes, Rules, and Regulations: Montana Code Annotated: 39-71-123(1)(b), MCA (1999). For purposes of determining the claimant's compensation rate, any back pay the claimant is entitled to on account of the employer's failure to comply with minimum wage and overtime pay requirements must be included. § 39-71-123(1)(b), MCA (1999).
Uninsured Employers: Indemnification. The Uninsured Employers' Fund is entitled to reimbursement from the uninsured employer for all benefits reasonably paid or to be paid a claimant. § 39-71-504(1)(b), MCA (1999).
Constitutions, Statutes, Rules, and Regulations: Montana Code Annotated: 39-71-504(1)(b), MCA (1999). The Uninsured Employers' Fund is entitled to reimbursement from the uninsured employer for all benefits reasonably paid or to be paid a claimant. § 39-71-504(1)(b), MCA (1999).
¶1 The trial in this matter was held on September 5 and 6, 2002, in Butte, Montana. Petitioner, Lyman Greene, was present and represented by Mr. Frank J. Joseph and Mr. David L. Vicevich. Respondent, Uninsured Employers' Fund (UEF), was represented by Ms. Julia W. Swingley. Respondent, Alder KOA Kampground (Alder KOA), was represented by Ms. Elizabeth A. O'Halloran.
¶2 Exhibits: Exhibits 1 through 25, 27 through 29, 31, 33 through 39, and 41 were admitted without objection. Exhibits 30 and 32 were admitted after the objections were withdrawn. Exhibit 40 was admitted over objection. The Court reserved ruling on Exhibit 26 pending its offer in connection with testimony at trial. The exhibit was not re-offered, is not in the Court's exhibit book, and is therefore not considered.
¶3 Witnesses and Depositions: Lyman Greene, Edward Nannini, Dennis Schmidt, Cory Petterson, Jean Shipp, Brenda Barnaby, and Dorla Hartford testified at trial. In addition the parties submitted depositions of Mark Hayden, Dr. Peter M. Sorini, Dr. Charles E. Buehler, Dr. Dana Headapohl, Edward N. Nannini, Cynthia Greene, and Lyman Greene for the Court's consideration.
¶4a Is Petitioner entitled to temporary and/or permanent wage loss benefits pursuant to the Workers Compensation Act?
¶4b If Petitioner is entitled to temporary and/or permanent wage loss benefits, what is the appropriate rate and amount of benefits available to Petitioner?
¶4c If the Petitioner is entitled to temporary and/or permanent wage loss benefits, is the Employer legally obligated to reimburse the UEF for all indemnity and medical benefits paid or to be paid by the UEF to Petitioner?
¶4d Was Petitioners pre-existing condition of bilateral spondylosis with Grade I spondylolisthesis at L5-S1 aggravated by the industrial accident of April 7, 2000?
¶4e Is conduct of Respondent Employer in its refusal to pay medical and wage loss benefits unreasonable and, if so, does said unreasonable conduct warrant the imposition of penalties against the Employer.
¶4f Is the conduct of Respondent UEF in its refusal to pay medical and wage loss benefits unreasonable, and, if so, does said unreasonable conduct warrant the imposition of penalties against the UEF.
¶6 Alder KOA is a campground operating under the KOA Kampground franchise. It is located in Alder, Montana.
¶7 Alder KOA is 22.2 acres, however, the campground only covers 7 acres. (Nannini Dep. at 38; Trial Test.) It has approximately 56 campsites, many of them with water and electricity suitable for recreational vehicles and trailers. (Id.) It has a convenience store with an apartment. The store sells gasoline and propane, as well as basic groceries and other items. The campground also has a double wide trailer, a camping cabin, a cook tent where some meals are served, a playground, and a pond for fishing. (Trial Test.) A diagram of the campground is found at Exhibit 39.
¶8 Alder KOA has been owned and operated by Nannini Brothers, Incorporated since March or April 1999. (Nannini Dep. at 7-8.) The corporation has two shareholders. (Id. at 8.) Edward Nannini (Nannini) is the majority shareholder, owning 51% or 52% of the stock (id.; Trial Test.), and is in charge of the actual operations of the Alder KOA.
