Title: IN THE MATTER OF THE WORKER'S COMPENSATION CLAIM OF ROGER KACZMAREK: STATE OF WYOMING, ex rel., WYOMING WORKERS' SAFETY AND COMPENSATION DIVISION V. ROGER KACZMAREK; IN THE MATTER OF THE WORKER'S COMPENSATION CLAIM OF ROGER KACZMAREK: CANNON OIL AND GAS WELL SERVICE, INC. V. ROGER KACZMAREK

State: wyoming

Issuer: Wyoming Supreme Court

Document:

IN THE MATTER OF THE WORKER'S COMPENSATION CLAIM OF ROGER KACZMAREK: STATE OF WYOMING, ex rel., WYOMING WORKERS' SAFETY AND COMPENSATION DIVISION V. ROGER KACZMAREK; IN THE MATTER OF THE WORKER'S COMPENSATION CLAIM OF ROGER KACZMAREK: CANNON OIL AND GAS WELL SERVICE, INC. V. ROGER KACZMAREK2009 WY 110Case Number: S-08-0208, S-08-0209Decided: 09/03/2009NOTICE:  This opinion is subject to formal revision before publication in Pacific Reporter Third.  Readers are requested to notify the Clerk of the Supreme Court, Supreme Court Building, Cheyenne, Wyoming 82002, of any typographical or other formal errors so that correction may be made before final publication in the permanent volume.
APRIL 
TERM, A.D. 2009

 
 
IN 
THE MATTER OF THE WORKER'S COMPENSATION CLAIM OF ROGER KACZMAREK: STATE OF 
WYOMING, ex rel., WYOMING WORKERS' SAFETY AND COMPENSATION 
DIVISION,Appellant(Respondent),v.ROGER 
KACZMAREK,Appellee(Petitioner), IN THE MATTER OF THE 
WORKER'S COMPENSATION CLAIM OF ROGER KACZMAREK: CANNON OIL AND GAS WELL SERVICE, 
INC.,Appellant(Respondent),v.ROGER 
KACZMAREK,Appellee(Claimant).

 
 
Appeal 
from the District Court of Sweetwater County

The 
Honorable Nena R. James, Judge

 
 

Representing 
Appellant in Case No. S-08-0208:

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

 
 

Representing 
Appellant in Case No. S-08-0209:

Clark 
D. Stith and Melissa J. Lyon of Rock Springs, Wyoming.  Argument by Ms. 
Lyon.

 
 

Representing 
Appellee in Case Nos. S-08-0208 & S-08-0209:

James 
R. Salisbury of Riske, Salisbury & Kelly, P.C., Cheyenne, 
Wyoming.

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

 
 
VOIGT, 
Chief Justice.

 
 
[¶1]      Roger Kaczmarek 
(the appellee) applied to the Wyoming Workers' Safety and Compensation Division 
(Division) for reimbursement of medical expenses relating to his back surgery in 
2006.  The appellee claimed that the 
2006 surgery was related to injuries sustained in a 1979 work-related accident 
for which the appellee received workers' compensation benefits.  The Division denied benefits and the 
matter was referred to the Office of Administrative Hearings (OAH), where the 
denial was affirmed.  The appellee 
appealed to the district court and the district court reversed the denial of 
benefits.  We will reverse the 
decision of the district court and affirm the Division's denial of 
benefits.

 
 
ISSUES

 
 
[¶2]      Two issues are 
before us in this appeal:

 
 
1.    Did the hearing examiner 
apply the proper burden of proof when denying the appellee's request for 
benefits under the second compensable injury rule?

 
 
2.    Was the hearing examiner's 
decision denying benefits to the appellee against the great weight of the 
evidence? 

 
 
FACTS

 
 
[¶3]      On February 
19, 1979, the appellee was injured when an oil well derrick collapsed and fell 
on top of him.  The appellee 
suffered an acute nondisplaced fracture of the pelvis and a chip fracture to the 
superior portion of the L4 vertebrae.  
The appellee received workers' compensation benefits resulting from these 
injuries.

