Case Title: Hoffman v. State ex rel. Workers' Safety & Comp. Div.

Citation: 

Docket Number: S-12-0092

State: wyoming

Court: Wyoming Supreme Court

Date: 2012-12-21T00:00:00Z

Document:
IN THE MATTER OF THE WORKER'S COMPENSATION CLAIM OF: RANDY W. HOFFMAN v. STATE OF WYOMING, ex rel., WYOMING WORKERS' SAFETY AND COMPENSATION DIVISION2012 WY 164Case Number: S-12-0092Decided: 12/21/2012This opinion is subject to formal revision before final publication in Pacific Reporter Third. Readers are requested to notify the Clerk of the Supreme Court, Supreme Court Building, Cheyenne, Wyoming 82002, of any typographical or other formal errors so that correction may be made before final publication in the permanent volume. 
OCTOBER TERM, A.D. 
2012 
 
IN 
THE MATTER OF THE WORKER’S COMPENSATION CLAIM OF:RANDY W. 
HOFFMAN,Appellant(Petitioner),v.STATE OF WYOMING, ex 
rel., WYOMING WORKERS’ SAFETY AND COMPENSATION 
DIVISION,Appellee(Respondent).
 
Appeal from the 
District Court of Natrona County
The Honorable David 
B. Park, Judge
 
Representing 
Appellant:
Peter 
J. Timbers of Schwartz, Bon, Walker, Studer, LLC, Casper, 
Wyoming.
 
Representing 
Appellee:
Gregory A. Phillips, 
Wyoming Attorney General; John D. Rossetti, Deputy Attorney General; Michael J. 
Finn, Senior Assistant Attorney General; Kelly Roseberry, Assistant Attorney 
General.
 
Before KITE, 
C.J., HILL, VOIGT, BURKE, JJ., and GOLDEN, J., Retired.
 
KITE, C.J., 
delivers the opinion of the Court; HILL, J., files a specially concurring 
opinion.
 
KITE, Chief 
Justice.
 
[¶1]  
Randy W. Hoffman injured his back while working in 1994.  
As a result, he had three back surgeries between 1995 and 
2004.  The Wyoming Worker’s Compensation Division (the 
Division) paid him benefits for the injury and associated treatment.  
In 2009, he fell on the ice at his home and underwent a fourth back 
surgery.  Claiming that the surgery was connected to his 
original work injury, Mr. Hoffman sought benefits.  The 
Division denied his claim.  After a hearing, the Medical 
Commission (the Commission) upheld the denial, concluding that Mr. Hoffman had 
failed to prove the 2009 surgery was causally connected to his 1994 work 
injury.  Mr. Hoffman filed a petition for review in district 
court, which affirmed the denial.  In his appeal to this 
Court, Mr. Hoffman asserts the Commission’s decision is arbitrary, capricious 
and not in accordance with the law because the evidence overwhelmingly showed 
the fourth surgery was causally connected to his work injury.  
We conclude that when the proper legal standard is applied, the 
Commission’s determination was contrary to the overwhelming weight of the 
evidence.  We, therefore, reverse. 

ISSUE
 
[¶2]  
Mr. Hoffman presents the following issue for this Court’s 
determination:
 
1.         
Whether the order denying benefits for Mr. Hoffman’s Second Fusion was 
arbitrary, capricious, and not in accordance with law.
 
The Division asserts 
substantial evidence supported the Commission’s decision. 
 
FACTS
 
[¶3]  
In October of 1994, while working on a drilling rig for Dunbar Well 
Service near Gillette, Wyoming, Mr. Hoffman fell from the rig floor to the 
ground three feet below, injuring his back.  After treating 
the injury conservatively for several months, Mr. Hoffman’s physician performed 
a surgical hemilaminectomy with partial discectomy at 
the L5-S1 level in 1995.    
 
[¶4]  
Six years later, in 2001, after Mr. Hoffman began experiencing pain in 
his lower back and leg, an orthopedic spine surgeon repeated the surgery 
performed in 1995. Between 2002 and 2004, Mr. Hoffman again experienced lower 
back pain.  He was referred to Dr. Thomas A. Kopitnik, 
a neurosurgeon, who ultimately performed a third surgery, fusing L4-5 and 
L5-S1.  Mr. Hoffman received worker’s compensation 
benefits for his treatment from the date of his injury through the 2004 
surgery.
 
[¶5]  
In April of 2009, Mr. Hoffman slipped and fell on ice at his 
home.  After suffering from back pain for several weeks, he 
again saw Dr. Kopitnik, who recommended another surgery to fuse the two 
levels above the site of the 2004 surgery.  
Dr. Kopitnik sought preauthorization for the surgery from the 
Division, stating that Mr. Hoffman’s fall on the ice exacerbated the underlying 
condition created by his work injury.  The Division retained 
Dr. Paul C. Williams, a neurosurgeon, to perform an independent medical 
evaluation (IME).  Dr. Williams concluded Mr. Hoffman’s 
back issues were less influenced by his work injury than degenerative changes 
resulting from natural aging.  After receiving Dr. Williams’ 
report, the Division issued a final determination denying preauthorization for 
the second fusion surgery.  Mr. Hoffman objected to the 
determination and requested a contested case hearing.
 
[¶6]  
Prior to the hearing, Dr. Kopitnik performed the second 
fusion surgery.  Consequently, the issue for determination at 
the hearing was not whether the Division properly denied preauthorization for 
the surgery but whether the surgery was covered by worker’s 
compensation.  After the hearing, the Commission denied 
benefits, concluding that Mr. Hoffman failed to meet his burden of proving the 
2009 fusion was causally connected to his 1994 work injury.  
In reaching that conclusion, the Commission found:
 
-          
“Mr. 
Hoffman’s present spinal problems are primarily caused by the 
non-industrial fall superimposed on a degenerating back . . .”; 
-          
“[his] need 
for surgery on the L2-3 and L3-4 segments . . . is not 
primarily due to adjacent segment deterioration as indicated by Dr. 
Kopitnik”; 
-          
“the 
non-work-related fall in 2009 was the primary contributing incident for 
Mr. Hoffman’s need for an additional surgery and fusion, coupled with his 
profound degenerative profile.”
 
In its conclusions of 
law, the Commission stated:  
 
Mr. Hoffman had 
received an excellent result from the 2004 fusion, and all medical expenses were 
paid by the Division as part of his original 1994 injury.  To 
hold the Employer responsible for care and treatment 15 years later, when a 
non-industrial intervening cause created the need for the latest surgery seems 
inherently unfair, particularly in light of Mr. Hoffman’s genetic predisposition 
for spinal pathology.       

 
The district court 
affirmed the Commission’s ruling.  Mr. Hoffman timely appealed 
to this Court. 
 
STANDARD OF 
REVIEW
 
[¶7]  
Mr. Hoffman contends the Commission applied the wrong legal standard and, 
when the correct legal standard is applied, its ruling was against the 
overwhelming weight of the evidence.  The question of whether 
the Commission applied the correct legal standard is one of law, which we review 
de novo.  Judd v. State ex rel. Wyo. Workers’ Safety 
& Comp. Div., 2010 WY 85, ¶ 27, 233 P.3d 956, 967 (Wyo. 
2010).  In reviewing the Commission’s conclusion that Mr. 
Hoffman did not meet his burden of proof, we apply the following standards: 

 
If the hearing 
examiner determines that the burdened party failed to meet his burden of proof, 
we will decide whether there is substantial evidence to support the agency’s 
decision to reject the evidence offered by the burdened party by considering 
whether that conclusion was contrary to the overwhelming weight of the evidence 
in the record as a whole.  If, in the course of its decision 
making process, the agency disregards certain evidence and explains its reasons 
for doing so based upon determinations of credibility or other factors contained 
in the record, its decision will be sustainable under the substantial evidence 
test.  Importantly, our review of any particular decision 
turns not on whether we agree with the outcome, but on whether the agency could 
reasonably conclude as it did, based on all the evidence before it.  