¶9 The Alder KOA is open year round, however, in the winter, spring, and fall its primary operation is its convenience store. Camping at the Alder KOA occurs mainly between Memorial Day and Labor day.
¶10 Nannini spends his winters in Sacramento, California, which is his primary residence.
¶12 Claimant traveled to Sacramento to meet with Nannini. After the meeting, Nannini hired claimant and Cynthia to manage the Alder KOA for $50.00 each a week plus room and board. The parties agree that the value of claimant's share of room and board was $280.00 monthly. (Petitioner's Proposed Finding of Fact ¶ 6; Ex. 6 at 4; Employer's Proposed Findings of Fact ¶ 110.) Claimant and Cynthia also received a 20 gallon a month gasoline allowance. (Uncontested Fact 3.) Claimant's share of that allowance averaged $17.06 per month during the five months he was employed. (Petitioner's Proposed Finding of Fact ¶ 6; Ex. 6 at 4; Employer's Proposed Findings of Fact ¶ 110.) On a weekly basis, the value of board, room, and gas was $68.37 ($297.06 x 12 months ÷ 52.14 weeks).
¶13 Thus, claimant's pay at the time of his injury was $118.37 a week ($50 + $68.37).
¶14 Claimant and Cynthia traveled to Alder in January 2000, moved into the apartment above the store, and began managing the Alder KOA.
¶17 At the time of the claimant's industrial injury, Alder KOA (Nannini Brothers, Incorporated) did not have workers' compensation insurance coverage.
¶19 UEF, however, has not paid all the benefits claimant alleges he is entitled to. Initially, it did not pay temporary total disability (TTD) benefits because Alder KOA modified his duties so he could continue working within his medical restrictions. According to the UEF's Proposed Findings of Fact at 3, UEF began paying TTD benefits on April 25, 2002, after Dr. Peter Sorini testified in deposition that claimant was unable to work. UEF and the employer also dispute claimant's wages and disability rate and the relationship of some of his back problems to his injury.
¶20 Resolution of many issues in this case depend upon my assessment of the witnesses' credibility. I did not find claimant a credible witness. Nannini was a far more credible witness.
¶21 Claimant asserts that the Court must base its calculation of his benefits on statutory minimum wage and overtime requirements rather than his actual wages. Since claimant may have been covered by minimum wage and overtime statutes, I determine the actual number of hours he worked.
¶23 I did not find his claim of all those hours credible. I was also unpersuaded by his supporting witnesses, whom I also found not credible.
¶24 The claimant and Cynthia were responsible for keeping the store open from 8:00 a.m. to 5:00 p.m. during the winter. (Nannini Trial Test.) From March 15th to Memorial day, they were required to keep the store open from 7:00 a.m. to 6:00 p.m. (Id.) During the winter, Nannini left it up to them whether to keep it open five or seven days a week, but I am persuaded that after March 15th it was to open seven days a week.
¶27 I am persuaded that claimant exaggerated both the nature of his work and the time he spent working. In assessing his credibility, I note his testimony that he worked two weeks on jack-leg fencing. There are pictures of the fence sections (Ex. 34 at 3-4) and, according to a written description of post-injury duties which was prepared by claimant, eight sections were built (Ex. 21, ¶ 8), a number confirmed by Nannini. (Trial Test.) These were simple fence sections, consisting of two poles crossed in an X fashion on each end, a long, horizontal pole between the two ends, and a single pole at each end to brace the end to the horizontal pole. Claimant only helped in building some of the sections. Maybe all told they took four hours to build, but four days is patently incredible.
¶28 With certainty the claimant grossly exaggerated other aspects of his work, for example the extent of his lawn mowing. His testimony that he serviced vehicles, including three days spent repairing a dashboard on a jeep, was not believable. The testimony that he traveled to and from Costco and other stores to pick up supplies for the convenience store was not believable. I note that the Alder KOA had regular suppliers who delivered supplies to the store.
[h]e would lay on the floor in the living room, complain of back pain all the time. He would take his medication on a regular basis and sleep most of the time.
¶30 Ultimately, claimant was responsible for his own hours of work. When not working on specific outdoor projects designated by Nannini, claimant was free to determine his work schedule.
