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In re Worker's Compensation Claim of Baker

Supreme Court of Wyoming

May 22, 2017

IN THE MATTER OF THE WORKER'S COMPENSATION CLAIM OF: JEFFREY BAKER, Appellant (Petitioner),
v.
STATE OF WYOMING, ex rel., DEPARTMENT OF WORKFORCE SERVICES, WORKERS' COMPENSATION DIVISION, Appellee (Respondent).

         Appeal from the District Court of Campbell County The Honorable John R. Perry, Judge

          Representing Appellant: Mark D. Sullivan, Mark D. Sullivan, P.C., Wilson, Wyoming.

          Representing Appellee: Peter K. Michael, Wyoming Attorney General; Michael J. Finn, Senior Assistant Attorney General; Benjamin E. Fischer, Assistant Attorney General.

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

          FOX, JUSTICE.

         [¶1] Jeffrey Baker injured his right shoulder at work, and his shoulder surgery was covered by the Wyoming Workers' Compensation Division (Division). Mr. Baker later requested temporary total disability benefits related to a neck injury he claimed occurred with the shoulder injury. The Division denied his request. On review, the Medical Commission Hearing Panel (Commission) denied his claim on the grounds that he failed to prove a causal relationship between his neck injury and the work-related accident. The district court upheld the Commission's decision and Mr. Baker appealed. We affirm.

         ISSUES

         [¶2] We rephrase the issues as:

1. Was the Commission's decision that Mr. Baker did not meet his burden of establishing the causal relationship between his neck injury and his work-related accident supported by substantial evidence?
2. Was the Commission's decision arbitrary and capricious?

         FACTS

         [¶3] Mr. Baker worked as a laborer for Van Ewing Construction, Inc. when he was injured while carrying a several-hundred-pound log. He went to the Campbell County Memorial Hospital (CCMH) walk-in clinic complaining of right-shoulder pain, numbness, and tingling in his arm. Shoulder x-rays taken at CCMH on the date of injury were negative for a fracture or other abnormality, and Mr. Baker was prescribed pain medication and a sling for his right arm. Due to continued pain in his right shoulder, Mr. Baker saw Joseph Allegretto, M.D., an orthopedist. Mr. Baker complained of "moderate to severe" "right shoulder pain in the area of the a.c. joint." Dr. Allegretto performed a physical examination, including an examination of Mr. Baker's head and neck, and reported that the head and neck area was normal and not producing injury or damage. Dr. Allegretto ordered an MRI of the right shoulder, and prescribed physical therapy.

         [¶4] Mr. Baker began physical therapy on December 12, 2013, and at his January 6, 2014 appointment with Dr. Allegretto, reported minimal relief of his right-shoulder pain, so Dr. Allegretto performed a corticosteroid injection into the subacromial space of Mr. Baker's shoulder, which also provided little relief. Mr. Baker then underwent an electrodiagnostic (EMG) study to determine whether his continued pain originated from carpal tunnel syndrome or a pinched nerve in the neck. The EMG study showed evidence of carpal tunnel syndrome, but neither a pinched nerve in the neck, nor right cervical radiculopathy or plexopathy. As a result, Mark Murphy, M.D., an orthopedic surgeon, performed a right shoulder arthroscopic Mumford distal clavicle excision, right carpal tunnel release, and right shoulder arthroscopic subacromial decompression, which was covered by the Division.

         [¶5] Mr. Baker continued to report numbness and tingling in his right arm as well as pain radiating into his right shoulder. A second EMG study found no evidence of right cervical radiculopathy, plexopathy, or entrapment neuropathy, and indicated Mr. Baker's carpal tunnel condition had been repaired. Dr. Murphy then ordered a cervical MRI which showed mild posterior disc bulging at C4-C5, minimal posterior disc bulging at C5-C6, and marked degenerative disc disease with extensive posterior disc bulging at C6-C7. Dr. Murphy referred Mr. Baker to Mahesh Karandikar, M.D., a neurosurgeon, who initially recommended a C4-C7 anterior cervical discectomy and fusion (ACDF). The Division denied Dr. Karandikar's preauthorization request for the C4-C7 ACDF on the basis that the procedure was not related to a work injury. Dr. Karandikar submitted a second preauthorization request to the Division, limiting the surgery to a C6-C7 ACDF. The Division again denied the request because it was not work related. Dr. Karandikar ultimately performed a C5-C7 ACDF on April 30, 2015.[1]

         [¶6] Prior to the April 30, 2015 ACDF surgery, Mr. Baker requested temporary total disability (TTD) benefits. Dr. Karandikar certified Mr. Baker as temporarily totally disabled between September 23 and November 23, 2014, and designated the disability as related to the cervical spine. The Division denied the benefits, and Mr. Baker objected to the determination and requested a hearing. After an evidentiary hearing, the Commission determined that Mr. Baker had "failed to show by a preponderance of the evidence that his cervical condition was causally related to the work injury on November 4, 2013." The district court affirmed the Commission's ruling, and Mr. Baker timely appealed to this Court.

         STANDARD OF REVIEW

         [¶7] This Court reviews a district court's decision on an administrative decision as though the case came directly from the administrative agency. Price v. State ex rel. Dep't of Workforce Servs., Workers' Comp. Div., 2017 WY 16, ¶ 7, 388 P.3d 786, 789 (Wyo. 2017). Our review is governed by the Wyoming Administrative Procedure Act (W.A.P.A.), which provides:

(c) To the extent necessary to make a decision and when presented, the reviewing court shall decide all relevant questions of law, interpret constitutional and statutory provisions, and determine the meaning or applicability of the terms of an agency action. In making the following determinations, the court shall review the whole record or those parts of it cited by a party ...

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