Source: http://wcc.dli.mt.gov/c/CHANEY_LD_FFCL.htm
Timestamp: 2019-04-21 06:15:09+00:00

Document:
The trial in this matter was held on June 28 and 29, 1994, in Great Falls, Montana. Petitioner, Larry D. Chaney (claimant), was present and represented by Mr. Randall O. Skorheim and Mr. Robert C. Melcher. Respondent, U.S. Fidelity & Guaranty (USF&G), was represented by Mr. Michael S. Lattier. Intervenor, State Compensation Insurance Fund (State Fund), was represented by Mr. Charles G. Adams. Claimant testified on his own behalf. Dr. Patrick E. Galvas and Scott Hall also testified. The depositions of the claimant, Dr. Stuart Reynolds, Dr. Patrick R. Cahill, Dr. John V. Stephens, Dr. Patrick E. Galvas and Mary Chaney were submitted for the Court's consideration. Exhibits 1 through 11 were admitted into evidence without objection. Exhibit 12 was offered by USF&G and objected to by claimant. The Court reserved its ruling on Exhibit 12. After considering the arguments made by both sides, Exhibit 12 is denied.
State Fund's motion to add issue: Prior to the commencement of the trial in this matter, the State Fund moved to add the issue of whether the State Fund is liable for the claimant's carpal tunnel syndrome. Based on the representation of claimant's counsel that the claim against the State Fund is being pursued under the Occupational Disease Act (ODA), the Court denied the motion. The Department of Labor and Industry, not the Court, has original jurisdiction over liability disputes under the ODA.
Issues: Claimant suffers from carpal tunnel syndrome (CTS). He alleges that his CTS is attributable to a November 3, 1983 injury he suffered while working on the green chain at Owens-Hurst Lumber Company (Owens-Hurst). He seeks a determination that USF&G, which insured Owens-Hurst at the time of the accident, is liable for temporary total, permanent total, permanent partial, rehabilitation and medical benefits, as well as attorney fees, and a penalty. The State Fund has intervened to seek indemnification for compensation and medical benefits it has paid claimant since 1993. Those benefits have been paid under a reservation of rights. As already noted in the second paragraph, the State Fund's liability, if any, is not at issue in this case.
1. At the time of trial claimant was thirty-two years old. He has completed high school.
2. The following findings must be prefaced by the Court's determination concerning claimant's credibility. Claimant was not a credible witness. The contradictions in claimant's testimony in deposition and at trial were numerous and blatant. Ultimately, it was impossible for the Court to ascertain an accurate history of claimant's finger, hand, wrist and arm complaints.
3. In 1979, while attending high school, claimant joined the National Guard (Guard). (Tr. at 109.) In 1981, at age 19, claimant dropped out of high school and attended advanced training in the Guard. (Id.) Claimant continued to serve in the Guard until 1985. (Id.) While in the Guard he worked as a mechanic.
9. At the time of the alleged fall, Owens-Hurst was insured by USF&G. USF&G has no record of any acceptance or denial of the claim in this case. Its file folder for claims made by employees of Owens-Hurst does record a claim made by Mr. Chaney for a November 3, 1983 accident. (Ex. 10.) USF&G paid no benefits (Ex. 10) with regard to the claim but it is possible that Owens-Hurst paid directly for a subsequent medical examination by Dr. Schroeder. Lacking any evidence that the claim was timely denied, the Court finds that the claim was accepted by USF&G.
10. Claimant's trial testimony concerning his 1983 industrial accident was inconsistent with what he reported at the time of the injury and with other parts of his trial and deposition testimony.
Arms and Hands started to go to sleep and get num [sic] while working and after work. Stacking 2x6s and Tye's [sic].
(Ex. 3 at 15.) No fall is mentioned.
Q. So you never reported that injury to your supervisor?
A. No. I didn't feel it was an injury at that time.
Q. So you didn't feel that getting scraped up was enough to complain about?
However, the quoted entry does not appear to have been made on November 3, 1983. Rather, it appears to have been made no earlier than November 10, 1983. That is because the three injuries immediately preceding the quoted one were for injury dates of 11-3-83, 11-9-83, and 11-10-83. Moreover, the file folder entry does not mention any fall or any report to a supervisor. The Court is left wondering how the entry could have jogged claimant's memory.
