Case Title: IN THE MATTER OF THE WORKER'S COMPENSATION CLAIM OF DAVID J. MONTOYA, AN EMPLOYEE OF KENNECOTT ENERGY COMPANY: DAVID J. MONTOYA V. STATE OF WYOMING ex rel. WYOMING WORKERS' SAFETY AND COMPENSATION DIVISION

Citation: 

Docket Number: S-07-0203

State: wyoming

Court: Wyoming Supreme Court

Date: 2009-03-06T00:00:00Z

Document:
IN THE MATTER OF THE WORKER'S COMPENSATION CLAIM OF DAVID J. MONTOYA, AN EMPLOYEE OF KENNECOTT ENERGY COMPANY: DAVID J. MONTOYA V. STATE OF WYOMING ex rel. WYOMING WORKERS' SAFETY AND COMPENSATION DIVISION2009 WY 32203 P.3d 1083Case Number: S-07-0203Decided: 03/06/2009
OCTOBER 
TERM, A.D. 2008

 
 
IN 
THE MATTER OF THE WORKER'S COMPENSATION CLAIM OF DAVID J. MONTOYA, AN EMPLOYEE 
OF KENNECOTT ENERGY COMPANY: DAVID J. 
MONTOYA,Appellant(Claimant),v.STATE OF WYOMING ex 
rel. WYOMING WORKERS' SAFETY AND COMPENSATION 
DIVISION,Appellee(Respondent).

 
 
Appeal 
from the District Court of Campbell County

The 
Honorable Michael N. Deegan, Judge

 
 

Representing 
Appellant:

Kenneth 
DeCock, Plains Law Offices, LLP, Gillette, Wyoming 

 
 

Representing 
Appellee:

No 
appearance.

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

 
 

GOLDEN, 
Justice.

 
 
[¶1]      David Montoya 
appeals the denial of his claim for worker's compensation benefits.  Mr. Montoya claims that he suffered 
injuries from an accident during work-related activities that aggravated a 
preexisting medical condition.  The 
Wyoming Workers' Compensation Division found Mr. Montoya's condition solely 
related to his preexisting condition.  
The Division's denial was upheld by the Office of Administrative Hearings 
(OAH).  The OAH decision was 
affirmed by the district court.  We 
reverse the decision of the OAH and remand with the directive that the Division 
award Mr. Montoya benefits.

 
 
ISSUES

 
 
[¶2]      Mr. Montoya 
presents three issues:

 
 
Is 
there substantial evidence to support the Hearing Officer's 
conclusion?

 
 
Is 
the Hearing Officer's decision arbitrary and capricious?

 
 
Did 
the Hearing Officer misinterpret case law and hold [Mr. Montoya] to an improper 
burden of proof?

 
 
FACTS

 
 
[¶3]      In 1999, Mr. 
Montoya was involved in a non-work related automobile accident, wherein he was 
struck from behind by another vehicle.  
He suffered what was described as "whiplash" injuries, resulting in back 
and neck pain.  Mr. Montoya 
testified he regularly suffered migraine headaches and impaired vision 
immediately after the accident but the worst of the symptoms cleared up after 
about three months.  The evidence 
indicates Mr. Montoya continued to suffer from migraine headaches intermittently 
after the automobile accident.  
Secondary to the migraines were vision problems, speech problems and 
nausea.  The physical symptoms, 
however, did not interfere with Mr. Montoya's ability to perform his job duties 
as a mine electrician.

 
 
[¶4]      The work-related 
accident at issue happened on February 10, 2003.  Mr. Montoya's then current employer was 
Kennecott Energy Company (Kennecott), where he had worked since about 1997.  He had worked as a mine electrician for 
at least sixteen years in total.  On 
February 10, 2003, Mr. Montoya slipped and fell on ice while at work.  Mr. Montoya remembers falling on his 
side, although he does not remember which side.  He does remember losing his hardhat in 
the fall.  Within fifteen to 
forty-five minutes after the fall, Mr. Montoya experienced a severe headache, 
impaired vision, slurred speech, and was moderately incoherent.  At that time, because his symptoms were 
similar to those he experienced after his 1999 automobile accident, Mr. Montoya 
attributed his symptoms to that 1999 accident.  Consequently, after discussing the 
matter with his supervisor and the human resources representative, it was 
decided not to file an incident report.  

