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

State: wyoming

Issuer: Wyoming Supreme Court

Document:

APPLEBY v. WYOMING WORKERS' SAFETY AND COMPENSATION DIVISION2002 WY 8447 P.3d 613Case Number: 00-273Decided: 06/05/2002
 APRIL TERM, A.D. 2002

 

                                                                                                            

 

IRENE 
AAKER APPLEBY, 

Appellant(Petitioner),

 

v.

 

STATE OF 
WYOMING, ex rel., WYOMING

WORKERS' 
SAFETY AND COMPENSATION

DIVISION, 

Appellee(Respondent).

 

Appeal 
from the District Court of Natrona County

The 
Honorable David B. Park, Judge 

 

Representing 
Appellant:

David A. 
Drell of Vlastos, Brooks, Henley & Drell, P.C., Casper, Wyoming.

Representing 
Appellee:

Gay 
Woodhouse, Wyoming Attorney General; John W. Renneisen, Deputy Attorney General; 
Gerald L. Laska, Senior Assistant Attorney General; David L. Delicath, Assistant 
Attorney General.

 

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

GOLDEN, 
Justice. 

[¶1]           
Appellant 
Irene Aaker Appleby (Appleby) challenges a decision by the Appellee Department 
of Employment Workers' Safety and Compensation Division's (Division) Internal 
Hearing Unit (IHU) that she did not file a timely request for hearing from the 
Division's final determination denying benefits.  Before the IHU, Appleby contended that 
the Division was equitably estopped from denying her a contested case hearing 
for failure to timely file, and the hearing examiner for the IHU initially 
agreed with that contention and recommended a contested case hearing.   The Division objected to that 
recommendation, and the matter was referred to the Interim Director of the 
Department of Employment (Director) who concluded that equitable estoppel did 
not apply, and denied Appleby a contested case hearing.

 

[¶2]           
We 
reverse and remand for a contested case hearing before the appropriate hearing 
authority, either the Office of Administrative Hearings or the Medical 
Commission, in accordance with Wyo. Stat. Ann. § 27-14-601(k)(v).  

 

 

ISSUES

 

[¶3]           
Appleby 
presents these issues for our review:

 

1.  Whether the Final Agency Order issued by 
the Interim Director of the Department of Employment, State of Wyoming rejecting 
the Hearing Officer's Report and Recommended Findings of Fact, Conclusions of 
Law, and Order dated December 14, 1999 was arbitrary, capricious, and an abuse 
of discretion, or otherwise not in accordance with law.

 

2.  Whether the July 19, 2000 Order 
Affirming Agency Decision of the Seventh Judicial District was arbitrary, 
capricious, and an abuse of discretion and otherwise not in accordance with 
law.

 

The 
Division rephrases the issues:

 

I.  Does equitable estoppel excuse 
Appellant's failure to file a timely objection to the Division's final 
Determination?

 

II. Did 
Appellant establish all the elements of her claim for equitable 
estoppel?

 

 

 

 

FACTS

 

[¶4]           
Appleby 
has been a checker for Safeway for twenty-five years.  While performing those duties, Appleby 
began to experience aching wrists and arms and sought medical attention. She was 
treated conservatively and continued to work.  In April of 1999, her doctors informed 
her that she would need surgery and would miss twelve to fourteen weeks of work. 
Her medical insurer informed her that worker's compensation benefits were 
available, and Appleby filed an injury report.  In the small box on the report form that 
asked for date of injury, Appleby wrote October 26, 1998.  In the small box asking time of injury 
and time of shift, Appleby wrote "n/a." 

 

[¶5]           
On April 
20, 1999, the Division issued its final determination letter informing her it 
had denied benefits for these reasons:

 

Your 
claim for benefits was not filed within the statute of limitations pursuant to 
Wyoming Statute 27-14-503(a).

