Koester v. State Ins. Fund

• Decision Date: 27 August 1993
• Docket Number: No. 19610,19610
• Citation: 124 Idaho 205,858 P.2d 744
• Court: Idaho Supreme Court
• Parties: , 22 A.L.R.5th 824 Debi KOESTER, Claimant-Appellant, v. State of Idaho, Community Action Program, Department of Health & Welfare, Employer, Defendant, STATE INSURANCE FUND, Defendant-Respondent. Coeur D'Alene, May 1993 Term

Page 744

858 P.2d 744

124 Idaho 205, 22 A.L.R.5th 824

Debi KOESTER, Claimant-Appellant, v. State of Idaho, Community Action Program, Department of Health & Welfare, Employer, Defendant STATE INSURANCE FUND, Defendant-Respondent.

No. 19610.

Supreme Court of Idaho,

Coeur D'Alene, May 1993 Term.

Aug. 27, 1993.

Cooke, Lamanna, Smith & Cogswell, Priest River, for appellant. Nicholas M. Lamanna, argued.

Larry EchoHawk, Atty. Gen., Boise, and Randall, Blake & Cox, Lewiston, for respondent. Jay P. Gaskill, argued.

SILAK, Justice.

Debi Koester sought worker's compensation benefits for two separate injuries: the first was Lyme disease from an alleged tick bite, and the second was a back injury from a fall, both of which she claimed occurred during the course of her employment as a homemaker for the State of Idaho Community Action Program (Action), who carried workers' compensation insurance through the State Insurance Fund (State Fund). Koester appeals from the Industrial Commission's order adopting the findings and conclusions made by a Commission referee that State Fund was not liable for the injury allegedly resulting from an insect bite.

FACTS AND PROCEDURAL BACKGROUND

Koester went to work for Action in the first part of 1988 as a home care provider. Koester's duties included entering the homes of elderly persons who were either confined or needed help caring for themselves. One of her clients was an elderly woman who lived in a small trailer outside of Potlatch, Idaho, along with as many as twenty-five cats, which were not allowed outside the home. The home was in a deplorable condition.

One day during the first two weeks of May 1988, while cleaning this client's bed, Koester felt an itching sensation on the inside of her left ankle. She did not immediately look at the spot, but loaded up the soiled linen and advised the client that she was leaving to take the bedding to the laundromat. Koester then looked down and noticed that she had "got a bite." Koester did not see what bit her, nor did she "actually feel the bite initiate." The bite produced continual itching and a discolored inflammation about two to three inches in diameter. She applied a local antibiotic ointment and the inflammation disappeared after two weeks. The day after the bite, Koester showed the mark to a co-worker, a secretary, and her work supervisor at Action and reported that she had been bitten. She did not, however, report this bite to her doctor. The bite did not Koester continued to work for Action until July 27, 1989. On that date, Koester sustained the back injury underlying her second claim. The injury occurred when she slipped and fell while cleaning the home of a client. Koester went to an orthopedic surgeon, Dr. Graeme French (French), for treatment of her back injury. Initially, French diagnosed Koester with a sprained sacroiliac. However, after she responded negatively to therapy, French made additional inquiries into Koester's health. French inquired into Koester's medical history and found symptoms of severe headaches, loss of sensation in her extremities, swelling in her lymph glands, and pain in her muscles and joints. French had tests performed from which he concluded that Koester's symptoms were probably caused by a neuroborreliosis infection and diagnosed chronic Lyme disease. He concluded further that the pain which Koester continued to experience in her back and left leg was largely attributable to Lyme disease, not solely the back injury she suffered when she fell in July of 1989. State Fund had been paying Koester disability benefits for her back injury; however, after French reported that Koester's continuing disability was most likely caused by Lyme disease, State Fund denied her any further benefits.

[124 Idaho 207] affect her ability to work during that time. Within two to three months after the bite, Koester began to experience numbness and tingling in her extremities, increasingly severe headaches, irregular heart palpitations and chest pains. Koester's physician at the time, Dr. Carl Melina, considered the symptoms to be caused by stress from her work and family responsibilities.

