Case Title: IN THE MATTER OF THE WORKER'S COMPENSATION CLAIM OF: HOFF

Citation: 

Docket Number: 

State: wyoming

Court: Wyoming Supreme Court

Date: 2002-09-04T00:00:00Z

Document:
IN THE MATTER OF THE WORKER'S COMPENSATION CLAIM OF: HOFF2002 WY 12953 P.3d 107Case Number: 01-128Decided: 09/04/2002
April Term, A.D. 2002

 
IN 
THE MATTER OF THE WORKER'S

COMPENSATION 
CLAIM OF:

 

MARY 
ANN MILLER HOFF,

 

Appellant(Petitioner) 
,

 

v.

 

STATE 
OF WYOMING, ex rel., WYOMING

WORKERS' 
SAFETY AND COMPENSATION

DIVISION,

 

Appellee(Respondent) 
.

 

W.R.A.P. 
12.09(b) Certification

from 
the District Court of Natrona County

The 
Honorable W. Thomas Sullins, Judge

 

Representing 
Appellant:

David 
A. Drell of Vlastos, Henley & Drell, P.C., Casper, WY.

 

Representing 
Appellee:

Hoke 
MacMillan, Attorney General; Gerald L. Laska, Senior Assistant Attorney General; 
and David L. Delicath, Assistant Attorney General.

 

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

 

 

*Chief 
Justice at time of expedited case conference.

 

LEHMAN, 
Justice.

 

[¶1]      This is an appeal 
from a determination of the State of Wyoming, Office of Administrative Hearings 
(OAH) denying worker's compensation benefits.  We 
affirm.  

 

 

ISSUES

 

[¶2]      Appellant Mary 
Ann Miller Hoff (Hoff) sets forth the following issue:

 

1.  Whether 
the Decision and Order Denying Benefits of the Office of Administrative Hearings 
was arbitrary, capricious and an abuse of discretion, otherwise not in 
accordance with law and, furthermore, not supported by substantial evidence. 

 

Appellee State of Wyoming ex rel. Wyoming Worker's Compensation 
Division (Division) phrases the issue:
 

The Hearing Examiner assigned greater weight to the medical opinion 
of Dr. Pitzer than to the opinions of Dr. Delgadillo and Dr. Narotzky. Was that 
assignment contrary to the overwhelming weight of the evidence?
 

 

FACTS

 

[¶3]      Hoff sustained a 
work-related injury on July 25, 1999.  
She received primarily chiropractic care and consulted with a 
neurosurgeon.  Initially, claims for 
medical care and temporary total disability were submitted to and paid by the 
Division.  However, on May 15, 2000, 
the Division issued a Final Determination wherein it denied all claims that were 
submitted by Hoff after August 31, 1999.  
This denial was based on a conclusion that all claims after August 31, 
1999, were not work related as the work injury of Hoff was resolved, and 
treatment after August 31, 1999, was for an underlying chronic cervical spine 
problem experienced by Hoff which affected the neck and right shoulder area 
unrelated to the work injury. 

 

[¶4]      Hoff appealed 
this determination, and a contested case hearing was held before the OAH.  The OAH upheld the decision of the 
Division.  Hoff then filed a 
petition for review before the district court, and this matter was certified 
directly to this court for appellate review.  

 

 

 

 

STANDARD 
OF REVIEW

 

[¶5]      Our standard of 
review when reviewing administrative agency action was recently clarified in the 
case of Newman v. State ex rel. Workers' Safety and Compensation Div., 
2002 WY 91, __ P.3d ___ (Wyo. 2002).  
Judicial review of an agency action is directed by Wyo. Stat. Ann. § 
16-3-114.1 

 

[¶6]      In appeals where both parties submit evidence at the 
administrative hearing, Newman mandates that appellate review be limited 
to application of the substantial evidence test.  Newman, 2002 WY 91, 
¶22.  This is true regardless of 
which party appeals from the agency decision.   In addition, this court is 
required to review the entire record in making its ultimate determination on 
appeal.  Newman, at ¶19 and 
¶¶24-26. 

