Case Title: Matter of Andren

Citation: 

Docket Number: 

State: wyoming

Court: Wyoming Supreme Court

Date: 1996-05-28T00:00:00Z

Document:
Matter of Andren1996 WY 72917 P.2d 178Case Number: 95-250Decided: 05/28/1996Supreme Court of Wyoming
In the Matter of the Worker's Compensation Claim of Melvin 
W. ANDREN.

 The CELOTEX CORPORATION, 

Appellant 
(Respondent-Employer),

v.

Melvin 
W. ANDREN, 

Appellee 
(Petitioner-Employee).

Appeal 
from the District Court of Park County, Hunter Patrick, J.

Colin 
M. Simpson of Simpson, Kepler & Edwards, L.C., Cody, for 
appellant.

Wm. 
Daniel Elsom and George Lemich of Elsom and Lemich, Cody, for 
appellee.

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

MACY, 
Justice.

[¶1]      Appellee Melvin 
Andren (the employee) sought review in the district court of the hearing 
examiner's order which denied his request for worker's compensation benefits. 
The district court reversed the hearing examiner's order, finding that the 
employee was entitled to receive benefits. Appellant Celotex Corporation (the 
employer) appeals from the district court's order which reversed the hearing 
examiner's decision.

[¶2]      We 
reverse.

ISSUES

[¶3]      The employer 
presents the following issues for our review:

1. 
The District Court applied an incorrect standard or rule and improperly 
reweighed the evidence presented at the contested [case] hearing.

2. 
The Hearing [Examiner's] determination that [the employee] had engaged in 
unsanitary or injurious practices contrary to W.S. § 27-14-407 and thus was not 
entitled to benefits[] was supported by substantial evidence.

FACTS

[¶4]      It is undisputed 
that the little finger on the employee's left hand was crushed on March 31, 
1994, while the employee was at work. He was taken to the emergency room where 
he was given pain killing medications and a tetanus shot. Later that day, an 
orthopaedic surgeon determined that immediate surgery was required.

[¶5]      During the 
surgery, the surgeon placed two surgical pins in the employee's finger to 
stabilize the joint. Tube gauze and an extension splint were placed over the 
finger after surgery to protect it. No complications were noted as a result of 
the surgery. The following day, the employee returned to the hospital to have 
his surgical dressing changed. He complained that he did not have any 
circulation in his finger due to the pressure of the postoperative dressing, so 
the dressing was changed. The next day, the employee redressed his wound 
himself, trying to ease the continuing pain. He also applied a topical coating 
of honey to his injury.

[¶6]      On April 4, 1994, 
the employee returned to work even though he had not yet been released by his 
surgeon to do so. The employee bought a supply of clean gloves and trimmed the 
protruding ends of the surgical pins by about an eighth of an inch to make it 
easier for him to get his gloves on and off.

[¶7]      On April 7 and 
April 12, 1994, the employee visited the surgeon's office. At both visits, his 
wound was "benign," but the surgeon did note that the employee had been using 
honey on his injury. The surgeon instructed the employee to wear his splint and 
not put honey on the wound.

[¶8]      On April 24, 
1994, the employee was not wearing his splint when his wife accidentally hit his 
finger. The employee's finger became progressively painful and swollen. Three or 
four days later, in an attempt to relieve the pain, the employee pulled both 
pins out of his finger with a pair of pliers. Despite having pain and swelling, 
the employee did not seek immediate medical treatment. When the employee did see 
a doctor approximately nine days after his finger had been struck, he had to 
have surgery because of extensive infection and the damage done to his finger. 
The finger had swollen to nearly four times its normal size, and it was a 
"purplish red" color. At the employee's insistence, the surgeon amputated the 
employee's finger during that surgery.

[¶9]      The employee 
applied for and received benefits under the provisions of the Wyoming Worker's 
Compensation Act. The employer subsequently objected to any benefits being paid 
to the employee after May 3, 1994, claiming that the employee had engaged in 
unsanitary or injurious practices which imperiled his recovery. After holding a 
contested case hearing, the hearing examiner concluded that the employee was not 
entitled to receive benefits for the treatment of the infection or for the 
amputation, finding that the employee had knowingly engaged in an unsanitary or 
injurious practice which tended to imperil or retard his recovery.