 
 
[¶4]      On September 28, 
1993, the appellee was lifting a tire weighing approximately 180 pounds when the 
tire broke loose from his truck where it was wedged, causing pain in the 
appellee's back.  The appellee 
sought treatment for that injury with Dr. James Plate on October 4, 1993.  An MRI, conducted on December 15, 1993, 
showed a bulged disc without herniation at L4/5 and a small extruded disc 
herniation in the right lateral recess of L5/S1.  This injury occurred while the appellee 
was working, and he received workers' compensation benefits for this injury, but 
not through the Wyoming workers' compensation system, as the appellee was 
subject to a different system at the time.

 
 
[¶5]      The appellee 
continued to experience back pain and in 2006, he sought additional treatment 
from Dr. Plate.  An MRI of the 
appellee's back showed various problems along the lumbar region of his spine.1  After reviewing the MRI, Dr. Plate 
referred the appellee to a surgery group in Ft. Collins, Colorado.  Dr. Plate also advised the appellee to 
contact his lawyer to see if they could "get something worked out" so that the 
Division would pay the costs of consultation and surgery. 

 
 
[¶6]      The appellee 
submitted his medical bills to the Division and on October 31, 2006, the 
Division denied his claim for benefits finding that he failed to meet the 
requirements of Wyo. Stat. Ann. § 27-14-605, which statute governs modification 
of benefits previously awarded.  The 
appellee timely objected to this determination and on August 14, 2007, the OAH 
held a hearing on the appellee's claim.  
The hearing examiner's Findings of Fact, Conclusions of Law and Order, 
issued on September 12, 2007, upheld the denial of benefits concluding that the 
appellee had failed to prove that his 2006 symptoms were caused by his 1979 
work-related injury.  On October 12, 
2007, the appellee filed a Petition for Judicial Review of Agency Action 
challenging the OAH's decision.  On 
July 28, 2008, the district court issued a decision letter reversing the OAH's 
decision and on August 22, 2008, entered an order remanding the matter to the 
Division with instructions to award benefits.

 
 
STANDARD 
OF REVIEW

 
 
[¶7]      When considering 
an appeal from a district court's review of an administrative agency's action, 
we give "no special deference to the district court's decision," but instead 
review the case as if it had come directly from the administrative agency.  Dale v. S & S Builders, LLC, 2008 WY 
84, ¶ 8, 188 P.3d 554, 557 (Wyo. 2008).  Our review of an administrative agency's 
action is governed by the Wyoming Administrative Procedure Act, which provides 
in pertinent part that 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.

 
 
Wyo. 
Stat. Ann. § 16-3-114(c) (LexisNexis 2009).  This appeal presents both a question of 
law (whether the proper burden of proof was applied) and a question of fact 
(whether the agency's determination that the appellee failed to satisfy that 
burden was supported by substantial evidence).  Questions of law are reviewed de novo.  Sheth v. State ex rel. Wyo. Workers' 
Comp. 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 & Comp. Div., 
2002 WY 145, ¶ 9, 55 P.3d 23, 26 (Wyo. 2002) (internal citations omitted) 
(quoting State ex rel. Workers' Safety & Comp. Div. v. Garl, 2001 WY 59, ¶ 9, 26 P.3d 1029, 1032 
(Wyo. 2001)).

 
 
[¶8]      With regard to 
factual questions, we recently reiterated in Dale v. S & S Builders how the 
substantial evidence standard of review should be applied:

 
 
Because 
contested case hearings under Wyoming's Administrative Procedures Act, are 
formal, trial-type proceedings, use of the substantial evidence standard for 
review of evidentiary matters is more in keeping with the original intent of the 
drafters of the administrative procedures act.

 
 

Thus, 
in the interests of simplifying the process of identifying the correct standard 
of review and bringing our approach closer to the original use of the two 
standards, we hold that henceforth the substantial evidence standard will be 
applied any time we review an evidentiary ruling.  When the burdened party prevailed before 
the agency, we will determine if substantial evidence exists to support the 
finding for that party by considering whether there is relevant evidence in the 
entire record which a reasonable mind might accept in support of the agency's 
conclusions.  If the hearing 
examiner determines that the burdened party failed to meet his burden of proof, 
we will decide whether there is substantial evidence to support the agency's 
decision to reject the evidence offered by the burdened party by considering 
whether that conclusion was contrary to the overwhelming weight of the evidence 
in the record as a whole.

 
 

Dale, 
2008 WY 84, ¶¶ 21-22, 188 P.3d  at 561 (internal citations 
omitted.)

 
 
DISCUSSION

 
 
1.          
Did the hearing examiner apply the 
proper burden of proof when denying the appellee's request for benefits under 
the second compensable injury rule?

 
 
[¶9]      Wyoming law has 
long recognized that a single incident at work can give rise to more than one 
compensable injury.  See Baldwin v. Scullion, 50 Wyo. 508, 62 P.2d 531, 539 (1936).  This 
principle, referred to as the second compensable injury rule, applies when "an 
initial compensable injury ripens into a condition requiring additional medical 
intervention."  Yenne-Tully v. State ex rel. Wyo. Workers' 
Safety & Comp. Div., 12 P.3d 170, 172 (Wyo. 2000).  When asserting a claim for a second 
compensable injury, the claimant has the burden of proving his claim by a 
preponderance of the evidence.  Walsh v. Holly Sugar Corp., 931 P.2d 241, 243 (Wyo. 1997).  

 
 
[¶10]   To define the burden of proof 
applicable to the second compensable injury rule, we have contrasted it with the 
burden articulated in Wyo. Stat. Ann. § 27-14-605 (LexisNexis 2009), which 
statute governs claims for modification of benefits based on an increase or 
decrease in capacity, mistake or fraud.2  Both the statute and the second 
compensable injury rule govern claims for benefits following a compensable 
injury; however, each applies in different circumstances and carries a distinct 
burden of proof.

 
 
Wyo. 
Stat. § 27-14-605 applies to original benefits awarded after a determination in 
favor of the employee.  Medical and 
temporary total disability benefits awarded at a later date pursuant to the 
second compensable injury rule are not among the benefits the statute 
controls.  Wyo. Stat. § 27-14-605 
rests on the premise that following an initial determination in favor of an 
injured employee, any party may, within four years of the award, seek to modify 
the benefits awarded.  To modify the 
initial award, one must rely on Wyo. Stat. § 27-14-605. 

 
 

Casper 
Oil Co. v. Evenson, 
888 P.2d 221, 225 (Wyo. 1995).  
"Under the second compensable injury rule, a worker who has received a 
compensable injury and received benefits for that injury can, regardless of the 
passage of time, receive more benefits for that compensable injury without 
meeting either of the time limits or increased burden of proof found in 
Wyo. Stat. Ann. § 27-14-605 (LexisNexis 2001)."  Yenne-Tully v. State ex rel. Wyo. Workers' 
Safety & Comp. Div., 2002 WY 90, ¶ 10, 48 P.3d 1057, 1062 (Wyo. 
2002).

 
 
[¶11]   Under Wyo. Stat. Ann. § 27-14-605, 
the claimant must prove to a "reasonable degree of medical certainty­" that the increase or 
decrease in capacity is "due solely to 
the injury."  Wyo. Stat. 
Ann. § 27-14-605(a) and (c)(ii) (emphasis added).  The claimant must show "he has sustained 
additional incapacity entirely as a result of the injury in order to collect 
additional benefits."  Loghry v. Capshaw Well Serv., 739 P.2d 1227, 1228 (Wyo. 1987).  A 
showing that the increase in incapacity was "more probably than not caused by 
the original injury" is insufficient.  Woodman v. Grace Bomac 
Drilling, 736 P.2d 313, 315-16 (Wyo. 1987).  In contrast, we have said that under the 
second compensable injury rule, the claimant only has to demonstrate that it is 
"more probable than not" that the 
first and second injuries are related.3  Pino v. State ex rel. Wyo. Workers' Safety 
& Comp. Div., 996 P.2d 679, 
685 (Wyo. 2000) (emphasis added).

 
 
We 
have ruled in a different medical context that the causal connection between an 
accident or condition at the workplace is satisfied if the medical expert 
testifies that it is more probable than not that the work contributed in a 
material fashion to the precipitation, aggravation or acceleration of the 
injury.  Claim of 
Taffner, 821 P.2d 103, 105 
(Wyo. 1991).  We do not invoke a 
standard of reasonable medical certainty with respect to such causal connection. 
 Kaan v. State ex rel. Wyoming 
Worker's Compensation Div., 
689 P.2d 1387, 1389 (Wyo. 1984) (citing Jim's Water Service v. Eayrs, 590 P.2d 1346 (Wyo. 1979)).  Testimony by the medical expert to the 
effect that the injury "most likely," "contributed to," or "probably" is the 
product of the workplace suffices under our established standard.  Kaan, 689 P.2d  at 1389. . . 
.

 
 
This 
record discloses that under either the "reasonable medical probability" or "more 
probable than not" standard, Pino succeeded in demonstrating the causal 
connection by a preponderance of the evidence. 

 
 

Id. 
at 
685.  Thus, in a second compensable 
injury case, the claimant must show, by a preponderance of the evidence, that it 
is more probable than not that there exists a causal connection between the 
first and second injuries.

 
 
[¶12]   The appellee argues that the 
hearing examiner used the wrong burden of proof when applying the second 
compensable injury rule.  
Specifically, the appellee contends that the hearing examiner required 
the appellee to prove his case under the stricter burden set forth in Wyo. Stat. 
Ann. § 27-14-605.  We disagree.  Regarding the burden of proof, the 
hearing examiner, in his Findings of Fact, Conclusions of Law and Order, wrote 
the following:

 
 
38.   The second compensable injury rule 
is alive and well in Wyoming. . . . 

39.   Under the second compensable injury 
rule, a worker who has received a compensable injury and received benefits for 
that injury can, regardless of the passage of time, receive more benefits for 
that compensable injury without meeting either of the time limits or increased 
burden of proof found in Wyo. 
Stat. Ann. § 27-14-605 (LEXIS 2003).  In order for a second injury to be 
compensable, the original compensable injury must itself be the direct 
cause of the subsequent injury. . . .

. 
. . .

42.   While sympathetic to [the 
appellee's] current situation, this Office cannot ignore the burden of proof 
requirement that [the appellee] prove, by a preponderance of the evidence, his 
2006 need for low back surgery is directly related to the [sic] his February 19, 
1979 injury.

. 
. . .

48.   Dr. Rangitsch, like Dr. Plate, 
provided it was possible [the 
appellee]'s 1979 work injury could have contributed to [the appellee]'s 2006 
need for treatment; however, Dr. Rangitsch was very clear that he could not say to a reasonable degree of 
medical probability that [the appellee]'s current need for treatment was related 
to the original injury 28 years prior. . . .  

49.   . . . Even under the more lenient 
second compensable injury rule, [the appellee] still must prove his current need 
for treatment is directly related to the original work 
injury.

 
 
(Emphasis 
in original.)

 
 
[¶13]   The hearing examiner explicitly 
acknowledged that the stricter burden of proof of Wyo. Stat. Ann. § 27-14-605 is 
not applicable in this case, and referred to the second compensable injury rule 
as being "more lenient."  Further, 
the hearing examiner's finding that the appellee was required to show the causal 
connection to a reasonable degree of medical probability, rather than requiring 
the appellee to show that the second injury was "due solely to" the original 
compensable injury, indicates the hearing examiner used the proper burden of 
proof.  From these findings, and 
from the hearing examiner's application of the burden of proof to the evidence 
before him, which we will discuss in the next section, we conclude that the 
hearing examiner applied the proper burden of proof.

 
 
2.          
Was the hearing examiner's decision denying benefits to the appellee 
against the great weight of the evidence?

 
 
[¶14]   To prove his second compensable 
injury claim, the appellee relied on the expert testimonies of Dr. James Plate, 
his treating family physician, and Dr. Mark Rangitsch, the orthopedic surgeon 
who performed an Independent Medical Examination upon him.  As noted above, to meet his burden, the 
appellee was required to present evidence that it was more probable than not 
that the 2006 injury was directly related to the 1979 injury.  On direct examination, Dr. Plate 
testified as follows:

 
 
Q.  [By Appellee's Counsel:]  And, Doctor, do you have an opinion 
whether this '79, 1979 injury progressed into the present condition with [the 
appellee]'s back, requiring additional medical treatment?

A.  [By Dr. Plate:]  Well, my opinion is that I think it 
could.  I do not have an opinion 
that says I am sure that it happened from '79.  I certainly think that his back injury 
in '79 may have predisposed him to some of the changes that have happened along 
the way.

I 
am appreciative that he has been a hard-working person and in a lot of times 
heavy lifting situation subsequent even to '79 and I think those things could 
have either, number 1, aggravated a preexisting condition or, number 2, caused 
his conditions primarily.

            
Unfortunately, I don't know that anyone or anything can retrospectively 
define what exactly caused his final scenario; in other words, he's in the 
condition he's in today based on his previous experiences, but which one of them 
and how much of each one of them caused it is a very difficult thing to try to 
define.  That is kind of a gray 
opinion, I understand, but I don't think I can give you anything more 
clarified.

 
 
On 
cross examination, Dr. Plate was unable to offer a more definitive medical 
opinion as to the causal relationship between the first and second injuries: 

 
 
Q.   [By Division's Counsel:]  But it appears to me your testimony is 
that just based on the period, the passage of time, that you are unable to see 
any objective evidence to make a determination to a reasonable degree of medical 
probability that the 1979 injury is the direct cause of the current 
symptoms.  Is that also a fair 
statement?

A.   [By. Dr. Plate:]  Yeah.  I think it's a gray statement, but it's 
probably a summary statement.

Q.   Okay.  You're just unable to state to a 
reasonable degree of medical probability whether the '79 injury caused his 
current symptoms, is that right?

A.   Right.  I think I alluded that I said it could 
predispose him to several things that can change with 
time.

 
 
Similarly, 
on direct examination, Dr. Rangitsch was unable to say that it was more probable 
than not that the 2006 injury and the original 1979 compensable injury were 
related.

 
 
Q.  [By Appellee's Counsel:]  Down in paragraph number one in response 
to a question from Mr. Jackson, it says, "Are [the appellee]'s current 
complaints of back pain from 9-19-06 directly and solely related to his original 
work injury of 2-19-79?"  And you 
say, "They may be related."

                  
Can you tell me what you based that on?

A.   [By 
Dr. Rangitsch:]  I base that on the 
force again that created.  I mean, I 
also  I state that it looks like he had an intervening problem [in 1993] and he 
was lifting and that being as good of a reason as the [1979] injury to have the 
problems he is having. 

Q.  Okay.  But do you know to any degree of medical 
certainty[4] whether it's the intervening 
accident that is the cause or the '79 injury that is the cause of his problems 
today?

A.  I can't say either 
way.

. 
. . . 

Q.  So it's possible that the '79 injury 
could ripen or cause or result in an injury that he has experienced in 
2006?

A.  Yes.

Q.  Can you say to a reasonable degree of 
medical certainty whether it would be?

A.  No, I would say it's way too far remote 
to say that.  I can't link the two 
completely.  I can just say it's a 
possibility.

. 
. . .

Q.  . . . So the gist of what I got from your 
report was that you can't say what he is experiencing in 2006 is or is not 
related to the 1979 injury?

A.  Correct.

 
 
Like 
Dr. Plate, on cross-examination, Dr. Rangitsch testified that he could not 
relate the 1979 injury to the symptoms the appellee experienced in 
2006:

 
 
Q.   [By the Division's Counsel:]  And I guess I will follow up one more, I 
said that was my last question, but basically, if I understand you correctly, 
based upon the period of time from 1979 until now, and based upon that there was 
an intervening event in 1999, it's just difficult for you to give an opinion 
whether or not the current symptoms are related to the '79 injury.  Is that a fair 
statement?

