Title: French v. Amax Coal West

State: wyoming

Issuer: Wyoming Supreme Court

Document:

French v. Amax Coal West1998 WY 108960 P.2d 1023Case Number: 97-121Decided: 08/19/1998Supreme Court of Wyoming
 
In 
The Matter of the Worker's Compensation Claim of Alice D. FRENCH, Appellant 
(Employee/Claimant),

v.

AMAX COAL WEST, Appellee 
(Employer/Objector), and State of Wyoming, ex rel., Wyoming Workers' 
Compensation Division, Appellee (Respondent).

 

Appeal from the District 
Court, Campbell County, Dan R. Price, Judge.

 

Donald J. 
Sullivan of Sullivan Law Offices, P.C., Cheyenne, for 
Appellant(Employee/Claimant).

Catherine 
MacPherson of MacPherson Law Offices, LLC, Rawlins, for Appellee Amax Coal 
West.

William U. Hill, 
Attorney General; Gerald W. Laska, Senior Assistant Attorney General; and 
Bernard P. Haggerty, Assistant Attorney General, Cheyenne, for Appellee State 
ex rel. Wyoming Workers' Compensation Division.

Before 
LEHMAN, C.J., and THOMAS, GOLDEN and TAYLOR,* JJ., and KALOKATHIS, 
District Judge.

* Chief Justice at time of 
oral argument.

TAYLOR, 
Justice.

[¶1]      Appellant 
challenges the order of the district court affirming the Medical Commission's 
denial of her claim for worker's compensation benefits. Appellant claims the 
Medical Commission was without jurisdiction to hear her case and exceeded its 
statutory authority in deciding issues of law. Finding that appellant's case was 
not a "medically contested case" as required by Wyo. Stat. § 27-14-616 
(Cum.Supp. 1994), we reverse the district court and 
remand.

I. 
ISSUES

[¶2]      Appellant, Alice 
D. French (French), presents eight issues framed in argumentative language and 
of dubious factual accuracy. We therefore choose to list here the headings of 
the three arguments contained in French's appellate brief:

I: [Whether] 
[t]he exercise of jurisdiction by the Medical Panel in the circumstances of this 
case was wholly erroneous and improper.

II: [Whether] 
[t]he Medical Panel usurped the roles of the Legislature and of the Supreme 
Court, improperly created a new "defense at law" to worker's compensation claims 
and improperly applied its new rule retroactively to this 
case.

III: [Whether] 
[t]he rulings of the Medical Panel ignore and violate the plain provisions of 
the Wyoming worker's compensation statute.

[¶3]      The employer, 
Amax Coal West (Amax), as appellee, responds with the following 
issues:

1. Whether the 
Medical Commission had jurisdiction to hear and decide all issues in this 
case?

2. Whether the 
Medical Commission's decision was arbitrary, capricious, an abuse of discretion, 
otherwise not in accordance with law or unsupported by substantial 
evidence?

State ex rel. 
Wyoming Workers' Compensation Division (Division) joined the appellate brief 
filed by Amax and asserted the same arguments.

II. 
FACTS

[¶4]      French was 
employed as a coal haul truck driver for Amax. On January 8, 1995, after 
finishing her lunch break in the haul truck, she resumed driving, became 
nauseated, and "passed out." The haul truck continued moving, proceeding over 
the highwall, where it fell to the coal pit below. The accident resulted in a 
head laceration, broken nose and teeth, and injury to French's back. At the time 
of the accident, it was windy and cold, and there had been two haul trucks 
parked up-wind, adjacent to French's haul truck throughout her lunch break. On 
these facts, French surmised that carbon monoxide poisoning caused her to lose 
consciousness.

