Case Title: BAILEY v. WYOMING WORKERS' SAFETY AND COMPENSATION DIVISION

Citation: 

Docket Number: 01-248

State: wyoming

Court: Wyoming Supreme Court

Date: 2002-09-30T00:00:00Z

Document:
BAILEY v. WYOMING WORKERS' SAFETY AND COMPENSATION DIVISION2002 WY 14555 P.3d 23Case Number: 01-248Decided: 09/30/2002
April Term, A.D. 2002

 
 

 

DEBRA 
BAILEY,

 

Appellant(Petitioner) 
,

 

v.

 

STATE 
OF WYOMING, ex rel., WYOMING

WORKERS' 
SAFETY AND COMPENSATION

DIVISION,

                                                                                                

Appellee(Respondent) 
.

 

 

The 
Honorable Nancy J. Guthrie, Judge

 

Representing 
Appellant:

Robert 
Anderson of Robert O. Anderson, P.C., Riverton, WY.

 

Representing 
Appellee:

Hoke 
MacMillan, Attorney General; Gerald L. Laska, Senior Assistant Attorney General; 
and David L. Delicath, Assistant Attorney General.

 

Before 
HILL, C.J., and GOLDEN, LEHMAN,* KITE, and VOIGT, JJ.

 

 

*Chief 
Justice at time of expedited case conference.

 

   LEHMAN, 
Justice.

 

[¶1]      This is an appeal 
from a determination of the State of Wyoming, Office of Administrative Hearings 
(OAH) denying neck and left knee related worker's compensation benefits.  We 
affirm.  

 

 

ISSUES

 

[¶2]      Appellant, Debra 
Bailey (Bailey), sets forth the following issues:

 

Was 
the decision of the Administrative Hearings Office arbitrary, capricious, or 
otherwise unlawful within the meaning of W.S. § 16-3-114(c)(ii)(A) in ruling 
that Appellant was not eligible for a Temporary Total Disability 
award?

 

Was 
the Office of Administrative Hearings' decision unsupported by substantial 
evidence in light of the fact that substantial expert evidence existed to 
support a contrary ruling as required by W.S. § 16-3-114(c)(ii)(E)? 

 

Appellee, State of Wyoming ex rel. Wyoming Worker's Compensation 
Division (Division), phrases the issue on appeal as:
 

Whether the Hearing Examiner erred in determining that Appellant 
failed to prove every element of her claim for benefits for her alleged neck and 
knee injuries. 
 

 

FACTS

 

[¶3]      On July 18, 1999, 
Bailey leaped into the back end of a company pickup truck while working as a 
flagger/maintainer for S & L Industrial within a construction zone near 
Marbleton, Wyoming due to an oncoming vehicle.1  Immediately after this work accident, 
Bailey felt pain "all over" but most significantly in her right hand.   Later that evening and into early 
the next morning, Bailey felt pain in her neck and experienced a headache.  A few days after this incident, Bailey 
also began feeling pain in her left knee.  
Subsequently, Bailey received medical care for these injuries and was 
taken off work.  Ultimately, Bailey 
was required to undergo surgery on the little finger on her right hand and her 
left knee.  Bailey was also 
scheduled to have surgery on her neck, but this surgery did not then occur 
because Bailey declined at the last moment.  Later, this surgical procedure was 
completed.  

 

[¶4]      Prior to the work 
accident, Bailey had injured her left knee in 1992 requiring surgery.  Hardware, which was placed in her knee 
during this surgery, was never subsequently removed contrary to medical 
advice.  In addition, eighteen years 
earlier, Bailey injured her neck in Tampa, Florida when the car in which she was 
riding was rear-ended by another vehicle.  
Bailey experienced episodic neck pain from 1995 through 1999.  In 1995, Bailey had an MRI performed on 
her neck.  Finally, Bailey was 
involved in another automobile accident in May of 1999.  Bailey's employer was notified prior to 
her employment that she had pre-existing back and neck problems and had been 
recently involved in an automobile accident.  

