In re Worker's Compensation Claim of David

• Court: Wyoming Supreme Court
• Writing for the Court: Hill
• Citation: In re Worker's Compensation Claim of David, 151 P.3d 280, 2007 WY 22 (Wyo. 2007)
• Decision Date: 08 February 2007
• Docket Number: No. 06-101.,06-101.
• Parties: In the Matter of the WORKER'S COMPENSATION CLAIM OF Daniel J. DAVID, an Employee of PDQ Transport, Inc. Daniel J. David, Appellant (Petitioner), v. State of Wyoming, ex rel., Wyoming Workers' Safety and Compensation Division, Appellee (Respondent).

151 P.3d 280

2007 WY 22

In the Matter of the WORKER'S COMPENSATION CLAIM OF Daniel J. DAVID, an Employee of PDQ Transport, Inc Daniel J. David, Appellant (Petitioner), v. State of Wyoming, ex rel., Wyoming Workers' Safety and Compensation Division, Appellee (Respondent).

No. 06-101.

Supreme Court of Wyoming.

February 8, 2007.

Representing Appellant: Sean W. Scoggin of Tiedeken & Scoggin, P.C., Cheyenne, Wyoming.

Representing Appellee: Patrick J. Crank, Wyoming Attorney General; John W. Renneisen, Deputy Attorney General; Steven R. Czoschke, Senior Assistant Attorney General; and Kristi M. Radosevich, Assistant Attorney General.

Before VOIGT, C.J., and GOLDEN, HILL, KITE, and BURKE, JJ.

HILL, Justice.

[¶ 1] Daniel J. David (David) appeals an order of the Office of Administrative Hearings denying medical and temporary total disability benefits for a lower back injury on the grounds that David had not met his burden of establishing that the requested benefits were for a work-related injury. We affirm.

ISSUES

[¶ 2] David sets forth three issues in his brief:

I. Whether the Office of Administrative Hearing [sic] examiner erred as a matter of law when he applied the incorrect burden of proof at the hearing of this matter.

II. Whether the Office of Administrative Hearing [sic] erred as a matter of law in failing to consider the facts of this case under the second compensable injury rule.

III. Whether the Office of Administrative Hearing [sic] examiner's decision that Mr. David's treatment and claims for disability benefits after September 13, 2004 were not work related for the purposes of worker's compensation benefits was arbitrary and capricious and not supported by the substantial evidence presented at the hearing and the standing case law.

FACTS

[¶ 3] In July of 2004, David was working for PDQ Transport of Cheyenne as a truck driver. He submitted an injury report to the Wyoming Workers' Safety and Compensation Division (Division) on July 22, 2004, claiming that an injury to his lower back occurred while he was strapping a tarp over a load. David had a long history of lower back problems. He had been treated for a herniated disc in the mid-1980's and suffered a non-work related lower back injury in July of 2001 that included pain radiating into his right leg. David received periodic chiropractic treatments for his back. He also had been treated for lower back and hip pain in early 2004.

[¶ 4] The Division concluded that David had suffered a compensable work-related injury and on August 11, 2004, issued a Final Determination opening a case and awarding medical benefits. On August 25, 2004, the Division issued a Final Determination awarding David temporary total disability benefits. Sometime in mid-September David fell at home, causing further injury to his back. On September 29, 2004, the Division notified David that pursuant to its authority under Wyo. Stat. Ann. § 27-14-601(b) (LexisNexis 2005),¹ it would no longer approve payment of any benefits for claims connected with the July 21, 2004 injury. The Division determined that "a new incident occurred on 9/13/2004 and current medical treatment is no longer directly and completely related to the work incident."

[¶ 5] David objected to the Division's determination, and a contested case hearing was scheduled. In its pre-hearing disclosure statement, the Division framed the issue before the hearing examiner as to whether David's back injury was the product of a pre-existing condition or an intervening trauma, and that the burden was on David to establish the compensability of his injury. In his disclosure statement, David countered that Wyo. Stat. Ann. § 27-14-601(b) did not give the Division the authority to terminate benefits and, since benefits had been awarded, the burden was on the Division to seek modification pursuant to Wyo. Stat. Ann. § 27-14-605(a) (LexisNexis 2005).² David reiterated that position at the commencement of the hearing. The hearing examiner took the question regarding the burden of proof under advisement and proceeded with the hearing. Both parties produced evidence. David testified and described his back injury that occurred while he was strapping a load onto his truck. He acknowledged his history of back problems but insisted that the pain related to this injury was different than that associated with his prior injuries. David attributed the cause of his fall in mid-September of 2004 to weakness in his leg caused by his work-related injury. He described the injury resulting from the fall as a "mild" scrape on his upper back and denied that the fall had any effect on his work-related back injury. David also offered the deposition testimony of his treating physician and physical therapist. Both medical professionals opined that David's benefit claims were related to the July 7, 2004 work injury. The Division's evidence consisted of medical records detailing David's history of medical treatment for his back.