 
 
[¶5]      Mr. Montoya 
immediately called his physician, Dr. Amin Rasul, and was seen that same 
day.  Dr. Rasul's medical chart note 
states:

 
 
The 
patient came in complaining of having speech difficulty as well as visual 
changes and trouble with memory.  He 
said he has had these symptoms on and off since the time of his accident.  He says that it usually starts in his 
lower back and he does hurt all over.  
He feels like there are pins and needles and this is usual with his 
migraine headaches.  If he sleeps it 
off, he gets better.  He gets tunnel 
vision where he sees in the middle, but not in the periphery.  His vision gets really fuzzy in the 
peripheral.  He cannot 
concentrate.  He describes his 
vision as getting very blurry and it looks like he is seeing through a cloud of 
smoke.  He has been taking 
chiropractic treatments, but not in the last few weeks, and since then his 
headaches have been coming on progressively.  He has not been getting chiropractic 
treatment because he has started on the Project 108, according to him, as of 
January 1st.  He also at the present time of this 
visit denies significant headache and says headache has subsided some.  He denies numbness and tingling.  He denies visual symptoms right now. . . 
.  He also does not have any speech 
problems right now.  This morning 
when he woke up he did have that.  

 
 
[¶6]      By letter dated 
February 12, 2003, the human resources representative from the mine contacted 
Dr. James Naramore, requesting he conduct a functional capacity evaluation of 
Mr. Montoya.  In the letter, she 
stated she was concerned about Mr. Montoya's ability to perform his job safely 
because of the symptoms he had displayed when she saw him after his fall at work 
two days earlier.  She related to 
Dr. Naramore that Mr. Montoya had not been harmed in the fall, but rather all 
his symptoms stemmed from the 1999 automobile accident.  She concluded by stating Mr. Montoya had 
been placed on medical leave and would not be allowed to return until he 
received a medical release.

 
 
[¶7]      What followed was 
a battery of medical examinations.  
Dr. Naramore saw Mr. Montoya for the first time on February 12, 
2003.  In his note from the 
examination, Dr. Naramore related the history of Mr. Montoya's automobile 
accident in 1999 but said nothing about Mr. Montoya's fall at work on February 
10, 2003.  Dr. Naramore summed up 
the history he was aware of by stating:

 
 
This 
patient has "migraine headaches" which evidently occurred Monday.  They have been less frequent than they 
were initially.  He had not had a 
migraine for some time but on Monday evidently was having one and could not 
track with his supervisors.  He 
began stuttering on Monday, complained of a headache and evidently was unable to 
continue doing his work.

 
 
Dr. 
Naramore's physical examination of Mr. Montoya revealed Mr. Montoya was 
suffering from short-term memory loss.  
The results of the exam were otherwise unremarkable.  

 
 
[¶8]      Mr. Montoya 
continued treating with Dr. Naramore.  
In consultation with Dr. Naramore, Mr. Montoya simultaneously received 
treatment from Dr. Tuenis Zondag of Central Wyoming Neurosurgery. Despite their 
best efforts, Mr. Montoya continued to suffer migraine headaches.  In order to rule out a closed head 
injury, Dr. Zondag ordered a brain MRI, which was conducted on March 31, 
2003.  The results of the brain MRI 
were normal (except for a sinus condition not at issue).

 
 
[¶9]      By the end of 
April 2003, Mr. Montoya told Dr. Naramore that he felt good and would like to 
return to work.  Having found no 
permanent injury and believing Mr. Montoya's migraines were being adequately 
controlled with medication, Dr. Naramore gave Mr. Montoya an unconditional work 
release.  

