Case Title: Matter of Worker's Compensation Claim of Thornberg

Citation: 

Docket Number: 

State: wyoming

Court: Wyoming Supreme Court

Date: 1996-03-26T00:00:00Z

Document:
Matter of Worker's Compensation Claim of Thornberg1996 WY 48913 P.2d 863Case Number: 95-121Decided: 03/26/1996Supreme Court of Wyoming

John W. THORNBERG,  

Appellant (Petitioner), 

 

v. 

 

STATE OF WYOMING ex rel. WYOMING WORKERS' 
COMPENSATION DIVISION,  

Appellee (Respondent).

 

 

Appeal 
from the District Court of Laramie County 

The 
Honorable Edward L. Grant, Judge

 

Representing 
Appellant: 

Daniel E. White of Gusea, Pattno & White, P.C., 
Cheyenne. 

Representing 
Appellee: 

William U. Hill, Attorney General; John W. Renneisen, 
Deputy Attorney General; Gerald W. Laska, Senior Assistant Attorney General; and 
Jennifer A. Evans, Assistant Attorney General.

 

Before THOMAS, MACY, 
TAYLOR and LEHMAN, JJ., and ARTHUR T. HANSCUM, District 
Judge.

HANSCUM, District 
Judge. 

[¶1]      Upon 
certification by the district court of a case in which Appellant John Thornberg 
filed a petition for judicial review of an administrative decision made by the 
hearing examiner in a worker's compensation case, we must review the findings, 
conclusions, and decision denying benefits for a medical condition diagnosed 
several months after an on-the-job injury.

 

[¶2]      The hearing 
examiner's decision is upheld.

 

ISSUES

 

[¶3]      Thornberg 
presents these issues for our review:

 

1. Does a review of the entire record show that 
substantial evidence exists to support the hearing [examiner's] findings of 
fact?

2. If so, did the hearing [examiner] properly apply 
the correct law to the facts to find that [Thornberg] failed to sustain his 
burden to show that a work-related accident which occurred on October 22, 1993 
was the cause of the injury for which compensation is sought pursuant to W.S. § 
27-14-102 and § 27-14-104?

3. If so, was the hearing [examiner's] conclusion 
arbitrary, capricious, an abuse of discretion or otherwise not in accordance 
with the law?

 

[¶4]      The district 
court's order which certified this case for our review sets forth the issues in 
slightly different terms as follows:

 

1. Whether the hearing examiner's December 16, 1994, 
Order denying [Thornberg's] claim for an award of worker's compensation benefits 
is arbitrary, capricious, an abuse of discretion or otherwise not in accordance 
with law; and[]

2. Whether the hearing examiner's December 16, 1994, 
Order, specifically findings of fact numbers 1, 2, 6, and 16,[1] are supported by substantial 
evidence.

 

FACTS

 

[¶5]      On October 22, 
1993, Thornberg, a big man, drove his fully loaded 40,000-pound dump truck up 
and over an eighteen- to twenty-four-inch ridge of dirt, slamming the truck's 
front wheels onto the ground, propelling Thornberg's six-foot two-inch, 
approximately 260-pound frame downward, and injuring his 
tailbone.

 

[¶6]      In the spring of 
1994, Thornberg stopped working because he was experiencing rectal discomfort 
and abscesses. Subsequently, he was diagnosed as having a condition known as 
coccydynia. He applied for worker's compensation benefits at that time, giving 
October 22, 1993, as the date he was injured. Both Thornberg's employer and the 
Workers' Compensation Division objected to the payment of Thornberg's claim. A 
contested case hearing was held before the hearing examiner. The hearing focused 
primarily on the opinion testimony given by five doctors. The hearing examiner 
denied Thornberg's application for benefits on the basis that Thornberg had 
failed to prove by a preponderance of the evidence that the coccydynia was 
causally related to the October 22, 1993, work incident.