 

[¶7]      The substantial 
evidence test to be applied is 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 
conclusions.  It is more than a 
scintilla of evidence.  

 

Newman, 
at ¶12 (quoting State 
ex rel. Workers' Safety and Compensation Div. v. Jensen, 
2001 WY 51, ¶10, 24 P.3d 1133, ¶10 (Wyo. 2001)).

 

[¶8]      Even when the 
factual findings are found to be sufficient under the substantial evidence test, 
Newman further concludes this court may be required to apply the 
arbitrary-and-capricious standard as a "safety net" to catch other agency action 
which prejudiced a party's substantial right to the administrative proceeding or 
which might be contrary to the other WAPA review standards.  A purely 
demonstrative listing is provided of situations which could warrant the 
consideration of the arbitrary-and-capricious standard in addition to the 
substantial evidence test.2  Newman, at ¶23.  However, this appeal presents no such 
unique circumstances.  

 

 

DISCUSSION

 

[¶9]      Hoff generally 
argues that the decision of the OAH is not supported by substantial 
evidence.  First, Hoff asserts that 
reliance by the OAH on the opinions of Dr. Neil Pitzer is misguided because Dr. 
Pitzer's opinions were speculative and not supported by substantial 
evidence.  In particular, Hoff 
argues that the bulk of medical records reviewed by Dr. Pitzer did not deal with 
cervical spine issues but with other unrelated back problems suffered by 
Hoff.  Hoff also contends that the 
opinions of Dr. Pitzer are contrary to the opinions expressed by Hoff's treating 
physicians.  Finally, Hoff asserts 
that she submitted adequate evidence to meet her burden of proof that the work 
accident caused her injuries and/or materially aggravated a preexisting 
condition.  Therefore, Hoff argues 
she is entitled to worker's compensation benefits.

 

[¶10]   Hoff's initial argument is that the 
OAH erred in finding Dr. Pitzer's opinions more credible than the opinions of 
Dr. Marc Delgadillo and Dr. Robert A. Narotzky.  Indeed, in the Order Denying Benefits 
entered by the OAH in this case, the hearing examiner 
stated:

 

8.  In 
weighing the medical evidence, this Office finds Dr. Pitzer's testimony more 
credible than Dr. Narotzky.  In 
making his medical opinion, Dr. Narotzky indicates that he reviewed information 
and his clinic notes, however there is no indication as to what information was 
review [sic] by him.  Dr. Pitzer 
reviewed extensive medical records and chiropractic records which support his 
opinion that Hoff's neck and right shoulder problems after August 30, 1999 are 
the result of her chronic cervical spine condition and not the July 25, 1999 
work injury.[3]

 

[¶11]   Review of the record discloses that 
Hoff was involved in a work-related injury on July 25, 1999, when a chair rolled 
in front of her causing her to twist but not fall.  On July 31, 1999, Hoff indicated in her 
Employee's Report of Injury that she had injured both her neck and lower back in 
this incident and that she had previously injured these areas of her body 
outside of work.  In addition, at 
the hearing Hoff testified that at the time of the accident she was primarily 
concerned with an injury to her lower back as she was then recuperating from a 
recent surgery to that area of her body.  

 

[¶12]   Dr. Pitzer was retained by the 
Division to perform a medical record review because the Division had concerns 
that Hoff had a history of considerable preexisting problems.  As a basis for his report, Dr. Pitzer 
was supplied with extensive medical records to review from the Division.4  Dr. Pitzer detailed that Hoff's medical 
records showed that she was extensively treated due to a motor vehicle accident 
in June of 1994 where she incurred lumbar spine pain.  X-rays at that time showed multiple 
level degenerative disc disease and, in December of 1995, Hoff submitted to an 
L4 through S1 fusion.  In August of 
1996, Hoff received a surgical revision of the graft site at the right iliac 
crest and, in December of 1997, repair of the right iliac crest 
musculature.  Hoff then obtained 
prolotherapy and injections in October of 1998 to the right iliac crest area and 
had the hardware removed concerning her fusion in April of 1999.  