 
 
[¶10]   Mr. Montoya returned to his job as 
a mine electrician for Kennecott in early May.  Mr. Montoya testified that after he 
returned to work he had trouble doing tasks that used to be easy for 
him:

 
 
Q:        Did 
you experience problems performing your job after the 
fall?

 
 
A:        
Yes.

 
 
Q:        What 
kind of things?

 
 
A:        I had 
real problems keeping as an electrician when my primary jobs was [sic] to read 
prints and stuff like that, troubleshoot the equipment.  And I had problems transposing the 
information I'd gotten from the prints over and do my job.  I just  I'd get over here and I'd 
forget what the heck I was doing; I'd have to go back to the prints, I mean for 
what would have been a simple problem.

 
 
Q:        Was 
that a normal part of your job?

 
 
A:        
Previous, yes.

 
 
Q:        Did 
you have any problems with that previous to your fall?

 
 
A:        
No.  In fact, I used to pride 
myself in being fairly good at it.  
I'd look at the print and troubleshoot by looking at a print and . . . a 
lot of times, go to the problem.  
But I definitely had that problem afterwards.  

 
 
Eventually, 
Mr. Montoya's concentration problems led to several incidents where he 
endangered the safety of both himself and others.  In mid-December, Kennecott again sent 
Mr. Montoya home.  Mr. Montoya did 
not receive another work-release from Dr. Naramore until mid-April 2004.  The work-release required Mr. Montoya to 
be under full supervision when doing any safety-sensitive jobs.  Mr. Montoya never returned to Kennecott 
because Kennecott could not accommodate this requirement in the positions it had 
available.

 
 
[¶11]   Because Mr. Montoya continued to 
have problems, Dr. Naramore referred him to Dr. Michael Harvey, a licensed 
psychologist, for a neuropsychological examination.  Dr. Naramore specifically asked Dr. 
Harvey "for clarification with regard to possible etiologies of [Mr. Montoya's] 
symptoms and recommendations for treatment." Dr. Harvey also noted there was a 
worker's compensation case pending.  
Dr. Harvey specified that "[s]ince the initial referral was from [Mr. 
Montoya's] physician this evaluation will be focused on referral questions from 
Dr. Naramore and issues involved in the compensation case, which would make this 
a forensic referral, will not be addressed directly in this report."  

 
 
[¶12]   The examination was conducted on 
January 6, 2006.  Dr. Harvey opined 
that Mr. Montoya suffered a mild traumatic brain injury, probably caused by the 
automobile accident in 1999:

 
 
These 
residual neurocognitive deficit[s] due to sheering most likely would be 
consistent with a mild traumatic brain injury.  Although there will remain some question 
as to when this injury might have occurred the evidence in the record would 
indicate the most probable time of mild traumatic brain injury would be during 
the automobile accident in November 1999.  
There was clear evidence of injury to the neck and back consistent with 
whiplash injury.  Whiplash can 
certainly result in a mild traumatic brain injury due to a sheering injury of 
this type.    

 
 
Dr. 
Harvey also noted that Mr. Montoya's symptoms worsened after Mr. Montoya's fall 
at work in February 2003.

 
 
[¶13]   Upon reviewing Dr. Harvey's report, 
Dr. Naramore wrote the following in a letter:

 
 
After 
seeing Mr. Montoya in my office on several occasions and in follow-up March 7, 
2006, I have concluded that his amnesia and forgetfulness regarding a fall, 
which occurred February 10, 2003 were related to that fall.  I think it is entirely possible that Mr. 
Montoya absolutely forgot about the fall when I saw him initially on February 
12, 2003.  Mr. Montoya was 
struggling to explain all of his symptoms when in fact he probably actually 
forgot about a major precipitating cause of his symptoms which indeed could have 
been the fall as mentioned above.

 
 
I 
have also read Dr. Harvey's notes.  
I do not feel that this patient can be further improved with more 
treatment.  He seems to be 
functioning well at the job currently.  
I think it would be very difficult to establish exactly the cause of all 
of his difficulties, though now looking at the total picture, I do believe the 
fall played a major role in his difficulties at work subsequently.  

