Summary 2006 WY 65

Summary of Decision issued May 31, 2006

[SPECIAL NOTE: This opinion uses the "Universal Citation." It was given an "official" citation when it was issued. You should use this citation whenever you cite the opinion, with a P.3d parallel citation. Please note when you look at the opinion that all of the paragraphs are numbered. When you pinpoint cite to a quote, you should cite to this paragraph number rather than to any page number. If you need assistance in putting together a citation using the Universal Citation form, please contact the Wyoming State Law Library for assistance.]

Summaries are prepared by Law Librarians and are not official statements of the Wyoming Supreme Court.

Case Name: In the Matter of Worker’s Compensation Claim of: Rodgers v. State, ex rel, Workers’ Safety and Compensation Division

Citation: 2006 WY 65

Docket Number: 05-144

Appeal from the District Court of Laramie County, the Honorable Peter G. Arnold, Judge.

Representing Appellant (Employee/Claimant): Kirk A. Morgan of Gage & Moxley, PC, Cheyenne, Wyoming.

Representing Appellee (Objector/Defendant): Patrick J. Crank, Wyoming Attorney General; John W. Renneisen, Deputy Attorney General; Steven R. Czoschke, Senior Assistant Attorney General; and Kristi M. Radosevich, Assistant Attorney General. Argument by Ms. Radosevich.

Date of Decision: May 31, 2006

Issue: Whether substantial evidence supports the Medical Commission’s decision denying workers’ compensation benefits to Appellant. Whether the Medical Commission properly evaluated conflicting medical evidence and set out findings of fact which indicated which evidence the Medical Commission considered probative.

Holding: Appellant suffered a work-related back injury on December 27, 1983 and since then has undergone twenty-one failed back and neck surgeries. His chronic pain has been treated with numerous narcotic and non-narcotic medications. From March 1997 through April 2000, Appellant began consultation and received treatment for abdominal pain which eventually led to findings including internal hemorrhoids, diverticulosis, ileus and/or non-mechanical gastric outlet obstruction resulting from narcotic medications, a normal esophagus, mild erosive gastritis and a single acute ulcer caused by aspirin in the Fiorinal being taken. In May 2001, an upper GI series and pharyngogram showed no evidence of any stricture, mass or ulceration in the esophagus. In October 2002, he was diagnosed by Dr. Kuckel with further problems secondary to a Helicobacter pylori (H. pylori) infection and at each visit the doctor repeated his diagnosis that Appellant suffered from an esophageal stricture secondary to reflux and gastroparesis secondary to his chronic use of pain medication. In May 2003, the Division issued a Final Determination denying benefits for Appellant’s gastrointestinal disorders stating that on the results of the Independent Medical Examination the treatment for the gastrointestinal disorders was not related to the 1983 back injury. The Medical Commission concluded that the care and treatment provided to Appellant through August 2002 was covered and that the esophageal stricture beginning in October 2002 was not related to the work injury of 1983 and therefore not compensable.
A worker’s compensation claimant has the burden of proving every essential element of his claim by a preponderance of the evidence. When the Court reviews an administrative agency order, they do so as if the case came directly from the agency. In appeals where both parties to a contested case submit evidence, appellate review of the evidence is limited to the application of the substantial evidence test. Even if the agency record contains sufficient evidence to support the administrative decision under the substantial evidence test, the Court applies the arbitrary and capricious standard as a “safety net” to catch other agency action that may have violated the Wyoming Administrative Procedures Act (Wyoming APA).
Findings of Fact: The Court found that the Medical Commission’s decision in the instant case ran afoul of the Wyoming APA because it failed to weigh all of the material evidence offered by the parties, it made ultimate findings of fact unsupported by any basic findings and it improperly took judicial notice of a contested fact.
Medical Commission’s Decision as Arbitrary and Capricious: The Court felt justified in taking the rare step of overturning the fact finder’s determination of the weight to be given a medical opinion and reversed with the directions to enter an order awarding benefits. The Court held that the Medical Commission’s decision to deny benefits was arbitrary and capricious because it was based on inaccurate findings of fact and is contrary to the overwhelming weight of the evidence. Because the medical history was incomplete and included flawed assumptions on which Dr. Perakos (the Independent Medical Examiner) based his opinion, the Court found the Medical Commission arbitrary and capricious.
The Medical Commission accepted the opinion of Dr. Kuckel as persuasive but then misstated the opinion. Based on Dr. Kuckel’s opinion, Appellant’s use of narcotic pain medications to treat his chronic back pain caused his gastrointestinal problems which caused his esophageal stricture. Only a “small portion” of Rodgers’ condition was related to the presence of H. pylori which all parties agreed was not related to the pain medications.

The Court reversed and remanded with directions to vacate the order denying benefits. The district court is to remand to the Medical Commission for entry of an order awarding benefits for the diagnosis and treatment of Appellant’s’ gastrointestinal problems and esophageal stricture, with the exception of costs related solely to the treatment for the presence of H. pylori.

J. Golden delivered the opinion for the court.

Link to the case: http://tinyurl.com/ooq5v .