 

[¶7]      Thornberg filed a 
petition with the district court for judicial review of the hearing examiner's 
decision. The district court certified the case to this Court pursuant to 
W.R.A.P. 12.09(b).

 

STANDARD 
OF REVIEW

 

[¶8]      General appellate 
standards used by a reviewing court of the first instance are applicable to 
cases certified to us pursuant to W.R.A.P. 12.09(b). Hepp v. State ex rel. Wyoming Workers' 
Compensation Division, 881 P.2d 1076, 1077 (Wyo. 1994). Judicial review of 
an administrative decision is limited to a determination of certain matters 
specified in WYO. STAT. § 16-3-114(c) (1990), which states 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.

 

[¶9]      In reviewing an 
administrative decision, we are required to examine the administrative agency's 
findings of fact under the "substantial evidence" 
standard:

 

"Our task is to examine the entire record to 
determine if substantial evidence exists to support the hearing examiner's 
findings. We will not substitute our judgment for that of the hearing examiner 
if his decision is supported by substantial evidence. Substantial evidence is 
relevant evidence which a reasonable mind might accept in support of the 
agency's conclusions."

 

Bearden v. State ex rel. Wyoming Workers' 
Compensation Division, 868 P.2d 268, 
269 (Wyo. 1994) (emphasis added) (quoting Romero v. Davy McKee Corporation, 854 P.2d 59, 61 (Wyo. 1993)). In Jaqua v. 
State ex rel. Wyoming Workers' Compensation Division, 873 P.2d 1219 (Wyo. 
1994), we imposed on the appellant the burden of proving the negative. We held 
that a "party who appeals from an administrative determination has the burden of 
proving the lack of substantial evidence to 
sustain the ruling of the agency." 873 P.2d  at 1221 (emphasis 
added).

 

DISCUSSION

 

A. Statutory Burdens of 
Proof

 

[¶10]   Thornberg asserts that his evidence 
was sufficient and that the medical testimony supported a finding of a nexus 
between the bumpy ride and his later diagnosed condition. To evaluate this 
argument, we will inventory the burdens of proof in worker's compensation 
cases.

 

[¶11]   - A claimant in a worker's 
compensation case has the burden of proving all the statutory elements which 
comprise a "compensable injury." Gifford 
v. Cook-McCann Concrete, Inc., 526 P.2d 1197, 1199 (Wyo. 1974); Black Watch Farms v. Baldwin, 474 P.2d 297, 298 (Wyo. 1970); Associated Seed 
Growers, Inc. v. Scrogham, 52 Wyo. 232, 252, 73 P.2d 300, 307 
(1937).

 

[¶12]   - To show "compensable injury," the 
claimant must prove all the essential elements of the claim by a "preponderance 
of the evidence." Hepp, 881 P.2d  at 
1078; Sims v. State ex rel. Wyoming 
Workers' Compensation Division, 872 P.2d 555, 557 (Wyo. 1994); Alco of Wyoming v. Baker, 651 P.2d 266, 
267 (Wyo. 1982).

 

[¶13]   - A "preponderance of the evidence" 
is defined as "proof which leads the trier of fact to find that the existence of 
the contested fact is more probable than its non-existence." Scherling v. Kilgore, 599 P.2d 1352, 
1359 (Wyo. 1979).

 

[¶14]   The only ostensible element missing 
in Thornberg's claim was the element of causation embedded in the definition of 
"injury":

 

(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.

 

WYO. STAT. § 
27-14-102(a)(xi) (Supp. 1995) (emphasis added). Thornberg's statutory burden to 
prove injury necessarily carries the evidentiary burden to prove that his 
coccydynia arose out of or was caused by the bumpy ride. 
Five doctors testified as expert witnesses and gave their opinions in support of 
or in opposition to Thornberg's contention that his condition was causally 
related to his injury. All the doctors were competent witnesses, and each was 
qualified to give expert testimony. Competency and expert witness status having 
been established, the hearing examiner was left to apply the evidentiary 
standards which pertain to administrative hearings.

