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In re Worker's Compensation Claim of Newman

Supreme Court of Wyoming

January 28, 2015

IN THE MATTER OF THE WORKER'S COMPENSATION CLAIM OF: WANDA NEWMAN, Appellant (Petitioner),
v.
STATE OF WYOMING, ex rel., DEPARTMENT OF WORKFORCE SERVICES, WORKERS' SAFETY AND COMPENSATION DIVISION, Appellee

Page 1067

Appeal from the District Court of Lincoln County. The Honorable Dennis L. Sanderson, Judge.

For Appellant: F. Gaston Gosar, F. Gaston Gosar, P.C., Pinedale, Wyoming.

For Appellee: Peter K. Michael, Attorney General; John D. Rossetti, Deputy Attorney General; Michael J. Finn, Senior Assistant Attorney General; Samantha Caselli, Assistant Attorney General.

Before BURKE, C.J., and HILL, KITE, DAVIS, and FOX, JJ.

OPINION

Page 1068

BURKE, Chief Justice.

[¶1] Appellant, Wanda Newman, appeals the district court's affirmation of an order from the Office of Administrative Hearings upholding a determination by the Wyoming Workers' Safety and Compensation Division denying her medical and temporary disability benefits. She claims the hearing examiner's decision to uphold the Division's determination is unsupported by substantial evidence and is arbitrary, capricious, and not in accordance with law. We will affirm.

ISSUES

[¶2] Ms. Newman presents two issues, which we have reworded for clarity:

1. Whether the hearing examiner's decision to deny benefits is supported by substantial evidence.
2. Whether the hearing examiner's decision to deny benefits is arbitrary, capricious, and not in accordance with law.

FACTS

[¶3] On December 19, 2008, Ms. Newman, while working as the municipal court judge for the town of Diamondville, Wyoming, slipped and fell on the icy outdoor steps of the town hall. She sought medical treatment for her injuries, complaining particularly of pain in her left knee and lumbar spine. The treating physician gave her pain medication and told her to return in seven to ten days if she did not improve. Conservative treatment failed to resolve her lower back pain, and she was referred to an orthopedic surgeon, Dr. Mary C. Neal. Dr. Neal recommended " an L5-S1 microdiscectomy with fusion and stabilization." Dr. Neal performed the surgery on Ms. Newman on September 25, 2009. The Division gave preauthorization approval, and paid for this surgery and related medical costs, along with temporary disability benefits.

[¶4] Soon after the surgery, Ms. Newman reported to Dr. Neal that she was doing better, although she was still suffering some pain. Dr. Neal felt the symptoms that led to the surgery were " gone." However, from late in 2009 to early in 2010, Ms. Newman reported a sudden increase in her lower back pain. Dr. Neal suspected a " delayed union," meaning that " the bone graft is not incorporating or becoming solid as quickly as would be typical." She continued monitoring Ms. Newman's condition, and in October of 2010, Ms. Newman reported that the pain was approximately 50% improved.

[¶5] On June 18, 2011, Ms. Newman experienced acute onset of pain in her lower back and left leg when she bent over in the shower. She was admitted to the hospital for pain management and further evaluation. A CT scan revealed narrowing of the L4-5 disk space and a disk bulge at that location, above the level of her previous back surgery. Dr. Neal performed another surgery in which she removed the bulging disk and fused the joint. Dr. Neal also revised some of the previous work done at the L5-S1 level to treat the likely delayed union at that level.[1]

[¶6] The Division denied coverage for Ms. Newman's second surgery, and also denied her application for temporary total disability benefits, on the basis that " the recent need for low back surgery is not directly related to the work injury, therefore, the need for lost time, at work is not due to a

Page 1069

work injury." Ms. Newman objected to the Division's determinations, and the matter was referred to the Office of Administrative Hearings.

[¶7] Following a contested case hearing, the hearing examiner determined that Ms. Newman had not proven that the herniated disk at L4-5 diagnosed in 2011 was causally related to her slip and fall on December 19, 2008. Ms. Newman appealed this decision to the district court, which affirmed it. Ms. Newman timely filed this appeal.

STANDARD OF REVIEW

[¶8] When we consider an appeal from a district court's review of an administrative agency's decision, we review the case as though it had come directly from the administrative agency. CalCon Mut. Mortg. Corp. v. State ex rel. Wyo. Dep't of Audit, 2014 WY 56, ¶ 6, 323 P.3d 1098, 1101 (Wyo. 2014) (citing State ex rel. Dep't of Family Services v. Kisling, 2013 WY 91, ¶ 8, 305 P.3d 1157, 1159 (Wyo. 2013)). Review of an administrative agency's action is governed by the Wyoming Administrative ...


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