SLH v. State Compensation Mut. Ins. Fund

• Decision Date: 28 December 2000
• Docket Number: No. 99-375.,99-375.
• Citation: 2000 MT 362,303 Mont. 364,15 P.3d 948
• Parties: S.L.H., Petitioner and Appellant, v. STATE COMPENSATION MUTUAL INSURANCE FUND, Respondent and Respondent/Insurer for Thirsty's Bar, Employer.
• Court: Montana Supreme Court

15 P.3d 948

2000 MT 362

303 Mont. 364

S.L.H., Petitioner and Appellant, v. STATE COMPENSATION MUTUAL INSURANCE FUND, Respondent and Respondent/Insurer for Thirsty's Bar, Employer.

No. 99-375.

Supreme Court of Montana.

Submitted on Briefs January 6, 2000.

Decided December 28, 2000.

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

William O. Bronson; James, Gray, Bronson & Swanberg Great Falls, MT, For Respondent.

Larry Howell, Attorney at Law, Missoula, MT, (for Montana Trial Lawyers Association), For Amicus.

Justice W. WILLIAM LEAPHART delivered the Opinion of the Court.

¶ 1 S.L.H. filed a petition with the Workers' Compensation Court to resolve a dispute regarding disability benefits, medical benefits and the State Compensation Mutual Insurance Fund's (State Fund) subrogation claim. S.L.H. now appeals the court's findings that she had a 1% mental impairment rating; that her time of injury job was medium-duty; and that certain of the State Fund's actions did not entitle S.L.H. to an award of penalties, attorney fees, and costs. Montana Trial Lawyers Association (MTLA) filed an amicus brief limited to the mental impairment rating issue. The State Fund has not appealed any of the court's findings. We affirm in part and reverse in part.

¶ 2 We restate the issues as follows:

¶ 3 I Did the court err when it held that Dr. Evans' inability to express her evaluation of S.L.H.'s mental impairments as a percentage was fatal to S.L.H.'s claim?

¶ 4 II Did the court err in determining that S.L.H.'s time of injury job was medium duty rather than heavy duty?

¶ 5 III Did the court err in its decisions regarding penalties, attorney fees, and costs?

Procedural and Factual Background

¶ 6 In November, 1991, S.L.H. was kidnaped from her job as a bartender and severely beaten and raped. At the time of the attack, S.L.H.'s employer was enrolled in a compensation plan and insured by the State Fund. While the State Fund accepted liability for S.L.H.'s injuries, the parties have disputed certain medical costs, S.L.H.'s wage loss and permanent mental impairments. As a result of these disagreements, S.L.H. filed a petition for hearing with the Workers' Compensation Court.

¶ 7 S.L.H.'s psychiatrist, Dr. Mary Ann Evans, diagnosed S.L.H. with post-traumatic stress disorder and major depressive disorder, and evaluated S.L.H.'s impairments according to the American Medical Association's "Guides to the Evaluation of Permanent Impairment." (AMA Guides). Both the third edition of the AMA Guides, in effect at the time of the assault, and the fourth edition, in effect at the trial, evaluate mental impairments under a five-class rating system, ranging from no impairment (Class 1) to extreme impairment (Class 5). Dr. Evans testified that S.L.H.'s post-traumatic stress disorder fell within Class 3 as a moderate impairment while her major depressive disorder fell between Class 3 and Class 2, and was therefore a moderate to mild impairment.

¶ 8 S.L.H.'s neurologist referred her to Dr. Patrick Galvas for a physical impairment rating. Although Dr. Galvas is neither a psychologist nor a psychiatrist, and was asked to evaluate only S.L.H.'s physical impairment, he provided a mental impairment evaluation as well.

¶ 9 Dr. Evans testified at the hearing that S.L.H.'s mental impairments were mild-to-moderate, falling between Classes 2 and 3 according to the AMA Guides. The court read § 39-71-711, MCA, which provides the procedure for rating impairments, as requiring that an impairment rating be expressed by the evaluator as a percentage. The court consequently asked Dr. Evans to provide the court with a percentage for S.L.H.'s mental impairments. Abiding by the AMA Guides' warning that "because no data exist that show the reliability of the impairment percentages, it would be difficult for Guides' users to defend their use in administrative hearings," Dr. Evans refused to translate S.L.H.'s mental impairment evaluation into a percentage. The Workers' Compensation Court did not question the accuracy and validity of Dr. Evans' evaluation and in fact the court concluded that S.L.H. suffered "severe psychological injuries." Although Dr. Evans' testimony sufficed to establish a mental impairment under the current AMA Guides, the court held it was insufficient to satisfy the percentage requirement in § 39-71-711(1)(c), MCA.

¶ 10 Dr. Galvas, on the other hand, in contravention of the AMA Guides' admonishment, but in compliance with § 39-71-711(1)(c), MCA, expressed his ratings of S.L.H.'s mental impairments as percentages: 1% for her post-traumatic stress disorder and 0% for her major depressive disorder.