[¶10]   The employee sought review of the 
hearing examiner's decision in the district court. The district court reversed 
the hearing examiner's decision, concluding that the employer had failed to meet 
and carry its burden of proof. The employer appeals from the district court's 
decision.

DISCUSSION

[¶11]   The employer contends that 
substantial evidence supported the hearing examiner's determination and that the 
district court improperly reversed the hearing examiner's decision. The employee 
maintains that the employer failed to meet its burden of proving that the 
employee forfeited his claim.

[¶12]   When we review an administrative 
order, we are not compelled to accept any of the conclusions reached by the 
district court. State ex rel. Wyoming Workers' Compensation Division v. Fisher, 
914 P.2d 1224, 1226 (Wyo. 1996). Instead, we review the case as if it had come 
directly to this Court from the agency. Id.

Our 
task is to examine the entire record to determine whether substantial evidence 
supported the hearing examiner's findings. We will not substitute our judgment 
for that of the hearing examiner when substantial evidence supports his 
decision. Substantial evidence is relevant evidence which a reasonable mind 
might accept in support of the agency's conclusions.

Latimer 
v. Rissler & McMurry Co., 902 P.2d 706, 708-09 (Wyo. 1995) (citations 
omitted). We do not, however, defer to an agency's conclusions of law. "Instead, 
if the `correct rule of law has not been invoked and correctly applied, . . . 
the agency's errors are to be corrected.'" Thunder Basin Coal Company v. Study, 
866 P.2d 1288, 1291 (Wyo. 1994) (quoting Devous v. Wyoming State Board of 
Medical Examiners, 845 P.2d 408, 414 (Wyo. 1993)).

[¶13]   Although the burden of establishing 
that a worker's compensation claim has been forfeited rests squarely on the 
employer, Kilburn Tire v. Meredith, 743 P.2d 874, 876 (Wyo. 1987), the party who 
appeals from an administrative determination has the burden of proving the lack 
of substantial evidence to sustain the agency's ruling. Jaqua v. State ex rel. 
Wyoming Workers' Compensation Division, 873 P.2d 1219, 1221 (Wyo. 1994). We 
construe the forfeiture mandate strictly due to its harshness. Kilburn Tire, 743 P.2d  at 876.

[¶14]   The substantive issue in this case 
is whether the hearing examiner properly applied WYO. STAT. § 27-14-407 (1991) 
to the facts in this case. Section 27-14-407 provides:

If 
an injured employee knowingly engages or persists in an unsanitary or injurious 
practice which tends to imperil or retard his recovery, or if he refuses to 
submit to medical or surgical treatment reasonably essential to promote his 
recovery, he forfeits all right to compensation under this act. Forfeiture shall 
be determined by the hearing examiner upon application by the division or 
employer.

 

The 
unambiguous language of § 27-14-407 requires that a showing be made that an 
employee has engaged in some action or activity which "tends" to impact his 
recovery. The word "tend" is defined in BLACK'S LAW DICTIONARY 1315 (5th ed. 
1979) in the following way:

To 
have a leaning; serve, contribute, or conduce in some degree or way, or have a 
more or less direct bearing or effect; to be directed as to any end, object, or 
purpose; to have a tendency, conscious or unconscious, to any end, object or 
purpose.

Regarding 
the forfeiture statute, we have said:

The 
actions required of an injured claimant necessary to invoke a forfeiture order 
by the district court have been explained previously by this court as 
follows:

"The 
`practice' must be something more than an occasional thoughtless or careless 
act, and must be shown to have been persisted by the injured workman. Among 
definitions of the verb `persist' we find the following: `. . . To continue 
steadily and firmly in some state, course of action, or pursuit, especially in 
spite of opposition, remonstrance, etc.' [Citation.]" In re Hibler, 37 Wyo. 332, 
341, 261 P. 648, 651 (1927).

