Provider Connection

2019 MTWCC 2; WCC No. 2018-4207 Everett Pate v. Montana State Fund


Summary:  Petitioner asserts that he injured his shoulder in an industrial accident in which a rung on a ladder broke, causing him to fall down and backwards, partially into a crawlspace.  Respondent denied liability, at first because Petitioner’s medical providers did not identify any objective medical evidence of a shoulder injury.  Respondent then relied on the opinion of its IME physician, who determined that while there is objective medical evidence of a shoulder injury or disease, there is no mechanism of a shoulder injury and that the time between the accident and the onset of Petitioner’s shoulder pain is too great to support a causal relationship.

Held:  Petitioner injured his left shoulder in his industrial accident.  Respondent’s IME physician failed to take an accurate history and, as a result, did not understand that the Petitioner used his arms to arrest his backwards fall.  Respondent’s IME physician also did not understand that Petitioner reported shoulder pain immediately after his fall and suffered shoulder pain again within two weeks of his fall.  Thus, this Court gave more weight to the evidence from the orthopedist treating Petitioner’s shoulder, which is sufficient to prove on a more-probable-than-not basis that Petitioner injured his shoulder in the fall.

Read More: Pate_2019MTWCC2 (1)

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