¶31 Unfortunately, there is no perfect benchmark for determining the hours the claimant worked prior to his injury. Neither claimant nor Nannini kept track of claimant's actual hours of work. I am therefore left to determine, as best I can, the actual number or hours the claimant actually worked. In sifting and weighing all the evidence, I am unpersuaded that claimant actually averaged no more than four hours a day. Even on a seven-days-a-week basis, I am unpersuaded he worked more than twenty-eight hours a week.
¶32 Following his April 7, 2000 injury, claimant was hospitalized for three days. (Ex. 28 at 25.) Following his discharge on April 10, 2000, he returned to his apartment at the Alder KOA.
¶33 Upon his return to the Alder KOA, Nannini instructed claimant to rest until he felt like helping out again. Nannini allowed claimant to return to his duties as he was able and continued to pay claimant and Cynthia on the same basis as before, increasing their wages to $100 per week each effective June 1, 2000.
¶34 Claimant in fact returned to some of his duties in late April 2000. On April 25, 2000, Dr. Charles E. Buehler, who had treated him for his fractures, noted that claimant was on crutches but released him to mow lawns with a riding mower. (Ex. 11 at 25.) On May 9, 2000, Dr. Buehler prescribed an "air cast splint" for claimant's left ankle, okayed him working without crutches but with a cane, and noted that he was "full weight bearing on the left [leg] side." (Id. at 24.) He approved claimant's return "to full duty at KOA . . . ." (Id.) On June 8, 2000, Dr. Buehler noted that claimant was out of his air cast but was having more back pain. (Id. at 23.) He noted that claimant reported moving 125 pound pumps and commented that "this is too heavy with his back condition." (Id.) He released claimant "for lighter sedentary type work."
¶35 Claimant continued to work. Nannini told him to do what he was able to do. He did not place any specific requirements on his work and hired other part-time employees to help with campground maintenance. Cynthia continued to manage the convenience store.
¶36 On June 24, 2000, Nannini reprimanded Cynthia for allowing drunken motorcyclists to camp at the Alder KOA. The conversation was short and Cynthia ended it by saying, "I quit. We'll be out of here Monday morning." Monday was the next day. Nannini saw claimant later that evening and claimant told him, "We'll be off the property tomorrow morning." The next morning the Greenes packed up their things and left. They never returned to work.
¶37 Claimant now asserts he was fired and did not quit. I note that in a wage and hour claim filed with the Department claimant indicated he "quit" his job at Alder KOA. (Ex. 3 at 1.) Claimant tried to explain away the "quit" statement, testifying that Cynthia filled out the response and that he intended to stay and continue working at Alder KOA while she moved elsewhere. As with other parts of his testimony, I simply did not believe his explanation. I find that both he and Cynthia quit and were not fired. I am persuaded that claimant could have continued to work for Alder KOA and would have continued to be allowed to perform only work he was physically able to do.
¶38 There is no dispute that claimant suffered a compression fracture of his L1vertebra and an ankle fracture. Claimant, however, asserts he also suffered an aggravation of pre-existing spondylosis with Grade I spondylolisthesis at L5-S1 and also traumatic bursitis of his left shoulder. (Petitioner's Proposed Finding of Fact, Conclusions of Law and Judgment, ¶ 75.) The UEF and Alder KOA dispute his contention.
¶40g In October 1999, while being treated for other conditions at the Adult Medicine Clinic in Tulsa, Oklahoma, claimant reported "sciatic nerve pain distribution" (Ex. 40 at 13), thus indicating that he was continuing to experience low-back and leg pain just three months prior to his being hired by Alder KOA.
He still has pain in his back. [H]e seems to have more pain now than prior to his fall. I think some of this is due to the compression fracture. Certainly some of it is due to spondylosis that was present prior to his injury. . . .
having some problem in the back & I am sure that the L1 compression fracture is showing some stenotic changes at that level. He probably is having some stenotic changes also at the level of his L5-S1 spondylolysis, but at this time I do not think surgical intervention is indicated.
feel [sic] off the steps of the trailer and landed on the left side of his body. He has had more problems with his back since that fall with radiation into the left leg.
