Original Insurer Still Liable for Covering Aggravated Carpal Tunnel
August 6, 2018
The Supreme Court of Montana has ruled that a Liberty Mutual Insurance Co. policy that covered an employee's carpal tunnel syndrome when it was originally diagnosed is liable when the injury later worsened, despite no longer being the company's insurer. The case is Mont. State Fund v. Liberty Nw. Ins. Corp., 2018 MT 188.
Kim Wiard began working at Tricon Timber, LLC in 2002. In 2010 or 2011 Wiard was diagnosed with bilateral carpal tunnel syndrome (CTS). The workers compensation insurer at the time was Liberty Northwest Insurance Corp. (Liberty). Liberty acknowledged their liability for the injury an occupational disease in August 2011. Wiard transferred to a different position at Tricon and her carpal tunnel symptoms dissipated. She used over-the-counter pain medication, stopped wearing her wrist brace, and stopped seeking treatment for her carpal tunnel syndrome.
Wiard soon again changed jobs at Tricon, to a position that she found to be more mentally and physically demanding than her previous jobs. Soon after, Liberty stopped providing workers' compensation for Tricon, replaced by insurer State Fund. Wiard started working longer and more frequent shifts. She was suffering from pain in her wrist but was unable to take time off of work. She sought medical treatment for the pain and was taken off of work and scheduled for follow-up care. Unfortunately her condition worsened severely and she went to the emergency room later that night with severe wrist pain radiating into her shoulder. The doctors diagnosed her with acute exacerbation of carpal tunnel syndrome and prescribed medication and referred her to an orthopedic surgeon. Two days later she went to another emergency room with complaints of pain in her other wrist. She was diagnosed with an acute exacerbation of chronic left carpal tunnel, and sent in for emergency carpal tunnel release that same day. She returned the next month for a right carpal tunnel release.
Wiard filed an occupational disease claim with State Fund, who denied the claim asserting that her diagnosis preceded their insurance coverage. Subsequently Wiard submitted her claim to Liberty who denied liability on the basis that State Fund was now liable. State Fund paid out the benefits and then sued Liberty for the money. Both parties agree to the material facts of the case. The Workers Compensation Court granted summary judgment for Liberty, and concluded that Wiard had fully recovered from her earlier diagnoses and her new position aggravated her occupational disease.
State Fund appealed. The Supreme Court of Montana found that whether Wiard had reached the maximum medical improvement, and whether her underlying occupational disease was materially aggravated by her position switch would both be relevant in determining liability in a case with multiple employers, in a case with one employer and multiple insurers both are irrelevant. A worsening or aggravated underlying disease is not enough to shift liability, so the only way an originally liable insurer can avoid later liability is by demonstrating that the injured worker is suffering from a new and different occupational disease.
Editor's Note: Under Montana's workers compensation insurance, the last injurious exposure rule dictates that the only employer liable is the employer in whose employment the employee was last exposed to the hazard. For the last injurious exposure rule to apply, the earlier insurer has the burden to prove that a second injury or exposure materially or substantially contributed to the disease. This rule was determined to be irrelevant in the case at hand because, as stated above, in a single-employer, multiple insurer scenario the only way the original insurer can avoid further liability is by demonstrating that a new and different occupational disease is afflicting the employee. The Montana Supreme Court determined that there was no question that she was still suffering from the same occupational disease, and is still employed by the same employer, so the original Liberty policy is the one that is still liable for her injury.