 

[¶5]      After hearing, 
the OAH found that Bailey's little finger injury was a compensable injury.  However, the OAH determined that 
Bailey's neck and left knee injuries were not compensable and denied coverage 
for those two claims.  Bailey sought 
review of this decision in the district court, which affirmed the decision of 
the OAH.  This appeal followed.  

 

 

STANDARD 
OF REVIEW

 

[¶6]      Our standard of 
review when reviewing administrative agency action was recently clarified in the 
case of Newman v. State ex rel. Workers' Safety and Compensation Div., 
2002 WY 91, 49 P.3d 163 (Wyo. 2002).  
In that case, we reiterated that when considering an appeal from a 
district court's review of agency action, we accord no special deference to the 
district court's conclusions and review the case as if it had come directly 
before this court from the administrative agency.   Newman, at ¶7 (citing 
French v. Amax Coal West, 960 P.2d 1023, 1027 (Wyo.1998)).  We further recognized the applicability 
of Wyo. Stat. Ann. § 16-3-114(c) which provides:

 

(c)  To 
the extent necessary to make a decision and when presented, the 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:

 

(i)  Compel 
agency action unlawfully withheld or unreasonably delayed; 
and

 

(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;

 

(B)  Contrary 
to constitutional right, power, privilege or immunity;

 

(C)  In 
excess of statutory jurisdiction, authority or limitations or lacking statutory 
right;

 

(D)  Without 
observance of procedure required by law; or

 

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

 

Newman, 
at ¶9.  In addition, we held that 
this court is required to review the entire record in making its ultimate 
determination on appeal.2  Newman, at ¶19 and ¶¶24-26. 

 

[¶7]      Moreover, this 
court provided clarification in Newman of the applicable standard of 
review for the benefit of litigants, counsel, and district courts.  After thorough consideration, this court 
adopted the reasoning utilized in Russell v. Workmen's Compensation Appeal 
Board (Volkswagen of America), 550 A.2d 1364, 1365 (Pa.Commw.Ct. 1988), in 
instances where both parties submit evidence at the hearing below.  Specifically, this court 
stated:

 

On 
this reasoning, we hold the substantial evidence test is the appropriate 
standard of review in appeals from WAPA contested case proceedings when factual 
findings are involved and both parties submit evidence.  We further hold, when only the party 
with the burden of proof submits evidence in the contested case proceeding and 
that party does not ultimately prevail, the arbitrary or capricious standard 
governs the judicial review of that agency decision. 

 

Newman, 
at ¶22.  This standard must be 
applied regardless of which party appeals from the agency 
decision.

 

[¶8]      Additionally, we 
indicated in Newman, at ¶12 (quoting State 
ex rel. Workers' Safety and Compensation Div. v. Jensen, 
2001 WY 51, ¶10, 24 P.3d 1133, ¶10 (Wyo. 2001)), 
that the substantial evidence test to be applied is as 
follows:

 

In 
reviewing findings of fact, we examine the entire record to determine whether 
there is substantial evidence to support an agency's findings.  If the agency's decision is supported by 
substantial evidence, we cannot properly substitute our judgment for that of the 
agency and must uphold the findings on appeal.  Substantial evidence is relevant 
evidence which a reasonable mind might accept in support of the agency's 
conclusions.  It is more than a 
scintilla of evidence.  

 

[¶9]      In State ex 
rel. Workers' Safety and Compensation Div. v. Garl, 2001 WY 59, ¶9, 26 P.3d 1029, ¶9 (Wyo.2001), we further recognized that:

 

            
The interpretation and correct application of the provisions of the 
Wyoming Worker's Compensation Act are questions of law over which our review 
authority is plenary. Collicott [v. State ex rel. Workers' Safety and 
Compensation Div., 2001 WY 35], ¶4 [20 P.3d 1077, ¶4 (Wyo. 2001)].  Conclusions of law made by an 
administrative agency are affirmed only if they are in accord with the law.  Id.  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.