[¶5]      Following the 
accident, French was taken to the hospital emergency room where Dr. Sara Hartsaw 
noted that the patient was taking Tegretol (an anti-convulsant medication), and 
had a history of seizures "which feel like fainting, last one, 1 yr. ago." After 
filing her claim for worker's compensation benefits with the Division, the 
Division requested information concerning why and when Tegretol was prescribed 
so the compensability of the case could be determined. On February 8, 1995, the 
Division issued its final determination denying benefits, stating that the 
"[m]edical records indicate your injury was caused by a loss of consciousness 
due to a pre-existing medical condition (seizures)." Through her attorney, 
French replied to the Division's request for information, explaining that her 
lost consciousness was likely due to carbon monoxide from the exhaust of the 
haul trucks, and that she was not claiming benefits for the condition which 
caused her to lose consciousness but only for the injuries she sustained from 
the accident at work. In response, the Division issued an amended final 
determination finding her injuries to be compensable.

[¶6]      Amax then filed 
an objection to the Division's determination and requested a hearing, claiming 
French did not suffer an "injury" as defined in Wyo. Stat. § 27-14-102(a)(xi) 
(Cum.Supp. 1994). Amax alleged that the condition which caused the accident 
existed at the time French sought employment, even though her work application 
stated she did not have and did not suffer from seizures. Therefore, the injury 
did not arise out of and in the course of employment. At the same time, the 
employer filed a request that this case be referred to the Medical Commission 
because "the issues involved are complex issues of medical causation best 
resolved by a medical hearing panel."

[¶7]      The Division 
referred the case to the Medical Commission on March 29, 1995. The Medical 
Commission issued its initial scheduling order on April 6, 1995, in which it 
requested, among other things, that the parties identify the "contested medical 
issues to be determined at the hearing[.]" The parties were not asked to 
identify legal issues. On June 19, 1995, the Medical Commission issued an order 
setting an evidentiary hearing for August 30, 1995, and designating the hearing 
panel members. On the same day, the Medical Commission issued a second order 
which contained a section entitled "Judicial Notice 
Taken:"

Under W.S. § 
16-3-108(d) and Chapter 8, § 1(g)1 of the Regular Rules of the Medical 
Commission, the hearing panel takes judicial notice of the 
following:

1. The fact that 
neuro-induced or neurogenic syncope is not a coronary 
condition.

2. The decision 
of the Wyoming Supreme Court in Long v. Big Horn Construction Company, 75 Wyo. 
276, [295] P.2d 750 (1956).2

The parties 
shall be afforded an opportunity to address the judicial notice taken by the 
Medical Commission hearing panel through the submission of briefs on these 
issues by August 1, 1995.

[¶8]      No party 
submitted briefs addressing the judicial notice. However, on August 22, 1995, 
after continuing discovery, discussion, and clarification of the issues, the 
parties stipulated to relevant facts and, concluding that resolution of the case 
rested primarily on issues of law, the parties requested termination of the case 
and referral of the proceedings to the Office of Administrative Hearings. This 
request was denied in an Order Rejecting Stipulation, which stated in relevant 
part:

The Medical 
Commission is prohibited by statute from reviewing the decision to refer a case 
to the commission for hearing [Wyo. Stat. § 27-14-616(b)(iv)]. The statute 
grants authority to the Medical Commission to "hear and decide all issues 
related to the written notice of objection." Though W.S. § 27-14-616(e) 
specifically provides that parties may agree to have a case transferred from the 
Office of Administrative Hearings to the Medical Commission for hearing, no 
provision is made to permit parties to transfer a case before the Medical 
Commission to the Office of Administrative Hearings, as anticipated by said 
STIPULATION filed herein.

(Emphasis in 
original.)

[¶9]      The transcript of 
the evidentiary hearing before the medical hearing panel on August 30, 1995 
indicates that the parties filed a second stipulation with a request to certify 
the legal issues to the district court. The factual stipulations were accepted. 
However, the medical hearing panel reserved for later determination whether it 
would accept the parties' stipulations as to the legal issues and whether it 
would reconsider certification of the issues to the district court. After the 
close of the hearing and the receipt of additional employment and medical 
records, the medical hearing panel entered its decision on December 12, 
1995.

[¶10]   The medical hearing panel found 
that an exact diagnosis of the condition which caused French to lose 
consciousness at the time immediately preceding the accident was not necessary. 
Instead, the medical hearing panel reviewed her medical records preceding the 
incident and compared her earlier reports of symptoms to the symptoms reported 
after the incident. Based on this comparison, the medical hearing panel 
concluded that French's loss of consciousness was caused by the same condition 
she experienced prior to seeking employment with Amax. The medical hearing panel 
further determined that French had knowingly misrepresented her physical status 
to the employer, and had she correctly apprised the employer of her condition, 
she would not have been hired. In conclusion, the medical hearing panel 
stated:

Ms. French has 
failed to show, by a preponderance of the evidence, that the injuries she 
incurred as a result of a fainting episode on January 8, 1995, while in the 
employ of Amax Coal West, are compensable under Long v. Big Horn Construction 
Company, 75 Wyo. 276, [295] P.2d 750 (1956).

French timely 
filed an appeal to the district court, which affirmed the Medical Commission's 
decision. This appeal followed.

III. STANDARD OF 
REVIEW

[¶11]   Review of an appeal from an 
administrative decision is governed by the provisions of Wyo. Stat. § 
16-3-114(c)(ii)(C) (1997), which directs a reviewing court to "[h]old unlawful 
and set aside agency action, findings and conclusions found to be * * * [i]n 
excess of statutory jurisdiction, authority or limitations or lacking statutory 
right[.]" Russell v. State ex rel. Wyoming Workers' Safety and Compensation 
Div., 944 P.2d 1151, 1155 (Wyo. 1997). The interpretation of statutes is a 
question of law to be reviewed de novo. Painter v. State ex rel. Wyoming 
Workers' Compensation Div., 931 P.2d 953, 954 (Wyo. 1997); Chevron U.S.A., Inc. 
v. State, 918 P.2d 980, 983 (Wyo. 1996). When considering an appeal from a 
district court's review of agency action, we accord no special deference to the 
district court's conclusions. Matter of Fisher, 914 P.2d 1224, 1226 (Wyo. 1996). 
Instead, we review the case as if it had come directly to us from the 
administrative agency. Id.

[¶12]   An administrative agency has only 
the powers granted to it by statute, and the justification for the exercise of 
any authority by the agency must be found within the applicable statutes. A 
statute will be strictly construed when determining the authority granted 
therein. In other words, " 'any reasonable doubt of existence of any power must 
be resolved against the exercise thereof. A doubtful power does not exist.' " US 
West Communications, Inc. v. Wyoming Public Service Com'n, 907 P.2d 343, 346 
(Wyo. 1995) (quoting Montana Dakota Util. Co. v. Pub. Serv. Comm'n, 847 P.2d 978, 983 (Wyo. 1993)).

IV. 
DISCUSSION

[¶13]   Essentially, French argues that the 
medical hearing panel was without jurisdiction to hear her case because it was 
not a "medically contested case." Our well known rules of statutory construction 
provide that we read unambiguous statutory language to give meaning to each word 
or phrase and so as not render any part superfluous. Russell, 944 P.2d  at 
1155.

[¶14]   The Medical Commission, created in 
1993 by Wyo. Stat. § 27-14-616, effective January 1, 1994, is assigned a number 
of duties, one of which is to furnish three members to serve as a medical 
hearing panel to determine the cases referred by the Division for hearing. Wyo. 
Stat. § 27-14-616(b)(iv), in effect at the time of this hearing, provided in 
pertinent part:

(iv) * * * The 
division shall refer medically contested cases to the commission for hearing by 
a medical hearing panel. The decision to refer a contested case to the clerk of 
court for referral to the office of administrative hearings or a medical hearing 
panel established under this section shall not be subject to further 
administrative review. Following referral by the division, the hearing examiner 
or medical hearing panel shall have jurisdiction to hear and decide all issues 
related to the written notice of objection filed pursuant to W.S. 27-14-601(k). 
* * * When hearing a medically contested case, the panel shall serve as the 
hearing examiner and shall have exclusive jurisdiction to make the final 
administrative determination of the validity and amount of compensation payable 
under this act.

