Title: Shepherd of the Valley Care Ctr. v. Fulmer

State: wyoming

Issuer: Wyoming Supreme Court

Document:

SHEPHERD OF THE VALLEY CARE CENTER V. REBECCA K. FULMER2012 WY 12Decided: 02/02/2012This 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.  
OCTOBER 
TERM, A.D. 2011
 
SHEPHERD 
OF THE VALLEY CARE 
CENTER,Appellant(Respondent),v.REBECCA K. 
FULMER,Appellee(Petitioner).
 
 
Appeal 
from the District Court of Natrona County
The 
Honorable David B. Park, Judge
 
 
Representing 
Appellant:
Scott 
P. Klosterman of Williams, Porter, Day & Neville, P.C., Casper, 
Wyoming
 
Representing 
Appellee:
Peter 
J. Timbers of Schwartz, Bon, Walker & Studer, LLC, Casper, 
Wyoming
 
 
Before 
KITE, C.J., and GOLDEN, HILL, VOIGT, and BURKE, 
JJ.
 
 
GOLDEN, 
Justice.
 
[¶1]      Rebecca K. Fulmer 
(Fulmer) suffered injuries on two separate dates while working as a Certified 
Nursing Assistant (CNA) at Shepherd of the Valley Care Center (Shepherd).  She submitted worker’s compensation 
claims for both injuries.  Shepherd 
objected to both claims, and the Wyoming Workers’ Safety and Compensation 
Division (Division) denied benefits for the two injuries. 
 
[¶2]      Fulmer requested 
a hearing, and following a combined contested case hearing, the Office of 
Administrative Hearings (OAH) upheld the denial of benefits.  The OAH concluded Fulmer was not 
entitled to benefits for her first injury because it was the result of Fulmer’s 
own culpable negligence.  It 
concluded Fulmer was not entitled to benefits for the second injury based on its 
finding that “Fulmer was performing activities of daily living not causally 
related to her work and the fracture could have become complete at any time or 
place.”  
 
[¶3]      Fulmer appealed, 
and the district court reversed the OAH decision.  The district court found the record did 
not support either the finding that Fulmer’s first injury was caused by her own 
culpable negligence or the finding that Fulmer’s second injury was caused not by 
her work but by normal activities of day-to-day living.  We affirm the decision of the district 
court and hold that Fulmer is entitled to benefits for both of her August 2008 
injuries.
 
ISSUES
 
[¶4]      The Division did 
not appeal the district court’s decision.  
Shepherd presents the following issues on appeal:
 
            
A.        
Whether the hearing examiner correctly determined that the injury 
sustained by Rebecca Fulmer on August 12, 2008, was caused by her culpable 
negligence and therefore [was] not a compensable injury as defined under Wyo. 
Stat. § 27-14-102(a)(xi).
 
            
B.        
Whether the hearing examiner correctly determined that the injury 
sustained by Rebecca Fulmer on August 30, 2008, resulted primarily from normal 
activities of day-to-day living and therefore [was] not a compensable injury as 
defined under Wyo. Stat. § 27-14-102(a)(xi).
 
 
 
 
FACTS
 
[¶5]      Fulmer began 
working as a CNA at Shepherd on May 22, 2006.  On the morning of August 12, 2008, 
Fulmer and another CNA, Seth Darrison, performed a two-person transfer of a 
Shepherd patient from the patient’s bed to the bathroom.  During this lifting procedure, Fulmer 
and Darrison heard Fulmer’s hip pop, and Fulmer felt pain in her right hip.  After Fulmer and Darrison transferred 
the patient from the bathroom to a recliner, Fulmer consulted with Mary Riggs, a 
physical therapy assistant who also works at Shepherd.  Riggs massaged and “popped” Fulmer’s 
right hip back into place.  Fulmer 
then continued working with Darrison to complete two-person transfers of around 
seven or eight additional patients.  

 
[¶6]      Sometime during 
the afternoon of August 12, 2008, Fulmer performed a transfer of another patient 
from her wheelchair to her bed.  
Fulmer performed this transfer by herself, even though the patient care 
instructions for the patient warned that the patient was at high risk for falls 
and directed that the patient be transferred using two CNAs and a Hoyer 
Lift.  After Fulmer completed the 
transfer of this patient, she began to experience severe pain in her right 
hip.  Before leaving work that day, 
she saw Riggs again, and Riggs repeated the procedure she had performed earlier 
in the day.1  
 
[¶7]      On August 15, 
2008, Fulmer saw Dr. Christopher Snyder for treatment of her right hip pain. Dr. 
Snyder diagnosed an “acute right lumbar strain with right lumbar 
neuroradiculitis.”  X-rays of 
Fulmer’s right hip and lumbar spine on August 15, 2008, showed no evidence of an 
acute abnormality and no evidence of inflammatory arthritis or significant 
degenerative change. Dr. Snyder prescribed muscle relaxants and 
anti-inflammatory and pain medications, and kept Fulmer off work for seventy-two 
hours with a return thereafter to light duty.  
 
[¶8]      On August 30, 
2008, Fulmer returned to light duty at Shepherd.  Her light-duty responsibilities included 
passing ice and water to residents, assisting in the dining room, and assisting 
in making beds.  In the afternoon, 
Fulmer was passing ice and water to the Shepherd residents, a task that involved 
pushing an ice cart through the halls, emptying pitchers in the rooms, and 
refilling those pitchers with ice and water.  While performing this task, Fulmer felt 
her hip snap and fell to the floor.  