 

B. Evidentiary Standard

 

[¶15]   The Wyoming Administrative 
Procedure Act, WYO. STAT. § 16-3-101 to -115 (1990 & Supp. 1995), sets the 
broad standard for admissibility of evidence at an administrative hearing: The 
evidence must be of the type that is "commonly relied upon by reasonably prudent 
men in the conduct of their serious affairs." Section 16-3-108(a). Thornberg's 
evidence must pass this broad test of relevancy, and each witness's testimony 
must be probative on the issue of causation.

 

[¶16]   The coccydynia was diagnosed 
several months after the incident; however, Thornberg's claim was submitted and 
adjudicated as a single occurrence case which arose out of that incident. 
Generally, when a single incident is alleged to have caused an injury, medical 
testimony is not required if it is not essential to establish a causal 
connection between the occurrence and the injury. Forni v. Pathfinder Mines, 834 P.2d 688, 693 (Wyo. 1992); Hansen v. Mr. D's 
Food Center, 827 P.2d 371, 373 (Wyo. 1992). However, under certain 
circumstances, medical testimony may be essential to establish a causal 
connection. Black Watch Farms, 474 P.2d  at 300. As a practical matter, medical testimony was indispensable to 
Thornberg's case since the medical condition complained of in the spring of 1994 
was not "`immediately and directly or naturally and probably'" the result of the 
October 1993 incident. Hansen, 827 P.2d  at 373 (quoting Colorado Fuel & 
Iron Corporation v. Frihauf, 58 Wyo. 479, 135 P.2d 427, 434 (1943)). It is 
only "`[w]here injuries are so immediately and directly or naturally and 
probably the result of an accident, [that] medical evidence is not essential to 
find a causal connection.'" Id.

 

[¶17]   The hearing examiner had the 
responsibility of determining relevancy, assigning probative value, and 
ascribing weight to be given to the doctors' testimony. The term relevancy as it 
is used to determine the existence of "relevant evidence" has the same 
definition as that which is found in the Wyoming Rules of Evidence. See Department of Employment, Labor 
Standards Division v. Roberts Construction Company, 841 P.2d 854, 857 (Wyo. 
1992); W.R.E. 402, 403. At a minimum, the administrative hearing examiner must 
consider only "evidence having any tendency to make the existence of any fact 
that is of consequence to the determination of the action more probable or less 
probable than it would be without the evidence." W.R.E. 
401.

 

[¶18]   Thornberg's medical evidence was 
admitted without objection at the administrative hearing. Implicitly, the 
testimony was relevant and had probative value. Thornberg's apparent 
deficiencies lie in the comparative weight the hearing examiner gave the 
medical testimony in this case.

 

C. Medical Testimony

 

[¶19]   1. JONATHAN HUMMEL, M.D., SURGEON, 
VETERANS ADMINISTRATION MEDICAL CENTER, CHEYENNE. Dr. Hummel treated Thornberg 
originally for an unrelated problem and happened across the symptomatology which 
gave rise to the coccydynia diagnosis. When he was asked whether in his opinion 
the tailbone incident caused the symptoms which led up to the coccydynia, Dr. 
Hummel stated:

 

Well, it's - it is certainly a possibility. I can't really make 
any, you know, authoritative statement on the probability of it, but it would 
certainly be possible.

 

Later, in the following 
colloquy, he offered these opinions:

 

Q. Isn't it true of, Dr. Hummel, that jolts or shocks 
to the tailbone area sometimes produce rectal abscesses and anal 
fistulas?

 

A. Can happen.

 

Q. I mean is that a fairly common phenomenon? 

 

A. It's not unusual. It wouldn't make 
Ripley's, you know. It's not - it's not the invariable way to get a fissure in 
ano or a perirectal abscess, but it could occur.

 

On cross-examination, he 
said:

 

Q. And, Doctor, if I understood your testimony 
correctly it would be speculative to conclude that Mr. 
Thornberg's coccydynia in May of '94 was due to going over a bump in October of 
'93?

