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Johnson v. State ex rel. Wyoming Workers' Safety & Compensation Div.

Supreme Court of Wyoming

March 5, 2014

IN THE MATTER OF THE WORKER'S COMPENSATION CLAIM OF: BENNIE JOHNSON, Appellant (Petitioner),
v.
STATE OF WYOMING, ex rel., WYOMING WORKERS' SAFETY AND COMPENSATION DIVISION, Appellee (Respondent)

Appeal from the District Court of Sweetwater County. The Honorable Nena James, Judge.

For Appellant: Donna D. Domonkos, Cheyenne, Wyoming.

For Appellee: Peter K. Michael, Wyoming Attorney General; John D. Rossetti, Deputy Attorney General; Michael J. Finn, Senior Assistant Attorney General; Peter Howard, Legal Intern.

Before KITE, C.J., and HILL, VOIGT[*], BURKE, and DAVIS, JJ.

OPINION

Page 319

KITE, Chief Justice.

[¶1] The State of Wyoming ex rel. Wyoming Workers' Safety and Compensation Division (the Division) denied Bennie Johnson's requests for preauthorization of bilateral total knee replacements and payment of other medical bills associated with his knees on the grounds the current condition of his knees was not related to a 1992 work injury. The Medical Commission held a contested case hearing and upheld the Division's decision. During the hearing it admitted into evidence,

Page 320

over Mr. Johnson's objection, three exhibits. We conclude the Medical Commission did not commit prejudicial error by admitting the exhibits and substantial evidence supports its decision. We, therefore, affirm.

ISSUES

[¶2] Mr. Johnson presents the following issues for this Court's consideration:

ISSUE I
Whether the Commission acted arbitrarily, capriciously or otherwise not in accordance with the law when it admitted into evidence unreliable and irrelevant evidence over objection.
ISSUE II
Whether the [Medical Commission's] decision is supported by substantial evidence.

The Division presents the same issues, although they are phrased differently.

FACTS

[¶3] Mr. Johnson has a long and complicated history of knee problems. On October 9, 1986, Mr. Johnson filed an injury report stating that a day earlier he fell ten feet while working as a pipe welder and injured his left shoulder. It did not indicate that he injured his knees, and he did not receive any worker's compensation benefits for his knees.

[¶4] Several years later, while still working as a welder, Mr. Johnson was seen by orthopedic surgeon Christian Guier, M.D. with complaints of bilateral knee pain. On the intake questionnaire dated September 23, 1992, he stated that he had " bad knees" after falling thirty feet in 1985(sic). Dr. Guier diagnosed him as suffering from bilateral patellar tendonitis and chondromalacia and stated he could not rule out mild medial/lateral meniscopathy in both knees.[1] Mr. Johnson sought worker's compensation benefits, and the Division concluded the time of the injury was " September 23, 1992" and " the injury appear[ed] to be work related."

[¶5] Dr. Guier performed surgery on both knees in December 1992, including bilateral " arthroscopy and chondral debridement for chondromalacia patellae" and " partial synovectomy." [2] Although Mr. Johnson returned to work shortly after the surgeries, within a few months he was again suffering from pain in both knees. Dr. Guier performed a second bilateral knee operation in May 1993. Approximately one week after the surgeries, Dr. Guier stated that he felt Mr. Johnson would " be permanently disabled from this injury and should seek another line of employment. A referral to Vocational Rehabilitation would be appropriate at this time." Mr. Johnson apparently remained off work for the next several months, and Dr. Guier continued to suggest he find a new means of earning a living. Mr. Johnson's knees, particularly the left, continued to bother him, and on December 9, 1993, Dr. Guier performed a third arthroscopy and chondral debridement of Mr. Johnson's left knee.

[¶6] On December 23, 1993 (approximately two weeks after the left knee surgery), Mr. Johnson's right leg and knee were seriously injured when he was struck by a vehicle while walking. He was diagnosed with " comminuted right knee lateral tibial plateau fracture with disruption of the anterior cruciate ligament insertion of the lateral meniscus," and Dr. Guier performed surgery the next day.

[¶7] Mr. Johnson received temporary total disability (TTD) benefits until the end of April 1995, when he accepted permanent partial disability benefits for both knees. He also received a vocational (loss of earning capacity) award to assist him in retraining for another occupation. He apparently used the award to start a fly fishing business sometime in 1995.

[¶8] Even though he changed professions, Mr. Johnson continued to suffer from knee problems. He reinjured his right knee

Page 321

while fishing on December 27, 1995, and underwent additional surgeries on his right leg/knee in 1995 and 1996. The Division denied his request for worker's compensation benefits for the 1996 surgery, and a Medical Commission panel upheld the denial, finding the surgery resulted from the pedestrian/car accident rather than his work injury.

[¶9] Mr. Johnson fell on April 11, 1997, injuring both knees and again on April 15, 1997, landing on a rock with his right knee. In 1998, Mr. Johnson received injections in his knees to relieve the pain. He underwent bilateral knee surgeries on November 3, 1998, and Dr. Guier stated the " majority" of Mr. Johnson's problems with both knees related to the work injury. Mr. Johnson fell and injured his right knee again in 1999 and underwent additional injections and another surgery on his right knee in 2000.

[¶10] During the 2000s, Mr. Johnson had carpel tunnel release surgery and was treated for knee, back, shoulder and neck problems. Over the lengthy term of his medical treatment, Mr. Johnson took a great deal of pain medication and his doctors expressed concern over his pain medication use. In 2003, Mr. Johnson was seen by a pain specialist, Tuenis Zondag, M.D., who noted he " lives with pain 24/7 and has multiple areas with problems."

[¶11] Despite his pain, Mr. Johnson worked in his fly fishing business and also returned to welding in the mid 2000s. Finally, in 2009, Dr. Guier and Mr. Johnson requested preauthorization from the Division to perform total knee replacement on both knees. The Division issued final determinations denying both requests and also denying payment of continued treatment of his knees by Dr. Zondag. The Division concluded the treatment and total knee replacements were not associated with the 1992 work injury. Mr. Johnson objected and the matters were consolidated for hearing. The Medical Commission issued its decision on February 1, 2011, upholding the denial of ...


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