 
[¶9]      Fulmer was taken 
to the Wyoming Medical Center, diagnosed with a fractured right hip and 
underwent surgery performed by Dr. Clayton Turner.  Dr. Turner diagnosed Fulmer as 
follows:
 
1.         
Displaced right femoral neck fracture.
2.         
Questionable history of right femoral neck stress         
fracture, which was completed with acute displacement on August 30, 2008, versus a 
pathologic     process that 
may result in bone weakening. 
 
[¶10]   Fulmer sought worker’s compensation 
benefits for both the August 12th and August 30th injuries to her right 
hip.  On March 15, 2009, Dr. Anne 
MacGuire performed an independent medical evaluation (IME).  Dr. MacGuire concluded that Fulmer’s 
August 12, 2008, hip injury was a work injury.  She concluded that Fulmer’s August 30, 
2008, injury was not work related based on the following 
observations:
 
The 
pathologic report completed postoperatively documented the claimant has 
osteoporosis of the right hip.  In 
my opinion, this was a fatigue fracture.  
Reviewing the definitions of injury and I quote from the information 
provided to me from the division of Workers’ Safety and Compensation (xi “Injury 
means any harmful change in human organism other than normal aging and includes 
damage to or loss of any artificial replacement and death arising out of and in 
the course of employment while at work in or about in the premises occupied, 
etc”).  The claimant was at work, 
but her fatigued fracture of her right hip is a normal aging process and while 
it occurred on the job was not due to any unusual or specific employment-related 
activity.  The claimant has risk 
factors for osteoporosis, which include multiparity and vitamin D 
deficiency.
 
* 
* * *
 
The 
claimant suffered [a] fragility fracture.  
It is my impression this fracture could have occurred at any time, and 
since she was not in the act of bending, twisting, or lifting, there does not 
appear to be an occupational cause for her fragility 
fracture.
 
* 
* * *
 
By 
history to Dr. Iverson and Dr. Turner, the claimant was walking passing out 
ice.  This would be activity 
considered normal during one’s active day.  
The fact that she was walking is not a particular function of her 
job.  The fragility fracture could 
have occurred at home getting in and out of a car or going to the grocery 
store.  The medical record does not 
provide evidence of any work-related activities that contributed to the 
fragility fracture suffered by Ms. Fulmer on 08/30/08.  
 
[¶11]   Dr. Turner, Fulmer’s treating 
orthopedic surgeon, disagreed with Dr. MacGuire’s conclusions.  Dr. Turner testified that while tests 
showed that Fulmer had a vitamin D deficiency, she had not been diagnosed with 
osteoporosis, and many people have low vitamin D levels without 
osteoporosis.  Dr. Turner disagreed 
that Fulmer suffered a fatigue fracture.  
It was his opinion that the August 12, 2008, injury caused a stress 
fracture that was missed on the earlier x-rays because the radiologist was not 
specifically looking for it.  Dr. 
Turner concluded that Fulmer’s twisting or pivoting during the task of passing 
out ice and water caused the fracture to complete.  
 
[¶12]   Shepherd objected to Fulmer’s 
worker’s compensation claims for both the August 12, 2008, injury and the August 
30, 2008, injury.  On October 3, 
2008, the Division issued a final determination denying benefits for the August 
12, 2008, injury.  The Division 
denied benefits for the first injury on the ground that Fulmer’s injury did not 
meet the definition of injury as defined by Wyo. Stat. Ann. § 
27-14-102(a)(xi).  On July 16, 2009, 
the Division issued a final determination denying benefits for the August 30, 
2008, injury.  The Division denied 
benefits for the second injury on the ground that Fulmer’s “hip fracture was not 
due to an extra-hazardous work activity.  
It occurred while performing an activity of daily living and was caused 
by a stress fracture due to an underlying medical condition.”  
 
[¶13]   Fulmer requested a hearing, and the 
two benefit denials were combined for a contested case hearing.  The OAH upheld the denial of benefits 
for both injuries.  The hearing 
examiner concluded that Fulmer’s August 12, 2008, injury occurred when Fulmer 
transferred a patient by herself, in violation of her employer’s policy, and was 
therefore the result of her own culpable negligence and not compensable.  With respect to the August 30, 2008, 
injury, the hearing examiner accepted the opinion of Dr. MacGuire and concluded 
the injury was the result of a normal activity of day-to-day living, not 
Fulmer’s work, and was therefore likewise not compensable.
 
[¶14]   Fulmer appealed, and the district 
court reversed.  The district court 
concluded that the hearing examiner’s finding of culpable negligence as a basis 
to deny benefits for the August 12, 2008, injury was not supported by 
substantial evidence.  The district 
court further concluded that the hearing examiner misapplied the law in finding 
that Fulmer’s August 30, 2008, injury resulted from a normal activity of 
day-to-day living.  

 
 
 
 
STANDARD 
OF REVIEW
 
[¶15]   We review administrative decisions 
based on the factors set forth in the Wyoming Administrative Procedure Act, 
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.
 
Wyo. 
Stat. Ann. § 16-3-114(c) (LexisNexis 2011).
 