Q. Okay. Dr. Galvas said that, in his report, "Patient states that his complaints with his hands began in 1982 when he was working in a sawmill, fell and caught himself on both hands. He experienced pain in his hands right afterwards. Patient states he was working outside in about 40 degrees below zero level weather."
Did you tell Dr. Galvas that?
Q. Is that when your problems with your hands started?
A. Well, I fell and I didn't have no real problems right then, but it was like a week or so afterwards my fingers started going numb.
Q. When did your hands start going numb?
Q. I mean in relation to your fall.
A. It was after the fall.
A. No. It was -- It could have been three days. It could have been seven days. I just remember that my hands started going numb, my fingertips. . . .
Q So based on your testimony, your deposition, it was about a week or two after the fall your hands started bothering you, correct?
A Could be. I'm not sure.
e. Claimant testified that he is unsure whether his alleged fall caused his current symptoms or whether they were caused by his repetitive work on the green chain.
11. Based on my assessment of claimant's credibility, the Employer's First Report, and Dr. Schroeder's report, I find that claimant did not fall as he now claims. More probably he experienced a gradual onset of numbness in his hands, arms and shoulders due to the repetitive nature of his work on the green chain.
12. Claimant's employment at Owens-Hurst terminated in December 1983.
Q What is the reason you quit there?
A Because I injured my back and fell so far behind on my rent I was going to be evicted, and I didn't have no choice but to take my family back to Montana, and then I went back out and finished up the last two weeks and then went back to Montana myself.
27. Olson Ford was insured by the State Fund during claimant's employment.
29. While in the Guard, claimant suffered a severe strain of one of his wrists. (L. Chaney Dep. at 115-116.) No medical records or further information was provided to the Court about this injury.
31. In June 1988, claimant suffered a back injury while working for the Firestone store. The injury is more fully described in Finding of Fact No. 19.
For the past mo, pt reports that his (L) hand and ½ way up forearm will "fall asleep" and get a tingling sensation in it. This sensation comes on when pt twists his hand in a certain way or grips a steering wheel to [sic] long.
For the past mo, pt reports that his (R) hand will sporadically get a similar tingling sensation in it. This feeling disappears if pt simply repeatedly flexes and extends fingers (works in (R) and (L)).
He's in today, he has continued hand numbness which wakes him from sleep at night now. He states today that over in western Montana he did have nerve conduction studies that showed compression of nerves consistent with carpal tunnel syndrome. Today he has bilaterally positive Tinel's sign. No evidence of any atrophy to the thenar or hypothenar eminences. I requested that we get medical records so we can get copies of his EMG studies. I have asked him to schedule a consultation visit with a surgeon, Dr. Reynolds, to discuss definitive treatment. We did discuss the possibility of use of cortisone injections to by time but I think he's smartest seeing a surgeon.
49. On February 9, 1993, and in subsequent examinations, Dr. Reynolds could find no objective reasons for claimant's complaints. Dr. Reynolds further told claimant that he could not "assess his [claimant's] subjective complaints." (Id.) Ultimately, unable to explain claimant's subjective complaints, Dr. Reynolds suggested that claimant be referred to a physiatrist.
Q. Towards the bottom of your office note for April 6, '93, you state that you told Larry that "since he continues to be subjectively disabled..." Could you explain what you meant by that term, "subjectively disabled"?
A. I don't have any objective signs regarding his muscle, tendon, or nerve function in his hand or arm.
Q. So you weren't able to determine objectively any reason for his complaints?
53. Claimant had not returned to work at the time of trial.
54. The medical opinions concerning the relatedness of claimant's CTS to his 1983 industrial accident were conflicting.
I can't guarantee to you that Dr. Schroeder was familiar with the name "carpal tunnel syndrome." If you're not dealing with a problem surgically, it's just the same as having some type of a tendonitis in the area. His description does not include information that is classical for carpal tunnel syndrome, but the description could be a pathologic process that would be the same.
