Case Title: Russell v. State ex rel. Wyoming Workers' Safety and Compensation Div.

Citation: 

Docket Number: 97-7

State: wyoming

Court: Wyoming Supreme Court

Date: 1997-09-15T00:00:00Z

Document:
Russell v. State ex rel. Wyoming Workers' Safety and Compensation Div.1997 WY 111944 P.2d 1151Case Number: 97-7Decided: 09/15/1997Supreme Court of Wyoming

BRUCE RUSSELL, 

Appellant (Petitioner), 

 

v. 

 

STATE OF WYOMING, ex rel., WYOMING WORKERS' SAFETY 
AND COMPENSATION DIVISION; and FLUOR DANIEL, (NPOSR), Inc., 

 Appellees (Respondents).

 

Appeal from the District Court of Natrona 
County

 The Honorable Dan Spangler, 
Judge

 

Deborah Ford Mincer, Cheyenne, for 
Appellant.

 

Stephenson D. Emery and Stuart R. Day of Williams, 
Porter, Day & Neville, P.C., Casper, for Appellee Fluor Daniel (NPOSR), Inc. 
William U. Hill, Attorney General; Gerald W. Laska, Sr. Assistant Attorney 
General; Pam Brontos, Student Extern, for Appellee State of 
Wyoming.

 

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

GOLDEN, Justice. 

[¶1]      Several 
months after injuring his back at work, Appellant Bruce Russell (Russell) filed 
for workers' compensation benefits for treatment of numbness in his extremities. 
A hearing examiner from the Office of Hearing Examiners (OAH) allowed his claim 
but ruled his health problems were not caused by a work-related injury and 
denied benefits. Russell petitioned for review of that decision, contending the 
hearing examiner did not have subject matter jurisdiction over a medically 
contested case, and the decision was not supported by substantial 
evidence.

 

[¶2]      We 
affirm.

 

ISSUES

 

[¶3]      Russell presents 
these issues for our review:

 

I. Whether the Office of Hearings and Appeals' 
decision was in accordance with law and within statutory 
jurisdiction?

II. In the alternative, pursuant to Wyo. Stat. 
16-3-114(c)(ii)(A), (D) and (E), whether the decision was arbitrary and 
capricious in that it was made in disregard of applicable law, procedures and 
evidence in the case and was unsupported by substantial 
evidence?

 

[¶4]      Appellee Workers' 
Compensation Division (Division) restates the issue as:

Whether substantial evidence supports the hearing 
examiner's second conclusion that Claimant failed to prove his injury arose out 
of and in the course of his employment.

 

[¶5]      Appellee and 
employer Fluor Daniel states the issue as:

 

Viewed in the light most favorable to Flour [sic] 
Daniel and the Division, does the record contain substantial evidence to support 
the Office of Administrative Hearings' second order denying 
benefits?

 

FACTS

 

[¶6]      After completing 
a pre-employment physical on September 7, 1994, that gave him a clean bill of 
health, Russell began working for Fluor Daniel on September 12, 1994. On October 
3, 1994, Russell injured his back while working and reported it to a supervisor. 
A written accident report was completed that day. He was given a back brace, 
worked the rest of the day, and continued to wear the back brace for another two 
days. Later in the month, Russell experienced numbness in one arm and leg and 
saw Dr. Dana Ideen about it on November 4, 1994. Russell thought the numbness 
might be a circulation problem, and Dr. Ideen, a family practitioner, referred 
Russell to a neurologist, a vascular specialist, and later, to the Mayo Clinic. 
After Russell's visit to the Mayo Clinic on February 6, 1995, Dr. Ideen advised 
Russell that the October back injury might be causing his back problem and 
recommended he not return to work because of his back injury. Russell filed a 
workers' compensation claim on February 16, 1995, for the October back 
injury.

 

[¶7]      The Division 
denied benefits, and a contested case hearing was held. The hearing examiner 
determined that the primary issue was whether or not the back injury was 
work-related and received into evidence various medical reports of Dr. Ideen, 
the Mayo Clinic, and other specialists' interpretations of the result of 
magnetic resonance imaging (MRI) indicating a bulging disc. At the hearing, Dr. 
Allerheiligen, the director of Wyoming Medical Center's Department of 
Occupational Medicine, reviewed the medical records and testified Russell's 
symptoms were most likely caused by fibromyalgia, otherwise known as myofascial 
pain syndrome and the disc problem seen on the MRI report was of no "clinical 
significance."

 

[¶8]      The hearing 
examiner concluded that the evidence showed that one of three possibilities was 
most likely true: Russell has fibromyalgia and the disc problem is not 
clinically significant; Russell has a circulatory problem caused by a 
pre-existing condition; or if Russell's back pain was caused by trauma, it 
preceded the October 3, 1994, injury and any injury on that date had resolved. 
The hearing examiner issued an order denying benefits, and that order was upheld 
by the district court.