[¶ 6] On August 12, 2005, the hearing examiner issued an order denying benefits. Initially, the examiner rejected David's argument that the Division had to file a petition to modify under § 27-14-605(a) instead holding that the Division could approve or deny any claim for medical benefits pursuant to § 27-14-601(b), and the burden was on David to establish that his claims for benefits were related to an injury that arose out of and in the course of his employment. The hearing examiner concluded that David had failed to meet that burden, finding that the medical opinions offered by his treating physician and physical therapist were not persuasive because neither of them possessed a complete medical history of David's back treatments. The district court affirmed the hearing examiner's decision and David has now brought the matter before this Court.

STANDARD OF REVIEW

[¶ 7] We do not afford any special deference to the district court's decision. We review the case as if it has come to us directly from the administrative agency. Alcorn v. Sauer Drilling Company, 2006 WY 15, ¶ 6, 126 P.3d 924, 925 (Wyo.2006) (citing Bailey v. State ex rel. Wyoming Workers' Compensation Division, 2002 WY 145, ¶ 9, 55 P.3d 23, 26 (Wyo.2002)). The scope of our review is dictated by Wyo. Stat. Ann. § 16-3-114(c) (LexisNexis 2005):

(c) To the extent necessary to make a decision and when presented, the reviewing court shall decide all relevant questions of law, interpret constitutional and statutory provisions, and determine the meaning or applicability of the terms of an agency action. In making the following determinations, the court shall review the whole record or those parts of it cited by a party and due account shall be taken of the rule of prejudicial error. The reviewing court shall:

(i) Compel agency action unlawfully withheld or unreasonably delayed; and

(ii) Hold unlawful and set aside agency action, findings and conclusions found to be:

(A) Arbitrary, capricious, an abuse of discretion or otherwise not in accordance with law;

(B) Contrary to constitutional right, power, privilege or immunity;

(C) In excess of statutory jurisdiction, authority or limitations or lacking statutory right;

(D) Without observance of procedure required by law; or

(E) Unsupported by substantial evidence in a case reviewed on the record of an agency hearing provided by statute.

Olivas v. State ex rel. Wyoming Workers' Safety and Compensation Division, 2006 WY 29, ¶ 11, 130 P.3d 476, 481-82 (Wyo.2006). When a hearing examiner has concluded that a worker's compensation claimant failed to meet his or her burden of proof, our review is pursuant to the arbitrary and capricious standard:

Under the arbitrary, capricious and abuse of discretion standard, we are charged with examining the entire record. In our examination and review of a hearing examiner's determination, we defer to the hearing examiner's findings of fact. We will examine conflicting and contradictory evidence to see if the hearing examiner reasonably could have made its findings based on all the evidence before it. The findings of fact may include determinations of witness credibility, as the hearing examiner is charged with determining the credibility of the witnesses. In our review, we will not overturn the hearing examiner's determinations regarding witness credibility unless they are clearly contrary to the overwhelming weight of the evidence.

Finley v. State ex rel. Wyoming Workers' Safety and Compensation Division, 2006 WY 46, ¶ 7, 132 P.3d 185, 187-88 (Wyo.2006) (quoting Boyce v. State ex rel. Wyoming Workers' Safety and Compensation Division, 2005 WY 9, ¶ 6, 105 P.3d 451, 454 (Wyo.2005); and Brees v. Gulley Enterprises, Inc., 6 P.3d 128, 132 (Wyo.2000)).

DISCUSSION

[¶ 8] Initially, David contends that the hearing examiner erred as a matter of law when he applied § 27-14-601(b) and placed the burden of proof on him. He argues that once the Division determined that he had suffered a compensable injury and awarded medical and temporary total disability benefits, termination of those benefits could only be accomplished by a petition for modification by the Division under § 27-14-605(a).

[¶ 9] This is not the first opportunity we have had to consider the interrelation between § 27-14-601(b) and § 27-14-605(a). In Martinez v. State ex rel. Wyoming Workers' Compensation Division, 917 P.2d 619 (Wyo.1996), the claimant suffered a work-related elbow injury on July 21, 1993. Five days later he was arrested after an altercation with police. While incarcerated, the claimant received medical treatment for the same elbow. Claimant was initially awarded benefits, including temporary total disability. Claimant continued to receive benefits until January of 1994, when the employer and Division objected to further payments and sought to recover payments already made on the grounds of mistake. After a contested case hearing, the hearing examiner concluded that the employer and Division had failed...