Weaver v. Cost Cutters

• Decision Date: 19 February 1998
• Docket Number: Nos. 97-68,97-106,s. 97-68
• Parties: Brenda K. WEAVER, Appellant (Petitioner), v. COST CUTTERS, Appellee (Respondent). Cost Cutters, Appellant (Employer/Respondent), and WYOMING WORKERS' SAFETY AND COMPENSATION DIVISION, Appellant (Objector/Respondent), v. Brenda WEAVER, Appellee (Employee/Petitioner).
• Court: Wyoming Supreme Court

Page 851

953 P.2d 851

Brenda K. WEAVER, Appellant (Petitioner), v. COST CUTTERS, Appellee (Respondent).

Cost Cutters, Appellant (Employer/Respondent), and WYOMING WORKERS' SAFETY AND COMPENSATION DIVISION, Appellant (Objector/Respondent), v. Brenda WEAVER, Appellee (Employee/Petitioner).

Nos. 97-68, 97-106.

Supreme Court of Wyoming.

Feb. 19, 1998.

Roger Fransen, HICKEY, MACKEY, EVANS, WALKER & STEWART, Cheyenne, for Appellant (Petitioner).

Steven K. Sharpe, ANTHONY, GOODRICH, NICHOLAS & SHARPE, LLC, Cheyenne, for Appellee (Respondent).

William U. Hill, Attorney General; John W. Renneisen, Deputy Attorney General; Gerald W. Laska, Senior Assistant Attorney General; and Bernard P. Haggerty, Assistant Attorney General, for Appellant (Objector/Respondent).

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

MACY, Justice.

These cases arose out of the same worker's compensation administrative hearing and were consolidated by this Court for our review and decision. The hearing examiner denied permanent partial impairment benefits for Brenda Weaver (the claimant) and considered Cost Cutters' (the employer) request to have the final determination modified on the grounds of mistake or fraud. Both parties, along with the Wyoming Workers' Safety and Compensation Division (the division), petitioned the district court to review the hearing examiner's order. The district court certified these cases to the Wyoming Supreme Court pursuant to W.R.A.P. 12.09(b).

We affirm in part, reverse in part, and remand.

ISSUES

The claimant offers the following issues for our review:

1. Whether the decision of the Office of Administrative Hearings to deny permanent partial impairment benefits is supported by substantial evidence.

2. Whether the Office of Administrative Hearings erred when it failed to recognize and give effect to a rebuttable presumption that [the claimant's] impairment was not caused by a preexisting condition.

The division and the employer present the following issues for our analysis:

A. Did the Hearing Examiner improperly deny modification of past benefits at a hearing on an outstanding permanent disability claim in which the Division was unrepresented?

B. Was the Hearing Examiner's decision limiting modification of benefits for fraud or mistake to outstanding claims contrary to law?

FACTS

The claimant worked for Cost Cutters as a cosmetologist. She claimed that she injured her back on July 29, 1994, when she slipped and fell at work while she was moving heavy boxes with a dolly. The claimant reported the accident to her manager on the day that the alleged fall occurred.

The employer's manager testified that the claimant was laughing while she was telling her about the fall and that the claimant indicated she did not need to go to a doctor. According to the manager, the claimant telephoned her later that evening to tell her: " 'I wasn't even going to go to the doctor until I thought about how sick I am of the company, and so I decided to go.' "

The claimant filed a claim for worker's compensation benefits on the day after she allegedly fell. In the injury report, she indicated that she had previously received medical treatment for a similar injury. The division reviewed the claim and awarded medical and disability benefits. The employer consented at that time to the division's determination.

After the claimant had received medical benefits for almost two years, the division issued a final determination, awarding permanent partial impairment benefits. The employer objected to the determination and requested a hearing. The employer claimed that the claimant's back injury did not result from the fall which allegedly had occurred while she was at work. The employer explained in a letter that, when the claimant began to work for the employer, she told the manager that she had recurring back problems. The employer also asserted that the claimant complained to co-workers and the manager about stomach and back pain which had been caused from her husband kicking her in the stomach. The hearing examiner scheduled a hearing to consider whether the claimant was entitled to receive permanent partial impairment benefits. The division elected not to participate in this hearing.

