Title: IN THE MATTER OF THE WORKER'S COMPENSATION CLAIM OF: BRYAN DUTCHER 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: BRYAN DUTCHER v. STATE OF WYOMING, ex rel., WYOMING WORKERS' SAFETY AND COMPENSATION DIVISION2010 WY 10223 P.3d 559Case Number: No. S-09-0093Decided: 02/04/2010
OCTOBER 
TERM, A.D. 2009

 
 
IN 
THE MATTER OF THE WORKER'S COMPENSATION CLAIM OF:BRYAN 
DUTCHER,Appellant(Petitioner),v.STATE OF WYOMING, ex 
rel., WYOMING WORKERS' SAFETY AND COMPENSATION 
DIVISION,Appellee(Respondent).

 
 
Appeal 
from the District Court of Campbell County

The 
Honorable Michael N. Deegan, Judge

 
 

Representing 
Appellant:

Kenneth 
DeCock, Plains Law Offices LLP, Gillette, Wyoming.

 
 

Representing 
Appellee:

Bruce 
A. Salzburg, Wyoming Attorney General; John W. Renneisen, Deputy Attorney 
General; James Michael Causey, Senior Assistant Attorney 
General.

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

 
 

KITE, 
Justice.

 
 
[¶1]  After experiencing sudden numbness and 
weakness on his left side while at work, Bryan Dutcher sought workers' 
compensation benefits.  The Wyoming 
Workers' Safety and Compensation Division (the Division) denied coverage and Mr. 
Dutcher objected.  The Office of 
Administrative Hearings (OAH) held a contested case hearing and, concluding that 
Mr. Dutcher failed to prove his injuries were work related, upheld the denial. 
 The district court affirmed and Mr. 
Dutcher appealed to this Court.  We 
affirm.

 
 
ISSUES

 
 
[¶2]  Mr. Dutcher presents the following 
issues for this Court's determination:

 
 

A.   Is 
there substantial evidence to support the Hearing Officer's 
conclusion?

 
 

B.   Is 
the Hearing Officer's decision arbitrary and capricious?

 
 
FACTS

 
 
[¶3]  Mr. Dutcher was employed as a laborer 
for L&L Mine Services in Gillette, Wyoming.  On October 9, 2006, he was lying on his 
left side scraping grease off a large piece of equipment.  As he reached with his right arm, he 
felt numbness and weakness in his left side.  Later, he felt dizzy, could not use his 
left arm and experienced weakness in his left leg and left facial droop.   

 
 
[¶4]      Mr. Dutcher informed his 
foreman, who transported him from the mine into town where his wife met them and 
took Mr. Dutcher to the emergency room.  
The medical personnel admitted and examined him over the next few days as 
a possible stroke victim.  The 
hospital released him on October 12, 2006.

 
 
[¶5] 
     On October 16, 
2006, Mr. Dutcher consulted Angelo Santiago, M.D., a neurologist who, after 
examining Mr. Dutcher and performing tests, diagnosed him with brachial 
plexopathy.1  Mr. Dutcher sought a second opinion from 
another neurologist, Robert Finley, M.D.  
After examining him, Dr. Finley recommended that Mr. Dutcher continue 
treatment with Dr. Santiago.  Mr. 
Dutcher sought still another opinion from Dr. Robert Neuwirth, who concluded 
brachial plexopathy was unlikely and the most likely diagnosis was cervical 
myelopathy.  Dr. Neuwirth also noted 
significant thyroid dysfunction as a contributing factor and the possibility of 
an injury to Mr. Dutcher's vertebral artery perhaps brought on by his prolonged 
position on his left side at work. 

 
 
[¶6]      Mr. Dutcher returned to work 
in the latter part of December, 2006.  
In May of 2007, his employer let him go and Mr. Dutcher filed an injury 
report with the Division.  The 
Division denied coverage in a final determination issued on August 7, 2007, in 
which it noted Mr. Dutcher had a pre-existing seizure condition and concluded 
there was no clear indication of a work injury.  Mr. Dutcher objected and the Division 
referred the case to the OAH.

 
 
[¶7] 
     In early 2008, 
the Division retained Thomas Mayer, M.D., another neurologist, to perform an 
independent medical examination of Mr. Dutcher.  Dr.  Mayer concurred with the diagnosis of 
brachial plexopathy and concluded it was related to Mr. Dutcher's 
employment.  Dr. Mayer also 
concluded the brachial plexopathy may have been followed by, and may have 
triggered, a seizure.  

