Case Title: Bando v. Clure Bros. Furniture

Citation: 

Docket Number: 

State: wyoming

Court: Wyoming Supreme Court

Date: 1999-05-18T00:00:00Z

Document:
Bando v. Clure Bros. Furniture1999 WY 59980 P.2d 323Case Number: 97-164Decided: 05/18/1999Supreme Court of Wyoming
 
JOHN 
A. BANDO, Appellant (Petitioner),

v.

CLURE BROTHERS FURNITURE; 
and STATE OF WYOMING, ex rel., WYOMING WORKERS' SAFETY AND COMPENSATION 
DIVISION, Appellees (Respondents).

 

Appeal from the District 
Court of Laramie County, The Honorable Edward L. Grant, 
Judge.

Deborah Ford 
Mincer, Cheyenne, WY, Representing Appellant. Argument presented by Ms. 
Mincer.

William U. Hill, 
Attorney General; Gerald W. Laska, Senior Assistant Attorney General; and 
Bernard P. Haggerty, Assistant Attorney General, Representing Appellee 
Workers' Safety and Compensation Div. Argument presented by Mr. 
Haggerty.

Before 
LEHMAN, C. J., and THOMAS, MACY, GOLDEN, and TAYLOR,* 
JJ.

* Chief Justice at time of 
oral argument; retired November 2, 1998.

LEHMAN, Chief 
Justice.

[¶1]      John A. Bando 
(Bando) appeals from the denial of his claim for worker's compensation benefits, 
arguing that the Office of Administrative Hearings was without jurisdiction 
because his case was medically contested. We disagree. The Wyoming Worker's 
Compensation Division, pursuant to its rule defining medically contested cases, 
properly determined that Bando's claim did not warrant medical commission 
review. In addition, we are satisfied that the record supports the hearing 
examiner's determination that Bando did not clearly prove that he suffered his 
hernia while working for Clure Brothers Furniture. We affirm the hearing 
examiner's order denying benefits.

ISSUES

[¶2]      Bando presents 
the following issues for our review:

I. Whether the 
Worker's Compensation Division ignored the statutory mandate to send this case 
to the Medical Commission and, therefore, the decision should be reversed 
because the Office of Administrative Hearings had no subject matter 
jurisdiction?

II. Whether the 
decision of the Office of Administrative Hearings was not in accordance with law 
in ruling that the claim was not timely filed? 

A. Whether the 
decision was not in accordance with law because it ignored this Court's 
precedents regarding the date of diagnosis?

B. Whether the 
decision was not in accordance with law because it misconstrued the requirements 
of Wyo. Stat. 27-14-502 regarding investigating an accident and monitoring 
medical treatment?

III. Whether the 
decision of the Office of Administrative Hearings was not in accordance with law 
in that it ignored applicable law on medical opinions, imposed upon Mr. Bando a 
burden of proof greater than that allowed by statute and failed to require the 
employer and Worker's Compensation Division to shoulder a burden of production 
of the evidence?

IV. Whether the 
decision of the Office of Administrative Hearings was arbitrary, capricious and 
an abuse of discretion and unsupported by substantial 
evidence?

Appellee, 
Wyoming Workers' Safety and Compensation Division (Division), counters with this 
statement of the issue:

A. Were the 
Hearing Examiner's decisions supported by substantial evidence and in accordance 
with law?

[¶3]      After the parties 
filed their principal briefs, we authorized supplemental briefing on the 
following issues:

1. Whether the 
Worker's Compensation Division adhered to fixed and objective procedural 
standards in making the decision to refer this case to the Office of 
Administrative Hearings rather than a medical hearing panel composed of three 
members of the Medical Commission?

2. Whether the 
Worker's Compensation Division's substantive decision to refer this case to the 
Office of Administrative Hearings rather than a medical hearing panel composed 
of three members of the Medical Commission was pursuant to fixed and objective 
standards and otherwise in accordance with law?

FACTS

[¶4]      Bando began work 
as a furniture mover for Clure Brothers Furniture of Cheyenne on January 22, 
1996. He quit on April 5, 1996. On April 8, Bando went to work for McIntyre's 
Garden Center. The following Sunday, April 14, Bando woke up with a "super ball" 
sized lump in his left groin. Bando was examined the next day by a nurse at the 
Veteran's Administration (VA) hospital and diagnosed with a bilateral inguinal 
hernia. On April 16, a VA physician confirmed the hernia diagnosis, and Bando 
filed an injury report in which he claimed he suffered his hernia while working 
at Clure Brothers.

