Jaqua v. State ex rel. Wyoming Workers' Compensation Div.

• Decision Date: 03 May 1994
• Docket Number: No. 93-167,93-167
• Citation: 873 P.2d 1219
• Parties: Donald T. JAQUA, Appellant (Petitioner), v. STATE of Wyoming, ex rel., WYOMING WORKERS' COMPENSATION DIVISION, Appellee (Respondent).
• Court: Wyoming Supreme Court

Page 1219

873 P.2d 1219

Donald T. JAQUA, Appellant (Petitioner), v. STATE of Wyoming, ex rel., WYOMING WORKERS' COMPENSATION DIVISION, Appellee (Respondent).

No. 93-167.

Supreme Court of Wyoming.

May 3, 1994.

Donald L. Painter, Casper, for appellant.

Joseph B. Meyer, Atty. Gen., John W. Renneisen, Deputy Atty. Gen., Kenneth E. Spurrier, Asst. Atty. Gen., W. Thomas Sullins, II, Sp. Asst. Atty. Gen., for appellee.

Before MACY, C.J., and THOMAS, CARDINE, GOLDEN and TAYLOR, JJ.

THOMAS, Justice.

The sole issue presented in this appeal is whether substantial evidence exists to support a denial of benefits under the Wyoming Worker's Compensation Act (WYO.STAT. §§ 27-14-101 to -805 (1991 & Supp.1993)). Donald T. Jaqua (Jaqua), in a creative manner, attempts to couch the question as one of law; but we are satisfied the determination by the hearing examiner is supported by substantial evidence, and the question truly is one of fact. Jaqua asserted an entitlement to benefits because of a back injury he sustained as a result of a fall on stairs while working as an employee of the Wyoming Highway Department. The Worker's Compensation Division (State) asserts that Jaqua is not entitled to benefits because the medical expenses and any disability were attributable to a preexisting condition. We hold Jaqua did not satisfy his burden of proof to establish his injury was related to his work. We affirm the Order on Appeal entered in the district court affirming the decision of the hearing examiner.

In his Appellant's Brief, Jaqua states this issue:

1. Whether Defendant's "injury" was, as a matter of law, a new injury or a recurrence of an old injury.

In the Brief of Appellee, the issue is asserted to be factual and is stated as:

I. Whether substantial evidence exists to support the hearing examiner's denial of employee-claimant's claim for worker's compensation benefits.

Jaqua was employed by the Wyoming State Highway Department (Department) in 1984. More than twenty years earlier, he sustained an injury to his back while serving in the Navy in 1961. Jaqua testified he had experienced back discomfort on numerous occasions during the twenty-three year period between the injury when he was in the Navy and his employment at the Department. He treated this back discomfort with non-prescription medication. Later, he experienced occasional discomfort in his surveying work for the Department when he was doing extensive walking and carrying equipment.

In 1988, Jaqua had nonwork-related surgery on his back involving a decompression laminectomy and the removal of a herniated disc. His medical records show he suffered an injury, which was not compensable, from a fall in November of 1989. On July 18, 1990, a Magnetic Resonance Imaging (MRI) diagnosis was accomplished due to bilateral hip pain and right side back pain, apparently induced by the 1989 fall. Again, on April 6, 1992, Jaqua sought treatment for his back condition. The report of the physician advises, "He [Jaqua] has progressive increasing symptoms over the past few years. He complains of pain in his back which radiates into his buttocks, notes feeling of numbness in both legs." The physician prescribed a back rehabilitation program.

Three weeks later, on April 27, 1992, according to Jaqua's report, he lost his footing, fell down a few stairs, landed in a sitting position, and injured his arm and buttocks while at work. He sought treatment from a physician in Phoenix, Arizona whose medical history record noted the failure of conservative treatment of rest, time, therapy, and past surgery, and also noted a continuing disk problem that had troubled Jaqua for a prolonged period. The Arizona physician performed back surgery on July 14, 1992.

Jaqua filed an Employee's Report of Injury, Occupational Illness or Disease related to the April 27, 1992 fall. The State issued an Initial Review--Due to Pre-Existing Condition and denied benefits because the medical reports reflected Jaqua's back condition was preexisting. Subsequently, the State furnished a Determination of Disputed Claim in which benefits again were denied because no medical evidence established Jaqua's back condition was the result of the accident while at work. Jaqua objected to the determination by the State, and a contested case hearing was scheduled. The hearing was continued on two occasions, due to the hearing examiner's request for additional discovery, and culminated on the third occasion when the Order Denying Benefits was issued. The critical findings in that Order Denying Benefits are:

1. That Employee-Claimant has failed to meet his burden of proof with respect to the benefits claimed, and the objections of the Objector-Defendant, State of Wyoming, ex rel., Wyoming Workers' Compensation Division to the award of the benefits claimed is sustained.

2. That Employee-Claimant has failed to meet his burden of proof to establish an "injury" pursuant to W.S.1977, § 27-14-102(a)(xi).

3. That the evidence presented reflects that Employee-Claimant had a pre-existing injury or condition, and therefore the claims for benefits herein are precluded pursuant to W.S.1977, § 27-14-102(a)(xi)(F).

4. That as a result of the inconsistencies in the Employee-Claimant's testimony and asserted positions with the notes, records, and testimony of the medical care providers herein, the Employee-Claimant has failed to meet his burden to establish a work related injury herein.

This Order Denying Benefits was affirmed by the district court of the Seventh Judicial District after judicial review was sought. Jaqua has appealed the order of the district court.

Our standard of review with respect to factual determinations by administrative agencies, particularly in Worker's Compensation cases, is well known:

Our standard for reviewing findings of fact made in an administrative worker's compensation hearing is well settled. If, after examining the entire record, we find substantial evidence to support the agency's finding, we will not substitute our own judgment for that of the agency. Instead, we will uphold the agency's finding. Substantial evidence is relevant evidence which a reasonable person might accept as supporting the agency finding. Aanenson v. State of Wyoming ex rel. Wyoming Worker's Compensation Division, 842 P.2d 1077, 1079 (Wyo.1992).

Sinclair Trucking v. Bailey, 848 P.2d 1349, 1351 (Wyo.1993).

The party who appeals from an administrative determination has the burden of proving the lack of substantial evidence to sustain the ruling of the agency. Application of Campbell County, 731 P.2d 1174 (Wyo.1987). In order to prevail before the hearing examiner, Jaqua was charged with demonstrating an injury, arising from his employment, while at work. That definition of injury is found in the Wyoming Worker's Compensation Act as follows:

(xi) "Injury" means any harmful change in the human organism other than normal aging and includes damage to or loss of any artificial replacement and death, arising out of and in the course of employment while at work in or about the premises occupied, used or controlled by the employer and incurred while at work in places where the employer's business requires an employee's presence and which subjects the employee to extrahazardous duties incident to the business. "Injury" does not include:

* * *

(F) Any injury or condition preexisting at the time of employment with the employer against whom a claim is made.

WYO.STAT. § 27-14-102(a) (Supp.1993).

We emphasize the exclusion found in this statute.

At the hearing, Jaqua's evidence consisted primarily of his testimony, much of which supports the determination of a preexisting condition. He advised he experienced very uncomfortable backaches in 1961, although they were not debilitating. He claimed the Navy had diagnosed his problem as a prostate ailment. He conceded he was uncomfortable on numerous occasions because of his back ailment...