 

[¶13]   Dr. Pitzer also indicated that he 
had reviewed extensive chiropractic notes apparently made by Dr. 
Delgadillo.  These notes, from April 
through August of 1998, referred to 12 sessions of chiropractic treatment that 
Hoff received primarily for neck and shoulder pain.  Trigger points likewise were established 
at this time on the right side.  
These notes also related another automobile accident that Hoff was 
involved in on October 30, 1998.  
From that time through June of 1999, Hoff had 17 additional chiropractic 
treatments, again substantially involving the right neck and right 
shoulder.  In early 1999, Hoff also 
experienced migraine-like headaches. 

 

[¶14]   Dr. Pitzer further identified that 
x-rays taken in April of 1999 showed degenerative changes on multiple levels in 
Hoff's cervical spine.  A cervical 
MRI, taken in August of 1999 after Hoff's July 25, 1999 work injury, indicated 
disc changes including midline bulging and spinal canal narrowing at C3 through 
C7 levels.  However, there were no 
comments on any acute changes suffered by Hoff.  Dr. Pitzer also pointed out the findings 
of Dr. Narotzky during his examination of Hoff, most notably that Hoff had no 
evidence of radiculopathy.  Finally, 
Dr. Pitzer recognized from his review that both Dr. Narotzky and Dr. Delgadillo 
had recommended only continuing conservative treatment for Hoff.  

 

[¶15]   Dr. Pitzer additionally reviewed 
medical records from the Wyoming Medical Center which made reference to a 
September 21, 1998 fall down some stairs experienced by Hoff.  Notes of Dr. Delgadillo from the period 
of August 13, 1999, to January of 2000 showed at least 47 chiropractic sessions 
for headaches, neck and shoulder pain and trapezius symptoms.  Dr. Pitzer concluded that the July 25, 
1999 work injury may have resulted in some mild aggravation of Hoff's cervical 
spine symptoms but felt Hoff was receiving treatment under the Wyoming Workers' 
Compensation system for a chronic problem which was not related to that work 
injury.  In particular, while Dr. 
Pitzer opined that limited chiropractic treatment of eight to twelve sessions 
would have been adequate to address any such aggravation, acknowledged that a 
few sessions of physical therapy were in order, and agreed that the MRI and 
x-rays taken were reasonably related to the work injury, he ultimately 
determined that any additional treatment received by Hoff was not related to her 
work injury but to an established chronic cervical degenerative spine problem 
effecting her neck and right shoulder area.  This opinion was appropriately based on 
the above-referenced medical history gleaned by Dr. Pitzer from review of Hoff's 
medical records and characterization that the work injury was a low speed, 
whiplash type injury without any head trauma or particular neck trauma.  Moreover, Dr. Pitzer stated that any of 
the previous events within Hoff's medical history may have caused her ongoing 
and chronic neck conditions.  

 

[¶16]   As ascribed previously, Hoff argues 
that the bulk of the medical records reviewed by Dr. Pitzer did not deal with 
cervical spine issues but with other unrelated back problems suffered by 
Hoff.  Certainly, while some of the 
medical records reviewed by Dr. Pitzer dealt with lower lumbar issues, other 
medical records dealt specifically with cervical spine related issues which were 
of direct concern in this manner.  
Evaluation of those medical records examined by Dr. Pitzer evidences the 
thoroughness of his review upon which he based his opinion.  Finally, we frankly know of no other 
means by which an appropriate and complete medical records review may be 
conducted than upon consideration of the past medical history of the person 
involved.

 

[¶17]   Additional evidence exists in the 
record to support Dr. Pitzer's conclusions.5  Medical notations concerning Hoff's 
visit to the Wyoming Medical Center on August 16, 1999, reflect only a cervical 
musculoskeletal strain.  On that 
same date, an x-ray examination of Hoff resulted in a conclusion that no 
significant change had occurred when compared with a previous study conducted on 
September 21, 1998.  Similarly, the 
cervical area MRI study taken on that day ended in findings that some of the 
previous problems noted in an MRI taken on March 28, 1991, were unchanged.  Additional problems were also 
established which supported a determination that Hoff suffered chronic cervical 
degenerative spine problems effecting her right neck area. 

