Case Title: Jackson v. J.W. Williams, Inc.

Citation: 

Docket Number: 94-99

State: wyoming

Court: Wyoming Supreme Court

Date: 1994-12-13T00:00:00Z

Document:
Jackson v. J.W. Williams, Inc.1994 WY 143886 P.2d 601Case Number: 94-99Decided: 12/13/1994Supreme Court of Wyoming
In the Matter of the 
Worker's Compensation Claim of Dennis R. JACKSON,

Appellant 
(Petitioner),

v.

J.W. WILLIAMS, 
INC.,

Appellee 
(Respondent).

 

Appeal from The District 
Court, Natrona County, Dan Spangler, J.

 

Patrick Dixon, 
Casper, representing appellant.

Thomas F. Reese 
of Brown & Drew, Casper, representing appellee.

 

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

MACY, 
Justice.

[¶1]      Appellant Dennis 
R. Jackson (the employee) appeals from the district court's order which affirmed 
the hearing examiner's denial of the employee's request for additional benefits 
after the employee underwent a third back surgery in 1993 which he claimed was 
necessary because of, and due solely to, a 1987 work-related 
injury.

[¶2]      We 
affirm.

ISSUES

[¶3]      The employee 
presents three issues:

A. Was the decision of 
the Administrative Law Judge contrary to law; that is, did the Administrative 
Law Judge take into consideration, and thus base his decision on factual issues 
which had been resolved, and were res judicata as to this 
proceeding?

B. Was the Administrative 
Law Judge's determination that the March 22, 1993 surgery was not attributable 
solely to the 1987 injury unsupported by substantial 
evidence?

C. Was the Administrative 
Law Judge's decision to wholly disregard the testimony of the Appellant and 
Appellant's treating physician based upon a perceived lack of credibility, 
arbitrary, capricious or an abuse of discretion?

FACTS

[¶4]      The employee 
injured his back in August 1987 while he was working as a welder for Appellee 
J.W. Williams, Inc. (the employer). The employee underwent two back surgeries: 
one in 1987 and one in 1989. He received medical benefits for both surgeries and 
both temporary total and permanent partial disability 
benefits.

[¶5]      In March 1993, 
the employee underwent a third back surgery, after which he applied for 
additional medical benefits and temporary total disability benefits. See 
WYO. STAT. § 27-14-605(a) (1991).1 The employer objected to the 
employee's request for additional benefits. After the Office of Administrative 
Hearings held a hearing, the hearing examiner denied the employee's request for 
additional benefits.

[¶6]      The employee 
filed a petition for review in the district court, and the district court 
affirmed the hearing examiner's decision. The employee appealed to this 
Court.

FINALITY

[¶7]      The employee 
claims that the hearing examiner's decision was contrary to the law because the 
hearing examiner disregarded the concepts of res judicata and finality. 
He asserts that the hearing examiner concluded the 1987 injury was not work 
related and, therefore, the 1993 surgery was not due solely to a work-related 
injury. The record does not substantiate this assertion.

[¶8]      At the hearing, 
the employee denied that he had experienced back problems prior to 1987. In 
order to attack the employee's credibility, the employer offered evidence which 
revealed that, prior to 1987, the employee had sustained two similar injuries. 
The hearing examiner stated that the issue of whether the 1987 injury was work 
related was not being decided, and he admitted the employer's evidence for other 
purposes. He found:

3. One of the issues in 
this case was to what extent the Employer-Objector could object to the benefits 
being claimed, and what issues were res judicata. This Office finds that an 
employer may object and is entitled to dispute whether a new claim is causally 
related to the previous industrial accident or whether it is attributable to 
some other event. The fact the Claimant was injured on August 17, 1987, while 
working for the Employer/Objector J.W. Williams, Inc., in this case, is 
something which has been previously established, and can not be contested in 
this proceeding.

(Citation 
omitted.) The hearing examiner treated the determination that the original 
injury was work related as being final. The employee's claim is, therefore, 
without merit.

BURDEN OF 
PROOF

[¶9]      The employee 
asserts that he was entitled to be awarded additional benefits because his 1993 
surgery was solely attributable to the 1987 injury and that the hearing 
examiner's decision to disregard the testimony of the employee and his treating 
physician was arbitrary and capricious. Specifically, the employee argues that 
the hearing examiner's decision was not supported by substantial evidence. We 
disagree.

[¶10]   Worker's compensation recipients 
may be awarded additional benefits.

(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 medical and disability 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.