 
 
[¶8]      The OAH held a contested case 
hearing on April 15, 2008.  
Following the hearing, the hearing examiner denied Mr. Dutcher's claim 
for benefits, concluding he did not meet his burden of proving that the seizure 
or brachial plexopathy were related to his employment.  Mr. Dutcher appealed the order to the 
district court which affirmed the denial of benefits.  Mr. Dutcher timely appealed to this 
Court.

 
 
STANDARD 
OF REVIEW

 
 
[¶9]      When we consider an appeal 
from a district court's review of an administrative agency's decision, we give 
no special deference to the district court's decision; instead, we review the 
case as if it had come directly to us from the administrative agency.  Dale v. S&S Builders, LLC, 2008 WY 
84, ¶ 8, 188 P.3d 554, 557 (Wyo. 2008).  
Our review is governed by Wyo. Stat. Ann. § 16-3-114(c) (LexisNexis 
2009), 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] 
  In this case, Mr. Dutcher 
challenges the hearing examiner's determination that he did not meet his burden 
of proving that his brachial plexopathy and seizure were related to his 
employment.  We, therefore, decide 
whether there is substantial evidence to support the hearing examiner's decision 
to reject the evidence Mr. Dutcher presented by considering whether that 
conclusion was contrary to the overwhelming weight of the evidence in the record 
as a whole.  Dale, ¶ 22, 188 P.3d  at 561.  If, in the course of its decision making 
process, the agency disregarded certain evidence and explained its reasons for 
doing so based upon determinations of credibility or other factors contained in 
the record, its decision will be sustainable under the substantial evidence 
test.  Id.  Importantly, our review of any 
particular decision turns not on whether we agree with the outcome, but on 
whether the agency could reasonably conclude as it did based upon all the 
evidence before it.  Id.

 
 
DISCUSSION

 
 
[¶11]   Mr. Dutcher asserts that the 
hearing examiner's decision is contrary to the overwhelming weight of the 
evidence because three doctors, including the doctor the Division retained, 
concluded the brachial plexopathy was related to his employment.  He contends that in reaching the 
contrary conclusion the hearing examiner had to ignore the opinions of those 
three doctors and rely exclusively on Dr. Neuwirth who reached his conclusions 
without the benefit of the test results Dr. Santiago obtained, which clearly 
showed Mr. Dutcher suffered from brachial plexopathy.

 
 
[¶12]  The Division responds that the hearing 
examiner's decision was supported by substantial evidence.  It asserts that Mr. Dutcher's story was 
inconsistent in that he did not report that his shoulder popped until he was 
seen by Dr. Mayer.  Given this 
inconsistency, the Division asserts, and the fact that Dr. Mayer's opinions were 
based heavily on what Mr. Dutcher told him, the hearing examiner properly 
discounted both Mr. Dutcher's testimony and that of Dr. Mayer.  The Division further contends that the 
other medical opinions did not tie the brachial plexopathy to Mr. Dutcher's 
work.   The Division asserts 
substantial evidence supported the hearing examiner's conclusions that the 
seizure was part of a pre-existing condition and was not triggered by the 
shoulder incident; it was questionable whether Mr. Dutcher suffered a brachial 
plexopathy; and, even if he suffered a brachial plexopathy, he failed to prove 
that it was related to his work.

 
 
[¶13]   Wyo. Stat. Ann. § 27-14-102(a)(xi) 
(LexisNexis 2009) defines the term injury in relevant part 
as:

 
 
[A]ny 
harmful change in the human organism other than normal aging . . . .  arising out of and in the course of 
employment while at work in or about the premises occupied, used or controlled 
by the employer and incurred while at work in places where the employer's 
business requires an employee's presence and which subjects the employee to 
extrahazardous duties incident to the business.  "Injury" does not include: 

 
 
. 
. . .

 
 
            
(F)  Any injury or condition 
preexisting at the time of employment with the employer against whom a claim is 
made[.]   