 
 
Indeed, 
previously, we have been focused very much on the patient's symptoms and ongoing 
headache problems not exactly putting together the fact that a fall and a head 
injury could have caused all of these since the patient did not bring that to 
the table when he initially saw me.  
Looking at the total picture now, I really do feel that Mr. Montoya's 
symptoms were possibly entirely due to that fall on February 10, 2003.  I do not feel the patient probably 
suffered a brain injury in a motor vehicle accident that he recalled on November 
8, 1999.  In fact, that was mostly a 
neck injury and not a cranial injury.  
He no doubt suffered a significant concussion and headaches as a result 
of the fall, which I had heretofore not realized occurred on February 10, 
2003.  

 
 
[¶14]   The hearing in this case was held 
May 16, 2006.  Besides the 
introduction of medical records, both Mr. Montoya and his wife testified.  Mr. Montoya and his wife had been 
married since 1997.  Mrs. Montoya 
testified to the problems Mr. Montoya had after his automobile accident in 1999, 
including migraines, stuttering, and vision problems.  She testified that the symptoms eased 
after the first month of the accident, although he continued to have 
migraines.  Mrs. Montoya testified 
that, after the work-related fall in 2003, Mr. Montoya's condition worsened 
substantially.  She testified that 
he developed serious sleep problems, his stuttering became much worse; he lost 
his short term memory almost completely; and he has trouble controlling his 
emotions  he cries easily and "if he isn't crying, then he's angry."  She never knew him to be angry before 
the fall but now he gets angry regularly for no readily apparent reason.  The short term memory problems are also 
new.  

 
 
[¶15]   In his final order, the hearing 
officer determined:

 
 
In 
complicated compensation cases, medical testimony is essential.  Bocek v. City of Sheridan, 432 P.2d 893 
(Wyo. 1967).  Also see, In re Boyce [2005 WY 9, ¶¶ 11, 16, 105 P.3d 451, 454-55 (Wyo. 2005)].  
Needless to say, this is a complicated case.  The evidence is clear that the Claimant 
was suffering from a pre-existing condition.  What is not clear, however, is the 
extent of that pre-existing condition.  
To compound said matter, the Claimant is a poor historian.  He was unable to state when the last 
time was that he suffered migraine symptoms prior to the February 10, 2003 
accident.  Furthermore, when he 
testified about the times prior to the fall when he would feel so poorly that he 
had to pull over to the side of the road while driving, he was not able to say 
when those occurred.  He testified 
that, on one occasion, he felt so nauseous he thought he was going to get 
sick.  However, he could not recall 
whether this happened before or after February 10, 2003.  He testified that it could have been 
before or after the February 10, 2003 accident.  The evidence presented, however, clearly 
indicates that the Claimant was suffering from an ongoing problem.  Dr. Rasul's chart note on February 10, 
2003 indicates that the Claimant was complaining of speech difficulty, visual 
changes and trouble with memory and that the Claimant advised he "had these 
symptoms on and off since the time of his accident."  (Exhibit S-4.)  When the Claimant was discussing his 
condition on February 10, 2003 with Aaron Spielman [Montoya's supervisor], the 
Claimant stated that "when he gets to feeling this way he stutters."  Mr. Spielman went on to state, "I was 
concerned about Dave's safety and especially after he stated that when he gets 
to feeling poorly he sometimes has to pull to the side of the road while 
driving."  (Exhibit S-5.)  In addition, it was the Claimant's own 
belief that his symptoms on February 10, 2003 were related to the automobile 
accident that happened in November of 1999.

 
 
In 
view of such ongoing condition, medical testimony is essential to provide the 
causal link between the pre-existing condition and the conditions of 
employment.  This, the Claimant has 
failed to do.