The employer submitted a second letter to the division, requesting that the final determination be modified on the grounds of mistake or fraud because the claimant suffered from a preexisting condition. The employer sought to have the claimant reimburse the division for the benefits which had been disbursed to her. The division issued a second final determination in which it denied all future benefits, stating that it made a mistake At the hearing on the permanent partial impairment benefits issue, the employer and the claimant were present. Evidence introduced by the employer to support the contention that the claimant had ongoing back problems prior to her alleged fall at work included testimony from the manager and a co-worker. The manager testified that, during the job interview, the claimant explained that she had a recurring back problem and would need time off to visit the chiropractor. The manager also stated that, before the claimant allegedly fell, she had missed several days of work because of back and leg problems.

when it found that the injury was work related. The claimant objected to this determination and asked for a hearing to consider the modification of benefits issue. Although the claimant specifically requested that this issue be considered during the hearing which had already been scheduled to consider permanent partial impairment benefits, the hearing examiner scheduled a separate hearing for the modification issue. The division planned to participate in the modification hearing.

The parties presented conflicting testimony about what occurred on the day before the claimant fell. The claimant's co-worker and the manager testified that the claimant told them her husband had kicked her in the stomach during a domestic dispute. They stated that the claimant appeared to be in a significant amount of pain. The claimant testified that her husband did not kick her in the stomach but, rather, that he kicked the screen door and the screen door hit her in the stomach. She stated that, after the door hit her, she was crying and her stomach was hurting but that she did not call the doctor. She also testified that she did not have pain in her back as a result of being hit by the screen door.

The employer offered the testimony of Roy Kanter, a neurologist who had reviewed the medical records and prepared a report on the claimant's condition. The doctor testified that he had reason to believe the claimant had back problems before she allegedly fell at work. He also testified that a hard kick to the stomach could have caused the claimant's back problems but that he could not reasonably determine whether it was the fall or the kick which actually caused the back problems she had experienced since July of 1994.

During this hearing, the hearing examiner addressed the modification of benefits issue even though the division was not present. She denied permanent partial impairment benefits but concluded that the employer's request for a modification of the benefits which had already been paid to the claimant should not be granted. The claimant petitioned the district court to review the administrative action. The employer and the division petitioned the district court to review the portion of the decision which dealt with the modification of benefits issue. The district court certified these cases to this Court pursuant to W.R.A.P. 12.09(b).

STANDARD OF REVIEW

When we are reviewing cases which have been certified to us pursuant to W.R.A.P. 12.09(b), we apply the appellate standards which are applicable to a reviewing court of the first instance. Fansler v. Unicover Corporation, 914 P.2d 156, 158 (Wyo.1996). W.R.A.P. 12.09(a) limits judicial review of administrative decisions to a determination of the matters which are specified in WYO. STAT. § 16-3-114(c) (1997). Section 16-3-114(c) provides in pertinent part:

(c) ... [T]he 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:

...

(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;

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

We will not adjust an agency's findings of fact unless they are clearly contrary to the overwhelming weight of the evidence. Nelson v. Sheridan Manor, 939 P.2d 252, 255 (Wyo.1997). We will not, however, grant the same deference to an agency's conclusions of law. Id. We affirm an agency's conclusions of law when they are in accordance with law. Corman v. State ex rel. Wyoming Workers' Compensation Division, 909 P.2d 966, 970 (Wyo.1996). When an agency has not invoked and correctly applied the correct rule of law, we correct the agency's errors. Gneiting v. State ex rel. Wyoming Workers' Compensation Division, 897 P.2d 1306, 1308 (Wyo.1995).

DISCUSSION

A. Burden of Proof

The claimant contends that she met her burden of proving her injury arose out of and in the course of her employment. A worker's compensation claimant has the burden of proving every essential element of her claim by a preponderance of the evidence. Cabral v. Caspar Building Systems, Inc., 920 P.2d 268, 269 (Wyo.1996). In meeting this burden, she must show that her injury arose out of and in the course of her employment while she was at work....