  

[¶14]  Applying this provision, we have said 
that an employer takes an employee as he finds him, and an employee who has a 
pre-existing condition may still recover if his employment substantially or 
materially aggravated the condition.  
Lindbloom v. Teton Int'l, 684 P.2d 1388, 1389 (Wyo. 1984).  We 
have cited with approval the widely accepted treatise, Larson's Workmen's 
Compensation Law, for the proposition that:

 
 
Preexisting 
disease or infirmity of the employee does not disqualify a claim under the 
"arising out of employment" requirement if the employment aggravated, 
accelerated, or combined with the disease or infirmity to produce the death or 
disability for which compensation is sought.

 
 

Lindbloom, 
684 P.2d  at 1389; Wyo. Workers' Comp. 
Div. v. Faulkner, 2007 WY 31, ¶ 11, 152 P.3d 394, 397 (Wyo. 2007); State ex rel. Wyo. Workers' Safety & 
Comp. Div. v. Fisher, 914 P.2d 1224, 1227 (Wyo. 1996).   

 
 
[¶15]   Whether the employment aggravated, 
accelerated, or combined with the pre-existing condition to produce the 
disability is a question of fact, not law, and a finding of fact on this point 
based on any medical testimony will not be disturbed on appeal.  Straube v. State ex rel. Wyo. Workers' 
Safety & Comp. Div., 2009 WY 66, ¶ 15, 208 P.3d 41, 48 (Wyo. 2009).  To prove aggravation of a preexisting 
condition, a claimant must demonstrate by a preponderance of the evidence that 
the work contributed to a material degree to the aggravation of the 
condition.  State ex rel. Wyo. Workers' Safety & 
Comp. Div. v. Slaymaker, 2007 WY 65, ¶ 14, 156 P.3d 977, 981-82 (Wyo. 
2007).  The causal connection 
between the work and the condition is satisfied if the medical expert testifies 
it is more probable than not that the work contributed in a material fashion to 
the aggravation of the injury.  Langberg v. State ex rel. Wyo. Workers' 
Safety & Comp. Div., 2009 WY 39, ¶ 26, 203 P.3d 1098, 1104 (Wyo. 
2009).  Testimony by the medical 
expert to the effect that the injury "most likely" or "probably" is the product 
of the workplace suffices under our established standard.  Decker v. State ex rel. Wyo. Med. Comm'n, 
2008 WY 100, ¶ 30, 191 P.3d 105, 121 (Wyo. 2008).

 
 
[¶16]   One difficulty with Mr. Dutcher's 
claim is that, contrary to his assertion, two of the three doctors upon whom he 
relies did not state that the brachial plexopathy was related to his work.  Dr. Santiago, who diagnosed Mr. Dutcher 
with left brachial plexopathy, did not express any opinion as to the cause of 
the condition.  Dr. Finley, who saw 
Mr. Dutcher next, noted only that Mr. Dutcher had a recent history of new onset 
of left face, arm and leg numbness and weakness; the hospital evaluation showed 
no definitive indications of a stroke; Dr. Santiago concluded based on EMG/nerve 
conduction studies that Mr. Dutcher suffered a left brachial plexus injury; and 
Mr. Dutcher was hypothyroid.  Like 
Dr. Santiago, Dr. Finley offered no opinion as to the cause of Mr. Dutcher's 
medical problems.  

 
 
[¶17]  The third physician upon whom Mr. 
Dutcher relies is Dr. Mayer, whose opinion the hearing examiner disregarded 
because it was based on the history he obtained from Mr. Dutcher, which the 
hearing examiner found to be inconsistent with the history Mr. Dutcher gave at 
the hospital and to Drs. Santiago, Finley and Neuwirth.  From the information Mr. Dutcher 
provided, Dr. Mayer concluded that he sustained a shoulder injury with resultant 
brachial plexus lesion followed by a seizure.  Dr. Mayer further concluded it was more 
likely than not that the brachial plexopathy was related to Mr. Dutcher's work 
activities.  Dr. Mayer also 
testified, however, that brachial plexopathy did not account for the left sided 
weakness Mr. Dutcher experienced.  
Dr. Mayer postulated that those symptoms were possibly caused by a 
seizure.  He testified that even the 
difficulties with Mr. Dutcher's left arm could have been related to a 
seizure.  Dr. Mayer testified that 
in his opinion the seizure was not related to Mr. Dutcher's work; however, he 
also testified that the brachial plexopathy "may well have been" a triggering 
event for the seizure.   

