Title: IN THE MATTER OF THE WORKER'S COMPENSATION CLAIM OF: HAL S. ALCORN V. SAUER DRILLING COMPANY and STATE OF WYOMING, ex rel., WYOMING WORKERS' SAFETY AND COMPENSATION DIVISION

State: wyoming

Issuer: Wyoming Supreme Court

Document:

Wyoming  Wyoming Supreme Court Cases

Cite as: 2006 WY 15, 126 P.3d 924

OCTOBER TERM, 
A.D. 2005

 
 
IN THE MATTER OF 
THE WORKER'S

COMPENSATION 
CLAIM OF:

 
 
HAL S. 
ALCORN,

 
 
Appellant

(Employee/Claimant),

 
 
v.

 
 
SAUER DRILLING 
COMPANY,

 
 
Appellee

(Employer/Respondent),

 
 
and

 
 
STATE OF 
WYOMING, ex rel., WYOMING

WORKERS' SAFETY 
AND COMPENSATION

DIVISION,

 
 
Appellee

(Objector/Respondent).

 
 
Appeal from the DistrictCourtofSweetwaterCounty

The Honorable Jere Ryckman, 
Judge

 
 
Representing 
Appellant:

Donald J. Rissler, of Rissler & 
Gosar & Bundy, LLC, Riverton, Wyoming.

 
 
Representing 
Appellees:

Stephenson D. Emery, of Williams, 
Porter, Day & Neville; Patrick J. Crank, 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.

 
 
BURKE, 
Justice.

 
 
[¶1]       In this 
worker's compensation appeal, Mr. Alcorn challenges the denial of his claim for 
retroactive temporary total disability (TTD) benefits.  We affirm.

 
 

ISSUE

 
 
[¶2]       We restate 
the issue as:

 
 
Did the hearing officer err in 
denying Mr. Alcorn's claim for TTD benefits because Mr. Alcorn failed to comply 
with applicable filing requirements?

 
 
FACTS

 
 
[¶3]       On October 
10, 2001, Mr. Alcorn sustained a left shoulder injury while working for Sauer 
Drilling Company (Sauer Drilling).  
He reported the incident to his employer, but did not initially file a 
claim with the Wyoming Workers' Safety and Compensation Division 
(Division).  He continued to 
experience left shoulder pain, but maintained his employment with Sauer 
Drilling.  On February 15, 2002, Mr. 
Alcorn sought medical treatment for his injury with Dr. Mark Grossnickle who 
ultimately diagnosed Mr. Alcorn's injury as a torn rotator cuff.  Mr. Alcorn did not return to work with 
Sauer Drilling after February 15, 2002.  
In late February 2002, his employment with Sauer Drilling was terminated 
for reasons unrelated to the injury.

 
 
[¶4]       Mr. Alcorn 
filed a claim for worker's compensation benefits with the Division on June 27, 
2002.  The claim was denied on the 
basis that it was untimely.  The 
Division subsequently reconsidered its position and awarded benefits on October 
1, 2002.  Sauer Drilling objected to 
the Division's award.  A contested 
case hearing was held on March 4, 2003, to determine whether Mr. Alcorn's claim 
was timely filed and whether he suffered a compensable injury.  The Office of Administrative Hearings 
(OAH) upheld the Division's determination and awarded benefits to Mr. 
Alcorn.  

 
 
[¶5]       After the 
determination in his favor, Mr. Alcorn sought TTD benefits.  He filed TTD certifications, signed by 
Dr. Grossnickle, dated April 18, 2003, and May 20, 2003.  The Division approved TTD benefits for a 
two-month period.  Mr. Alcorn 
challenged this determination and claimed that he was owed retroactive TTD 
benefits from February 2002 through April 2003.  A contested case hearing was held before 
the OAH.  The OAH denied Mr. 
Alcorn's claim.  The district court 
affirmed the decision of the OAH.  
This appeal followed.

 
 
STANDARD OF 
REVIEW

 
 
[¶6]       The 
interpretation and correct application of the provisions of the Wyoming Worker's 
Compensation Act are questions of law.  
We apply a de novo standard 
when reviewing questions of law.  Sheth v. State ex rel. Wyo. Workers' 
Compensation Div., 11 P.3d 375, 378-79 (Wyo. 2000).  "Conclusions of law made by an 
administrative agency are affirmed 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."  
Bailey v. State ex rel. Wyo. Workers' Safety and 
Compensation Div., 2002 WY 145, ¶ 9, 55 P.3d 23, 26 (Wyo. 2002) 
(internal citations omitted) (quoting State ex rel. Workers' Safety and 
Compensation Div. v. Garl, 2001 WY 59, ¶ 9, 26 P.3d 1029, 1032 (Wyo. 
2001)).  We review this case as if 
it had come directly to this Court from the agency and do not afford any 
deference to the district court's decision.  Bailey, ¶ 6. 