 

The 
burden of proof in contested cases involving injuries which occur over a 
substantial period of time is on the employee to prove by competent medical 
authority that his/her claim arose out of and in the course of his/her 
employment and to prove by a preponderance of evidence 
that:

a.  There is a direct causal connection 
between the condition or circumstances under which the work is performed and the 
injury.

b.  The injury can be seen to have followed 
as a natural incident of the work as a result of the employment. 

c.  The injury can fairly be traced to the 
employment as a proximate cause.

d.  The injury does not come from a hazard 
to which employees would have been equally exposed outside of the 
employment.

e.  The injury is incidental to the 
character of the business and not independent of the relation of employer and 
employee.  (Wyoming Statute 
27-14-603(a)).

 

Definition 
of injury does not include:  Any 
injury resulting primarily from the natural aging process or from the normal 
activities of day-to-day living, as established by medical evidence supported by 
objective findings.  (Wyoming 
Statute 27-14-102(a)(xi)(G)).

 

The 
burden is on the claimant to prove each essential element of his or her claim by 
a preponderance of the evidence.

 

Either 
the injured worker or the employer may object to this determination and request 
a hearing.  Affected parties have a 
right to a hearing before a hearing examiner as provided by the Wyoming Workers' 
Compensation Act and to legal representation.  We must receive a written request, 
stating your reason(s) for objecting on or before 5-14-99.  If a timely written request for hearing 
is not filed with this division, the final determination by the Division 
pursuant to W.S. 27-14-601(k) shall not be subject to further administrative or 
judicial review.

 

If there 
are any questions, please contact me at (307)777-5677.

 

The 
letter was signed by the claims analyst.  
Appleby had not filed a claim before, and, before the May 14, 1999, 
deadline passed, Appleby's husband called the claims analyst and asked why 
benefits had been denied.  According 
to Mr. Appleby, the claims analyst explained that October 26, 1998, was a 
significant date, and while the final determination could be appealed, it would 
be useless because the October 26, 1998, date meant that it was filed too late 
to be approved.  The claims analyst 
testified that he did recall speaking with Mr. Appleby on one occasion, but did 
not specifically recall this conversation.  
He guessed that he would have explained the need for an appeal.  During examination at the hearing, the 
claims analyst admitted that he handles several hundred cases at any given time 
and spends a great deal of time on the phone answering questions similar to 
those posed here.  He stated that he 
would have explained to Appleby that the Division's rationale for denying 
benefits here was essentially that her injury report was untimely, and her 
injury was a pre-existing condition. 

 

[¶6]           
On 
September 8, 1999, the Division received Appleby's written request for a 
hearing.  The Division sent her 
notice that she was no longer entitled to a hearing because her response was 
late; however, she could object to the finding that her response was late and 
request a hearing only on that particular determination.  Appleby did request a hearing, and the 
matter was set before the IHU.  

 

[¶7]           
The 
IHU's hearing examiner heard evidence from both Appleby and the claims analyst 
concerning statements made during the telephone conversation.  Appleby testified that the claims 
analyst informed her agent that it would be fruitless to request a hearing 
because her injury report was untimely.   Based on this conversation, 
Appleby did not request a hearing by the deadline.  After the deadline had passed, Appleby 
consulted an attorney who requested a hearing on the final determination's 
denial of benefits.   The 
hearing examiner concluded that the claims analyst's misleading statement 
regarding the futility of Appleby's objection to the final determination, 
although unintentional, was sufficient to constitute estoppel and prevent the 
Division from invoking untimeliness as the basis for denying a hearing.  The hearing examiner cited Bauer v. 
Workers' Compensation Div., 695 P.2d 1048, 1053 (Wyo. 1985), as authority 
for this conclusion. 

 

[¶8]           
The 
Director reversed and issued a final order that made credibility determinations 
and concluded that equitable estoppel principles did not apply to the particular 
facts of the case.  The Director 
ruled that Appleby's request for a contested case hearing on the final 
determination must be denied as untimely.  
On review by the district court, that court determined that by statutory 
amendment an equitable estoppel defense was no longer available to a claimant, 
and the district court affirmed the Director's final order.  This appeal 
followed.

 

 

 

 

[¶9]           
When 
reviewing an administrative order, we are not compelled to accept any of the 
conclusions reached by the district court, and will review the case as if it had 
come directly to this Court from the agency.  Howton v. State ex rel. Wyo. Worker' 
Comp. Div., 899 P.2d 869, 870 (Wyo. 1995).   Although W.R.A.P. 12.09 generally 
confines review to the issues set forth in the petition and raised before the 
agency, jurisdictional issues may be considered at any time.  Wyo. Workers' Comp. Div. v. 
Summers, 987 P.2d 153, 156 (Wyo. 1999).  

 

The 
interpretation and correct application of the provisions of the Wyoming Workers' 
Compensation Act is a question of law over which our review authority is 
plenary.  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.

 

Wright 
v. State ex rel. Wyoming Worker' Safety and Compensation Div., 952 P.2d 209, 211 (Wyo. 1998) (citations omitted).

 

[¶10]       
Our 
well-established rules of statutory interpretation were recently summarized to 
be:

 

We decide initially whether the 
statute is clear or ambiguous.  This 
Court makes that determination as a matter of law.  If we determine that a statute is clear 
and unambiguous, we give effect to the plain language of the statute.  In effectuating the plain language of 
the statute, we begin by making an inquiry respecting the ordinary and obvious 
meaning of the words employed according to their arrangement and 
connection.  We construe the statute 
as a whole, giving effect to every word, clause, and sentence, and we construe 
together all parts of the statute in pari materia.  If, on the other hand, we determine that 
the statute is ambiguous, we resort to general principles of statutory 
construction to determine the legislature's intent.  

 

Wyo. 
Dept. of Transportation v. Haglund, 982 P.2d 699, 701 (Wyo. 1999) (citations and quotations 
omitted).

 

 

 

[¶11]       
Any 
interested party may request a hearing before a hearing examiner on the final 
determination of the Division by filing a written request for hearing with the 
Division within fifteen days after the date the notice of the final 
determination was mailed by the Division.  
Wyo. Stat. Ann. § 27-14-601(k)(iv) (LexisNexis 2001).   If timely written request for 
hearing is not filed, the final determination is not subject to further 
administrative or judicial review.  
Wyo. Stat. Ann. § 27-14-601(k)(vi) (LexisNexis 2001).  That does not mean, however, that the 
Division's determination on the timeliness of a request for hearing is not 
reviewable.  Scheneman v. Div. of 
Workers' Safety and Comp., 956 P.2d 344, 351 (Wyo. 1998).   Indeed, Scheneman went on 
to review such a timeliness decision.

 

[¶12]       
The term 
"final determination" has a specialized meaning under subsection 601(k), which 
states:  

 

(k) 
Determinations by the division pursuant to this section and W.S. 27-14-605 shall 
be in accordance with the following:

 

            
(i) The initial review of entitlement to benefits pursuant to subsections 
(a) and (e) of this section shall be made by the division within fifteen (15) 
days after the date the injury report or claim is filed.  Following initial review, the division 
shall issue a final determination or if a final determination cannot be made 
based upon available information at that time, the division may issue a request 
for additional information as necessary;

            
(ii) Following issuance of a request for additional information under 
paragraph (k)(i) of this section, the division shall investigate the matter and 
issue its final determination within forty-five (45) days after issuing the 
request;

            
(iii) Notice of a final determination issued by the division under this 
subsection shall include a statement of reasons and notice of the right to a 
hearing;

            
(iv) Any interested party may request a hearing before a hearing examiner 
on the final determination of the division by filing a written request for 
hearing with the division within fifteen (15) days after the date the notice of 
the final determination was mailed by the division.  If the division has not rendered a final 
determination within sixty (60) days following the date the claim was filed, any 
interested party may request a hearing before a hearing examiner in the manner 
prescribed by this paragraph.  If 
the written request for hearing is sent to the division by certified or 
registered mail, postage prepaid, return receipt requested, proof of such 
mailing within the time provided by this subsection with a receipt signed by an 
agent of the state of Wyoming shall be presumed to be timely filing of the 
request with the division;

            
(v) Upon receipt of a request for hearing, the division shall immediately 
provide notice of the request to the appropriate hearing authority as determined 
pursuant to W.S. 27-14-616[.]

