Ford v. Sentry Casualty Co.
2012 MT 156
Mont.2012Background
- Ford, 38, yard worker, suffered a September 29, 2009 work injury; initial cervical strain accepted by Sentry and treated.
- MRI revealed preexisting degenerative cervical changes and possible disc herniation; dispute whether the accident caused or aggravated the disc condition.
- Treating and independent doctors gave mixed opinions on causation; some opined preexisting degenerative disease predates injury, some suggested possible but not certain relation to the accident.
- WCC found no causal link between the accident and the cervical disc condition, and held Ford failed to prove causation by objective medical findings; WCC ruled against ongoing temporary total disability and against costs/fees.
- Statutory framework requires proving an injury, accident, and causation by more probable than not, with causation and injury established by objective medical findings; Ford appeals, Court affirms on all issues.
- Court notes the governing statute date and conventional standard, and clarifies application of causation standards for future cases.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Causation standard for injury and aggravation | Ford argues WCC applied non-statutory standard | Sentry argues WCC used proper standard or equivalently interpreted | More probable than not with objective medical findings governs; WCC’s result affirmed |
| Reliance on medical opinions to prove causation | Ford contends objective findings not solely medical opinions | Sentry contends medical opinions sufficient under statute | Objective medical findings required; medical opinions properly weighed; affirmed WCC on causation |
| Temporary total disability benefits | Ford asserts ongoing disability due to disc condition | Sentry asserts no TTDS as no permanent restrictions from accident | Affirmed; no TTDB as no objective basis showing inability to work due to accident after MMI |
Key Cases Cited
- Dallas v. Burlington N., Inc., 212 Mont. 514 (Mont. 1984) (admissibility of medical opinions and probative standard for causation)
- Plainbull v. Transamerica Ins. Co., 264 Mont. 120 (Mont. 1994) (judiciary requirement of medical opinion evidence before 1995 amendments)
- Prillaman v. Community Med. Ctr., 264 Mont. 134 (Mont. 1994) (medical opinion evidence not sole basis for occurrence/causation)
- Narum v. Liberty N.W. Ins. Corp., 2009 MT 127 (Mont. 2009) (aggravation standard for preexisting conditions; differing facts)
- Burns v. Plum Creek Timber Co., 268 Mont. 82 (Mont. 1994) (definition of injury and causation under §39-71-119; more probable than not)
- Miller v. Natl. Cabinet Co., 168 N.E.2d 811 (N.Y. 1960) (probability standard in expert medical testimony)