Houts v. Kare-Mor, Inc., KARE-MO

• Decision Date: 19 February 1993
• Docket Number: No. 92-140,INC,KARE-MO,92-140
• Citation: 847 P.2d 701,257 Mont. 65
• Parties: Pamela J. HOUTS, Claimant/Petitioner/Respondent, v., d/b/a Butte Park Royal Convalescent Center, and Horizon Healthcare Corp., d/b/a Butte Park Royal Convalescent Center, and State Compensation Mutual Insurance Fund, Employer/Defendant/Respondent, and Horizon Healthcare Corp., d/b/a Butte Park Royal Convalescent Center, and General Insurance Company of America, Employer/Defendant/Appellant.
• Court: Montana Supreme Court

Page 701

847 P.2d 701

257 Mont. 65

Pamela J. HOUTS, Claimant/Petitioner/Respondent, v. KARE-MOR, INC., d/b/a Butte Park Royal Convalescent Center, and Horizon Healthcare Corp., d/b/a Butte Park Royal

Convalescent Center, and State Compensation Mutual Insurance

Fund, Employer/Defendant/Respondent,

and

Horizon Healthcare Corp., d/b/a Butte Park Royal

Convalescent Center, and General Insurance Company

of America, Employer/Defendant/Appellant.

No. 92-140.

Supreme Court of Montana.

Submitted on Briefs Oct. 22, 1992.

Decided Feb. 19, 1993.

Geoffrey R. Keller, Matovich, Addy & Keller, Billings, for General Ins. Co. of America.

R. Lewis Brown, Atty. at Law, Butte, for Houts.

Michael McCarter, Hughes, Kellner, Sullivan & Alke, Helena, for State Compensation Mut. Ins. Fund.

HUNT, Justice.

Appellant General Insurance Company of America appeals a decision of the Workers' Compensation Court finding that respondent Pamela J. Houts' current medical condition, resulting from surgery on April 11, 1988, stemmed from her April 4, 1988, industrial injury.

We affirm.

General Insurance presents two issues for review. Houts believes that the two issues can be combined into one. We will review the following issues:

1. Is there substantial evidence to support the Workers' Compensation Court's Findings of Fact and Conclusions of Law?

2. Did the Workers' Compensation Court err in finding that General Insurance unconditionally accepted liability for Houts' April 4, 1988, claim?

Pamela J. Houts worked as a nurse's aide at Butte Park Royal Convalescent Center from September 4, 1984, until her employment was terminated on October 27, 1988. During that period, she reported six workers' compensation injuries. The insurer, the State Fund, accepted claims for four injuries occurring from 1985 through 1987. General Insurance was the insurer for two injuries that occurred in 1988.

Houts' first industrial injury occurred on October 7, 1985. She suffered an inguinal hernia while lifting a patient. She filed a claim and received temporary total disability benefits from the State Fund. The hernia was repaired by surgery on November 11, 1986, after which she received temporary total disability benefits. On January 15, 1987, she returned to work without restrictions as a nurses' aide.

On March 22, 1986, Houts sprained her lower back while putting a patient to bed. She filed her claim and received temporary total disability benefits until April 4, 1986, when she returned to work.

On April 22, 1987, Houts injured her lower side abdomen while lifting patients. Her condition was diagnosed as nerve entrapment for which she had surgery on May 12, 1987. At the time of trial, the State Fund was still paying her temporary total disability benefits attributable to this injury.

Houts' fourth industrial injury occurred on December 24, 1987, when she was lifting a patient into a wheelchair and she felt a pain on her left side. Houts reported the accident and filed a claim which was accepted by the State Fund, but no medical expenses or wage loss was reported.

On April 4, 1988, Houts was injured when she was lifting a patient and felt a sharp pain in her left side. The insurer at this point was General Insurance. Houts was examined by Dr. John M. Gallus, her treating physician, who concluded that the problem was a continuation of her previous medical problems on her left side. Houts continued to experience discomfort and on April 7, 1988, Dr. Gallus referred her to Dr. R.E. Nehls in Butte who was board certified in obstetrics and gynecology. On April 11, 1988, Dr. Nehls performed a laparoscopic examination of her abdomen which revealed for the first time that her left tube and ovary were attached to her abdominal wall by dense adhesions. Dr. Nehls decided to perform general surgery and remove the abnormal condition of the tube and left ovary. Following the surgery, Houts' abdominal pain was gone, however, she now had pain in the front area of her left thigh. She was then referred to Dr. W.T. Escober, a neurologist, for a neurological exam. Houts received temporary total disability benefits from April 18, 1988, through mid-August 1988, when she returned to work.

The last industrial injury Houts suffered occurred on October 26, 1988, when she was attempting to place a shirt on a patient and was punched in the stomach. No disability was alleged from the incident. Houts was terminated the following day when her supervisor told her that they had no light duty positions available for her.

A petition for hearing was filed on January 16, 1991, and was heard before the hearing examiner on September 4, 1991. On February 28, 1992, the Workers' Compensation Court adopted the hearing examiner's findings of fact and conclusions of law which stated that Houts' current symptoms arose from the April 11, 1988, surgery stemming from her April 4, 1988, claim. General Insurance appeals the decision of the Workers' Compensation Court.

I.

Is there substantial evidence to support the Workers' Compensation Court's Findings of Fact and Conclusions of Law?

Our standard of review in a workers' compensation case is that this Court will not substitute its judgment for that of the Workers' Compensation Court where there is substantial evidence to support the court's findings of fact. Laber v. Skaggs Alpha Beta (1991), 247 Mont. 172, 805 P.2d 1375. Our responsibility is not to determine whether sufficient evidence supports a contrary finding. Hall v. Atlantic Richfield Co. (1991), 248 Mont. 484, 812 P.2d 1262. The claimant is required to prove by the preponderance of the evidence that her current disability was caused by an injury sustained on the job. Hall, 812 P.2d at 1264. Therefore, we will not overturn the Workers' Compensation Court unless its findings are not supported by substantial evidence.

In its conclusions of law, the Workers' Compensation Court determined that during the laparoscopic examination Dr. Nehls discovered that Houts' left ovary was attached to the abdominal wall and covered with dense adhesions. This...