State ex rel. Dep't of Workforce Servs. v. Hall (In re Hall), S-17-0176

• Decision Date: 30 March 2018
• Docket Number: S-17-0176
• Citation: 414 P.3d 622
• Parties: In the MATTER OF the Worker's Compensation Claim of James A. HALL. State of Wyoming, ex rel., Department of Workforce Services, Workers' Compensation Division, Appellant (Respondent), v. James A. Hall, Appellee (Petitioner).
• Court: Wyoming Supreme Court

414 P.3d 622

In the MATTER OF the Worker's Compensation Claim of James A. HALL.State of Wyoming, ex rel., Department of Workforce Services, Workers' Compensation Division, Appellant (Respondent),

v.James A. Hall, Appellee (Petitioner).

S-17-0176

Supreme Court of Wyoming.

March 30, 2018

Representing Appellant: Peter K. Michael, Wyoming Attorney General; J.C. Demers, Senior Assistant Attorney General; Benjamin E. Fischer, Assistant Attorney General.

Representing Appellee: Brian J. Hunter, McKellar, Tiedeken & Scoggin, LLC, Cheyenne, Wyoming.

Before BURKE, C.J., and HILL^* , DAVIS, FOX, and KAUTZ, JJ.

FOX, Justice.

[¶1] Approximately six years after receiving workers' compensation benefits for a workplace injury to his right knee, James A. Hall underwent another knee surgery, approved by the State of Wyoming Workers' Compensation Division (the Division). The Division denied Mr. Hall's application for temporary total disability (TTD) benefits, alleging that Wyo. Stat. Ann. § 27-14-605(b) terminated Mr. Hall's right to TTD benefits. On summary judgment, the Office of Administrative Hearings (OAH) did not uphold the Division's determination, concluding that § 27-14-605 did not govern Mr. Hall's claim and Mr. Hall was entitled to TTD benefits as a matter of law. The district court affirmed the OAH's judgment, and the Division now appeals. We affirm.

ISSUE

[¶2] The Division raises one issue in this appeal, rephrased as: Does Wyo. Stat. Ann. § 27-14-605 bar a claimant from receiving temporary total disability benefits for a second compensable injury when he has not filed a claim for benefits on his original injury within four years?

FACTS

[¶3] The facts of this case are not disputed. In 2007, Mr. Hall suffered a work-related injury to his right knee, for which the Division paid medical and TTD benefits. Mr. Hall underwent arthroscopic surgeries in 2007 and 2008 and filed no further claims for benefits until 2014, when the Division "reopened" Mr. Hall's claim for medical benefits and preapproved a total knee arthroplasty. After the surgery, Mr. Hall's physician certified him as temporarily totally disabled as a result of the arthroplasty, but the Division denied Mr. Hall's application for TTD benefits. The Division stated that it could reopen Mr. Hall's case only for medical benefits pursuant to Wyo. Stat. Ann. § 27-14-605(c).

[¶4] Mr. Hall appealed the Division's determination to the OAH. The Division agreed that the total knee arthroplasty was reasonable, necessary, and related to Mr. Hall's 2007 work injury. The Division also agreed that Mr. Hall met the causation requirements of either § 27-14-605(c) or the second compensable injury rule. The sole issue was whether Mr. Hall was entitled to TTD benefits related to the total knee arthroplasty after not seeking benefits on his original injury for over four years. On summary judgment, the OAH concluded that Mr. Hall suffered a second compensable injury that § 27-14-605 did not control, thus entitling Mr. Hall to TTD benefits. The district court affirmed the OAH's decision. The Division timely filed this appeal.

STANDARD OF REVIEW

[¶5] The parties ask us to interpret § 27-14-605 and its applicability to second compensable injuries, which are questions of law that we review de novo. State ex rel.,Wyo. Workers' Safety & Comp. Div. v. Smith , 2013 WY 26, ¶ 9, 296 P.3d 939, 942 (Wyo. 2013). "Conclusions of law made by an administrative agency are affirmed only if they are in accord with the law. We do not afford any deference to the agency's determination, and we will correct any error made by the agency in either interpreting or applying the law." Id. (citations omitted). We review the district court's decision as if it had come directly from the administrative agency. Id. (citation omitted).

DISCUSSION

[¶6] The Wyoming Worker's Compensation Act (the Act), Wyo. Stat. Ann. §§ 27-14-101 through 27-14-806 (LexisNexis 2017), provides employees exclusive rights and remedies against employers for workplace injuries. Wyo. Stat. Ann. § 27-14-104(a). Under the Act, an "injury" is "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 ...." Wyo. Stat. Ann. § 27-14-102(a)(xi). We have long held that "the term ‘injury,’ as used in the Worker's Compensation [Act], means compensable injury and is not used in the sense of the occurrence of an industrial accident giving rise to or causing the compensable injury." Smith , 2013 WY 26, ¶ 14, 296 P.3d at 943 (quoting In re Barnes , 587 P.2d 214, 218 (Wyo. 1978) ). Thus, "a single incident at work can give rise to more than one compensable injury." Hardy v. State ex rel. Dep't of Workforce Servs., Workers' Comp. Div. , 2017 WY 42, ¶ 12, 394 P.3d 454, 457 (Wyo. 2017) (citations omitted).