[¶5]      On May 2, 1996, 
Bando underwent laproscopic surgery to repair the hernia. The surgery was 
successful, and Bando filed a claim with the Division seeking reimbursement for 
surgery costs as well as lost wages. Clure Brothers objected to Bando's claim by 
filing a written response. In addition to objecting to Bando's injury report as 
untimely, the response asserted that (1) Bando continued working and moving 
furniture for twenty days after the date he claims he suffered his hernia; (2) 
Bando never mentioned to anyone the possibility of having a hernia nor missed 
any work because of hernia pains; and (3) Bando was observed doing onehanded 
pushups in the store at a time when he was supposed to be suffering from a 
hernia.

[¶6]      The Division 
issued a final determination which denied Bando's claim for benefits. In 
addition to reciting Clure Brothers' timeliness objection, the final 
determination stated that the Division was denying the claim because it could 
not verify that Bando received an injury at [his] place of employment. Bando 
objected and filed a timely written request for a hearing. After the Division 
assigned his case to the Office of Administrative Hearings (OAH), Bando moved to 
dismiss for lack of jurisdiction, arguing that the OAH did not have jurisdiction 
because his case was medically contested, and jurisdiction thus rested with the 
Worker's Compensation Medical Commission pursuant to Wyo. Stat. Ann. § 27-14-616 
(Michie Cum. Supp. 1995). The hearing examiner denied Bando's motion and held a 
contested case hearing.

[¶7]      When, where, and 
how Bando suffered his hernia were all in dispute at the contested case hearing. 
Throughout, Bando has maintained that he was injured on March 15, 1996, while 
working for Clure Brothers. He claims that, when lifting a sofa, he felt a sharp 
pain in his groin area. A self-examination revealed a lump in the area, but 
Bando neither sought medical attention nor filed an injury report. There is also 
conflicting testimony over when Bando told his co-worker, Chuck Pyle, that he 
was injured and whether Pyle passed this information along to Clure 
Brothers.

[¶8]      Relying on two 
alternate grounds, the hearing examiner denied benefits. The hearing examiner 
determined that Bando had not satisfied his burden to clearly prove that he 
suffered his hernia while employed at Clure Brothers. Wyo. Stat. Ann. § 
27-14-603 (Michie 1997). In addition, the hearing examiner ruled that Bando's 
injury report had not been filed in a timely fashion, as required by Wyo. Stat. 
Ann. § 27-14-502 (Michie Repl. 1991). Bando filed a timely appeal to the 
district court, which certified this case pursuant to W. R. A. P. 
12.09.

[¶9]      After the parties 
filed their principal briefs in this court, we released our decision in Russell 
v. State, ex rel. Workers' Safety and Compensation Div., 944 P.2d 1151 (Wyo. 
1997). In Russell, we concluded that the Division's decision to refer a case to 
either the OAH or the Medical Commission, although not subject to further 
administrative review, is subject to judicial review. Id. at 1154. Relying on 
Russell, Bando requested, pursuant to W. R. A. P. 12.08, a remand to elicit 
evidence the Division relied upon in making its decision to refer this case to 
the OAH rather than the Medical Commission. We granted Bando's motion for 
remand, and the OAH held another evidentiary hearing.

[¶10]   At the hearing, Bando called both 
the Division administrator and the claims analyst who handled Bando's claim. The 
claims analyst testified that she relied on the Division's rule defining 
medically contested cases in making her decision to refer the case to the OAH. 
She further testified that Bando's claim did not satisfy any of the criteria of 
the Division's rule. She affirmed that "[t]he problem was I couldn't 
substantiate that the injury happened at Clure Brothers the date he said it 
happened." After the hearing was completed, we authorized supplemental briefing 
on the two issues outlined above.

STANDARD OF 
REVIEW

[¶11]   Our review of a hearing examiner's 
decision is limited to the determination of the matters specified in Wyo. Stat. 
Ann. § 16-3-114(c) (Michie 1997), which mandate that 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.

