Title: In re WORKER'S COMPENSATION CLAIM OF HAMPTON v. LIFECARE CTR. OF CHEYENNE

State: wyoming

Issuer: Wyoming Supreme Court

Document:

In re WORKER'S COMPENSATION CLAIM OF HAMPTON v. LIFECARE CTR. OF CHEYENNE2000 WY 783 P.3d 837Case Number: 99-119Decided: 04/06/2000Supreme Court of Wyoming
 
IN THE MATTER OF THE 
WORKER'S COMPENSATION CLAIM OF LARIS HAMPTON, AN EMPLOYEE OF LIFECARE CENTER OF 
CHEYENNE: LARIS HAMPTON, Appellant (Petitioner), v.LIFECARE CENTER OF CHEYENNE, and 
STATE OF WYOMING, ex rel., WYOMING WORKERS' SAFETY AND COMPENSATION DIVISION, 
Appellees (Respondents).

Representing 
Appellant: Timothy C. Kingston of 
Graves, Miller & Kingston, P.C., Cheyenne, Wyoming.Representing 
Appellee State ex rel., Wyoming Workers' Safety and Compensation Division: 
Gay Woodhouse, Attorney General; John W. Renneisen, Deputy Attorney General; 
Gerald W. Laska, Senior Assistant Attorney General; and Bernard P. Haggerty, 
Senior Assistant Attorney General, Cheyenne, Wyoming.

Before 
LEHMAN, C.J., and THOMAS, MACY, GOLDEN, and HILL, JJ.

THOMAS, 
Justice.

[¶1] In this 
case, the Office of Administrative Hearings found against Laris Hampton 
(Hampton) with respect to the timely reporting of a claimed work-related injury, 
and ruled that she had not met her burden of proving a lack of prejudice to her 
employer or the Wyoming Workers' Safety and Compensation Division (Division). An 
injured employee is required by Wyo. Stat. Ann. § 27-14-502(a) (Lexis 1999) to 
report an injury no later Athan seventy-two (72) hours after the general nature 
of the injury became apparent * * *." Hampton offered a theory that the injury 
was timely reported because no one told her that her condition was work related 
until after she had surgery for the condition, but the hearing examiner found 
that her injury was not timely reported. In the absence of a timely report of 
her injury, Hampton is required by Wyo. Stat. Ann. § 27-14-502(c)1 to establish by clear and 
convincing evidence that neither her employer nor the Division suffered 
prejudice in the investigation of an accident or the monitoring of medical 
treatment because of her late report to her employer. Our examination of the 
record satisfies us that there is substantial evidence to support the finding 
that Hampton's report of injury was not timely, and we also are satisfied from 
the record that the decision that Hampton failed to establish the lack of 
prejudice by clear and convincing evidence was not arbitrary, capricious, or an 
abuse of discretion. The Order Denying Benefits by the Office of Administrative 
Hearings is affirmed.

[¶2] This 
statement of the issues is found in the Appellant's Opening Brief, filed by 
Hampton:

1. Did the Office of 
Administrative Hearings err by denying the Appellant's application for workers' 
compensation benefits? 

2. Did the Office of 
Administrative Hearings err by finding that the Appellant did not timely file 
her report of injury?

3. Did the Office of 
Administrative Hearings err by finding that the Appellant's employer and the 
Wyoming Workers' Safety and Compensation Division were prejudiced by the 
Appellant's untimely filing of her report of injury?

[¶3] This 
Statement of the Issues is found in the Brief of Appellee, filed by the 
Division:

The Employee sought 
treatment for recurrent symptoms of a previous injury. She filed an injury 
report fifty-seven (57) days after she was told she needed surgery, and a week 
after surgery was complete.

A. Was the Hearing 
Examiner's denial of benefits for an untimely injury report supported by 
substantial evidence, within his discretion, and in accordance with 
law?

The Employee first 
experienced symptoms of her condition more than a year before her 
surgery.

B. Did the Employee fail 
to meet the burden of proof for injuries occurring over 
time?

C. Did the Employee 
submit a timely "claim for benefits?"

[¶4] Hampton is 
a licensed practical nurse who became employed at Life Care Center of Cheyenne 
(Life Care) in 1990. In that year, she injured her left wrist at work while 
lifting a patient. Her physician prescribed pain medication and a wrist splint 
to treat that injury. In February of 1997, Hampton sustained another injury to 
her left wrist when a patient twisted it so severely that her little and ring 
fingers of her left hand became numb. On that occasion, a physician diagnosed 
the injury as an ulnar nerve compression, and he opined that it would heal 
without treatment in a matter of weeks. Hampton was injured a third time in 
April of 1997 when a patient again grabbed and twisted her left wrist, causing 
pain and swelling. After that injury, her physician recommended therapy, but he 
also noted that she might need an orthopedic evaluation. Neither Hampton nor 
Life Care reported these injuries to the Division.

[¶5] In January 
1998, Hampton was seen by her physician, and, at that time, reported that the 
little and ring fingers on her left hand had been numb for about six weeks. She 
was referred to a surgeon who, on February 2, 1998, recommended surgical release 
of the ulnar nerve. The next week, Hampton requested medical leave from work, 
but she did not say that her medical condition was work related. Life Care 
approved the leave request, and Hampton underwent a successful surgery on March 
24, 1998.

[¶6] On March 
31, 1998, Hampton completed a Wyoming Report of Occupational Injury or Disease, 
which was received by the Division on April 2, 1998. Life Care contested the 
claim, asserting that Hampton did not timely report her injury. The Division 
issued a Final Determination denying Hampton's claim on May 18, 1998. In 
response, Hampton objected to the Final Determination and requested a hearing, 
which was held before a hearing examiner on November 23, 
1998.

[¶7] In 
resolving the issues presented under Wyo. Stat. Ann. § 27-14-502, the hearing 
examiner found:

9. Hampton knew or should 
have known on February 2, 1998, that her condition was work-related, and she 
should have notified Lifecare and filed a report at that time. Since she did not 
notify Lifecare and file a report of injury until March 31, 1998, she has failed 
to timely report and file as required by statute.

10. Since Hampton failed 
to timely report and file, it is presumed that benefits be denied. This 
presumption can only be refuted if she establishes by clear and convincing 
evidence a lack of prejudice to the Division and Lifecare. Hampton has failed to 
meet her burden. The Division and Lifecare were prejudiced in monitoring medical 
treatment because they were not aware of the claimed work injury until after 
surgery had been performed. Lifecare was unable to take steps to minimize any 
injury and adjust Hampton's work because they did not know there was a problem. 
Additionally, the Division and Lifecare were prejudiced in investigating the 
incident. Benefits are denied.

[¶8] The Order 
Denying Benefits was entered in the Office of Administrative Hearings on 
December 17, 1998, and Hampton then filed a Petition for Review in the district 
court on January 15, 1999. The district court entered an Order Certifying Case 
to Wyoming Supreme Court, pursuant to W.R.A.P. 12.09, on March 15, 
1999.

[¶9] We review 
the decision of a hearing examiner in accordance with Wyo. Stat. Ann. § 
16-3-114(c) (Lexis 1999), which provides that the reviewing court 
shall:

(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;

* * 
*

(D) Without observance of 
procedure required by law; or

(E) Unsupported by 
substantial evidence in a case reviewed on the record of an agency hearing 
provided by statute.

[¶10] We will 
not disturb an agency's finding of fact unless it is clearly contrary to the 
overwhelming weight of the evidence. Wyoming Steel & Fab., Inc. v. Robles, 
882 P.2d 873, 875 (Wyo. 1994). Agency conclusions of law are affirmed only if 
they are in accord with the law. Matter of Corman, 909 P.2d 966, 970 (Wyo. 
1996). In a case such as this one, in which the hearing examiner determines the 
claimant has failed to rebut the presumption of prejudice, we conduct our review 
under the "[a]rbitrary, capricious, an abuse of discretion or otherwise not in 
accordance with law" standard set forth in Wyo. Stat. Ann. § 16-3-114(c)(ii). 
Pederson v. State ex rel. Wyoming Workers' Compensation Div., 939 P.2d 740, 742 
(Wyo. 1997).

[¶11] In arguing 
her first issue, Hampton challenges the finding of the hearing examiner that she 
did not file a timely claim. She contends that she was not aware her wrist 
injury was work related until after her surgery, and she promptly reported and 
filed a claim when she understood it was a result of the injury sustained at 
Life Care. The record demonstrates substantial evidence to support this finding 
by the hearing examiner.

[¶12] Hampton 
had sought medical attention for her wrist injuries on at least three occasions. 
On the second of those occasions, she reported numbness in two fingers after a 
patient grabbed and squeezed her wrist on February 26, 1997. Her physician 
diagnosed the condition as ulnar nerve compression. When Hampton sought medical 
attention from a physician on February 2, 1998, complaining of identical 
symptoms, the physician again diagnosed an ulnar nerve entrapment. The hearing 
examiner refused to credit the theory that an experienced medical care giver, 
confronted with identical symptoms and an identical diagnosis, failed to suspect 
identical causation less than one year after the initial diagnosis. There is 
sufficient evidence in this record to demonstrate that Hampton knew or should 
have known her condition was work related no later than February 2, 1998. She 
did not complete her injury report to the Division, however, until sixty days 
later. We affirm the hearing examiner's conclusion that Hampton did not report 
her injury or file a claim in a timely manner.

[¶13] Hampton 
next contends that even if her reporting and filing were untimely, Life Care and 
the Division were not prejudiced in investigating her injury or monitoring her 
medical treatment. In such a dispute, neither the employer nor the Division is 
required to prove prejudice. The statute provides:

(c) Failure of the 
injured employee, any dependent or personal representative to report the 
accident or injury to the employer and to file the injury report in accordance 
with subsection (a) of this section is a presumption that the claim shall be 
denied. The presumption may be rebutted if the employee establishes by clear and 
convincing evidence a lack of prejudice to the employer or division in 
investigating the injury and in monitoring medical 
treatment.

Wyo. Stat. Ann. 
§ 27-14-502(c).

[¶14] At the 
hearing, Hampton testified that, to her knowledge, Life Care had not 
investigated her injury or monitored her condition. On cross-examination, 
however, she admitted that she did not know whether Life Care conducted any 
investigation, and it may have done so. A representative of Life Care testified 
that Life Care monitors the treatment of Workers' Compensation claimants. It 
would have done that with respect to Hampton's condition, and she would have 
been offered lighter duties had Life Care known she had a work-related injury. 
Even without the contrary evidence, the evidence supporting a lack of prejudice 
falls far short of being clear and convincing. We hold the hearing examiner did 
not err in concluding Hampton failed to establish a lack of 
prejudice.

[¶15] Hampton 
also argues that Life Care's policies and procedures regarding work-related 
injuries were inadequate and were not effectively carried out. In addition, she 
contends that investigation and monitoring would have been meaningless because 
her surgery was inevitable. These arguments do not serve to demonstrate a lack 
of prejudice by clear and convincing evidence. Post hoc rationalizations, simply 
amounting to speculation as to what might have occurred had the injury been 
reported as the statute requires and a timely claim filed on appeal do not 
constitute clear and convincing evidence at a hearing.

[¶16] The Order 
Denying Benefits entered by the Office of Administrative Hearings is 
affirmed.
Footnotes
Footnotes

1 In relevant 
part, Wyo. Stat. Ann. § 27-14-502 provides:

(a) As soon 
as is practical but not later than seventy-two (72) hours after the general 
nature of the injury became apparent, an injured employee shall, in writing or 
by other means approved by the department, report the occurrence and general 
nature of the accident or injury to the employer. In addition, the injured 
employee shall within ten (10) days after the injury became apparent, file an 
injury report with the employer and the division in a manner and containing 
information prescribed by division rule and regulation. * * 
*

* * 
*

(c) Failure 
of the injured employee * * * to report the accident or injury to the employer 
and to file the injury report in accordance with subsection (a) of this section 
is a presumption that the claim shall be denied. The presumption may be rebutted 
if the employee establishes by clear and convincing evidence a lack of prejudice 
to the employer or division in investigating the injury and in monitoring 
medical treatment.