Andersen v. Zurich American Insurance Company6/26/2003
ll fall. I further find that the injury he suffered on August 1, 2001, was more probable than not an injury of the sacroilliac joint and was wholly unrelated to the herniated disk he suffered in March 2002. Finally, I find that the herniated disk diagnosed on March 22, 2002, and thereafter treated, was caused by a March 16, 2002 slip and fall at the Marshall Mountain Ski Area. It was a new and distinct injury unrelated to claimant's August 1, 2001 industrial injury.
CONCLUSIONS OF LAW
This case is governed by the 2001 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 he is entitled to the benefits he 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).
Claimant has established by a preponderance of the evidence that he suffered an industrial injury on August 1, 2001. He has shown that he suffered (1) internal harm to his sacroiliac joint from an unexpected strain or incident. The incident is identifiable by time and place, consisted of a single event on a single day, and affected a specific, identifiable body part. Thus, the injury and accident criteria of section 39-71-119, MCA (2001), are satisfied. However, claimant failed to establish any entitlement to benefits on account of the injury and condition. He continued working without loss of time and did not seek medical treatment with the possible exception of his visit to a physician's assistant on February 8, 2002. That visit, however, was also for treatment of a lesion and there is no evidence of any further need for medical treatment other than the over-the-counter medication he was taking.
As to the herniated disk and treatment subsequent to March 16, 2002, claimant was required to show that his condition and treatment were caused by or related to his August 1, 2001 industrial accident. Section 39-71-704(1)(a), MCA (2001), requires the insurer to furnish medical care only for "conditions resulting from the injury ." Compensation benefits are payable only for disability resulting from an industrial injury. ยงยง 30-71-701, -702, -703, MCA (2001).
Claimant has failed to prove his herniated disk was caused or related to his August 1, 2000 industrial accident. Rather, his herniated disk was the result of a new, non-work- related accident at the ski area. It was a new, separate, and distinct injury . Indeed, the injury was to a different part of his back. He is therefore not entitled to benefits for the herniated disk or for medical treatment and surgery after March 16, 2002.
JUDGMENT
While the claimant has established he suffered an industrial back injury on August 1, 2001, he has failed to establish that the medical condition (herniated disk) and disability from which he subsequently suffered are related to the industrial injury, therefore he is not entitled to benefits and his petition is dismissed with prejudice.
This JUDGMENT is certified as final for purposes of appeal.
Any party to this dispute may have twenty days in which to request a rehearing from these Findings of Fact, Conclusions of Law and Judgment.
DATED in Helena, Montana, this 26th day of June, 2003.
Mike McCarter JUDGE
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