Title: LOGUE v. WYOMING WORKERS' SAFETY AND COMPENSATION DIVISION

State: wyoming

Issuer: Wyoming Supreme Court

Document:

LOGUE v. WYOMING WORKERS' SAFETY AND COMPENSATION DIVISION2002 WY 6244 P.3d 90Case Number: 01-127Decided: 04/16/2002
 APRIL TERM, A.D. 2002

 

                                                                                                                                   

 

JUDY B. 
LOGUE, 

Appellant(Petitioner),

 

v.

 

STATE OF 
WYOMING, ex rel., WYOMING

WORKERS' 
SAFETY AND COMPENSATION

DIVISION, 

Appellee(Respondent).

 

 

 

Representing 
Appellant: 

            
Donald L. Painter, Casper, Wyoming.

Representing 
Appellee: 

            
Hoke MacMillan, Attorney General; John W. Renneisen, Deputy Attorney 
General; Gerald L. Laska, Senior Assistant Attorney General; and David L. 
Delicath, Assistant Attorney General.

 

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

VOIGT, 
Justice, delivered the opinion of the Court; 
GOLDEN, 
Justice, filed a dissenting opinion.

  

            
VOIGT, Justice. 

[¶1]      The Office of 
Administrative Hearings (OAH) awarded Judy B. Logue (the appellant) worker's 
compensation benefits for a neck injury, but denied benefits for a lower back 
injury.  Following a contested case 
hearing, the hearing examiner found that the appellant failed timely to report 
and file her claim for the alleged back injury.  This created a presumption that the 
benefits for the back injury would be denied unless the appellant could 
establish by clear and convincing evidence that neither her employer nor the 
Wyoming Workers' Safety and Compensation Division (the Division) was prejudiced 
by the late filing.  The appellant 
presented no evidence to rebut the presumption, and the hearing examiner denied 
benefits for the back injury.  We 
affirm.

 

ISSUES

 

[¶2]      The appellant 
states the issue as:

 

Whether 
Appellant failed to timely report and file a report of her low back 
injury.

 

The 
Division, as appellee, phrases the issue as:

 

            
Did the Hearing Examiner correctly find that Appellant's reporting 
obligations arose when she knew, no later than January 2000, that her back 
injury was work-related and compensable?

 

FACTS

 

[¶3]      The appellant 
worked as a meat cutter at a Safeway store in Casper.  In October 1999, the appellant suffered 
an injury to her neck while lifting a case of large frozen turkeys from a 
pallet.1  The appellant testified that prior to 
that date, she did not have any physical problems associated with her work at 
Safeway.2  The appellant believed she had pulled a 
muscle in her neck and told her immediate supervisor about the incident after 
she finished unloading the pallet.  
She testified that she felt a pop in her neck and began experiencing pain 
in her neck shortly after the incident.  
Approximately two weeks later, the appellant tripped over a pallet.  She testified she thought she had pulled 
a muscle in her back.  She did not 
report this injury to her supervisor.  
The appellant further testified that after the second injury, her pain 
would come and go but never went completely away, and her leg often went to 
sleep.

 

[¶4]      In December of 
1999, the pain worsened.  The 
appellant testified that she knew sometime after Christmas 1999 that her neck 
and back symptoms had increased and the pain had not subsided.  She had not, at that point, consulted 
with a doctor.  On May 23, 2000, 
when she went for an annual checkup, the appellant told her family physician 
about the pain in her neck and back, and stated, "I can't stand the pain in my 
neck no longer."  She further stated 
that her leg was constantly going numb, and that it felt like it was continually 
being stuck with needles.  The 
doctor ordered x-rays and informed the appellant on May 24, 2000, that she had 
degenerative disks in her neck and back, and limited her to lifting no more than 
twenty-five pounds.

 

[¶5]      The appellant was 
referred to two additional doctors and was ultimately referred to a 
rehabilitative specialist, Dr. Hemler, for treatment.  The appellant saw Dr. Hemler on 
September 22, 2000.  He diagnosed 
her with degenerative osteoarthritis with cervical (neck) segmental pain and 
lumbar (back) degenerative disease.  
Dr. Hemler concluded that these conditions arose directly as a result of 
the appellant's employment and that she had a work-related injury.  He again saw the appellant on November 
9, 2000, and stated that the appellant's condition was unlikely to improve 
medically.  Dr. Hemler diagnosed the 
appellant as having five percent impairment in the neck area and having five 
percent impairment to the back.  
This equaled a ten percent total body impairment, which he considered to 
be directly related to the appellant's combined work-related 
injuries.

