Does compromise settlement of Petitioner’s wage-loss benefits preclude him from asserting that he is permanently totally disabled?

IN THE WORKERS’ COMPENSATION COURT OF THE STATE OF MONTANA 2017 MTWCC 10 WCC No. 2017-3948. ALAN DAVIS vs. LIBERTY INSURANCE CORPORATION, EMPLOYMENT RELATIONS DIVISION, DEPARTMENT OF LABOR AND INDUSTRY Intervenor.

Summary: Respondent moved to amend its Response to Petition for Hearing to assert affirmative defenses based on its contention that the compromise settlement of Petitioner’s wage-loss benefits precludes him from asserting that he is permanently totally disabled. Respondent maintains that Petitioner’s medical benefits terminated under the 60-month limitation of medical benefits in § 39-71-704(1)(f)(i), MCA (2011), and that Petitioner does not have the right to ongoing medical benefits under § 39-71-704(1)(f)(ii), MCA, (2011) which provides that the 60-month limitation “does not apply to a worker who is permanently totally disabled as a result of a compensable injury.”

Held: This Court denied Respondent’s Motion to Amend because its proffered affirmative defenses are not legally tenable defenses. As a matter of law, the issues settled via a compromise settlement remain “uncertain or undetermined.” Thus, Petitioner may litigate the issue of whether he is permanently totally disabled under the definition at § 39-71-116(28), MCA (2011), for purposes of establishing his right to medical benefits under § 39-71-704(1)(f)(ii), MCA (2011), notwithstanding the compromise settlement of his asserted right to PTD benefits under § 39-71-702, MCA (2011). Moreover, Petitioner expressly reserved medical benefits “to the extent allowed under the Workers’ Compensation Act,” which includes the contractual right to maintain that he is permanently totally disabled for purposes of medical benefits under § 39-71- 704(1)(f)(ii), MCA (2011).

Judgment: Liberty’s Motion to Amend is denied.

READ FULL DOCUMENT AT ORIGNAL SOURCE: http://wcc.dli.mt.gov/d/Davis_2017MTWCC10.pdf