Title: Matter of Worker's Compensation Claim of Hemme

State: wyoming

Issuer: Wyoming Supreme Court

Document:

Matter of Worker's Compensation Claim of Hemme1996 WY 53914 P.2d 824Case Number: 95-144Decided: 04/10/1996Supreme Court of Wyoming

In 
the Matter of the WORKER'S COMPENSATION CLAIM OF DONNA L. HEMME, an Employee of 
Memorial Hospital of Carbon County:

 

DONNA L. HEMME, 

Appellant (Claimant), 

 

v. 

 

STATE OF WYOMING, ex rel.,  

WYOMING WORKERS' COMPENSATION 
DIVISION,  

Appellee (Respondent).

 

Appeal 
from the District Court of Natrona County 

Honorable 
Dan R. Spangler, Judge.

 

Representing 
Appellant: 

Richard E. Kraemer, Kraemer & Associates, P.C., 
Fort Collins, Colorado. 

Representing 
Appellee: 

William U. Hill, Attorney General; John W. Renneisen, 
Deputy Attorney General; Jennifer A. Evans, Assistant Attorney General, 
Cheyenne, Wyoming.

 

Before THOMAS, MACY, 
TAYLOR and LEHMAN, JJ. and STEBNER, D.J.

STEBNER, District 
Judge. 

[¶1]      We review the 
district court's order affirming an award of worker's compensation benefits for 
appellant Donna L. Hemme. Hemme suffered a back injury in the course and scope 
of her employment, as well as complications arising out of that injury. The 
central issues concern the percentage of Hemme's permanent partial disability 
and the delinquency of the Worker's Compensation Division in paying claims which 
have been ordered to be paid.

 

[¶2]      We 
affirm.

 

[¶3]      Hemme poses these 
issues:

 

I. Did the District Court err in its refusal to 
remand to the Workers' Compensation Division for the taking of further evidence 
where the Claimant objected to reliance upon an outdated and incomplete 
vocational evaluation and disability rating and the division had failed to 
provide a second opinion?

II. Did the District Court err in failing to reverse 
the decision of the Administrative Law Judge in his denial of Appellant's 
request to change physicians and order payment for medical care providers 
located outside of Wyoming?

III. Was the decision of the Administrative Law Judge 
arbitrary and capricious where the Judge ordered the division to delay payment 
of the Appellant's health care providers until after Appellant had proved that 
Appellant had submitted those expenses to her husband's employer's health 
insurance provider and that those bills had not been paid?

IV. Did the Administrative Law Judge and the District 
Court Judge err in denial of payment for prescription medicines Desipramine and 
Klonopin?

V. Did the District Court err in ordering the 
Appellant to pay from her own resources her attorneys fees expense related to 
the appeal to the District Court upon the sole ground that she had not prevailed 
in having the Administrative Law Judge's decision 
reversed?

 

[¶4]      The Division 
restates this set of issues:

 

A. Whether the district court properly denied 
Claimant's motion for leave to present additional evidence under Rule 12.08 of 
the Wyoming Rules of Appellate Procedure.

B. Whether the record contains substantial evidence 
to support the hearing examiner's permanent partial disability 
award.

C. Whether the Supreme Court has jurisdiction to 
review any provisions of the January, 1993 order from which no notice of appeal 
was filed.

D. Whether the hearing examiner's denial of medical 
benefits was in accordance with law.

E. Whether the Supreme Court has jurisdiction to 
review the district court order denying payment of attorney's fees, from which 
order no notice of appeal was filed.

 

[¶5]      Hemme was injured 
while in the course and scope of her employment on May 29, 1989. An award of 
benefits was made after hearing before an administrative hearing examiner. Hemme 
took an appeal from that award, but it eventually was dismissed with prejudice 
on December 6, 1993, a result to which Hemme stipulated. Based upon her further 
application for vocational benefits, a contested case hearing was held on 
October 10, 1994. On November 7, 1994, a second hearing examiner issued an order 
awarding benefits to Hemme which contained, in principal part, a finding that 
she suffered a permanent partial disability of 37%, whole body. Hemme sought 
review of that order awarding benefits in the district court. The district court 
affirmed the award. Hemme now seeks further review of the matter 
here.

 

[¶6]      As a preface, we 
observe that Hemme's claims for benefits were complex and difficult to sort out. 
Counsel on both sides have exacerbated those problems by inattentiveness to 
detail and petty squabbling. The Division has neglected to scrutinize the 
hearing examiners' awards of benefits with the care and probity required in a 
difficult case. Against this background, we affirm the orders awarding 
benefits.

 

[¶7]      The first issue 
Hemme advances arises because the district court did not grant Hemme's motion to 
remand this matter to the administrative hearing examiner for additional 
evidence in accordance with WYO.R.APP.P. 12.08. Rule 12.08 requires that one 
applying to present additional evidence demonstrate that the additional evidence 
relates to a material issue and that there was good cause for failing to present 
such evidence at the original hearing. Harris v. Sinclair Trucking, 900 P.2d 1163, 1166-67 (Wyo. 1995). We are satisfied that the additional evidence Hemme 
sought to present (a second vocational evaluation) was material to her cause. 
However, we are unable to agree with her that good cause exists for failure to 
present that additional evidence at the original hearing. We are satisfied from 
our review of the record1 that Hemme failed to demonstrate 
good cause to present the additional evidence.

 

[¶8]      The central 
element of Hemme's argument is WYO. STAT. § 27-14-405(m) (Supp. 1995),2 which provides: "If the percentage 
of physical impairment is disputed, the division shall obtain a second opinion 
and if the ratings conflict, shall determine the physical impairment award upon 
consideration of the initial and second opinion." Appellant did not put much 
effort into explicating the record in this case. It is a voluminous record, 
filling a 12" x 10" x 15.5" banker's box. As a statement of facts we have little 
more than an unedited quotation from the January 1993 Order Awarding Benefits. 
Our review of the record convinces us that WYO. STAT. § 27-14-405(m) was not 
applicable under the circumstances presented by this case, but even if it was 
applicable, it appears to have been observed.

 

[¶9]      As a second point 
of argument, Hemme contends that her diagnosis of fibromyalgia syndrome was 
ignored in the only vocational assessment which was done. That contention is not 
supported by the record. Although the word "fibromyalgia" is not used in the 
report, it is clear that the vocational assessor had access to all of Hemme's 
medical records, as well as interviewing Hemme in person. We hold the district 
court was correct in refusing to remand to the administrative hearing examiner 
for taking additional evidence because Hemme failed to demonstrate good cause 
for her failure to have presented such evidence at the initial hearing, as well 
as because her contention that a second opinion was required was not so much as 
mentioned at the administrative hearing.

 

[¶10]   Hemme next contends that the order 
awarding benefits entered in January 1993 denied her constitutional rights to 
interstate travel, as well as rights to equal protection of the laws, because 
the hearing examiner denied her request to change physicians to an out-of-state 
physician or to order payment for medical care providers which the Worker's 
Compensation Division had not otherwise approved. Those matters were appealed to 
the district court and, pursuant to a stipulation of the parties that appeal was 
dismissed. In essence, no appeal was taken from that order, and consideration of 
those matters is now barred by principles of res judicata and collateral 
estoppel. We will not consider them in this appeal, which is from the November 
1994 order awarding benefits. See Slavens 
v. Board of County Commissioners, 854 P.2d 683, 686-87 (Wyo. 1993); Stockdale v. Transystems Services, Inc., 
908 P.2d 980, 983 (Wyo. 1995).

 

[¶11]   Hemme also contends that the 
condition imposed by the administrative hearing examiner in his January 1993 
order, which required Hemme, in some instances, to submit her claims to a 
private insurance carrier before worker's compensation would be obligated to pay 
them is arbitrary, capricious and contrary to law. This matter is also res 
judicata, and we will not further consider it in this appeal, except as more 
fully explained below.