(Id. at 73.) Although claimant had experienced leg pain prior to his employment at Alder KOA, this was the first mention after his April injury of pain radiating into his leg. Significantly, the development of that pain followed a fall at home.
¶45 After October 31, 2000, claimant continued to experience significant left leg and back symptoms. It was Dr. Buehler's impression that the L1 compression fracture was significantly contributing to his back problems.
¶45a On December 15, 2000, Dr. Buehler recorded that claimant was "having progressive difficulty with his left leg," was "developing more numbness & weakness into the left lower extremity", and was "having a difficult time getting around. (Id. at 60.) He suspected spinal stenosis at L1 and commented that he thought claimant's symptoms were more compatible with L1 stenosis than a L5-S1 spondylolysis.
[H]e has definite neurogenic claudication with bilateral L5 radiculopathy, left greater than right. This is almost certainly due to the Grade I spondylolisthesis at L5-S1 and bilateral L5 par's defects. I took an extensive history from Mr. Greene and it appears to me that these symptoms started after the fall. Obviously the L5-S1 spondylolisthesis and bilateral par's defects were present before the fall but my opinion is that this radiographic abnormality became symptomatic after the fall.
¶48 Dr. Sorini saw claimant a second time on February 20, 2002. (Id. at 3, 21.) He reported the examination to the UEF's claims adjuster. I set out his report in full because it indicates the nature of claimant's complaints, the need for further electro diagnostic studies, and Dr. Sorini's opinions concerning the relationship of claimant's conditions to his April 7, 2000 industrial accident.
I had a nice visit with Lyman Greene. He brought his ex-wife along with him. He has 75 percent low back pain and 25 percent lower extremity pain with the pain in the left leg being worse than the right. The pain in his back and legs is mechanical in nature, i.e., it seems to be worse with activity but he also has a lot of pain in his legs at rest. The pain in his back and legs is otherwise constant. He has no problems with his bowel or bladder. He has no problems with sexual function.
Examination is somewhat difficult because he has a lot of splinting and give-and-take type strength loss but he appears to have normal reflexes at the knees and ankles with distraction. He has negative straight leg raising with distraction. He does appear to be weak about the left foot but again there is a give-and-take quality apparent.
Imaging studies were re-viewed. He has an L1 compression fracture with an 18-degree kyphosis therein. He has central stenosis because of the fracture. At L5-S1 he has a dynamic listhesis with increase with flexion. He has bilateral L5 par's defects. He has bulging disks at L3-L4 and more so at L4-L5.
I would like to get electrophysiologic studies of the lower extremities before I make a final opinion. If these are normal or show only chronic and mild changes, I believe that we can watch Lyman closely over time. If on the other hand he has evidence of severe nerve compromise, we should probably proceed with decompression.
I do believe that the spondylolisthesis at L5-S1, although of long-standing nature, has become symptomatic since his fall. The L1 compression fracture is obviously related to the fall.
If you have any questions or concerns, please do not hesitate to call.
¶51 On June 28, 2002, Dr. Dana Headapohl, a specialist in occupational disease, conducted a comprehensive review of claimant's post-industrial accident medical records to determine the relationship between his various conditions and his accident. She also addressed whether the need for surgery was related to the accident. Her report is found at Exhibit 35.
¶53 Drs. Buehler, Sorini, and Headapohl all testified by deposition. Each was asked to address the relationship between claimant's L5-S1 symptoms to his industrial accident, as well as their recommendations need for further treatment.
¶60 Dr. Sorini did not treat claimant's ankle condition and did not express any opinions regarding that condition.
¶66 Dr. Headapohl did not examine claimant, rather she reviewed his medical records. Unlike Dr. Sorini, she reviewed and considered the medical records immediately following his October fall at home. Unlike both Drs. Sorini and Buehler, she reviewed the claimant's pre-2000 medical records which has been summarized previously in this decision.
¶70 Dr. Headapohl agreed with Dr. Sorini that any surgery on claimant's back would be high risk. (Id. at 27.) She recommended conservative, non-surgical treatment at the present time.