 
 
The 
hearing officer went on to summarize the medical evidence that was presented at 
the hearing.  The hearing officer 
concluded that none of the medical evidence established causation between Mr. 
Montoya's fall at work and a material aggravation of his pre-existing 
condition.  The hearing officer 
concluded that "Claimant has failed to meet his burden of proof to show that he 
sustained a compensable injury on February 10, 2003."

 
 
DISCUSSION

 
 
Standard 
of Review

 
 
[¶16]   Our scope of review is prescribed 
by Wyo. Stat. Ann. § 16-3-114(c) (LexisNexis 2007), which provides in pertinent 
part:

 
 
(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:

 
 
                        
* * * *

 
 
            
(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;

 
 
                        
* * * *

 
 
(E) 
Unsupported by substantial evidence in a case reviewed on the record of an 
agency hearing provided by statute.  

 
 
[¶17]   As recently explained in Dale v. S & S Builders, LLC,  2008 WY 84, 188 P.3d 554 (Wyo. 2008), 
whenever this Court is called upon to review a decision based on the evidence in 
the case, we review the decision to see if it is supported by substantial 
evidence.  Questions of law are 
reviewed de novo.  Id., ¶¶ 22, 25, 26, 188 P.3d  at 
561.  "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."  Id., ¶ 22, 188 P.3d  at 561.  See also Horn-Dalton v. State ex rel. Wyoming 
Workers' Safety & Comp. Div., 2009 WY 14, ¶ 7, 200 P.3d 810, 813 (Wyo. 
2009).

 
 
Jurisdiction

 
 
[¶18]   As with all cases that come before 
us, our first duty is to ensure we have jurisdiction to review the case.  Ragsdale v. Hartford Underwriters Ins. 
Co., 2007 WY 163, ¶ 4, 169 P.3d 78, 80 (Wyo. 2007).  This case presents a jurisdictional 
question in that the Division included in its reasons for denying Mr. Montoya's 
claim for benefits that Mr. Montoya did not timely file his claim as required by 
Wyo. Stat. Ann. § 27-14-503.1  The hearing officer, in setting out the 
issues before him at the hearing, listed the timeliness of the filing of the 
claim as one of the issues.  
Ultimately, in an otherwise very thorough decision, the hearing officer 
expressly declined to decide the issue of the timeliness of the filing of the 
claim and instead decided the case solely on its merits.  The problem with this approach is that 
if the claim was not timely filed, the OAH would not have the authority to 
decide the case on its merits.  The 
instant order would be void, leaving nothing for this Court to review.  In short, the question of timeliness is 
of jurisdictional magnitude and must be decided before turning to the merits of 
the case.

 
 
[¶19]   Fortunately, although the issue of 
timeliness was not decided by the hearing officer, we need not remand the case 
because the uncontradicted evidence at the hearing was that Mr. Montoya complied 
with the pertinent statute.2  At the outset, we note the Division 
seems to have abandoned the issue.  
During the course of the hearing, the attorney for the Division made only 
one brief comment regarding timeliness in his opening statement.  He never mentioned the issue again.  Most importantly, the attorney for the 
Division did not mention the timeliness issue in his closing argument.  

 
 
[¶20]   On the other side, Mr. Montoya 
testified as to when he discovered he had a work-related injury and that he 
filed his claim shortly thereafter.  
His testimony is uncontradicted.  
Since the statute at issue is a discovery statute, and the only testimony 
is that its requirements were complied with, it is not surprising the Division 
abandoned the issue.3  Given the evidence, we find Mr. Montoya 
timely filed his claim for benefits, and we therefore have jurisdiction to 
continue our review.  

 
 
Aggravation 
of Preexisting Condition

 
 
[¶21]   The hearing officer determined Mr. 
Montoya had not met his burden of proving his on-the-job injury aggravated a 
preexisting condition.  
Specifically, the hearing officer determined Montoya had not provided 
adequate medical evidence proving the relationship between his work-related 
injury and his preexisting condition.

