Title: In re Nissen

State: wyoming

Issuer: Wyoming Supreme Court

Document:

In re Nissen1999 WY 92983 P.2d 722Case Number: 98-11Decided: 06/29/1999Supreme Court of Wyoming

In 
The Matter Of The Worker's Compensation Claim Of Sheila K. Nissen, An

 

Employee Of Cheyenne frontier Days, 
Inc.:

Sheila K. Nissen, Appellant 
(petitioner),

v.

Cheyenne Frontier Days, Inc., and  State Of Wyoming, 
ex

rel., Wyoming Workers' Safety And  Compensation Division, Appellees 
(Respondents).

 

                                 

Appeal from the District Court of Laramie County, 
Edward L. Grant, J.

  

 

 Bert T. Ahlstrom, Jr., Cheyenne, WY. 
Representing Appellant.

 For Cheyenne Frontier Days, Inc.: James W. Gusea of James W. Gusea, P.C., Cheyenne, 
W.Y., For Worker's Safety and Compensation Division: William U. Hill, 
Attorney General; Gerald W. Laska, Senior Assistant Attorney General; and Bernard P. 
Haggerty, Assistant Attorney General.

 

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

   * Chief 
Justice at time of expedited case conference; retired November 2, 
1998.

 

    LEHMAN, Chief 
Justice.

  [¶1]      A hearing examiner denied injured worker 
Sheila Nissen's claim for benefits. The hearing examiner determined that Nissen 
failed to rebut the presumption that her claim be denied pursuant to Wyo. Stat. 
Ann. § 27-14-502(c) (Michie June 1991 Rpl.). We are satisfied the hearing 
examiner's determination was not an abuse of discretion.

 

  [¶2]      We affirm.

 

                               
ISSUES

 

  [¶3]      Appellant Sheila Nissen (Nissen) states 
the following issues:

 

            A. 
Whether the reporting requirements of W.S. Section 27-14-502 (a) were met in 
this case; and, if not:

 

                        
1. Whether the presumption of W.S. Section 27-14-502(c) was rebutted in 
this case; and/or,

 

                        
2. Whether the burden shifted to the Employer and/or Division to show 
prejudice to them.

 

B. Whether the Hearing Examiner correctly determined 
that Appellant was not entitled to an award of benefits, under the 
circumstances.

 

  Appellee State, ex rel. Worker's 
Compensation Division (Division) presents the issue as:

 

A. Was the Hearing Examiner's decision supported by 
substantial evidence, within his discretion, and in accordance with 
law?

 

                                
FACTS

 

  [¶4]      Nissen worked as a sales clerk in the 
Old West Gift Shop, operated by Frontier Marketing, LLC. Sometime in early to 
mid April of 1996, Nissen and her supervisor, Jan Hertel (Hertel), moved a 
display unit in the store. During the move, Nissen felt a pop in her lower back 
but said nothing to Hertel. After arriving home from work that day, Nissen called a physician. 
The physician instructed her to treat her back with hot and cold packs. Hertel 
first became aware of Nissen's back pain on April 24, 1996. An entry in Hertel's 
daily records on that date indicates Nissen called work and said that her back 
was in pain and she would not make it in 
to work.

 

  [¶5]      Nissen returned to work in late April to 
cover a short shift for Hertel. During the shift, Nissen reached for a fan above 
a counter and wrenched her back. When Hertel returned to the store, she found 
Nissen leaning against a counter in obvious pain.  Nissen left the store and did not return 
to work after that day.

  

  [¶6]      Nissen's back pain persisted and, on May 
3, 1996, she went to her chiropractor. The chiropractor diagnosed "acute lumbar 
sprain/strain," "disc degeneration," and "lumbar disc syndrome."  During this initial visit, the 
chiropractor mentioned the possibility of worker's compensation benefits. 
Because she was under the impression 
worker's compensation did not cover part- time employees, Nissen did not pursue 
benefits at that time.

 

  [¶7]      Subsequently, Nissen twice re-injured 
her back. In late July, Nissen stepped in a hole at her daughter's house. The 
chiropractor's notes of August 2, 1996, indicate she "Hurt [her] back again 
[when she] stepped in a hole."  The 
second re-injury occurred when Nissen reached to pick up her 
cat.