 

A. Yes, I think that's probably a good word for it. It's speculative. It's not impossible, 
but I don't know how you'd ever prove it.

 

[¶20]   2. JOHN H. BABSON, M.D., GENERAL 
PRACTITIONER, CHEYENNE. Dr. Babson performed a physical examination of Thornberg 
shortly after the coccydynia diagnosis. After having been informed of 
Thornberg's patient history, including the tailbone injury, Dr. Babson rendered 
his opinion:

 

However as of now I cannot identify any abnormalities 
which may relate to an 
injury.

 

[¶21]   3. CLAUDE O. GRIZZLE, M.D., 
NEUROSURGEON, CHEYENNE. Dr. Grizzle, reviewing the case for the Workers' 
Compensation Division, was asked whether the coccydynia which Thornberg was 
experiencing was caused by the October 22, 1993, incident. He 
testified:

 

A. Well, I have an opinion, and that's based on probabilities.

 

Q. Okay. Well, what is your 
opinion?

 

A. My opinion is that it is unlikely.

 

He further 
testified:

 

My opinion is that his coccy[]dynia, which was 
mentioned for the first time approximately May 4th, 1994, was remote from the event that happened 
that's described when he drove over the bump.

 

[¶22]   4. EDWARD JEFFREY DONNER, M.D., 
ORTHOPEDIC SURGEON, LOVELAND, COLORADO. Dr. Donner evaluated Thornberg and 
performed a physical examination. He assessed the history of Thornberg's medical 
condition in these words:

 

Well, in his case it sounds as though he was injured, he 
was treated for all the rectal problems, and as they recovered, his coccyx, for 
whatever reason, becomes more painful and, you know, just doesn't heal, just as 
can happen if you injure your 
shoulder or any other joint, a lot of people go on to heal and there's enough of 
them who won't, that continue to have symptoms, that you have to treat more 
aggressively.

 

He gave his opinion on the 
causation in the following dialogue:

 

Q. Do you have an opinion then based on reasonable medical probability that 
this - the bump that Mr. Thornberg took in his truck, as described to you, is 
the - is the cause of the coccy[]dynia or pain in his coccyx that you evaluated 
and treated him for?

 

A. Yes.

 

Q. And what is that opinion?

 

A. That it's my opinion that [was] the most 
likely source and cause of his pain.

 

[¶23]   5. MILO E. WILCOX, DOCTOR OF 
CHIROPRACTIC, CHEYENNE. Dr. Wilcox provided chiropractic adjustment and other 
services to Thornberg. He gave the following opinion with regard to the 
displacement of Thornberg's coccyx and the cause of his 
coccydynia:

 

Mr. Thornberg said he was driving a dump truck of 
some kind, or a truck of some kind, and he - he bounced over a heavy bump, and 
he had a strong compressive force that, you know, between his buttocks and his 
rear end in the seat. And so when he came smashing down like that, my opinion 
that's what not only irritated the coccyx but also the sacrum and the lower 
lumbar area which I found in exam to also be 
involved.

 

D. Weight of the Evidence

 

[¶24]   As can be readily seen from the 
emphasis supplied to the doctors' excerpted testimony, the doctors' opinions 
were conflicting. The fact finder was left with weighing these opinions, and to 
do so he had to consider (1) the opinion, (2) the reasons, if any, given for it, 
(3) the strength of it, and (4) the qualifications and credibility of the 
witness expressing it. Krause v. State ex 
rel. Wyoming Workers' Compensation Division, 803 P.2d 81, 83 (Wyo. 1990); Rice v. State, 500 P.2d 675, 676 (Wyo. 
1972).