 

[¶9]      Russell filed a 
petition for review, and this Court subsequently entered an order permitting the 
presentation of additional evidence before the hearing examiner. Another 
contested case hearing was held on June 14, 1996, and additional evidence was 
received. That additional evidence included deposition testimony from Dr. 
Kenneth Pettine, a board certified orthopaedic surgeon. Dr. Pettine had 
performed back surgery on Russell on December 27, 1995, and repaired a torn 
disc. Dr. Pettine testified that the torn disc was the result of the 
work-related injury Russell suffered on October 3, 1994. Another doctor, Dr. 
Ruttle, reviewed Russell's medical records from the previous hearing, Dr. 
Pettine's records, and Dr. Pettine's deposition testimony. Based on the history, 
he concluded that the injury was not work-related, but was the result of 
"cumulative trauma."

 

[¶10]   The hearing examiner found that Dr. 
Pettine's conclusion that the injury was work-related was based solely on the 
history supplied to him by Russell. The examiner's findings of fact focused on 
the early medical reports and testimony by Russell's co-workers, both of which 
indicated that the October 3 injury was minor and had resolved itself. The 
findings noted that Dr. Ideen's handwritten notes from Russell's first 
appointment did not contain any reference to a work injury. Those notes did 
contain a reference to Russell's building a house in the previous few months. 
Because Dr. Ideen's notes did not reference the work injury but did reference 
Russell's building a house, the hearing examiner concluded the 
following:

 

This leads this Hearing Examiner to find it is most 
likely the Claimant told Dr. Ideen he had been building a house in the previous 
few months, when asked what he did or might have done to cause his back 
problems. The statements of the Claimant in the month or so following the 
claimed injury are found to be more reliable than the subsequent history given 
to Dr. Pettine over one year later.

 

[¶11]   The hearing examiner agreed with 
Dr. Ruttle that because Russell did not mention his work injury in his first 
visit to Dr. Ideen, it was proper to conclude that the torn disc was the result 
of cumulative trauma and was not related to a specific work injury. The hearing 
examiner concluded that Russell had not met his burden of proof that the back 
injury was work-related and entered a second order denying benefits. This appeal 
followed.

 

DISCUSSION

 

[¶12]   Russell first argues that the 
Office of Hearing Examiners lacked subject matter jurisdiction to hear this case 
because WYO. STAT. § 27-14-616 required the Division to refer this medically 
contested case to the medical commission for hearing. The statute 
states:

 

§ 
27-14-616. Medical commission; hearing panels; creation; membership; duties; 
rulemaking.

 

(a) The medical commission is created to consist of 
eleven (11) health care providers appointed by the governor as follows: . . 
.

(b) . . . The duties of the commission shall 
be:

* 
* *

(iv) To furnish three (3) members of the commission 
to serve as a medical hearing panel to hear cases referred for hearing. The division shall refer medically 
contested cases to the commission for hearing by a medical hearing panel. The 
decision to refer a contested case to the office of administrative hearings or a 
medical hearing panel established under this section shall not be subject to 
further administrative review. Following referral by the division, the 
hearing examiner or medical hearing panel shall have jurisdiction to hear and 
decide all issues related to the written notice of objection filed pursuant to 
W.S. 27-14-601(k).

* 
* *

At least one (1) member of each panel shall be a 
physician. One (1) member shall be designated by the executive secretary to 
serve as chairman of the panel. When hearing a medically contested case, the 
panel shall serve as the hearing examiner and shall have exclusive jurisdiction 
to make the final administrative determination of the validity and amount of 
compensation payable under this act.

 

WYO. STAT. § 27-14-616 
(1997) (emphasis added).

 

[¶13]   The Division argues first that, 
upon referral, the office had subject matter jurisdiction and, second, its 
decision to refer a case is not subject to judicial review based upon the 
express language of the statute. We agree that based on the plain language of 
the statute, the office had subject matter jurisdiction upon referral but 
disagree that the Division's decision is beyond our review. Plainly, the statute 
does not prohibit judicial review, it prohibits administrative review. When a 
statute within the Workers' Compensation Act is silent on the issue of judicial 
review, in the absence of clear and convincing evidence that the legislature 
otherwise intended, judicial review of administrative agency action takes place 
according to WYO. STAT. § 16-3-114. See Taylor v. Wyoming Bd. of Medicine, 930 P.2d 973, 974 (Wyo. 1997); Pisano v. 
Shillinger, 835 P.2d 1136, 1138-39 (Wyo. 1992).