Koester subsequently filed two applications for hearing seeking to recover benefits for her first injury (Lyme disease) which she alleged resulted from an accident (tick bite) she suffered on the job in May 1988, and for her second injury (back) when she fell at work in July 1989. Koester's claims were consolidated and heard by a referee on April 18, 1991. In the findings of fact, conclusions of law, and proposed order, the referee found that Koester had failed to meet her burden of showing that her first disability resulted from an injury which occurred in the course of her employment. Therefore, the referee concluded it was not necessary to determine whether Koester had Lyme disease.

The referee concluded that Koester could not identify what bit her, or when, and it was impossible to ascertain whether the insect bite which caused the Lyme disease occurred on the job or somewhere else. Koester claimed she received the insect bite which caused her Lyme disease which she was working the client's home described above. The referee found, however, that although the conditions in the client's home were deplorable and the client and many cats lived in filthy conditions, the evidence showed that the client was bedridden, the cats were never allowed to leave the trailer, and there was no evidence from which to infer the presence of ticks or lice in the home. During 1988, Koester and her family lived in a residential area of Potlatch with two large fir trees in the backyard, grass in the yard, lilac bushes along the side of the house, and other trees growing at the edge of town. Koester owned two outside pets and one inside pet. Koester's husband was logging during the months of May, June and July of 1988, and when he was working, he was in the woods; he started back to work after "breakup" and would return home each night after work. Based on this evidence, the referee found that Koester "may actually have been more likely to encounter ticks in her own home than" in the client's home where she claims to have been bitten. Therefore, the referee concluded, Koester had failed to meet her burden of proving that she contacted, and was bitten by, a tick or louse in the course of her employment.

Based on these findings the referee concluded that Koester was not entitled to benefits for her disabilities related to Lyme disease. The referee found, however, that Koester was entitled to the benefits she had already received for her back injury, but because she had failed to show that her continuing disability was related to her back injury and not the Lyme disease These findings and conclusions were issued on September 19, 1991. On September 30, 1991, the Industrial Commission adopted and filed the referee's findings and conclusions and issued an order denying Koester's claim based upon the insect bite. Koester filed a notice of appeal on October 23, 1991.

[124 Idaho 208] Koester was not entitled to any further benefits on her second claim.

ISSUES

Although Koester asserts three issues on appeal, her appeal raises only one issue: whether the Industrial Commission's findings and conclusions are supported by substantial competent evidence. The other issues Koester raises concern the medical diagnosis of Lyme disease and her credibility concerning her medical condition. Because the Commission did not rule on Koester's medical diagnosis, these issues are not properly before this Court and we will not address them.

STANDARD OF REVIEW

In appeals from the Industrial Commission our review is limited to whether the Commission's factual findings are supported by substantial and competent evidence. Neufeld v. Browning Ferris Industries, 109 Idaho 899, 902, 712 P.2d 600, 603 (1985); IDAHO CONST. art. V, § 9; I.C. § 72-732. The determination whether an injury arose from the course of employment is a question of fact. Id. This determination requires the weighing of evidence and assessing the credibility of witnesses, and the Commission's conclusions as to weight and credibility will not be disturbed unless they are clearly erroneous. Id. While the Workers' Compensation Act is to be construed liberally in favor of the injured employee, Steinebach v. Hoff Lumber Company, 98 Idaho 428, 431, 566 P.2d 377, 340 (1977), a claimant has the burden of proving a probable, not merely a possible, causal connection between the employment and the injury or disease. Neufeld, 109 Idaho at 902, 712 P.2d at 603.

KOESTER FAILED TO PROVE HER INJURY WAS JOB RELATED

Koester argues that "the medical evidence did prove that [she] was bitten" on the job and that "in all probability" the insect bite that she received in May 1988, occurred in the course of her employment. To support her arguments, Koester's brief cites extensively from the depositions of her doctors; however, she failed to provide this Court with a record that included the depositions. The record before us shows that Koester presented testimonial evidence wherein she states, "[w]hen I got the bite, I was in the home of Kathryn Edar, I was stripping her bed. I didn't actually feel the bite initiate." In addition, she testified that the bite became inflamed and produced a patchy discolored spot around the bite which lasted approximately two to three weeks after the bite was discovered.

State Fund argues that there was no direct evidence of when or by what Koester was bitten. To support its argument State Fund points out the following: Koester merely noticed for the first time what she alleged was a bite while she was cleaning a client's home. She never actually saw what bit her. There was no evidence from which to infer the presence of ticks or lice in the client's home. The only insects Koester ever testified she observed in the home were flies. Further, the client was bedridden and her pets were never...