Case Title: TODD ROGERS, AN EMPLOYEE OF R.A. MANNING CONSTRUCTION v. STATE OF WYOMING, ex rel., WYOMING WORKERS' SAFETY AND COMPENSATION DIVISION

Citation: 

Docket Number: S-12-0001

State: wyoming

Court: Wyoming Supreme Court

Date: 2012-09-07T00:00:00Z

Document:
TODD ROGERS, AN EMPLOYEE OF R.A. MANNING CONSTRUCTION v. STATE OF WYOMING, ex rel., WYOMING WORKERS' SAFETY AND COMPENSATION DIVISION2012 WY 117284 P.3d 815Case Number: S-12-0001Decided: 09/07/2012
APRIL 
TERM, A.D. 2012
IN 
THE MATTER OF THE WORKER'S COMPENSATION CLAIM OF:TODD ROGERS, AN 
EMPLOYEE OF R.A. MANNING 
CONSTRUCTION,Appellant(Petitioner),v.STATE OF 
WYOMING, ex rel., WYOMING WORKERS' SAFETY AND COMPENSATION 
DIVISION,Appellee(Respondent).
Appeal 
from the District Court of Teton County
The 
Honorable Timothy C. Day, Judge 
Representing 
Appellant:
Jack D. Edwards of 
Edwards Law Office, P.C., Etna, WY.
Representing 
Appellee:
Gregory A. Phillips, 
Wyoming Attorney General; John D. Rossetti, Deputy Attorney General; Michael J. 
Finn, Senior Assistant Attorney General; and Kelly Roseberry, Assistant Attorney 
General.
Before KITE, C.J., 
and GOLDEN, HILL, VOIGT, and BURKE, JJ.
HILL, Justice.
[¶1]      
Todd Rogers challenges an order from the Office of Administrative Hearings (OAH) 
denying benefits to him for lower back treatment.  The OAH ruled that 
Rogers did not prove his 2010 condition was related to his 2002 work 
injury.  We affirm.
ISSUE
[¶2]      
Rogers  phrases his single issue as follows:
1.    Did the hearing 
examiner error [sic], as a matter of law, in concluding that Mr. Rogers failed 
to meet his burden of proof that his 2010 injuries are related to his 2002 work 
injury?
FACTS
[¶3]      
In March of 2002 Rogers, while working as a carpenter, slipped on ice and fell 
down a flight of stairs.  He injured his shoulder, left elbow, and his 
back.  After seeking treatment in the emergency room, Rogers began seeing 
Dr. Alvis Forbes, who noted bruising in Rogers’s upper lumbar area.  After 
a CT scan revealed no evidence of fracture, Dr. Forbes prescribed pain medicine 
and physical therapy.
[¶4]      
In April of 2002 the Worker’s Compensation Division (Division) issued a final 
determination opening the case for an injury to “Back and Left Arm – 
Elbow.”  Later that same month, Dr. Forbes referred Rogers to Dr. Geoffrey 
Skene after Dr. Forbes began to believe the “magnitude of Rogers’s pain 
complaint … far exceeds my diagnosed pathology.”
[¶5]      
After receiving his new patient, Dr. Skene ordered an MRI of Rogers’s lumbar 
spine, which showed that Rogers suffered degenerative disc disease.  Rogers 
was then referred to Dr. Mary Neal for further treatment.  Rogers also 
received chiropractic care and physical therapy.  By July of 2003 Rogers 
had discontinued treatment.  Rogers did not submit any bills for medical 
benefits between 2004 and 2010.
[¶6]      
Until June of 2010, Rogers did not seek any further treatment for his 
back.  According to Rogers, he continued to have back pain but he treated 
himself with over-the-counter pain medication, an adjustable bed, and a hot 
tub.  However, on June 16, 2010 Rogers sought treatment with a 
chiropractor, Dr. John Zendler.  Dr. Zendler diagnosed Rogers with lumbago, 
thoracic spine pain, and muscle spasms.  Rogers submitted claims for 
benefits for his three visits to Dr. Zendler but the Division denied the claims 
writing that Rogers’s “current treatment to the lumbar spine is not related to 
the thoracic sprain on March 21, 2002.”  Rogers objected and his case was 
referred to the OAH.
[¶7]      
The OAH conducted a contested case hearing on November 18, 2010 and again 
Rogers’s claims for benefits were denied.  The OAH concluded that 
Rogers
            
