Powell v. State Compensation Ins. Fund

• Decision Date: 12 December 2000
• Docket Number: No. 99-291.,99-291.
• Citation: 2000 MT 321,15 P.3d 877,302 Mont. 518
• Parties: Michael POWELL, Petitioner/Appellant, v. STATE COMPENSATION INSURANCE FUND, Respondent/Insurer for Security Armored Express, Employer/Insured.
• Court: Montana Supreme Court

15 P.3d 877

2000 MT 321

302 Mont. 518

Michael POWELL, Petitioner/Appellant, v. STATE COMPENSATION INSURANCE FUND, Respondent/Insurer for Security Armored Express, Employer/Insured.

No. 99-291.

Supreme Court of Montana.

Submitted on Briefs December 2, 1999.

Decided December 12, 2000.

Sara R. Sexe, Marra, Wenz & Johnson, Great Falls, MT, For Appellant.

Ann Clark, Carrie Garber, State Compensation Insurance Fund, Helena, MT, For Respondent.

Justice JAMES C. NELSON delivered the Opinion of the Court.

¶ 1 Michael Powell (Michael) appeals a decision of the Workers' Compensation Court denying his constitutional challenge to § 39-71-1107(3), MCA (1995), governing domiciliary care benefits. We affirm.

¶ 2 Michael raises the following issue on appeal:

¶ 3 Whether the statutory cap on domiciliary care benefits as provided in § 39-71-1107(3), MCA (1995), is unconstitutional.

Factual and Procedural Background

¶ 4 Michael suffered severe head and facial injuries in a motor vehicle accident that occurred in the course and scope of his employment with Security Armored Express. The accident occurred on October 7, 1995, therefore, the 1995 version of the Workers' Compensation Act governs his benefits. Buckman v. Montana Deaconess Hosp., (1986) 224 Mont. 318, 321, 730 P.2d 380, 382 (citing Trusty v. Consolidated Freightways, 210 Mont. 148, 151, 681 P.2d 1085, 1087 (1984); Iverson v. Argonaut Ins. Co., (1982) 198 Mont. 340, 342, 645 P.2d 1366, 1367).

¶ 5 After the accident, Michael remained in the hospital until October 20, 1995. He was then admitted to the Comprehensive In Patient Rehab Unit where he remained until November 10, 1995. Upon his discharge from the rehab unit, Dr. Bill Tacke, the rehab physician, recommended that Michael have, at the least, daily supervision.

¶ 6 In late 1995, Michael began having seizures which cause him to lose consciousness and to lose muscle control. In addition, due to the injuries he sustained in the accident, Michael has attention, concentration and memory difficulties.

¶ 7 Michael has good days and bad days. On a good day, he bathes and showers himself and walks to the post office to check his mail, buying a cup of coffee along the way. He will occasionally do some cooking and a few household chores. Also on a good day, Michael will walk the seven blocks to the home of one of his friends and he will occasionally go out in the evening by himself to play cards with his friends.

¶ 8 On bad days, generally following a seizure, Michael is virtually bedridden. He only gets up to eat and to use the bathroom. Even on Michael's good days, Mary, Michael's wife, fixes many of his meals, washes his clothes and makes sure he takes his medicine. Michael developed diabetes in April 1997, and Mary must also make sure that Michael monitors his blood sugar.

¶ 9 The State Compensation Insurance Fund (State Fund), acting as Security Armored Express's insurer, accepted liability for Michael's injuries and paid medical and wage loss benefits. Michael also requested payment for domiciliary care provided by Mary, but the State Fund denied payment of those benefits. Consequently, Michael filed a petition in the Workers' Compensation Court requesting retroactive and ongoing domiciliary care benefits at a rate of compensation greater than allowed by § 39-71-1107, MCA (1995), the statute governing payment of those benefits. This statute provides:

Domiciliary care—requirements—evaluation. (1) Reasonable domiciliary care must be provided by the insurer:

(a) from the date the insurer knows of the employee's need for home medical services that results from an industrial injury;

(b) when the preponderance of credible medical evidence demonstrates that nursing care is necessary as a result of the accident and describes with a reasonable degree of particularity the nature and extent of duties to be performed;

(c) when the services are performed under the direction of the treating physician who, following a nursing analysis, prescribes the care on a form provided by the department;

(d) when the services rendered are of the type beyond the scope of normal household duties; and (e) when subject to subsections (3) and (4), there is a means to determine with reasonable certainty the value of the services performed.

(2) When a worker suffers from a condition that requires domiciliary care, which results from the accident, and requires nursing care as provided for in Title 37, chapter 8, a licensed nurse shall provide the services.

(3) When a worker suffers from a condition that requires 24 hour care and that results from the accident but that requires domiciliary care other than as provided in Title 37, chapter 8, the care may be provided by a family member. The insurer's responsibility for reimbursement for the care is limited to no more than the daily statewide average medicaid reimbursement rate for the current fiscal year for care in a nursing home. The insurer is not responsible for respite care.