[¶15]   The plain and unambiguous statutory 
language limits the jurisdiction of the medical hearing panel to "medically 
contested cases," but did not define this term within the statute. Picking up 
the reins, the Division adopted the following definition in its rules and 
regulations:

(f) Contested 
Case Proceedings. Upon receipt of a request for hearing, the division shall 
immediately transmit a copy of the request to the appropriate clerk of district 
court for referral to the hearing examiner. The transmittal shall identify the 
Office of Administrative Hearings (OAH) or Workers' Compensation Medical 
Commission as the appropriate hearing examiner.

(i) For purposes 
of referring contested cases to the Workers' Compensation Medical Commission for 
hearing - W.S. § 27-14-616(b)(iv), the phrase "medically contested cases" shall 
include those cases in which the primary issue is:

(A) A 
worker/claimant's percentage of physical impairment;

(B) Whether a 
worker/claimant is permanently totally disabled;

(C) Whether a 
worker/claimant who has been receiving temporary total disability benefits 
remains eligible for those benefits under W.S. § 
27-14-404(c);

(D) Any other 
issue, the resolution of which is primarily dependent upon the evaluation of 
conflicting evidence as to medical diagnosis, medical prognosis, the 
reasonableness and appropriateness of medical care, or the appropriateness of 
fees charged by a health care provider.

Wyoming Workers' 
Compensation Rules, Regulations and Fee Schedule, ch. 5, § 3 (July 1994) 
(emphasis added). " 'When rules are adopted pursuant to statutory authority and 
are properly promulgated, they have the force and effect of law.' " Wagoner v. 
State, Dept. of Admin. and Information, 924 P.2d 88, 90 (Wyo. 1996) (quoting 
Fullmer v. Wyoming Employment Sec. Com'n, 858 P.2d 1122, 1123-24 (Wyo. 1993) and 
citing Drake v. State ex rel. Dept. of Revenue and Taxation, 751 P.2d 1319, 1322 
(Wyo. 1988)).

[¶16]   The issues determined by the 
medical hearing panel in French's case are not found within the definition of a 
medically contested case. By order dated June 19, 1995, the medical hearing 
panel judicially noticed the decision in Long v. Big Horn Const. Co., 75 Wyo. 
276, 295 P.2d 750 (1956) as providing law relevant to the resolution of this 
case.3 Thus, as early as June 19, 1995, 
the medical hearing panel indicated that the "primary" issue in French's case 
may involve a question of law.

[¶17]   By the time of the hearing, the 
legal issues of the case had clearly taken precedence over the medical issues. 
All parties agreed that legal issues, yet to be expressly decided in Wyoming 
case law, controlled the outcome of the case. In its final order, the medical 
hearing panel stated:

We recognize 
that the specific medical diagnosis of Ms. French's loss of consciousness need 
not be determined. Though a definitive diagnosis prior to that offered by Dr. Li 
on August 10, 1995 would be helpful, it is not imperative.

The only medical 
issue was whether French's loss of consciousness was caused by her preexisting 
condition. However, the medical hearing panel expressly stated that this 
determination did not require an evaluation of conflicting diagnoses.4 Thus, there were no issues which 
fell within the Division's definition of a "medically contested case." Instead, 
the primary issue in this case was the extent to which our holding in Long, 75 
Wyo. 276, 295 P.2d 750 would apply to a factual situation in which the claimant 
knowingly misrepresented her health status to her employer. A subsidiary legal 
issue was whether the applicability of Long was to be vitiated by the claimant 
or whether an alleged misrepresentation constituted an affirmative defense to be 
raised by the employer. Consequently, this case was not within the statutory 
jurisdiction of the Medical Commission.