Section 
27-12-412 [now § 27-14-407] plainly requires the finder of fact, in the instant 
case the district court, to initially determine whether the injured claimant has 
acted in conformity with the above definitions. If so, the district judge is to 
declare a forfeiture of the claim.

Kilburn 
Tire, 743 P.2d  at 876.

[¶15]  After holding a hearing, the hearing 
examiner rendered the following findings of fact:

1. 
[The employee] experienced a work-related injury on March 31, 1994.

2. 
[The employee's] initial treatment at the WestPark Hospital Emergency Room 
consisted of suturing pieces of skin on the left little finger, and the 
administration of pain killing medications and a tetanus shot. Later that day, 
[the employee] was examined by . . . an orthopedic surgeon, who determined 
immediate surgery was necessary, and who inserted two stabilization pins into 
the finger, cross-wise through the knuckle joint. Said pins protruded 
approximately 1/4 inch beyond the skin of the finger. [The surgeon] also wrapped 
the finger in gauze and placed an aluminum splint or sheath on it.

. 
. . .

4. 
[The employee] usually wore the splint, in accordance with his doctor[']s 
instructions, although at times when he was not working, he did not wear it. 
While at work, he wore work gloves in order to protect the finger, but also cut 
out the top of the little finger of the left glove to accommodate the wearing of 
the splint.

. 
. . .

6. 
On April 7, 1994, [the employee] quit taking antibiotics. Said prescription 
would have taken him through April 10, 1994, if he had taken them as his doctor 
ordered.

. 
. . .

10. 
[The employee] stopped wearing his splint at work approximately April 20, 
1994.

11. 
[The surgeon] instructed [the employee] to wear his splint until the pins were 
removed.

12. 
On April 24, 1994, while the finger was unprotected by the sheath, [the 
employee's] wife accidently hit the injured hand. The finger immediately swelled 
up and became painful, and after three days of the pain and swelling, [the 
employee] pulled the pins out of his finger himself, using a pair of pliers. At 
this time, he had a scheduled appointment with [the surgeon] for five days in 
the future, which was later rescheduled.

13. 
After removing the gauze and splint and cleaning his finger, [the employee] saw 
[the surgeon] on May 3, 1994, who scheduled surgery the next day to address the 
obvious infection of the finger. A decision was made at that time to amputate 
the little finger.

. 
. . .

16. 
[The employee's] complication of his original injury, in the form of an 
infection, which necessitated the amputation, was caused by the unintentional 
bumping of the pin by his wife while at church, and not by the removal of the 
pins or the early cessation of antibiotics. In this regard, the Hearing Examiner 
finds [the surgeon's] opinions . . . more persuasive than the statement of [the 
physician who reviewed the employee's medical records]. . . . The most 
satisfactory explanation for what caused the infection, was that it was caused 
when the bacteria on the pin were driven under the subcutaneous tissues when the 
finger was bumped by [the employee's] wife. . . .

17. 
It is uncertain if the infection, which was caused by the bumping, would not 
have occurred if [the employee] had been wearing his sheath as instructed by his 
doctor, in that [the employee's] finger was apparently bumped on the side, where 
the pins protruded and not on the top, where the sheath would have protected 
it.

The 
hearing examiner made the following conclusions of law:

1. 
The unsanitary or injurious practice would not be [the employee's] early return 
to work, his trimming of the pins, or even his failure to wear his splint, in 
that it appears that since the sheath covered only the top of the finger, and 
the pins were on the side, that he was bumped on the side and the sheath 
wo[uld]n't have protected it anyway. This behavior, although questionable, did 
not imperil or retard his recovery.

2. 
The [employee's] self-help removal of the pins in his left little finger and the 
[employee's] failure to seek medical treatment after the bumping does rise to 
the level of both "knowingly engaging" and "persisting" in a more than 
occasionally thoughtless or careless unsanitary or injurious act. Further, this 
conduct indicated a continuously steady and firm course of action. It is more 
likely than not that . . . waiting [nine] days [to get treatment] imperiled his 
recovery from the original injury.

