Title: COSGROVE v INDUSTRIAL INDEMNITY CO
Citation: N/A
Docket Number: 13265
State: Montana
Issuer: Montana Supreme Court
Date: July 16, 1976

No. 13265 I N THE SUPREME C O U R T O F T H E STATE OF M O N T A N A 19 7 6 RUTH COSGROVE, P l a i n t i f f and Appellant, -vs - INDUSTRIAL INDEMNITY C O M P A N Y , Defendant and Respondent. Appeal from: workers' Compensation Court Honorable William E. Hunt, Judge presiding. Counsel of Record: For Appellant: Hoyt and Bottomly, Great F a l l s , Montana John C. Hoyt argued, Great F a l l s , Montana For Respondent: Marra, Wenz and Iwen, Great F a l l s , Montana Joseph Re Marra argued, and Charles Johnson argued, Great F a l l s , Montana -- Submitted: May 26, 1976 Decided : JUf- 1 6 197E ' I l k 1 6 1976 Filed: - Honorable Bernard W. Thomas, District Judge, sitting in place of Mr. Chief Justice James T. Harrison, delivered the Opinion of the Court. Plaintiff appeals from an adverse judgment of the Worker's Compensation Court. The sole issue to be considered is whether plaintiff is entitled to attorney fees under the provisions of section 92-616, R.C.M. 1947, as amended by Chap- ter 173, Laws of 1974. The facts are: Plaintiff was injured in the course of her employment on March 25, 1974. Defendant, as the employer's insurance carrier under Plan Two of the Workmen's Compensation Act accepted plaintiff's claim and commenced paying her com- pensation for temporary total disability which was continued through December 16, 1974. On December 17, 1974, defendant notified plaintiff that effective December 16, 1974, compensa- tion payments were being terminated on the basis of medical opinions from two Great Falls orthopedists that plaintiff was then able to return to work. Thereafter, plaintiff retained . cornsel who, on or about January 10, 1975, made demand on defend- ant that plaintiff be reinstated on compensation, since she still complained of pain and felt unable to work. Although defendant at that time refused to resume the compensation payments, it did agree to have plaintiff examined further at the Upper Extremity Clinic in Missoula and to pay the expenses incurred by plaintiff for that examination. On February 27, 1975, plaintiff was examined at the Missoula dlinic and the examining doctors made their report containing their diagnosis and their recommendations reading: "This lady needs cervical myelogram to determine definitely whether or not there is a C-6 nerve root impingement. If the myelogram is compatible with clinical evaluation then anterior cervical decompression, excision of osteophytes, and intravertebral arthrodesis would be indicated. It is felt that this patient is to be considered unemployable during this period of time of eval- uation. " This report was received by defendant on March 17, 1975, Defendant thereupon requested the Workmen's Compensation Division - 2 - (hereinafter referred to as the Division) to obtain a clarif- ication of the last sentence of the recommendations. The Division on March 19, 1975, wrote for a clarification. The clarification was supplied by a letter to the Division dated April 18, 1975, in which it was stated: "What we meant was that until the cervical myelo- gram was performed and some decision made as to her definite diagnosis that I would have to con- sider her unemployable. * * *" This clarification was received by defendant on April 29, 1975. By letter to plaintiff's counsel dated April 30, 1975, defendant delivered a compensation check for plaintiff in the amount of $593.56 covering the period from December 17, 1974 through April 28, 1975, and stated that defendant would be unable to continue compensation payments beyond that date unless plaintiff made arrangements for the myelogram. In the meantime, on March 17, 1975, plaintiff's coun- sel wrote to the Division demanding an emergency hearing and asking that plaintiff be placed on temporary compensation and that defendant be assessed with attorney fees and a ten percent penalty. On April 30, 1975, the Division mailed notice of hearing to be held on May 20, 1975. This notice was received by defendant on May 1, 1975, a day following defendant's payment of the $593.56 covering plaintiff's compensation from December 17, 1974 through April 28, 1975. On May 15, 1975 the Division received defendant's answer and motion to dismiss plaintiff's request for hearing in which it was stated that defendant in- tended to continue paying "benefits