Case Title: IN THE MATTER OF THE WORKER'S COMPENSATION CLAIM OF DANIEL J. DAVID, AN EMPLOYEE OF PDQ TRANSPORT, INC.: DANIEL J. DAVID V. STATE OF WYOMING, ex rel., WYOMING WORKERS' SAFETY AND COMPENSATION DIVISION

Citation: 

Docket Number: 06-101

State: wyoming

Court: Wyoming Supreme Court

Date: 2007-02-08T00:00:00Z

Document:
IN THE MATTER OF THE WORKER'S COMPENSATION CLAIM OF DANIEL J. DAVID, AN EMPLOYEE OF PDQ TRANSPORT, INC.: DANIEL J. DAVID V. STATE OF WYOMING, ex rel., WYOMING WORKERS' SAFETY AND COMPENSATION DIVISION2007 WY 22151 P.3d 280Case Number: 06-101Decided: 02/08/2007
OCTOBER TERM, A.D. 2006

 
 
IN THE 
MATTER OF THE WORKER'S COMPENSATION CLAIM OF DANIEL J. DAVID, AN EMPLOYEE OF PDQ 
TRANSPORT, INC.:

 
 
DANIEL 
J. DAVID,

 
 
Appellant

(Petitioner),

 
 
v.

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

 
 
Appellee

(Respondent).

 
 

Appeal from the DistrictCourtofLaramieCounty

The Honorable Edward L. Grant, Judge

 
 
Representing Appellant:

Sean W. Scoggin of Tiedeken & Scoggin, P.C., Cheyenne, Wyoming

 
 

Representing Appellee:

Patrick J. Crank, Wyoming Attorney General; John W. 
Renneisen, Deputy Attorney General; Steven R. Czoschke, Senior Assistant 
Attorney General; and Kristi M. Radosevich, Assistant Attorney General

 
 
Before VOIGT, C.J., and GOLDEN, HILL, KITE, and BURKE, 
JJ.

 
 

HILL, Justice.

 
 
[¶1]      Daniel J. David 
(David) appeals an order of the Office of Administrative Hearings denying 
medical and temporary total disability benefits for a lower back injury on the 
grounds that David had not met his burden of establishing that the requested 
benefits were for a work-related injury.  We affirm.

 
 

ISSUES

[¶2]      David sets forth 
three issues in his brief:

 
 
I.          
Whether the Office of Administrative Hearing [sic] examiner erred as a 
matter of law when he applied the incorrect burden of proof at the hearing of 
this matter.

 
 
II.         
Whether the Office of Administrative Hearing [sic] erred as a matter of 
law in failing to consider the facts of this case under the second compensable 
injury rule.

 
 
III.        Whether 
the Office of Administrative Hearing [sic] examiner's decision that Mr. David's 
treatment and claims for disability benefits after September 13, 2004 were not 
work related for the purposes of worker's compensation benefits was arbitrary 
and capricious and not supported by the substantial evidence presented at the 
hearing and the standing case law.

 
 
FACTS

 
 
[¶3]      In July of 2004, 
David was working for PDQ Transport of Cheyenne as a truck driver.  He submitted an 
injury report to the Wyoming Workers' Safety and Compensation Division 
(Division) on July 22, 2004, claiming that an injury to his lower back occurred 
while he was strapping a tarp over a load.  David had a long history of lower back 
problems.  He 
had been treated for a herniated disc in the mid-1980's and suffered a non-work 
related lower back injury in July of 2001 that included pain radiating into his 
right leg.  David received periodic chiropractic 
treatments for his back.  He also had been treated for lower back and 
hip pain in early 2004.

 
 
[¶4]      The Division 
concluded that David had suffered a compensable work-related injury and on 
August 11, 2004, issued a Final Determination opening a case and awarding 
medical benefits.  
On August 25, 2004, the Division issued a Final Determination awarding 
David temporary total disability benefits.  Sometime in mid-September David fell at home, 
causing further injury to his back.  On September 29, 2004, the Division notified 
David that pursuant to its authority under Wyo. Stat. Ann. § 27-14-601(b) 
(LexisNexis 2005),1 it would no longer approve payment of any 
benefits for claims connected with the July 21, 2004 injury.  The Division 
determined that "a new incident occurred on 9/13/2004 and current medical 
treatment is no longer directly and completely related to the work incident." 

 
 
[¶5]      David objected to the 
Division's determination, and a contested case hearing was scheduled.  In its pre-hearing 
disclosure statement, the Division framed the issue before the hearing examiner 
as to whether David's back injury was the product of a pre-existing condition or 
an intervening trauma, and that the burden was on David to establish the 
compensability of his injury.  In his disclosure statement, David countered 
that Wyo. Stat. Ann. § 27-14-601(b) did not give the Division the authority to 
terminate benefits and, since benefits had been awarded, the burden was on the 
Division to seek modification pursuant to Wyo. Stat. Ann. § 27-14-605(a) 
(LexisNexis 2005).2  David reiterated that position at the 
commencement of the hearing.  The hearing examiner took the question 
regarding the burden of proof under advisement and proceeded with the hearing. 
 Both parties 
produced evidence.  David testified and described his back injury 
that occurred while he was strapping a load onto his truck.  He acknowledged his 
history of back problems but insisted that the pain related to this injury was 
different than that associated with his prior injuries.  David attributed the 
cause of his fall in mid-September of 2004 to weakness in his leg caused by his 
work-related injury.  He described the injury resulting from the 
fall as a "mild" scrape on his upper back and denied that the fall had any 
effect on his work-related back injury.  David also offered the deposition testimony 
of his treating physician and physical therapist.  Both medical 
professionals opined that David's benefit claims were related to the July 7, 
2004 work injury.  The Division's evidence consisted of medical 
records detailing David's history of medical treatment for his back.

 
 
[¶6]      On August 12, 2005, 
the hearing examiner issued an order denying benefits.  Initially, the 
examiner rejected David's argument that the Division had to file a petition to 
modify under § 27-14-605(a) instead holding that the Division could approve or 
deny any claim for medical benefits pursuant to § 27-14-601(b), and the burden 
was on David to establish that his claims for benefits were related to an injury 
that arose out of and in the course of his employment.  The hearing examiner 
concluded that David had failed to meet that burden, finding that the medical 
opinions offered by his treating physician and physical therapist were not 
persuasive because neither of them possessed a complete medical history of 
David's back treatments.  The district court affirmed the hearing 
examiner's decision and David has now brought the matter before this Court.

 
 
STANDARD OF REVIEW

 
 
[¶7]      We do not afford any 
special deference to the district court's decision.  We review the case 
as if it has come to us directly from the administrative agency.  Alcorn v. Sauer 
Drilling Company, 2006 WY 15, ¶ 6, 126 P.3d 924, 925 (Wyo. 
2006) (citing Bailey 
v. State ex rel. Wyoming Workers' Compensation Division, 2002 WY 145, ¶ 9, 55 P.3d 23, 26 (Wyo. 
2002)).  The 
scope of our review is dictated by Wyo. Stat. Ann. § 16-3-114(c) (LexisNexis 
2005):

 
 
(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. 

 
 

Olivas v. State ex rel. Wyoming Workers' Safety and 
Compensation Division, 2006 WY 29, ¶ 11, 130 P.3d 476, 481-82 (Wyo. 
2006).  When a 
hearing examiner has concluded that a worker's compensation claimant failed to 
meet his or her burden of proof, our review is pursuant to the arbitrary and 
capricious standard:

 
 
Under the arbitrary, capricious and abuse of discretion 
standard, we are charged with examining the entire record.  In our examination 
and review of a hearing examiner's determination, we defer to the hearing 
examiner's findings of fact.  We will examine conflicting and contradictory 
evidence to see if the hearing examiner reasonably could have made its findings 
based on all the evidence before it.  The findings of fact may include 
determinations of witness credibility, as the hearing examiner is charged with 
determining the credibility of the witnesses.  In our review, we will not overturn the 
hearing examiner's determinations regarding witness credibility unless they are 
clearly contrary to the overwhelming weight of the evidence.

 
 

Finley v. State ex rel. Wyoming Workers' Safety and 
Compensation Division, 2006 WY 46, ¶ 7, 132 P.3d 185, 187-88 (Wyo. 
2006) (quoting Boyce 
v. State ex rel. Wyoming Workers' Safety and Compensation Division, 2005 WY 9, ¶ 6, 105 P.3d 451, 454 (Wyo. 
2005); and Brees v. 
Gulley Enterprises, Inc., 6 P.3d 128, 132 (Wyo. 2000)).

 
 
DISCUSSION

 
 
[¶8]      Initially, David 
contends that the hearing examiner erred as a matter of law when he applied § 
27-14-601(b) and placed the burden of proof on him.  He argues that once 
the Division determined that he had suffered a compensable injury and awarded 
medical and temporary total disability benefits, termination of those benefits 
could only be accomplished by a petition for modification by the Division under 
§ 27-14-605(a). 

 
 
[¶9]      This is not the first 
opportunity we have had to consider the interrelation between § 27-14-601(b) and 
§ 27-14-605(a).  In Martinez v. State ex rel. 
Wyoming Workers' 
Compensation Division, 917 P.2d 619 (Wyo. 1996), the claimant suffered a 
work-related elbow injury on July 21, 1993.  Five days later he was arrested after an 
altercation with police.  While incarcerated, the claimant received 
medical treatment for the same elbow. Claimant was initially awarded benefits, 
including temporary total disability.  Claimant continued to receive benefits until 
January of 1994, when the employer and Division objected to further payments and 
sought to recover payments already made on the grounds of mistake.  After a contested 
case hearing, the hearing examiner concluded that the employer and Division had 
failed to meet their burden under § 27-14-605(a) and, accordingly, denied the 
employer's and Division's request to recoup benefits already paid and awarded 
the claimant benefits on all outstanding claims.  On petition for review, the district court 
agreed that the employer and Division had the burden of proof pursuant to § 
27-14-605(a) as to whether any benefits already received by the claimant were 
mistakenly paid.  The court, however, reversed the hearing 
examiner on the question of claimant's outstanding claims, holding that the 
claimant had the burden of proving that he was entitled to compensation for 
those claims.  917 P.2d  at 620-21.  On appeal to this 
Court, the question was the proper allocation of burden of proof.  It is worthwhile for 
our present purposes to quote extensively from that discussion:

 
 
We have repeatedly stated that a claimant has the burden of 
proving all the essential elements of his worker's compensation claim by a 
preponderance of the evidence.  See, e.g., Padilla v. Lovern's, 
Inc., 883 P.2d 351, 354 
(Wyo. 1994); Gilstrap v. State ex 
rel. Wyoming Workers' 
Compensation Division, 875 P.2d 1272, 1273 (Wyo. 1994).  We have also 
recognized, however, that the party who seeks to reopen or modify a worker's 
compensation case under § 27-14-605(a) has the burden of proof.  Britton v. Halliburton 
Services, 895 P.2d 45, 48 (Wyo. 1995).

 
 
In reaching its conclusion that the employee had the burden 
of proving that he was entitled to receive benefits on his outstanding claims, 
the district court relied on Wyo. Stat. § 27-14-606 (1991).  That section 
states:

 
 
Each determination or award within the meaning of this act 
is an administrative determination of the rights of the employer, the employee 
and the disposition of money within the worker's compensation account as to all 
matters involved.  No determination shall be final without notice 
and opportunity for hearing as required by this act.

 
 
Section 27-14-606.  We considered this statute in Herring v. Welltech, 
Inc., 660 P.2d 361 (Wyo. 1983), and stated that, under 
the language of the statute, "the employer must be advised of each award of 
compensation or allowance of any expense claim and [be] given the opportunity to 
object."  660 P.2d  at 366.  See also Padilla, 883 P.2d  
at 354.  The 

Herring Court concluded that 
each award or claim is a separate matter for administrative determination and 
held:

 
 
It follows that the employer is entitled to dispute any 
award or claim on the basis that it is unreasonable or improper, and certainly 
can raise the question as to whether the award or claim is causally related to 
the industrial accident which occurred or whether it may be attributable to some 
other event.

 
 
660 P.2d  at 366.  From the clear language of § 27-14-606 and this Court's 
decisions which have interpreted the statute, it is obvious that the normal 
process for an employer's objection applied to the employee's outstanding 
claims.  It 
follows, then, that the employee bore the usual burden of proving that he was 
entitled to receive benefits for his outstanding claims.  To place the burden 
of proof on the employer to dispute an employee's right to receive benefits on 
any further claims after the employee's first claim has been approved would 
effectively nullify the provisions of § 27-14-606.

 
 
The employee likens his case to State ex rel. 
Wyoming Workers' 
Compensation Division v. Jerding, 868 P.2d 244 (Wyo. 1994).  In that case, the 
Workers' Compensation Division petitioned under § 27-14-605(a) to reopen the 
claimant's case, seeking to terminate the claimant's right to receive any 
further benefits because it made a mistake in concluding that the claimant's 
injury was compensable.  868 P.2d  at 246.  The Court ostensibly 
placed the burden of proving that a mistake had been made and that the claimant 
was not entitled to receive any future benefits upon the Workers' Compensation 
Division.  868 P.2d  at 250.

 
 
An important distinction exists, however, between the case 
at bar and the Jerding case which prevents Jerding from 
controlling our decision in this case.  In Jerding, the Workers' Compensation Division was seeking 
to revisit its initial determination that the claimant's injury was compensable. 
868 P.2d  at 246.  In the portion of this case which pertains to 
the employee's outstanding claims, the Workers' Compensation Division was not 
contesting the compensability of the initial injury.  Instead, it was 
arguing that the employee's outstanding claims should not be paid because his 
current disability was caused by his altercation with the police.  The Workers' 
Compensation Division aptly stated its position in its brief: 

 
 
It is therefore important to distinguish what the [Workers' 
Compensation] Division disputes with regard to [the employee's] claims and what 
it does not dispute. The [Workers' Compensation] Division does not deny that 
[the employee] suffered a work-related injury on July 21, 1993  it does not now 
seek a determination that when [the employee] injured his elbow on July 21, 
1993, he was not acting within the course and scope of his employment.  What the [Workers' 
Compensation] Division questions now is the percentage, if any, of [the 
employee's] current disability which can be attributed to the July 21, 1993 work 
injury.  This 
question is appropriate in light of the medical testimony that all or some 
percentage of [the employee's] current disability may be attributable to the 
July 26, 1993 altercation, unrelated to [the employee's] employment.

 
 
The employee also asserts that the Workers' Compensation 
Division should have been estopped from disputing the compensability of his 
claims.  The 
employee relies on a statement in Herring as being support for his argument:

 
 
Once the accident is acknowledged to have occurred in the 
course of employment and not to have been due to the culpable negligence of the 
employee, the employer is estopped from taking a contrary position at a later 
date and after some claims have been paid.

 
 
                        
660 P.2d  at 366.

 
 
It is true in the case at bar that the employer and the 
Workers' Compensation Division did not contest the compensability of the initial 
injury.  In 
fact, the employer signed the consent and waiver form, consenting to the first 
payment of temporary total disability benefits to the employee.  We agree that the 
employer and the Workers' Compensation Division were estopped from contesting 
the compensability of the initial injury except under the provisions of § 
27-14-605(a).  However, as we explained earlier in this 
opinion, the same analysis does not apply to the employee's outstanding claims. 
 Since each new 
claim or award involved a separate administrative determination under § 
27-14-606, the employer and the Workers' Compensation Division were entitled to 
contest the employee's outstanding claims by arguing that the employee's 
altercation with the police caused his current disability.

 
 
917 P.2d  at 621-22 (emphasis added; footnote omitted). 
 Since each new 
claim or award involves a separate administrative determination under § 
27-14-606, the claimant is required to prove that he or she is entitled to 
receive benefits for all outstanding claims even if he or she has received 
previous awards for the same injury.  Id.; see also Tenorio v. State ex rel. Wyoming Workers' Compensation 
Division, 931 P.2d 234, 239-41 (Wyo. 
1997) (since Division was only challenging future payments and not contesting 
the compensability of employee's original claim or seeking to recover any 
previous awards, the burden was on the employee to "prove that the extent of her 
current claim is the result of her work-related injury"); and Fritz v. State ex rel. 
Wyoming Workers' Safety and Compensation Division, 937 P.2d 1345, 1347-48 
(Wyo. 1997). 

 
 
[¶10]   Here, the Division did not contest the 
initial determination that David's injury was work-related or seek to recover 
any benefits paid.  
It challenged the compensability of an outstanding claim on the grounds 
that David's medical treatments were no longer related to his work injury but 
rather to an intervening accident or to a pre-existing condition.  The hearing examiner 
properly placed the burden of proof to establish the compensability of the 
outstanding claims on David.

 
 
[¶11]   In his next argument, David contends 
that this case is similar to the situation confronted by this Court in Carabajal v. State ex 
rel. Wyoming Workers' Safety and Compensation Division, 2005 WY 119, 119 P.3d 947 (Wyo. 2005) 
wherein benefits were granted under the second compensable injury rule.  The second 
compensable injury rule is applicable when "an initial compensable injury ripens 
into a condition requiring additional medical intervention."  Carabajal at 
¶ 12, 119 P.3d  at 951 (quoting Yenne-Tully v. State ex rel. Workers' Safety and 
Compensation Division, 12 P.3d 170, 172 (Wyo. 2000)).  In other words, "a subsequent injury is 
compensable if it is causally related to the initial compensable work injury." 
 State ex rel. Wyoming 
Workers' Safety and Compensation Division v. Pickens, 2006 WY 54, ¶ 31, 
n.6, 134 P.3d 1231, 1241, n.6 
(Wyo. 2006).  In Carabajal, the employee had suffered a work-related 
lower back injury.  Several years after last receiving benefits 
for his injury, the employee sought medical treatment for back pain.  The employee applied 
for medical and temporary total disability benefits citing his previous work 
injury as the cause of his current problems.  The hearing examiner denied benefits and the 
district court affirmed.  Carabajal, at ¶¶ 3-7, 119 P.3d  at 949-50.  On appeal to this 
Court, the employee argued that the hearing examiner erred by not considering 
the applicability of the second compensable injury rule.  Id. at ¶ 9, 119 P.3d  at 
951.  While 
acknowledging that he had not explicitly raised the rule as a theory of recovery 
in the contested case hearing, the employee argued that the argument and 
evidence he presented were sufficient to alert the hearing examiner to his 
theory of recovery.  Id. at ¶ 19, 119 P.3d  at 
953-54.  We 
agreed with the employee:

 
 
In the context of the second compensable injury rule, we 
have recognized that the hearing examiner "has an obligation to invoke and apply 
the rules of law that support a claimant's theory of the case."  [Pino v. State ex rel. 
Wyoming Workers' Safety and 
Compensation Division, 996 P.2d 679, 687 (Wyo. 2000)].  The information presented by Mr. Carabajal was 
sufficient to alert the hearing examiner to Mr. Carabajal's theory of the case 
so that he should have applied the second compensable injury rule.  Our determination is 
in accord with our holding in Pino:

 
 
We conclude that the hearing examiner failed to recognize 
that the issue before the agency was one of a second subsequent injury rather 
than simply one of proximate causation.  Like a trial judge instructing a jury, the 
Office of Administrative Hearings has an obligation to invoke and apply the 
rules of law that support a claimant's theory of the case.  It may be that this 
Court has explained the case in more detail and with more specificity than did 
Pino, but the fact remains that his theory of the case encompassed a second 
compensable injury.  The hearing examiner should have invoked and 
applied the rule relied upon in the cited cases.  Under the circumstances, the failure to do so 
constitutes a decision "not in accordance with law."

 
 
                        
[Pino, 
996 P.2d  at 687.]

 
 

Carabajal, at ¶ 21, 119 P.3d  at 954.  David did not 
explicitly raise the second compensable injury rule in the proceedings before 
the hearing examiner but as was the case in Carabajal and Pino, he contends 
that his theory of the case sufficiently encompassed the concept, and the 
hearing examiner erred by not granting him benefits under the rationale of the 
rule. 

 
 
[¶12]   A further review of the record, 
however, shows that the second compensable injury rule was not part of David's 
theory of recovery either explicitly or implicitly.  In his brief, David 
supports his argument that the rule is applicable here by citing the deposition 
testimony of his treating physician, Dr.Conklin:

 
 
Q:  And did you have an opinion at that time as 
to the causation of the low back pain and strain for Mr. David?

 
 
. . . .

 
 
A:  So the note says, low back pain strain.  It should have been 
accompanied by herniated disc.

 
 
Q:  And your opinion as to causation of those 
problems was what?

 
 
                        
A:  Work-related from lifting.

 
 
Q:  Did the indication of the slip and fall in 
September 3rd of 2004, does that change your opinion at all, as 
to causation in October of 2004?

 
 
A:  No.  I deemed that a reexacerbation.

 
 
Q:  What do you mean by that?

 
 
A:  Meaning when you already have a problem and 
you just do something that exacerbates, makes it worse again, makes it flare 
up.

 
 
Q:  And are those opinions you just gave to a 
reasonable degree of medical probability?

 
 
A:  Yes, they are. I think so.

 
 
In his testimony, David claimed that his fall was caused by 
his work-related injury:

 
 
Q:  Did there come a time then when you had some 
kind of a fall?

 
 
[David]:  Yeah, in, I believe it was October  
September or October.  End of September.  Yeah, I believe it 
was the end of September, I had an [sic] fall stepping down into my garage 
because of my right leg pain.  Because of the nerve, when I tried to catch 
myself with the left foot, I fell against the floor and the step.  And just a fall. 
 And put a 
scrape on my back.

. . . .

. . . But it was because of the injury that I, you know, 
fell in the first place.  I mean, it was just my leg giving out.  And then from 
sciatic nerve pain going down my leg, I couldn't hold my weight up.

 
 
David, however, maintained that the fall did not result in 
any injury to his lower back nor did it re-exacerbate his work-related 
injury:

 
 
[David]: . . . And when I got to therapy the next day, [the 
physical therapist] asked me how I scraped my back.  And I told her. 
 That's how the 
whole discrepancy and the Workmens' Comp came back on it.  It was a mild scrape 
on my back.  Wasn't in the same place that my injury 
was.

 
 
Q:  What part of the back did you have the scrape 
on?

 
 
A:  Just the top of my spine.  About a third of the 
way up my back.  Probably about four inches or so above where 
the original injury was.  

 
 
Q:  At the time of the fall, did you experience 
any kind of an onset of pain or anything in your low back?

 
 
A:  Not increasing, you know, what I was already 
having.

 
 
. . . .

 
 
Q:  And then when you had this fall that [your 
counsel] asked you about, how did that occur?

 
 
A:  All right.  I was going from my house into my garage. 
 And when I 
went to step down the stairs [my] right leg went out from under me.  The brunt of the 
pain was in my right leg and the nerve, you know, being in pain.  And when I went to 
catch myself, I scraped my back when I slid down the step.

 
 
Q:  What did you land on?

 
 
A:  I landed on the threshold of the door.

 
 
Q:  Did you land on your back on the steps?

 
 
A:  I landed on my elbows and my back, more or 
less.  I mean, 
it wasn't a fall per se, but a slip.  It just scraped my back a little bit, probably 
six inches, eight inches above my tail bone, little scrape about the size of a 
quarter.  More 
like a rug-burn type scrape.

 
 
. . . .

 
 
Q:  Do you believe that the fall on the steps 
made your back pain worse?

 
 
A:  No.

 
 
Q:  Do you know why Dr. Conclin [sic] might have 
written a letter  looking at Claimant's Exhibit 11 indicating that you 
apparently tripped and re-exacerbated your back pain or your spine?

 
 
A:  He apparently misunderstood the way I 
explained what happened to him [sic].

 
 
Q:  So you don't know why he would describe that 
incident as having caused an exacerbation?

 
 
A:  I don't know what exacerbation is.

 
 
Q:  Well, let's ask you  you don't know why he 
would have said that incident caused a worsening of your condition?

 
 
A:  I told him I had pain, but it wasn't really 
any different than it was before.  Even if you look at the therapy, the therapist 
said it didn't show any recognition of difference from before or afterwards in 
the therapy.

 
 
Q:  Do you know why he would indicate  why it 
would have made your condition worse?

 
 
A:  No.  Other than I possibly told him at the time 
that there was, you know, a little bit more pain.  But it was within a 
few days back to the same, you know, where it was.  It didn't, I mean, 
really increase anything as far as difference, or changes, or recovery time, or 
anything like that.

 
 
Q:  Well, do you know why a 9/17/04 report from 
your physical therapist would state that the fall on 9/13/04, it slowed your 
progress?  And 
that note would also indicate that you had increased pain since the fall Monday 
night[?]

 
 
A:  I had some increased pain, but you know, not 
a dramatic amount.  And after a few days, like I said, it was 
better again. 

 
 
David's counsel echoed that testimony in his opening 
remarks:

 
 
That on September 13, he will testify that he did have a 
fall.  What had 
happened was he was having some weakness in his right leg that was associated 
with the herniated disk which Dr. Conclin [sic] testified to in his deposition, 
in his low back had some weakness with that.  Had a fall where he will testify that he did 
have a scrape on his back, but that had no effect on his low back.

 
 
I mean, the records show that he had a fall but that he had 
just a very slight increase in his low back pain and that Dr. Conclin's [sic] 
treatment, the physical therapy treatment was all the same.  There were no 
changes in that.

 
 
And in his closing:

 
 
. . . [This] possible fall is nothing.  It's not a new 
injury.  It's 
not an exacerbation.  It's just that [sic] a slip that didn't change 
any of his treatment.

 
 
[¶13]   At the contested case hearing, David's 
theory was that while his initial work injury caused him to slip and fall, the 
resulting injury was relatively minor in nature, affecting a different area of 
his back and did not exacerbate or otherwise impact the original injury.  Effectively, David 
disclaimed any intent to recover benefits based on compensability of the 
injuries resulting from his fall.  David's theory of recovery was based on a 
linkage of his outstanding claims to the compensability of his original injury; 
it did not encompass a claim, even implicitly, under the second compensable 
injury rule.  Our discussions in Carabajal and Pino are inapposite 
to the situation here.  Under the circumstances, the hearing 
examiner's failure to address the second compensable injury rule was not in 
error.

 
 
[¶14]   In his final issue, David insists that 
he met his burden of proof and the record contains sufficient evidence to 
support his claim for benefits.  David points to the opinion testimony of his 
treating physician and physical therapist that his back injury was work-related, 
and that his claims for benefits were related to that injury. 