¶72 Dr. Buehler, claimant's treating physician, indicated that the claimant's L5-S1 condition was aggravated by the April 7, 2000 industrial accident, but he did so only weakly. I am not persuaded by his opinion. As set out in paragraph 62, he testified that relating the claimant's L5-S1 symptoms to the industrial accident was "a difficult thing to say because I never did see him prior to it" and that in tendering his opinion he "certainly was not strong on that." (Buehler Dep. at 18, 62.) Dr. Buehler did not have the claimant's pre-2000 medical records. Significantly, in a letter of September 20, 2000 to the UEF he did not mention any L5-S1 problems. (Ex. 12 at 74.) Finally, he testified that claimant suffered an "additional injury" in October 2000.
¶73 Dr. Sorini was more positive in his opinion that the L5-S1 condition was made symptomatic by the industrial accident. However, he did not have claimant's pre-2000 medical records and did not consider the claimant's October 2000 fall at home. He conceded that he based his opinion on the history given him by claimant, that his radicular symptoms arose soon after his industrial accident. Dr. Sorini conceded that the lack of radicular symptoms prior an October 2000 fall would "be significant." (Sorini Dep. at 68.) He acknowledged that if claimant's symptoms "materially changed in location, intensity, et cetera, following that [October 2000] fall out of his trailer", then those facts "would be important." (Id.) In fact, the claimant's radicular leg pain was not present after the claimant's April 7, 2000 industrial accident, rather it arose immediately after his October 2000 fall at home.
¶74 In contrast, Dr. Headapohl reviewed and considered the claimant's pre-2000 medical records, his post-April 2000 records, and the records pertaining to his October 2000 fall at home. She considered the significant change in claimant's symptoms (the new radicular symptoms) immediately following his October 2000 fall at home and concluded that those symptoms were triggered by the October 2000 fall, not his April 2000 industrial accident. She concluded that the April industrial accident did not materially aggravate the claimant's L5-S1 condition. Her testimony was supported by medical history and was more supported than the testimony of Drs. Sorini and Buehler.
¶75 I therefore find that claimant, who bears the burden of proof, has failed to prove that his L5-S1 spondylolisthesis and other conditions at that level were materially and permanently aggravated by his April 7, 2000 industrial accident.
¶76 In reviewing the claimant's pre-2000 medical history, it is difficult to believe that he was capable of gainful work when he was hired by Alder KOA. On the other hand, there is evidence that he lost significant weight (he was grossly obese in 1995 when he was pursuing his social security benefits), and that his physical condition improved, as evidenced by the diminished medical treatment between 1995 and 2000.
¶77 I conclude as a matter of fact that prior to April 7, 2000, the claimant could physically perform his duties as the maintenance manager at the campground, although I am also convinced that at times he engaged in lifting and other activities incompatible with his preexisting medical conditions.
¶78 Following his April 2000 industrial accident, the claimant plainly could not perform all of the maintenance functions assigned to him. However, his employer modified his job to allow him to do only those tasks which he was physically capable of performing.
¶79 It is clear that the claimant was in fact able to perform his modified duties after his industrial accident. He determined what he would do. He in fact continued to work until June 24, 2000. And, as I have found previously, his termination of employment was unrelated to his physical limitations, rather it was in reaction to Nannini's reprimand of Cynthia. Claimant and Cynthia simply quit their jobs.
¶80 The critical question is whether the claimant's accident-related conditions thereafter deteriorated to the point that he would no longer have been able to perform his modified duties.
¶81 There is no medical or other evidence indicating that claimant's ankle worsened and prevented him from continuing to work. However, Dr. Sorini testified in his April 2002 deposition that claimant's back and leg pain, on top of his other medical conditions, precluded him from engaging in regular, meaningful employment. Dr. Buehler, who saw claimant a month later, agreed that claimant could not work. In reviewing claimant's back and leg complaints, Dr. Sorini's testimony seems reasonable and supported. I am therefore persuaded that claimant has been physically incapable of working at any gainful employment, including the modified job at Alder KOA as of April 2002.
¶82 Both Dr. Buehler and Dr. Sorini opined that the claimant's L1 compression fracture is a significant contributor to the claimant's disabling back and leg pain, although it appears that Dr. Buehler assigns it a larger role than does Dr. Sorini. There is little question that the claimant's L1 compression fracture is contributing to both the claimant's back pain and his total disability. It is impossible to separate out the contribution of the L1 fracture to his pain and disability, I therefore conclude that claimant's total disability is related to his industrial accident.
