Case Title: Claim of Nielsen

Citation: 

Docket Number: 90-246

State: wyoming

Court: Wyoming Supreme Court

Date: 1991-02-22T00:00:00Z

Document:
Claim of Nielsen1991 WY 23806 P.2d 297Case Number: 90-246Decided: 02/22/1991Supreme Court of Wyoming
In the Matter of the 
Worker's Compensation Claim of Richard V. NIELSEN, an Employee of Ronstad & 
Olsen Construction.

Richard V. 
NIELSEN,

Appellant 
(Employee-Claimant),

v.

STATE of Wyoming ex rel., 
WYOMING WORKERS' COMPENSATION DIVISION,

Appellee 
(Objector-Defendant).

 

Rehearing Denied March 
27, 1991.

Appeal from the District 
Court, Johnson County, James N. Wolfe, J.

 

Randall T. Cox 
of Omohundro & Palmerlee, Buffalo, for appellant.

Joseph B. Meyer, 
Atty. Gen., Ron Arnold, Sr. Asst. Atty. Gen., for 
appellee.

 

Before 
URBIGKIT, C.J., and THOMAS, CARDINE, MACY and GOLDEN, JJ.

URBIGKIT, Chief 
Justice.

 

[¶1]      The issue to be 
decided in this case is the date, for purposes of computing the amount of 
workers' compensation total disability benefits, on which appellant's injury was 
deemed to have occurred as contemplated by W.S. 27-14-403(c). The industrial 
accident occurred in 1963 and total disability was medically determined in 
1988.1 

[¶2]      We will reverse 
and remand to the administrative hearing officer with directions that appellant 
be paid at the rates applicable in 1988 when the medical decision was made from 
which appellant became aware that he was 100% disabled.

[¶3]      Appellant, 
Richard V. Nielsen, suffered a compensable injury within the course and scope of 
his employment on June 29, 1963 when he fell from a bridge at a construction 
site. Nielsen received workers' compensation benefits until his case was closed 
on November 30, 1967. Eventually, Nielsen returned to work as a truck driver 
from 1977 until November 20, 1986. Nielsen also received some additional 
benefits for treatments in 1982. In November 1986, he experienced numbness in 
his right side and was no longer able to continue his work. This problem was 
corrected through back surgery in December 1986. He then experienced numbness in 
his left side and a second back surgery was performed in December 1987. All of 
these medical procedures were paid by workers' compensation. By letter dated May 
2, 1988, an examining physician reported that Nielsen was 100% disabled and 
could perform no work, even work of a sedentary nature. On December 5, 1988, 
Nielsen submitted his claim for permanent total disability benefits. The claim 
was based upon a compensable injury date when his 100% disability was 
established by medical authority in the May 2, 1988 medical report.

[¶4]      There are no 
disputed facts in this matter. The only issue to be decided is whether Nielsen 
will be paid his permanent total disability benefits at rates applicable at the 
time of the original injury (1963), at the time the 1963 injury manifested 
itself in pain and numbness that prevented Nielsen from continuing his 
employment (1986), or at the time Nielsen was determined to be 100% disabled and 
applied for benefits (1988). After Workers' Compensation objection and resulting 
hearing, the administrative hearing officer determined that Nielsen should be 
paid at the rates applicable at the time of the original injury (1963). Nielsen 
petitioned for review in the district court and the district court certified the 
matter to this court for resolution pursuant to W.R.A.P. 12.09.

[¶5]      Nielsen poses 
this statement of the issues:

I. Whether the 
Independent Hearing Officer's Findings of Fact are supported by substantial 
evidence:

A. Whether the finding 
that the employee suffered the pertinent "compensable injury," to wit, Permanent 
Total Disability, on June 29, 1963, is supported by substantial 
evidence.

B. Whether the finding 
that the employee's "disability was evident and became a fact prior to the 
changes in the compensation rates" is supported by substantial 
evidence.

II. Whether the 
Independent Hearing Officer's Conclusions of Law and Order are in conformity 
with law:

C. Whether the 
Conclusions of Law and Order holding that the employee is limited to benefits 
based upon the 1963 statutes in effect at the time of the original industrial 
accident, when the employee's compensable injury of Permanent Total Disability 
occurred in 1986 or 1988, is in accordance with law or is an error of 
law.

[¶6]      The Workers' 
Compensation Division (state fund) counters with this statement of the 
issues:

I. Whether the 
administrative hearing examiner's decision is supported by substantial 
evidence.

II. Whether appellant is 
entitled to collect permanent total disability benefits pursuant to W.S. § 
27-14-406 (1986) or under W.S. § 27-85 (1963).

