No. 86-295
IN THE SUPREME COURT OF THE STATE OF MONTANA
1987
GLORIA RIGHTNOUR,
Claimant and Respondent,
-vs-
KARE-MOR , INC .,
Employer,
and
INTERMOUNTAIN INSURANCE COMPANY,
Defendant and Appellant.
APPEAL FROM: The Workers' Compensation Court, The Honorable
Timothy Reardon, Judge presiding.
COUNSEL OF RECORD:
For Appellant:
Garlington, Lohn & Robinson; Larry W. Jones, Missoula,
Montana
For Respondent:
David L. Holland, Butte, Montana
Submitted on Briefs: Dec. 11, 1986
Decided: January 2 0 , 1987
Filed: "IAN 2 0 18
97
Mr. Justice John Conway Harrison delivered the Opinion of the
Court.
This is an appeal from an order of the Montana Workers'
Compensation Court granting summary judgment to
plaintiff/claimant and denying defendant/appellantls motion
for summary judgment. Claimant sustained a compensable
injury in January, 1982. The settlement agreement included
reservation of medical benefits. Following surgery performed
in March, 1985, claimant was awarded medical benefits as
benefits reserved. We affirm.
The claimant suffered a low back injury arising out of
and in the course of her employment, January 19, 1982. Her
employer, Kare-Mor, Inc., of Butte, Montana, was enrolled
under compensation plan number I1 of the Workers'
Compensation Act. Insurer was Intermountain Insurance
Company (appellant). The employer and appellant accepted
liability for the claimant's injury and paid weekly temporary
total disability benefits pursuant to 5 39-71-701, MCA.
A lumbar laminectomy on a herniated disk at the L4-L5
level was performed September 30, 1982, by Dr. James P.
Murphy. Dr. Murphy performed a second surgery in the same
area March 30, 1983, to relieve nerve root compression and to
remove loose fragments. Dr. Murphy testified in a deposition
that claimant's healing period had ended and she had reached
maximum healing November 22, 1983. A final settlement was
negotiated and approved January 20, 1984, with the claimant
reserving medical benefits.
In March, 1984, the claimant was caring for children in
her home when she went outside to retrieve a child because of
the cold. Her dog moved in front of the steps and she
tripped on his chain and fell. Dr. Paul Giacomini made a
house call to examine the claimant. She could not move her
left leg because of severe pain and had muscle spasm in the
lumbar region. He prescribed a muscle relaxant. The
doctor's examination notes of September, 1984, indicate he
believed her tripping and falling caused the pain in her leg,
which was becoming progressively more severe.
The claimant was examined by Dr. Murphy in March, 1985.
A lumbar myelogram indicated subluxation, the movement of one
vertebrae over another. He performed surgery to fuse the L-4
to the sacrum because of the subluxation. This third surgery
was not to repair a defect in the prior surgery. The
appellant denied liability for payment to claimant of
disability and medical benefits under the Workers'
Compensation Act.
Both parties deposed Drs. Murphy and Giacomini.
Appellant then moved the court for summary judgment on the
ground the injury for which claimant was seeking medical and
disability benefits did not arise out of and in the course of
her employment. In turn, claimant filed a motion for summary
judgment, arguing the injury did arise out of and in the
course of her employment. The Workers' Compensation Court
adopted the hearing examiner's findings of fact, conclusions
of law and proposed judgment ordering appellant to pay
claimant's medical benefits as the medical benefits reserved
by the claimant relating to her compensable injury of
January, 1982. Appellant filed a motion for a new trial, or
in the alternative asked the court to amend its order to
conform to the findings. The motion was denied and this
appeal was filed.
The facts are not in dispute, leaving only a question
of law to be resolved by this Court. Solich v. Hale (1967),
150 Mont. 358, 361, 435 P.2d 883, 885; S 25-7-102, MCA.
If [the question on appeal] is a question
of law, . .. our scope of review is not
so limited [as when reviewing a question
of fact]. In such a case, the
appropriate standard of review is simply
whether the lower court's interpretation
of the law is correct. We are not bound
by the lower court's conclusion and
remain free to reach our own.
Wassberg v. Anaconda Copper Co. (Mont. 1985), 697 P.2d 909,
912, 42 St.Rep. 388, 391.
Liabilty is limited statutorily to those injuries
sustained arising out of and in the course of the claimant's
employment.
Every insurer is liable for the payment
of compensation, in the manner and to the
extent hereinafter provided, to an
employee of an employer it insures who
receives an injury arising out of and in
the course of his employment. . .
Section 39-71-407, MCA.
The essential element to be proved by a claimant is a
direct relationship between the claimant's employment and the
injury. Schwartzkopf v. Industrial Accident Board (1967),
149 Mont. 488, 493, 428 P.2d 468, 470. That is, a subsequent
injury is compensable if it is the direct and natural result
of a compensable primary injury, and not the result of an
independent intervening cause attributable to the claimant's
own intentional conduct. See Breen v. ~ndustrial ~ccident
Board (1968), 150 Mont. 463, 436 P.2d 701. When a subsequent
injury is compensable, the claimant is entitled to receive
those benefits which are payable because of medical treatment
necessitated by the original injury pursuant to $ 39-71-407,
MCA, and $ 39-71-704, MCA, including any medical benefits
reserved.
Dr. Giacomini testified the fall aggravated her
preexisting weakened back condition. When asked if the
subluxation that precipitated the third surgery was a result
of the fall in 1984, Dr. Giacomini answered ". .. the fall
of 1984 could have caused the subluxation because the
previous operation[s] had weakened her spine." He testified:
[Flrom the time she lifted the patient in
the nursing home and injured herself to
the time she had surgery this last time
is just one continuous line that might
have direct ties or indirect ties. But
it is the same injury.
Dr. Murphy testified it was "probable the first incident
requiring not one, but two surgeries, can be extrapolated
back to her original injury." He said the fall could have
aggravated the original injury.
The need for two surgeries as a result of the original
injury is undisputed. Nor is there dispute the claimant now
has a weakened lower back. The Workers' Compensation Court
concluded
[tlhe claimant has proven to a reasonable
degree of medical certainty that the
original compensable injury of January
19, 1982 and the two subsequent surgeries
weakened her back, and combined with the
fall in her home in March, 1984, resulted
in a third surgery being required. Such
surgery and other medical bills related
to that fall are the natural consequence
of the original injury.
The claimant has shown by medical testimony a causal
connection between her injury of January, 1982, and the
surgery performed in March, 1985. Thus we affirm the order
of the Workers' Compensation Court.
We concur: