Title: IN THE MATTER OF THE WORKER'S COMPENSATION CLAIM OF: BRETT A. CRAMER V. STATE OF WYOMING, ex rel., WYOMING WORKERS' SAFETY AND COMPENSATION DIVISION

State: wyoming

Issuer: Wyoming Supreme Court

Document:

IN THE MATTER OF THE WORKER'S COMPENSATION CLAIM OF: BRETT A. CRAMER V. STATE OF WYOMING, ex rel., WYOMING WORKERS' SAFETY AND COMPENSATION DIVISION2005 WY 124120 P.3d 668Case Number: 04-217Decided: 09/28/2005
APRIL TERM, A.D. 2005

 
 
IN THE 
MATTER OF THE WORKER'S

COMPENSATION 
CLAIM OF:

 
 
BRETT A. 
CRAMER,

 
 
Appellant

(Employee/Petitioner),

 
 
v.

 
 
STATE OFWYOMING, ex rel., WYOMING

WORKERS' 
SAFETY AND COMPENSATION

DIVISION,

 
 
Appellee

(Respondent).

 
 
 
 
Appeal 
from the DistrictCourtofCampbellCounty

 
 

Representing 
Appellant:

C. John 
Cotton, Cotton Law Office, Gillette, Wyoming

 
 

Representing 
Appellee:

Patrick 
J. Crank, Wyoming Attorney General; John W. Renneisen, Deputy Attorney General; 
Steven R. Czoschke, Senior Assistant Attorney General; Kristi M. Radosevich, 
Assistant Attorney General

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

 
 
 
 

GOLDEN, 
Justice.

 
 

[¶1]           
Brett 
Cramer alleges that he suffered a cervical spine injury out of and in the course 
of his employment with Weld Test & Inspection.  The Wyoming Workers' Compensation 
Division (Division) denied Cramer's claim for benefits, and Cramer 
objected.  After a contested case 
hearing, the Office of Administrative Hearings (OAH) also denied his claim, 
finding Cramer did not meet his burden of proving that the injury occurred while 
in the course and scope of his employment.  
Cramer appealed to the district court, which affirmed the denial of 
benefits, and he now appeals to this Court.  We affirm.

 
 
ISSUES

 
 

[¶2]           
Cramer 
presents two issues for our review:

 
 
1.  Was the decision of the OAH contrary to 
the record, and unsupported by substantial evidence?

2.  Was the decision of the OAH arbitrary, 
capricious, or an abuse of discretion?

 
 

FACTS

 
 

[¶3]           
On 
October 18, 2002, Cramer was employed as a weld inspector by Weld Test & 
Inspection.  While performing an 
inspection at a mine site near Gillette, Wyoming, Cramer fell from a ladder and 
fractured the heel in his left foot.  
He was treated by Dr. Bryan Den Hartog of the Black HillsOrthopedic & 
SpineCenter, P.C., in 
Rapid City, South Dakota, on October 23, 2002, and taken 
off work due to his fractured foot.  
Cramer submitted a Report of Injury, listing only the injury to his 
foot.  On November 1, 2002, the 
Division determined Cramer's foot injury was compensable and his claims for 
medical care and temporary total disability were paid by the Division.  

 
 

[¶4]           
Cramer 
continued to seek treatment from Dr. Hartog for his foot injury until April 9, 
2003.  On that occasion, Cramer also 
sought treatment for left knee pain that he claimed was related to the October 
18, 2002, work accident.  
Examination of the knee revealed a calcified nodule on the medial aspect 
of the patella, which Dr. Hartog noted would "be somewhat of a problem for 
[Cramer] as far as his kneeling and squatting goes."  Dr. Hartog also concluded that, given 
the improvement in his foot, Cramer should be able to return to full work duty 
in a week.  Cramer did not return to 
work nor did he seek additional medical treatment for his foot or knee until 
August 25, 2003, a month after he received notification (his third) from the 
Division requesting further information regarding the injury to his left knee. 

 
 

[¶5]           
In the 
meantime, Cramer saw Dr. Max Winkler, a chiropractor in Rapid City, on June 27, 
2003, about pain and numbness in his neck, shoulder and left arm.  Cramer attributed the symptoms to the 
October 18, 2002, work accident.  
However, Dr. Winkler noted Cramer reported that the symptoms started just 
three weeks before that initial office visit.   Dr. Winkler also noted the date of 
injury as June 13, 2003.  Dr. 
Winkler treated Cramer's physical symptoms on that date and again on July 
7.  Cramer never filed a report or 
claim with the Division regarding Dr. Winkler's treatment.