 

[¶18]   A cervical discography performed on 
Hoff on November 22, 1999, ordered by Dr. Narotzky, identified a disc with 
abnormal appearance, a disc space with abnormal appearance with narrowing and 
abnormal layering as opposed to pooling centrally in the nucleus and contrast 
leaking.  Given these factors, it 
was found that Hoff had spurring and leaking consistent with an annular 
degeneration or tearing at the C4-5 plane, diffuse degeneration of the disc and 
spurring impinging on the thecal sac at the C5-6 level and degenerative 
arthritic change with contrast spread consistent at the C6-7 area.  Correspondingly, it was noted that Hoff 
had pain during the injection consistent with some but not all of her previous 
complaints.  Dr. Angelo M. Santiago, 
a specialist in neurology, conducted a neurologic examination and an EMG study 
on Hoff on December 28, 1999, concluding that there were no remarkable 
abnormalities and that he was "uncertain as to what could be really causing Ms. 
Hoff's constellation of symptomatology aside from a cervical musculo-ligamentous 
strain."  Hence, the opinions of Dr. 
Pitzer were not misguided, speculative, or unsupported by substantial 
evidence.

 

[¶19]   Furthermore, Hoff also contends 
that the opinions of Dr. Pitzer are contrary to the opinions expressed by Hoff's 
treating physicians.   
Nevertheless, review of the record shows upon examination of Hoff on 
August 30, 1999, and review of the recent cervical x-rays and MRI taken of Hoff, 
that Dr. Narotzky recognized Hoff had a history of four operations to her lower 
back and several surgeries to her iliac crest bone graft site to repair a 
"slipped muscle."  Additionally, the 
doctor noted degenerative changes, spondylosis with disc bulging, and a 
combination of osteophyte formation and disc bulging causing mild canal stenosis 
and associated neural foraminal stenosis within the cervical area of Hoff.  Finally, Dr. Narotzky recognized that 
Hoff suffered from multilevel disease and no evidence of myelopathy or 
radiculopathy on exam and recommended only continued conservative 
treatment.  

 

[¶20]   Dr. Delgadillo, upon his initial 
examination of Hoff on August 16, 1999, referenced Hoff's degenerative cervical 
history upon review of x-rays and made a diagnosis of cervical strain.  Later, in his Health Care Provider 
Initial Report of August 20, 1999, Dr. Delgadillo noted right neck and right arm 
pain but identified that these body parts had been previously injured by Hoff as 
a result of a prior automobile accident.  
He then again diagnosed these injuries as a cervical strain.  In a letter written by Dr. Delgadillo on 
October 12, 1999, he further recognized Hoff's degenerative disc disease in the 
cervical area given the x-ray and MRI results obtained.  Dr. Delgadillo similarly stated that 
Hoff's discogram "showed some major problems" involving the C5-6 disc.  

 

[¶21]   Review of Dr. Delgadillo's 
treatment notes concerning Hoff for the period of April 14, 1998, through May 4, 
2000, indicates problems experienced by Hoff with her right neck, right shoulder 
and right arm.  In particular, the 
May 12, 1998 notation reflects Hoff was experiencing soreness and stiffness in 
the right side of her neck and right shoulder and had difficulty in moving her 
right shoulder because of an exacerbation of old problems.  She was also experiencing spasms in the 
right side of her neck.  These 
difficulties continued into the following month.  

 

[¶22]   In November of 1998, Dr. Delgadillo 
stated in his notations that Hoff was involved in an automobile accident causing 
her pain, soreness, stiffness and tenderness on the right side of her neck and 
spasms in her right side trapezius.  
In March and April of 1999, Hoff experienced right side neck and right 
shoulder pain with migraine like pain.  
She also had a tight right trapezius and shoulder blade with spasms and 
trigger points.  