DISCUSSION 

Referral to the 
OAH

[¶12]   In 1993, the Wyoming legislature 
created the Worker's Compensation Medical Commission. Wyo. Stat. Ann. § 
27-14-616 (effective January 1, 1994). To fulfill one of its duties, the Medical 
Commission established a medical hearing panel that determines medically 
contested cases referred to it by the Division. The statute mandates that the 
Division "shall refer medically contested cases to the commission for hearing by 
a medical hearing panel". Wyo. Stat. Ann. § 27-14-616(b)(iv). Because of the 
mandatory "shall," the Division does not have an option; it must determine if a 
case is medically contested and, if it is, that case must be referred to the 
Medical Commission. Russell v. State, ex rel. Workers' Safety and Compensation 
Div., 944 P.2d  at 1155.

[¶13]   Bando claims the Division should 
have referred his case to the Worker's Compensation Medical Commission because 
it was medically contested. We disagree with Bando and conclude that referral of 
his case to the Office of Administrative Hearings (OAH) was proper. First, we 
find that the Division followed and applied its own rule in making the referral 
decision. Second, the Division properly applied the standards and criteria 
contained in that rule when it determined that Bando's case was not medically 
contested.

[¶14]   As a preliminary matter, we note 
that we have an adequate record to review the Division's referral decision. The 
referral decision is subject to judicial review. Russell, 944 P.2d  at 1154. In 
Russell, the record did not contain the Division's reason for denying benefits 
or the employer's objections to benefits. Thus, we were unable to review the 
Division's referral decision because Russell had not provided a record showing 
what information formed the basis for the Division's decision to refer that case 
to the OAH. Id. at 1156. In this case, after remand, included in the record are 
the Division's final determination, Clure Brothers' objections, testimony from 
the Division administrator, testimony from the claims analyst who handled 
Bando's claim, medical reports relied upon by the claims analyst, and various 
other exhibits. With this adequate record, we proceed to our review of the 
referral decision.

[¶15]   We will first determine whether the 
Division adhered to its own rules in deciding that Bando's case was not 
medically contested. See MB v. Laramie County Dep't of Family Servs. in Interest 
of LB, 933 P.2d 1126, 1130 (Wyo. 1997) (administrative agency is bound to follow 
its own rules and regulations). Although the legislature has not defined a 
medically contested case, the Division, pursuant to its rule-making authority, 
has promulgated the following interpretive rule:

(i) For purposes 
of referring contested cases to the Workers' Compensation Medical Commission for 
hearing, W. S. § 27-14-616(b)(iv), the phrase "medically contested cases" shall 
include those cases in which the primary issue is:

(A) A 
worker/claimant's percentage of physical impairment;

(B) Whether a 
worker/claimant is permanently totally disabled;

(C) Whether a 
worker/ claimant who has been receiving temporary total disability benefits 
remains eligible for those benefits under W. S. § 
27-14-404(c)[;]

(D) Any other 
issue, the resolution of which is primarily dependent upon the evaluation of 
conflicting evidence as to medical diagnosis, medical prognosis, the 
reasonableness and appropriateness of medical care, or the appropriateness of 
fees charged by a health care provider.

Wyoming Workers' 
Compensation Rules, Regulations and Fee Schedule, ch. 5 § 3 (Jan. 1996) 
(emphasis supplied).

[¶16]   The record is clear that the 
Division applied this rule in making its decision to refer Bando's case to the 
OAH. The Division administrator and the claims analyst both testified that, as a 
general matter, claims analysts are expected to follow Division rules and 
regulations in making a referral decision. Further, the claims analyst in 
Bando's case made the referral decision in light of the Division's rule defining 
medically contested cases. In making the decision, the claims analyst reviewed 
reports from Bando's surgeon as well as the Division's case-review doctor. She 
also looked at reports from the VA hospital. She analyzed each of the rule's 
four subsections, but she didn't feel that [Bando's case] met any of the 
criteria we had in rules and regulations to go to the Medical Commission. After 
reviewing the evidence produced at the supplemental hearing, we are satisfied 
that the Division followed its own rules in making the referral 
decision.

