Title: IN THE MATTER OF THE WORKERS' COMPENSATION CLAIM OF: RONALD A. BUSH V. STATE OF WYOMING, ex rel., WYOMING WORKERS' SAFETY AND COMPENSATION DIVISION

State: wyoming

Issuer: Wyoming Supreme Court

Document:

IN THE MATTER OF THE WORKERS' COMPENSATION CLAIM OF: RONALD A. BUSH V. STATE OF WYOMING, ex rel., WYOMING WORKERS' SAFETY AND COMPENSATION DIVISION2008 WY 117193 P.3d 260Case Number: S-07-0226Decided: 10/07/2008
OCTOBER 
TERM, A.D. 2008

 
 
IN 
THE MATTER OF THE WORKERS' COMPENSATION CLAIM OF: RONALD A. 
BUSH,Appellant(Employee/Petitioner),v.STATE OF 
WYOMING, ex rel., WYOMING WORKERS' SAFETY 
AND COMPENSATION 
DIVISION,Appellee(Objector/Respondent).

 
 
Appeal 
from the DistrictCourtofFremontCounty

The 
Honorable Norman E. Young, Judge

 
 

Representing 
Appellant:

David 
M. Gosar of Jackson, 
Wyoming.

 
 

Representing 
Appellee:

Bruce 
A. Salzburg, Wyoming Attorney General; John W. Renneisen, Deputy Attorney 
General; Steven R. Czoschke, Senior Assistant Attorney General; Kristi M. 
Radosevich, Senior Assistant Attorney General.

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

 
 
VOIGT, 
Chief Justice.

 
 
[¶1]      This is an appeal 
from the district court's affirmance of an Order of the Office of Administrative 
Hearings (OAH) denying the appellant's claim for worker's compensation 
benefits.  We will affirm because 
the decision of the hearing examiner was not unsupported by substantial 
evidence.

 
 
ISSUES

 
 
[¶2]     1.   Did the appellant fail timely to 
report an injury to his employer and fail timely to report an injury to the 
Wyoming Workers' Safety and Compensation Division?

 
 
           
2.   Was the hearing 
examiner's decision that the appellant failed to prove that his injury was 
work-related unsupported by substantial evidence?

 
 
FACTS

 
 
[¶3]      In the summer of 
2002, the appellant worked for Riverton Ready Mix.  On Wednesday, July 3, 2002, the 
appellant left work earlyat 12:30 p.m.with his employer's permission.  That afternoon and evening, he worked as 
a sound technician for a local band.  
The next morning, he drove a car in a local parade.  He returned to work on Monday, July 8, 
which was the next regular work day, and worked that full week.  On the following Saturday, July 13, he 
drove two rounds in a demolition derby, entering and exiting the vehicle by 
sliding out through the vacant front windshield area and stepping to the 
ground.

 
 
[¶4]      Interspersed 
among these events were certain "medical events" that underlie the present 
controversy.  After the parade on 
July 4, the appellant went to the hospital emergency room complaining of an 
injured ankle.  The emergency room 
record indicates that the appellant reported injuring his ankle just prior to 
arrival when he stepped out of a truck.  X-rays did not reveal the ankle to be 
broken or dislocated, leaving the emergency room physician, Dr. Jarrard, to 
conclude that the ankle was sprained.  
The doctor told the appellant he could go to work if he felt capable of 
doing so.

 
 
[¶5]      The appellant 
returned to work on Monday, July 8, and reported to his supervisor, Steven 
Harless, that the ankle injury occurred at about 9:00 a.m. on Wednesday, July 3, 
when he stepped out of a work truck.  
On Thursday, July 11, or Friday, July 12, the appellant's fiancée made an 
appointment for him with Dr. Michael Ford, an orthopedic surgeon, for Monday, 
July 15.  During that appointment, 
Dr. Ford diagnosed torn ligaments and widening of the ankle mortise.1  He surgically corrected those injuries 
on July 19.

