NO. 91-031
IN THE SUPREME COURT OF THE STATE OF MONTANA
1991
EBI/ORION GROUP,
Petitioner/Appellant and Cross-Respondent,
-vs-
STATE COMPENSATION MUTUAL INSURANCE FUND,
Defendant/~espondentand Cross-Appellant,
in re CLAUDE ATHEY,
Intervenor/Claimant.
APPEAL FROM: Workers' Compensation Court.
The Honorable Timothy Reardon, Judge presiding.
COUNSEL OF RECORD:
For Appellant:
Bradley J, Luck and Charles E. McNeil; Garlington,
Lohn & ~obinson, Missoula, Montana.
For Respondent:
Richard E, Bach, Attorney at Law, Helena, Montana;
AUG 2 2 1991 Submitted on briefs: July 2, 1991
. . .. .
. __,
Decided: August 22, 1991
ZILERK OF SUPREME COUR'b
S'FA'TE OF MONTANA
Clerk
Justice R. C. McDonough delivered the Opinion of the Court.
EBI/Orion Group appeals from the judgment of the Workers'
Compensation Court which held that it was not entitled to
indemnification from the State Compensation Mutual Insurance Fund
for workerst compensation benefits paid to claimant, Claude Athey.
We affirm.
Although several issues have been submitted on appeal, we find
only one necessary to our review:
Whether substantial credible evidence supports the
Workers' Compensation Court's determination that no
second injury occurred while State Compensation Mutual
Insurance Fund was on risk.
On September 19, 1985, claimant, Claude Athey injured his back
in a slip and fall accident. This injury occurred in the course
and scope of his employment with Harp Line Construction. At this
time Harp Line Construction was insured, for workers' compensation
purposes, by EBI/Orion Group (EBI). Despite this injury, Mr. Athey
continued to work until he was laid off seasonably and did not seek
medical attention until February of 1986.
In May of 1986, Mr. Athey1s treating physicians determined
that his back condition had become medically stable. During the
summer of 1986, Mr. Athey continued his employment with Harp Line
Construction. His employment required him to engage in heavy work
activities that periodically caused pain in the area of his back
injury. At this point in time, Harp Line Construction was insured
by the State Compensation Mutual Insurance Fund (State Fund).
On September 8, 1986, Mr. Athey was working particularly hard
lifting and stacking tires. He suffered an injury to his chest and
stomach and also experienced pain in his back. He reported the
injury to his superiors at Harp Line Construction and apparently
determined that he could no longer work.
Mr. Athey filed a claim for workers' compensation benefits
following this accident. Apparently, Mr. Athey has problems
reading and writing, so consequently his employer filled out the
form for him. Mr. Athey had not filed a claim after his slip and
fall accident and it was his impression that the claim for
compensation was for both the 1985 injury and his present injuries
received when moving the tires. On receipt of the claim, the State
Fund began payment of benefits under 5 39-71-608, MCA, while its
investigation of the circumstances surrounding the claim continued.
After investigation, the State Fund determined that the date
of Mr. Athey's injuries was September 19, 1985, when EBI was the
insurer at risk. On this basis, it terminated the benefits it had
been paying Athey.
On January 23, 1987, EBI received a claim for workers'
compensation benefits. Eventually EBI accepted liability for Mr.
Athey's condition. However it retained a full reservation of
rights to recover any amounts paid, from the State Fund, in the
event further investigation revealed that a second injury occurred
with the State Fund on risk. After settlement was reached with Mr.
Athey, EBI requested that the State Fund contribute 50% toward the
settlement. The State Fund refused.
EBI filed a petition before the Workers' Compensation Court
for determination of its right to indemnification from the State
Fund. The Workerst Compensation Court granted summary judgment in
favor of the State Fund. EBI appealed to this Court and we
reversed. EBI/Orion Group v. State Compensation Ins. Fund (1989),
240 Mont. 99, 782 P.2d 1 2 7 6 . On remand we directed the Workersf
Compensation Court "to determine whether Claude Athey had reached
the condition of maximum healing following his injury of September
19, 1985, prior to his second injury, and whether in fact a second
injury occurred." EBI/Orion Group, 240 Mont. at 105, 782 P.2d at
1280. In its Order on Remand, the Workers' Compensation Court
denied EBI8s claim for indemnification on the grounds that Athey
did not suffer an "injury" on September 8, 1986. This appeal
followed.
As stated above, the State Fund has cross-appealed from the
judgment of the Workers' Compensation Court. It maintains that the
court erred when it found that Mr. Athey had reached a medically
stable condition before the accident of 1986. Because we affirm
the Workers1 Compensation Court we need not address this issue.