 
 
[¶18]  As noted above, the hearing examiner 
disregarded Dr. Mayer's opinions because he testified they were based on the 
history Mr. Dutcher provided, which the hearing examiner found to be 
inconsistent with his earlier reports.  
Dr. Mayer's records reflect that Mr. Dutcher reported that he was lying 
on his left side "with the elbow propped out" scraping grease with his right 
hand when "his elbow slipped and he felt a pop in his shoulder."  The treatment record continues:  "He did not think much of this and 
finished what he was doing.  
Sometime shortly thereafter, he got up and stated that he just did not 
feel right.  He was somewhat weak on 
the left side, involving not only the arm, but also the face and leg." 

 
 
[¶19]  Like his report to Dr. Mayer, Mr. 
Dutcher testified at the hearing that he was lying on his left side with his 
weight on his elbow cleaning off a hoist case when he felt his shoulder pop 
out.  He testified that he felt pain 
in his neck, started to get up and felt dizzy.  He sat back down and felt pain radiating 
from his neck down his arm to his fingers.  
He testified that later, after he resumed working, his left arm began to 
go numb and he could not use it.  He 
testified that he took his lunch break, went back to work and, after finishing 
his shift, told his foreman, Steven Peterson, he needed medical attention.  He testified Mr. Peterson drove him to 
town and by the time they arrived at the shop his left side was shutting down, 
his tongue was swelling and he could hardly talk.  The next morning his left leg would not 
function.  

 
 
[¶20]  In contrast to Mr. Dutcher's hearing 
testimony and the history he provided to Dr. Mayer, the records following the 
incident contain no reference to a shoulder injury or to his shoulder 
"popping."  The hospital records 
state that Mr. Dutcher arrived at the emergency room after a sudden onset of 
left-sided tingling and numbness, difficulty moving his left arm, left facial 
droop with tingling in his mouth and slowed speech.  Dr. Santiago's records from a week after 
the incident indicate that Mr. Dutcher reported he had been lying on his left 
side for thirty to forty minutes cleaning heavy equipment when he experienced 
left upper extremity numbness and weakness.2  Dr. Finley, who saw Mr. Dutcher three 
weeks after the incident, reported that Mr. Dutcher said he had been lying on 
his left shoulder for about thirty minutes while doing some scraping with his 
right hand when his left side seemed to go to sleep.  When he stood up, his left arm and leg 
were numb, his speech was somewhat impaired and his tongue and lips were 
numb.  Dr. Neuwirth's records from 
one month after the incident indicate Mr. Dutcher reported he was lying on his 
left side propped up on his elbow cleaning a large machine when he suddenly had 
difficulty moving his arm.  Dr. 
Neuwirth's records continue:  "This 
got worse over the next little while to where he could not walk at all and he 
was having difficulty with moving on the left side of his face."  

 
 
[¶21]  In addition to considering Mr. Dutcher's 
description of the incident contained in these records, the hearing examiner 
heard the testimony of Mr. Peterson, Mr. Dutcher's foreman, which differed 
somewhat from Mr. Dutcher's testimony.  
Mr. Peterson testified that at around 9:00 or 10:00 a.m. he saw Mr. 
Dutcher working on cleaning a shovel, thought he looked pale and asked him if he 
was okay.  He testified Mr. Dutcher 
responded that he was fine.  Mr. 
Peterson testified that he saw Mr. Dutcher again before the lunch break, he 
still looked pale, he asked him again if he was okay and Mr. Dutcher again said 
he was fine.  Mr. Peterson testified 
that after lunch, as they were heading back to work, Mr. Dutcher said that his 
left side had gone numb and his lips were tingling.  Later, Mr. Dutcher told him he lost 
control over his left side when he was cleaning the shovel.  Mr. Peterson testified that Mr. Dutcher 
did not say anything about his shoulder going out until he returned to work in 
May of 2007.    

 
 
[¶22]  From our review of the record, we 
conclude there is substantial evidence to support the hearing examiner's 
decision to reject the evidence Mr. Dutcher presented and that decision was not 
contrary to the overwhelming weight of the evidence in the record as a 
whole.  Dale, ¶ 22, 188 P.3d  at 561.  There is no question that Mr. Dutcher 
had a long history of a seizure disorder.  
The symptoms he reported at the hospital and within the next few weeks 
following the incident were consistent with a seizure.  Even Dr. Mayer testified that the 
left-sided symptoms, including the arm weakness and numbness, could have been 
related to a seizure.  His testimony 
that Mr. Dutcher suffered a work related brachial plexopathy was based entirely 
on the patient's report that his elbow slipped and his shoulder popped.  Yet, there was no indication in any of 
the early medical records that Mr. Dutcher suffered a shoulder injury or that he 
felt his shoulder pop.  