A.   [By Dr. Rangitsch:]  Well, you said '99, it's 
'93.

Q.   Sorry.  Yes, '93.

A.   That's a fair 
statement.

 
 
[¶15]   Based on this testimony, the 
hearing examiner found:

 
 
47.       Dr. Plate, 
[the appellee]'s long term treating physician, admitted repeatedly that he could 
not directly relate [the appellee]'s 2006 need for treatment to the February 19, 
1979 injury.  Dr. Plate testified 
the 1979 injury could have 
predisposed [the appellee] to degenerative changes, but Dr. Plate could not 
say the 1979 injury actually did cause the current problems with [the 
appellee]'s back.  Dr. Plate 
admitted that no objective evidence existed to prove [the appellee]'s 2006 need 
for treatment was related to the 1979 injury and any attempt to do so would be 
mere speculation.

48.       Dr. 
Rangitsch, like Dr. Plate, provided it was possible [the appellee]'s 1979 work 
injury could have contributed to [the appellee]'s 2006 need for treatment; 
however, Dr. Rangitsch was very clear that he could not say to a reasonable degree of 
medical probability that [the appellee]'s current need for treatment was related 
to the original injury 28 years prior.  
Dr. Rangitsch testified that due to the lack of testing in 1979, the 
passage of time, [the appellee]'s return to physical labor and [the appellee]'s 
intervening 1993 injury, it was not possible to relate [the appellee]'s current 
need for treatment to the 1979 injury.

 
 
(Emphasis 
in original.)  The hearing examiner 
concluded "[t]here is no competent medical evidence which demonstrate[s] that 
[the appellee]'s current chronic low back pain and herniated disk [sic] is 
directly related to the February 19, 1979 work injury."

 
 
[¶16]   In an effort to show that the 
hearing examiner's determination was against the great weight of the evidence, 
the appellee points to portions of testimony similar to those quoted above, 
where Dr. Rangitsch and Dr. Plate testified that the 1979 injury "could have 
contributed," or "may be" related to the 2006 symptoms, that the 1979 injury 
"could predispose" the appellee to future back injury, that it was "possible" 
that the appellee had undiagnosed injuries from the 1979 injury, and that the 
original injury "could have progressed" into the 2006 condition.  The appellee does not argue that these 
statements, or anything in the record, establish that it is more probable than 
not that the first injury was causally related to the second injury; rather, the 
appellee claims that under the second compensable injury rule, his burden is 
only to show that "the 1979 injury predisposed and contributed in some fashion" 
to his current condition.  The 
appellee cites no authority where "predisposed and contributed in some fashion" 
was the burden of proof used in a second compensable injury case, and we 
likewise found none.  Whether a 
first injury predisposed an individual to a second injury may be a factor 
considered in determining whether a claimant has satisfied his burden of proof. 
 See Pino, 996 P.2d  at 686-87.  However, such a finding, without an 
ultimate conclusion that it is more probable than not that the second injury was 
causally related to the first, is inadequate.  Also, to allow claimants to seek 
benefits for a second compensable injury requiring only that the claimant show 
that the first injury "contributed in some fashion" to the second is an 
unworkable standard that would open the door to tenuous, vague, and even 
contrived claims.

 
 
[¶17]   We will briefly discuss two 
previous second compensable injury cases to illustrate application of the rule, 
focusing particularly on the nature of the evidence required to satisfy the 
burden of proof.  In Walsh v. Holly Sugar Corp., 931 P.2d 241 
(Wyo. 1997), the claimant was treated for low back pain of an unknown origin in 
1984.  Id. at 242.  In 1989, he suffered a compensable back 
injury.  Id. at 243.  In 1993, the claimant asserted a claim 
for a second compensable injury after re-injuring his back while working at his 
farm.  Id.  
The claimant's physician testified:

 
 
Q    (By [Counsel])  If the 1989 injury had not happened, 
assume that, it is just as possible that as a result of his 1984 problems that 
this 1993 injury would have cropped up, isn't it?

A    Yes.

* 
* *

Q    [BY COUNSEL]  Okay.  And despite that, you still make your 
opinion that there's some connection, in your mind, between the '93 injury and 
the '89 injury?

A    Yes.

* 
* *

Q    [BY COUNSEL]  And so I understand you, it's just 
basically you're speculating on this '93 injury and how it relates back to the 
'89 injury, are you not?