 
 
DISCUSSION

 
 
[¶7]       Temporary 
total disability is defined as "that period of time an employee is temporarily 
and totally incapacitated from performing employment at any gainful employment 
or occupation for which he is reasonably suited by experience or training. The 
period of temporary total disability terminates at the time the employee 
completely recovers or qualifies for benefits under W.S. 27-14-405 or 
27-14-406."  Wyo. Stat. Ann. § 
27-14-102(a)(xviii) (LexisNexis 2001). The purpose of temporary total disability 
benefits is "to provide income for an employee during the time of healing from 
his injury and until his condition has stabilized."  Pacific Power and Light v. Parsons, 692 P.2d 226, 228 (Wyo. 1984).  As the claimant, Mr. Alcorn bears the 
burden of proving his entitlement to worker's compensation benefits by a 
preponderance of the evidence.  He 
also must establish his compliance with the rules and procedures set forth in 
the Wyoming Worker's Compensation Act.  
Pittman v. State ex rel. 
Wyo. Workers' Compensation Div., 917 P.2d 614, 617 (Wyo. 
1996).  

 
 
[¶8]       The 
procedural requirements for obtaining TTD benefits are set forth in Wyo. Stat. 
Ann. § 27-14-404 (LexisNexis 2001) which provides in pertinent 
part:

 
 

(a)                             
If after 
a compensable injury is sustained and as a result of the injury the employee is 
subject to temporary total disability as defined under W.S. 27-14-102(a)(xviii), 
the injured employee is entitled to receive a temporary total disability award 
for the period of temporary total disability as provided by W.S. 27-14-403(c). . 
. .

 
 
. . . 

(d)        . . . Benefits under subsection (a) of this 
section shall not be paid if:

   (i)      An employee or 
his personal representative fails to file a claim for benefits within thirty 
(30) days after the first day immediately succeeding the first thirty (30) days 
of any certified period of temporary total disability;

 
 

   (ii)     A claim is filed 
without the signature of the claimant and certification by the attending health 
care provider[.]

 
 
(Emphasis 
added.)

 
 
[¶9]       The rules 
and regulations governing TTD benefits also require timely filing of a properly 
certified claim.  They provide in 
pertinent part:

 
 
Claim for Temporary Total Disability 
(TTD) Benefits (Lost Wages).

 
 

(i)                   
When 
Submitted.  A claim for TTD must be 
filed within 60 days after the first day of certified temporary total 
disability.  W.S. § 
27-14-404(d).

 
 

(ii)                 
Certification.  An award of TTD cannot be made without 
certification from a treating health care provider that the worker is 
temporarily and totally disabled (that is, incapacitated from performing any 
gainful employment for which the worker is reasonably suited by experience or 
training).  The certification shall 
specify the reasons for the total disability and the expected period of 
disability.

 
 
Wyoming Workers' Safety and 
Compensation Division, Rules, Regulations and Fee Schedules, ch. 5, § 4(b)(i) 
and (ii).  Thus, in order to be 
entitled to TTD benefits, a claimant must: (1) obtain a treating healthcare 
provider's certification that he is temporarily totally disabled; and (2) file 
the claim for TTD benefits within sixty (60) days of the first day of certified 
disability.

 
 
[¶10]     At the contested case 
hearing, Mr. Alcorn conceded that, for the time period in dispute, he did not 
file a TTD claim within 60 days of the first day of certified disability.  He contended, however, that he was 
excused from compliance with the statutory filing requirements because his case 
was "pending before the Division as a contested case."  Mr. Alcorn relied upon our holding in State ex rel. Wyo. Workers' Safety and 
Compensation Div. v. Gerdes, 951 P.2d 1170 (Wyo. 1997) in support of his 
position.  The hearing examiner 
concluded that Gerdes did not excuse 
Mr. Alcorn's noncompliance with the filing requirements and denied Mr. Alcorn's 
claim.  In his Order Denying 
Benefits, the hearing examiner explained his reasoning: 

 
 

5.       
In order 
to qualify for TTD benefits, Alcorn's physician must certify or re-certify 
Alcorn at intervals not less than 60 days.  
Wyo. 
Stat. Ann. § 27-14-404(g) (LEXIS 2001).  
Alcorn must also file a claim for TTD with his signature and that of his 
physician's within 30 days after the first day immediately succeeding the first 
30 days of any certified period.  
Wyo. Stat. Ann. § 27-14-404(d)(i) and (ii) (LEXIS 2001).  By filing his first TTD application in 
April 2003, Alcorn failed to comply with the filing requirements in the TTD 
statutes and is not eligible for retroactive TTD benefits from February 2002 
through April 2003.  Nor is Alcorn's 
May 21, 2003 certification attempting to certify a period from October 2002 
through April 2003 a proper certification as it attempts to certify a six month 
rather than a 60 day period as required by statute.