 
 
[¶22]   In the spirit of not reinventing 
the wheel, in cases involving the issue of material aggravation of an existing 
condition, the principles governing a claimant's burden of proof are well 
known:

 
 
In 
order to be eligible to receive worker's compensation benefits, a claimant must 
have sustained an "injury" as defined by Wyo. Stat. Ann. § 27-14-102(a)(xi) 
(LexisNexis 2001).  "Injury'" means 
any harmful change in the human organism other than normal aging . . . arising 
out of and in the course of employment while at work. . . ."  To demonstrate that an injury arose out 
of the course of employment, the claimant must establish a causal connection 
between the work-related incident and the injury.  Hanks v. City of Casper, 2001 WY 4, ¶ 6, 
16 P.3d 710, 711 (Wyo. 2001).  The 
claimant bears the burden of proving this causal connection by a preponderance 
of the evidence.  Clark v. State ex rel. Wyoming Workers' 
Safety and Compensation Div., 2001 WY 132, ¶ 19, 36 P.3d 1145, 1150 (Wyo. 
2001).  "A preponderance of the 
evidence' is defined as proof which leads the trier of fact to find that the 
existence of the contested fact is more probable than its non-existence.'"  Matter of Worker's Compensation Claim of 
Thornberg, 913 P.2d 863, 866 (Wyo. 1996) (quoting Scherling v. Kilgore, 599 P.2d 1352, 
1359 (Wyo. 1979)).  

 
 

Anastos 
v. General Chemical Soda Ash, 
2005 WY 122, ¶ 20, 120 P.3d 658, 665-66 (Wyo. 2005).  

 
 
            
"Injury," as the term is defined in Wyo. Stat. Ann. § 27-14-102(a)(xi) 
(LexisNexis 2003) of the Wyoming Workers' Compensation Act, does not include any 
injury or condition preexisting at the time employment begins with the employer 
against whom a claim is made.  
However, "in Wyoming an employer takes the employee as he finds 
him."  Lindbloom v. Teton International, 684 P.2d 1388, 1389 (Wyo. 1984).  If an 
employee suffers from a preexisting condition, that employee may still recover 
if his employment substantially or materially aggravates that condition.  Id. In Lindbloom, we cited with approval the 
widely accepted treatise, Larson's Workmen's Compensation Law, for the 
proposition that:

 
 
Preexisting 
disease or infirmity of the employee does not disqualify a claim under the 
"arising out of employment" requirement if the employment aggravated, 
accelerated, or combined with the disease or infirmity to produce the death or 
disability for which compensation is sought.  

 
 
1 
Larson's Workmen's Compensation Law, § 12.20, p. 273-276.  Larson goes on to 
say:

 
 
Since 
the rule of law stated at the beginning of this section is so widely accepted, 
in practice most of the problems in this area are medical rather than 
legal.  * * * *  It will be found then that denials of 
compensation in this category are almost entirely the result of holdings that 
the evidence did not support a finding that the employment contributed to the 
final result.  Whether the 
employment aggravated, accelerated, or combined with the internal weakness or 
disease to produce the disability is a question of fact, not law, and a finding 
of fact on this point * * * * based on any medical testimony * * * * will not be 
disturbed on appeal.  

 
 

Id., 
§ 12.20, p. 313-16.  

 
 

Boyce 
v. State ex rel. Wyoming Workers' Safety & Comp. Div., 
2005 WY 9, ¶ 10, 105 P.3d 451, 454-55 (Wyo. 2005).

 
 
            
Expert opinion testimony ordinarily will be required to establish the 
link between the employee's work activity or injury and the preexisting disease 
or condition; the expert need not state with specificity that the work 
activities or injury materially or substantially aggravated, accelerated, or 
combined with the preexisting disease or condition to necessitate the medical 
treatment for which compensation is sought; and the expert need not apportion 
between the work activity or injury and the preexisting disease or condition; 
the relative contribution of the work activity or injury and the preexisting 
disease or condition is not weighed.  

