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Scozzari v. Montana Schools Group Insurance Authority2/17/2004
inconsistent with her present assertion that she submitted a claim for compensation the day after her November 2000 fall.
The present case involves claimant's left knee. The first medical record of any complaint regarding her left knee was on December 27, 2002 (Ex. 4 at 13), more than two years after her fall. On that visit she was seen by her family physician for unrelated medical problems. The doctor's note, however, records her left knee complaints:
he is also complaining of some left-sided knee pain, as knee pain has been present for approximately two months. It is causing her to limp at times. . . .
(Id.)
On April 7, 2003, claimant was diagnosed as suffering from a torn medial meniscus of the left knee. (Id. at 53, 76.) On April 25, 2003, she underwent arthroscopic surgery to repair the meniscus. (Id. at 73.) It is the left knee condition and surgery which caused claimant to pursue and litigate a claim for compensation with respect to her November 2000 fall.
In light of the history outlined above, I have grave doubt as to whether claimant's left knee condition, for which she underwent surgery on April 25, 2003, was in fact due to her fall on November 17, 2000. There are no medical opinions addressing the causation question and the lapse of time from her fall until her first complaints of left knee pain certainly raise a significant causation issue. MSGIA denies there is any causal relationship between the claimant's November 2000 fall and her left knee surgery, however, the only issue presented at trial is whether the claimant filed a timely workers' compensation claim. I therefore do not consider causation.
CONCLUSIONS OF LAW
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).
Claimant bears the burden of proving by a preponderance of the evidence that she is entitled to the benefits she 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).
Section 39-71-601, MCA (1999), provides as follows:
39-71-601. Statute of limitation on presentment of claim -- waiver. (1) In case of personal injury or death, all claims must be forever barred unless signed by the claimant or the claimant's representative and presented in writing to the employer, the insurer, or the department, as the case may be, within 12 months from the date of the happening of the accident, either by the claimant or someone legally authorized to act on the claimant's behalf.
(2) The insurer may waive the time requirement up to an additional 24 months upon a reasonable showing by the claimant of:
(a) lack of knowledge of disability;
(b) latent injury; or
(c) equitable estoppel.
(3) Any dispute regarding the statute of limitations for filing time is considered a dispute that, after mediation pursuant to department rules, is subject to jurisdiction of the workers' compensation court.
The statute required claimant to submit her written claim for compensation within twelve months unless the Court finds grounds under section 39-71-601(2), MCA, for waiving the requirement.
I have found as a matter of fact that the claimant did not submit a written claim within one year of her injury. I also find no basis for extending the period for filing a claim. There is no estoppel since the employer specifically asked her to fi
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