[¶16]   When factual findings are 
challenged, “'we will affirm those findings if they are supported by substantial 
evidence.’”  McCall-Presse v. State ex rel. Wyo. Workers’ 
Safety & Comp. Div., 2011 WY 34, ¶ 6, 247 P.3d 505, 509 (Wyo. 2011) 
(quoting Newman v. State ex rel. Wyo. 
Workers’ Safety & Comp. Div., 2002 WY 91, ¶ 26, 49 P.3d 163, 173 (Wyo. 
2002).  In regard to the 
interpretation and application of law, we have stated:
 
The 
interpretation and correct application of the provisions of the Wyoming Workers’ 
Compensation Act are questions of law over which our review authority is 
plenary. Conclusions of law made by an administrative agency are affirmed only 
if they are in accord with the law. We do not afford any deference to the 
agency’s determination, and we will correct any error made by the agency in 
either interpreting or applying the law.
 
Wyoming 
Workers’ Safety & Comp. Div. v. Faulkner, 
2007 WY 31, ¶ 10, 152 P.3d 394, 396 (Wyo. 2007) (quoting Bailey 
v. State ex rel. Wyo. Workers’ Safety & Comp. Div., 
2002 WY 145, ¶ 9, 55 P.3d 23, 26 (Wyo. 2002)).  
 
[¶17]   In 
an appeal from a district court’s appellate review of an administrative 
decision, we review the case as if it came directly from the hearing examiner, 
affording no deference to the district court’s decision.  Deloge v. State ex rel. Wyo. Workers’ Safety 
& Comp. Div., 2011 WY 154, ¶ 5, 264 P.3d 28, 30 (Wyo. 2011); In re Kaczmarek, 2009 WY 110, ¶ 7, 215 P.3d 277, 280 (Wyo. 2009).
 
DISCUSSION
 
August 
12, 2008, Injury: Culpable Negligence
 
[¶18]   The hearing examiner found that 
although Fulmer did experience a popping and discomfort in her right hip when 
performing the day’s first two-person transfer with her co-worker Darrison on 
the morning of August 12, 2008, the diagnosed injury for which she received 
treatment occurred when she performed a solo transfer of a patient later in the 
day.  The hearing examiner further 
found that the patient care instructions mandated a two-person transfer for that 
particular patient, that Fulmer’s use of a solo transfer was a direct violation 
of those instructions, and that such a violation was “clear evidence” of 
culpable negligence.  On that basis, 
the hearing examiner upheld the denial of benefits for Fulmer’s August 12, 2008, 
injury.
 
[¶19]   Because the record contains 
evidence to support the hearing examiner’s finding that Fulmer’s August 12th 
injury occurred during the transfer she performed by herself in the afternoon of 
that day, we will defer to that finding.  
See Huntington v. State ex rel. Wyo. Workers’ 
Comp. Div., 2007 WY 124, ¶ 11, 163 P.3d 839, 842 (Wyo. 2007) (resolving 
ambiguities or inconsistencies in the record by 
weighing evidence and assessing witness credibility is the trier of fact’s 
responsibility and not the prerogative of the reviewing court).  Where we part ways with the 
hearing examiner is in his finding of culpable negligence.
 
[¶20]   A claimant must prove all essential 
elements of her claim for worker’s compensation benefits.  Keck v. State ex rel. Wyo. Workers’ Safety 
& Comp. Div., 985 P.2d 430, 433 (Wyo. 1999).  Once a claimant meets that burden, then 
the burden shifts to the party opposing benefits to establish an exclusion from 
worker’s compensation coverage.  Id.  The exclusion at issue with respect to 
Fulmer’s August 12th injury is the “culpable negligence” exclusion.  Specifically, the Wyoming Workers’ 
Compensation Act (Act) excludes from the definition of injury any injury “due 
solely to the culpable negligence of the injured employee.”  Wyo. Stat. Ann. § 27-14-102(a)(xi)(C) 
(LexisNexis 2011).  

 
[¶21]   The term “culpable negligence” 
means “willful and serious misconduct.”  
Brebaugh v. Hales, 788 P.2d 1128, 1136 (Wyo. 1990).  “Willful” 
means that the misconduct was done “purposely, with knowledge,” or that the 
misconduct was “of such a character as to evince a reckless disregard of 
consequences.”  Id.  To be culpable negligence, an act must 
be “intentional, unreasonable and taken in disregard of a known or obvious risk 
so great as to make it probable injury will follow.”  Martin v. Alley Const., Inc., 904 P.2d 828, 832 (Wyo. 1995).  It requires 
more than a finding of unreasonable conduct.  Baros v. Wells, 780 P.2d 341, 343 (Wyo. 
1989).   A finding of culpable 
negligence requires “an extreme departure from ordinary care in a situation 
where a high degree of danger is apparent.”  Martin, 904 P.2d  at 832.  
 
[¶22]   Thoughtless, heedless, or 
inadvertent acts or mere errors in judgment or simple inattention do not 
constitute culpable negligence.  Martin, 904 P.2d  at 832; see also Brebaugh, 788 P.2d  at 1136-40 
(supervisor who instructed crew to make repairs to conveyor belt in coal mine 
without training or supervision not guilty of culpable negligence).  The party claiming culpable negligence 
must prove that the claimant was acting with a state of mind that approaches 
intent to do harm to him or herself.  
Brebaugh, 788 P.2d  at 
1136.  This may be established by a 
showing that the claimant has intentionally committed an act of unreasonable 
character in disregard of a known or obvious risk that is so great as to make it 
highly probable that harm will follow.  
Id.; see also Weidt v. Brannan Motor Co., 72 
Wyo. 1, 260 P.2d 757 (1953) (employee who drove company vehicle on company 
business at speeds of eighty to ninety miles per hour in violation of posted 
forty-five mile per hour speed limit guilty of culpable 
negligence).
 