 
 

[¶6]           
Almost 
two months later, on September 2, 2003, Cramer saw Dr. Nathan Simpson, an 
orthopedic spine surgeon, with complaints of pain in his neck and his left 
shoulder and arm.  Cramer reported 
he suffered a work-related fall on October 18, 2002, and that "he started 
developing neck pain that goes into the left shoulder and down the back of his 
left arm" subsequent to the work accident.  
Dr. Simpson diagnosed a cervical spine injury and ordered an MRI, which 
revealed a herniated disc at C6/7.  
Medical records submitted to the Division by Dr. Simpson indicated Cramer 
was a candidate for surgical repair of his herniated disc, Cramer desired to 
undergo the surgery, and Cramer would not be able to return to work until at 
least six weeks after the cervical spine surgery.  

 
 

[¶7]           
In a 
Final Determination Letter issued on September 19, 2003, the Division denied 
Cramer's claim for medical and disability benefits stemming from the cervical 
spine injury on the ground that Cramer had not demonstrated the injury was a 
compensable work-related injury.  
Cramer objected to the final determination, and a contested case hearing 
was held on April 21, 2004.  The 
hearing officer denied benefits following that hearing.  Ultimately, the hearing officer 
determined Cramer had not met his burden of proving the cervical spine injury 
was work related.  

 
 
 
 

STANDARD 
OF REVIEW

 
 

[¶8]           
"The 
claimant has the burden of proving every essential element of his claim by a 
preponderance of the evidence.  
Under the statutory definition of injury, he must prove that his injury 
arose out of and in the course of his employment.  Whether an employee's injury occurred in 
the course of his employment is a question of fact."  Kuntz-Dexter v. State ex rel. Wyoming 
Workers' Safety and Comp. Div., 2002 WY 101, ¶ 9, 49 P.3d 190, 192 (Wyo. 
2002) (citations omitted).

 
 

[¶9]           
When 
reviewing a matter initiated before an administrative agency we do not afford 
any special deference to the district court's decision.  Instead, we review the case as if it 
came directly from the administrative agency.  Hicks v. State ex rel. Wyoming Workers' 
Safety and Comp. Div., 2005 WY 11, ¶ 16, 105 P.3d 462, 469 (Wyo. 2005) 
(citing Robbins v. State ex rel. Wyoming 
Workers' Safety and Compensation Division, 2003 WY 29, ¶ 15, 64 P.3d 729, 
732 (Wyo. 2003)).  The scope of our 
review of an administrative decision is limited by Wyo. Stat. Ann. § 16-3-114(c) 
(LexisNexis 2005), which provides:

 
 
(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.  In making the 
following determinations, the court shall review the whole record or those parts 
of it cited by a party and due account shall be taken of the rule of prejudicial 
error.  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:

(A)       Arbitrary, 
capricious, an abuse of discretion or otherwise not in accordance with 
law;

(B)       Contrary to 
constitutional right, power, privilege or immunity;

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

(D)       Without 
observance of procedure required by law; or

(E)       Unsupported 
by substantial evidence in a case reviewed on the record of an agency hearing 
provided by statute.

 
 
 
 

[¶10]       
We 
recently reiterated the standard of review to be applied when both parties 
present evidence at an administrative hearing in Berg v. State ex rel. Wyoming Workers' 
Safety and Comp. Div., 2005 WY 23, ¶ 7, 106 P.3d 867, 870 (Wyo. 
2005):

 
 
In 
appeals where both parties submit evidence at an administrative hearing, Newman mandates that appellate review be 
limited to application of the substantial evidence test.  Newman [v. State ex rel.    
  Wyoming Workers' Safety 
and Comp. Div.], 2002 WY 91, ¶ 22, 49 P.3d 163 [(Wyo. 2002)].  This is true regardless of which party 
appeals from the agency decision.  
In addition, this court is required to review the entire record in making 
its ultimate determination on appeal.  
Newman, at ¶ 19 and ¶¶ 
24-26.

 
 
The 
substantial evidence test to be applied is as follows:

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

 
 

Newman, at ¶ 
12 (quoting State ex rel. Workers' Safety 
and Compensation Div. v. Jensen, 2001 WY 51, ¶ 10, 24 P.3d 1133, ¶ 10 (Wyo. 
2001)).

 
 
Even 
when the factual findings are found to be sufficient under the substantial 
evidence test, Newman further 
concludes this court may be required to apply the arbitrary-and-capricious 
standard as a "safety net" to catch other agency action which prejudiced a 
party's substantial right to the administrative proceeding or which might be 
contrary to the other [Wyoming Administrative Procedural Act] review 
standards.

 
 

Loomer 
v. State ex rel. Wyoming Workers' Safety Comp. Div., 2004 
WY 47, ¶ 15, 88 P.3d 1036, ¶ 15 (Wyo. 2004)

 
 
 
 

DISCUSSION

 
 
Substantial 
Evidence

 
 

[¶11]       
In 
denying benefits for Cramer's cervical spine injury, the hearing examiner 
found:

 
 
The 
record in this case is insufficient to establish that the herniation at C6/7 was 
caused by the industrial accident on October 18, 2002.  It is certainly possible that the disc 
herniation may have been caused or exacerbated by the fall, but the significant 
delay in emergence and reporting of symptoms makes it impossible to sustain the 
Claimant's burden of proof.  

 
 
Cramer 
attacks random factual findings of the hearing officer and asserts that his 
ultimate conclusion is not supported by substantial evidence.  Review by this Court is not limited to 
reviewing Cramer's isolated alleged factual discrepancies.  Rather, this Court is charged with 
reviewing the entire record to determine if substantial evidence supports the 
hearing officer's ultimate determination that Cramer failed to establish his 
cervical spine injury was caused by a work-related injury. 

 
 

[¶12]       
Upon 
review of the entire record, we find the hearing officer's denial of benefits is 
supported by substantial evidence.  
The record reveals Cramer suffered a fractured left foot as a result of a 
work-related injury on October 18, 2002.  
The Division determined the injury was compensable.  In February of 2003, Cramer complained 
of pain in his left knee, which he also attributed to his work injury.  Cramer submitted bills to the Division 
for medical treatment received on his knee. The first indication that the 
Division received from Cramer regarding the cervical spine injury at issue was 
in early September 2003 when the Division received medical bills encompassing 
treatment for that injury.  

 
 

[¶13]       
The 
cervical spine injury manifested itself by way of pain in the neck, left 
shoulder and numbness in the left arm.  
Cramer, his wife (Laura) and his father (Glenn), the only witnesses who 
provided live testimony at the hearing, all testified Cramer first experienced 
those symptoms in late December 2002.  
Cramer testified he reported such symptoms to Dr. Hartog at that time and 
during each subsequent visit.  Dr. 
Hartog's medical records contained detailed notes concerning his treatment of 
Cramer's foot and knee injuries but contained no notations regarding any 
complaints about, or treatment of, neck, shoulder or arm pain or numbness.  In a letter admitted during the hearing, 
Dr. Hartog specifically stated he did not recall any discussions with Cramer 
concerning neck or shoulder problems. 

 
 

[¶14]       
The 
witnesses also recounted specific incidents in April and June of 2003 when 
Cramer complained of pain in his left shoulder and arm.  Cramer and his father testified the pain 
eventually became so unbearable that, on June 27, 2003, Cramer sought treatment 
from a chiropractor, Dr. Max Winkler. Dr. Winkler's records reflected complaints 
by Cramer of pain in his neck, left shoulder and arm.  The intake records indicated Cramer 
attributed the pain to his work injury.  
Cramer also stated on the intake form that he had been experiencing the 
complained of pain for approximately three weeks before the office visit and had 
never previously experienced similar pain.  
Dr. Winkler's notes confirmed Cramer told him the pain began three weeks 
earlier.  Dr. Winkler listed the 
date of injury as June 13, 2003.  
Cramer saw Dr. Winkler only one further time, July 7.  Cramer did not file a claim or report 
with the Division for any treatment received by Dr. Winkler.  