 

[¶6]      After learning on 
May 24, 2000, that she had degenerative disks in her neck and back, the 
appellant informed the Safeway store manager of her condition.  He prepared an Employer's Report of 
Injury, which he faxed to Safeway's corporate office on May 25, 2000.  The manager's report indicated that the 
appellant notified him of her condition on May 25, 2000, but left blank the date 
of her actual injury.  The appellant 
completed an Employee's Report of Injury on May 25, 2000, indicating that the 
date of injury was May 23, 2000, and that she reported the incident to her 
employer on May 25, 2000.  The 
appellant filed a worker's compensation claim on June 9, 
2000.

 

[¶7]      On August 8, 
2000, the Division sent the appellant a Final Determination letter in response 
to her claim.  It concluded that it 
could not pay her benefits because:  
(1) the Division was prejudiced by the late filing of the claim, and (2) 
the Division had not received any medical information relating to the 
injury.  The appellant timely 
objected to this determination on August 18, 2000.  After a contested case hearing on March 
12, 2001, the OAH issued an Order Awarding and Denying Benefits dated April 12, 
2001.  The OAH awarded the appellant 
benefits for medical and temporary total disability for her neck condition, but 
denied benefits for the back injury.  
The appellant petitioned the district court on April 26, 2001, for review 
of the OAH's order.  The district 
court certified review to this Court on June 4, 2001.

 

STANDARD 
OF REVIEW

 

[¶8]      When the district 
court certifies directly to this Court an administrative agency's decision, we 
review that agency decision "under the same appellate standards applicable to 
the reviewing court of the first instance."  Matter of Bessemer Mt., 856 P.2d 450, 453 (Wyo. 1993), cert. denied, 519 U.S. 1091 (1997).  Our review is limited to a determination 
of the factors specified in Wyo. Stat. Ann. § 16-3-114(c) (LexisNexis 
2001).  The reviewing court 
shall:

 

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;

 

            
* * *

 

            
(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)(ii).

 

[¶9]      The 
interpretation and correct application of the provisions of the Wyoming Worker's 
Compensation Act are a question of law over which our review authority is 
plenary.  In re Jensen, 2001 
WY 51, ¶ 10, 24 P.3d 1133, 1136 (Wyo. 2001).  We affirm an administrative agency's 
conclusions of law only if they are in accord with the law.  We do not afford any deference to the 
agency's determination, and we will correct any error made by the agency in 
either interpreting or applying the law.  
Id.

 

[¶10]   In reviewing the findings of fact, 
we examine the entire record to determine whether there is substantial evidence 
to support an agency's findings.  
Id.  If the agency's 
decision is supported by substantial evidence, we cannot properly substitute our 
judgment for that of the agency, and we must uphold the findings on appeal.  Substantial evidence is relevant 
evidence that a reasonable mind might accept in support of the agency's 
conclusion.  It is more than a 
scintilla of evidence.  
Id.

 

[¶11]   In a worker's compensation case, 
the claimant has the burden of proving the statutory elements that comprise a 
"compensable injury."  Matter of 
Workers' Compensation Claim of Jacobs, 924 P.2d 982, 984 (Wyo. 
1996).  The claimant must show the cause of the 
condition for which compensation is claimed, and that the injury occurred in the 
course of employment.  State ex 
rel. Wyoming Workers' Compensation Div. v. Espinoza, 924 P.2d 979, 981 (Wyo. 
1996).

 

DISCUSSION

 

[¶12]   The appellant argues that she fully 
and timely complied with the reporting and filing requirements of Wyo. Stat. 
Ann. § 27-14-502(a) (LexisNexis 2001), which states, in pertinent 
part:

 

As soon 
as is practical but not later than seventy-two (72) hours after the general 
nature of the injury became apparent, an injured employee shall, in writing or 
by other means approved by the department, report the occurrence and general 
nature of the accident or injury to the employer.  In addition, the injured employee shall 
within ten (10) days after the injury became apparent, file an injury report 
with the employer and the division in a manner and containing information 
prescribed by division rule and regulation.

 

The 
reporting and filing requirements under Wyo. Stat. Ann. § 27-14-502(a) are 
triggered by a compensable injury.  
Big Horn Coal Co. v. Wartensleben, 502 P.2d 187, 188 (Wyo. 
1972).  The law on determining the date of a 
compensable injury is well established.  
The notice and claim requirements of the worker's compensation statutes 
do not begin to run until the employee becomes aware that an accident has caused 
an injury; and the term "injury" as used in the statutes means compensable 
injury.  Wesaw v. Quality 
Maintenance, 2001 WY 17, ¶ 10, 19 P.3d 500, 504 (Wyo. 2001).  "[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?"  Aanenson v. State ex rel. Wyoming 
Workers' Compensation Div., 842 P.2d 1077, 1082 (Wyo. 1992).

