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ALAN DAVIS vs. LIBERTY INSURANCE CORPORATION

Workers' Compensation Court of the State of Montana

Does the Court have jurisdiction if Petitioner has not gone through the administrative process to reopen his medical benefits?

IN THE WORKERS’ COMPENSATION COURT OF THE STATE OF MONTANA 2017 MTWCC 11
WCC No. 2017-3948. ALAN DAVIS vs. LIBERTY INSURANCE CORPORATION, EMPLOYMENT RELATIONS DIVISION, DEPARTMENT OF LABOR AND INDUSTRY Intervenor.

Summary: Respondent moved to dismiss Petitioner’s claim that he is permanently totally disabled and therefore has the right to medical benefits under § 39-71-704(1)(f)(ii), MCA (2011). Respondent contends that this Court does not have jurisdiction because Petitioner has not gone through the administrative process to reopen his medical benefits. In the alternative, Respondent alleges that Petitioner settled the issue of whether he is permanently totally disabled, and must reopen his settlement before he can argue he is permanently totally disabled.

Held: This Court denied Respondent’s motion. Under the plain and unambiguous language of § 39-71-704(1)(f)(ii), MCA, a permanently totally disabled claimant’s medical benefits do not terminate 60 months from his date of injury, and a permanently totally disabled claimant is not required to petition the DLI to “reopen” his medical benefits. Moreover, Petitioner is not attempting to reopen his settlement agreement. He did not settle the issue of whether he is permanently totally disabled; he settled his claimed right to PTD benefits on a compromise basis, thereby leaving the issue of whether he is permanently totally disabled “uncertain” and “undetermined.” And, the settlement agreement states that his medical benefits remained open “to the extent such benefits are allowed under the Workers’ Compensation Act.” This includes the contractual right to medical benefits under § 39-71-704(1)(f)(ii), MCA.

Judgment: Liberty’s Motion to Dismiss or in the Alternative Motion for Summary Judgment is denied.

READ FULL DOCUMENT AT ORIGNAL SOURCE: http://wcc.dli.mt.gov/d/Davis_2017MTWCC11.pdf