Section 
27-14-605(a). Employees who are seeking additional benefits pursuant to § 
27-14-605(a) have the same burden of proof as they had in their original 
worker's compensation claims. Warehime v. State ex rel. Wyoming Workers' 
Compensation Division, 806 P.2d 292, 295 (Wyo. 1991). Employees must 
demonstrate by a preponderance of the evidence that, through an increase in 
incapacity due solely to the injury, they are entitled to be awarded additional 
benefits. 806 P.2d  at 295-96. Whether an increase in incapacity is due solely to 
the original work-related injury is a question of fact. See Hunteman v. Ward 
Transport, Inc., 706 P.2d 1126, 1129 (Wyo. 1985); see also Padilla v. 
Lovern's, Inc., 883 P.2d 351, 354 (Wyo. 1994). We review factual issues by 
applying the substantial evidence standard. WYO. STAT. § 16-3-114(c)(ii)(E) 
(1990).

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

Romero v. 
Davy McKee Corporation, 854 P.2d 59, 61 (Wyo. 
1993), quoted in Padilla, 883 P.2d  at 354. "The party who appeals from an 
administrative determination has the burden of proving the lack of substantial 
evidence to sustain the ruling of the agency." Jaqua v. State ex rel. Wyoming 
Workers' Compensation Division, 873 P.2d 1219, 1221 (Wyo. 
1994).

We have held that the 
finder of fact is not bound by the medical evidence and that he is entitled to 
consider relevant factors other than the medical evidence. The fact finder is in 
the best position to judge both the claimant's credibility and the weight to be 
given to the medical evidence.

Padilla, 883 P.2d  at 355 
(citations omitted).

[¶11]   The orthopedic surgeon who 
performed the employee's 1993 back surgery testified that, in his opinion, the 
problems which resulted in the employee requiring the 1993 surgery were related 
to the employee's 1987 injury. On cross-examination, in response to a series of 
hypothetical questions, the surgeon speculated that, if, after his first two 
surgeries, the employee had reinjured his back in an automobile accident, by 
shoveling snow, or by lifting a heavy load, the new injury could have led to the 
1993 surgery. The hearing examiner did not consider the surgeon's speculative 
testimony when he made his decision.

[¶12]   The surgeon based his opinion that 
the 1993 surgery was related to the employee's 1987 injury on the information 
which the employee had provided in his patient's history. In that history, the 
employee did not report that any new injury had occurred after the first two 
surgeries had been performed. The employee also testified at the hearing that he 
had not done anything to reinjure his back after he underwent his first two 
surgeries. The employer, however, presented evidence which indicated that 
between 1987 and 1993 the employee had worked at a liquor store against his 
doctor's orders and that in December 1992 the employee had experienced soreness 
in his lower back after he had shoveled snow.

[¶13]   The hearing examiner 
found:

7. In considering all of 
the evidence, this Hearing Examiner is not convinced, even to a degree of 
probability, as to the relationship between the March 22, 1993 surgery and the 
work-related injury of August 17, 1987. This lack of being convinced is a result 
of the lack of credibility of the [employee]. When a [c]laimant is not credible, 
it creates doubts, which, if significant enough, make it difficult to award 
benefits. In this case, the lack of credibility has created sufficient doubts so 
as to result in a denial of benefits. It seems just as likely, or even more so, 
that with regard to the March 22, 1993 surgery, the [employee] substantially 
aggravated or injured his back from activities such as shovelling snow or 
working at [a liquor store], rather than as a result of his work injury of 
August 17, 1987.

[¶14]   The hearing examiner was in the 
best position to judge both the employee's credibility and the weight to be 
given to the surgeon's testimony, especially since the surgeon had based his 
testimony on information which had been provided by the employee. The hearing 
examiner's decision to disregard the testimony of the employee and his treating 
physician was not arbitrary, capricious, or an abuse of discretion, and his 
conclusion that the employee had failed to meet his burden of proof was 
supported by substantial evidence. WYO. STAT. § 16-3-114(c)(ii)(A), (E) 
(1990).

MOTION TO AMEND 
CLAIM

[¶15]   The employee asks this Court to 
allow him to amend his claim for relief on appeal to request that, if we reverse 
the district court's decision, we remand with instructions to refer the case to 
a medical hearing panel pursuant to WYO. STAT. § 27-14-616(b)(iv) (Supp. 1994). 
Because we are affirming the district court's decision, we have no reason to 
grant this motion; therefore, we order that the employee's Motion to Amend Claim 
for Relief on Appeal be, and hereby is, denied.

CONCLUSION

[¶16]   We hold that the district court did 
not err when it affirmed the hearing examiner's decision to deny the employee's 
request for additional benefits.

[¶17]   Affirmed.

Footnotes

1 Amended by 
1994 WYO. SESS. LAWS ch. 86, § 2 effective July 1, 1994.