[¶7]  Surprisingly, the parties have posed the 
issues in terms of the existence of substantial evidence. Resolution of this 
case turns only on our construction of W.S. 27-14-403(c) which became effective 
on July 1, 1987. Wyo. Sess. Laws ch. 3, § 3 (1986 Sp. Sess.). W.S. 27-14-403(c) 
provides in part:

All awards stated in 
subsection (a) of this section except awards under subsections (b), (e)(ii), 
(iv) and (v) and (h)(ii) of this section shall be paid monthly at the rates 
prescribed by this subsection. For permanent partial and permanent total 
disability or death under paragraphs (a)(ii) through (iv) of this section, the 
award shall be paid monthly at the rate of two-thirds (2/3) of the statewide 
average monthly wage for the twelve (12) month period immediately preceding the 
quarterly period in which the injury occurred as determined pursuant to W.S. 
27-14-802.

Our task is to 
ascertain the meaning of the statute with regard to when an injury is deemed to 
have occurred. This decision on appeal addresses the construction of a statute 
and becomes a decision as a matter of law for which we apply a plenary review. 
Union Pacific R. Co. v. Wyoming State Bd. of Equalization, 802 P.2d 856 
(Wyo. 1990). This appellate review presents neither factual conflict nor a 
sufficiency of the evidence issue. Matter of Patch, 798 P.2d 839 (Wyo. 
1990).

[¶8]      While it is true 
a claimant has the burden of proving the actual time of disability and its 
cause, Bemis v. Texaco, Inc., 400 P.2d 529, 531, reh'g denied 401 P.2d 708 (Wyo. 1965), for purposes of establishing the date of occurrence of an 
injury to ascertain the time from which the statute of limitations begins to run 
is a legal question and not one of fact. In the Matter of Barnes, 587 P.2d 214, 219 (Wyo. 1978); McKeever Custom Cabinets v. Smith, 379 N.W.2d 368, 374 (Iowa 1985). We further note that rule in this instance, because 
determining the date of the occurrence of injury, for purposes of ascertaining 
the applicable compensation schedule, is likewise a question of law. The state 
fund argues for a construction of W.S. 27-14-403(c) which equates the "accident" 
with the "occurrence of the injury," so as to tie the schedule of benefits only 
to the accident and not to the occurrence of the injury. In many cases, there 
may be coincidence of accident and injury. 1B Larson, The Law of Workmen's 
Compensation, § 39 (1987). However, we have held that "accident" and "injury" 
are not identical in meaning. In the Matter of Barnes, 587 P.2d  at 218. 
Under the undisputed facts which govern this matter, Nielsen's disabling injury 
is clearly one that was not coincidental with the accident.

In Bemis, 400 P.2d  
at 530-31, we held: Nevertheless, in instances where employment has continued 
until the time of actual disability, we must hold that, where disability becomes 
a fact after a change in compensation rates, such changes have become an 
integral part of the employment status.

In that case, we 
concluded that the applicable compensation schedule was that which was in effect 
in 1963 when Bemis' disability became apparent, rather than that schedule which 
was in effect at the time of the accident in 1954. We iterated this principle in 
In the Matter of Barnes, 587 P.2d  at 219. It has been, and continues to 
be, a governing rule in workers' compensation cases nationwide. E.g., 
Prescott v. United States, 523 F. Supp. 918, 926 (D.Nev. 1981), 
aff'd 731 F.2d 1388 (9th Cir. 1984) (relying in part upon Bemis); 
State Compensation Ins. Fund v. Industrial Com'n of State, 724 P.2d 679, 
680 (Colo. App. 1986) (death benefits paid per schedule in effect at time of 
death, not accident); State Indus. Ins. System v. Harrison, 103 Nev. 543, 
746 P.2d 1095, 1098 (1987) (relying in part upon In the Matter of 
Barnes); and Liberty Mut. Ins. Co. v. Starnes, 563 S.W.2d 178, 179 
(Tenn. 1978) (relying in part upon Bemis). Moreover, we have repeatedly 
held that a single accident may give rise to more than one compensable injury. 
Matter of Krause, 803 P.2d 81 (Wyo. 1990) (and cases cited 
therein).