 

[¶25]   Dr. Donner, a medical doctor, 
offered an opinion favorable to Thornberg that the bumpy ride was the most 
likely source of the coccydynia. Dr. Wilcox, a doctor of chiropractic, opined 
that the bumpy ride caused the coccydynia. Dr. Grizzle and Dr. Babson, two 
medical doctors, offered their opinions that the coccydynia could not relate to 
the October 1993 incident. Finally, Dr. Hummel, a medical doctor and Thornberg's 
treating physician, hedged his opinion by saying that causation was "certainly a 
possibility" but that he would not make an "authoritative statement," observing 
that "[i]t wouldn't make Ripley's, you know." This equivocation may have dealt a 
serious blow to Thornberg, who held the burden of proof on the issue. All 
tolled, our review of the record convinces us that there was a "rational view" 
for the hearing examiner's findings 1, 2, 6, and 16. Wyoming Department of Employment, Division 
of Unemployment Insurance v. Rissler & McMurry Company, 837 P.2d 686, 
689 (Wyo. 1992).

 

[¶26]   Even if it were a close question, 
we would rely upon the decision of the hearing examiner because "[o]ur deference 
for findings of fact is reserved for the fact-finder." Employment Security Commission of Wyoming 
v. Western Gas Processors, Ltd., 786 P.2d 866, 870 (Wyo. 1990). The hearing 
examiner articulated in his findings2 the weight he assigned to the 
medical testimony under applicable legal standards. We have said that the fact 
finder is in the best position to judge both credibility and "weight to be given 
the medical evidence." Padilla v. 
Lovern's, Inc., 883 P.2d 351, 355 (Wyo. 1994).

 

[¶27]   The medical testimony, when viewed 
in the aggregate, is equivocal on the question of whether Thornberg's claimed 
injury was work related. The hearing examiner, having determined the 
admissibility of the doctors' medical testimony, assigned a probative value and 
then weighed it, a process contemplated by and in accordance with administrative 
law. We will do no more than our assigned duty on review:

 

The testimony in this record may be subject to 
varying interpretations, but we will not usurp the function of the [trier of 
fact] in making factual findings with respect to this case. It is the duty of 
the trier of fact to weigh and evaluate the testimony of the witnesses, 
including that given by experts. . . . [The trier of fact] "was the sole judge 
of the credibility of the witnesses and was entitled to interpret the evidence." 
Ward v. Yoder, Wyo., 355 P.2d 371, 
374 (1960).

 

Creek v. Town of Hulett, 657 P.2d 353, 357 (Wyo. 1983), quoted in Hepp, 881 P.2d  at 1079. See also Atchison v. Career Service 
Council of State of Wyoming, 664 P.2d 18 (Wyo.), cert. denied, 464 U.S. 982, 104 S. Ct. 424, 78 L. Ed. 2d 359 (1983). Furthermore, "[w]hen the inconsistencies in the 
evidence and the claimant's testimony make it impossible for the hearing 
examiner to determine whether the accident arose out of [and] in the course of 
his employment, the claimant has failed to sustain his burden." Latimer v. Rissler & McMurry Co., 
902 P.2d 706, 711 (Wyo. 1995).

 

CONCLUSION

 

[¶28]   Thornberg has failed to carry his 
appellate burden of proof to show the lack of substantial evidence to support 
the hearing examiner's decision. The hearing examiner, having employed the 
proper burdens of proof and evidentiary standards, decided to deny benefits 
because Thornberg failed to carry the burden of proof. We are not in a position 
to hold otherwise. The hearing examiner's decision is, therefore, 
upheld.

 

Footnotes

1 Findings 1, 2, 6 and 16 read as 
follows:

1. On October 22, 1993, Claimant was 
driving an "end dump" truck number 6196 when he observed a bump in the road 
between 18 and 24 inches high. He slowed down to about five miles per hour and 
went over the bump. As the front axle passed over the bump Claimant experienced 
a jolt and came down hard on his tailbone. The jolt was severe enough that 
Claimant let out a yip. Claimant felt a sharp pain and his tail[]bone hurt. 
Prior to this date, Claimant had no history of pain in the tail[]bone 
area.

