French v. Amax Coal West

• Decision Date: 19 August 1998
• Docket Number: No. 97-121,97-121
• Parties: In The Matter of the Worker's Compensation Claim of Alice D. FRENCH, Appellant (Employee/Claimant), v. AMAX COAL WEST, Appellee (Employer/Objector), and State of Wyoming, ex rel., Wyoming Workers' Compensation Division, Appellee (Respondent).
• Court: Wyoming Supreme Court

Page 1023

960 P.2d 1023

In The Matter of the Worker's Compensation Claim of Alice D. FRENCH, Appellant (Employee/Claimant), v. AMAX COAL WEST, Appellee

(Employer/Objector),

and

State of Wyoming, ex rel., Wyoming Workers' Compensation Division, Appellee (Respondent).

No. 97-121.

Supreme Court of Wyoming.

Aug. 19, 1998.

Donald J. Sullivan of Sullivan Law Offices, P.C., Cheyenne, for Appellant(Employee/Claimant).

Catherine MacPherson of MacPherson Law Offices, LLC, Rawlins, for Appellee Amax Coal West.

William U. Hill, Attorney General; Gerald W. Laska, Senior Assistant Attorney General; and Bernard P. Haggerty, Assistant Attorney General, Cheyenne, for Appellee State ex rel. Wyoming Workers' Compensation Division.

Before LEHMAN, C.J., and THOMAS, GOLDEN and TAYLOR, ^* JJ., and KALOKATHIS, District Judge.

TAYLOR, Justice.

Appellant challenges the order of the district court affirming the Medical Commission's denial of her claim for worker's compensation benefits. Appellant claims the Medical Commission was without jurisdiction to hear her case and exceeded its statutory authority in deciding issues of law. Finding that appellant's case was not a "medically contested case" as required by Wyo. Stat. § 27-14-616 (Cum.Supp.1994), we reverse the district court and remand.

I. ISSUES

Appellant, Alice D. French (French), presents eight issues framed in argumentative language and of dubious factual accuracy. We therefore choose to list here the headings of the three arguments contained in French's appellate brief:

I: [Whether] [t]he exercise of jurisdiction by the Medical Panel in the circumstances of this case was wholly erroneous and improper.

II: [Whether] [t]he Medical Panel usurped the roles of the Legislature and of the Supreme Court, improperly created a new "defense at law" to worker's compensation claims and improperly applied its new rule retroactively to this case.

III: [Whether] [t]he rulings of the Medical Panel ignore and violate the plain provisions of the Wyoming worker's compensation statute.

The employer, Amax Coal West (Amax), as appellee, responds with the following issues:

1. Whether the Medical Commission had jurisdiction to hear and decide all issues in this case?

2. Whether the Medical Commission's decision was arbitrary, capricious, an abuse of discretion, otherwise not in accordance with law or unsupported by substantial evidence?

State ex rel. Wyoming Workers' Compensation Division (Division) joined the appellate brief filed by Amax and asserted the same arguments.

II. FACTS

French was employed as a coal haul truck driver for Amax. On January 8, 1995, after finishing her lunch break in the haul truck, she resumed driving, became nauseated, and "passed out." The haul truck continued moving, proceeding over the highwall, where it fell to the coal pit below. The accident resulted in a head laceration, broken nose and teeth, and injury to French's back. At the time of the accident, it was windy and cold, and there had been two haul trucks parked up-wind, adjacent to French's haul truck throughout her lunch break. On these facts, French surmised that carbon monoxide poisoning caused her to lose consciousness.

Following the accident, French was taken to the hospital emergency room where Dr. Sara Hartsaw noted that the patient was taking Tegretol (an anti-convulsant medication), and had a history of seizures "which feel like fainting, last one, 1 yr. ago." After filing her claim for worker's compensation benefits with the Division, the Division requested information concerning why and when Tegretol was prescribed so the compensability of the case could be determined. On February 8, 1995, the Division issued its final determination denying benefits, stating that the "[m]edical records indicate your injury was caused by a loss of consciousness due to a pre-existing medical condition (seizures)." Through her attorney, French replied to the Division's request for information, explaining that her lost consciousness was likely due to carbon monoxide from the exhaust of the haul trucks, and that she was not claiming benefits for the condition which caused her to lose consciousness but only for the injuries she sustained from the accident at work. In response, the Division issued an amended final determination finding her injuries to be compensable.