[¶17]   We are also satisfied that referral 
to the OAH was substantively correct because Bando's case was not medically 
contested. Although Bando does not refer to the Division's rule, we presume that 
Bando is claiming that his case is "primarily dependent upon the evaluation of 
conflicting evidence as to medical diagnosis." Ch. 5, § 3(i)(D). In the 
materials available to the claims analyst at the time of the referral decision, 
there was no conflicting evidence of medical diagnosis. The Division's 
case-review doctor did not question whether Bando had suffered a hernia. He did, 
however, question whether Bando suffered the hernia while working for Clure 
Brothers. Thus, the claims analyst concluded that: "The problem was I couldn't 
substantiate that the injury happened at Clure Brothers the date he said it 
happened."

[¶18]   Furthermore, the employer did not 
question whether Bando suffered a hernia. Although the employer did object to 
Bando's claim, its objections were based on other grounds. With both the 
employer and the Division essentially admitting that Bando had suffered a 
hernia, Bando's case was not primarily dependent upon the evaluation of 
conflicting evidence as to medical diagnosis. The claims analyst correctly 
summed up Bando's case when she testified: "I did not believe this was a Medical 
Commission issue. I believe this was an issue involving establishing a work 
related injury." We conclude that the Division's referral to the OAH was the 
result of an appropriate application of the Division's rule on medically 
contested cases.

The Hearing 
Examiner's Decision

[¶19]   Bando lodges numerous complaints 
about the hearing examiner's order denying benefits. First, Bando argues that 
the hearing examiner improperly ignored testimony from two doctors who testified 
on Bando's behalf. He further complains that the hearing examiner's decision was 
not in accordance with law because it subjected him to an enhanced burden of 
persuasion, while improperly relieving the employer and the Division of their 
burden of production. Finally, Bando contends that he clearly proved his claim, 
and the hearing examiner's decision is thus arbitrary, capricious, and an abuse 
of discretion.

[¶20]   Pursuant to Wyo. Stat. Ann. § 
27-14-603(c) (Michie 1997), an employee seeking worker's compensation benefits 
for a hernia bears a heavy burden. That statute provides:

(c) If an 
employee suffers a hernia, he is entitled to compensation if he clearly proves 
that:

(i) The hernia 
is of recent origin;

(ii) Its 
appearance was accompanied by pain;

(iii) It was 
immediately preceded by some accidental strain suffered in the course of the 
employment; and

(iv) It did not 
exist prior to the date of the alleged injury.

[¶21]   An employee's burden to clearly 
prove the elements of 27-14-603(c) requires evidence that is clear and 
convincing. In re Hardison, 429 P.2d 320, 322 (Wyo. 1967). Clear and convincing 
evidence is something more than a preponderance, but less than proof beyond a 
reasonable doubt. Id. It is the kind of proof that would persuade a trier of 
fact that the truth of the contention is highly probable. Matter of Paternity of 
TS, 917 P.2d 183, 185 Wyo. 1996); Matter of GP, 679 P.2d 976, 982 (Wyo. 
1984).

[¶22]   Bando argues that the hearing 
examiner improperly ignored testimony from two doctors who testified on his 
behalf. The VA physician who diagnosed Bando's hernia asserted that the most 
probable cause of Bando's hernia was lifting furniture at Clure Brothers. 
Bando's surgeon testified that "the most likely cause after acknowledging his 
congenital predisposition for hernias would be his history of lifting." Bando 
asserts that, because the adverse parties did not present any conflicting 
evidence on the cause of his hernia, the hearing examiner did not consider the 
foregoing testimony in making the decision, and the decision is thus not in 
accordance with law.

[¶23]   When presented with medical opinion 
testimony, the hearing examiner, as the trier of fact, is responsible for 
determining relevancy, assigning probative value, and ascribing the relevant 
weight to be given to the testimony. Clark v. State, ex rel. Workers' Safety and 
Compensation Div., 934 P.2d 1269, 1271 (Wyo. 1997). In weighing the medical 
opinion testimony, the fact finder considers: (1) the opinion; (2) the reasons, 
if any, given for it; (3) the strength of it; and (4) the qualifications and 
credibility of the witness or witnesses expressing it. Id. (quoting Matter of 
Worker's Compensation Claim of Thornberg, 913 P.2d 863, 868 (Wyo. 
1996)).

[¶24]   The hearing examiner did not ignore 
the medical testimony, as Bando contends. Instead, the hearing examiner assigned 
the medical testimony the weight that was deemed appropriate. Because medical 
personnel must rely on a patient's assertion of when a hernia developed, neither 
Bando's surgeon nor the VA physician was able to state with any degree of 
medical certainty the date on which the hernia occurred. Therefore, the question 
of when Bando suffered his hernia became a question of Bando's credibility 
because the doctors' testimony necessarily relied on what Bando told them during 
examinations. The hearing examiner was thus free to assess what Bando told his 
doctors in light of the other facts and circumstances involved in this case. As 
will be discussed later, the hearing examiner carefully analyzed the surrounding 
facts and circumstances and determined that Bando had not clearly proved his 
claim. Additionally, the hearing examiner referred to both doctors' testimony in 
the order, a clear indication that she considered the testimony. We reject 
Bando's claim that the hearing examiner ignored the doctors' 
testimony.

[¶25]   Bando presents two claims that 
pertain to the hearing examiner's application of the burden of proof. The term 
"burden of proof" identifies two separate legal doctrines: the burden of 
persuasion and the burden of production. Casper Iron & Metal, Inc. v. 
Unemployment Ins. Comm'n of Dep't of Employment, 845 P.2d 387, 393 (Wyo. 1993) 
(citing D. Louisell & C. Mueller, Federal Evidence § 66 (1977)). The burden 
of persuasion, which normally becomes operative only after all the evidence is 
submitted, attaches to the party that runs the risk of nonpersuasion. This means 
if the party with the burden of persuasion has not sustained his burden, that 
party must fail. Id. The related term, burden of production, is also known as 
the burden of producing evidence or going forward with the evidence. This burden 
involves the obligation of a party to present, at the appropriate time, evidence 
of sufficient substance on the issue involved to permit the fact finder to act 
upon it. Unlike the burden of persuasion, the burden of production shifts during 
the presentation of evidence. Id.

[¶26]   Bando contends that the hearing 
examiner's decision was not in accordance with law because it relieved the 
Division and the employer of their burden of producing evidence. According to 
Bando, the burden of production shifted to the Division and Clure Brothers once 
Bando shouldered his burden of production by presenting evidence to establish 
each element of his claim. Bando contends that neither the Division nor the 
employer produced any evidence to disprove his claimed hernia. We view the 
record differently. The adverse parties did produce evidence, both through 
cross-examination and by their own witnesses' testimony, which tended to 
disprove Bando's claim. As will be discussed later, the Division and the 
employer developed contradictions to, and inconsistencies in, Bando's claim to 
the extent that the hearing examiner decided Bando had not clearly proved his 
claim. We do not agree that the hearing examiner relieved Clure Brothers or the 
Division of any burden. Rather, the hearing examiner simply held Bando to the 
enhanced burden of persuasion that attaches to proving a 
hernia.

[¶27]   Bando also claims that the hearing 
examiner's decision imposed a heavier burden of persuasion than that required by 
law. According to Bando, the hearing examiner's assertion that Bando could have 
been injured somewhere other than Clure Brothers indicates that the hearing 
examiner placed a heavier burden upon Bando than the "clearly prove" requirement 
of Wyo. Stat. Ann. § 27-14-603. To support his claim, Bando directs us to the 
following passages from the hearing examiner's decision: (1) "After Bando left 
Clure Brothers, he began working for McIntyre's Garden Center and could have 
been injured there;" and (2) "Bando could have suffered the hernia at any time 
prior to April 15, 1996."

[¶28]   When the two passages are placed in 
context, we cannot agree that the hearing examiner increased Bando's burden of 
persuasion. The first passage is contained in the hearing examiner's findings of 
fact where she references Clure Brothers' objections. As such, it is merely a 
recitation of a parties' allegations. The second passage is located near the end 
of the hearing examiner's order. After discussing the inconsistencies and 
contradictions in Bando's claim, the order mentions that Bando could have been 
injured elsewhere that at Clure Brothers. The Hearing examiner's reference to 
what could have happened is thus a natural result of Bando's failure to sustain 
his burden of proof, as well as an appropriate inference to be drawn from the 
evidence. We conclude that the hearing examiner did not place an increased 
burden of persuasion on Bando.

