Summary 2007 WY 126
Summary of Decision issued August 6, 2007
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Case Name: Alvarez v. State ex rel.
Citation: 2007 WY 126
Docket Number: 06-139
Appeal from the
Representing Appellant (Respondent): David M. Gosar,
Representing Appellee (Petitioner): Patrick J. Crank, Attorney General; John W. Renneisen, Deputy Attorney General; and Steven R. Czoschke, Senior Assistant Attorney General; Kristi M. Radosevich, Assistant Attorney General.
Issues: Whether the Court should overrule Bruhn v. State and extend benefits to workers who sustain additional injuries while traveling to or from receiving medical care for work-related injuries. Or whether, in the alternative, the Court should clarify or modify Bruhn to extend coverage to workers who re-injure their original workplace injuries while traveling to or from obtaining medical care for these injuries.
Facts/Discussion: After injuring her left rotator cuff at work, Alvarez filed for and received worker’s compensation benefits. Two months later, she fell and re-injured her rotator cuff. The Division denied her claim for benefits on the ground it was caused by the fall and was not work-related. Alvarez requested a hearing and the Division referred the matter to the Medical Commission (Commission.) After the hearing, the Commission awarded Alvarez benefits. The Division filed a petition for review in the district court which reversed the Commission’s decision.
The Court reviews an appeal from a district court as if it came directly from the agency.
The Division and the Commission both emphasized Bruhn, so Alvarez framed the issue as being dependent on the meaning of the Court’s holding in that case. The Court concluded that Bruhn did not govern the outcome of the case, rather the second compensable rule applied. The Court also stated the Commission properly decided the case because it was a medically contested case in which the primary issue required the application of medical judgment to complex medical facts.
The second compensable injury rule applies when an initial compensable injury ripens into a condition requiring additional medical attention. The Court reviewed cases where they have applied the rule including: Casper Oil Co. v. Evenson; Pino ex rel. Wyo. Workers’ Safety & Comp. Div.; Carabajal v. State ex rel. Wyo. Workers’ Safety and Comp. Div.; Yenne-Tully v. State ex rel. Wyo. Workers’ Safety & Comp. Div.; and Walsh v. Holly Sugar Corp. The Court reviewed the record and agreed with the Commission’s conclusion that Alvarez had met her burden of proving the re-tear and resulting surgery were compensable. There was no dispute that the initial rotator cuff tear was work-related and required surgical intervention. While she was recovering from that surgery she fell. Her doctor testified that in his opinion the tear was related to the initial work related tear. The Court stated there is nothing in the second compensable injury rule that attributes any significance to where the worker was at the time the injury manifested itself, nor is any triggering event required. What matters is whether the initial compensable injury ripened into a condition requiring additional medical intervention and whether the subsequent injury was causally related to the initial compensable injury.
Holding: The Court held that Alvarez met her burden of proving the re-tear was a compensable consequence of her initial work injury and the Commission’s decision was supported by the second compensable injury rule. The Court was cognizant that Alvarez did not expressly argue the second compensable injury rule in support of her claim but relied on the Bruhn premises rule. The Commission was alerted to the theory as evidenced by its discussion of the rule in its conclusions of law.
Reversed and remanded.
J. Kite delivered the decision.
J. Golden, dissenting, joined by C.J. Voigt: The Justices would have held that the Commission lacked subject matter jurisdiction to decide Alvarez’s case because it was not a medically contested case as required by Wyo. Stat. Ann. § 27-14-616(b)(iv). Review of the record confirmed that the case required no medical expertise for its resolution. The primary issue involved the legal issue of coverage. The Commission should have dismissed the case and returned it to the Division.
Link: http://tinyurl.com/37bcv6 .
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