Case Title: KESTIE v. WYOMING WORKERS' SAFETY AND COMPENSATION DIVISION

Citation: 

Docket Number: 

State: wyoming

Court: Wyoming Supreme Court

Date: 2003-07-17T00:00:00Z

Document:
KESTIE v. WYOMING WORKERS' SAFETY AND COMPENSATION DIVISION2003 WY 8872 P.3d 1162Case Number: 02-194Decided: 07/17/2003
APRIL 
TERM, A.D. 2003

 

                                                                                                                                   

 

IN 
THE MATTER OF THE WORKER'S

COMPENSATION 
CLAIM OF CHERYL KESTIE

 

STATE 
OF WYOMING, ex rel.,

WYOMING 
WORKERS' SAFETY

AND 
COMPENSATION DIVISION,

 

Appellant(Respondent),

 

v.

 

CHERYL 
KESTIE,

 

Appellee(Petitioner).

 

 

Representing 
Appellant:

 

            
Hoke MacMillan, Attorney General; John W. Renneisen, Deputy Attorney 
General; and David L. Delicath, Assistant Attorney General, Cheyenne, 
Wyoming.

 

Representing 
Appellee:

 

            
Barbara A. Baker, Sheridan, Wyoming.

 

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

 

 

            
VOIGT, Justice.

 

[¶1]      The district 
court reversed a determination by the Worker's Safety and Compensation Division 
(Division) that the appellee, Cheryl Kestie (Kestie), was untimely in responding 
to the Division's final determination denying benefits.  We affirm the district court and remand 
to the district court for further remand to the Division for proceedings 
consistent herewith.

 

ISSUES

 

[¶2]      The parties' 
divergent views of this case are reflected in their divergent statements of the 
issue being appealed.  The Division 
presents the issue as follows:

 

            
The agency determined that Ms. Kestie did not file a timely response to 
the Division's January 21, 2000 final determination denying benefits for carpal 
tunnel syndrome.  Does substantial 
evidence support that determination?

 

[¶3]      Kestie describes 
the issue quite differently:

 

            
Did the District Court properly determine that Employee/Claimant should 
be entitled to present evidence regarding her medical condition based upon her 
June 2001 filing?

 

FACTS

 

[¶4]      Kestie worked for 
Children's Center in Sheridan.  In 
November 1999, she submitted to the Division a claim for worker's compensation 
benefits for a condition she suspected to be carpal tunnel syndrome.1  The claim was submitted on the wrong 
formemployer instead of employeeand it contained no authorization for the 
Division to obtain Kestie's medical records.  Nevertheless, the Division treated 
Kestie's submission as an injury report and sent Kestie a letter entitled 
"Initial Review:  Notice of Lack of 
Information," asking Kestie to complete an enclosed injury report form, a 
written statement as to how the injury occurred, and an authorization to release 
medical information.

 

[¶5]      The Division 
requested receipt of Kestie's written responses by January 3, 2000.  Kestie did not respond, however, and on 
January 21, 2000, the Division issued a Final Determination denying benefits for 
lack of medical information and Kestie's failure to sign and submit the 
Employee's Report of Injury.  The 
Final Determination also notified Kestie that she had the right to file a 
written objection and request for hearing on or before February 11, 2000.  That date passed without Kestie 
submitting anything further to the Division.

 

[¶6]      On May 9, 2001, 
nearly sixteen months after issuance of the Final Determination, the Division 
received from Kestie another Employer's Report of Injury.  Then, on June 16, 2001, Kestie filed an 
Employee's Report of Injury.2  The reports indicated symptoms similar 
to those Kestie had reported in November 1999, and indicated that the employer 
had been notified of the injury on December 15, 1999.  The Division considered the reports 
filed in 2001 to be an untimely objection to the Final Determination of January 
21, 2000, and sent Kestie a Notification of Late Response on July 5, 2001.  The notification stated that Kestie had 
until July 26, 2001, to file a written request for a hearing if she "still 
believe[d] that [her] objection was timely filed . . .."  On July 12, 2001, the Division received 
Kestie's letter requesting a hearing.

 

[¶7]      A hearing 
examiner from the Division's Internal Hearing Unit conducted an evidentiary 
hearing on October 17, 2001.  At the 
hearing, Kestie testified that the application for benefits in 2001 was for the 
same condition she had in 1999.  She 
further testified that, although she had received the Notice of Lack of 
Information, the press of family matters dictated that "it was not a good time" 
to pursue worker's compensation benefits, so she did not respond to the 
Division's request.

 

[¶8]      The hearing 
examiner issued recommended findings of fact and conclusions of law.  After setting forth the facts outlined 
above and chronicling the Division's utilization of proper statutory and 
administrative procedures, including appropriate notice to Kestie, the hearing 
examiner recommended that a final order be entered finding that Kestie did not 
respond to the Final Determination within the time allowed by law and declaring 
the Final Determination a final order binding on all parties and not subject to 
further administrative or judicial review.  
The Final Agency Order to that effect was signed November 23, 2001, by 
the Director of the Department of Employment.

 

[¶9]      Kestie challenged 
the final order by filing in the district court a Petition for Review of 
Administrative Action pursuant to Wyo. Stat. Ann. § 16-3-114 (LexisNexis 2003) 
and W.R.A.P. 12.  The district court 
reversed and remanded the case to the Division "with the direction to allow 
Petitioner/Claimant an opportunity to present evidence regarding claims for 
possible compensable injury submitted in June of 2001."  The Division has appealed that decision 
to this Court.