 
 
[¶15]   The hearing examiner discounted the 
opinion testimony of David's experts finding them unpersuasive because neither 
opinion was based upon a complete medical history from David.  A "hearing examiner 
is entitled to disregard an expert opinion if he finds the opinion unreasonable, 
not adequately supported by the facts upon which the opinion is based, or based 
upon an incomplete and inaccurate medical history provided by the claimant." 
 Taylor v. State ex rel. 
Wyoming Workers' Safety and Compensation Division, 2005 WY 148, ¶ 15, 123 P.3d 143, 148 (Wyo. 
2005) (citing Franks 
v. State ex rel. Wyoming Workers' Safety and Compensation Division, 2002 WY 77, ¶ 18, 46 P.3d 876, 879-80 (Wyo. 
2002) (In re Franks); and Clark v. State ex rel. Wyoming Workers' Safety and 
Compensation Division, 934 P.2d 1269, 1271 (Wyo. 1997)).

 
 
It is the obligation of the trier of fact to sort through 
and weigh the differences in evidence and testimony, including that obtained 
from medical experts.  Morgan v. Olsten Temporary Services, 975 P.2d 12, 16 
(Wyo. 1999).  "The task of 
determining the credibility of the witnesses and weighing the evidence is 
assigned to the [hearing examiner], and its determination will be overturned 
only if it is clearly contrary to the great weight of the evidence."  [Hurley v. PDQ 
Transport, Inc., 6 P.3d 134, 138 (Wyo. 2000)]

 
 
"Where the testimony of a disinterested witness is not 
directly contradicted but there are circumstances which controvert the testimony 
or explain it away, or if such testimony is clouded with uncertainty and 
improbability, or otherwise appears to be unreliable or unworthy of belief, the 
trier of fact is not bound to accept it.  Justice does not require a court or jury to 
accept as an absolute verity any statement of a witness merely because it is not 
directly or specifically contradicted by other testimony, and there are many 
things which may properly be considered in determining the weight that should be 
given the direct testimony of a witness even though no adverse verbal testimony 
is adduced.  If 
such testimony is evasive, equivocal, confused, or otherwise uncertain, it may 
be disregarded."

 
 

Krause v. State ex rel. Wyo. Workers' Compensation Div. (Matter of 
Krause), 803 P.2d 81, 83 (Wyo. 1990).

 
 

Taylor, at ¶ 16, 123 P.3d  at 148. 

 
 
[¶16]   David's treating physician admitted 
that in forming his opinion, he was not aware that David had been treated prior 
to July of 2004 for pain in his lower back that radiated into his right leg. 
 He 
acknowledged that the information could have an impact on a determination of 
causation.  
David's physical therapist admitted that she did not have information 
about the back treatments David underwent between 2001 and the date of his work 
injury nor about right hip pain that David experienced in May of 2004, when 
forming her opinion.  
Under the circumstances, we cannot say that the hearing examiner was 
wrong to discount the medical opinions proffered by David's witnesses.  The determination by 
the hearing examiner that David had failed to meet his burden of proof was not 
arbitrary or capricious.

 
 
CONCLUSION

 
 
[¶17]   The hearing examiner's determination 
that David had not met his burden of establishing the compensability of his 
outstanding claims for benefits was not arbitrary or capricious.  The order denying 
benefits is affirmed.

 
 
FOOTNOTES

 
 

1§ 
27-14-601. Payment or denial of claim by division . . .[.]

. . . .

(b)  Following 
review of each bill and claim for medical and hospital care pursuant to W.S. 
27-14-401(b), the division may approve or deny payment of all or portions of the 
entire amount claimed and shall:

(i)  Notify the 
employee and the health care provider in writing of any portion of a claim for 
which the employee may be liable for payment;

(ii)  Provide 
the health care provider with a detailed monthly statement of respective claims 
and bills for services rendered and the amount approved for payment;

(iii)  Provide 
the employer with a detailed monthly statement of all medical and hospital 
claims affecting his experience rating.

 
 
Wyo. Stat. Ann. § 
27-14-401(b)(LexisNexis 2005) provides:

 
 
No fee for medical or 
hospital care under this section shall be allowed by the division without first 
reviewing the fee for appropriateness and reasonableness in accordance with its 
adopted fee schedules.

 
 

2§ 
27-14-605.  Application for modification of benefits . . 
.[.]

(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.