A finding in favor of the State Fund on this issue would not change
the result of this opinion. We need only review EBIfs assignment
of error that the lower court incorrectly found Mr. Athey did not
suffer an injury in September of 1986.
The standard of review utilized when reviewing decisions of
the Workerst Compensation Court is well established.
Our function in reviewing a decision of the Workers'
Compensation Court is to determine whether there is
substantial evidence to support the findings and
conclusions of that court. We cannot substitute our
judgment for that of the trial court as to the weight of
evidence on questions of fact. Steffes v. 93 Leasincl Co.
I c (1978), 177 Mont. 83, 86, 580 P.2d 450, 452.
n.
However, decisions of the Workers' Compensation Court
must be based upon substantial credible evidence.
OtBrienv. Central Feeds (1990), 241 Mont. 267, 271, 786
P.2d 1169, 1172. If the conclusions of law are not
supported by the Court's findings of fact, those
conclusions must be reversed. Hume v. St. Reqis Paper
Company (1980), 187 Mont. 53, 608 P.2d 1063.
Hash v. Montana Silversmith (Mont. 1991), 810 P.2d 1174, 1175, 48
St.Rep. 364, 365.
The Workers1 Compensation Court found that the State Fund was
not legally required to indemnify EBI for benefits paid to Claude
Athey. In reaching this conclusion, the court relied upon the
Belton rule. Simply stated the Belton rule holds that once a
claimant has reached maximum healing or a medically stable
condition, the insurer at risk is no longer responsible for any
subsequent injuries or conditions. See Belton v. Carlson Transport
(1983), 202 Mont. 384, 389, 658 P.2d 405, 408. As this rule
clearly states, in order for EBI to sustain a claim of
indemnification against the State Fund it must establish two
elements. First it must show that Mr. Athey had attained a
condition of maximum healing. Second, it must establish that he
sustained an injury after he reached maximum healing.
As stated above, the Workers1 Compensation Court found, and
EBI agrees, that Claude Athey had reached maximum healing before
the injury of September 8, 1986. However, the Workers
Compensation Court did not find that Mr. Athey injured his back
while lifting tires on that date. Based upon this finding, the
court denied EBI's claim for indemnification.
5
EBI maintains that the Workers' compensation Court's judgment
on this issue was not supported by substantial evidence. In making
this argument, EBI relies upon testimony elicited from Athey's
doctors which suggests that the September 1986 accident permanently
aggravated his condition. The Workers' Compensation Court did not
attribute much weight to this testimony because it found that the
doctors' responses to questions on this issue resulted more from
skillful examination of EBI1s counsel than from medical fact. This
doctor was deposed ex parte and the other doctor's opinion
contradicted an earlier report that he issued. In weighing all
evidence including Athey1sown testimony, the court determined that
the back condition when Athey left work on September 8, 1986, was
the result of Athey1s gradually worsening condition and was not a
separate injury that caused any permanent aggravation. Therefore
no injury, within the meaning of 5 39-71-119, MCA, occurred.
We disagree with EBI's argument that this conclusion was not
properly supported. We have fully read the depositions that were
submitted to the Workers' Compensation Court. It is by no means
clear that Mr. Athey1s 1986 accident permanently aggravated his
underlying back condition or constituted an injury as that term is
defined by the Workers' Compensation Act. While there may be some
conflicting evidence on this point, the lower court's judgment is
supported by substantial evidence.
Substantial evidence has been defined as that evidence that
a reasonable mind might accept as adequate to support a conclusion.
Although it may be based upon weak and conflicting evidence, in
order to rise to the level of substantial evidence it must be
greater than trifling or frivolous. Christensen v. Britton (1989),
240 Mont. 393, 401, 784 P.2d 908, 913. In this case, the Workers'
Compensation Court considered the depositions of all doctors
involved in this case. It also took into account Mr. Athey's
testimony concerningthe circumstances surrounding his accident and
injury and that his back hurt him all of the time and progressively
worsened. Substantial evidence supports the court's judgment on
this issue. Accordingly, its judgment is affirmed.
@P ~k&,&
Justice ,
' /
We Concur:
August 22, 1991
CERTIFICATE O F SERVICE
I hereby certify that the following order was sent by United States mail, prepaid, to the
following named:
Bradley J. Luck and Charles E. McNeil
GARLINGTON, LOHN & ROBINSON
199 W. Pine, P.O. Box 7909
Missoula, MT 59807-7909
RICHARD E. BACH
State Compensation Mutual Ins. Fund
5 South Last Chance Gulch
Helena, MT 59601
Joseph F. Daley, Esq.
DALEY, SEAMAN & VANNOY
1325 Highway 2 West
Kalispell, MT 59901
Attorney for Claimant
ED SMITH
THE SUPREME COURT
STA F MONTANA