Amax then filed an objection to the Division's determination and requested a hearing, claiming French did not suffer an "injury" as defined in Wyo. Stat. § 27-14-102(a)(xi) (Cum.Supp.1994). Amax alleged that the condition which caused the accident existed at the time French sought employment, even though her work application stated she did not have and did not suffer from seizures. Therefore, the injury did not arise out of and in the course of employment. At the same time, the employer filed a request that this case be referred to the Medical Commission because "the issues involved are complex issues of medical causation best resolved by a medical hearing panel."

The Division referred the case to the Medical Commission on March 29, 1995. The Medical Commission issued its initial scheduling order on April 6, 1995, in which it requested, among other things, that the parties identify the "contested medical issues to be determined at the hearing[.]" The parties were not asked to identify legal issues. On June 19, 1995, the Medical Commission issued an order setting an evidentiary hearing for August 30, 1995, and designating the hearing panel members. On the same day, the Medical Commission issued a second order which contained a section entitled "Judicial Notice Taken:"

Under W.S. § 16-3-108(d) and Chapter 8, § 1(g)[ ¹] of the Regular Rules of the Medical Commission, the hearing panel takes judicial notice of the following:

1. The fact that neuro-induced or neurogenic syncope is not a coronary condition.

2. The decision of the Wyoming Supreme Court in Long v. Big Horn Construction Company, 75 Wyo. 276, P.2d 750 (1956). [ ²]

The parties shall be afforded an opportunity to address the judicial notice taken by the Medical Commission hearing panel through the submission of briefs on these issues by August 1, 1995.

No party submitted briefs addressing the judicial notice. However, on August 22, 1995, after continuing discovery, discussion, and clarification of the issues, the parties stipulated to relevant facts and, concluding that resolution of the case rested primarily on issues of law, the parties requested termination of the case and referral of the proceedings to the Office of Administrative Hearings. This request was denied in an Order Rejecting Stipulation, which stated in relevant part:

The Medical Commission is prohibited by statute from reviewing the decision to refer a case to the commission for hearing [Wyo. Stat. § 27-14-616(b)(iv) ]. The statute grants authority to the Medical Commission to "hear and decide all issues related to the written notice of objection." Though W.S. § 27-14-616(e) specifically provides that parties may agree to have a case transferred from the Office of Administrative Hearings to the Medical Commission for hearing, no provision is made to permit parties to transfer a case before the Medical Commission to the Office of Administrative Hearings, as anticipated by said STIPULATION filed herein.

(Emphasis in original.)

The transcript of the evidentiary hearing before the medical hearing panel on August 30, 1995 indicates that the parties filed a second stipulation with a request to certify the legal issues to the district court. The factual stipulations were accepted. However, the medical hearing panel reserved for later determination whether it would accept the parties' stipulations as to the legal issues and whether it would reconsider certification of the issues to the district court. After the close of the hearing and the receipt of additional employment and medical records, the medical hearing panel entered its decision on December 12, 1995.

The medical hearing panel found that an exact diagnosis of the condition which caused French to lose consciousness at the time immediately preceding the accident was not necessary. Instead, the medical hearing panel reviewed her medical records preceding the incident and compared her earlier reports of symptoms to the symptoms reported after the incident. Based on this comparison, the medical hearing panel concluded that French's loss of consciousness was caused by the same condition she experienced prior to seeking employment with Amax. The medical hearing panel further determined that French had knowingly misrepresented her physical status to the employer, and had she correctly apprised the employer of her condition, she would not have been hired. In conclusion, the medical hearing panel stated:

Ms. French has failed to show, by a preponderance of the evidence, that the injuries she incurred as a result of a fainting episode on January 8, 1995, while in the employ of Amax Coal West, are compensable under Long v. Big Horn Construction Company, 75 Wyo. 276, P.2d 750 (1956).

French timely filed an appeal to the district court, which affirmed the Medical Commission's decision. This appeal followed.

III. STANDARD OF REVIEW

Review of an appeal from an administrative decision is governed by the provisions of Wyo. Stat. § 16-3-114(c)(ii)(C) (1997), which directs a reviewing court to "[h]old unlawful and set aside agency action, findings and conclusions found to be * * * [i]n excess of statutory jurisdiction, authority or limitations or lacking statutory right[.]" Russell v. State ex rel. Wyoming Workers' Safety and Compensation Div., 944 P.2d 1151, 1155 (Wyo.1997). The interpretation of statutes is a question of law to be reviewed de novo. Painter v. State ex rel. Wyoming Workers' Compensation Div., 931 P.2d 953, 954 (Wyo.1997); Chevron U.S.A., Inc. v. State, 918 P.2d 980, 983 (Wyo.1996). When considering an appeal from a district court's review of agency action, we...