3. 
Since the Hearing Examiner concludes as a matter of law that the "injurious 
practice" statute prohibits [the employee] from recovering benefits for the 
subsequent infection and amputation, the Hearing Examiner need not consider the 
other objections raised.

4. 
[The employee] is not entitled to benefits for the treatment of the subsequent 
infection in his finger, and the amputation thereof.

[¶16]   The employee argues that the issue 
of whether he "persisted" in a course of action which "tended" to imperil or 
impede his recovery is one which requires expert medical testimony and that such 
testimony is absent from the record.

We 
have held that medical testimony is not required if it is not essential to 
establish a causal connection between the accident and the injury. We also have 
held that the finder of fact is not necessarily bound by the medical evidence. 
On the other hand, we have acknowledged that where a medical question is 
complex, and the fact finding must be done in a realm that appropriately relies 
upon technical medical knowledge and expertise, medical testimony should not be 
ignored.

Forni 
v. Pathfinder Mines, 834 P.2d 688, 693 (Wyo. 1992) (citations omitted). We have 
also held: "`[W]here injuries are so immediately and directly or naturally and 
probably the result of an accident, medical evidence is not essential to find a 
causal connection.'" Hansen v. Mr. D's Food Center, 827 P.2d 371, 373 (Wyo. 
1992) (quoting Colorado Fuel & Iron Corporation v. Frihauf, 58 Wyo. 479, 135 P.2d 427, 434 (1943)).

[¶17]   Medical evidence was introduced 
which established that, when the employee visited the surgeon on April 7 and 
April 12, 1994, his finger appeared to be "benign" and well on its way to 
recovering. The physician who reviewed the employee's medical records stated in 
a letter which was introduced into evidence:

I 
had the opportunity to review medical records on [the employee]. Despite a 
significant injury, which would have left him with an imperfect finger, I 
think that his lack of compliance to the program outlined by the operating 
physician contributed in part to his end results. I base this on review of 
records provided to me in your letter of October 13.

 

(Emphasis 
added.) The employee's discharge orders after his finger was amputated included 
the following notes:

Medications 
- . . . . He is not to use the hand for any reason. He is not to disturb the 
dressings which was a major problem with the care prior to the surgery. . . . 
Patient has been specifically instructed not to treat his wound with honey since 
this is quite likely a causative factor in his developing severe infection 
earlier. I have also given his wife instructions prior to his discharge about 
patient's restrictions and my desire for him not to do anything with this hand 
until we are sure that the wound is healing well. Whether or not the patient 
will follow our instructions remains to be seen. There [were] significant 
problems with compliance along with the first injury.

(Emphasis 
added.) Additionally, while the employee's acts of trimming the surgical pins, 
treating his injury with honey, not taking all his antibiotics, returning to 
work although his surgeon had not released him to do so, failing to wear the 
splint at all times, and pulling the pins out of his finger were not in and of 
themselves injurious practices, they demonstrated a pattern of conduct by the 
employee which supported the hearing examiner's conclusion that the employee's 
failure to seek medical attention was part of a persistent pattern of 
activity.

[¶18]   The employee decided not to seek 
medical attention even though he was in pain and his finger was red and swollen. 
This evidence not only supported the conclusion that the employee "persisted" in 
a course of action which "tended" to imperil or impede his recovery but also 
supported the finding that his actions actually impeded and imperiled his 
recovery.

[¶19]   Medicine is not so complicated that 
an average person cannot understand that infection is a possibility after an 
operation, that he should seek immediate medical attention when signs of 
infection arise, and that, if left untreated, a severe infection in a finger 
could lead to the finger being amputated. Common sense tells us that we must 
consult with a doctor in a timely manner when an injury, which seems to be 
healing normally, becomes red and very swollen after it has been 
bumped.

[¶20]   Substantial evidence supported the 
hearing examiner's conclusion that the employer had met its burden of proving 
that § 27-14-407 applied to preclude further benefits from being paid to the 
employee. The district court, therefore, erred when it reversed the hearing 
examiner's order.

[¶21]   Reversed.