 

[¶13]   This question requires a careful 
evaluation of all facts to determine when an employee reasonably understood the 
nature and seriousness of her condition and that it was work-related.  While employees need not file claims for 
trivial injuries to avoid timeliness issues, the employee may not ignore the 
requirements for compensable injuries because notice and the statute of 
limitations exist to allow employers to investigate claims, monitor medical 
care, and avoid stale claims.  
Sherwin-Williams Co. v. Borchert, 994 P.2d 959, 964 (Wyo. 
2000).  The finder of fact must determine the 
time and cause of a compensable injury.  
Whether an employee's claim is to be barred for failure timely to file 
notice or a claim is a mixed question of fact and law.  Aanenson, 842 P.2d  at 
1080.

 

[¶14]   The appellant argues that she was 
not aware of the magnitude and extent of her injuries until she saw her family 
physician on May 23, 2000, and he informed her of her condition on May 24, 
2000.  She contends that she timely 
filed a report with her employer on May 25, 2000, and with the Division on June 
9, 2000.

 

[¶15]   The Division alleged that the 
appellant did not suffer a compensable injury and that the appellant failed 
timely to report the injury to Safeway and to the Division.  The Division also argued that it and 
Safeway were prejudiced in investigating the incident and in monitoring medical 
treatment.  In order to overcome a 
presumption of claim denial for failure timely to file, the appellant had to 
show a lack of prejudice to Safeway and the Division by clear and convincing 
evidence.  Wyo. Stat. Ann. § 
27-14-502(c).  Whether a claimant 
has established a lack of prejudice is a question of fact.  In re Worker's Compensation Claim of 
Payne, 993 P.2d 313, 316 (Wyo. 1999).  In Wesaw, we stated that the 
presumption of claim denial "does not arise unless an employee failed to report 
within 72 hours and failed to file an injury report within ten 
days."  Wesaw, 2001 WY 17, ¶ 
14, 19 P.3d  at 506 (emphasis in original).

 

[¶16]   In the instant case, the 
appellant's actions indicate that she understood by January 2000 the nature of 
her injuries and that they were work-related.  The appellant immediately told her 
supervisor about her neck injury after it occurred in October 1999.  She characterized the injury as a pulled 
muscle that was painful.  
Approximately two weeks later, she tripped over a pallet and again 
characterized the injury as a pulled muscle, this time in her back, yet she 
failed to report this to her employer until May 25, 2000.  The record shows the appellant knew 
sometime after Christmas 1999 that her neck and back symptoms had increased and 
the pain had not subsided.  An 
injury is apparent when the claimant knows she ""has suffered an injury which 
can result in, or is likely to cause, a compensable disability."'"  Beitel v. State ex rel. Wyoming 
Workers' Compensation Div., 991 P.2d 1242, 1245 (Wyo. 1999) (quoting 
Matter of Zielinske, 959 P.2d 706, 709 (Wyo. 1998) and Curnow v. State ex 
rel. Wyoming Workers' Compensation Div., 899 P.2d 875, 878 (Wyo. 
1995)).  The appellant's testimony suggests that 
the injury occurred within a reasonably definite time period, and that she knew 
she had a compensable injury by January 2000, triggering the notice requirement 
pursuant to Wyo. Stat. Ann. § 27-14-502(a).

 

[¶17]   Based on the evidence, the hearing 
examiner concluded that the appellant had timely reported her neck injury to 
Safeway, but did not timely report her back injury to Safeway or the 
Division.  The hearing examiner 
found that the appellant was entitled to benefits for the neck injury as the 
medical evidence had established a causal connection between work and her neck 
condition.  The hearing examiner 
presumed benefits were denied for the back injury pursuant to Wyo. Stat. Ann. § 
27-14-502(c), which states:

 

Failure 
of the injured employee . . . to report the accident or injury to the employer 
and to file the injury report in accordance with subsection (a) of this section 
is a presumption that the claim shall be denied.  The presumption may be rebutted if the 
employee establishes by clear and convincing evidence a lack of prejudice to the 
employer or division in investigating the injury and in monitoring medical 
treatment.

 

[¶18]   We hold that there is substantial 
evidence to support the hearing examiner's factual findings.  We also agree with the hearing examiner 
that the appellant presented no evidence to rebut the presumption of claim 
denial.  We affirm the hearing 
examiner's award of benefits for the appellant's neck injury and the denial of 
benefits for the appellant's back injury.

  

GOLDEN, 
J., dissenting. 

