Tuesday, November 01, 2011

Summary 2011 WY 149

Summary of Decision November 1, 2011

[SPECIAL NOTE: This opinion uses the "Universal Citation." It was given an "official" citation when it is issued. You should use this citation whenever you cite the opinion, with a P.3d parallel citation. You will also note when you look at the opinion that all of the paragraphs are numbered. When you need to provide a pinpoint citation to a quote the universal portion of the citation will use that paragraph number. The pinpoint citation in the P.3d portion will need to have the reporter page number. If you need assistance in putting together a citation from this, or any future opinion using the Universal Citation form, please contact the Wyoming State Law Library and we will provide any needed assistance]

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

Case Name: Bodily v. State ex rel. Workers’ Safety and Compensation Division

Citation: 2011 WY 149

Docket Number: S-11-0013

URL: http://wyomcases.courts.state.wy.us/applications/oscn/DeliverDocument.asp?CiteID=464693

Appeal from the District Court of Natrona County, Honorable W. Thomas Sullins, Judge

Representing Appellant (Petitioner): Stephenson D. Emery of Williams, Porter, Day & Neville, Casper, Wyoming

Representing Appellee (Respondent): Gregory A. Phillips, Wyoming Attorney General; John W. Renneisen, Deputy Attorney General; James Michael Causey, Senior Assistant Attorney General; Kelly Roseberry, Assistant Attorney General

Date of Decision: November 1, 2011

Facts: The Wyoming Workers’ Compensation Division (Division) denied Appellant benefits for medical expenses related to his L5-S1 micro-lumbar discectomy because it determined the medical treatment was not related to his earlier compensable work-related back injuries. Appellant requested a contested case hearing before the Office of Administrative Hearings (OAH) to challenge Division’s denial of benefits. Before conducting the hearing, OAH granted Division’s motion for summary judgment against Appellant. On review of that decision, the district court affirmed.

Issues: Whether claimant’s testimony and his surgeon’s opinion create a genuine issue of material fact about causation of his disc herniation precluding entry of summary judgment against claimant on his claim for the surgery expenses.

Holdings: This case is a “second compensable injury case,” where in a contested case hearing a petitioner must prove by a preponderance of the evidence that the injury requiring treatment was the direct result of work-related activities. To avoid the Division’s motion for summary judgment, a petitioner need only demonstrate that a genuine issue of material fact about causation exists.

There is no requirement that medical testimony be presented in any specific form in a workers’ compensation case. Generally, when a single incident is alleged to have caused an injury, medical testimony is not required if it is not essential to establish a causal connection between the occurrence and the injury. However, under certain circumstances, medical testimony may be essential to establish a causal connection. Where the medical evidence shows that a party was injured and that the injury he suffered was of the sort that could have occurred during the work-related incident, that testimony alone may not be sufficient to meet the burden of proof on causation, however, it is certainly permissible for Appellant to fill that gap with evidence of his symptoms between the incident and the diagnosis.

Appellant argues that OAH erred by concluding that medical evidence is required to establish causation for his herniated disc. The only medical evidence presented was from Appellant’s physician who was unable to date the injury and admitted an earlier work incident or a number of outside work activities could have caused Appellant’s herniated disc.

When OAH stated that it considered “all the evidence” and concluded Appellant’s herniated disc is most likely to have resulted from his outside work activities and not from his earlier work injuries, OAH erroneously strayed from its function at the summary judgment stage to determine whether a genuine issue of material fact as to causation existed, giving the non-movant, Appellant, the benefit of all favorable inferences, and OAH erroneously engaged in weighing all the evidence and making credibility determinations. OAH was erroneously acting as the trier of fact which was not its judicial function at the summary judgment stage of this contested case. The main issue in this case – whether Appellant’s earlier work-related back injuries are causally connected to his herniated disc surgery – is in factual dispute, and the evidence presented to OAH, including Appellant’s testimony and his physician’s testimony, permit more than one reasonable inference as to causation to be drawn therefrom.

The summary judgment in favor of Division is reversed and the matter is remanded to the district court for remand to OAH for a contested case hearing.

J. Golden delivered the opinion for the court.

No comments:

Check out our tags in a cloud (from Wordle)!