 
Davenport v. State ex 
rel. Wyo. Workers’ Safety & Comp. Div., 2012 WY 6, ¶ 12, 
268 P.3d 1038, 1041-42 (Wyo. 2012) (citation omitted).  

 
DISCUSSION
 
[¶8]  
Mr. Hoffman asserts that Drs. Kopitnik and Williams both 
testified that the 2004 surgery contributed to the need for a second fusion; 
therefore, the Commission’s finding that the 2009 surgery was not causally 
connected to his 1994 work injury is contrary to the overwhelming weight of the 
evidence.  He maintains that he was only required to prove 
that his work injury contributed to the 2009 surgery, not that it contributed to 
any particular degree, and since both experts testified that it contributed, the 
Commission erred in concluding he did not prove his case.  The 
Division responds that substantial evidence supported the Commission’s 
conclusion that Mr. Hoffman did not meet his burden of proving a causal 
connection between his 1994 work injury and the 2009 surgery.   

 
[¶9]  
Mr. Hoffman’s claim that he is entitled to benefits for the 2009 surgery 
requires application of the second compensable injury rule.  
“The second compensable injury rule applies when an initial compensable 
injury ripens into a condition requiring additional medical 
intervention.”  Rogers v. State ex rel. Wyo. Workers’ 
Safety & Comp. Div., 2012 WY 117, ¶ 14, 284 P.3d 815, 819 
(Wyo. 2012), quoting Alvarez v. State ex rel. Wyo. Workers’ Comp. Div., 
2007 WY 126, ¶ 18, 164 P.3d 548, 552 (Wyo. 2007).  
“Under the second compensable injury rule, a subsequent injury or 
condition is compensable if it is causally related to the initial compensable 
injury.”  Id.  As with claims for 
benefits arising from an initial injury, an employee claiming entitlement to 
benefits under the second compensable injury rule has the burden of proving “a 
causal connection exists between a work-related injury and the injury for which 
worker’s compensation benefits are being sought.”  
Davenport, ¶ 21, 268 P.3d  at 1044 (citation 
omitted).  In order to receive benefits, therefore, Mr. 
Hoffman had to prove by a preponderance of the evidence that the condition 
giving rise to his 2009 surgery was causally connected to his 1994 work 
injury.  In other words, he had to prove that his initial work 
injury ripened into a condition requiring additional medical intervention in 
2009.  Id., quoting Wyo. Workers’ Safety & Comp. 
Div. v. Kaczmarek, 2009 WY 1001, ¶ 9, 215 P.3d 277, 281 
(Wyo. 2009).  
 
[¶10]  
In attempting to make that showing, Mr. Hoffman relied primarily on the 
medical records and deposition testimony of Dr. Kopitnik. 
 Upon reviewing a CT scan taken after Mr. Hoffman’s fall in 
2009, Dr. Kopitnik noted “segmental breakdown of his previous fusion 
at L3-4 . . . and some stenosis1 developing at 
L2-3.”  Subsequently, in a letter to the Division, 
Dr. Kopitnik stated that the segmental breakdown in the area above 
the 2004 fusion at L2-3 and L3-4 was clearly related to the 2004 
fusion which resulted from his 1994 work injury.  He stated 
further:
 
[Mr. 
Hoffman] has segmental breakdown from facet joint disease and mechanical failure 
at the level immediately adjacent to his previous fusion.  
This is a known possible sequela of lumbar fusion.
 
I 
believe this is related to his previous work related injury and need for a 
previous lumbar fusion.  I believe that his fall on the ice 
was merely exacerbating his underlying spinal degenerative condition that was 
proven by lumbar myelogram post myelographic CT 
scan.  I believe this is clearly a compensable injury. 