 

[¶10]   The de novo review by this 
court of the application of law made by the administrative agency is not to be 
confused with the arbitrary-and-capricious standard of review also enumerated in 
Newman.  Newman 
contemplates that even when the factual findings are found to be sufficient 
under the substantial evidence test, this court may be required to apply the 
arbitrary-and-capricious standard as a "safety net" to catch other agency action 
which prejudiced a party's substantial right to the administrative proceeding or 
which might be contrary to the other WAPA review standards.  A purely 
demonstrative listing is provided of situations which could warrant the 
consideration of the arbitrary-and-capricious standard in addition to the 
substantial evidence test.3  Newman, at ¶23.  However, this appeal presents no such 
unique circumstances.  In accord, 
see Vaughn v. State, 962 P.2d 149, 151 (Wyo. 1998).

 

 

 

DISCUSSION

 

[¶11]   Bailey argues that the decision of 
the OAH is not supported by substantial evidence and  that the OAH erred as a matter of law in 
rendering its determination.   
Specifically, Bailey asserts that given the testimony of Dr. Hume and 
evidence that prior to the work accident she was able to perform her work 
responsibilities, substantial evidence exists to support a ruling that Bailey's 
knee and neck injuries were compensable under the Wyoming workers' compensation 
system.  Bailey contends that she 
submitted adequate evidence to meet her burden of proof that the work accident 
materially aggravated her admitted pre-existing conditions to her knee and neck 
and that she should have been awarded worker's compensation benefits concerning 
these injuries.  

 

[¶12]   In making our review, we apply the 
substantial evidence test as required by our recent opinion in Newman 
detailed above.  This review 
criteria is applicable in this case because the OAH was required to make factual 
findings in this instance and both Bailey and the Division submitted evidence at 
the time of the administrative hearing held before the 
OAH.

 

[¶13]   Review of the entire record discloses 
that Bailey was injured on July 18, 1999 while working in a construction zone 
when she was forced to jump into the bed of a company pickup truck by an 
oncoming vehicle.  Immediately after 
this event, Bailey felt pain "all over" but most particularly in her right 
hand.  Bailey testified that she 
felt pain in her neck and experienced a headache that evening and into early the 
next morning.  However, Shannon 
Garrett, one of Bailey's friends and co-workers with whom Bailey had spent the 
evening of the work accident, testified that the only complaint made by Bailey 
concerned her right hand and right arm from the bicep to the wrist.  Ms. Garrett further testified that she 
only recognized that Bailey's hand was "very swollen" during this evening.  

 

[¶14]   The following morning when she went 
to work, Bailey reported the work accident to her employer by informing her 
supervisor, Charlotte Brinkerhoff.  
Ms. Brinkerhoff  testified 
that, at that time, Bailey only complained about injury to her right hand and 
that she personally recognized only that Bailey's right hand was swollen.  Ms. Brinkerhoff then took Bailey to the 
local medical clinic to receive medical care.  

 

[¶15]   Bailey testified at the hearing 
that when she was examined at the local medical clinic she was primarily 
concerned with an injury to her right hand.  Rich Anderson, the physician's assistant 
who treated Bailey, testified via deposition and two separate affidavits.  Mr. Anderson stated that Bailey chiefly 
complained to him about injury to her hand and that he did not have any 
independent recollection of Bailey complaining of any injury to her head, neck, 
shoulders, back, or knee.  Mr. 
Anderson's notes also only reflected treatment was received by Bailey for her 
hand.  No other complaints or 
injuries were indicated in these notes.  
Ms. Brinkerhoff was present during this examination and confirmed the 
fact that Bailey only complained about injury to her hand.4  

 

[¶16]   Bailey freely admits that she had 
previously injured her left knee and neck.  
As indicated above, prior to the work accident Bailey had injured her 
left knee in 1992 when kicked by a horse.  
This injury required surgery to her knee and the hardware, which was 
placed in her knee during surgery, was never removed although recommended by a 
medical professional.  

 

[¶17]   Eighteen years before the work 
accident, Bailey injured her neck in Tampa, Florida when the car in which she 
was riding was rear-ended by another vehicle.  Bailey had also experienced episodic 
neck pain from 1995 through 1999.  
In 1995, Bailey had an MRI performed on her neck.  Bailey was involved in another 
automobile accident in May of 1999.  
This accident resulted in Bailey's head being thrown against the 
windshield with such force that the windshield was cracked.  