A    It occurred or is it 
speculation?

Q    To tie it together, you're 
speculating that those things are tied together?

A    Yes.

 
 

Id. 
at 243-44.  We affirmed the district 
court's finding that the second injury was not causally related to the first, 
stating "that it could be fairly summarized that the current problem could be 
causally related to the 1989 injury and that it could just as well not be 
related to the 1989 injury."  Id. at 243.

 
 
[¶18]   Here, like in Walsh, one of the doctors testified that 
the intervening injury was "as good of a reason as the [1979 injury] to have the 
problems he is having."  We have held that "speculative medical testimony is insufficient to satisfy a claimant's 
burden of proof."  Anastos v. Gen. Chem. Soda 
Ash, 2005 WY 122, ¶ 21, 120 P.3d 658, 666 (Wyo. 2005).  Just as we found in Walsh, speculation as to the cause of 
the second injury falls short of the requirement that the claimant show it is 
more probable than not that his second injury is causally related to the 
first.  

 
 
[¶19]   Another illustrative case is Chavez v. State ex rel. Wyoming Workers' 
Safety and Compensation Division,  2009 WY 46, 204 P.3d 967 (Wyo. 
2009).  There the claimant sustained 
a compensable back injury in 1989.  Id. at ¶ 4, 204 P.3d  at 968.  The claimant underwent back surgery in 
1991, which surgery was paid for by the Division.  Id. at ¶¶ 5, 7, 204 P.3d  at 969.  The claimant continued suffering back 
pain until 2006, when he underwent a second surgery to "decompress and fuse the third, fourth, and fifth lumbar 
vertebrae."  Id. at ¶ 6, 204 P.3d  at 969.  The claimant requested, and was denied, 
benefits for the second surgery. Id. 
at ¶ 7, 204 P.3d  at 969.  At the 
hearing, the testimony of two physicians presented conflicting opinions 
concerning whether the 2006 surgery was causally related to the 1989 injury. 
 Id. at ¶¶ 8, 15, 16, 204 P.3d  at 969, 
970-71.  On appeal, we affirmed the 
denial of benefits, stating:

 
 
As 
discussed above, Dr. Beer's opinion was that Mr. Chavez's 2006 surgery was 
causally related to the initial compensable work injury he received in 
1989.  If the Commission had 
accepted Dr. Beer's opinion, that might have been a sound basis for awarding 
benefits to Mr. Chavez under 
the second compensable injury rule.  What Mr. Chavez overlooks, however, is that the Commission 
explicitly chose to give more weight to the opinion of Dr. Ruttle, who testified 
that Mr. Chavez's 2006 surgery 
was not the result of the incident in 1989.  This testimony 
supported the Commission's finding that the 2006 surgery was not causally 
related to the compensable work injury that occurred in 
1989.

 
 

Id. 
at 
¶ 27, 204 P.3d  at 974.

 
 
[¶20]   Unlike in Chavez, the hearing examiner in the 
present case did not have to weigh or decide whether to consider one doctor's 
testimony over the other's, as neither doctor was able causally to relate the 
second injury to the first.  Without 
some testimony or other evidence showing it was more probable than not that the 
second injury was caused by the first, the claimant cannot satisfy his burden of 
proof.    

 
 
CONCLUSION

 
 
[¶21]   We find that, as a matter of law, 
the hearing examiner used the proper burden of proof when deciding whether the 
appellee was entitled benefits under the second compensable injury rule.  Also, after reviewing the entire record, 
we hold that the hearing examiner's conclusion that the appellee was unable to 
prove that his 2006 condition was related to the 1979 injury, and thus 
compensable as a second compensable injury, is supported by substantial 
evidence.  Thus, we will reverse the 
decision of the district court and remand for proceedings consistent with this 
opinion.