 
[¶11]  
In his deposition, Dr. Kopitnik reiterated that tests 
performed after Mr. Hoffman slipped and fell in 2009 showed that he had 
developed spinal stenosis and segmental breakdown at the level 
immediately above his 2004 surgery.  Dr. Kopitnik 
testified that in his opinion it was probable the stenosis was 
related to the fusion performed in 2004.  He further testified 
that he did not believe the fall on the ice had anything to do with 
the stenosis because a fall on the ice would not cause spinal 
stenosis, which takes many months or years to develop.  
Dr. Kopitnik also testified that in his opinion, rather than 
resulting from natural aging or the fall, the condition of Mr. Hoffman’s back in 
2009 more probably resulted from accelerated aging due to mechanical failure 
adjacent to the 2004 surgery and was, therefore, related to his 1994 work 
injury.    
 
[¶12]  
In addition to Dr. Kopitnik’s records and testimony, Mr. 
Hoffman points to Dr. Williams’ testimony that in his opinion the 2009 fusion 
and the 1994 work injury “may be related” and that the 2004 fusion necessitated 
by the 1994 work injury “contributed” to the condition which led to the fusion 
in 2009.  Although Dr. Williams testified he thought several 
other more important factors contributed to Mr. Hoffman’s back problems in 2009, 
Mr. Hoffman points out that Dr. Williams agreed “it would be remiss” not to 
include the 2004 fusion as one factor that contributed to Mr. Hoffman’s 
condition.   
 
[¶13]  
Considering the testimony of Drs. Kopitnik and Williams, it 
is clear that considerable evidence was presented showing the 2009 surgery was 
causally connected to the 1994 work injury.  In the language 
of the second compensable injury rule, evidence was presented from two expert 
witnesses that the initial 1994 compensable injury ripened into a condition 
requiring additional medical intervention in 2009.  In 
rejecting Mr. Hoffman’s claim based on its findings that the 1994 work injury 
was not the primary cause of the condition giving rise to the 2009 surgery, the 
Commission misapplied Wyoming law.  Mr. Hoffman was not 
required to prove his work injury was the primary cause; he was only required to 
prove the 1994 work injury and the need for additional medical treatment in 2009 
were causally connected.  Davenport, ¶ 22, 
268 P.3d  at 1044.  Applying the proper standard, 
the question is whether substantial evidence supported the Commission’s decision 
to reject Mr. Hoffman’s evidence.   In making that 
determination, we consider whether the Commission’s decision was contrary to the 
overwhelming weight of the evidence in the record as a whole.  

 
[¶14]  
In addition to its misapplication of Wyoming 
law, which we have already discussed, the Commission’s decision to reject Mr. 
Hoffman’s evidence appears to have been based primarily on three 
factors:  its conclusion that other evidence was entitled to 
greater weight than Mr. Hoffman’s evidence; its conclusion that 
Dr. Kopitnik was not a credible witness; and its conclusion that it 
would not be fair to hold the employer liable for the 2009 surgery.  
Although these conclusions are closely intertwined, we address each of 
them separately.  
 
[¶15]  
In rejecting the expert medical opinions, the Commission found persuasive 
radiology records from 2007 showing that Mr. Hoffman had degenerative facet and 
disc disease.  Those records, combined with evidence showing 
that Mr. Hoffman had good results from, and went back to work after, the 2004 
surgery and received no further medical care for his back until after he fell in 
2009, persuaded the Commission that the 2009 surgery was caused by the fall and 
the degenerating condition of Mr. Hoffman’s back.  
 
[¶16]  
The task of weighing the evidence is assigned to the 
Commission.  Hurley v. PDQ Transport, Inc., 
6 P.3d 134, 138 (Wyo. 2000).  It was not error for 
the Commission to consider the 2007 radiology reports and evidence surrounding 
the 2004 surgery and weigh that evidence against the expert 
testimony.  The fact that the Commission found the other 
evidence persuasive as tending to show the 2009 surgery was causally connected 
to factors other than the 1994 work surgery is not error.  
However, in order to conclude that those factors alone gave rise to the 
condition necessitating the 2009 surgery, the Commission had to reject the 
evidence showing that the 1994 injury and the 2009 surgery were causally 
connected.  Specifically, the Commission had to reject the 
testimony of Drs. Kopitnik and 
Williams.     
 
