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In the Matter of the Worker's Compensation Claim of v. State of Wyoming

May 25, 2012


Appeal from the District Court of Converse County The Honorable John C. Brooks, Judge

The opinion of the court was delivered by: Burke, Justice.

Before KITE, C.J., and GOLDEN, HILL, VOIGT, and BURKE, JJ.

NOTICE: This opinion is subject to formal revision before publication in Pacific Reporter Third. Readers are requested to notify the Clerk of the Supreme Court, Supreme Court Building, Cheyenne, Wyoming 82002, of any typographical or other formal errors so that correction may be made before final publication in the permanent volume.

[¶1] The Wyoming Workers' Safety and Compensation Division awarded benefits to Appellant, Gary Mitcheson, after he fell at work and injured his tailbone in July of 2007. Approximately two years later, the Division issued a final determination denying payment for medical care that Mr. Mitcheson claimed was related to his workplace injury. Mr. Mitcheson requested a contested case hearing, and the Office of Administrative Hearings (OAH) upheld the Division's determination. Mr. Mitcheson appealed to the district court, which upheld the OAH's order. He challenges the district court's decision in this appeal. We affirm.


[¶2] Appellant presents the following issues:

1. Is the OAH Order arbitrary and unsupported by substantial evidence?

2. Is the OAH Order denying payment for treatment of Mr. Mitcheson's tailbone injury arbitrary?

3. Is [the] OAH Order denying payment for medical care contrary to the "Rule Out" Rule and therefore contrary to law?

The Division phrases the issues as follows:

1. In making its determination, the OAH utilized the medical records submitted into evidence, but gave very little weight to the testimony of Mitcheson and his physician because the OAH found their testimonies to be incredible. Does the evidence that the OAH deemed credible constitute substantial evidence to support the OAH's determination that Mitcheson failed to prove a causal connection between his 2007 work injury and his 2009 medical treatment?

2. Was the OAH's decision denying benefits to Mitcheson arbitrary, capricious, or otherwise not in accordance with Wyoming law?


[¶3] Mr. Mitcheson fell and fractured his tailbone on July 8, 2007, as he was finishing work on a water well for his employer, Douglas Exploration. According to Mr. Mitcheson, he fell backwards off of a raised deck, striking his tailbone on a piece of angle iron on his way down, and then fell approximately four more feet, landing on the edge of a metal, box-shaped mud pit, which was situated eighteen inches above the ground. Mr. Mitcheson was unable to go to work the next day because he was too sore. Suspecting that he had broken his tailbone, Mr. Mitcheson rested in his motel room for a few days and then drove to his home in Utah.

[¶4] Five days after his fall, Mr. Mitcheson was examined by a nurse practitioner at the Emery Medical Center in Castle Dale, Utah. The initial report of injury submitted to the Division indicated that Mr. Mitcheson had reported pain in his tailbone and left side. The report also stated that Mr. Mitcheson had a "resolving large bruise to lower back," as well as bruising on his tailbone and left flank. Mr. Mitcheson was diagnosed with a tailbone fracture and a left lumbar hematoma, and was treated with non-narcotic pain medication and a plastic donut. The Wyoming Workers' Safety and Compensation Division issued a final determination opening Mr. Mitcheson's case, which noted that the body parts to be covered were his "tailbone (coccyx), kidney, mid back (thoracic), and low back (lumbar)."

[¶5] Although Mr. Mitcheson was released to work on the day after his visit to the Emery Medical Center, he did not work again until seven months later, in February of 2008.*fn1 In October of 2008, Mr. Mitcheson found a job driving a truck for Target Trucking, which required a commercial driver's license (CDL). In order to maintain his CDL, Mr. Mitcheson was required to pass a physical examination administered by a Utah Department of Transportation medical examiner. Due to a high diastolic blood pressure reading on his first two medical exams, however, Mr. Mitcheson did not qualify for a one-year medical certificate until his third exam, in January of 2009. On the "health history" portion of each of his medical examinations, Mr. Mitcheson reported that he had no history of spinal injury or disease, and that he had no history of chronic low back pain.

[ΒΆ6] In March of 2009, approximately twenty months after his workplace injury, and approximately five months after he began working as a truck driver, Mr. Mitcheson returned to the Emery Medical Center and reported that he had been having pain in his lower back since the accident in July of 2007. At this visit, Mr. Mitcheson complained of low back pain and vertebral tenderness. Mr. Mitcheson was referred to Dr. Robert Bourne, who noted in July of 2009 that Mr. Mitcheson complained of back pain and numbness in his left foot, and that Mr. Mitcheson's complaints stemmed "from an accident two years ago when he was working on a drill rig." Dr. Bourne ordered an x-ray that revealed "a mild to moderate sized bone spur at L4 with minimal degeneration at that level." Dr. Bourne submitted a bill to the Division and requested authorization for an MRI. The Division denied payment, finding that "Current treatment to the back is not related to the original July 8, 2007 work injury to ...

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