Case Title: City of Casper v. Haines

Citation: 

Docket Number: 94-24

State: wyoming

Court: Wyoming Supreme Court

Date: 1994-12-07T00:00:00Z

Document:
City of Casper v. Haines1994 WY 138886 P.2d 585Case Number: 94-24, 94-25Decided: 12/07/1994Supreme Court of Wyoming
CITY OF 
CASPER,

Appellant 
(Petitioner),

 v.

 James 
HAINES,

Appellee 
(Respondent).

 

STATE of Wyoming, ex 
rel., WYOMING WORKER'S COMPENSATION DIVISION,

Appellant 
(Petitioner),

 v.

 James 
HAINES,

Appellee 
(Respondent).

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

 

Joseph B. Meyer, 
Atty. Gen., John W. Renneisen, Deputy Atty. Gen., Kenneth E. Spurrier, Asst. 
Atty. Gen., Cheyenne, Courtney Kepler, Sp. Asst. Atty. Gen., of Brown & 
Drew, Casper, for appellant State of Wyoming, ex rel. Wyoming Worker's 
Compensation Div.

Gayla Daniels, 
Deputy City Atty., Casper, for appellant City of 
Casper.

Don Painter, 
Casper, for appellee.

 

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

GOLDEN, Chief 
Justice.

[¶1]      In these 
consolidated cases, the City of Casper and the State of Wyoming's Worker's 
Compensation Division seek review of the district court's order affirming the 
decision granting worker compensation benefits to appellee James Haines. 
Appellants' major contention is that the statute of limitations bars appellee's 
award of benefits. WYO. STAT. § 27-12-503(a) (1977).1 Appellants also contest findings 
that an untimely report was excusable and the injury occurred in the course of 
employment.

[¶2]      Based upon our 
decision in Aanenson v. State ex rel. Worker's Comp., 842 P.2d 1077, 1079 
(Wyo. 1992), we hold that appellee did not claim within the statutory time 
period. We reverse.

[¶3]      Appellant City of 
Casper presents these issues:

I. Whether the findings 
and conclusions of the administrative law judge are arbitrary, capricious, an 
abuse of discretion or otherwise not in accordance with the law, and thus 
unlawful under WYO. STAT. § 16-3-114(c)(ii)(A)?

A. Whether the 
Administrative Law Judge properly construed and applied the statutory 
requirements of WYO. STAT. § 27-14-502 and § 27-14-503?

II. Whether the findings 
and conclusions of the administrative law judge are unsupported by substantial 
evidence in the record, and thus unlawful under WYO. STAT. § 
16-3-114(c)(ii)(E)?

A. Whether there was 
substantial competent evidence to warrant the Administrative Law Judge's 
findings that the compensable injury to the Employee/claimant's left knee arose 
out of and during the course of his employment with the 
City?

B. Whether there was 
substantial evidence to support the Administrative Law Judge's Finding that the 
non-compensable injury to the Employee-Claimant's left knee in May, 1992 was not 
an intervening cause nor the cause of the July, 1992 reconstructing 
surgery?

C. Whether the finding of 
the Administrative Law Judge that the surgery was not "elective" is supported by 
substantial evidence in the record?

[¶4]      Appellant Wyoming 
Worker's Compensation Division presents this issue:

Whether the hearing 
officer failed to properly apply the pertinent statute of limitations by 
awarding benefits for an unreported, eleven year old knee 
injury?

[¶5]  Appellee Haines states the issues 
as:

1. Whether 
Employee-Claimant's claims are barred by the terms of § 27-14-503 W.S. 
1977.

2. Whether 
Employee-Claimant's claims are barred by the terms of § 27-14-502 W.S. 1977, 
either by failure to comply or by failing to show lack of prejudice to the 
employer's right to investigate and monitor medical care.

FACTS

[¶6]      Haines, a Casper 
police officer, suffered a knee injury on November 18, 1980, while responding to 
an armed burglary call. An emergency room doctor at the Wyoming Medical Center 
diagnosed it as a nonserious, twisted knee injury which did not require any 
treatment, and Haines returned to work. Haines only reported the injury, without 
identifying which knee was injured, on a police "sick and injured" report form 
and did not file a worker's compensation injury report and claim. Later, Haines 
consulted with Dr. John Bailey on March 26, 1981, about a left knee injury. Dr. 
Bailey diagnosed an "anterior cruciate ligament" tear injury, discussed the 
nature and extent of the injury with Haines, but determined that surgery was not 
indicated at that time.

[¶7]      In May of 1992, 
Haines, injured his left knee, this time in a non-work related accident. Dr. 
Jerome A. Behrens diagnosed a medial meniscal tear. Dr. Behrens performed 
arthroscopic surgery for this latest injury on May 25, 
1992.