 

[¶12]   Counsel for Hemme contends the 
district court erred in denying his motion for payment of attorney's fees for 
the appeal in the district court. The district court's order states that the 
reason for denying those fees is that Hemme did not prevail. The district court 
is awarded considerable discretion in awarding attorney's fees under WYO. STAT. 
§ 27-14-615 (Supp. 1995).3 Lebsack v. Town of Torrington, 698 P.2d 1141, 1148-49 (Wyo. 1985). We do not view counsel's failure to have separately 
appealed the order denying an award of attorney's fees to be fatal to 
consideration of this issue, nor do we condone the district court's use of the 
"did not prevail" language in the order denying an award of attorney's fees.4 However, counsel's only contention 
is that the district court could not order Hemme to pay the attorney's fees from 
her own resources. The district court did not issue any such order.5 No other cogent argument or 
pertinent authority is presented in this regard and we will not consider the 
matter further. Beaudoin v. Kibbie, 
905 P.2d 939, 941 (Wyo. 1995).

 

[¶13]   Hemme contends that medical bills 
which have been ordered to be paid, have not been paid. These items were 
specifically discussed in the administrative hearing examiner's order of 
November 7, 1994: (1) Carbon County Counseling Center, $240.00, unless already 
paid; (2) all sums due Centennial Peaks Hospital for treatment of Hemme which 
have not already been paid by worker's compensation or private insurance; (3) 
reimbursement to Hemme for the cost of a hot tub (this may be accomplished by 
the Division making the arrangements for purchase and installation of the hot 
tub, rather than by reimbursement - the critical factor is that the hot tub 
conform to the physician's prescription);6 (4) Dr. Walter Winslow's bill for 
$250.00, unless already paid; and (5) Dr. Wayne F. Phillips' bills totaling 
$400.00, unless already paid. The Division shall ensure that these items are 
promptly and exactingly paid. If portions of the bills have been paid by private 
insurance, the Division only needs to pay the unpaid portion. The costs of all 
medical care provided by any other health care providers, which have been 
adjudicated to arise from her work-related injuries, shall be promptly and 
exactingly paid by the Division without certification by Hemme that they have 
been submitted to private insurance carriers.7 The Division shall carefully review 
Hemme's file to ensure that all benefits ordered by the hearing examiners are 
paid. In this regard, all orders of the hearing examiners are the law of this 
case and are affirmed in all respects.

 

[¶14]   Because we find no reversible error 
and hold the orders of the hearing examiners to be supported by substantial 
evidence, we affirm in all respects.

 

Footnotes

1 We take note at this juncture that 
counsel for the appellant, who is admitted to the Wyoming State Bar, but is not 
a resident practitioner, failed to comply with the Wyoming Rules of Appellate 
Procedure in many respects, both in the district court and in this Court. None 
of those failings are fatal to this appeal, but we do remind nonresident members 
of the Bar that such failings may result in dismissal of an appeal, or other 
sanctions. It seems it should hardly need mentioning, but apparently it does: 
When practicing in Wyoming courts, nonresident practitioners must follow the 
court rules applicable in this state, rather than their state of 
residence.

2 This subsection was denoted § 
27-14-405(e) at the time of the proceedings before the hearing 
examiner.

3 Although amended since these 
proceedings were completed, for purposes of this appeal the language of the 
statute prior to the amendment does not make a 
difference.

4 The district court directed that 
Hemme's counsel prepare the order denying benefits and the offending language 
was placed in that order by Hemme's counsel.

5 Indeed, the implicit finding of the 
district court was that counsel's services were, in essence, of no value to the 
district court or to the client.

6 The hot tub was prescribed by Hemme's 
attending physician as a treatment for back pain. We will emphasize in this 
footnote that the record demonstrates that Hemme's medical conditions were very 
real, that she was very cooperative in her treatments, including work hardening 
programs to deal with pain, and that the use of a hot tub was prescribed as a 
medical, not a recreational, treatment.

7 As a part of our decision, we also 
affirm the hearing examiner's direction to the Division contained in footnote 1, 
, of the November 7, 1994 decision 
letter.