 
 
[¶6]      The Division did 
not receive the accident report forms until July 23.  The delay resulted from the appellant's 
belief that the forms could not be sent in until the employer's section was 
completed, and Harless's belief that completion of the employer's section 
constituted an admission that the injury was work-related.  At any rate, the Division issued its 
Final Determination on August 5, denying benefits because (1) the injury was not 
proven to be work-related, as required by Wyo. Stat. Ann. § 27-14-102(a)(xi) 
(LexisNexis 2007); (2) the injury was 
not reported to the employer within the 72-hour time limit of Wyo. Stat. Ann. § 
27-14-502(a); and (3) the injury report was not filed with the Division within 
the 10-day time limit of Wyo. Stat. Ann. § 27-14-502(a).

 
 
[¶7]      The appellant 
objected to the Final Determination and requested a hearing.  The Division then referred the matter to 
the OAH.  The hearing took place on 
December 12, 2002, and an Order Denying Benefits was issued on February 18, 
2003.  The hearing examiner found 
and concluded that the appellant had not timely reported the injury to his 
employer, had not timely filed the injury report with the Division, and had 
failed to prove that the injury was work-related.

 
 
[¶8]      The appellant 
next filed in the district court a Petition for Review of Administrative Action, 
dated March 11, 2003.  The district 
court reviewed the record presented to it, along with the parties' briefs, and 
on August 2, 2004, affirmed the decision of the hearing examiner on the grounds 
that (1) factual findings were supported by substantial evidence; (2) no agency 
action was shown to be arbitrary or capricious; and (3) the appellant had failed 
to meet his burden of proving by a preponderance of the evidence that his injury 
was work-related.  The appellant 
appealed that decision to this Court on August 20, 2004.2

 
 
[¶9]      Our opinion in 
the first appeal of this case did not reach the merits.  In Bush v. State ex rel. Workers' Compensation 
Division, 2005 WY 120, ¶¶ 12-13, 120 P.3d 176, 180-81 (Wyo. 2005) (Bush I), we concluded that the hearing 
officer's order did not contain adequate findings to support its conclusions, so 
we remanded the matter to the district court for further remand to the OAH for 
supplemental findings and entry of a new order.  That new order was entered by the OAH on 
March 27, 2006.  The appellant again 
petitioned for review in the district court, the OAH order again was affirmed, 
and the appellant again appealed to this Court.

 
 
DISCUSSION

 
 
Did 
the appellant fail timely to report an injury to his employer and fail timely to 
report an injury to the Wyoming Workers' Safety and Compensation 
Division?

 
 
[¶10]   Wyo. Stat. Ann. § 27-14-502(a) 
provides that an injured employee must report the "general nature of the 
accident or injury" to his or her employer within 72 hours "after the general 
nature of the injury became apparent."  
The same statutory subsection requires an injured employee to file an 
injury report with the Division within ten days "after the injury became 
apparent."  Subsection (c) of the 
same statute provides that failure to do both of these tasks results in "a 
presumption that the claim shall be denied."  See Wesaw v. Quality Maint. (In re Worker's 
Comp. Claim), 2001 WY 17, ¶ 14, 19 P.3d 500, 506 (Wyo. 2001).  To overcome the presumption, the 
employee must show by clear and convincing evidence that the delay prejudiced 
neither the employer nor the Division "in investigating the injury and in 
monitoring medical treatment."  
Id. at ¶ 12, at 
505.

 
 
[¶11]   In its first Order Denying 
Benefits, the OAH found that the appellant did not report the injury to his 
employer within 72 hours and did not file an injury report with the Division 
within 10 days of the apparent injury.  In its conclusions of law, the OAH then 
detailed the time limits of Wyo. Stat. Ann. § 27-14-502(a) and the presumption 
of Wyo. Stat. Ann. § 27-14-502(c).  
None of this, however, appeared to factor into the denial of the 
claim.  In any event, that Order was 
vacated by our decision in Bush I, 
2005 WY 120, ¶ 13, 120 P.3d  at 181.

 
 
[¶12]   In the second go-round, the hearing 
examiner entered a more fully detailed Order in which benefits were denied 
solely based upon the conclusion that the appellant had not met his burden of 
proving that the injury was work-related.  The issues of timely reporting and timely 
filing are not even mentioned in the Order and apparently had no bearing upon 
the decision to deny benefits.  Nor 
was timeliness raised by the district court in affirming the Order of the OAH. 
 That, no doubt, is why the 
appellant did not raise the issue in his current appellate 
brief.