[¶19]       
In a series of decisions over the 
last year, this Court has settled the law in a troublesome area of workers' 
compensation: when can valid claims be denied because all reporting requirements 
were not followed.  Because these 
denials must comport with the constitutional right to due process, our decisions 
developed an appropriate standard of review, focused on the proper 
interpretation of the statutory requirements, and distinguished between the 
definition of a "compensable injury" and that of an "incident" or 
"accident."  Resolving whether 
notices and claims were timely presents mixed questions of fact and law, and our 
review is de novo.  Wesaw 
v. Quality Maintenance, 2001 WY 17, ¶¶11, 12, 19 P.3d 500, ¶¶11, 12 (Wyo. 
2001).  Applying a de novo 
review to the denial of benefits for Logue's back injury, I find that the 
record does not support the denial, and I must respectfully 
dissent.

 

[¶20]       
The facts of this case are 
simple.  In October of 1999, Logue 
injured her neck.  Approximately a 
week or two later, Logue injured her back.  
It was the holiday season, a very busy time at her store, and she 
continued working.  In May 2000, she 
had her annual check-up and reported neck pain and leg numbness to her 
doctor.  A series of tests produced 
a diagnosis that she had suffered work-related injuries to both her neck and 
back.  She reported the diagnosis to 
her Safeway department supervisor, and her employer provided her with an injury 
report that both completed and submitted to the Division.  The Division denied her claim for both 
injuries stating they were not work-related and had not been timely 
reported.  

 

[¶21]       
At the 
contested case hearing, Logue testified that she told her supervisor of her neck 
injury, and the hearing examiner found that Logue had timely told her supervisor 
in October that she had injured her neck.  
Safeway did not have Logue complete an injury report at that time.  Logue then testified that she tripped 
and hurt her back but did not "report" it at that time.   On cross-examination, Logue 
testified that she did tell her supervisor that she had hurt her back when it 
happened.  She confirmed this fact 
on redirect examination.  
Importantly, the Division did not have Logue's supervisor testify.  In Wesaw, we stated that if a 
claimant timely tells her supervisor of a work-related injury, her claim cannot 
be denied under Wyo. Stat. Ann. § 27-14-502.  Wesaw, ¶15.  

 

[¶22]       
Despite 
receiving the same testimony on both injuries, the hearing examiner found that 
Logue did not tell her employer about her back injury.  The basis for this last finding was the 
hearing examiner's finding #19 which stated:

            

Had 
Logue had [sic] mentioned an accident at work, a supervisor would have filled 
out a report and faxed it to "loss control."  Safeway would then contact the employee, 
discuss medical treatment and conduct an additional investigation if 
needed.  Safeway did not do that in 
this case because Logue did not report a specific injury.

 

Yet we 
know that Logue reported her earlier neck injury, and Safeway did not follow 
this process.  It is against the 
great weight of the evidence and purely speculative, in addition to being 
illogical, for the hearing examiner to decide that this process would have been 
followed for the later back injury when Safeway did not follow this procedure 
for the neck injury.  We, therefore, 
have the same evidence, Logue's testimony, that she reported both the neck and 
back injuries to her supervisor after each happened.  If that testimony is sufficient to 
establish the neck injury, then it is sufficient to establish the back 
injury.

 

[¶23]       
In 
addition, even if we assume that Logue's unrefuted testimony is not sufficient 
to grant her benefits for her back injury, we must nevertheless apply our law 
regarding "compensable injury."  
Wesaw, ¶¶15, 16.  
In its disclosure statement, the Division contended that Logue 
untimely filed her report on May 25, 2000.  
Logue had received her doctor's diagnosis on May 23, 2000. The hearing 
examiner determined that because Logue's symptoms increased during the holidays, 
Logue knew or should have known no later than January 2000 that she had a 
work-related injury or injuries.  
However, these symptoms were neck pains and are not relevant to the back 
injury.  "Knowledge of the full 
extent and nature of the injury' must be distinguished from an incident' or an 
accident' before the notice and claim requirements of Wyo. Stat. Ann. §§ 
27-14-502 and 503 are triggered."  
Id. at ¶17.  There is 
no evidence establishing that Logue knew that her leg numbness was caused by the 
tripping incident that pulled a muscle in her back.  She discovered that relationship when 
she received her doctor's diagnosis, and it was then that she knew the "full 
extent and nature of her injury."

 

[¶24]       
This is 
not a Beitel case where the claimant sought chiropractic treatment but 
did not file an injury report for several months.  Here, the claimant suffered minor 
injuries and continued to work; however, repetitive trauma to those minor 
injuries resulted in a compensable injury made known to the claimant only after 
testing and a doctor's diagnosis.  
Logue timely filed her reports after receiving this diagnosis, the 
hearing examiner determined that these injuries were work-related, and she is 
entitled to benefits.   

 

[¶25]       
I would 
reverse the hearing examiner's order.  
I respectfully dissent from the majority's decision to 
affirm.

 

FOOTNOTES

  1A case contained 
four turkeys, each weighing between ten and fifteen 
pounds.

  2Safeway hired 
the appellant for the meat cutter position in 1991.