(4) Domiciliary care by a family member that is necessary for a period of less than 24 hours a day may not exceed the prevailing hourly wage, and the insurer is not liable for more than 8 hours of care per day.

¶ 10 On the second day of trial, the parties reached a settlement wherein they agreed that Mary would be paid for providing domiciliary care for Michael. The agreement called for payment at the maximum rate permitted by § 39-71-1107(3), MCA (1995). This rate was determined to be $80.15 per day for fiscal year 1995; $82.64 per day for fiscal year 1996; $85.62 per day for fiscal year 1997; and $87.76 per day for fiscal year 1998.

¶ 11 On May 15, 1998, the parties reduced their agreement to a written stipulation for judgment and, on May 28, 1998, judgment was entered pursuant to that stipulation. Michael reserved his right to challenge the constitutionality of § 39-71-1107(3) and (4), MCA (1995). The Montana Attorney General's Office was notified of the constitutional challenge, but filed a Notice of Intent Not to Intervene on March 27, 1998.

¶ 12 The Workers' Compensation Court subsequently found § 39-71-1107, MCA, to be constitutional. The court also ruled that Michael did not have standing to challenge subsection (4) of the statute because he required 24-hour care and thus was not affected by that subsection. This appeal followed.

Standard of Review

¶ 13 Resolution of this issue involves a question of constitutional law. The standard for reviewing conclusions of law is whether they are correct. Henry v. State Compensation Ins. Fund, 1999 MT 126, ¶ 10, 294 Mont. 448, ¶ 10, 982 P.2d 456, ¶ 10 (citing State v. Butler, 1999 MT 70, ¶ 7, 294 Mont. 17, ¶ 7, 977 P.2d 1000, ¶ 7).

The constitutionality of a legislative enactment is prima facie presumed, and every intendment in its favor will be presumed, unless its unconstitutionality appears beyond a reasonable doubt. The question of constitutionality is not whether it is possible to condemn, but whether it is possible to uphold the legislative action which will not be declared invalid unless it conflicts with the constitution, in the judgment of the court, beyond a reasonable doubt.

Stratemeyer v. Lincoln County, (1993) 259 Mont. 147, 150, 855 P.2d 506, 508-09, cert. denied, 510 U.S. 1011, 114 S.Ct. 600, 126 L.Ed.2d 566 (1993) (citing Fallon County v. State, (1988) 231 Mont. 443, 445-46, 753 P.2d 338, 339-40). See also State v. Lilburn, (1994) 265 Mont. 258, 262, 875 P.2d 1036, 1039,

cert. denied, 513 U.S. 1078, 115 S.Ct. 726, 130 L.Ed.2d 630 (1995). Every possible presumption must be indulged in favor of the constitutionality of a legislative act. Davis v. Union Pacific R. Co. (1997), 282 Mont. 233, 240, 937 P.2d 27, 31 (citing State v. Safeway Stores, (1938) 106 Mont. 182, 199, 76 P.2d 81, 84.) The party challenging a statute bears the burden of proving that it is unconstitutional beyond a reasonable doubt and, if any doubt exists, it must be resolved in favor of the statute. Grooms v. Ponderosa Inn, (1997) 283 Mont. 459, 467, 942 P.2d 699, 703 (1997) (citing Heisler v. Hines Motor Co., 282 Mont. 270, 279, 937 P.2d 45, 50).

Discussion

¶ 14 Whether the statutory cap on domiciliary care benefits as provided in § 39-71-1107(3), MCA (1995), is unconstitutional. ¶ 15 Michael challenges the constitutionality of § 39-71-1107(3), MCA, on two related grounds. First, he contends that the limitation on benefits for 24-hour care violates his right to equal protection of the laws under the Fourteenth Amendment to the United States Constitution and Article II, section 4 of the Montana Constitution because, as a result of his choice to live at home rather than a skilled nursing facility, Mary is significantly under compensated for providing Michael's care. Second, he contends that the limitation on benefits is arbitrary and capricious thereby violating his right to substantive due process under the Fourteenth Amendment to the United States Constitution and Article II, section 17 of the Montana Constitution.

A. Equal Protection

¶ 16 Both the Fourteenth Amendment to the United States Constitution and Article II, section 4 of the Montana Constitution provide that no person shall be denied the equal protection of the laws. Indeed, the principal purpose of Montana's Equal Protection Clause is to ensure that Montana's citizens are not subject to arbitrary and discriminatory state action. Davis, 282 Mont. at 240, 937 P.2d at 31 (citing In re Outfitter's License of Godfrey v. Montana State Fish & Game Com'n, (1981) 193 Mont. 304, 306, 631 P.2d 1265, 1267

). And, "[n]otwithstanding the deference that must be given to the Legislature when it enacts a law, it is the express function and duty of this Court to ensure that all Montanans are afforded equal protection under the law." Davis, 282 Mont. at 240,

937 P.2d at 31.

¶ 17 We review equal protection challenges to legislation under one of three recognized levels of scrutiny. First, where the legislation at issue infringes upon a...