[¶17]  
In the context of cases involving an aggravation of a pre-existing 
condition, we have said: 
 
the 
causal connection between the work and the condition is satisfied if the medical 
expert testifies it is more probable than not that the work contributed in a 
material fashion to the aggravation of the injury.  Expert 
medical testimony to the effect that the work “contributed to” the injury or 
that the injury “most likely” or “probably” is the product of the workplace 
suffices.
 
Boyce 
v. State ex rel. Wyo. Workers’ Safety & Comp. Div., 2005 
WY 9, ¶ 11, 105 P.3d 451, 455 (Wyo. 2005) (citations 
omitted).  If we have not previously made it clear that the 
same standard applies in the context of a second compensable injury, we do so 
now.  In a second compensable injury case, the causal 
connection between the work injury and the second injury is satisfied if the 
medical expert testifies that the work injury contributed to the second 
injury.  Dr. Kopitnik stated that the condition 
giving rise to the 2009 surgery was “clearly related to” and “more probably 
resulted from” Mr. Hoffman’s original work injury and resulting 2004 
fusion.  Dr. Williams testified that the 1994 work injury and 
resulting 2004 fusion contributed to the condition giving rise to the 2009 
surgery and were factors that should be considered.  This 
testimony satisfied the requirement for proving a causal connection.  

 
[¶18]  
The Commission rejected Dr. Kopitnik’s opinions on the basis 
that he “had a financial stake in the outcome,” and had conceded that some of 
his opinions regarding adjacent segment disease were “theoretical.”  
No evidence was presented that Dr. Kopitnik had a financial 
stake in the outcome; therefore, that conclusion is not supported by the record 
and the Commission erred in relying on it as a basis for rejecting 
Dr. Kopitnik’s opinions.2  Camilleri 
v. State ex rel. Wyo. Workers’ Safety & Comp. Div., 2010 WY 156, ¶ 31, 
244 P.3d 52, 62 (Wyo. 2010).  The Commission’s 
statement that Dr. Kopitnik’s opinions were theoretical is based on 
the following exchange during his deposition:
 
Q.        
What do you believe that the stenosis is a result 
of?
A.        
I don’t think – I don’t think that’s clear, but I think that 
it’s prob – more likely than not – and I understand the legal 
definition of probable and possible.  I think it is probable 
that it is related to the need to have a fusion at the L5-S1 space 
to have a non-motion segment of L4, 5 and S1 and shifting 
mechanical stress to the one space adjacent to it, and that has accelerated 
degenerative disease at that level.  And I believe more 
probable than not the need of a fusion at L4-5 and L5-S1 is 
the proximate cause of accelerated age at the L3-4 disk space 
and stenosis at the level.
Q.        
Could you go farther in depth with regard to the mechanical effects of 
the fused disks on the disks immediately adjacent?
A.        
Not much more than common sense.  You have fused spaces 
that are not moving and you have an adjacent level that is moving, and it just 
theoretically sees increased mechanical stress and so it will wear and age 
theoretically faster.
Q.        
And that is due to the rigidity of the fused disks?
A.        
In some part, yes, sir.  Some of this is theoretical, 
so it’s theoretically due to the rigidity of the fusion, yes, sir.
 
As this 
excerpt reflects, the Commission’s statement is supported by the record and it 
was entitled to weigh Dr. Kopitnik’s testimony along with the other 
evidence presented.  The Commission did not err in considering 
Dr. Kopitnik’s testimony that some of his conclusions concerning 
adjacent segment disease were theoretical.  
 