…. has not met the jurisdictional requirements of Wyo. Stat. Ann. § 27-14-605 
which clearly applies since no claim for benefits was received within the four 
year period and because the Office also finds that there was insufficient proof 
to establish a second compensable injury.
77.  As stated 
above, the only medical evidence in this case that Rogers[’s] condition in 2010 
is causally related to the 2002 injury is the response to the questionnaire 
filled out by Dr. Neal.  …  That questionnaire and the answers by Dr. 
Neal do not meet the standard of Wyo. Stat. Ann. § 27-14-605 in this Hearing 
Officer’s estimation.  That conclusion is based upon the 
following,
            
a) Dr. Neal had not examined Rogers since 2004.
b) It is not clear 
that Dr. Neal reviewed any medical records as she did not fill in the blank at 
the bottom of the form regarding time spent on reviewing records.  In any 
event it does not appear from the cover letter to Dr. Neal that Dr. Neal was 
provided with the x-rays taken by Dr. Zendler.
c) Dr. Neal did 
not provide any basis for her opinion or explain how treatment in 2010 was 
causally related to the 2002 injury.  She has not addressed the source of 
his current problems and how that relates to the strain Dr. Forbes diagnosed or 
the myofascial pain she diagnosed.
d) Dr. Neal did 
not have the benefit of nor did she address comments by Rogers that stress and 
the everyday activities of his work caused his back to become worse.
78.  In 
short, the affirmative answers to the questions provided to Dr. Neal, simply did 
not rise to the level to show that Rogers[’s] condition in 2010 was directly 
related to the injuries suffered in 2002.  The jurisdictional statute 
clearly requires proof by “competent medical authority and to a reasonable 
degree of medical certainty that the condition is directly related to the 
original injury.”  Rogers has failed to meet his burden of proof in this 
regard.
79.  Given 
the statutory mandate for competent medical authority, given the lapse of seven 
years from date of the last treatment to date of the current treatment and 
finally given the suggestion that there may be something more involved in 
Rogers[’s] current condition such as a disc problem, this is not a case in which 
the Hearing Officer can would [sic] award benefits solely on the basis of the 
claimant’s condition.
80.  For 
the same reasons set forth above, Rogers has failed to meet his burden of proof 
to show a second compensable injury which would take his case out from under 
Wyo. Stat. Ann. § 27-14-605.  Again the medical testimony is insufficient 
to show the direct causal connection.
[¶8]      
On review in the district court, the court affirmed the OAH’s denial of 
benefits.  This appeal followed.
STANDARD OF 
REVIEW
[¶9]      
When reviewing worker’s compensation cases on appeal, we begin with the factors set forth in the Wyoming Administrative 
Procedure Act, which 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.
Wyo. Stat. Ann. § 
16-3-114(c) (LexisNexis 2011).
[¶10]   
This Court has stated in relation to the foregoing statute as 
follows:
Under 
this 
statute, we review an agency’s findings of fact by applying the substantial 
evidence standard. Dale v. S & S Builders, LLC, 2008 WY 84, ¶ 22, 188 P.3d 554, 561 (Wyo. 
2008).  Substantial evidence means “such relevant evidence as a reasonable 
mind might accept as adequate to support a conclusion.”  Bush v. State ex rel. Wyo. Workers’ Comp. 
Div., 2005 WY 120, ¶ 5, 120 P.3d 176, 179 (Wyo. 
2005).  “'Findings of fact are supported by substantial evidence 
if, from the evidence preserved in the record, we can discern a rational premise 
for those findings.’”  Kenyon v. State 
ex rel. Wyo. Workers’ Safety & Comp. Div., 2011 WY 
14, ¶ 11, 247 P.3d 845, 
849 (Wyo. 2011) (quoting Bush, 
¶ 5, 120 P.3d at 179).
With regard to an 
agency's determination that a claimant did not satisfy his burden of proof, this 
Court has said:
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. If, in the course of its decision making process, 
the agency disregards certain evidence and explains its reasons for doing so 
based upon determinations of credibility or other factors contained in the 