[¶23]   With this guidance in mind we turn 
to the OAH decision.  The hearing 
examiner made the following findings to support his conclusion that Fulmer’s 
August 12, 2008, injury was caused by her own culpable 
negligence:
            
5.         
The Resident Care Plan for [patient]2 clearly required a two person 
assist for all transfers as [patient] was a patient with high risk for 
falls.
 
* 
* * *
 
            
16.       
. . . Fulmer admitted [patient] is a two person transfer but she did a 
one person transfer to speed things up.
 
* 
* * *
 
            
20.       
The evidence established Fulmer sought medical treatment and was 
diagnosed with an acute lumbar strain and right lumbar neuroradiculitis from 
transferring a patient by herself.  
From the evidence presented it appears Fulmer had some discomfort in the 
morning but actually suffered an injury while transferring [patient] by herself 
in direct violation of the required two person transfer.  This is clear evidence of culpable 
neglect and benefits should be denied for the August 12, 2008, alleged 
injury.  It should also be noted the 
medical records are somewhat unclear as to the exact injury Fulmer sustained on 
August 12, 2008.  

 
[¶24]   The hearing examiner’s basic 
findings of fact were essentially that Fulmer knew the patient required a 
two-person transfer, and she nonetheless performed a one-person transfer.  Although the hearing examiner did find 
that the patient care plan identified the patient as being at a high risk for 
falling, he did not make the necessary follow-up findings regarding Fulmer’s 
understanding of the risk of harm to herself were she to perform a one-person 
transfer rather than the required two-person transfer.  Specifically, the hearing examiner made 
no findings as to what Fulmer knew or understood from reading the plan, no 
findings as to what Fulmer should have known or understood from the plan, and no 
findings as to whether Fulmer customarily read patient care plans or had ever 
read this particular patient’s care plan.  

 
[¶25]   We recognize that in this case such 
findings would have been difficult for the hearing examiner to make.  Although Fulmer testified, she was not 
asked questions concerning her understanding of the patient care instructions 
for the particular patient involved, her understanding of transfer techniques or 
her understanding of the risk in not using proper techniques.  In so observing, we do not mean to 
suggest that a claimant’s testimony is the only viable evidence to make this 
proof.  Other evidence could have 
included Shepherd’s policies on performing patient transfers, its policies on 
its employees reading, understanding, and adhering to patient care plans, its 
training of employees on these issues, and any warnings Shepherd issued 
concerning risks of an employee ignoring or violating the policies or patient 
care instructions, with respect to either employee and patient safety or 
employee discipline.  Unfortunately, 
the record is devoid of such evidence.  
As the district court observed, the record simply does not contain any 
evidence from which a trier of fact could find that Fulmer acted in disregard of 
a known or obvious risk so great as to make it probable injury would follow: 

 
First, 
there is nothing in the record to show why this policy was adopted; 
specifically, whether it was for the protection of the patient or for the 
protection of the health care worker or both.  If Fulmer violated a policy that was in 
place to protect a patient, her violation would not be evidence of negligence, 
let alone culpable negligence.  
Secondly, there is nothing to show that Fulmer was aware that violation 
of the policy would likely result in an injury to her.  The record is totally devoid of any 
indication that violation of the policy would lead to Fulmer’s injury or that 
Fulmer was aware of such risks.  If 
the risk was not identified and if there was no showing that Fulmer was aware of 
the risk, it cannot be said that she acted in disregard of a known or obvious 
risk so great as to make it probable injury will follow.  
 
[¶26]   Shepherd attempts on appeal to 
avoid the district court’s reasoning and bolster the hearing examiner’s culpable 
negligence finding by supplying its own interpretation of the record.  On pages 16-17 of its brief, Shepherd 
argues:
 
            
On August 12, 2008, Fulmer volunteered to perform “doubles” or 
“two-person” transfers of residents along with co-employee Seth Darrison.  (Record Vol. III at p. 16).  By volunteering to perform “doubles” or 
“two-person” transfers of residents, Fulmer was uniquely aware that the 
residents that she would be transferring that day required the assistance of two 
CNA’s.  Furthermore, as an 
experienced and well trained CNA, Fulmer knew and understood:  (1) the different transfer techniques to 
be used with certain residents; (2) that the resident care plan established for 
each resident was to be strictly followed; (3) the purpose for following the 
transfer technique set forth in the resident’s care plan is to protect both the 
resident and SVCC employees from injuries;  
and (4) failing to follow the transfer technique in the resident’s care 
plan is an obvious risk that would make it highly probabl[e] that harm would 
result.  (Record Vol. II at pp. 
0271, 0283-0284, 0327).  Finally, 
Fulmer admitted that she knew the resident . . . was a “two-person” 
transfer.  (Record Vol. III at 
pp.51-52).
 
 (Emphasis in 
original.)
 