[¶7] What is commonly known as a "second compensable injury" includes, as is the case here, "an initial compensable injury [that] ripens into a condition requiring additional medical intervention." Id. (citing Kenyon v. State ex rel. Wyo. Workers' Safety & Comp. Div. , 2011 WY 14, ¶ 15, 247 P.3d 845, 850 (Wyo. 2011), quoting Yenne-Tully v. Workers' Safety & Comp. Div., Dep't of Emp't , 12 P.3d 170, 172 (Wyo. 2000) ( Yenne-Tully I ) ); see also Casper Oil Co. v. Evenson , 888 P.2d 221, 224-25 (Wyo. 1995) ; In re Barnes , 587 P.2d at 215-19. This is consistent with § 27-14-102(a)(xi), as the additional medical intervention is necessitated by a "harmful change in the human organism other than normal aging." The "second compensable injury rule" requires a claimant to prove "by a preponderance of the evidence, that it is more probable than not that a causal connection exists between the first and second injuries." Hardy , 2017 WY 42, ¶ 12, 394 P.3d at 457 (citing In re Kaczmarek , 2009 WY 110, ¶ 11, 215 P.3d 277, 282-83 (Wyo. 2009) ).

[¶8] Once an employee establishes that his injury is compensable under the Act, he may apply to the Division for a range of benefits, such as compensation for medical expenses, temporary disability, permanent disability, vocational rehabilitation, and death. See Wyo. Stat. Ann. §§ 27-14-401 through 27-14-408. One such benefit is TTD, which Wyoming law defines as "that period of time an employee is temporarily and totally incapacitated from performing employment at any gainful employment or occupation for which he is reasonably suited by experience or training .... [which] terminates at the time the employee completely recovers or qualifies for benefits under W.S. 27-14-405 or 27-14-406." Wyo. Stat. Ann. § 27-14-102(a)(xviii). The purpose of a TTD award is "to provide income for an employee during the time of healing from his injury and until his condition has stabilized." Smith , 2013 WY 26, ¶ 10, 296 P.3d at 942 (citation omitted). Wyo. Stat. Ann. § 27-14-404(a) entitles an employee to receive TTD "if after a compensable injury is sustained and as a result of the injury the employee is subject to temporary total disability as defined under W.S. 27-14-102(a)(xviii)."

[¶9] The Division argues that § 27-14-605 limits the award of TTD benefits for second compensable injuries, terminating all but medical benefits to a claimant who, as here, suffers a second compensable injury outside the four-year limitation period of § 27-14-605(a). We have regularly rejected similar arguments in the past.¹ The Division nevertheless urges us to abandon our long-established caselaw to adopt its interpretation of § 27-14-605(b) and (c).

[¶10] We recognize "a strong interest in adhering to past precedent under the doctrine of stare decisis. " Collins v. COP Wyo., LLC , 2016 WY 18, ¶ 15, 366 P.3d 521, 525 (Wyo. 2016) (citations omitted). The principle of stare decisis furthers the "evenhanded, predictable, and consistent development of legal principles, fosters reliance on judicial decisions, and contributes to the actual and perceived integrity of the judicial process." State ex rel. Wyo. Workers' Comp. Div. v. Barker , 978 P.2d 1156, 1161 (Wyo. 1999) (quoting Cook v. State , 841 P.2d 1345, 1353 (Wyo. 1992), in turn quoting Payne v. Tennessee , 501 U.S. 808, 827, 111 S.Ct. 2597, 2609, 115 L.Ed.2d 720 (1991) ). Although we are not compelled to follow precedent that is poorly reasoned or no longer workable, Barker , 978 P.2d at 1161, our examination of the plain text of § 27-14-605 confirms that our precedent on this issue is sound.

[¶11] Wyo. Stat. Ann. § 27-14-605 is titled "Application for modification of benefits; time limitation; grounds; termination of case; exceptions ," and provides that,

(a) If a determination is made in favor of or on behalf of an employee for any benefits under this act, an application may be made to the division by any party within four (4) years from the date of the last payment for additional benefits or for a modification of the amount of benefits on the ground of increase or decrease of incapacity due solely to the injury, or upon grounds of mistake or fraud. The division may, upon the same grounds and within the same time period, apply for modification of medical and disability benefits to a hearing examiner or the medical commission, as appropriate.

(b) Any right to benefits shall be terminated and is no longer under the jurisdiction of this act if a claim for any benefit is not filed with the division within the four (4) year limitation prescribed under subsection (a) of this section.

(c) A claim for medical benefits which would otherwise be terminated under subsection (b) of this section and barred under W.S. 27-14-503(a) and (b) may be paid by the division if the claimant:

(i) Submits medical reports to the division substantiating his claim;

(ii) Proves by competent medical authority and to a reasonable degree of medical certainty that the condition is directly related to the original injury; and

(iii) Submits to an examination by a health care provider selected by the division and results of the examination

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