¶83 Dr. Buehler's records and testimony establish that the claimant reached MMI with respect to his ankle fracture on September 20, 2000. (Buehler Dep. at 39.) There is no contrary medical evidence.
¶84 With respect to the claimant's L1 compression, the evidence concerning MMI is conflicting. Dr. Buehler recommended L1 surgery, however, Dr. Sorini testified that the surgery recommended by Dr. Buehler would be "disastrous." (Sorini Dep. at 17-18.) Dr. Sorini recommended that L5-S1 surgery precede any L1 surgery, and recommended a different type of L1 surgery. Ultimately, however, Dr. Sorini recommended that surgery be deferred on account of the high risk of complications; for now he recommends that claimant simply be monitored. Dr. Headapohl agreed. I find their opinions regarding surgery persuasive. I therefore conclude that no further treatment is presently warranted and that claimant is at MMI with respect to his L1 compression fracture.
¶85 This case is governed by the 1999 version of the Montana Workers' Compensation Act since that was the law in effect at the time of the claimant's industrial accident. Buckman v. Montana Deaconess Hospital, 224 Mont. 318, 321, 730 P.2d 380, 382 (1986).
¶86 Claimant bears the burden of proving by a preponderance of the evidence that he is entitled to the benefits he seeks. Ricks v. Teslow Consolidated, 162 Mont. 469, 512 P.2d 1304 (1973); Dumont v. Wicken Bros. Construction Co., 183 Mont. 190, 598 P.2d 1099 (1979).
¶87 I address the fourth issue first. That issue is whether claimant's "preexisting condition of bilateral spondylosis with grade one spondylolisthesis at L5, S-1 [was] aggravated by the industrial accident of April 7, 2000." Resolution of that issue is necessary before addressing the other issues.
¶88 Initially, there is no dispute that the claimant's L5-S1 spondylosis and spondylolisthesis preexisted his April 7, 2000 industrial accident. However, it has long been the rule that the employer or insurer are liable for material, permanent aggravations of preexisting conditions. The employer takes its workers as it finds them with all of their preexisting conditions.
The well established rule in Montana is that an employer takes his employee subject to the employee's physical condition at the time of the employment. The fact that an employee is suffering from or [is] afflicted with a pre-existing disease or disability does not preclude compensation if the disease or disability is aggravated or accelerated by an industrial accident.
Robins v. Anaconda Aluminum Co., 175 Mont. 514, 518, 575 P.2d 67 (1978).
¶90 As a matter of fact, the claimant has failed to prove that his April 7, 2000 industrial accident symptomatically lit up or materially worsened his L5-S1 condition. The radicular leg pain emanating from the L5-S1 level had waned prior to April 7, 2000, and did not re-emerge until October 2000, immediately following claimant's fall at his home.
¶91 While Dr. Sorini felt that claimant's L5-S1 condition was lit up by the industrial accident, he was unaware of the October incident when he rendered his opinion and admitted that a fall in October 2000 "would be important" to determining the cause of the claimant's L5-S1 symptoms. Dr. Headapohl testified without contradiction that if the April 2000 accident lit up the claimant's L5-S1 symptoms, then those symptoms should have been present immediately following that accident: in fact those symptoms were not present and did not emerge until six months later following another accident at home. On a more-likely-than-not basis, it was the October 2000 accident at home that triggered the reemergence of the claimant's L5-S1 symptoms. I therefore conclude that the UEF and employer are not liable for claimant's L5-S1 condition.
¶92 The claimant is entitled to medical benefits for his L1 compression fracture and his ankle fracture. It is not clear to me whether all of those benefits have been paid. Where the medical services relate to the back and it is impossible to distinguish between examination and treatment for L1 symptoms and L5-S1 symptoms, then the UEF and the employer are liable for the services. If the parties cannot determine which services are covered, they may request a further hearing. I retain continuing jurisdiction to make that determination.
