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Hand v. Royal Insurance Company of America

12/19/2002

eturned to work.


Upon her return to Helena, claimant went to the emergency room of St. Peter's Hospital, where she was seen by Dr. Mark Ibsen. (Ex. 18 at 8.) Dr. Ibsen's note indicates that she reported she had stepped backwards and down about a foot. (Id.) Her complaints were of "some pain in her mid back and right lower chest area." (Id.) X-rays were taken but were negative. (Id.) His impression was vague: "Back pain from fall." (Id.)


At the time of the incident, Washington was insured by Royal Insurance. Washington reported the July 2nd incident to Royal Insurance (Ex. 5 and Ex. 6 at 34) and on August 3, 2001, Royal Insurance agreed to pay claimant temporary total disability benefits under a reservation of rights pending its completion of an investigation into the claim. (Ex. 6 at 6). It thereafter paid benefits retroactive to July 10, 2001, and commenced paying biweekly benefits. (Ex. 6 at 5, 32.)


On August 23, 2001, claimant underwent surgery on her neck. (Uncontested Fact 2; Trial Test.) The surgery was done by Dr. Steven Rizzolo, a neurosurgeon practicing in Billings. (Uncontested Fact 2; Weinert Dep. at 22.) He performed an anterior discectomy and fusions at the C5 through C7 levels. (Weinert Dep. at 23-24.)


On September 4, 2001, Royal Insurance's adjuster queried Dr. Weinert about claimant's condition and surgery. (Id.) On September 6, 2001, Dr. Weinert wrote back that claimant's need for "[neck] surgery pre-exists her injury of 7-2-01, although that injury may have caused a slight aggravation." (Ex. 7 at 17.) After receiving Dr. Weinert's response, Royal Insurance notified claimant on September 10, 2001, that it was terminating her temporary total disability benefits because her need for surgery antedated her July 2, 2001 injury. (Ex. 6 at 23.) It also denied liability for the expense of her surgery. (Id. at 44.)


Claimant is seeking benefits. While she has not identified the specific benefits she is seeking, it is clear that she is alleging that her surgery and her disability during recovery are related to her July 2, 2001 injury , thus she is seeking at minimum temporary total disability and medical benefits related to her surgery.


The only opinions concerning causation are those of Dr. Weinert and Dr. Rizzolo. Dr. Weinert testified. Dr. Rizzolo did not but did express his opinion in writing.


As noted earlier, Dr. Weinert had been treating claimant prior to July 2, 2001. His treatment goes back at least to September 11, 1992, when he evaluated claimant and diagnosed fibromyalgia, TMJ dysfunction, lumbar strain, and anxiety neurosis. (Ex. 7 at 86-88.) He saw her numerous times over the next nine years, including six times in 2000 and five times between January 1, 2001 and July 2, 2001. (Ex. 7 at 20-43 and exhibits to Weinert Dep.)


Dr. Weinert saw claimant on June 26, 2001, just a week prior to the July 2nd incident. His office note for that date is found in the exhibits to his deposition but does not appear to have been included in the exhibit notebook proffered at trial. Insofar as the cervical spine, the note reflects his prior diagnosis of "C-5-6 and C6-7 disk disease" as demonstrated by x-ray. (Weinert Dep. Ex. 11, June 26, 2001 office note.) On June 26th claimant reported "arm numbness" and that "her neck and arm symptoms are getting worse." (Id.) His impression was " ncreased neck pain and symptoms of arm numbness of uncertain etiology. Rule out cervical disk herniation." (Id.) He ordered an MRI of the neck. (Id.)


Dr. Weinert's records reflect prior reports of arm or hand numbness and pain. For example, in February 1999 she was complaining of bilateral hand numbness

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