[¶9]      The determination 
of when an injury of a gradual nature has occurred is not always a simple one. 
Professor Larson identifies two options: (1) injury has occurred the first 
moment the pain or illness makes it impossible to work; or (2) the date on which 
the disabling accident finally prevents the claimant from performing his work. 
1B Larson, supra, at 7-350.28. Which of these options is applied will 
make a significant difference to the claimant. If we were to adopt the position 
of the state fund and the decision of the administrative hearing officer, 
Nielsen would be compensated in 1988 with 1963 dollars - a result only one step 
above no compensation at all - and, as we search for the most prudent and 
accurate construction of W.S. 27-14-403(c), we are, needless to say, mindful of 
our often repeated rule that workers' compensation statutes are to be liberally 
construed to effectuate their beneficent purposes and, if it is rationally 
possible, to construe them so that industry, rather than the injured workman, 
bears the burden of industrial accidents. Lehman v. State ex rel. Wyoming 
Workers' Compensation Div., 752 P.2d 422, 425 (Wyo. 1988). Also, whether 
Nielsen receives the average wage prevalent in 1986 or 1988 will make a 
difference in dollars and cents, even if it is a relatively modest amount, of 
special meaning to a working man who no longer has the capacity to do work of 
any sort.

[¶10]   In McKeever Custom Cabinets, 
379 N.W.2d  at 374 (and cases cited therein), the Iowa Supreme Court employed the 
rule that injury occurs and the employee is disabled when he can no longer work 
because of pain or physical inability. Application of this rule, to the facts of 
this case, would mean that Nielsen would be compensated at 1986 rates because 
Nielsen left his job in November 1986 because his condition at that time drove 
him to quit his employment.

[¶11]   In Coy v. Dover Corp./Norris 
Div., 773 P.2d 745, 747 (Okla. 1989), the Oklahoma Supreme Court held that 
cumulative injury cases (the injury at issue was hearing loss) were governed by 
a two-pronged rule. The court held that such injuries occur when: (1) the worker 
is aware he has an injury; and (2) is aware that the injury is causally related 
to the working environment. Application of this rule could support Nielsen's 
claim for benefits at the 1988 rates. In Harrison, 746 P.2d 1095, the 
Nevada Supreme Court treated the amputation of a leg, which occurred eight years 
after that leg was broken in an industrial accident, as a new injury. Although 
in that case the total disability was readily evident at the time the operation 
was performed, because there was no hiatus between the operation and the 
awareness of disability, this rule also tends to support Nielsen's claim for 
benefits at the 1988 rate.

[¶12]   In In the Matter of Barnes, 
587 P.2d  at 219, we held that the compensable injury occurred when Barnes was 
operated on some nine years after the accident causing the injury for purposes 
of determining the date from which the statute of limitations would run. While 
this ruling is instructive, it did not respond to the question posed in this 
case and so cannot be treated as controlling.

[¶13]   Each of the rules cited above have 
some merit, and each is useful for analyzing cases such as Nielsen's. It is 
apparent that no one black-letter rule will suffice to answer the question posed 
herein for all future such cases. We shall set down the perimeters of the rule, 
but it will be necessary to leave room for its maturation because there are, no 
doubt, an infinite variety of circumstances which no one hard and fast rule can 
accommodate. Under the circumstances presented here, we will employ what is, in 
essence, the Oklahoma rule cited above. Nielsen may have known that his 1963 
injury was the source of his medical difficulties as early as November 1986, but 
it was not until May 1988, when so informed by his examining physician, that he 
became aware that his injury (total disability) had occurred. The significance 
of the operations in this case would only have been to trigger the running of 
the statute of limitations for filing a claim for those operations. When Nielsen 
left his work in November 1986 to receive treatment, he could not have filed a 
claim for total disability because he didn't have knowledge, nor apparently did 
the attending physicians, that he was 100% disabled. It was likely contemplated 
that Nielsen would benefit enough from the surgeries to return to be a 
functional worker of some sort. Unfortunately, the operations did not produce 
that result.

[¶14]   Thus, we hold that, pursuant to 
W.S. 27-14-403(c), Nielsen's injury occurred when the physician's report was 
communicated by a mailing of the report to the covered worker on May 2, 1988. 
That date became his stated date of injury by determination and discovery which 
was recited in his December 5, 1988 claim from which the issues of this appeal 
were developed.

[¶15]   Reversed and remanded to the 
administrative hearing officer for further proceeding consistent with this 
opinion.

Footnotes

1 The difference in 
potential benefit payment is stark. Specific totals are not clearly identified, 
but the 1963 amount is suggested to be $150 compared to the 1988 monthly benefit 
of something more than $1,000 per month or approximate total payments of $9,000 
versus nearly $62,000.