(4) If the treating physician releases a worker to return to the same, a modified, or an alternative position that the individual is able and qualified to perform with the same employer at an equivalent or higher wage than the individual received at the time of injury, the worker is no longer eligible for temporary total disability benefits even though the worker has not reached maximum healing. A worker requalifies for temporary total disability benefits if the modified or alternative position is no longer available to the worker for any reason except for the worker's incarceration as provided for in 39-71-744, resignation, or termination for disciplinary reasons caused by a violation of the employer's policies that provide for termination of employment and if the worker continues to be temporarily totally disabled, as defined in 39-71-116.
In this case, Alder KOA created a modified position for claimant following his April accident, allowing him to perform only those duties he was physically capable of doing. Dr. Buehler, released claimant to light or sedentary work.
¶94 Claimant continued to work until June 24, 2000, when he quit work after Cynthia was criticized for allowing drunken motorcyclists to camp at the campground. Since claimant quit, and has failed to demonstrate that his modified position would have been eliminated at some future time, he did not requalify for TTD benefits. I therefore conclude that he is not entitled to TTD benefits unless his condition deteriorated to the point that he could not perform even minimal duties associated with the modified position.
¶95 Dr. Buehler continued to release claimant for light or sedentary work until May 22, 2002, when he concluded that claimant was incapable of any type of work. (¶ 50.) But even prior to that time, on April 25, 2002, Dr. Sorini opined in his deposition that claimant's back pain, considered in conjunction with his other preexisting conditions, precluded him from performing any sort of work. That opinion was persuasive. I therefore conclude that as of April 25, 2002, the claimant was no longer able to perform any work at the Alder KOA, thus he was unable to perform the modified job.
¶96 I have previously found that in combination the claimant's L1 and L5-S1 conditions are disabling. Since the L1 condition cannot be isolated from his overall back pain and disability, the UEF and employer are liable for his total disability.
¶97 As I have found, the claimant is presently at maximum medical healing with respect to both his L1 compression fracture and his ankle fractures. MMI is the "point in the healing process when further material improvement would not be reasonably expected from primary medical treatment." § 39-71-116(18), MCA (1999). Dr. Buehler expressly found the claimant at MMI with respect to his ankle on September 20, 2000 (¶ 83), and that opinion was uncontradicted. Dr. Sorini's and Dr. Headapohl's testimony establish that short of surgery there is no present treatment that will materially improve the claimant's L1 condition, and neither doctor currently recommends surgery. Therefore, at present the L1 condition is at MMI.
(1) If a worker is no longer temporarily totally disabled and is permanently totally disabled, as defined in 39-71-116, the worker is eligible for permanent total disability benefits. Permanent total disability benefits must be paid for the duration of the worker's permanent total disability, subject to 39-71-710.
(24) "Permanent total disability" means a physical condition resulting from injury as defined in this chapter, after a worker reaches maximum medical healing, in which a worker does not have a reasonable prospect of physically performing regular employment. Regular employment means work on a recurring basis performed for remuneration in a trade, business, profession, or other occupation in this state. Lack of immediate job openings is not a factor to be considered in determining if a worker is permanently totally disabled.
Since claimant has reached MMI with respect to both of his industrial injuries and his back conditions preclude him from performing regular work of any sort, claimant is entitled to permanent total disability benefits as of April 25, 2002.
I have highlighted subsection (1)(b) because it answers the employer's and the UEF's contention that the Court must use only $50 a week and the value of board and room in computing the claimant's wages for purposes of benefits. On a 28-hour-a-week basis, claimant's wages amounted to $4.22 per week. If federal or state law required that claimant be paid minimum wage, then he is entitled to back pay and that back pay must be included in computing the claimant's wages and benefits.
¶100 Claimant pursued a wage and hour claim against Alder KOA. An initial determination was issued by the Department finding that claimant was subject to federal minimum wage provisions because he occasionally processed credit cards in the convenience store. The initial decision does not cite any legal authority for that proposition and the claim was subsequently mediated and settled after Alder KOA requested a contested case hearing. If the matter had gone to hearing and a final decision had been issued by the Department, that decision would have been res judicata as to the wage issue - both as to the minimum wage and the hours worked by the claimant. See Nasi v. State Dept. of Highways, 231 Mont. 395, 753 P.2d 327 (Mont. 1988). However, the initial determination of the Department was not made after hearing and did not constitute a final Department adjudication; it is therefore not binding and the Court is left to determine for itself whether claimant was subject to the minimum wage laws.