record, its decision will be sustainable under the substantial evidence test. 
Importantly, our review of any particular decision turns not on whether we agree 
with the outcome, but on whether the agency could reasonably conclude as it did, 
based on all the evidence before it.
Kenyon 
¶ 12, 247 P.3d  at 849 
(quoting Dale, ¶ 22, 188 P.3d at 561).
McMasters v. State ex 
rel. Wyo. Workers’ Safety & Comp. Div., 2012 WY 32, ¶¶ 55-58, 271 P.3d 422, 435 (Wyo. 
2012).
[¶11]   
We review an agency’s conclusions of law de novo and will affirm only if 
the agency’s conclusions are in accordance with the law.  McMasters, 
¶ 58, 271 P.3d 436.  In an appeal from a district court’s appellate 
review of an administrative decision, we review the case as if it came directly 
from the hearing examiner, affording no deference to the district court’s 
decision.  Id.
DISCUSSION
[¶12]   
Despite his initial phrasing of his single issue on appeal, Rogers’s 
only issue on appeal is that the OAH’s decision was not supported by substantial 
evidence.  He argues that the Division did not rebut his prima facie 
showing that his 2010 condition is causally related to his 2002 work 
injury.  Specifically, Rogers argues that the OAH’s basis for disregarding 
Dr. Neal’s opinion is not supported by the record and is based upon erroneous 
findings, and that Dr. Zendler’s records provide more evidence of the causal 
connection.
[¶13]   In 
response, the Division submits that there was substantial evidence to support 
the hearing examiner’s decision.  First, the Division argues that the OAH 
properly analyzed Rogers’s case under Wyo. Stat. Ann. § 27-14-605(c)(ii) 
and the second compensable injury rule, and properly required Rogers to prove 
that his 2010 treatment was causally related to the 2002 work injury.  
Furthermore, the Division contends that Dr. Neal’s opinion did not provide the 
requisite causal connection and that the OAH appropriately gave little weight to 
the opinions of Dr. Neal and Dr. Zendler and explained its reasons for doing 
so.
[¶14]   
Wyo. Stat. Ann. § 27-14-605(c)(ii) (LexisNexis 2011) states as 
follows:
§ 
27-14-605.  Application for modification of benefits; time limitation; 
grounds; termination of case; exceptions.
(a) If 
a determination is made in favor of or on behalf of an employee for any benefits 
under this act, an application may be made to the division by any party within 
four (4) years from the date of the last payment for additional benefits or for 
a modification of the amount of benefits on the ground of increase or decrease 
of incapacity due solely to the injury, or upon grounds of mistake or fraud. The 
division may, upon the same grounds and within the same time period, apply for 
modification of medical and disability benefits to a hearing examiner or the 
medical commission, as appropriate.
(b) Any 
right to benefits shall be terminated and is no longer under the jurisdiction of 
this act if a claim for any benefit is not filed with the division within the 
four (4) year limitation prescribed under subsection (a) of this 
section.
(c) A 
claim for medical benefits which would otherwise be terminated under subsection 
(b) of this section and barred under W.S. 27-14-503(a) and (b) may be paid by the division if the 
claimant:
(i)  Submits 
medical reports to the division substantiating his claim;
(ii) Proves 
by competent medical authority and to a reasonable degree of medical certainty 
that the condition is directly related to the original injury; and
(iii) Submits 
to an examination by a health care provider selected by the division and results 
of the examination validate his claim.
In the context of 
this statute, we have said about subsequent injuries: “The second compensable 
injury rule applies when an initial compensable injury ripens into a condition 
requiring additional medical intervention.”  Alvarez v. State ex rel. 
Wyo. Workers’ Safety & Comp. Div., 2007 WY 126, ¶ 18, 164 P.3d 548, 552 (Wyo. 2007) 
(citing Yenne-Tulle v. Workers’ Safety & Comp. Div., 12 P.3d 170, 172 (Wyo. 
2000)).  “Under the rule, a subsequent injury is compensable if it is 
causally related to the initial compensable work injury.”  Id. 