 
 
[¶23] 
It is the hearing examiner's responsibility to determine the credibility of the 
witnesses and weigh the evidence.  
Dale, ¶ 49, 188 P.3d  at 
566.  Additionally, a hearing 
examiner is entitled to disregard an expert opinion if he finds the opinion 
unreasonable, not adequately supported by the facts upon which the opinion is 
based, or based upon an incomplete and inaccurate medical history provided by 
the claimant.  Id.  The hearing examiner in the present case 
heard the testimony of Mr. Dutcher and Mr. Peterson and was entitled to weigh 
their credibility.  In weighing Mr. 
Dutcher's testimony, the hearing examiner also considered the medical records 
containing the history Mr. Dutcher gave immediately after the incident.  Dr. Mayer conceded that he relied on the 
history Mr. Dutcher related in reaching the conclusion that Mr. Dutcher suffered 
a shoulder injury. Those factors, coupled with the fact that, until Dr. Mayer 
examined Mr. Dutcher in 2008, none of the records mentioned a shoulder injury or 
shoulder popping, supports the hearing examiner's 
decision.

 
 
[¶24]  In addition to the inconsistent 
reporting, the lack of testimony linking Mr. Dutcher's medical condition to his 
work supports the hearing examiner's ruling.  Dr. Neuwirth stated the most likely 
diagnosis was cervical myelopathy with a possibility of injury to Mr. Dutcher's 
left vertebral artery perhaps related 
to the physical position he was in at work.  This language does not satisfy our 
standards requiring medical evidence that the work "most likely" or "probably" 
contributed to the injury.  The possibility of an injury that is perhaps related to the work is not 
sufficient.

 
 
[¶25]  Dr. Mayer's testimony likewise was not 
sufficient.  Although he testified 
that in his opinion Mr. Dutcher suffered from work related brachial plexopathy, 
Dr. Mayer also testified that brachial plexopathy did not explain the symptoms 
involving Mr. Dutcher's left leg, face and speech.  Dr. Mayer testified that the left-sided 
symptoms, including those involving the arm, could have been related to a 
seizure.   He further testified 
that the seizure was not work related.  
However, he later testified that brachial plexopathy could have triggered 
the seizure.  Given this wavering 
testimony, we conclude substantial evidence supported the hearing examiner's 
conclusion that Mr. Dutcher failed to meet his burden of proving his condition 
was work related and that conclusion was not against the overwhelming weight of 
the evidence.     

 
 
[¶26]  There is no question from the evidence 
that Mr. Dutcher experienced left-sided weakness at work after lying on his left 
side cleaning equipment.  The 
difficulty with Mr. Dutcher's claim, however, is that the physicians who 
evaluated him did not all agree on a diagnosis and, of the physicians who did 
agree (or at least did not disagree) with the brachial plexopathy diagnosis, 
none of them sufficiently linked his condition to his work.  There was no testimony that Mr. 
Dutcher's left-sided numbness and weakness was related to the work he was 
performing at the time.

 
 
[¶27]  Affirmed.

 
 
FOOTNOTES

 
 

1Brachial 
plexopathy is pain, decreased movement, or decreased sensation in the arm and 
shoulder due to a nerve problem.  It 
occurs when there is damage to the brachial plexus, an area where a nerve bundle 
from the spinal cord splits into the individual arm nerves.  Damage to the brachial plexus is usually 
related to direct injury to the nerve, stretching injuries, pressure from tumors 
in the area, or damage that results from radiation therapy.  http:www.nlm.nih.gov/medlineplus/ency/article/001418.htm.

 
 

2In the "Chief Complaint and History of  Present Illness" paragraph, Dr. 
Santiago's records state that Mr. Dutcher experienced "right" upper extremity 
weakness.   However, his 
impression and diagnosis, as well as the hospital and other physician records, 
reflect left-sided weakness.  
Therefore, we will assume the initial references to right upper extremity 
weakness were error.