 
 
[¶13]   The Division contends, to the 
contrary, that the issue of timeliness survives, and is before this Court, 
because it was a basis for decision in the Final Determination and was listed as 
an issue in the Notice of Referral for Hearing.  We do not agree.  Even though the hearing examiner did not 
provide an additional hearing upon remand, the Division still had the 
opportunity to raise in the district court the hearing examiner's failure to 
address timeliness in the second OAH Order, and it did not do so.  Because untimely reporting and filing 
create only an evidentiary presumption, rather than a lack of subject matter 
jurisdiction, we need not raise or consider the issue.  It is our determination that, if the 
issue did survive the first go-round, the Division waived it below in the second 
go-round.

 
 
Was 
the hearing examiner's decision that the appellant failed to prove that his 
injury was work-relatedunsupported by substantial 
evidence?

 
 
[¶14]   W.R.A.P. 12.09(a) directs us to 
Wyo. Stat. Ann. § 16-3-114(c) (LexisNexis 2007) for the matters to be considered in 
the review of administrative action.  
We recently said the following with regard to the standard of review when 
we are required to examine the evidentiary findings of an 
agency:

 
 
Section 
16-3-114(c)(ii) provides only one evidentiary standard of review.  Under the plain language of the statute, 
reversal of an agency finding or action is required if it is "not supported by 
substantial evidence."  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.  33 Fed. Prac. & Proc., Judicial 
Review §§ 8333, 8334.

 
 
            
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.  See, Wyo. Consumer Group v. Public Serv. 
Comm'n of Wyo., 882 P.2d 858, 860-61 
(Wyo. 1994); 
[Board of Trustees of Laramie County 
School Dist. No. 1 v.] Spiegel, 
549 P.2d [1161,] 1178 [(Wyo. 1976)] (discussing the definition of 
substantial evidence as "contrary to the overwhelming weight of the 
evidence").  If, in the course of 
its decision making process, the agency disregards certain evidence and explains 
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.  
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 on all the evidence before it.

 
 

Dale 
v. S & S Builders, LLC, 
2008 WY 84, ¶¶ 21-22, 188 P.3d 554, 561 (Wyo. 2008).3  An agency's conclusions of law are 
reviewed de novo, and are affirmed if 
they are in accordance with the law.  
Id., 2008 WY 84, 
¶ 26, 188 P.3d  at 562.  "[W]e afford 
no deference to conclusions reached by the district court, but review the case 
as if it had come directly from the agency."  Loomer v. State ex rel. Wyo. Workers' Safety 
& Comp. Div., 2004 WY 47, ¶ 15, 88 P.3d 1036, 1041 (Wyo. 
2004).

 
 
[¶15]   There is no question that the 
appellant did, indeed, suffer a serious ankle injury.  His ankle was surgically repaired on 
July 19, 2002.  The question is 
simply whether the appellant proved that the injury occurred at work.  From the facts presented, there are only 
two possibilities:  the injury 
either occurred at work during the morning of July 3, or it occurred away from 
work between 12:30 p.m. on July 3 (when the appellant left work) and 4:30 p.m. 
on July 4 (when the appellant went to the emergency room).

 
 
[¶16]   The hearing examiner characterized 
this conflict in the evidence as a credibility contest.  On one side are the appellant, his 
fiancée, and two friends.  
Collectively, their version of events is that the appellant injured his 
ankle at work on the morning of July 3, that he complained of pain in his ankle 
during the afternoon and evening of July 3, and that the ankle looked swollen 
and discolored that night.  The 
appellant's fiancée and friends all testified that he told them at the time that 
the injury occurred at work.

 
 
[¶17]   On the other side, the appellant's 
supervisor testified that he talked to the appellant three times during the 
morning of July 3, that the appellant never mentioned an injury, and that the 
appellant did not appear to be limping at any time that morning.  In addition, the hospital record 
generated after the appellant's trip to the emergency room at 4:30 p.m. on July 
4 indicates that the appellant reported that the injury occurred at home just 
prior to his arrival at the hospital.