 

Wyo. 
Stat. Ann. § 27-14-601(k) (LexisNexis 2001).

 

[¶13]       
Following 
the Division's initial review of entitlement to benefits, this section directs 
that the Division must issue a "final determination" that includes a statement 
of reasons and notice of the right to hearing.  Thus, we see that the term "final 
determination" is not used generally, but, under this statutory section, refers 
specifically to the written letter stating the Division's decision about a 
claimant's entitlement to benefits, its statement of reasons, and its notice of 
hearing.  Because "final 
determination" is a term for the Division's written letter responding to a 
claim, its use in subsection 601(k)(vi) does not preclude review of the 
Division's decision that a request is timely.  Should that review affirm the 
untimeliness decision, however, the "final determination," meaning the written 
letter stating the reasons why the claimant is not entitled to benefits and a 
notice of hearing, is not subject to further review.

 

 

[¶14]       
The 
novel question in Scheneman was 
whether the Division had authority to establish the IHU to determine the 
correctness of the Division's decision that claimant's request for a hearing is 
untimely.  Scheneman, 956 P.2d  at 351.  The IHU is a creature 
of Division rules, specifically, Chapter 1, Sections 4, 5, and 6.  Id. at 350; Dep't of Employment, 
Wyoming Workers' Safety and Compensation Div., Rules and Regulations (Oct. 
1999).  In Scheneman, a final 
determination was issued to Scheneman denying benefits for a coronary condition 
because he had failed to provide proper documentation of his condition.  Id. at 346-47.   The final determination provided a 
date by which Scheneman had to object and request a hearing.  Several days after that deadline had 
passed, Scheneman's request for hearing was received by the Division, and the 
Division issued a notice of late response.  
From his objection to that notice of late response, the Division granted 
Scheneman a hearing before its IHU.  
Id. at 347.  The IHU 
hearing officer made recommended findings of facts and conclusions of law that 
determined the Division had properly advised Scheneman of all deadlines and had 
properly computed those deadlines.   
Based on these conclusions, Scheneman's request for hearing was ruled 
untimely, and the final determination was not subject to further administrative 
or judicial review.  Id. at 
347-48.   

 

[¶15]       
On appeal, we 
determined that, where the statute prohibited review of a final determination 
before either the OAH or the Medical Commission when the request for hearing was 
untimely, the Division did have statutory authority to promulgate rules and 
regulations creating the IHU to review processing decisions that a request for 
hearing was untimely.  Id. at 349-50.  In Scheneman, the IHU's jurisdiction over the 
procedural aspect of processing a claim was distinguished from a claimant's 
substantive right to a contested case hearing before the OAH or the Medical 
Commission that is fixed at the time of injury.  Id. at 351.   Although the statute terminated 
Scheneman's substantive right to a contested case hearing on the denial of 
benefits, we held that IHU's jurisdiction over the preliminary processing issue 
did not adversely affect his rights.  
Id. at 351.   This Court then went on to review 
whether substantial evidence supported the IHU's decision that Scheneman's 
request for hearing was untimely.  
Id.  Thus, Scheneman is clear, the IHU has jurisdiction 
over the procedural matter of whether a request for hearing was 
untimely.

 

[¶16]       
Scheneman addressed the issue of what process 
is due when a claimant contends that the Division has wrongly determined that a 
request for hearing was untimely.  
The Workers' Compensation Act (Act) and the Wyoming Administrative 
Procedure Act (WAPA) require that no determination or award be final without 
notice, an opportunity for hearing and judicial review.  Wyo. Stat. Ann. § 27-14-606 (LexisNexis 
2001); Wyo. Stat. Ann. § 16-3-114 (LexisNexis 2001); Wyo. Stat. Ann. § 
16-3-101(b)(ii) (LexisNexis 2001).  
Our jurisprudence requires that

 

[b]oth general due process 
considerations of fairness and specific statutory restrictions directly limit 
the manner in which an agency may exercise its designated responsibilities.  Additional restrictions are imposed by 
the often stated principle that an agency enjoys only those powers which the 
legislature has expressly conferred and the corollary rule of construction that 
statutes under which an agency purports to exercise a doubtful power must be 
strictly construed against the exercise of that power.

 

Jackson v. State ex rel. Wyoming 
Workers' Compensation Div., 786 P.2d 874, 878 (Wyo. 1990) 
(citations omitted).

  

[¶17]       
Scheneman 
recognized the IHU jurisdiction over the specific facts in that case.  It made no determination that the IHU 
had jurisdiction beyond determining whether the Division had properly advised of 
and computed deadlines before rejecting as untimely a request for a contested 
case hearing on a final determination denying benefits.  The issue before us is, therefore, 
whether, considering all statutory and due process requirements, the IHU has 
subject matter jurisdiction over the issue of equitable 
estoppel.

 

[¶18]       
Subject 
matter jurisdiction is an issue that this Court may raise upon its own 
motion.  Summers, 987 P.2d  at 
156.  In this case, Appleby conceded 
that her request for hearing was untimely, but contended that the Division was 
equitably estopped from denying her a contested case hearing on the final 
determination.  Equitable estoppel 
is a tort doctrine that requires proof of misrepresentation.  B&W Glass v. Weather Shield Mfg., 
829 P.2d 809, 813 (Wyo. 1992).  
Generally, the doctrine is considered a rule of substantive law.  Blais v. Allied Exterminating Co., 
482 S.E.2d 659, 662 (W.Va. 1996) (collecting cases).  This Court has repeatedly applied 
equitable estoppel in the workers' compensation benefits context, and subject 
matter jurisdiction does exist for its determination by a contested case 
hearing.  Bauer, 695 P.2d at 
1050-53; Wyo. Workers' Comp. Div. v. Barker, 978 P.2d 1156, 1060-61 (Wyo. 
1999); Wyo. Worker's Comp. v. Rivera, 796 P.2d 447, 450-51 (Wyo. 
1990).   Scheneman 
recognized the IHU's jurisdiction to insure claims processing; however, that 
recognition does not extend to determining issues involving rules of substantive 
law such as equitable estoppel, which the Act requires to be heard by contested 
case proceeding.  See Wyo. 
Stat. Ann. § 16-3-101(b)(ii) (LexisNexis 2001) (defining "contested case" as a 
proceeding in which legal rights are required by law to be determined by an 
agency after an opportunity for hearing).  
The IHU does not have subject matter jurisdiction to determine rights 
under the substantive legal doctrine of equitable estoppel.  

 

 

 

[¶19]       
Having 
decided that IHU jurisdiction does not extend to equitable estoppel, the 
developed record on this issue does permit us to examine whether, as a matter of 
law, those legal principles would apply to the facts in this case.  We have recognized that estoppel is 
available against a governmental agency for the unintentional, misleading 
statement of its representative.  
Barker, 978 P.2d at 1159-61; Bauer, 695 P.2d  at 
1050-53.  Equitable estoppel may be 
invoked to prevent strict application of both the workers' compensation statute 
of limitations and its accident report requirement.  Id. at 1053.  If a valid claim is lost because of 
some action by the employer or the insurance provider (here the state of 
Wyoming) reasonably relied upon by the employee to her detriment, relief should 
be granted.  Id. at 
1052.

 

[¶20]       
Bauer 
and 
Barker both applied equitable estoppel after the employer provided 
erroneous information that coverage was not available.  In another case, equitable estoppel 
applied because the Division erroneously informed a court clerk calling on 
behalf of a claimant's wife that coverage was not available.  Rivera, 796 P.2d  at 450.  In this case, Appleby had written notice 
that a hearing was available to her upon written request stating her reasons for 
objecting to the denial of benefits.  
The question thus arises whether, as a matter of law, a claimant's 
reliance upon verbal representations rather than the written notice can ever be 
reasonable.

 

[¶21]       
In this 
case, we find Appleby's reliance reasonable because the final determination 
erroneously applied two statutes and because its provided reasons, stated in the 
most technical fashion, encouraged the claimant to seek a telephone 
explanation.  Wyo. Stat. Ann. § 
27-14-601(j) (LexisNexis 2001) states (emphasis added):

 

Notice 
to any employee or his 
dependents under this section of a final determination by the division 
denying the compensability of an initial injury, a claim for medical or 
hospital care for which the employee or his dependents may be liable for payment 
or denying any impairment, disability or death benefit, shall include reasons 
for denial and a statement of the employee's or his dependents' rights to a 
hearing before a hearing examiner as provided by this act and to legal 
representation.

 

            

[¶22]       
Arguably, 
the final determination's statutory quotations satisfy the legislature's intent 
and can be classified as "reasons for denial;" however, to then require that the 
claimant state her reasons for disagreeing with them goes beyond the strictures 
of subsection 601(k).  The final 
determination's requirement that Appleby provide a reason for objecting is not 
authorized by statute.  The relevant 
subsection states in pertinent part:

 

(iv) 
Any interested party may request a hearing before a hearing examiner on the 
final determination of the division by filing a written request for hearing with 
the division within fifteen (15) days after the date the notice of the final 
determination was mailed by the division.

 

Wyo. 
Stat. Ann. § 27-14-601(k)(iv) (LexisNexis 2001).  Plainly, this section does not require 
that a claimant state reasons for objecting in order to secure the hearing.  Similar language is used in subsections 
601(j) and 601(k)(vi).  The Division 
is without authority to require a claimant to provide a reason for objecting to 
the determination in a written request for hearing.  

 

[¶23]       
But 
having done so in this case, it must have been expected that a claimant would 
call the listed telephone number and seek an understandable explanation. Indeed, 
the claims analyst testified that he spent a great amount of time responding to 
these types of telephone inquiries.  
Here, Appleby testified that she did not understand her final 
determination and naturally her representative called the phone number listed 
and was informed that the final determination was telling her that she had not 
filed on time and she had a pre-existing condition.  At that point, it was reasonable for 
Appleby to believe that she did not have any reason for objecting to the denial 
of benefits, which would permit her to request a hearing.

 

[¶24]       
We found 
one other error in applying a statute in the final determination, and mention it 
because it shows that Appleby's request for hearing would not have been "futile" 
as she was advised by the claims analyst.  
The final determination stated that "[y]our claim for benefits was not 
filed within the statute of limitations pursuant to Wyoming Statute 
27-14-503(a).   Subsection 
503(a) states:

 

A 
payment for benefits involving an injury which is the result of a single brief 
occurrence rather than occurring over a substantial period of time shall not be 
made unless in addition to the proper and timely filing of the injury reports, 
an application or claim for benefits is filed within one (1) year after the 
date the injury occurred or for injuries not readily apparent, within one 
(1) year after discovery of the injury by the employee.  The injury report is not a claim for 
benefits.

 

Wyo. 
Stat. Ann. § 27-14-503(a) (LexisNexis 2001) (emphasis added).  The final determination made this 
statement based on information in the injury report that Appleby completed.  In that injury report, Appleby stated 
that her date of injury was  October 
26, 1998.  Her claim for benefits 
was filed on April 12, 1999, less than a year later.  We see no reasonable basis for the 
Division's final determination to have stated this as a reason for denial of 
benefits, and no reasonable basis for the claims analyst to have relied upon it 
either when he wrote the letter of final determination to Appleby, or when he 
explained the timing problem over the telephone to Appleby's 
representative.

 

[¶25]       
Based on 
this analysis, it would appear that the Division is estopped from asserting as a 
defense that Appleby's request for hearing is denied.  The Division contends, however, that, by 
statutory amendment, equitable estoppel is a common law defense that is no 
longer applicable to workers' compensation cases.  In 1994, the legislature amended Wyo. 
Stat. Ann. § 27-14-101 by adding subsection (b), which 
provides:

 

(b) It 
is the intent of the legislature in creating the Wyoming worker's compensation 
division that the laws administered by it to provide a worker's benefit system 
be interpreted to assure the quick and efficient delivery of indemnity and 
medical benefits to injured and disabled workers at a reasonable cost to the 
employers who are subject to the Worker's Compensation Act.  It is the specific intent of the 
legislature that benefit claims cases be decided on their merits and that the 
common law rule of "liberal construction" based on the supposed "remedial" basis 
of workers' benefits legislation shall not apply in these cases.  The worker's benefit system in 
Wyoming is based on a mutual renunciation of common law rights and defenses by 
employers and employees alike.  
Accordingly, the legislature declares that the Worker's Compensation Act 
is not remedial in any sense and is not to be given a broad liberal construction 
in favor of any party.

 

1994 
Wyo. Sess. Laws, Ch. 86 § 2 (emphasis added).

 

[¶26]       
The 
Workers' Compensation Act (Act) must be interpreted as implementing Wyo. Const. 
Art. 10, § 4 which in relevant part states that "[t]he right of each employee to 
compensation from the fund shall be in lieu of and shall take the place of any 
and all rights of action against any employer contributing as required by law to 
the fund in favor of any person or persons by reason of the injuries or 
death."  We have recognized that by 
this provision and the Act workers do not have a cause of action against 
employers but are assured of benefits for compensable injuries.  "The traditional tort recovery, with its 
essential elements and historical defenses, was replaced by a state-administered 
industrial insurance program that required no showing of fault." Mills v. 
Reynolds, 807 P.2d 383, 389 (Wyo. 1991).  See also Anderson v. Solvay Minerals, 
Inc., 3 P.3d 236, 240 (Wyo. 2000).

 

[¶27]       
We have 
previously interpreted Wyo. Stat. Ann. § 27-14-101(b) and determined that the 
Legislature has specifically renounced any rule affording liberal construction 
to workers' compensation statutes, and our statutory interpretations must be 
reached without the assistance of any presumption in favor of coverage.  State ex rel. Wyo. Workers' Safety 
and Comp. Div. v. Sparks, 973 P.2d 507, 510 (Wyo. 1999).  We interpret both the constitutional 
provision and the statutory scheme in a way that gives effect to the lawmakers' 
intent and preserves the historic compromise between workers and employers.  Summers, 987 P.2d  at 157.   We also interpret the statute as 
intending to "assure the quick and efficient delivery of indemnity and medical 
benefits to injured and disabled workers."  
Wyo. Stat. Ann. § 27-14-101(b) (LexisNexis 2001).  In interpreting subsection 101(b), the 
risk of loss is placed on industry rather than on the individual employee.  Casper Oil Co. v. Evenson, 888 P.2d 221, 227 (Wyo. 1995).  

 

[¶28]       
In 
interpreting the Act, we have applied equitable estoppel against the Division, 
saying: 

 

Equitable 
estoppel should not be invoked against a government or public agency functioning 
in its governmental capacity, except in rare and unusual circumstances and may 
not be invoked where it would serve to defeat the effective operation of a 
policy adopted to protect the public. 

 

Our 
holding in Bauer v. State ex rel. Wyoming Workers' Compensation Division, 
695 P.2d 1048 (Wyo. 1985), delineates, however, a rare and unusual circumstance 
in which equitable estoppel operates against a public agency.  

 