 

[¶14]   Russell contends that this Court is 
presented with a question of law to be reviewed in accordance with WYO. STAT. § 
16-3-114(c). That portion of the statute states:

 

(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. . . . 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:

* 
* *

(C) In excess of statutory jurisdiction, authority or 
limitations or lacking statutory right; . . . .

 

WYO. STAT. § 16-3-114(c) 
(1997).

 

[¶15]   The interpretation of statutes is a 
question of law. We read unambiguous statutory language to give meaning to each 
word or phrase and so as not to render any part as superfluous. Desotell v. State ex rel. Wyoming 
Worker's Comp. Div., 767 P.2d 998, 1002 (Wyo. 1989). The use of "shall" in a 
statute is considered mandatory language requiring that the statute be obeyed. Thomson v. Wyoming In-Stream Flow 
Committee, 651 P.2d 778, 787 (Wyo. 1982). This particular statute requires 
the Division to refer "medically contested" cases to a panel chosen from the 
medical commission and which includes a physician. The purpose of the statute is 
obviously to provide medical expertise to resolve medically contested claims. 
The Division does not have an option; it must determine if a case is medically 
contested and, if it is, it must be referred to the medical 
commission.

 

[¶16]   The Division has promulgated rules 
concerning "medically contested" cases:

 

Chapter 5: Determination By The Division - Coverage 
and Compensability and Claims.

* 
* *

Section 4. Contested Case Proceedings. Upon receipt 
of a request for hearing, the division shall immediately transmit a copy of the 
request and a notice of request for hearing to the Office of Administrative 
Hearings (OAH) or Workers' Compensation Medical Commission as 
appropriate.

(a) For purposes of referring contested cases to the 
Workers' Compensation Medical Commission for hearing, W.S. § 27-14-616(b)(iv), 
the phrase "medically contested cases" shall include those cases in which the 
primary issue is:

(i) A worker/claimant's percentage of physical 
impairment;

(ii) Whether a worker/claimant is permanently totally 
disabled;

(iii) Whether a worker/claimant who has been 
receiving temporary total disability benefits remains eligible for those 
benefits under W.S. § 27-14-404(c).

(iv) Any other issue, the resolution of which is 
primarily dependent upon the evaluation of conflicting evidence as to medical 
diagnosis, medical prognosis, the reasonableness and appropriateness of medical 
care, or the appropriateness of fees charged by a health care 
provider.

 

Workers' Compensation Rules 
and Regulations, Chap. 5, Sec. 4 (1997).

 

[¶17]   The Workers' Compensation Medical 
Commission has promulgated rules concerning the referral of medically contested 
cases and provides for the panel to receive referrals in two 
ways:

 

CHAPTER 3: REFERRAL OF MEDICALLY CONTESTED 
CASES

 

Section 1. From the Division.

 

(a) 
The commission shall accept for hearing those cases determined by the division 
to be medically contested under Workers' Compensation Rules and Regulations, 
Chapter VII, Section 2(f)1, as amended, and referred by the 
clerks of district courts.

 

* * *

Section 2. From the Office of Administrative 
Hearings. Pursuant to W.S. 27-14-616(e), upon agreement of all parties to a 
case, the hearing examiner in a contested case which has been referred to the 
Office of Administrative Hearings may:

 

(i) transfer a medically contested case to the 
commission for review by a medical hearing panel; or

(ii) seek the advice of the commission on specified 
medical issues. The advice will be in writing and transmitted to the hearing 
examiner for distribution to the parties and incorporation into the contested 
case record.

 

Workers' Compensation 
Medical Commission Rules of Practice and Procedure, Chap. 3, Sec. 1, 2 
(1996).

 

[¶18]   Russell has not provided a record 
showing what information formed the basis for the Division's decision to refer 
this case to the OAH. The record before us does not contain either the 
Division's reason for denying benefits or the employer's objections to benefits. 
Although Russell does not refer to the Division's rule on medically contested 
cases or explain what particular issue made this a medically contested case, we 
assume he makes the argument on the basis of "(iv) Any other issue, the 
resolution of which is primarily dependent upon the evaluation of conflicting 
evidence as to medical diagnosis." Workers Compensation Rules, Chap. 5, Sec. 
4(a)(iv) (1997).