¶101 None of the parties have addressed whether minimum wage laws apply to the claimant's employment, I therefore do not have the benefit of their legal argument on this point. I therefore request the UEF and the employer to notify the Court whether they contest the application of the federal minimum wage to claimant's employment or the $5.15 amount used by the Department in its initial wage determination. If there is a dispute, further briefing will be ordered.
(3)(a) Except as provided in subsection (3)(b), for compensation benefit purposes, the average actual earnings for the four pay periods immediately preceding the injury are the employee's wages, except that if the term of employment for the same employer is less than four pay periods, the employee's wages are the hourly rate times the number of hours in a week for which the employee was hired to work.
(b) For good cause shown, if the use of the last four pay periods does not accurately reflect the claimant's employment history with the employer, the wage may be calculated by dividing the total earnings for an additional period of time, not to exceed 1 year prior to the date of injury, by the number of weeks in that period, including periods of idleness or seasonal fluctuations.
Since the exception refers to the claimant's employment "history", the one-year period cannot reflect subsequent employment. Therefore, I cannot consider any increase in claimant's hours subsequent to his industrial accident. His benefits must be limited to the 28-hour a week average during the four weeks prior to his accident.
¶103 If there is no dispute over the application of minimum wage laws to claimant's employment and the actual amount of the minimum wage, then the weekly wage for purposes of determining claimant's benefits is $144.20 a week ($5.15 x 28 hours).
(b) The fund shall collect from an uninsured employer an amount equal to all benefits paid or to be paid from the fund to an injured employee of the uninsured employer.
Alder KOA does not dispute the fact that it was an uninsured employer. Therefore, it is liable for benefits paid and to be paid to the claimant by the UEF.
¶105 Finally, I address the claimant's request for a penalty. He requests penalties both against the UEF and against the employer for their failure to pay medical and compensation benefits. The arguments presented indicate that the "penalties" contemplated include not only the penalty provided in section 39-71-2907, MCA (1999), but also the attorney fees which may be awarded pursuant to sections 39-71-611 and -612, MCA (1999). I therefore consider both attorney fees and the penalty.
(14) "Insurer" means an employer bound by compensation plan No. 1, an insurance company transacting business under compensation plan No. 2, or the state fund under compensation plan No. 3.
¶107 Claimant is entitled to medical benefits with respect to his ankle and L1 compression fractures. In the event the parties cannot agree on which medical expenses are related to those conditions, the Court retains continuing jurisdiction to do so.
¶108 The claimant's L5-S1 spondylosis and spondylolisthesis were not aggravated by his industrial injury, therefore, the UEF and Alder KOA are not liable for that condition.
¶109 The claimant is entitled to permanent total disability benefits as of April 25, 2002. His request for total disability benefits prior to that date is denied.
¶110 The UEF and Alder KOA shall notify the Court within ten days of this decision whether they dispute the applicability of minium wage laws providing a $5.15 minimum wage to the claimant's employment. If they dispute the applicability or amount of the minimum wage, then they shall also provide legal briefs supporting their positions. Claimant shall then have ten days in which to file an answer brief. The UEF and Alder KOA then have another ten days in which to file reply briefs. If there is no dispute, then benefits shall be computed based on a $144.20 average weekly wage.
¶111 The claimant is not entitled to attorney fees or a penalty.
¶112 The UEF is entitled to indemnification from Alder KOA (Nannini Brothers, Incorporated) for benefits it has paid to the claimant and for benefits which become due in the future. If the UEF and Alder KOA cannot agree on the amounts of reimbursement, then they may request a hearing to determine those amounts. The Court retains continuing jurisdiction to determine such amounts.
¶113 Claimant is entitled to his costs and shall file his memorandum of costs in accordance with Court rules.
¶114 This JUDGMENT is not certified as final since an issue concerning application of minimum wage laws remains to be resolved.
¶115 Any party to this dispute may have twenty days in which to request a rehearing from these Findings of Fact, Conclusions of Law and Judgment.
DATED in Helena, Montana, this 9th day of April, 2003.

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