If you would persistently do an activity that creates the symptoms of carpal tunnel syndrome for two years in a row, you would tend to create more damage to the nerve, compared to a situation where you did it for a month and quit for three and did it for a month and quit for three; it's just a matter of exposure over a period of time.
d. Dr. Reynolds was unable to relate claimant's condition at the time of his surgery to claimant's work at Owens-Hurst. (Reynolds Dep. at 20-21.) He testified that it was medically improbable that the condition diagnosed by Dr. Schroeder in 1983 was the same as when Dr. Reynolds treated claimant.
A It's possible that the diagnosis made by Dr. Schroeder and the description is the same as what I saw when I saw him.
Q Is it probable, more probable than not?
A It's probably not. In my mind it would not be probable that they're both totally related and there was unchanged disease process between '83 and '91.
Q Do you have an opinion as to what would have caused his condition to change from mild to moderate or severe over the year?
A Well, I would suspect that peeling bark off of yew trees for a summer is fairly stressful to the hands and wrist; and working as a mechanic, lifting weight, heavy weights, pulling on wrenches, using screwdrivers, is going to cause the recurrence of the tendonitis.
When you see that degree of change, it does not usually fit with someone who says, Doc, I wore my splints; I stopped doing all hobbies that would overwork my hands; at work they have moved me to some position where I am not doing repetitive work, and have that degree of change from '91 to '92. That would be distinctly unusual and not very likely at all.
So it still would indicate -- I mean, if I were a betting man, I would say during that year, that intervening 13 months between my first two studies, there continued to be some factor, whether it is occupational related, some factor that has aggravated that condition to the point where it caused that degree of change.
58. Dr. Galvas specializes in physical and rehabilitation medicine and testified at trial.
1. In the early stages of CTS, symptoms come and go. (Tr. at 44.) Provocative activities -- i.e., hand and wrist use which involves hyper-flexion and extension of the wrist -- may exacerbate symptoms.
4. If claimant's onset of symptoms in 1983 was due to the repetitive handwork of his job on the green chain, he would still conclude that claimant experienced an onset of CTS at that time and that it resulted in his 1992 surgeries.
If a patient tells you that their symptoms disappear, I guess one should explore, to say, "Have you changed your work in any way? Are you not doing particular movements?" If they say, "I am still doing them, but it is gone," then one could say they are doing provocative measures. No longer have these symptoms; it must have resolved. If they say, "Yes, I am not doing it," then the case would be, well, they aren't exacerbating their symptoms. Indeed, the condition could still be persisting, but you aren't picking it up because they aren't doing the provocative measures.
59. After considering all of the medical opinions in this case, and claimant's medical history, I am not persuaded that claimant's symptoms in 1983 represented a permanent injury or condition leading to his subsequent CTS condition and CTS surgery. Since claimant did not see a physician with regard to hand or wrist complaints from 1983 until 1989, it is impossible to precisely determine when he reached maximum healing. However, he continued to work during that six year period. In 1989 when his CTS was first diagnosed, it was diagnosed only as "mild." Dr. Galvas and Dr. Cahill based their opinions on the medical history claimant provided to them. That history was unreliable. As already found, claimant did not suffer a fall in 1983 as he claims. The history of symptoms claimant provided during his deposition and at trial was confusing and often conflicting. He was not a credible witness. For the period of 1984 until 1989, I am unable to determine on a more probable than not basis what symptoms he experienced and when. I am not persuaded that claimant experienced continuous symptoms. I am not persuaded that after 1983 he did not experience asymptomatic periods while engaging in provocative activities. On the other hand, I am persuaded that since 1983 claimant has engaged in many provocative activities, including jobs as a mechanic, peeling yew bark and extensive writing during his student days, and that those activities cumulatively caused his CTS, as diagnosed in 1989, and a substantial worsening of that condition between October 1991 and November 1992.
1. Claimant alleges that he was injured in November of 1983. Therefore, the 1983 version of the Workers' Compensation Act governs his entitlement to benefits. Buckman v. Montana Deaconess Hospital, 224 Mont. 318, 730 P.2d 380 (1986).