¶ 11 Relying on Dr. Galvas' impairment ratings, which were the only percentages provided by an impairment evaluator, the court found that S.L.H. suffered a 1% permanent mental impairment rating.

¶ 12 In September of 1998, a vocational consultant analyzed S.L.H.'s job, as it existed at the time of the assault and concluded that S.L.H.'s bartending job was medium duty. S.L.H. did not object to introduction of the job analysis as an exhibit at trial, but both S.L.H. and her mother testified that the job, as it existed in 1991, was a heavy-duty job. The court concluded that S.L.H.'s time of injury job was medium duty.

Standard of Review

¶ 13 We review the Workers' Compensation Court's conclusions of law to determine if they are correct. Russette v. Chippewa Cree Housing Auth. (1994), 265 Mont. 90, 874 P.2d 1217. The Court reviews questions of fact to determine if substantial credible evidence in the record supports them. Wunderlich v. Lumbermens Mut. Cas. Co. (1995), 270 Mont. 404, 892 P.2d 563. We will not substitute our judgment for that of the trial court where conflicting evidence, weight to be given witnesses' testimony, or their credibility is at issue. Burns v. Plum Creek Timber Co. (1994), 268 Mont. 82, 84, 885 P.2d 508, 509.

¶ 14 This Court will not rule on the constitutionality of a statute if we can decide a case without addressing constitutional concerns. Wolfe v. Montana Dep't of Labor & Indus. (1992), 255 Mont. 336, 339, 843 P.2d 338, 340. Because this issue can be decided without reaching constitutional concerns, we decline to address the appellant's constitutional arguments.

Discussion

¶ 15 I Did the court err when it held that Dr. Evans' inability to express her evaluation of S.L.H.'s mental impairments as a percentage was fatal to S.L.H.'s claim?

¶ 16 Statutory construction is a "holistic endeavor" and must account for the statute's text, language, structure, and object. United States Nat'l Bank v. Indep. Ins. Agents of Am., Inc. (1993), 508 U.S. 439, 455, 113 S.Ct. 2173, 2182, 124 L.Ed.2d 402, 418 (internal quotations omitted). Our purpose in construing a statute is to ascertain the legislative intent and give effect to the legislative will. Section 1-2-102, MCA. ¶ 17 We discern the intent of the legislature from the text of the statute if the words are clear and plain. Western Energy Co. v. State, Dep't of Revenue, 1999 MT 289, ¶ 11, 297 Mont. 55, ¶ 11, 990 P.2d 767, ¶ 11 (citation omitted). To avoid an absurd result and to give effect to a statute's purpose, we read and construe the statute as a whole. Skinner Enterprises, Inc. v. Lewis and Clark County Board of Health (1997), 286 Mont. 256, 274, 950 P.2d 733, 744.

¶ 18 S.L.H. and Amicus contend that the Workers' Compensation Court erred in its interpretation of § 39-71-711, MCA, and that this interpretation led to an absurd result in the context of mental impairments. Prescribing the procedure for determining an impairment rating for use in calculating an injured worker's disability award, § 39-71-711, MCA, provides:

(1) An impairment rating:

(a) is a purely medical determination and must be determined by an impairment evaluator after a claimant has reached maximum healing;

(b) must be based on the current edition of the Guides to Evaluation of Permanent Impairment published by the American medical association; and

(c) must be expressed as a percentage of the whole person.

¶ 19 The Workers' Compensation Court interpreted the statute to require that the impairment evaluator, who determines the impairment rating, as required by subsection (a) must also satisfy each of the other two subsections of § 39-71-711, MCA. S.L.H. and MTLA argue that this creates an internal inconsistency because an impairment evaluator, under the current AMA Guides (since 1988) can no longer satisfy both subsection (b) and subsection (c) in the context of a mental impairment.

¶ 20 The AMA Guides, in both the third and fourth editions, specifically advise practitioners against the use of percentages for mental impairments. The fourth edition of the AMA Guides admonishes:

There is no available empiric evidence to support any method for assigning a percentage of impairment of the whole person.... Translating these guidelines for rating individual impairment on ordinal scales into a method for assigning percentage of impairments ... cannot be done reliably .... The use of percentages implies a certainty that does not exist....

AMA Guides 300-01 (4th ed.1993).

¶ 21 According to the court's interpretation, the statute requires the evaluator to express her evaluation of impairment as a percentage. Although the court accepted Dr. Evans' evaluation when it found "[t]he assault and rape resulted in severe physical and psychological injuries to the claimant," the court nonetheless concluded that S.L.H.'s claim failed "since she could not establish a percentage rating under the AMA Guides to impairment." We conclude that the court erred when it required that Dr. Evans translate her evaluation into percentages before the court would consider the evaluation for impairment rating purposes.

¶ 22 A. Was the court's interpretation required under the plain language of the statute?

¶ 23 In effect, the Workers' Compensation Court held that subsection (a)'s language that the impairment ...