[¶8]      The surgery 
revealed to Dr. Behrens the condition of the anterior cruciate ligament. Dr. 
Behrens recommended reconstruction surgery of this ligament to Haines. Haines 
discussed the recommendation with the City of Casper, had the surgery, and then 
filed a worker's compensation claim. Appellants objected, mainly contending that 
appellee was barred from receiving benefits for violations of WYO. STAT. § 
27-14-502 and WYO. STAT. § 27-14-503 (1991).

[¶9]      A hearing was 
held, and the hearing officer concluded that although Haines injured his knee in 
1980, he had not suffered a compensable injury until 1992. Other issues were 
resolved in Haines' favor, and he was granted benefits. The appellants 
petitioned for review to the district court. The district court upheld the 
hearing officer's decision, and this appeal followed.

DISCUSSION

[¶10]   Appellants' major issue challenges 
the hearing examiner's conclusion that Haines' injury was not compensable until 
1992 when the first surgery was performed. Appellants contend it was apparent to 
Haines that the injury was compensable following Dr. Bailey's diagnosis of the 
anterior cruciate ligament tear injury on March 26, 1981. They contend, under 
the statute of limitations for worker's compensation claims, Haines had one year 
after his discovery of the injury to file a claim, WYO. STAT. § 27-12-503(a) 
(1977), and because Haines did not file his claim until 1992, his claim is 
time-barred.

Standard of 
Review

[¶11]   Our standard of review of factual 
findings is whether they are supported by substantial evidence in light of the 
whole record. Little America Refining Co. v. Witt, 854 P.2d 51, 57 (Wyo. 
1993). This court will defer to a hearing officer's findings of basic fact if 
there is substantial evidence and will not substitute our judgment for that of 
an agency. We have said, "The historical actions and inactions of [the 
claimant], as determined by the hearing officer, are historical or basic facts." 
Aanenson, 842 P.2d  at 1079.

[¶12]   When reviewing mixed questions of 
law and fact, as in an agency's finding of ultimate fact, this court separates 
the factual and legal aspects of the finding to determine whether the correct 
rule of law has been properly applied to the facts. Aanenson, 842 P.2d at 
1079-80; and see Union Pacific R.R. Co. v. State Bd. of Equalization, 802 P.2d 856, 860-61 (Wyo. 1990). We do not afford deference to an agency's 
determination but correct the agency's error in either stating or applying the 
law. Aanenson, 842 P.2d  at 1079-80. The worker's compensation statute of 
limitations in effect at the time of injury states:

(a) No order or award for 
compensation involving an injury which is the result of a single brief 
occurrence rather than occurring over a substantial period of time, shall be 
made unless in addition to the reports of the injury, an application or claim 
for award is filed with the clerk of court in the county in which the injury 
occurred, within one (1) year after the day on which the injury occurred or 
for injuries not readily apparent, within one (1) year after discovery of the 
injury by the employee. The reports of an accident do not constitute a claim 
for compensation.

WYO. STAT. § 
27-12-503 (1977) (emphasis added).

Findings

[¶13]   The hearing officer made the 
following findings relevant to this particular issue:

4. Employee-Claimant 
continued to work as a police officer for the City of Casper without any 
interruption due to the subject injury until around the middle of May 1992. In 
the interim, Employee-Claimant had bought elastic supports for the knee from 
time-to-time out of his own pocket and, except for that, had not occurred [sic] 
any medical expense or had any medical treatment for the subject injury except 
for consulting with John Bailey, M.D. on March 26, 1981 who, like Dr. Shure, 
determined there was no need for any medical attention at the 
time.

* * * * * 
*

6. During the performance 
of the orthoscopic [sic] surgery on May 25, 1992, it was discovered that 
Employee-Claimants anterior cruciate ligament, diagnosed on March 26, 1981 as 
having been injured on November 18, 1980 was finally in need of surgical 
repair in the opinion of the attending physician, Jerome Behrens, M.D., an 
orthopedic surgeon.

* * * * * * 

8. It was during the 
period of May 25, 1992 through July 2, 1992 that Employee-Claimant realized or 
should have realized that this injury to his anterior cruciate ligament in his 
left knee had become compensable.

(Emphasis 
added).

[¶14]   Finding No. 8 is an application of 
the definition of compensable injury. The statute of limitations does not begin 
running until the claimant has suffered a compensable injury. Aanenson, 842 P.2d  
at 1081.

[W]hen determining the 
time a particular injury became compensable, it should be asked: When would a 
reasonable person, under the circumstances, have understood the full extent and 
nature of the injury and that the injury was related to his or her employment? 
The statute of limitations starts running when that date is 
fixed.

Aanenson, 842 P.2d  at 
1082.

[¶15]   The hearing officer's finding that 
the knee injury was diagnosed on March 26, 1981, is a basic fact supported by 
the record. However, the finding that the injury was not compensable until 1992 
is an application of the law to the facts and we review whether the law was 
properly applied to the facts.