2. Claimant has the burden of proving by a preponderance of the evidence that he is entitled to compensation. Ricks v. Teslow Consolidated, 162 Mont. 469, 483-484, 512 P.2d 1304 (1973); Dumont v. Wicken Bros. Construction Co., 183 Mont. 190, 598 P.2d 1099 (1979). Claimant must prove that his 1983 injury is the cause of his disabling condition. Eastman v. Transport Ins. Co., 255 Mont. 262, 266, 843 P.2d 300 (1992).
The Court finds that claimant did not meet his burden of proof. The physician treating claimant in 1983 did not diagnose claimant's condition in 1983 as CTS. While claimant's 1983 symptoms were consistent with a CTS diagnosis, which involves compression of the median nerve within the carpal tunnel of the wrist, CTS is not necessarily a permanent condition and may vary in degree. As Dr. Galvas testified, compression of the median nerve may occur with tendinitis and may wholly resolve when the inflammation of the tendon subsides. Claimant must, therefore, establish on a more probable than not basis that his 1983 injury resulted in permanent damage involving the carpal tunnel. He failed to do so.
Initially, he failed to persuade the Court that he suffered any acute injury due to a fall. As a matter of fact, I have found that the fall did not occur. While Dr. Galvas adhered to his opinion irrespective of whether claimant's 1983 symptoms arose from a fall or from repetitive wrist movement while working the green chain, his opinion was not premised on any objective evidence but rather on the medical history related by the claimant. The credibility of that history carries over "into the credibility of the doctors' diagnoses based on the claimant's statements." McIntyre v. Glen Lake Irrigation Dist., 249 Mont. 63, 69, 813 P.2d 451 (1991). In other words, the doctors' opinions are only as good as the history provided to them, when based on history. I found claimant entirely incredible. Based on inconsistencies of his testimony and my observation of him at trial, I am unable to determine what symptoms he had and when he had them. I do not believe that he had consistent symptoms since 1983. He sought out medical care at that time, but then went six years without again seeing a physician with regard to numbness in his hands and wrists. His accounts of his symptoms over those years were contradictory. During those years he engaged in provocative activities at various times. His CTS worsened remarkably during a time when he was doing a lot of writing while in school and stripping bark from yew trees, two activities that are likely to lead to or exacerbate CTS. It appears likely that claimant's CTS developed over a period of several years.
3. The Intervenor, State Fund, is not entitled to indemnification from USF&G for the benefits it paid to claimant.
4. Since USF&G has prevailed in this action, the claimant is not entitled to attorney fees, costs or a penalty.
1. Claimant 's injury in November of 1983, is not the proximate cause of claimant's current CTS condition and recent need for surgery. He is not entitled to benefits from USF&G.
2. The State Fund is not entitled to indemnification from USF&G for benefits paid to claimant.
3. Claimant is not entitled to a penalty.
4. Claimant is not entitled to attorney's fees or costs.
5. The JUDGMENT herein is certified as final for purposes of appeal pursuant to ARM 24.5.348.
6. Any party to this dispute may have twenty (20) days in which to request a rehearing from these Findings of Fact, Conclusions of Law and Judgment.
Dated in Helena, Montana, this 6th day of April, 1995.
Q Your original testimony, when I asked you the question earlier, Page 31 of your deposition: "Would any subsequent numbness or tingling he may have relate to that original injury, then? . . . Your answer was: "The only way one can ascertain if a person's complaints are consistent from the time of the injury, they say, 'Ever since that period of time I have had complaints of achiness, numbness,' that leads me back to that injury. If they tell you, you know, 'I had that for a while and then it went away,' and they were symptom-free for a period of time, and they changed occupations or had another event, then you would say that probably relates, then, to another fall. Or if they can say, 'This didn't happen until I started moving my wrist a bunch, working on this keyboard for a bunch of months, having problems again,' I would probably relate it, then, to that particular repetitive motion, or another single event, based on the patient's complaints and history."

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