[¶19]  
Notwithstanding Dr. Kopitnik’s testimony concerning adjacent 
segment disease, however, the Commission still had before it Dr. Williams’ 
testimony that the original work injury and resulting surgery contributed to the 
need for the 2009 surgery.  The Commission addressed that 
testimony by stating, “Ultimately Dr. 
Williams agreed that the 2004 fusion may have some level of contribution 
for the need for the subsequent fusion extension, but he attributes far more 
contribution to the degenerative component . . . .” (emphasis in 
original).  We considered a similar statement by the 
Commission in Judd, ¶ 23, 233 P.3d  at 966.  
There, the Commission concluded that the “contribution of the significant 
preexisting condition to the total knee replacement was far more considerable 
than the relatively minor fall that occurred on that date.”  
Concluding that this was “a clear statement of apportionment [which] is 
not permitted by Wyoming statute,” we held the Commission erred in comparing the 
relative contributions of the work injury and the pre-existing condition as a 
basis for denying benefits.  Id., ¶ 40, 
233 P.3d  at 971.  
 
[¶20]  
In Judd, we cited State ex rel. Wyo. Workers’ Safety & 
Comp. Div. v. Faulkner, 2007 WY 31, ¶ 18, 152 P.3d 394, 399-400 
(Wyo. 2007) where we expressly rejected arguments by the Division and the 
employer that apportionment is required under Wyoming’s worker’s compensation 
statutes.  We considered statutory language from other states 
where apportionment is allowed and concluded no similar statutory language 
exists in Wyoming.  Id., ¶ 18, 152 P.3d  at 
399-400.  Because the Wyoming legislature had not enacted a 
statute requiring apportionment, we applied the general rule disallowing 
apportionment in the absence of a specific statute requiring 
apportionment.  Id.  Since 
Faulkner, the legislature has not acted to require apportionment and we 
continue to apply the general rule disallowing apportionment in the absence of 
statutory language directing otherwise.      

 
[¶21]  
As in Judd, the Commission erred in comparing the relative 
contributions of the degenerative component with the work injury and resulting 
fusion as a basis for denying compensation.  The fact that Dr. 
Williams opined that the degenerative component played a greater role in the 
condition bringing about the 2009 surgery simply is not a proper basis for 
disregarding his testimony that the 1994 work injury and resulting fusion 
contributed to Mr. Hoffman’s need for another surgery in 2009.  
Correctly applying Wyoming law, Dr. Williams’ testimony supported 
awarding Mr. Hoffman benefits for the 2009 
surgery.      
 
[¶22]  
As an additional reason for disregarding Mr. Hoffman’s evidence, the 
Commission concluded it would not be fair to hold Mr. Hoffman’s employer 
responsible for the 2009 surgery.  Wyo. Stat. Ann. § 
27-14-616(b)(iv) (LexisNexis 2011), the provision establishing the Medical 
Commission, states in pertinent part:
 
When 
hearing a medically contested case, the [Commission] shall serve as the hearing 
examiner and shall have exclusive jurisdiction to make the final administrative 
determination of the validity and amount of compensation payable under 
this act. 
 
(emphasis 
added).  Thus, the legislature has charged the Commission with 
determining the validity of a medically contested claim and the amount of 
compensation payable.  In carrying out that charge, the 
Commission is obligated to apply the law to the facts.  The 
Commission’s perception of what is or is not “fair” is not an appropriate 
consideration.  The Commission erred in considering 
it.     
 
[¶23]  
We have said the role of the Medical Commission is to resolve medically 
contested issues through the professional expertise of health care 
providers.  Hurley, 6 P.3d  at 
138.  The task of determining the credibility of witnesses and 
weighing the evidence is assigned to the Commission and its determination will 
be overturned only if it is clearly contrary to the great weight of the 
evidence.  In Mr. Hoffman’s case, the Commission’s efforts to 
determine the validity of his claim were undermined by a misunderstanding of the 
applicable legal standard.  Under Wyoming law, Mr. Hoffman was 
required to prove that the 2009 surgery was causally connected to his 1994 work 
injury.  His treating physician and the Division’s medical 
expert testified that it was.  In rejecting that testimony, 
the Commission improperly considered Dr. Kopitnik’s “financial 
stake” in the outcome, a factor for which there was no evidentiary support, and 
its own perceptions of what was fair.  Taking those 
considerations out of the mix and applying the correct legal standard, we 
conclude the decision to reject Mr. Hoffman’s evidence was contrary to the 
overwhelming weight of the evidence.    
 