2. Claimant called into the office to 
report the bump and talked to Mr. Steve Snyder. The bump was "feathered" down by 
the time he made his next trip over the bump. At the end of the work day 
Claimant told anyone who was close that he hurt his tail[]bone and might have 
told Mr. Snyder.

. . . .

6. Claimant drew unemployment from 
November, 1993, until April 19, 1994, when he went back to work. He was unable 
to work for more than a few days because of severe pain in his rectal 
area.

. . . .

16. We have the opinions of five doctors 
on the issue of whether or not Claimant's coccydynia, which was first diagnosed 
in May, 1994, is related to the bump in October, 1993. Two doctors (Dr. Donner 
and Dr. Wilcox) say it is related and three doctors (Dr. Babso[n], Dr. Hummel 
and Dr. Grizzle) say it is not related. This Office finds that the opinion of 
Dr. Hummel, the treating physician from October, 1993, to May, 1994, is more 
persuasive. As such, Claimant has failed to establish by a preponderance of the 
evidence that the bump in October, 1993, resulted in the medical condition for 
which he is seeking benefits.

2 Findings 7, 11, 14, 15, and 16 read as 
follows:

7. On May 2, 1994, Dr. Hummel, the 
physician at the V.A., diagnosed Claimant as having coccydynia. . . . Dr. Hummel 
testified that it was possible that the rectal pain masked the coccyx pain but 
that if coccydynia was the major problem between October, 1993, and May, 1994, 
it would have been noted in the records and it was not. Dr. Hummel said it was 
speculative to say that the bump caused the coccyx pain. He went on to state 
that he could not say that the bump did cause the coccyx problems because he 
could not tie the bump to the pain. On the other hand he could not say that the 
two were not related.

. . . .

11. Claimant was examined by Dr. Donner 
on August 11, 1994, for chronic pain in the lower back and coccyx area. After 
taking a history from Claimant which included a description of the bump in 
October, 1993, he confirmed that Claimant had coccydynia. Dr. Donner stated that 
with a reasonable degree of medical probability . . . the bump in October, 1993, 
was the most likely source and cause of Claimant's pain. . . . Dr. Donner also 
stated that if Claimant did not have a history of pain prior to October, 1993, 
and did have pain after that date then this was more evidence that the injury 
caused the tail[]bone pain. . . .

. . . .

14. A medical review of Claimant's 
records was performed by Dr. Grizzle. After examining the records of the V.A., 
Dr. Babso[n], Dr. Donner, Dr. Wilcox, and the various x-rays, Dr. Grizzle stated 
that to a reasonable degree of medical certainty it is unlikely that Claimant's 
coccydynia was directly related to the bump in October, 1993. . . . It was his 
feeling that if Claimant actually had coccydynia in October, 1993, it would have 
been noted in the V.A. records before the diagnosis in May, 
1994.

15. The burden is on the Claimant to 
establish by a preponderance of the evidence that he suffered an injury as 
defined in W.S. 27-14-102(a)(xi). An injury is defined as "any harmful change in 
the human organism other than normal aging . . . arising out of and in the 
course of employment. . . ." In this case, Claimant must also establish by a 
preponderance of the evidence that the cause of his condition arose out of the 
work effort with the employer. Where the condition involves complex medical 
issues, the knowledge and testimony of medical experts is highly persuasive and 
relevant.

16. We have the opinions of five doctors 
on the issue of whether or not Claimant's coccydynia, which was first diagnosed 
in May, 1994, is related to the bump in October, 1993. Two doctors (Dr. Donner 
and Dr. Wilcox) say it is related and three doctors (Dr. Babso[n], Dr. Hummel 
and Dr. Grizzle) say it is not related. This Office finds that the opinion of 
Dr. Hummel, the treating physician from October, 1993, to May, 1994, is more 
persuasive. As such, Claimant has failed to establish by a preponderance of the 
evidence that the bump in October, 1993, resulted in the medical condition for 
which he is seeking benefits.

(Citations 
omitted).