Opinion ID: 2788697
Heading Depth: 2
Heading Rank: 1

Heading: Causally Related

Text: [¶16] We begin with the inquiry of whether the treatment is causally related to the compensable injury. Mr. Hildebrant argues that there is substantial evidence in the record to support the conclusion that the treatment is causally related to his compensable injury. The State argues that there is no causal connection. We find that there is substantial evidence to support the hearing examiner’s conclusion that the treatment is causally related to Mr. Hildebrant’s compensable workplace injury. [¶17] The burden rests with the claimant to demonstrate that the treatment for which preauthorization is sought is causally related to the compensable injury. Beall, 2012 WY 38, ¶¶ 24-27, 271 P.3d at 1032-33; Delacastro v. State ex rel. Wyo. Workers’ Safety & Comp. Div., 2014 WY 40, ¶ 22, 321 P.3d 327, 333 (Wyo. 2014) (“A workers’ compensation claimant has the burden of proving each of the essential elements of his claim, including causation, by a preponderance of the evidence.”) In this case, the hearing examiner did not expressly find the spinal cord stimulator trial was causally related to the compensable injury. However, the examiner relied on Dr. Narotzky’s opinion in part because Dr. Narotzky “acknowledged that there was at least some component to [Mr. Hildebrant’s] low back pain as a result of the fall off the ladder[.]” [¶18] The Division determined that Mr. Hildebrant suffered a compensable injury to his “low back (lumbar), mid back (thoracic), and right shoulder.” In his supplemental report, Dr. Narotzky attributed a number of causes to Mr. Hildebrant’s ongoing back and leg pain, including the August 3, 2011 fall. Moreover, Dr. Narotzky recognized that, generally, a spinal cord stimulator can be a reasonable treatment to relieve back pain. Thus, the evidence, presented through Dr. Narotzky’s supplemental report, demonstrates a causal connection between Mr. Hildebrant’s compensable injury―“low back (lumbar), mid back (thoracic), and right shoulder” resulting from the August 3, 2011 fall―and the 7 proposed treatment―a spinal cord stimulator trial.5 The substantial evidence presented through Dr. Narotzky supports the hearing examiner’s conclusion that there was a causal connection between Mr. Hildebrant’s compensable injury of August 3, 2011, and the proposed treatment of implantation of a spinal cord stimulator.