 
 

6.       
In order 
for TTD benefits to revert back to February 2002, Alcorn's physician needed to 
certify Alcorn in March 2002 and re-certify Alcorn for 60-day intervals 
thereafter.  Prior to a timely 
certification, the Division issued a series of Final Determinations beginning in 
July 2002 and culminating in Alcorn's objection in August 2002.  Alcorn had not been certified for TTD 
benefits prior to his August 2002 objection.  In State Ex Rel. Workers' Compensation Division 
v. Gerdes, 951 P.2d 1170, 1175 (Wyo. 1997), the claimant had been receiving 
TTD benefits when the Division issued a Final Determination terminating those 
benefits.  Gerdes did not file TTD applications 
during the pendency of her hearing on continued entitlement to TTD 
benefits.  The Wyoming Supreme Court 
held the "application of the procedural requirements found in Article 4 of the 
Wyoming Worker's Compensation Act during the pendency of a contested case does 
not further efficient service to an injured claimant, but rather prevents a 
meritorious claim from being decided based on the merits of the case."  Unlike Gerdes, Alcorn had no certifications 
filed prior to or during the pendency of the contested case.  Unlike Gerdes Alcorn was not seeking continuous 
benefits during the pendency of the proceedings.  Alcorn was not relieved of his duty to 
file an initial TTD certification prior to the contested case hearing in order 
to be relieved of his statutory duty to timely file for those 
benefits.

 
 
[¶11]     In Gerdes, the employee sustained a 
work-related injury in November 1993.  
 Gerdes, 951 P.2d  at 1172.  The employee promptly filed TTD 
certifications and the Division approved the benefits from the time of her 
injury until June 7, 1995.  
Id.  In June 1995, the Division terminated 
TTD benefits because, in its opinion, the employee had reached maximum medical 
improvement.  Id.  The employee appealed this 
determination.  Id.  While the appeal was pending, the 
employee failed to re-certify for TTD benefits.  Id. 
at 1173.  The OAH determined that 
the employee had not reached maximum medical improvement and, despite the 
employee's noncompliance with the re-certification requirements, awarded the 
employee retroactive benefits for the time during which the appeal had been 
pending.  Id.  

 
 
[¶12]     We affirmed the OAH's 
ruling and held that Wyo. Stat. Ann. § 27-14-404(d) (LexisNexis 2001) allows an 
award of retroactive TTD benefits despite noncompliance with the statute during 
the pendency of an appeal regarding the termination of TTD benefits.  Id. 
at 1175.  In so holding, we noted 
that Wyo. Stat. Ann. § 27-14-404(d) is silent regarding whether its procedural 
requirements "apply after benefits 
are terminated and the claimant awaits a contested case hearing."  Id. 
at 1174 (emphasis added).  We 
examined the legislative purpose served by the procedural requirements for 
certification and determined that they exist to allow the Division an 
opportunity to effectively monitor entitlement to TTD benefits.  Id.  We held that the requirements did not 
apply to the period following a termination of TTD benefits, because "no number 
of filings or certifications will reinstate the benefits or allow the 
claim to be heard on its merits."  
Id. (emphasis added).  We stated that a strict application of 
the statute was unnecessary because it "would serve only to burden a claimant 
with the attendant costs of continued certification, even though 
the Division has predetermined that these costs are not compensable."  Id. 
at 1175 (emphasis added).

 
 
[¶13]     The facts regarding Mr. 
Alcorn's claim for TTD benefits are distinguishable from those presented in Gerdes.  Mr. Alcorn's claim for retroactive TTD 
benefits is a claim for initial TTD benefits.  It is not a claim for a continuation of 
TTD benefits as was present in Gerdes.  The applicable statutes and rules are 
not silent regarding the procedural requirements which must be met by a claimant 
for an initial award of TTD benefits.  
The unambiguous language of the pertinent statutes and rules requires 
timely filing of the TTD claim and certification by a healthcare provider.  A claimant's failure to file a timely 
claim limits the Division's opportunity to effectively monitor and evaluate a 
claimant's entitlement to TTD benefits.  
The failure to properly file an initial TTD claim also undermines an 
employer's right to offer light duty work to the employee in lieu of TTD 
benefits.1

 
 
[¶14]     Based upon the 
foregoing, the OAH properly denied Mr. Alcorn's claim for retroactive TTD 
benefits on the basis that Mr. Alcorn failed to file a timely TTD claim properly 
certified by one of his healthcare providers for the time period at issue.  The OAH and the district court correctly 
concluded that our decision in Gerdes 
did not excuse Mr. Alcorn's failure to comply with the filing requirements for 
TTD benefits.

 
 
[¶15]     
Affirmed.

 
 

FOOTNOTES

  1Wyo. Stat. Ann. § 
27-14-404(j) (LexisNexis 2001) provides: