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Watkins v. State Compensation Insurance Fund2/22/2002
FINDINGS OF FACT, CONCLUSIONS OF LAW AND JUDGMENT
Summary: Claimant seeks medical and compensation benefits with respect to knee replacement surgery, arguing in the alternative that the surgery is related to a 1997 injury or to an occupational disease.
Held: Claimant is not entitled to benefits. Claimant failed to establish that he suffers from an occupational disease or that the surgery was causally related to his 1997 injury. Rather the surgery was an inevitable consequence of an earlier 1975 injury.
Topics:
Causation: Medical Condition. Where surgery was the direct and inevitable result of a prior injury, and a subsequent exacerbation of the pre-existing condition did not cause the surgery or materially accelerate the need for surgery, the insurer for the subsequent exacerbation is not liable for the surgery.
Occupational Disease: Disease. Where claimant presented no medical testimony that he suffered from an occupational disease proximately causing his condition, his occupational disease claim must fail.
Occupational Disease: Proximate Cause. Where claimant presented no medical testimony that he suffered from an occupational disease proximately causing his condition, his occupational disease claim must fail.
The trial in this matter was held on September 18, 2001, in Missoula, Montana. Petitioner, Gerald Watkins (claimant), was present and represented by Mr. Andrew F. Scott. Respondent State Compensation Insurance Fund (State Fund) was represented by Mr. Greg E. Overturf. Respondent Credit General Insurance Company (Credit General) was represented by Mr. Michael P. Heringer and Ms. Lisa A. Speare.
Exhibits: Exhibits 1 through 9 were admitted without objections.
Witnesses and Depositions: Claimant and Dr. Dana Headapohl testified at trial. In addition the Court received and has considered depositions of claimant, Dr. Dana Headapohl, Dr. Greg Thomson, Dr. Walter Peschel, Dr. Michael Sousa, and Dr. Wayne L. Davis.
Issues Presented: The Pretrial Order sets forth nine issues, however, they can be condensed to one overriding issue, which is whether either the State Fund or Credit General is liable for treatment of claimant's left knee after February 1998, including a total knee replacement, and for any compensation benefits on account of disability since that time.
Having considered the Pretrial Order, the testimony presented at trial, the demeanor and credibility of the witnesses, the depositions and exhibits, and the arguments of the parties, the Court makes the following:
FINDINGS OF FACT
Claimant is presently 58 years old. Over his lifetime he has worked mostly as a truck driver but has also worked at other jobs, including construction.
In October 1975, while working as a framing (construction) contractor, claimant fell sixteen feet from a house and suffered a "partially comminuted fracture to the proximal tibia" of the left leg, in other words a fracture of the tibia at the left knee. (Watkins Dep. at 15; Ex. 1 at 129.) Initially, he underwent surgery which included the use of hardware. (Watkins Dep. at 21-22; Ex. 1 at 129, 132.) He subsequently underwent four additional surgeries, apparently to remove hardware. The last surgery was in 1980 or 1981 to remove a plate in the knee. (Watkins Dep. at 22.)
While the medical records pertaining to claimant's treatment for his 1975 knee injury are sparse, claimant testified that he was told by his treating physician that in "8 to 12 years" he probably would have to have additional surgery to his knee. (Id. at 21.) According to claimant, the docto
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