[¶29]   In the order denying benefits, the 
hearing examiner indicated that Bando failed to clearly prove that he suffered 
his hernia while working for Clure Brothers. Bando disagrees, insisting that he 
proved all elements of his claim. When, as here, a hearing examiner decides that 
a party charged with the burden of proof has failed to meet that burden, the 
case is reviewed under the "[a]rbitrary, capricious, an abuse of discretion or 
otherwise not in accordance with law" standard of Wyo. Stat. Ann. § 16-3-114 
(c)(ii)(A). Pederson v. State, ex rel. Workers' Compensation Div., 939 P.2d 740, 
742 (Wyo. 1997); Bohren v. State, ex rel. Worker's Compensation Div., 883 P.2d 355, 357-58 (Wyo. 1994). The hearing examiner, as the trier of fact, is charged 
with weighing the evidence and determining the credibility of witnesses. 
Pederson, 939 P.2d  at 742. A hearing examiner's findings of fact are accorded 
deference, and the hearing examiner's decision will not be overturned unless it 
is clearly contrary to the overwhelming weight of the evidence. Id. 
Demonstrating evidentiary contradictions in the record does not establish the 
ruling was irrational, but we do examine conflicting evidence to determine if 
the agency reasonably could have made its finding and order based upon all of 
the evidence before it. Id. The hearing examiner's findings of fact include 
enough contradictory evidence, provided by Bando's own actions as well as other 
inconsistencies, to uphold the hearing examiner's determination that Bando did 
not clearly prove that he suffered his hernia while working for Clure Brothers. 
Although Bando claimed he suffered his hernia on March 15, the manager of Clure 
Brothers testified that he witnessed Bando performing one-handed pushups in the 
store after that date. Around the same time, Bando lifted the Clure Brothers' 
manager, a large man whose weight was estimated at 275 or 280 pounds, off the 
ground in a bear hug position. Most importantly, Bando kept performing his 
furniture moving duties for three weeks after the date he claims he suffered his 
hernia. During this time, he did not complain to Clure Brothers' management. 
According to the Division's physician, these actions are inconsistent with the 
actions of someone who is suffering from a hernia. See In re Frihauf, 58 Wyo. 
479, 498, 135 P.2d 427, 433 (Wyo. 1943) ("It is hardly probable that the workman 
could have done the heavy work he did on February 4, if the hernia had made its 
appearance previously.").

[¶30]   In addition to Bando's own actions 
that contradict his claim, the record includes other inconsistencies. Bando 
asserted that he and a co-worker were unloading an England Corsair furniture 
truck when he suffered his hernia. To counter this testimony, Clure Brothers' 
manager testified that England Corsair did not make a delivery on March 15, the 
day Bando claims he was injured. In addition, the co-worker testified that Bando 
told him in February that he thought he might have a hernia. These 
inconsistencies on the time of the claimed hernia are significant because time 
of injury is particularly important in cases involving hernias. In re Hardison, 
429 P.2d  at 322 (citing In re Johnson, 51 Wyo. 111, 114, 63 P.2d 791, 792 
(1937)); see also Big Horn Coal Co. v. LaToush, 501 P.2d 1250, 1251 (Wyo. 
1972).

[¶31]   With the foregoing contradictions 
in the record, the hearing examiner concluded that Bando had not met his 
enhanced burden of clearly proving that his hernia occurred while working for 
Clure Brothers. Because our duty is not to re-weigh conflicting evidence, we 
cannot disagree. We hold that the hearing examiner's decision to deny benefits 
was not arbitrary, capricious, an abuse of discretion or otherwise not in 
accordance with law.

Timeliness

[¶32]   Because we affirm the hearing 
examiner's determination that Bando did not suffer his injury while working for 
Clure Brothers, we do not reach the issue of whether Bando's injury report was 
filed in a timely fashion.

CONCLUSION

[¶33]   Although the adverse parties 
disputed whether Bando had suffered his hernia while working for Clure Brothers, 
they did not challenge his hernia diagnosis. Thus, Bando's case did not qualify 
as a medically contested case under the Division's rule; referral to the OAH was 
proper. In addition, the record establishes that Bando kept moving furniture, 
performed onehanded pushups, and lifted a co-worker during the three weeks that 
followed the date that he claims he suffered his hernia. All the while, he never 
told Clure Brothers of his problem. With this evidence in the record, we uphold 
the hearing examiner's determination that Bando did not satisfy the heavy burden 
of clearly proving his hernia claim.

[¶34]   Affirmed.