 

[¶23]   Even after the work injury, Dr. 
Delgadillo referred to further exacerbations to Hoff's difficulties.  On October 8, 1999, it was recognized 
that Hoff experienced a slight exacerbation of unknown origin causing her 
additional tenderness to the right side of her neck.  On October 28, 1999, Hoff was thrown 
from a chair at work causing her additional problems with her neck.  Still, in March of 2000, two separate 
further exacerbations to Hoff's right cervical area were noted; one of unknown 
origin and the other caused by Hoff walking and stepping off a curb.   

 

[¶24]   During his testimony, Dr. 
Delgadillo explained that he first began seeing Hoff in 1985 for occasional neck 
pain, headaches and lower back pain.  
He further confirmed Hoff's 1994 automobile accident and stated that Hoff 
had fairly involved neck problems that resulted from that accident.  Dr. Delgadillo also attested that Hoff 
complained of neck related difficulties from approximately October of 1998 
through April of 1999 prior to the work related injury.6  

 

[¶25]   The record before us does reflect 
evidence that is contrary to the ultimate decision made by the OAH.  For instance, Hoff testified that the 
symptoms that she experienced after the work injury were different than those 
symptoms that she had experienced previous to that event.  Dr. Narotzky wrote a letter dated 
November 28, 2000, to Hoff's counsel stating that it appeared that although Hoff 
had preexisting spondolyosis prior to her work injury, that this work injury 
caused this previous problem to become symptomatic necessitating treatment with 
Dr. Delgadillo and himself from the date of injury at least through mid-October 
of 2000.  Additionally, Dr. 
Delgadillo testified that he concurred with these statements made by Hoff and 
Dr. Narotzky.  However, this 
evidence is not of sufficient weight to convince us that the determination of 
the OAH was incorrect.7  We, therefore, determine that the 
findings and rulings reached by the OAH were based on substantial evidence and 
within established law.       

 

 

CONCLUSION

 

[¶26]   We hold that the record before us 
provided a rational basis for the hearing examiner's ultimate findings of fact 
and conclusions of law.   As 
such, we hold that these findings of fact and conclusions of law were not 
clearly contrary to the overwhelming weight of the evidence.  

 

[¶27]   The order denying benefits of the 
OAH is affirmed.

 

FOOTNOTES

1Wyo. 
Stat. Ann. § 16-3-114(c) (LexisNexis 2001) provides:

 

(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:

 

(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. 

 

2"For 
example, the administrative record may be replete with evidence supporting the 
decision, and yet the agency may have willfully discounted credible evidence, 
refused to admit certain testimony or documentary exhibits, or failed to provide 
findings of fact or conclusions of law."  
Newman, at ¶23.

3The 
hearing examiner must have meant to refer to Dr. Delgadillo rather than Dr. 
Narotzky, as Dr. Delgadillo was the only doctor to testify as a witness at the 
hearing.  Further, Dr. Pitzer did 
not actually testify, but his medical record review report was submitted as 
documentary evidence.

 

4The 
medical record review report of Dr. Pitzer was admitted into evidence without 
objection.  

5Again, 
each of the documents referred to herein was admitted into evidence without 
objection.  

6Hoff 
during her testimony admitted to her extensive prior medical history related to 
her right neck and right shoulder areas and experienced headaches and to those 
post-work accident incidences she was involved in which exacerbated her subject 
cervical related work injuries.

 

7The 
record reflects that Hoff responded that she "did not recall" to numerous fact 
related questions surrounding the subject work accident and her medical history 
on cross-examination. Yet, Hoff was able to respond with specificity that she 
had never previously experienced those difficulties prior to the work accident. 
Further, Hoff admitted that she had previously spoken to Dr. Narotzky about her 
workers' compensation related difficulties and that he stated that he would do 
anything he could to help her with her case.  Finally, throughout his testimony, Dr. 
Delgadillo often became confused, could not keep his notes in order for 
reference and stated that his opinion was based exclusively on his review of his 
own notes. These circumstances, of course, may or may not have been considered 
in weighing overall credibility.