[¶27]   We reject Shepherd’s argument for 
two reasons.  First, Shepherd is asking this Court to stand in the place of the 
hearing examiner and make basic findings and evidence assessments that the 
hearing examiner did not make.  That 
is something this Court will not do.  
The Wyoming APA requires the hearing examiner to make findings of basic facts upon all material issues and 
upon which his ultimate findings of fact or conclusions are based.  Rodgers v. State ex rel. Wyo. Workers’ 
Safety & Comp. Div., 2006 WY 65, ¶ 32, 135 P.3d 568, 579 (Wyo. 2006) 
(citing  FMC 
v. Lane, 
773 P.2d 163 (Wyo.1989) 
and Wyo. Stat. Ann. § 16-3-110).  “Appellate briefing is not the place to articulate sufficient 
findings of fact. It is not the duty of this Court to analyze and assess 
evidence presented to an administrative body to determine the weight to be given 
evidence or the credibility to be afforded witnesses.”  Rodgers, ¶ 29, 135 P.3d  at 579; Decker v. State ex rel. Wyo. Med. 
Comm’n, 2005 WY 160, ¶ 35, 124 P.3d 686, 697 (Wyo. 2005).  
 
[¶28]   Second, even if this Court were to 
put itself in the role of hearing examiner and search the record to glean basic 
findings that might lend support to the hearing examiner’s ultimate conclusion, 
we do not agree with Shepherd’s interpretation of the evidence.  Shepherd directed this Court to the 
following testimony excerpts to support the hearing examiner's 
decision:
 
Testimony 
of Seth Darrison, Shepherd CNA:
 
            
A.        
Rebecca had asked me to assist her with the resident, [name omitted], in 
order to get her safely on to the toilet.  
It was a two assist resident so at that point at that particular time, I 
was wearing gloves because I was going to be pulling down her pants and removing 
her Depends for when she did sit on the toilet so she could go. 

 
Testimony 
of Roger Furhman, Shepherd Physical Therapist:
 
            
Q.        Are 
you familiar with pivot transfers that people here perform on 
patients?
 
            
A.        
Yes.
 
            
Q.        Are 
those potentially dangerous to the person performing the 
transfer?
 
* 
* * *
 
            
A.        A 
pivot transfer by definition is a stand and turn transfer.  You’re pivoting from one location to the 
other location.  In the vagueness of 
that, a pivot transfer can go from hands on or from no assistance to needing 
extensive assistance.  It’s part of 
any of the training of any CNA.  
It’s the way that basically any resident here is transferred unless 
they’re a mechanical transfer.  So 
is it inherently dangerous?  Walking 
across the floor can be dangerous.  
A pivot transfer if done properly and done as instructed should carry a 
very low risk of injury to either the patient or the transfer.  That’s why we come up with transfer 
techniques, transfer training instruction.
 
            
Q.        Have 
you seen CNAs or other people that perform pivot transfers injured doing a pivot 
transfer?
 
            
A.        
There’s injuries all the time on people doing transfers.  I mean, that’s somewhat the nature of 
the job, but again, if transfers are done per protocol, if they’re done per 
training, the risk level is low, but it’s – there’s an inherent risk in the 
job.
 
            
Q.        So 
your answer is yes, you’ve seen people injured or no, you 
haven’t?
 
            
A.        
Yes.  I have seen people that 
have been injured.  

 
Testimony 
of Danielle Wagner, Shepherd Employee:
 
            
Q.        You 
mentioned that you had training in how to transfer a 
patient?
 
            
A.        
Uh-huh.
 
            
Q.        What 
sort of principles are important in that training?
 
* 
* * *
 
            
Q.        Can 
you think of any principles that would be important to you in you wanting to 
transfer a patient?

* 
* * *
 
            
Q.        Does 
the question make sense to you?
 
            
A.        It 
does make sense to me.  The only 
thing I will say is that we are taught good mechanics for lifting and 
transferring for the safety of us.
 
            
Q.        Have 
you been able to observe Rebecca Fulmer transferring 
patients?
 
            
A.        
Yes.
 
            
Q.        Could 
you comment on her – 
 
            
A.        
Yes.
 
            
Q.        -- 
ability to do this?
 
            
A.        By 
the book.  And what I mean by the 
book, I mean if it takes two people, she will do two people.  If it says to use a particular transfer 
technique with two people with the Hoyer sling, she will do that.  If it calls for a gate belt, she will do 
that.  Very much the way by the book 
that we’re taught.  

 
[¶29]   We do not agree with Shepherd that 
these excerpts support its assertions that Fulmer understood the need to 
strictly adhere to resident care plans and the obvious risk of harm to herself 
if she failed to follow lifting instructions.  At least one reading of the evidence 
above suggests that lifting injuries are an inherent risk of the job, and not 
just a risk of improper transfer procedures.  As to Fulmer’s specific knowledge, the 
evidence relied on by Shepherd definitively shows little more than that Fulmer 
knew how to properly perform patient transfers and did not do so in this 
instance.  As set forth above, 
thoughtless acts or errors in judgment are not the types of “serious and willful 
misconduct” that constitute culpable negligence.  See Martin, 
904 P.2d  at 832.
 
[¶30]   We agree with the district court 
that this case is more akin to the facts in Baros, 780 P.2d 341.  In Baros, it was alleged that an employee’s 
act of remaining in a hole where a backhoe was excavating, in violation of 
company policy, was culpable negligence.  
This Court found no culpable negligence: 
 
[W]hile 
this evidence might well establish negligence on the part of Wells and, for that 
matter, Baros, it does not make out a case of culpable negligence against Wells. 
Baros’ testimony as to his perception that he would lose his job if he came out 
of the hole has no bearing on the question of whether Wells possessed the 
requisite state of mind for a finding of culpable negligence. The evidence 
indicates the men had been working for several hours and were near the end of 
the task. They were tired, and they, particularly Wells, relaxed the usual 
safety precautions. While Wells’ conduct may have been unreasonable, culpable 
negligence “involves more than unreasonable conduct; it involves 
willfulness.”
 
Id. 
at 344-45.
 
[¶31]   Fulmer’s testimony regarding her 
decision to perform a one-person transfer rather than the required two-person 
transfer was similar.  She performed 
the task toward the end of her shift, and she testified that she performed the 
task by herself to save time and complete the work faster.  As in Baros, Shepherd may have established 
that Fulmer’s conduct was unreasonable or inadvisable, but it did not meet its 
burden of proving that her actions were willful and serious 
misconduct.
 
August 
30, 2008, Injury: Normal Activities of Daily 
Living
 
[¶32]   One of Fulmer’s tasks as a CNA was 
to deliver pitchers of water and ice to patients in the nursing home, and Fulmer 
was performing that task when her hip fractured. Shepherd does not dispute the 
water and ice delivery was a work-related task.  It instead asserts it was the walking 
portion of the task that caused Fulmer’s injury, and because walking is a normal 
activity of daily living, benefits must be denied.  The hearing examiner agreed, and on the 
basis that injuries caused by normal activities of daily living are excluded 
from coverage, he upheld the denial of benefits.  The district court reversed, observing 
that if the act of walking in the performance of a task could exclude an injury 
from coverage, the exclusion might very well swallow the coverage 
altogether.  We agree and hold that 
the employer did not in this case meet its burden of proving the exclusion 
should apply.  

 
[¶33]   The Act excludes from coverage any 
injury “resulting primarily from the natural aging process or from the normal 
activities of day-to-day living, as established by medical evidence supported by 
objective findings.”  Wyo. Stat. 
Ann. § 27-14-102(a)(xi)(G) (LexisNexis 2011).  This Court first addressed the meaning 
of the phrase “normal activities of day-to-day living” in State ex rel. Wyo. Workers’ Comp. Div. v. 
Sparks, 973 P.2d 507 (Wyo. 1999).  
In searching for a definition, we expressed the following concern with 
the exclusion:
 
The 
phrase “day-to-day living” is extremely broad and essentially amorphous. We do 
not know whether it alludes to the daily activities of the employee or the daily 
activities of the entire population. It indeed is possible for that language to 
encompass almost any possible human physical effort. We do not assume that, by 
adopting this language, the legislature intended to abolish worker’s 
compensation benefits in Wyoming. As the hearing examiner pointed out, that 
could be a possible consequence of adopting the Division’s 
view.
 
Id. 
at 
509.
 
[¶34]   Bearing this concern in mind, this 
Court defined the exclusion in the following manner:
 
We 
are satisfied that when an employee is engaged in activities over which the 
employer is vested with the right of control, these cannot be normal activities 
of day-to-day living because the employer has no such right with respect to the 
normal activities of day-to-day living. Consequently, the statutory phrase would 
allude to those activities accomplished within the workplace over which the 
employer is not vested with any right of control. We turn then to what the 
phrase “right of control” connotes. In Natural 
Gas Processing Co. v. Hull, 
886 P.2d 1181, 1185 (Wyo. 1994) 
(emphasis in original), we quoted this language:
 
“The 
control of the work reserved in the employer which effects a master-servant 
relationship is control of the means and manner of performance of the 
work, as well as of the result * * *.” 41 
Am.Jur.2d Independent 
Contractors 
§ 8 (1968).
 
It 
follows that when the employer has the right of control and can tell the 
employee not only what to do, but how to do it, that is not one of “the normal 
activities of day-to-day living.” 

 
Sparks, 
973 P.2d  at 511.
 
[¶35]   We have considered the “normal 
activities of day-to-day living” exclusion, as so defined, in four cases:  Sparks, 973 P.2d 507; Sellers v. State ex rel. Wyo. Workers’ 
Safety & Comp. Div., 979 P.2d 959 (Wyo. 1999); Keck, 985 P.2d 430; and Yenne-Tully v. State ex rel. Wyo. Workers’ 
Safety & Comp. Div., 48 P.3d 1057 (Wyo. 2002).  In all but Yenne-Tully, we rejected the exclusion 
as a basis to deny benefits.
 
[¶36]   In Sparks, the claimant was working as a 
hospital nurse when she bent over to pick up a patient’s medication from a 
medicine cart.  Sparks, 973 P.2d  at 508.  She experienced severe and sudden pain 
in her lower back and was diagnosed with a herniated disc in her lumbar 
region.  Id.  The Division denied benefits on the 
ground that the act of leaning over to pick up medication from the cart was a 
normal activity of daily living.  Id.  The hearing examiner in that case 
rejected the Division’s argument and we affirmed, concluding that “[w]hen we 
examine the factual background of this case, it is clear that the hospital had 
the right to control the means and manner of the performance of Sparks’ tasks as 
well as the result.”  Id. at 511.
 
[¶37]   In Sellers, the claimant, a Rock Springs 
animal control officer, injured her lumbar spine while exiting her work 
truck.  Sellers, 979 P.2d  at 960.  The Division denied benefits on the 
ground that “the acts of entering and exiting a motor 
vehicle are normal activities of day-to-day living.”  Id.  The hearing examiner affirmed, and we 
reversed.  In so ruling, we observed 
that a claimant is not required to show some unique work related circumstance or 
event occurred to take the injury out of an act of everyday living.  Id. at 962.  “The Division, in accordance with the 
right-of-control test, must present evidence to show that the activity in 
question is a normal activity of day-to-day living.”  Id. 
 
[¶38]   In Keck, the claimant, a food server, 
injured her knee when she twisted her body while carrying glasses.  Keck, 985 P.2d  at 431.  The pain was not immediately apparent, 
but after the claimant completed her shift, the knee became painful and swollen, 
and the claimant was eventually diagnosed with an aggravation of inflammatory 
arthritis in her knee.  Id.  The Division denied benefits, and the 
Medical Commission affirmed on the ground that “although her injury aggravated a 
preexisting condition, the injury was not compensable because twisting is an 
activity of day-to-day living.”  Id. at 432.  We reversed:
 
Keck 
twisted and injured 
her knee 
while moving glasses, a job-related activity. Although the Division presented 
evidence that twisting is an activity of daily living, it failed to meet its 
burden of offering any right-of-control evidence establishing Keck injured 
her knee 
while engaged in an activity beyond her employer’s control. The Commission 
acknowledged that Keck’s work injury aggravated an underlying condition. It 
erred, however, in applying the day-to-day living exclusion, Wyo. 
Stat. Ann. § 27–14–102(a)(xi)(G), 
and by deciding Keck’s injury was not compensable. We are, therefore, compelled 
to reverse the Commission’s decision because it is not in accordance with 
law.
 
Id. 
at 433.
 
[¶39]   In Yenne-Tully, the claimant worked as a 
guard at the Wyoming State Penitentiary and submitted a worker’s compensation 
claim for a herniated disc.  Yenne-Tully, ¶ 3, 48 P.3d  at 1059.  The claimant suffered a work injury in 
1989 when he fell down a flight of stairs, but the herniated disc at issue did 
not present itself until 1997.  Id.  During that approximately eight-year 
interim, the claimant continued to work and live a very active life outside 
work.  His life outside work 
included horseback riding and an incident in which he was dragged by a 
horse.  Id. at ¶ 4, 48 P.3d  at 1060.  Medical testimony established that the 
cause of the claimant’s herniated disc could be attributed approximately seventy 
percent to the claimant’s activities outside work.  Id.  The Division denied benefits, and a 
hearing examiner affirmed that denial.  
We likewise affirmed the denial:
 
This 
Court has stated that the phrase “day-to-day living,” as used in Wyo. 
Stat. Ann. § 27-14-102(a)(xi)(G) 
describes those activities that a worker’s employer does not have the right to 
control. State 
ex rel. Wyoming Workers’ Safety and Compensation Div. v. Sparks, 
973 P.2d 507, 511 (Wyo. 1999). 
Common actions such as getting out of a car or bending to pick up a pen are not 
considered activities of day-to-day living when performed in the course of 
employment. In 
re Worker’s Compensation Claim of Keck, 
985 P.2d 430, 433 (Wyo. 1999); 
Sellers 
v. State ex rel. Wyoming Workers’ Safety and Compensation Div., 
979 P.2d 959, 960 (Wyo. 1999). 
Recreational activities, performed outside the workplace, or household chores 
are beyond the control of the employer and would be characterized as day-to-day 
living activities. We conclude that the cumulative trauma responsible for the 
majority of the appellant’s injury is attributable to day-to-day living, and the 
appellant does not have a compensable injury pursuant to Wyo. 
Stat. Ann. § 27-14-102(a)(xi).
 
Yenne-Tully, 
¶ 13, 48 P.3d  at 1062-63.
 
[¶40]   Turning to the present case, the 
hearing examiner, in holding that Fulmer’s hip fracture was not compensable, 
relied on Dr. MacGuire’s opinion that Fulmer was engaged in a normal activity of 
daily living.3  Dr. MacGuire summarized her opinion as 
follows:
 
By 
history to Dr. Iverson and Dr. Turner, the claimant was walking passing out 
ice.  This 
would be activity considered normal during one’s active day.  The fact that she was walking is not a 
particular function of her job.  
The fragility fracture could have occurred at home getting in and out of 
a car or going to the grocery store.  
The medical record does not provide evidence of any work-related 
activities that contributed to the fragility fracture suffered by Ms. Fulmer on 
08/30/08.  [Emphasis added.] 

 
[¶41]   As the district court observed, the 
problem with Dr. MacGuire’s conclusion is that it applies the wrong legal 
standard.  To determine coverage, 
the question that must be answered is whether Shepherd, Fulmer’s employer, had 
the right to control the task in which Fulmer was engaged when she suffered her 
injury.  Dr. MacGuire’s opinion does 
not address this question and therefore cannot, standing alone, provide a basis 
for finding that a normal activity of daily living caused Fulmer’s injury. 

 
[¶42]   To address the correct legal 
standard on appeal, Shepherd contends in its brief that “[t]here is simply no 
evidence that SVCC controlled the details of Fulmer’s walking activity.  SVCC did not control where Fulmer walked 
nor did it control how she walked.”  
This argument on appeal likewise misses the crux of our inquiry in these 
types of cases, and it is further misplaced because it attempts to shift the 
burden of proof from Shepherd, the party asserting the exclusion, to the 
claimant.  
 
[¶43]   Our prior cases in this area have 
established that “[c]ommon actions such as getting 
out of a car or bending to pick up a pen are not considered activities of 
day-to-day living when performed in the course of employment.”  Yenne-Tully, ¶ 13, 48 P.3d  at 
1062.  Our analysis does not parse 
the mechanics of performing a task to determine whether the employee is engaged 
in a normal activity of daily living.  
The question is not whether an employer controls every physical motion of 
an employee in the performance of an assigned task.  The question is whether the employer had 
the right to control the task the employee was performing when she was injured, 
including the means and manner of performance.  Id., ¶ 13, 48 P.3d at 1062-63; Keck, 985 P.2d  at 433; Sellers, 979 P.2d  at 962; Sparks, 973 P.2d  at 
511.
 
[¶44]   The question in this case then is 
not whether Shepherd had a right to control Fulmer’s walking, but rather whether 
it had a right to control the task Fulmer was performing when she suffered a 
fractured hip.  On this point, 
Shepherd’s complaint regarding a lack of evidence rings hollow.  Shepherd, as the party asserting the 
exclusion from coverage, carried the burden of proving the exclusion applied, 
including the burden of presenting evidence that Shepherd did not have a right 
to control the means and manner in which Fulmer delivered pitchers of ice and 
water to patients.  See Keck, 985 P.2d  at 433 (party 
opposing compensability must produce medical evidence showing that claimant’s 
injury resulted from the normal activities of daily living as well as 
right-of-control evidence showing the employer had no control over the 
claimant’s activity).  Shepherd 
produced no such evidence.  

 
[¶45]   What evidence the record does 
contain on the question of control over Fulmer’s water and ice delivery is in 
fact to the contrary.  The delivery 
of pitchers of ice and water was a duty specifically included in the light duty 
agreement Shepherd entered into with Fulmer on August 20, 2008, ten days before 
her injury.  It was plainly a task 
she performed at Shepherd’s direction. Shepherd did not meet its burden of 
proving that the task of delivering ice and water to its patients was a normal 
activity of day-to-day living, and we thus affirm the decision of the district 
court.
 
CONCLUSION
 
[¶46]   Shepherd did not meet its burden of 
proving Fulmer was culpably negligent when she injured her hip lifting a patient 
by herself; nor did it meet its burden of proving a normal activity of 
day-to-day living caused Fulmer’s hip fracture.  We therefore remand to the district 
court with directions that it remand to the OAH for entry of an order awarding 
benefits to Fulmer for both her August 12, 2008, and August 30, 2008, hip 
injuries.
 
FOOTNOTES
  1Riggs did not 
recall that she saw Fulmer twice on August 12, 2008.  She recalled only the afternoon 
procedure she performed on Fulmer.  
We acknowledge the discrepancy but find it has no bearing on our 
analysis.  Additionally, we note 
that the OAH findings of fact indicate two treatments by Riggs, one in the 
morning and one in the afternoon.  

2In the interests of patient privacy, we have redacted patient names from 
our discussion.
3As 
indicated above, there is a dispute in the medical evidence with respect to how 
Fulmer’s hip fractured.  Dr. Turner, 
Fulmer’s treating physician, believed the fracture was a stress fracture that 
started with the August 12th injury and then completed on August 30th.  Dr. MacGuire, who performed an IME on 
Fulmer, believed the hip fracture was a fatigue fracture that resulted from 
osteoporosis.  The hearing examiner 
weighed the evidence, assessed the opinions of the two physicians, and decided 
to accept Dr. MacGuire’s opinion.  
The record contains sufficient evidence to support the hearing examiner’s 
acceptance of Dr. MacGuire’s opinion over Dr. Turner’s opinion, and we agree 
with the district court that the reviewing court may not substitute its judgment 
for that of the hearing examiner on which medical opinion to accept.  See Huntington, ¶ 11, 163 P.3d  at 842.  We thus base 
our analysis on the acceptance of Dr. MacGuire’s 
opinion.
 
            
We note also that neither 
the Division nor Shepherd contested Fulmer’s claim for benefits on the ground of 
a preexisting condition, but many references are made to Fulmer’s alleged 
underlying condition of osteoporosis.  
To the extent that Dr. MacGuire’s report may suggest that such an 
underlying condition is in itself a basis to deny coverage, we of course reject 
that suggestion. The question of whether Fulmer’s preexisting condition was 
aggravated is not an issue in this case, and the existence of such a condition 
is not in itself a basis to deny coverage.  
See Keck, 985 P.2d  at 431-33 (benefits 
awarded where twisting motion aggravated underlying arthritic condition); see also Straube v. State ex rel. Wyo. Workers’ 
Safety & Comp. Div., 2009 WY 66, ¶ 17, 208 P.3d 41, 48 (Wyo. 2009) 
(employer takes employee as it finds him).