[¶18]   Amax argues that subject matter 
jurisdiction was conferred at the time of the Division's referral when it 
appeared that the case depended upon the evaluation of conflicting evidence as 
to medical diagnosis. Subject matter jurisdiction is the power to hear and 
determine cases of a certain class. "It either exists or it does not, and before 
proceeding to a disposition on the merits, a court should be satisfied it does 
have the requisite jurisdiction." In Interest of MKM, 792 P.2d 1369, 1373 (Wyo. 
1990). We cannot agree that the Division's decision to refer the case to the 
Medical Commission, a decision which must be made "immediately" and with only 
limited information, overrides statutory jurisdictional limitations. See Wyo. 
Stat. § 27-14-601(k)(v) (Cum.Supp. 1994). The difficulty, however, is that the 
statute is silent as to what should be done when it is apparent, after referral 
of a case to the Medical Commission, that the matter is not a "medically 
contested case."

[¶19]   Relying on the legislature's 
pronouncement that "[t]he decision to refer a contested case to the clerk of 
court for referral to the office of administrative hearings or a medical hearing 
panel * * * shall not be subject to further administrative review," the medical 
hearing panel rejected the attempts of the parties to have the case transferred 
to the Office of Administrative Hearings or to certify the legal issues to the 
district court. Wyo. Stat. § 27-14-616(b)(iv). The decision to retain 
jurisdiction over the case was buttressed by citing to Wyo. Stat. § 
27-14-616(e), which provides:

Upon agreement 
of all parties to a case, the hearing examiner in a contested case under this 
chapter may transfer a medically contested case to a medical hearing panel or 
may seek the advice of the medical commission on specified medical issues in the 
contested case. The advice shall be in writing and shall become part of the 
record of the case.

The medical 
hearing panel determined that the absence of a corollary provision allowing 
transfer from the medical hearing panel to the Office of Administrative Hearings 
precluded the movement of the case to another decision-making 
forum.

[¶20]   In Russell, 944 P.2d  at 1154, we 
held that the Division's referral of a contested case to the Office of 
Administrative Hearings confers subject matter jurisdiction upon that office. 
Wyo. Stat. § 27-14-616(e) provides that the Office of Administrative Hearings 
may transfer a medically contested case which has been referred to that agency 
or to seek the advice of the Medical Commission on specified medical issues. The 
use of the permissive "may" authorizes the Office of Administrative Hearings to 
hear all contested cases which are referred by the Division. In contrast, Wyo. 
Stat. § 27-14-616(b)(iv) directs the Division to refer only "medically contested 
cases" to the medical hearing panel. The exclusive jurisdiction of the medical 
hearing panel to make the final determination of the validity and amount of 
compensation payable arises only "[w]hen hearing a medically contested 
case." Wyo. Stat. § 27-14-616(b)(iv) (emphasis added). There is no statutory 
exception to this jurisdiction.

[¶21]   There is no doubt that many 
contested worker's compensation claims involve both legal and medical issues. 
The hearing examiners in the Office of Administrative Hearings, previously 
vested with sole jurisdiction to hear these claims, have professional legal 
training and must be members in good standing of the Wyoming State Bar. Wyo. 
Stat. § 9-2-2201(c) (1997). The law has long recognized the limitations of a 
legally trained fact finder in circumstances which require a special expertise 
accumulated through extensive professional training and experience. In many such 
instances, the courts have sought counsel from special masters to assist in a 
factual understanding of the complex issues presented. The creation of the 
Medical Commission reflects the legislature's recognition that many contested 
claims involve complex medical issues, and in some cases, those issues are 
dispositive. Thus, each medical hearing panel will have at least one physician, 
and all will be health care providers, with the expertise to determine the 
medical issues before them. A medical hearing panel does not, however, have the 
legal training or expertise to determine the issues of law which may 
arise.

