Medical Evidence: Objective Medical Findings

MONTANA SUPREME COURT DECISIONS

Ford v. Sentry Casualty Company, 2012 MT 156 Because of changes the 1995 Legislature made to §§ 39-71-119 and -407, MCA, the Montana Supreme Court overruled that statement in Boyd v. Zurich Am. Ins. Co., ¶ 22, that “claimants are not required to prove causation through medical expertise or opinion.”  Since 1995, Claimants must establish injury and causation by objective medical findings.

 
WORKERS' COMPENSATION COURT DECISIONS

Vonfeldt v. Costco Wholesale Corp. [11/16/15] 2015 MTWCC 20 Petitioner is entitled to acceptance of liability for her myofascial pain syndrome as an OD, as the physicians identified trigger points, which Petitioner’s treating physician defined as a “band of isolated muscle spasm[s],” and decreased range of motion, both of which are specifically included in the definition of “objective medical findings.”

Koch v. Employers Ins. Group [05/19/14] 2014 MTWCC 14 While the Court does not expect medical providers to know and apply the legal definition of “objective medical findings,” the Court will consider items enumerated in the statute as objective medical findings – such as muscle spasms – to be objective medical findings, even if the medical provider does not consider them to be.

Boland v. Montana State Fund [03/21/14] 2014 MTWCC 8 Although the statute requires that an occupational disease be established by objective medical findings, the Court was unable to determine which objective medical findings Petitioner’s treating physician and an IME physician relied upon in reaching their respective opinions.  This, in part, led to the Court concluding that Petitioner had not met his burden of proving that he suffered from an occupational disease arising out of certain employment.

Cornelius v. Lumbermen's Underwriting Alliance [08/07/12] 2012 MTWCC 29 Where an e-mail sent by one medical provider did not contain objective medical findings, but where the records of two other medical providers contained objective medical findings specifically noted by the Court, the Court concluded that the medical evidence, taken together with Petitioner’s testimony, demonstrated that she suffered from an occupational disease.

Koch v. Employers' Ins. Group [04/30/12] 2012 MTWCC 14 The IME physician believed Petitioner was embellishing and exaggerating her pain; however, no amount of purported embellishment will cause the objective medical finding of a herniated disk to appear on an MRI.

Cornelius v. Lumbermen's Underwriting Alliance [04/27/12] 2012 MTWCC 13 Under the definition in § 39-71-116(19), MCA, the “global motion deficits” and decreased sensation in one leg noted by Petitioner’s medical providers constitute objective medical findings.

Wilson v. Uninsured Employers' Fund [12/09/10] 2010 MTWCC 33 Petitioner’s treating physician testified that he observed objective medical findings including tenderness over the SI joint, abnormal posture, and limited range of motion, and further testified that Petitioner’s abnormal posture and limited range of motion has been consistent throughout his years of treatment. The Court concluded that these observations were objective medical findings within the meaning of § 39-71-702, MCA, and supported Petitioner’s entitlement to PTD benefits.

Fleming v. Montana Schools Group Ins. Authority [06/04/10] 2010 MTWCC 13 Where Petitioner’s physician noted decreased range of motion following her injury and increased her pain medication, Petitioner’s pain differed from the pain she experienced prior to the accident, and Petitioner’s symptoms correlated with her post-injury SPECT scan, the Court held that Petitioner established by objective medical findings that she sustained an injury.
Brown v. Hartford Ins. Co. [12/16/09] 2009 MTWCC 38 Where a PA-C and a physician both found medical evidence, substantiated by their clinical findings, that a claimant suffered from a bilateral strain or overuse condition related to her employment, these findings were “objective medical findings” within the meaning of § 39-71-116(19), MCA.
Healy v. Liberty Northwest [10/23/07] 2007 MTWCC 43 The Court is unpersuaded by an IME doctor’s opinion that no objective medical findings support the claimant’s complaints of back pain when an MRI revealed a bulging disk at L4-5 and a herniation at L3-4 which were disregarded by the doctor for unknown reasons. While the doctor may have had evidence which warranted a skeptical approach to the claimant’s subjective pain complaints, objective findings were present and at least warranted further investigation.
Foster v. Montana Schools Group [06/11/07] 2007 MTWC 18 Where Petitioner established that she sustained avascular necrosis of the subchondral area of the lateral femoral condyle, but failed to show how the AVN condition was causally related to her initial injury or subsequent arthroscopy with objective medical findings, Petitioner failed to meet her burden of proof pursuant to the 1995 amendments to § 39-71-407, MCA.
Johnson v. State Compensation Insurance Fund [8/20/99] 1999 MTWCC 52 63-year old truck driver fell and hit his head, shoulder, and lower back. Insurer accepted liability, but terminated TTD benefits when a physician released claimant to return to work. Medical records indicate claimant exaggerated his symptoms and failed to cooperate with medical testing and examination. His in-court testimony about his pain and limitations was not credible. While claimant unquestionably suffers from osteoarthritis, there was no objective medical evidence that he could not return to work in identified jobs. While it is possible claimant suffers genuine neck and low-back pain, his invalid responses during IME and FCE testing, his questionable responses during other medical examinations, and his behavior in Court make it impossible for the WCC to determine the true nature of his pain and disability. TTD benefits properly terminated; claimant is not PTD.
Matthews v. State Fund [2/4/99] 1999 MTWCC 13 affirmed Matthews v. State Fund, 1999 MT 225 No medical evidence supports claimant's theory of conversion disorder resulting from fall at work. Claimant's arguments are based on references within some medical records to possibilities for consideration, not upon objective medical conclusions. Claim denied.