[¶16]   Haines' medical file dating back to 
1980, received in evidence by the hearing officer, revealed that Dr. Bailey 
recorded the following in Haines' medical record after the March 26, 1981 
visit:

ON EXAM: * * * I think 
James has a significant tear of his anterior cruciate ligament. I discussed this 
with him as well as the inherent risks, that is currently present in his knee. I 
do not feel that any reconstruction is indicated at this time, but if it worsens 
or if he begins damaging the knee joint then it probably will be 
indicated.

[¶17]   On direct examination, Haines 
testified that Dr. Bailey had told him that he had torn the front ligament of 
his knee. Dr. Bailey's recommended treatment was to do nothing unless he had 
problems; if Haines had problems with the knee, surgery would be required. 
Appellants urge that a diagnosis of a torn ligament which may require surgery is 
a discovery of a compensable injury.

[¶18]   Haines argues that "where the 
original knee injury was trivial in nature and required only medical advice 
without any care until 1992, it is rather clear that the `compensible [sic] 
injury' occurred between May 25, 1992 and July 2, 1992." We assume Haines' 
argument is a claim that the injury was not readily apparent and therefore not 
discovered until 1992. WYO. STAT. § 27-12-503 (1977) makes provisions for 
injuries which are "not readily apparent," instructing that reports and claims 
be filed "within one (1) year after the discovery of the injury by the 
employee." WYO. STAT. § 27-12-503(a).

[¶19]   Haines primarily relies upon Big 
Horn Coal Company v. Wartensleben, 502 P.2d 187 (Wyo. 1972) for his 
contention the knee injury suffered was not a compensable injury until 1992. He 
also cites State, ex rel. Wyo. Worker's Comp. Div. v. Malkowski, 741 P.2d 604 (Wyo. 1987); Baldwin v. Scullion, 50 Wyo. 508, 62 P.2d 531, 108 
A.L.R. 304 (Wyo. 1936); and Bemis v. Texaco, Inc., 400 P.2d 529 (Wyo. 
1965). Appellants contend that WYO. STAT. § 27-12-503 is analogous to WYO. STAT. 
§ 27-12-502, which is the statute construed in Big Horn. We are satisfied 
that the concept of a compensable injury should be the same for purposes of both 
statutes. The thrust of the holding of Big Horn, however, is not helpful 
to Haines.

[¶20]   Our decision in Aanenson 
discussed Big Horn's contribution to the compensable injury concept. 
There, we stated it held the claimant had suffered a "compensable injury" when 
he was correctly informed of the serious injury. Aanenson, 842 P.2d  at 
1082. We reiterated Big Horn's clarification of the distinction between a 
trivial injury and a compensable injury:

[W]here an employee in 
the course of his employment sustains an apparent trivial injury which does not 
result in present disability and which would not reasonably be expected to cause 
future disability, but which injury in fact over a period of latency does cause 
future disability, the time for giving notice of the occurrence of the injury to 
the employer runs from the time when it becomes apparent that such injury has 
resulted in, or is likely to cause, compensable 
disability.

Aanenson, 842 P.2d  at 1082. 
And see Big Horn Coal, 502 P.2d  at 188.

[¶21]   As seen by Aanenson's 
discussion, this court's decisions, including those cited by appellee, 
consistently hold that when a correct diagnosis and prognosis of present or 
likely future disability is communicated to the claimant, the injury is 
discovered, it is compensable, and the statute of limitations begins to run. 
Aanenson, 842 P.2d  at 1081-83 (discussing this court's decisions 
regarding compensable injury).

[¶22]   In Aanenson, the claimant's 
back injury was diagnosed as a ruptured disc in 1986, and conservative treatment 
was prescribed. The claimant did not file a worker's compensation claim or 
accident report. In 1990, the claimant's pain from the injury returned and was 
diagnosed as the same disc injury as in 1986. The claimant filed a worker's 
compensation injury report and claim, but was denied coverage because the time 
had passed for filing reports of the 1986 injury. That decision was affirmed by 
a hearing officer, the district court and then finally by this 
court.

[¶23]   The present case is analogous to 
Aanenson and requires reversal. The facts of this case establish that on 
March 26, 1981, Dr. Bailey diagnosed a ligament injury and informed Haines that 
he "did not feel any reconstruction is indicated at this time but if it worsens 
or if he begins damaging the knee joint then it probably will be indicated." 
This communication would have caused a reasonable person to discover he had 
suffered an injury likely to cause compensable disability. Aanenson, 842 P.2d  at 1083.

[¶24]   The statute of limitation's 
language as construed by our decision in Aanenson required Haines to claim for 
award within one year of the March 26, 1981 diagnosis. He failed to comply when 
he did not file a report and claim until eleven years later. Our law and 
precedent require we hold the hearing officer erred in applying the law, and we 
must reverse the grant of benefits.

[¶25]   Reversed.

Footnotes

1 The statute 
was renumbered as WYO. STAT. § 27-14-503 in 1986.