 

  [¶8]      On Nissen's May 22, 1996 visit to her 
chiropractor, he suggested she contact a physician for further evaluation. 
Nissen ultimately underwent an MRI, and the attending physician referred her to 
a surgeon who recommended surgery. As an alternative to surgery, Nissen started 
water therapy but discontinued the sessions due to cost.

 

  [¶9]      In a letter dated September 30, 1996, 
and postmarked October 19, 1996, Nissen informed Hertel that she was filing a 
worker's compensation claim. Nissen did not file the injury report with the 
clerk of court until October 30, 1996, and the Division did not receive the 
report until November 4, 1996. The report identified the date of injury as April 
23, 1996. The Division denied payment of benefits, finding that Nissen failed to 
meet the timely filing requirements of 
Wyo. Stat. Ann. § 27-14-102(a)(c).

 

   [¶10] After a contested case 
hearing, a hearing examiner from the Office of Administrative Hearings (OAH) 
also denied Nissen's claim for benefits. The hearing examiner found that Nissen 
suffered back pain on April 30, 1996, when she reached for the fan, and that she 
knew the general nature of her injury no later than May 3, 1996, when she saw 
her chiropractor. The hearing examiner noted that six months had passed between 
the time Nissen quit work and the time she filed her report. In his conclusions 
of law, the hearing examiner found that the failure to timely file created a 
rebuttable presumption of prejudice under Wyo. Stat. Ann. § 27-14-502(c). Going 
to the central issue of this case, the hearing examiner concluded that Nissen 
failed to produce clear and convincing 
evidence of a lack of prejudice to the employer or the 
Division:

 

12. Nissen has failed to meet her burden of proving 
by clear and convincing evidence that her late filing did not prejudice Frontier 
Days or the Division in their ability to investigate her injury and monitor her 
medical treatment.  The presumption 
of claim denial found in Wyo. Stat. § 27-14-502(c) (1986) has therefore not been 
overcome.

 

  [¶11] 
  Nissen filed a petition for 
review with the district court, which certified the case here pursuant to 
W.R.A.P. 12.09(b).

 

                         
STANDARD OF REVIEW

 

  [¶12] 
  When an agency determines 
that a claimant for worker's compensation benefits failed to meet her burden of 
proof, the appropriate review is the "[a]rbitrary, capricious, an abuse of 
discretion or otherwise not in accordance with law" standard set forth in Wyo. 
Stat. Ann. § 16-3-114(c)(ii)(A) (Lexis 1999).  Pederson v. State, ex rel. Workers' 
Compensation Div., 939 P.2d 740, 742 (Wyo. 1997); City of Casper v. Utech, 895 P.2d 449, 452 (Wyo. 1995); Stuckey v. State, ex rel. Workers' Compensation Div., 
890 P.2d 1097, 1099 (Wyo. 1995). In our review of an agency determination for 
abuse of discretion, we adhere to specific rules of review. The agency, as the 
trier of fact, must weigh the evidence and determine the credibility of the 
witnesses. Utech, 895 P.2d  at 451 (and 
cases therein cited). "[S]ince we cannot reweigh the evidence nor redetermine 
the credibility of the evidence, no purpose is to be served by demanding the 
agency explain how it evaluated the evidence in arriving at a conclusion that a 
party failed to meet its burden of proof."  
Id. at 452.  Instead, in 
determining whether or not the agency decision was an abuse of discretion, we 
must examine the entire record. Wyo. Stat. Ann. § 16-3-114(c). If we find an 
agency decision clearly contrary to the overwhelming weight of the evidence in 
the record, then we will overturn the decision. Utech, 895 P.2d  at 452; 
Pederson, 939 P.2d  at 742.

 

                             
DISCUSSION

 

  [¶13] 
  Nissen's injury occurred in 
the spring of 1996, and her claim is covered by the law in effect when the 
injury occurred. Clark v. State, ex rel. Workers' Safety & Compensation 
Div., 968 P.2d 436, 438 (Wyo. 1998); State, ex rel. Workers' Compensation Div. 
v. Jacobs, 924 P.2d 982, 984 (Wyo. 1996). The applicable 
version of Wyo. Stat. Ann. § 
27-14-502 (Michie June 1991 Rpl.) provides in relevant 
part:

 

(a) 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 report the occurrence and general nature of the 
accident to the employer and within ten (10) days after the injury became 
apparent, file the report in the office of the clerk of court of the county in which the 
accident occurred.

 

            * * 
*

 

            * * 
*

 

(c) Failure of the injured employee * * * to report 
the accident to the employer and to file the report with the clerk of court 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 accident and in 
monitoring medical treatment.

 

  [¶14] 
  Nissen claims that she met 
the reporting requirements. Nissen, however, admits that six months passed 
between the time she knew of her injury and the time she filed her injury 
report. The record supports the hearing examiner's determination that Nissen 
knew no later than May 3, 1996, that she had a compensable injury and that she 
did not file an injury report with the clerk of court until October 30, 1996, 
thus creating an untimely filing.

 

  [¶15] 
  Nissen contends that if her 
filings were not timely, she nevertheless rebutted the presumption of prejudice 
as required by Wyo. Stat. Ann. § 27-14-502(c). In order to rebut the presumption 
of prejudice set forth in the statute, a claimant must establish by clear and 
convincing evidence that prejudice did not occur. Id. Clear and convincing evidence is the type of 
evidence that persuades a trier of fact that the truth of the contention is 
highly probable. Matter of GP, 679 P.2d 976, 982 (Wyo. 1984); Matter of 
Paternity of TS, 917 P.2d 183, 185 (Wyo. 1996).

 

  [¶16] 
  We find the record supports 
the hearing examiner's determination that Nissen did not produce "clear and 
convincing evidence that there was a lack of prejudice to [her employer] or the 
Division in investigating her injury and in monitoring her medical treatment as 
a result of her late filing of her injury report."  "It is apparent from the language of 
Wyo. Stat. § 27-14-502(c) * * * that the legislature was relying upon the 
statute to afford the employer or the Division an opportunity to investigate and 
monitor medical treatment."  Neal v. 
Caballo Rojo, Inc., 899 P.2d 56, 61 
(Wyo. 1995). Here Nissen failed to submit evidence to show how the Division and 
her employer were not prejudiced by their lack of opportunity to investigate and 
monitor. Without such evidence in the record, an employee cannot rebut the 
presumption of prejudice. Clark, 968 P.2d  at 439.

 

  [¶17] 
  Moreover, even if Nissen 
had presented evidence to rebut the presumption of prejudice, the hearing 
examiner found that the record reflects prejudice to both the employer and the 
Division in investigating the injury and monitoring the medical treatment.  A period of six months passed between 
Nissen's last day of work and the date 
of filing. During that time, at least three doctors treated her, and she 
suffered two more injuries to her back.  
Since Nissen failed to timely report her injury, neither the Division nor 
her employer had an opportunity to investigate and monitor her medical treatment 
prior to her other injuries. Under these circumstances, the hearing examiner 
correctly determined that Nissen's claim for benefits should be 
denied.

 

  [¶18] 
 In her second argument, 
Nissen, relying on Bauer v. State, ex rel. Workers' Compensation Div., 695 P.2d 1048 (Wyo. 1985), contends that her employer should be estopped from raising the 
statute of limitations as a defense. With tenuous record support, she contends 
that her employer should be estopped because it did "nothing to help, and 
everything to block" her efforts to pursue her claim. Excepting a lack of record 
support, Nissen faces a more difficult hurdle:  she has raised this argument for the 
first time on appeal. We do not review 
issues raised for the first time on appeal. Shaffer v. State, ex rel. Workers' 
Safety & Compensation Div., 960 P.2d 504, 507-08 (Wyo. 1998) (quoting Nelson 
v. Sheridan Manor, 939 P.2d 252, 255 (Wyo. 1997)).

 

                             
CONCLUSION

 

  [¶19] 
  The hearing examiner's 
determination that Nissen failed to meet her burden of proof is supported by the 
record. The hearing examiner acted appropriately, and we find no abuse of 
discretion.  The order denying 
benefits is affirmed.