 

[¶18]   Bailey's medical records admitted 
at the time of hearing evidence Bailey's previous difficulties with her knee and 
neck.  Treatment notes of Dr. Alvis 
Forbes concerning his examination of Bailey on August 14, 1995, stated that 
Bailey complained of pain in her left knee following a tibial plateau fracture 
of three years ago and experienced catching, grabbing, and pain along the 
lateral aspect of that knee.  These 
notes also expressed that Bailey had experienced pain in her neck since a car 
accident several years ago.  Dr. 
Forbes then recommended surgery be performed on the left knee.  Dr. Forbes, in an August 28, 1995 
treatment notation, also noted that a recent MRI taken of Bailey's neck showed a 
significant C5-6 disc herniation.  

 

[¶19]   Bailey later saw Dr. Forbes in 
January of 1997, for left knee pain when a bale of hay fell on that knee.  He then indicated that Bailey had 
chronic knee pain with a little bone piece off the lateral edge of the lateral 
condyle.  Bailey again saw Dr. 
Forbes in July 1997, and January of 1998, for neck pain.  On each of these occasions, Dr. Forbes 
stated that Bailey suffered from recurrent neck pain at the C5-6 location 
concerning a previously experienced relatively large disc herniation.  In 1997, Dr. Forbes prescribed a Medrol 
dosepak for Bailey's neck and, in 1998, scheduled a series of epidural steroid 
injections to her neck that were never administered to Bailey.  Following Bailey's automobile accident 
of May 1999, Dr. Forbes wrote that Bailey was seeing him in follow-up of her 
cervical disc problem with increased symptoms of cervical radiculopathy.  Again, Dr. Forbes prescribed a Medrol 
dosepak.  On July 9, 1999, just nine 
days before the work accident, Dr. Forbes again saw Bailey and prescribed 
another Medrol dosepak.  

 

[¶20]   Considerable medical testimony was 
also presented at the time of the hearing through previously recorded 
depositions.  Dr. Peter Rork of 
Orthopaedics of Jackson Hole testified that Bailey did not tell him about any 
recent knee injury but rather related to him that the injury occurred eight 
years ago.  Dr. Rork also indicated 
that he could not give an opinion about whether the events that occurred during 
the work accident caused or contributed to the condition of Bailey's knee.  However, it was Dr. Rork's impression 
that the degenerative changes noted during the 1997 surgery to Bailey's knee 
stemmed from her 1992 fracture of the knee.  

 

[¶21]   Dr. James Champa of Orthopaedics of 
Jackson Hole testified that Bailey's C5-6 herniation pre-existed the work 
accident and that he had no opinion about the cause of this herniation.  Dr. Geoffrey Skene also of Orthopaedics 
of Jackson Hole testified that comparison of the MRI reports of 1995 and 1999 
showed little difference, if any, in Bailey's neck condition.  Dr. Skene could also not offer an 
opinion about the cause of Bailey's herniated disk.  Further, Bailey admitted that in 1994 
she had applied for social security disability benefits related to the 
difficulties she experienced with her knee and neck.  

 

[¶22]   Bailey relies heavily on the 
testimony of Dr. Mary Hume of Orthopaedics of Jackson Hole in support of her 
contention that her neck injuries were compensable.  However, although Dr. Hume testified 
that the work accident could have been an event that may have caused a 
significant inflammatory response wherein Bailey went from sporadic pain to 
constant pain, she recognized that comparison of the 1995 and 1999 MRIs showed 
that the herniation in Bailey's neck had not changed and that there were any 
number of things including, but not limited to, a car accident or any other 
"jarring activity" that could have also caused such a significant inflammatory 
response.  Dr. Hume was unable to 
determine between the 1999 automobile accident and the work accident which was 
the more likely event to have exacerbated Bailey's neck condition.  The only thing that Dr. Hume could state 
with certainty was that Bailey's medical conditions were caused by some sort of 
trauma with uncertain etiology.  
Therefore, we do not find Dr. Hume's testimony as conclusive as proffered 
by Bailey.  