 
 
[¶18]   In his findings of fact, the 
hearing examiner evaluated this contradictory evidence as 
follows:

 
 
15.       In this 
matter the Employee must meet his burden of proof in order that he prevail in 
his claim and receive benefits.  
Accordingly, the case turns on the credibility of the witnesses and the 
information that they provide.  The 
Employee's case is primarily based upon his recitation of events and those 
people to whom he described his accident [].  This Hearing Officer is not convinced by 
the testimony presented to support Employee's claim.  There were no eyewitnesses to the injury 
or to employee's behavior after the alleged injury except his supervisor who was 
not told of an injury and did not notice Employee limping.  The Employee had participated in several 
activities the day of his injury and prior to when he saw Doctor Jarrad during 
which he did not manifest symptoms of a serious injury.  He went to a concert in which his band 
participated and was there for more than 12 hours even going to a restaurant for 
a late night dinner at approximately 1:30 a.m., and the next day he went to the 
July 4th parade where he had a demolition car as an exhibit.  He did not go to the hospital until late 
in the afternoon of the day after he claims to have been injured.  One week later he was in the demolition 
derby during which he had to get in and out of the car through the windshield 
more than once.  There are other 
facts that are not consistent with Employee's claim that he had a serious injury 
on July 3rd.  Employee testified he 
decided to see the doctor when he took his boot off late that night and saw it 
was swollen and that he went to the hospital soon after he left the parade.  The hospital admission form says he told 
the clerk that he injured his ankle at home just prior to coming to the 
hospital.  The time recorded that 
Employee was at the hospital is 4:30 p.m. long after the end of the parade.  He did not mention the injury to his 
employer until July 8, 2002, even though he talked to him three times on the day 
he claims he was injured and the supervisor did not notice that Employee had a 
limp when he had an opportunity to observe Employee.  Much testimony centered around Employee 
participating in the demolition derby 10 days after the alleged injury.  This information is significant because 
it shows a pattern of activity by Employee that is not consistent with a person 
that had a serious injury requiring a reconstruction of his ankle.  Employee's conduct during the weekend 
[of] July 4th is also not consistent with his having incurred a serious injury 
the day before.  His inconsistent 
behavior on the day of the alleged injury and the day after belies the testimony 
presented.  Considering all these 
facts and the actions of the Employee, this Hearing Officer does not find 
Employee's testimony to be credible and that he has met his burden of 
proof.

 
 
[¶19]   "A hearing examiner's determination 
of credibility will not be overturned unless it is clearly contrary to the 
overwhelming weight of the evidence."  
Olivas v. State ex rel. Wyo. 
Workers' Safety & Comp. Div., 2006 WY 29, ¶ 17, 130 P.3d 476, 485 (Wyo. 
2006); see also Pederson v. State ex rel. 
Wyo. Workers' Comp. Div., 939 P.2d 740, 742 (Wyo. 1997).  In the present case, we cannot say that 
the "overwhelming weight of the evidence" supports the appellant's version of 
events, as opposed to the testimony of Harless, the timing of the emergency room 
visit, the information contained in the emergency room record, and the 
appellant's participation in that weekend's events.  While we are not convinced that the fact 
of the appellant's participation in the demolition derby a week after the injury 
sheds much light on whether the injury occurred on July 3 or July 4, we do find 
that substantial evidence in the record supports the conclusion that the 
appellant did not prove that the injury occurred at work on July 
3.

 
 
CONCLUSION

 
 
[¶20]   
The issues of the timeliness of the appellant's reporting of his 
alleged work injury to his employer and the timeliness of his filing of an 
injury report with the Division played no part in the hearing officer's decision 
in this case, and were waived below by the Division.  The hearing officer's determination that 
the appellant did not prove that his injury was work-related was not unsupported 
by substantial evidence.

 
 
[¶21]   Affirmed.

 
 
FOOTNOTES

 
 

1The ankle 
mortise is "[t]he seating for the talus formed by the union of the distal fibula 
and the tibia at the ankle joint."  
Stedman's Medical Dictionary 
1132 (27th ed. 2000).

 
 

2These 
dates are correct.  We discovered 
nothing in the record that explains the district court ruling following the 
filing of the petition by seventeen months.

 
 

3Although 
not relevant in the instant case, the "arbitrary and capricious" standard 
remains as a "safety net" for certain agency action that may be related to the 
evidence, but which action is not a true evidentiary question.  Dale, 2008 WY 84, ¶ 23, 188 P.3d  at 
561.