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Wiard v. Liberty Northwest Insurance Corp.10/30/2003
Submitted on Briefs: March 14, 2002
Richard Wiard (Wiard) appeals the Montana Workers' Compensation Court's holding that medical benefits resulting from Wiard's 1992 work-related neck injury terminated after his employer's insurer, Liberty Northwest Insurance Corporation (Liberty), paid no medical claims resulting from this injury for 60 months, pursuant to § 39-71-704(1)(d), MCA (1991). We affirm.
Wiard raises the following issues on appeal:
1. Whether the Workers' Compensation Court erred in its interpretation of the medical benefit provision within the Petition for Compromise and Release Settlement.
2. Whether Wiard was denied medical benefits without due process of law.
3. Whether Liberty should be equitably estopped from asserting § 39-71-704(1)(d), MCA (1991), as a defense.
4. Whether Liberty violated the implied covenant of good faith and fair dealing and the Unfair Trade Practices Act.
5. Whether the Workers' Compensation Court erred by finding that a prior determination of Wiard's maximum medical improvement precluded further medical benefits.
FACTUAL AND PROCEDURAL BACKGROUND
Upon stretching in bed on the morning of August 5, 1992, Wiard experienced intense neck pain that radiated down his arm to the index and long fingers of his right hand. Dr. Richard C. Dewey diagnosed a herniated cervical disc between C6-C7, which was attributed to the repeated jostling and jarring Wiard endured as a crane operator for DAW Forest Products in Superior, Mineral County, Montana. Wiard underwent a partial discectomy in early 1993. According to Dr. Dewey, Wiard suffered a 10 percent impairment of the whole man as a result of the industrial injury. Within a few months, Wiard resumed work as a heavy equipment operator.
Liberty provided workers' compensation insurance for Wiard's employer. Acting pro se , Wiard entered into negotiations with Liberty to settle his claim. The parties executed a Petition for Compromise and Release Settlement (agreement) on February 24, 1994, in which the insurer accepted liability for Wiard's neck injury. The Montana Department of Labor and Industry (DOLI) approved the agreement by written order. According to the agreement, the insurer compensated Wiard for lost wages in the amount of $5,085.60; paid Wiard's medical costs of $6,647.64; and proffered permanent partial disability payments totaling $8,550.05. Wiard's future medical and hospital benefits were expressly reserved by the agreement.
On April 25, 1995, Wiard returned to Dr. Dewey with intrascapular pain and tingling in his right arm, which Wiard associated with his attempt to grab at a falling cabinet five to six weeks earlier while he was assembling cabinets for another employer. Liberty denied the claim for Wiard's office visit based upon Dr. Dewey's conclusion that Wiard's recent neck and right arm pain was caused by a new injury, for which Liberty was not the insurer. Wiard disagreed that he had sustained a new injury but did not contest Liberty's denial. He received no further treatment as a result of the 1995 incident. Wiard did not seek medical care with respect to his neck again until September 2000.
After experiencing discomfort for about two weeks, Wiard awoke early in the morning of September 5, 2000, unable to move his head. Acute pain radiated down his right arm and numbed his right fingers. Attributing these problems to Wiard's original 1992 injury and subsequent neurosurgical decompression, Dr. Carter E. Beck performed a complete anterior discectomy and fusion at C6-C7. The surgical procedure and treatment by other health care providers
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