[¶24]  
Reversed and remanded for proceedings in accordance with this 
decision.
 
HILL, 
Justice, specially 
concurring.
 
[¶25]   
I concur wholly in the result reached by the majority 
opinion.  I write separately because I prefer that this Court 
reject altogether the suggestion that a treating physician’s testimony may be 
ignored because of the physician’s alleged financial stake in being compensated 
for treating the worker’s compensation claimant.  In 
Watkins v. State ex rel. Wyo. Med. Comm., 2011 WY 49, 
250 P.3d 1082 (Wyo. 2011), I commented on the speculative nature of 
such credibility determinations:
 
The 
Medical Commission also found all of Watkins’ physicians not to be credible on 
the basis that they had a financial interest in treating Watkins. 
 My sense is just the opposite; the only physician 
(compensated expert witness only, no treatment goal) with what amounted to a 
financial stake in this case was the physician who produced an IME 
that was tailored to the Division’s needs.
 
Watkins, ¶ 30, 
250 P.3d  at 1092 (Hill, J., dissenting).
 
[¶26]   
In Moss v. State ex rel. Wyo. Workers’ Safety and Compensation 
Div., 2010 WY 66, 232 P.3d 1 (Wyo. 2010), this Court rejected a 
credibility finding based on the claimant’s financial stake in the outcome of 
his claim, explaining:
 
The 
Medical Commission’s further observations that Mr. Moss’s credibility was 
impacted because he “seemed angry” and “has a financial stake in the outcome” 
are of little significance.  Every claimant has a financial 
stake in the outcome of his or her worker’s compensation benefits claim and it 
is likely that more than a few are angry about their situation. These 
observations do not support the Medical Commission's conclusion that Mr. Moss 
was not credible.
 
Moss, ¶ 30, 
232 P.3d  at 9.
 
[¶27]   
In the present case, the Court found no evidence in the record that 
Dr. Kopitnik had not been paid for the surgery he performed on 
Hoffman, and the Court thus rejected the Medical Commission's finding that 
Dr. Kopitnik’s testimony was not credible because of his financial 
stake in the outcome.  I agree with the majority’s rejection 
of the Commission’s credibility finding, but I would reach that result by 
extending the approach this Court took in Moss.  I 
would hold that a treating physician’s payment or lack thereof for treatment of 
the claimant is not the type of financial stake in the claim’s outcome that may 
be used to support a negative credibility finding.  It is no 
doubt true that the treating physician would like to be compensated for his 
services, just as a claimant would like to receive benefits, but it is my sense 
that the link between those desires and the testimony’s credibility will always 
be speculative and tenuous and should be rejected.
FOOTNOTES
1Stenosis is a narrowing of the spinal 
canal.  
2Evidence was presented that Dr. Kopitnik 
sought preauthorization from the Division for the 2009 surgery, the Division did 
not give the authorization and Dr. Kopitnik performed the surgery 
anyway.  This evidence might support an inference that 
Dr. Kopitnik was not paid, which inference would support the 
Commission’s finding that he had a financial stake in the outcome.  
It is equally possible, however, that Dr. Kopitnik received 
payment from another source in which case the evidence would not support the 
inference or the Commission’s finding.  The same could be said 
if the Commission were inclined in these cases to reject the Division’s expert 
medical testimony based upon an inference that he or she was testifying against 
the claimant because the Division was paying the bill for the medical opinion. 
This illustrates the problem that arises when a fact finder makes a finding 
based upon an inference when no evidence is presented on the 
issue.