 

STANDARD 
OF REVIEW

 

[¶10]   In appeals from administrative 
agencies, we afford no deference to the conclusions reached by the district 
court and we review such cases as if they had come directly from the 
agency.  Appleby v. State ex rel. 
Wyoming Workers' Safety and Compensation Div., 2002 WY 84, ¶ 9, 47 P.3d 613, 
616 (Wyo. 2002).  Where both parties presented evidence at 
the agency hearing, we apply the substantial evidence test to findings of 
fact.  Newman v. State ex rel. 
Wyoming Workers' Safety and Compensation Div., 2002 WY 91, ¶ 22, 49 P.3d 163, 171 (Wyo. 2002).  That test has been described as 
follows:

 

"In 
reviewing findings of fact, we examine the entire record to determine whether 
there is substantial evidence to support an agency's findings.  If the agency's decision is supported by 
substantial evidence, we cannot properly substitute our judgment for that of the 
agency and must uphold the findings on appeal.  Substantial evidence is relevant 
evidence which a reasonable mind might accept in support of the agency's 
conclusion.  It is more than a 
scintilla of evidence."

 

Id., 
2002 WY 91, ¶ 12, 49 P.3d  at 168 (quoting In re Jensen, 2001 WY 
51, ¶ 10, 24 P.3d 1133, 1136 (Wyo. 2001)).  Even where there is substantial evidence 
to support the findings of fact, however, we may apply the "arbitrary and 
capricious" standard as a "safety net" to catch agency action that prejudiced a 
party's substantial right to the administrative proceeding or was contrary to 
other administrative review standards.  
Hoff v. State ex rel. Wyoming Workers' Safety and Compensation Div., 
2002 WY 129, ¶ 8, 53 P.3d 107, 110 (Wyo. 2002).  We affirm an agency's conclusions of law 
only if they are truly in accord with law.  
Kuntz-Dexter v. State ex rel. Wyoming Workers' Safety and Compensation 
Div., 2002 WY 101, ¶ 10, 49 P.3d 190, 193 (Wyo. 2002).  "Whether an employee's claim is to be 
barred for failure timely to file notice or a claim is a mixed question of fact 
and law."  Logue v. State ex rel. 
Wyoming Workers' Safety and Compensation Div., 2002 WY 62, ¶ 13, 44 P.3d 90, 
95 (Wyo. 2002).

 

DISCUSSION

 

[¶11]   The Division argues that the only 
issue before the agency and subsequently before the district court on appeal was 
whether Kestie had complied with the procedural requirements to have her claim 
decided on the issue of compensability.  
The Division contends that the district court erred when it ordered a 
remand because substantial evidence supports the Director's ruling that Kestie's 
objection was untimely.  The 
Division argues that the 2001 injury report is either an untimely response to 
the Division's final determination denying benefits or it is an untimely report 
of a 1999 injury.

 

[¶12]   Kestie's response is 
multi-faceted.  First, she contends 
that in 1999 she had not even been to a doctor and had not been diagnosed.  Consequently, the nature, cause, and 
date of her injury were unknown.  
Second, Kestie contends that her 1999 submission should not even have 
been considered a claim, inasmuch as it did not meet basic filing 
requirements.  Third, Kestie notes 
that the Division denied benefits after the 1999 filing on the ground that "we 
cannot open the case because an unsigned injury report is not filed in a manner 
prescribed by the Division . . .."  
And fourth, Kestie argues that her 2001 filing clearly was a report of 
injury and not an objection to the earlier denial.

 

[¶13]   The district court's reversal of 
the Final Agency Order was premised upon the following 
reasoning:

 

            
CTS [carpal tunnel syndrome] is a condition generally not described as 
trauma resulting from one incident.  
Prior cases indicate CTS can be caused and/or aggravated by 
employment.  Determining if CTS is a 
work related, compensable injury requires an analysis of whether, ". . . work 
effort contributed to a material degree to the precipitation, aggravation or 
acceleration of the existing condition of the employee."  Frontier Refining, Inc. v. Payne, 
23 P.3d 38, 40 (Wyo.2001).

 

            
Even if Petitioner suffered from CTS in 1999, she did not have an 
opportunity to present evidence of any aggravation or acceleration of an 
existing condition due to denial on procedural grounds.  It seems noteworthy that Petitioner's 
1999 claim did not contain expert opinion that she suffered from CTS.  Petitioner's lay opinion 
her condition in 2001 was the same as in 1999 should not preclude either side 
from offering expert medical opinions on the subject.

 

(Emphasis 
in original.)

 

[¶14]   The district court did not simply 
conclude that the Division's reliance upon procedural default denied Kestie an 
opportunity to be heard on the merits, so she should be afforded such an 
opportunity.  Rather, the district 
court correctly concluded that by treating Kestie's 2001 injury report as a 
late-filed objection to the Division's Final Determination, the Division denied 
Kestie the chance to prove that the injury from which she suffered in 2001 was 
compensable.  Kestie's lay opinion 
that the underlying condition was the same, in and of itself, should not have 
been fatal to her claim.  The 
Division must assess the 2001 injury report on its own merits, or lack 
thereof.3

 

CONCLUSION

 

[¶15]   The Division erred in treating 
Kestie's 2001 report of injury as an untimely objection to denial of her 1999 
claim.  We affirm the district court 
and remand to the district court for remand to the Division for further 
proceedings consistent with this opinion.

 

FOOTNOTES

  1Kestie had not at that time been 
examined by a physician and she did not have a physician's 
diagnosis.

  2The record does not disclose how it 
came about that Kestie filed two separate reports in 2001.

  3By this resolution, we do not hold 
that the Division is foreclosed from assessing whether the 2001 filing met the 
procedural requirements for an injury report, including 
timeliness.