until such time that a cervical myelogram is performed at which time a definite diag- nosis can be made." Plaintiff's counsel opposed the motion to dismiss and the Division went ahead with the hearing on May 20, 1975. Thereafter, on August 29, 1975, the hearing examiner for the Division made his findings of fact and conclusions of law. - 3 - In a d d i t i o n t o t h e foregoing f a c t s , t h e hearing examiner found t h a t defendant f a i l e d t o comply with t h e pro- v i s i o n s of s e c t i o n 92-615, R.C.M. 1947, when it terminated b e n e f i t s t o p l a i n t i f f a s of December 16, 1974, i n t h a t it had not given f i f t e e n days' w r i t t e n n o t i c e of t h e termination to p l a i n t i f f and t h e Division. For t h a t reason, t h e examiner concluded t h a t a penalty of 1 0 % of t h e compensation payable over t h e period December 16, 1974 t o A p r i l 28, 1975 should be 92 imposed on defendant under t h e provisions of s e c t i o n 93-824.1, R.C.M. 1947. A f u r t h e r finding was, t h a t a t t h e conclusion of t h e hearing, it w a s agreed t h a t defendant would continue t o pay temporary t o t a l d i s a b i l i t y b e n e f i t s f o r a reasonable period of t i m e so t h a t p l a i n t i f f could s e l e c t a doctor and a place t o have a c e r v i c a l myelogram performed. This w a s followed by a conclusion of law t h a t t h e defendant should continue t o pay t o t h e p l a i n t i f f bi-weekly compensation b e n e f i t s u n t i l t h e evidence revealed t h a t t h e payments should be terminated o r paid pursuant t o a provision of t h e Workmen's Compensation Act o t h e r than s e c t i o n 92-701.1, R.C.M. 1947, which s e c t i o n covers compensation f o r temporary t o t a l d i s a b i l i t y . Another conclusion of law on t h e p a r t of t h e hearing examiner w a s t h a t " t h e language contained i n s e c t i o n 92-616, coupled with t h e f a c t s presented i n t h e i n s t a n t c a s e , does n o t permit t h e Division t o order defendant t o pay p l a i n t i f f ' s c o s t s and a t t o r n e y f e e s . " The findings of f a c t and conclusions of law of t h e hearing examiner w e r e adopted by t h e judge of t h e Worker's Compensation Court. P l a i n t i f f ' s counsel contends t h a t p l a i n t i f f would never have been placed back on temporary t o t a l compensation but f o r h i s e f f o r t s and t h e hearing which he demanded; t h a t only on t h e compulsion of a pending hearing and t h e f e a r t h a t p l a i n t i f f would be awarded a t t o r n e y f e e s d i d defendant resume payment of b e n e f i t s t o p l a i n t i f f ; and t h a t t o allow defendant t o d e f e a t p l a i n t i f f ' s r i g h t t o a t t o r n e y f e e s by t h e voluntary payment under t h e s e circumstances would be t o emasculate t h i s s t a t u t e and d e s t r o y t h e purpose of it and t h e i n t e n t of t h e l e g i s l a t u r e . Defendant responds t h a t its resumption of compensation payments was not t h e r e s u l t of t h e hearing o r of any order o r adjudication and p o i n t s o u t t h a t it made t h e d e f i c i e n c y payment of $593.56 immediately upon receiving t h e c l a r i f i c a t i o n from t h e Upper Extremity C l i n i c and before receiving n o t i c e of t h e hearing, and t h a t a s a p a r t of its motion t o dismiss p l a i n t i f f ' s r e q u e s t f o r a hearing, it had agreed t o continue compensation payments u n t i l t h e myelogram could be made. Whatever it was t h a t motivated defendant t o resume pay- ment of compensation, it i s c l e a r t h a t t h e Division has no author- i t y t o r e q u i r e payment of a t t o r n e y f e e s by defendant u n l e s s t h a t a u t h o r i t y is found within t h e terms of s e c t i o n 92-616, a s amended. Since t h e 1974 amendment, which became e f f e c t i v e on March 11, 1974, s e c t i o n 92-616 reads: " I n t h e event t h e i n s u r e r denies t h e claim f o r compensation o r terminates compensation b e n e f i t s , and t h e claim i s l a t e r adjudged cornpensable, by t h e d i v i s i o n o r on appeal, t h e i n s u r e r s h a l l pay reasonable c o s t s and a t t o r n e y s 1 f e e s a s e s t a b l i s h e d by t h e d i v i s i o n . However, under r u l e s adopted by t h e d i v i s i o n and i n d i s c r e t i o n of t h e d i v i s i o n , an i n