 

[¶23]   The record does reflect evidence 
contrary to the ultimate decision made by the OAH.  For instance, Bailey testified that the 
symptoms she experienced after the work accident were different than those 
symptoms that she had experienced previous to that event.  She further testified at length that 
although she experienced difficulty with her knee and neck for an extended 
period prior to the work accident, she was always able to perform her required 
work tasks and various other tasks related to her personal life.  Bailey's daughter and husband also 
testified that after the work accident, Bailey was more limited with respect to 
her normal personal life activities.  
However, this evidence alone is inadequate to convince us that the 
determination of the OAH was not supported by sufficient evidence or against the 
clear weight of the evidence.  Given 
the entirety of the record before us, we conclude that the findings of fact and 
conclusions of law reached by the OAH were based on substantial evidence and 
were within established law.   
None of the evidence presented conclusively shows a causal link between 
the work accident and Bailey's knee and neck injuries.      

 

[¶24]   We have long recognized that 
the burden of proof is on the claimant to prove that her work accident, not her 
preexisting condition, caused an injury.  
Dan's Supermarket v. Pate, 2001 WY 104, ¶17, 33 P.3d 1121, ¶17 
(Wyo. 2001); Corman v. State ex rel. Workers' Compensation Div., 909 P.2d 966, 970 (Wyo. 1996).  A preexisting 
condition is noncompensable unless the claimant can prove that the work-related 
injury materially aggravated the preexisting injury.  Dan's Supermarket, at ¶17; 
Brees v. Gulley Enterprises, Inc., 6 P.3d 128, 132 (Wyo. 2000).   See also Franks v. State ex 
rel. Workers' Safety and Compensation Div., 2002 WY 77, ¶13, 46 P.3d 876,  ¶13 (Wyo. 
2002).

 

[¶25]   The issue of the existence of a 
preexisting condition is indistinguishable from the central factual issuedid 
the injury "arise out of and occur in the course of employment?"   If the injury resulted from a 
preexisting condition, rather than from the work-related accident, no 
compensable injury occurred.  
Consequently, when there is a conflict in the evidence as to this 
question, the claimant must prove by a preponderance of the evidence that the 
injury was work-related and not preexisting.  Dan's Supermarket, at ¶19, 
quoting Corman, 909 P.2d  at 969.  
Simply put, Bailey failed to prove by a preponderance of the evidence 
that her knee and neck injuries were work related and not preexisting.  The medical and other evidence, even 
when viewed in a light most favorable to Bailey, is inconclusive.  Therefore, because the evidence 
presented does not support Bailey's claim for benefits with respect to her knee 
and neck injuries, the OAH properly denied those claims.

 

[¶26]   Finally upon our de novo 
review, we hold that the denial of temporary total disability benefits to 
Bailey by the OAH under the above circumstances was in accord with the law as 
expressed under the applicable provisions of the Wyoming Worker's Compensation 
Act. 

 

CONCLUSION

 

[¶27]   We affirm the order of the OAH 
denying benefits to Bailey concerning her knee and neck injury 
claims.

 

FOOTNOTES

1For 
ease, this event will be hereinafter described as the "work 
accident."

 

2In 
making this holding, this court specifically abrogated previous case law which 
required this court to review the record in an administrative action by 
examining only that evidence that favors the prevailing party, allowing every 
favorable inference, while omitting consideration of any conflicting 
evidence.  This previously required 
type of review was aptly characterized by this court as the "prevailing parties' 
evidence" concept.  Newman, 
at ¶25. 

   

3"For 
example, the administrative record may be replete with evidence supporting the 
decision, and yet the agency may have willfully discounted credible evidence, 
refused to admit certain testimony or documentary exhibits, or failed to provide 
findings of fact or conclusions of law."  
Newman, at ¶ 23.

 

4Bailey 
explained this fact at hearing by claiming that she had already decided to visit 
Orthopaedics of Jackson Hole, where she had previously sought medical care with 
respect to those complaints unrelated to her hand.