 
 

Ramos 
v. State ex rel. Wyoming Workers' Safety & Comp. Div., 
2007 WY 85, ¶ 18, 158 P.3d 670, 677 (Wyo. 2007) (citing Boyce, ¶¶ 11, 16, 105 P.3d at 
455-56).

 
 
[¶23]   We find that, applying the above 
analysis, the overwhelming weight of the evidence supports a finding that Mr. 
Montoya's February 2003 work-related fall aggravated a preexisting 
condition.  We disagree with the 
hearing officer that more specific medical evidence was essential for Mr. 
Montoya to establish his case.4  Dr. Harvey opined that Mr. Montoya 
suffered from a mild, traumatic brain injury.  While he attributed it most likely to 
Mr. Montoya's 1999 automobile accident, since the claim is for an aggravation of 
a preexisting condition such opinion is not inconsistent with the claim.  More importantly, Dr. Harvey noted that 
Mr. Montoya's symptoms were aggravated by his 2003 fall. 

 
 
[¶24]   Dr. Naramore had the final 
word.  His letter very strongly 
states that Mr. Montoya's current symptoms are attributable to his 2003 
fall.  The hearing officer dismissed 
this evidence because "Dr. Naramore fails to address the Claimant's ongoing 
condition prior to the February 10, 2003 accident and the relationship of that 
accident with the pre-existing condition."  
As a matter of law, this the doctor need not do.  We reiterate: 

 
 
[T]he 
expert need not apportion between the work activity or injury and the 
preexisting disease or condition; the relative contribution of the work activity 
or injury and the preexisting disease or condition is not weighed.  

 
 

Ramos, 
¶ 
18, 158 P.3d  at 677.  Dr. Naramore's 
opinion was sufficient to establish an aggravation of a pre-existing 
condition.

 
 
[¶25]   Even should the medical evidence be 
considered weak, there is other, strongly circumstantial, evidence supporting 
Mr. Montoya's claim.  Both Mr. and 
Mrs. Montoya testified that, while Mr. Montoya suffered some similar symptoms 
before his fall, after the fall the symptoms were exacerbated and new symptoms 
appeared.  All medical evidence 
supports this testimony.  Most 
telling, and incontrovertible, is the fact that Mr. Montoya was able to perform 
his job functions for over three years after his November 1999 automobile 
accident.  After his work-related 
fall in 2003, he was no longer able to perform these same functions.   

 
 
CONCLUSION

 
 
[¶26]   Given the state of the evidence, we 
find the overwhelming weight of the evidence proves a material aggravation of 
pre-existing condition.  We remand 
this case to the district court with instructions that the order of the OAH be 
reversed and Mr. Montoya awarded benefits.

 
 
FOOTNOTES

 
 

1Wyo. Stat. Ann. §  27-14-503 
(LexisNexis 2007), entitled "Statute of limitations," states, in pertinent 
part:

 
 
            
 (a) A payment for benefits 
involving an injury which is the result of a single brief occurrence rather than 
occurring over a substantial period of time shall not be made unless in addition 
to the proper and timely filing of the injury reports, an application or claim 
for benefits is filed within one (1) year after the date the injury occurred or 
for injuries not readily apparent, within one (1) year after discovery of the 
injury by the employee.  The injury 
report is not a claim for benefits.

 
 

2We take this opportunity to again encourage hearing officers to determine 
all issues properly before them.  See Rice v. State ex rel. Wyoming Workers' 
Safety and Compensation Div., 2001 WY 21, ¶ 18, 19 P.3d 508, 514 (Wyo. 
2001).

 
 

3Gillis v. 
F & A Enterprises, 934 P.2d 1253, 1256 (Wyo. 1997) (under a discovery statute, the statute of limitations is 
not triggered until a plaintiff knows or has reason to know a cause of action 
exists).

 
 

4To the 
extent the hearing officer believed medical testimony regarding the issue of 
causation is an essential component of any claimant's case as a matter of law, 
he misreads our precedent.  While 
medical evidence is helpful and "ordinarily" should be provided, it is not 
essential.