s u r e r may suspend compensation payments f o r not more than t h i r t y ( 3 0 ) days pending t h e r e c e i p t of medical information." The 1974 amendment rewrote t h i s s e c t i o n which was o r i g i n a l l y enacted a s Section 2 , Chapter 477, Laws of 1973, and a s then enacted read: " I n t h e event t h e i n s u r e r denies t h e claim, o r terminates a claim t h a t has already been accepted, and t h e claim is l a t e r determined t o be compen- s a b l e e i t h e r through hearing o r appeal t o t h e c o u r t s , t h e i n s u r e r s h a l l pay a l l c o s t s incurred by t h e claimant, including reasonable a t t o r n e y s ' f e e s a s e s t a b l i s h e d by t h e d i v i s i o n . " I n construing a s t a t u t e , t h e Court must determine t h e p l a i n meaning of t h e words used. The language is t o be i n t e r p r e t e d i n accordance with i t s u s u a l , o r d i n a r y and accepted meaning, and t h e i n t e n t i o n of t h e l e g i s l a t u r e i n enacting it must be gathered from t h e language employed t h e r e i n . S e c t i o n 93-401-15, R.C.M. 1947. County of H i l l v. County of L i b e r t y , 62 Mont. 15; 203 P. 500; M i l l s v. S t a t e Board of Equalization, 97 Mont. 13, 33 P.2d 563; S t a t e v. Midland N a t l l Bank, 132 Mont. 339; 317 P.2d 880. The p l a i n import of s e c t i o n 92-616 i s t h a t an adjudi- c a t i o n of t h e claim a s compensable e i t h e r by t h e Division o r on appeal t o t h e c o u r t s is a p r e r e q u i s i t e t o t h e allowance of a t t o r - neys' f e e s t o t h e claimant. That t h i s was t h e i n t e n t i o n of t h e l e g i s l a t u r e i s emphasized by t h e change of wording adopted by t h e l e g i s l a t u r e when it rewrote t h e s e c t i o n i n 1974. P l a i n t i f f argues t h a t under t h e r u l e of l i b e r a l construc- t i o n s e c t i o n 92-616 should be i n t e r p r e t e d a s r e q u i r i n g t h e pay- ment of a t t o r n e y s ' f e e s when t h e i n s u r e r has attempted t o circum- v e n t t h e s t a t u t o r y provision by agreeing t o pay compensation be- f o r e t h e r e has been a n a d j u d i c a t i o n of compensability, and cites a s a u t h o r i t y t h e c a s e of C i t y of Miami Beach v. Schiffman, 144 So.2d 799, 802, i n which t h e F l o r i d a Supreme Court i n t e r p r e t e d an a s s e r t e d l y s i m i l a r F l o r i d a s t a t u t e a s warranting an allowance of a t t o r n e y s 1 f e e s t o t h e claimant i n t h e absence of a n award f o r compensation, even though t h e s t a t u t e appeared t o make such an allowance dependent upon a n award f o r compensation. S e c t i o n 440.34(1) of t h e F l o r i d a s t a t u t e , a s set o u t i n Schiffman ' ' I (1) I f t h e employer o r c a r r i e r s h a l l f i l e n o t i c e of controversy a s provided i n § 440.20 * * *, o r s h a l l d e c l i n e t o pay a claim on o r before the twenty-first day after they have notice of the same, or shall otherwise resist unsuccess- fully the payment of compensation, and the injured person shall have employed an attorney at law in the successful prosecution of his claim, there shall, in addition to the award for compensation be awarded reasonable attorneys fee, to be approved by the com- mission * * *.'" In reaching its decision in the Schiffman case, the Florida court found some doubt in the language of this section and held that, if doubt exists, it should be resolved in favor of the working man. While we must and do agree that the Workmen's Compensa- tion Act should be construed liberally and in favor of the work- ing man, the language of the statute must first allow some room for construction. It is obvious that section 92-616 is written in language entirely different from that of the Florida statute and without doubt requires that the claim be "adjudged compen- sable by the division or on appeal" before the insurer can be required to pay attorney fees. There has been no finding or adjudication of compensability by the Division or by the Worker's Compensation Court in this case. We must rule on the law as it is and not what some may desire it to be. In the Matter of West Gt. Falls F1. Cont. Dist., 159 Mont. 277, 496 P.2d 1143. The judgment of the Worker's Compensation Court is affirmed. Hon. Bernard W. Thomas, District Judge, sitting in place of Mr. Justice James T. Harrison. We Concur a