Rivera, 796 P.2d  at 450 (quoting Big Piney Oil & Gas Co. v. Wyo. Oil & Gas 
Conservation Comm'n, 715 P.2d 557, 560 (Wyo. 1996)).  Plainly, we have determined that 
equitable estoppel arises and is permitted under the Act.  As recently as 1999, we rejected the 
Division's assertion that statutory language rendered obsolete our rationale for 
the application of equitable estoppel doctrine.  Barker, 978 P.2d  at 1160. Nothing 
indicates that by eliminating the liberal construction rule and mandating the 
"quick and efficient delivery" of benefits, the legislature intended to change 
the equitable estoppel that this Court has applied under the Act since 
1985.  The Division's proposed 
interpretation would actually impede the legislative intent, and although we 
need not decide it, it is not likely that Art. 10 § 4 would permit such a 
statutory amendment.1  Our rules of statutory interpretation 
require that we, in seeking legislative intent, must find a consistent and 
realistic intendment which includes the presumed desire of the legislature to 
recognize its legislative duty to act constitutionally.  Parker Land and Cattle Co. v. Wyo. 
Game & Fish Comm'n, 845 P.2d 1040, 1081 (Wyo. 1993).  Having previously interpreted this 
constitutional provision to eliminate those tort causes of actions that would 
provide tort remedies, the statutory amendment cannot now be interpreted as 
reaching common law rights and defenses other than tort.  We would also point out that should we 
apply this language literally as the Division contends we should, it would mean 
that other common law remedies and defenses such as res judicata and collateral 
estoppel2 would also fall, and it is doubtful 
that the legislature intended this language to so broadly sweep or that the 
Division would desire to lose the benefit of those common law doctrines.  We, therefore, conclude that the 
emphasized statutory language applies to the elimination of causes of action 
arising under tort law, and does not apply to those rules of substantive law 
that are applicable to avoid inequity in application of the Act.  To do otherwise would threaten the 
historic compromise.

 

[¶29]       
The 
Division also argues that, as a matter of law, equitable estoppel does not apply 
because the final determination that it sent Appleby contradicted the statements 
made by the claims analyst, and her reliance was unreasonable after she received 
legal representation.  We have 
already addressed the written notice issue.  The Division's authority for its last 
assertion comes from a separately written opinion statement in Wyo. Workers' 
Comp. Div. v. Halstead, 795 P.2d 760, 775 (Wyo. 1990) (Rooney, J., 
concurring in part and dissenting in part), opining that it should be considered 
unreasonable reliance if legal representation is provided during the period 
where a claim could have been timely filed.  Appleby did not have legal 
representation during the period where a claim could have been timely filed, and 
the authority does not support the argument.  The Division's arguments support the 
following conclusions of law made by the Director:

 

15. Any 
reliance on the claims analyst's verbal statements would be unjustified if those 
statements contradicted the proper written notices received by the 
Petitioner.

16. Even 
if the Petitioner had justifiably relied on a misrepresentation by the claims 
analyst, that reliance would have terminated when the claims analyst told 
Petitioner to get an attorney, or when Petitioner spoke with an attorney in 
June, 1999.  Since Petitioner's 
objection was filed on September 7, 1999, it was late even if the period to 
object began to run on June 30, 1999.

 

As 
Appleby contends, equitable estoppel does apply, reliance does not terminate, 
and these legal conclusions are in error as a matter of law.  The proper legal analysis is that made 
above where Bauer was properly applied to the facts.  

 

[¶30]       
We have 
decided that the Division is equitably estopped from claiming that Appleby's 
request for hearing was untimely.  
Appleby is therefore entitled to a contested case hearing on the final 
determination that denied her benefits.  
The district court's order affirming the Director's order denying a 
contested case hearing is reversed, and this case is remanded for a contested 
case hearing by the appropriate hearing authority, either the OAH or the Medical 
Commission, as statute dictates.  
Wyo. Stat. Ann. § 27-14-601(k)(v) (LexisNexis 
2001).

FOOTNOTES

1The relevant part of Wyo. Const. art. 
10, § 4 states (emphasis added):

The right of each employee to 
compensation from the fund shall be in lieu of and shall take the place of 
any and all rights of action against any employer contributing as 
required by law to the fund in favor of any person or persons by reason of the 
injuries or death.

2Res judicata bars relitigation of 
previously litigated claims or causes of action, and collateral estoppel bars 
relitigation of previously litigated issues.  Tenorio v. State ex rel. Wyoming 
Workers' Compensation Div., 931 P.2d 234, 238 (Wyo.1997).   As recognized in this state, these 
doctrines incorporate a universal precept of common law jurisprudence.  State, Dept. of Family Services v. 
PAJ, 934 P.2d 1257, 1260 (Wyo. 1997).