 
 

[¶15]       
Cramer 
did not seek any additional treatment for his neck, shoulder or arm until 
September 2, 2003.  On that date he 
saw Dr. Simpson, an orthopedic spine surgeon.  Cramer reported to Dr. Simpson that he 
was involved in a work-related fall on October 18, 2002, and he subsequently 
developed pain in his neck, left shoulder and arm.  There is no indication as to exactly 
when, "subsequently," Cramer began to experience pain.  An MRI of Cramer's back and neck showed 
a herniated disc at the C6/7 level.  
The bills and the medical records which resulted from Cramer's 
consultations with Dr. Simpson were submitted to the Division.  This is the first notification the 
Division had of any injury of the cervical spine.  

 
 

[¶16]       
At the 
hearing through deposition testimony taken on January 20, 2003, Dr. Simpson 
testified Cramer had suffered a cervical spine injury, his complaints of pain 
and numbness were caused by the herniated disc and nerve impingement at the C6/7 
level, and the herniated disc was most likely caused by a traumatic event, not 
by aging or degenerative disc disease.  
Dr. Simpson stated Cramer provided no information regarding the date of 
the onset of his symptoms.  Based on 
the information provided by Cramer, Dr. Simpson could not pinpoint when Cramer's 
cervical spine injury occurred and, therefore, was unable to offer an opinion as 
to the cause of the injury and whether it was related to Cramer's October 18, 
2002, work-related accident.   
Dr. Simpson opined that it would be unusual for a person with Cramer's 
injury to go nearly a year before making a complaint to a medical provider.  

 
 

[¶17]       
In a 
letter dated January 27, 2004, which was based on a review of Cramer's medical 
records, Dr. Simpson, once again, declined to offer an opinion that Cramer's 
symptoms resulted from the work accident.  
Dr. Simpson found that Dr. Winkler's notes of June 27, 2003, the only 
medical records substantiating Cramer's complaints of pain in his neck, shoulder 
and arm, were "far enough removed from the time of the accident that that [sic] 
cannot be used, in my opinion, to state that his symptoms dated from the time of 
the accident."  Dr. Simpson 
concluded: "If [Cramer] complained of his neck, shoulder and arm pain and/or arm 
numbness soon after the accident, then it is most likely due to the 
accident.  If, however, he did not 
complain of these symptoms until many months after the accident, then that 
correlation cannot clearly be made."  

 
 

[¶18]       
From the 
above evidence, the hearing officer found Cramer had not proved by a 
preponderance of the evidence that his cervical spine injury was work 
related.  Specifically, relying on 
the medical evidence, the hearing officer concluded the evidence was 
insufficient to show a causal connection between the herniated disc and his 
October 18, 2002, work accident.  
The Division received no notification of the herniated disc until early 
September 2003, nearly one year after Cramer's work accident.  Even providing for Cramer's visit to the 
chiropractor towards the end of June 2003, Dr. Simpson stated that, because the 
symptoms arose so far removed from the date of the work accident, he could not 
causally connect the cervical spine problem to that accident.  Although Cramer and his witnesses 
testified that Cramer experienced pain in his neck, shoulder and arm as early as 
late December 2002, the medical records did not support their testimony.  As a finder of fact, the hearing officer 
was entitled to weigh the evidence and resolve any conflicts.  Kuntz-Dexter, 2002 WY 101, ¶ 12, 49 P.3d  
at 193.  Viewing the evidence in its 
entirety, we cannot say the hearing officer's conclusion was not supported by 
substantial evidence.

 
 
 
 
Arbitrary, 
Capricious or Abuse of Discretion

 
 

[¶19]       
Cramer 
alleges that the decision denying benefits was arbitrary, capricious or an abuse 
of discretion.  The primary premise 
of Cramer's argument is that the hearing officer found Cramer and his witnesses 
to be credible, which should inevitably have led to a decision in his favor and 
the granting of benefits.  According 
to Cramer, any other outcome is illogical.

 
 

[¶20]       
After 
thoroughly reviewing the Order, this Court finds no evidence that the hearing 
officer determined that everything Cramer and his witnesses testified about was 
material and truthful.  For 
instance, in discussing Cramer's testimony regarding Cramer's conversations with 
Dr. Hartog, the hearing officer implicitly rejected Cramer's testimony to the 
effect that he specifically complained to Dr. Hartog of pain in his neck and 
shoulder.  Instead, the hearing 
officer was only inclined to believe Cramer had requested Dr. Hartog examine his 
neck and back for evidence of additional injuries.  Such is evidenced by the following two 
paragraphs:

 
 
The fact 
that the Claimant may have asked Dr. Hartog on occasion to examine his back and 
neck and upper extremities for evidence of further injuries, is not the same as 
complaining of significant symptoms.  
Even as late as April of 2003, when Dr. Hartog was still treating the 
Claimant, his records contain no reference to complaints of neck or pain or 
upper extremity symptoms.  

 
 
* * * 
*

 
 
The 
demeanor and manner of the witnesses seemed to be appropriate and 
responsive.  Good eye contact was 
maintained and answers to questions were generally direct, although all 
witnesses showed a tendency to volunteer additional information.  It is difficult to conclude from 
observation of the witnesses that they were willfully misrepresenting 
facts.  However, as noted, a request 
to a physician to perform examinations to rule out problems is not the same as 
demonstrating significant symptoms.  
Lay witnesses may not know how to assign weight to events and 
conditions.  

 
 
 
 

[¶21]       
On other 
issues, the hearing officer indicated he did not believe Cramer's 
testimony:

 
 
If the 
Claimant had truly believed that he had injured his neck, and if he was 
suffering neck or shoulder pain symptoms shortly after the industrial accident, 
he could have communicated this information to his case analyst.  When the Claimant went to see the 
chiropractor, he was suffering great pain.  
If he had truly thought that his injury was work-related, he could, and 
should have reported that to his case analyst or to the chiropractor.[1]  Although the Claimant testified that he 
did talk to his case analyst about his knee injury and perhaps about his other 
symptoms, there was nothing in the record to corroborate this.  The Claimant's analyst is an experienced 
Worker's Compensation analyst who would presumably have made notes if a Claimant 
had complained of additional symptoms.  

 
 
 
 
Thus, 
the Order reflects that, contrary to Cramer's assertions, the hearing officer 
did not find the testimony of Cramer, his wife and his father to be credible in 
all respects.  Consequently, because 
Cramer's initial premise is incorrect, the denial of benefits is not illogical 
on the ground claimed.

 
 

[¶22]       
Cramer 
also alleges that the final determination was arbitrary, capricious or an abuse 
of discretion because the hearing officer found the herniated disc was most 
likely caused by a traumatic event and that nothing in the record suggested the 
disc herniation was caused by anything other than the traumatic fall at 
work.  This theory, however, fails 
to account for the fact that it is Cramer's burden to affirmatively prove a 
causal connection between his herniated disc and the October 18, 2002, work 
accident.  Newman, 2002 WY 91, ¶ 27, 49 P.3d  at 
174.  The Division is not required 
to prove a negative.  Rather, the 
complainant must prove a causal connection by a preponderance of the 
evidence.

  

[¶23]       
In the 
instant case, the hearing officer seemed to agree with Dr. Simpson "that the 
herniated disc was most likely caused by a traumatic event, not by aging or 
degenerative disc disease." The hearing officer, quite correctly, did not 
automatically assume Cramer's work accident was that traumatic event.  Indeed, Dr. Simpson "was unable to offer 
an opinion regarding whether the industrial accident on October 18, 2002, was 
the event which caused trauma to the cervical spine." It was Cramer's burden to 
affirmatively connect the herniated disc to his work accident.  The hearing officer determined Cramer 
failed to prove causation by a preponderance of the evidence.  Reviewing the entire record, this Court 
fails to discern how the hearing officer's determination was arbitrary, 
capricious or an abuse of discretion.

 
 

[¶24]       
In a 
final desperate attempt to get the Order overturned, Cramer alleges the hearing 
officer impermissibly relied upon the absence of notes of the Division's claim 
analyst to raise an inference that Cramer did not report his complaints of neck 
and shoulder pain.  Cramer has not, 
however, presented any indication that any such notes exist.  Cramer's argument is based upon nothing 
more than sheer speculation, and this Court will not consider it 
further.

 
 
 
 
CONCLUSION

 
 

[¶25]       
The 
final determination of the hearing officer is supported by substantial evidence, 
is not arbitrary, capricious or an abuse of discretion.  Affirmed.

 
 
FOOTNOTES

 
 

1Cramer 
complains that Dr. Winkler's records show that he did report that his symptoms 
were due to the work-related accident.  
However, the records are ambiguous in this regard since Dr. Winkler 
listed the date of injury as June 13, 2003.  At any rate, any potential error by the 
hearing officer is harmless given the extent of the other evidence in the 
record.