[¶15]   To 
prove entitlement to an award of benefits, Rogers had to sustain an “injury” as 
defined by Wyo. Stat. Ann. § 27-14-102(a)(xi) (LexisNexis 2011):
[A]ny harmful change 
in the human organism other than normal aging and includes damage to or loss of 
any artificial replacement and death, arising out of and in the course of 
employment while at work in or about the premises occupied, used or controlled 
by the employer and incurred while at work in places where the employer’s 
business requires an employee’s presence and which subjects the employee to 
extrahazardous duties incident to the business.
As we have stated 
before, the requirement that the injury “arise out of and in the course of 
employment” is premised upon a determination of whether or not the relationship 
between the injury and the employment is sufficient that the injury should be 
compensable.  Haagensen v. State ex rel. Wyoming Workers’ 
Compensation Div., 949 P.2d 865, 867 (Wyo. 1997).  A causal connection exists between the 
employee’s injury and the course of employment when “there is a nexus between 
the injury and some condition, activity, environment or requirement of the 
employment.”  Id.
[¶16]   
There is no dispute that Rogers suffered a compensable injury in 2002 and 
properly received medical benefits and a 5% whole person total disability award 
based on that injury.  However, the hearing examiner concluded that Rogers 
did not meet his burden to show that his need for treatment in 2010 was causally 
related to his 2002 work injury.  In her order, the hearing examiner 
explained how she reached this conclusion based upon four sets of factual 
findings:
(a) Dr. Neal had 
not examined Rogers since 2004. 
(b) It is not 
clear that Dr. Neal reviewed any medical records as she did not fill in the 
blank at the bottom of the form regarding time spent on reviewing records.  
In any event it does not appear from the cover letter to Dr. Neal that Dr. Neal 
was provided with the x-rays taken by Dr. Zendler.
(c) Dr. Neal did 
not provide any basis for her opinion or explain how treatment in 2010 was 
causally related to the 2002 injury.  She has not addressed the source of 
his current problems and how that relates to the strain Dr. Forbes diagnosed or 
the myofascial pain she diagnosed.
(d) Dr. Neal did 
not have the benefit of nor did she address comments by Rogers that stress and 
the everyday activities of his work caused his back to become worse. 
[¶17]   Dr. 
Neal did opine in a questionnaire that it was “more likely than not” that 
Rogers’s 2010 issues were related to the 2002 work injury.  However, in a 
letter Dr. Neal expounded on that opinion and wrote:
Difficult to know for 
sure, but they certainly could be [related].  An MRI scan may help in that 
determination, but someone must first agree to pay for the study (regardless of 
results) in order to get the information.  The MRI scan may or may not be 
decisive with regarding [sic] to ruling in a linkage, but may be very helpful 
with regard to ruling out a linkage.  What I mean is this:  If there 
are findings that could be “old” or could be part of a degenerative process 
related to an injury in 2002, it would be impossible to definitely say that the 
findings are or are not linked.  If there are findings that are “new,” then 
it would be possible to definitively say that the findings are not linked to his 
2002 accident.
Based upon that 
explanation, the hearing examiner seems to appropriately have discounted Dr. 
Neal’s opinion.
[¶18]   
With regard to Dr. Zendler, Rogers contends that his chiropractic notes prove 
the requisite causal connection.  Dr. Zendler did not testify but the court 
reviewed his notes and noted that his treatment appeared to be focused on 
specific levels of the spine but found that the records never identified a 
specific area of injury.  Also, the hearing examiner found that while 
Rogers testified that Dr. Zendler told him that there was a disc injury caused 
by the original injury, the evidence in Dr. Zendler’s records, including his one 
x-ray with no interpreting notes, was insufficient to draw such a 
conclusion.  Furthermore, there was conflicting testimony that Rogers had 
or had not told Dr. Zendler in 2010 that he fell off a ladder “five or six years 
ago,” possibly inferring that his 2010 problems were not causally connected to 
the 2002 work injury.  Lastly, Dr. Zendler did not treat Rogers until June 
of 2010--over eight years after Rogers’s compensable injury.  Any 
indication of a causal connection contained within his chiropractic notes was 
based entirely on the history provided by Rogers, not on his objective 
findings.
[¶19]   
The OAH’s decision included a detailed review of the testimony and evidence 
presented and careful explanation of why it treated the evidence the way it 
did.  The only evidence that Rogers presented to connect his 2010 back 
issues to his 2002 work injury were Dr. Neal’s testimony and Dr. Zendler’s 
medical records. The OAH decision to discount both doctors’ contributions to the 
case was, in Dr. Neal’s case, based upon contrary and relatively uncertain 
conclusions, and in Dr. Zendler’s case, based upon conflicting testimony and the 
fact that Dr. Zendler’s findings were not “objective.”  It is the hearing 
examiner’s duty to weigh the credibility of witnesses and the hearing examiner 
may disregard expert testimony that is unreasonable.  McCall-Presse v. 
State (In re Worker’s Comp. Claim of McCall-Presse), 2011 WY 34, ¶ 11, 247 P.3d 505, 511 (Wyo. 
2011).  The evidence presented at the hearing, 
in light of the testimony presented and other facts in the record, supported the 
hearing examiner’s conclusion that Rogers did not meet his burden of proving 
that his 2010 treatment was the result of his 2002 work-related injuries.  
The OAH decision is not against the overwhelming weight of the evidence and is, 
therefore, supported by substantial evidence in the record.  
Affirmed.