 
 
FOOTNOTES

 
 

1The 
MRI revealed the following:  mild 
disc degeneration at the L1-2 level without significant bulging or herniation, 
disc dehydration and broad-based anterior and posterior disc bulging and facet 
arthropathy and bilateral facet arthropathy at L2-L3, mild disc degeneration 
without herniation and severe facet arthropathy and ligamentum flavum 
hypertrophy at L3-L4, a left paracentral disc protrusion which extends 
inferiorly along the posterior margin of the L5 vertebral body within the 
lateral recess which likely impinges on the left L5 nerve root at L4-L5, and a 
right paracentral disc protrusion with annular tear which appeared to abut the 
exiting L5 nerve root at L5-S1.

 
 

2Wyo. 
Stat. Ann. § 27-14-605, entitled "Application for modification of benefits; time 
limitation; grounds; termination of case; exceptions" reads: 

 
 
(a)   If a determination is made in favor 
of or on behalf of an employee for any benefits under this act, an application 
may be made to the division by any party within four (4) years from the date of 
the last payment for additional benefits or for a modification of the amount of 
benefits on the ground of increase or decrease of incapacity due solely to the 
injury, or upon grounds of mistake or fraud. The division may, upon the same 
grounds and within the same time period, apply for modification of medical and 
disability benefits to a hearing examiner or the medical commission, as 
appropriate.

(b)   Any right to benefits shall be 
terminated and is no longer under the jurisdiction of this act if a claim for 
any benefit is not filed with the division within the four (4) year limitation 
prescribed under subsection (a) of this section.

(c)   A claim for medical benefits which 
would otherwise be terminated under subsection (b) of this section and barred 
under W.S. 27-14-503(a) and (b) may be paid by the division if the 
claimant:

(i)      Submits medical 
reports to the division substantiating his claim;

(ii)     Proves by competent 
medical authority and to a reasonable degree of medical certainty that the 
condition is directly related to the original injury; and 

(iii)    Submits to an examination by 
a health care provider selected by the division and results of the examination 
validate his claim.

 
 

3We 
have used a number of terms to describe the required causal connection between 
the first and second injuries including:  
"direct cause" (Pino v. State ex 
rel. Wyo. Workers' Safety & Comp. Div., 996 P.2d 679, 684 (Wyo. 2000); Taylor v. State ex rel. Wyo. Workers' Safety 
& Comp. Div., 2003 WY 83, ¶ 12, 72 P.3d 799, 803 (Wyo. 2003)); 
"caused by" (Casper 
Oil Co. v. Evenson, 
888 P.2d 221, 226 (Wyo. 1995)); 
"causally related to" (Chavez v. State ex rel. Wyo. Workers' Safety 
& Comp. Div., 2009 WY 46, ¶¶ 26-27, 204 P.3d 967, 973-74 (Wyo. 2009); Walsh v. Holly Sugar Corp., 931 P.2d 241, 243 (Wyo. 1997)); "direct causal connection" (Alvarez v. State ex rel. Wyo. Workers' 
Safety & Comp. Div.,  2007 WY 126, ¶ 17, 164 P.3d 548, 
552 (Wyo. 2007)); "direct and natural result" (Stewart v. State ex rel. Wyo. Workers' 
Safety & Comp. Div., 2007 WY 58, ¶ 12, 155 P.3d 198, 203 (Wyo. 2007) 
(quoting 1 Arthur Larson & Lex K. Larson, Larson's Workers' Compensation Law § 
10.10, at 10-2 (2006))); "significant causal connection" and "predominant cause" 
(Yenne-Tully v. State ex rel. Wyo. 
Workers' Safety & Comp. Div., 2002 WY 90, ¶ 11, 48 P.3d 1057, 1062 (Wyo. 
2002)); "fairly be traced to" and "a contributing cause" (State ex rel. Wyo. Workers' Safety & 
Comp. Div. v. Bruhn, 951 P.2d 373, 377 (Wyo. 1997)).  Regardless of the terminology used to 
describe the causal connection, the burden remains the same: the claimant must 
show, by a preponderance of the evidence, that it is more probable than not that 
the second injury was caused by the first.

 
 

4The 
appellee's counsel asked about "reasonable medical certainty."  This language is consistent with Wyo. 
Stat. Ann. § 27-14-605, which statute, as the appellee points out, does not 
apply to the present proceedings.  
Thus, it can be reasonably assumed that the appellee's counsel meant 
"reasonable medical probability."