 

[¶19]   After the referral was made, the 
contested case hearing was held, and from the transcript of the first hearing we 
gather that a threshold issue existed as to whether or not Russell had timely 
filed a claim for injury. He was injured on October 3, 1994, and did not file a 
claim until February 16, 1995, a four-month delay. The hearing examiner heard 
both parties on that issue, and the hearing progressed to evidence regarding 
whether the October 3 back injury was the cause of Russell's health problems. It 
is apparent that the Division and the employer conceded that Russell was 
experiencing medical symptoms but disputed whether or not those medical symptoms 
were caused by a work-related injury. The rule explains that unless resolution 
of this issue turns upon conflicting medical opinion, resolution of this issue 
is appropriately determined by OAH and not a medical panel. In this case, 
Russell does not claim that the nature of his injury is determinative of whether 
or not it is work-related, requiring the medical expertise of the panel. Based 
upon the evidence received by the hearing examiner, we find neither conflicting 
medical opinion nor the nature of the injury were central to the 
work-relatedness issue, and it was appropriate that a hearing examiner resolved 
the issue of whether or not this injury was work-related.

 

[¶20]   We do note, however, that the 
medical commission has anticipated that referrals might not always be correct 
and has provided for referrals from hearing examiners to the medical panel upon 
agreement of all of the parties. Apparently, Russell did not seek such a 
transfer even after our remand. We believe that seeking a transfer is necessary 
to avoid waiver.

 

Substantial Evidence

 

[¶21]   Russell contends the decision 
stating he failed to carry his burden that his injuries are work-related is not 
supported by substantial evidence.

 

Our standard for reviewing findings of fact made in 
an administrative worker's compensation hearing is well settled. If, after 
examining the entire record, we find substantial evidence to support the 
agency's finding, we will not substitute our own judgment for that of the 
agency. Instead, we will uphold the agency's finding. Substantial evidence is 
relevant evidence which a reasonable person might accept as supporting the 
agency finding. . . . In addition, we examine only the evidence which favors the 
prevailing party, allowing every favorable inference, while omitting 
consideration of any conflicting evidence. . . . This is the applicable standard 
under which WYO. STAT. § 16-3-114(c)(ii)(E) (1990) demands that findings of fact 
are to be tested. This rule clearly encompasses the proposition that the 
reviewing court does not reweigh the evidence. On judicial review of an agency 
determination, the burden usually is assigned to the appellant to demonstrate 
that the agency's findings and conclusions are not supported by substantial 
evidence.

* 
* *

Our review of an agency's findings of fact and 
conclusions of law is simple. First, if we can find from the evidence preserved 
in the record a rational view for the findings of fact made by the agency, we 
then say the findings are supported by substantial evidence. Second, we ask if 
the conclusions of law made by the agency are in accordance with 
law.

 

Wyoming Steel & Fab, Inc. v. 
Robles, 882 P.2d 873, 876-77 (Wyo. 
1994) (citations and footnote omitted). Russell has the burden of proving 
entitlement to workers' compensation benefits. Id. at 875.

 

[¶22]   Russell's argument can be 
summarized as follows. The hearing examiner stated that he found Russell to be a 
credible witness. The evidence showed that Russell stopped working on his house 
in August. His pre-employment physical in September did not indicate any back 
problems. Russell suffered a back injury in October and before the end of the 
month was experiencing back pain and numbness. After evaluations by several 
specialists, Russell believed that his health problems were caused by the 
October 3 injury and filed for benefits. Dr. Ideen and Dr. Pettine testified 
that Mr. Russell's back pain and disability were related to the October 1994 
work injury. The hearing examiner ignored this evidence and, instead, improperly 
speculated without evidence that Russell's injury was caused by building a 
house.

 

[¶23]   Our review shows that the second 
hearing did result in eliminating two of the possibilities for Russell's health 
problems that the hearing examiner had discussed in the first order denying 
benefits. The issue remaining was the third possibility noted in the first 
order:

c. If the problems being experienced by the Claimant 
with regard to his back and legs were caused by trauma, it was most likely 
caused by something other than work, such as building a house in the few months 
preceding the claimed injury. Any injury on October 3, 1994, had 
resolved.

As our factual discussion 
related, the second hearing resulted in the hearing examiner rejecting Dr. 
Ideen's testimony as less reliable than his handwritten notes made at Russell's 
first appointment and rejecting Dr. Pettine's testimony because it was based 
upon the history provided by Russell. The decision whether the evidence showed 
injuries caused by a work-related incident or another incident was for the 
hearing examiner to make. Sufficient evidence exists in the record to justify 
either conclusion, but the decision is the prerogative of the finder of fact, 
the hearing examiner. Robles, 882 P.2d  at 879. To reverse that decision would require us to reweigh the evidence 
and substitute our opinion for that of the agency, which we may not do. Id. at 879-80.

 

[¶24]   The decision is 
affirmed.

 

Footnotes

1 The Workers' Compensation Rules and 
Regulations were republished in February of 1997 and the proper citation is now 
Chapter 5, Section 4(a).