[¶22]   Contemplating the overlap of the 
areas of expertise in some cases, the legislature determined that with the 
agreement of the parties, the Office of Administrative Hearings may transfer an 
appropriate case or seek counsel from its medical counterpart. This provision 
affords the flexibility for the separate areas of expertise to work in tandem. 
The absence of a corollary provision does not expand the jurisdiction of a 
medical hearing panel, but only underscores the limited jurisdiction of the 
Medical Commission as authorized by Wyo. Stat. § 
27-14-616(b)(iv).

[¶23]   We are mindful of the legislature's 
express intent that the Wyoming Worker's Compensation Act is to be construed to 
afford "quick and efficient" determination of a worker's claim. Wyo. Stat. § 
27-14-101 (1997). It is inconceivable that the legislature intended cases which 
are not "medically contested" to proceed to a final decision before a medical 
hearing panel, only to be reversed on jurisdictional grounds at the point of 
judicial review. In this light, we urge the Division to carefully review each 
matter prior to referral to either hearing agency. Even so, we recognize the 
Division's time and informational constraints may unavoidably result in 
inappropriate referrals. In that case, upon recognition that the Medical 
Commission lacks subject matter jurisdiction, the case should be immediately 
returned to the Division for referral to the Office of Administrative Hearings. 
To hold otherwise would condone unnecessary waste of time and resources contrary 
to the intent of the legislature and common sense.

[¶24]   We wish to emphasize that our 
decision here does not contain any finding or implication that the legal 
conclusions of the medical hearing panel were in error. No matter how 
well-reasoned or articulate that decision may be, however, the Medical 
Commission lacked subject matter jurisdiction. Consequently, the order of the 
Medical Commission is void ab initio. MN v. CS, 908 P.2d 414, 416 (Wyo. 
1995).

V. 
CONCLUSION

[¶25]   Wyo. Stat. § 27-14-616(b)(iv) 
limits the jurisdiction of the Medical Commission to hear only "medically 
contested cases." A "medically contested case," as defined by the Division, is 
one in which the primary issue requires the application of a medical judgment to 
complex medical facts or conflicting diagnoses. In this case, the ultimate issue 
was an issue of law, thereby placing the case outside the jurisdiction of the 
Medical Commission. The decision of the district court affirming the order of 
the Medical Commission is reversed and the case remanded for disposition in 
accordance with this opinion.

Footnotes

1 Chapter 8, 
§ 1(g) of the Regular Rules of the Medical Commission 
provides:

Notice may be taken of judicially cognizable facts, along with technical 
or scientific fact within the agency's specialized knowledge or information, 
provided the parties are properly notified of any material facts 
noticed.

2 In Long, an 
injured worker misrepresented his age in order to procure employment. His claim 
for benefits was denied on the basis of the misrepresentation. On appeal, we 
noted:

[M]ost jurisdictions have adopted the rule of law that employment induced 
by false or fraudulent representations, not going to the factum of the contract, 
is voidable and not void and, therefore, the relationship of the employer and 
employee exists and compensation will be allowed for injuries sustained during 
such employment unless there is a causal connection between the injury and the 
misrepresentation.

Long v. Big Horn Const. Co., 75 Wyo. 276, 295 P.2d 750, 752 (1956). We 
acknowledged that this was the law of the case, but reversed the district court 
because there was insufficient evidence to support the element of causation. 
However, this decision did not directly review the application of this rule of 
law to the Wyoming Worker's Compensation Act.

3 We do not 
reach the propriety of taking "judicial notice" of case law under the Rules of 
the Medical Commission or W.R.E. 201.

4 The medical 
hearing panel found:

The 
symptoms preceding these episodes beginning in December 1992 bear great 
similarity to the prodrome Ms. French experienced on January 8, 1995. Dr. Li, 
Dr. Hartsaw, Dr. Howell and Dr. Tschida all describe symptoms consistent with 
neuro-mediated syncope. Dr. Johnson, apparently, did not have enough clinical 
information available to him to reach a conclusion regarding the exact nature of 
Ms. French's episodes. However, his consultation does not contradict Dr. Li's 
definitive diagnosis.