IN THE MATTER OF THE WORKER'S COMPENSATION CLAIM OF, JAMES D. BOYCE, AN EMPLOYEE OF HALLIBURTON:
STATE OF WYOMING, ex rel., DEPARTMENT OF WORKFORCE SERVICES, WORKERS' COMPENSATION DIVISION, Appellee (Respondent). JAMES D. BOYCE, Appellant (Petitioner),
from the District Court of Sweetwater County The Honorable
Nena James, Judge
Representing Appellant: Jack D. Edwards of Edwards Law
Office, P.C., Etna, WY.
Representing Appellee: Peter K. Michael, Wyoming Attorney
General; Daniel E. White, Deputy Attorney General; and
Michael J. Finn, Senior Assistant Attorney General.
BURKE, C.J., and HILL, DAVIS, FOX, and KAUTZ, JJ.
James Boyce suffered an inguinal hernia while working and
received workers' compensation benefits to cover that
injury. The Wyoming Workers' Compensation Division
(Division) denied benefits, however, for subsequently
discovered conditions in Mr. Boyce's lumbar spine. The
Medical Commission upheld the Division's denial of
benefits, and Mr. Boyce appealed. The district court affirmed
the Medical Commission's decision, and we likewise
Mr. Boyce states his single issue on appeal as follows:
ISSUE ONE: Whether the Medical Commission
provided a sufficient explanation as to why it ruled the way
In May 2013, Mr. Boyce was working for Halliburton Energy
Services as a "frac hand, " which meant he was
tasked with delivering equipment and materials to well sites,
and setting up and taking down the well equipment. On May
11th, Mr. Boyce was assigned to transport equipment and
material from Rock Springs, Wyoming to a well site in
Nebraska. Because his delivery included hazardous materials,
he was required to have a placard on the back of the
eighteen-wheeler warning of the hazardous materials on board.
The placard was in place when Mr. Boyce left the Halliburton
yard in Rock Springs, but when he stopped at a truck stop a
short distance from the yard, he discovered it had fallen
Mr. Boyce reported the situation to his supervisor, who then
met Mr. Boyce at the truck stop and took him to search for
the placard. When they located the placard, they pulled over,
and the two of them lifted the placard to place it in the
back of the supervisor's three-quarter-ton truck. The
placard weighed about a hundred pounds and was mounted in an
8.5-foot metal frame. Mr. Boyce and the supervisor were
standing on the passenger side of the truck bed, with Mr.
Boyce closest to the cab. Each lifted a side of the placard,
and because the truck had racks and a diesel tank on the bed
closest to the cab, where Mr. Boyce was lifting, he had to
stand on his toes to lift it high enough to place it in the
truck. When Mr. Boyce did that, he felt a sharp shooting pain
down the right side of his groin.
Mr. Boyce and his supervisor eventually got the placard into
the back of the truck, and once the placard was securely
fastened to the back of Mr. Boyce's rig, he continued his
trip to Nebraska. After Mr. Boyce completed his Nebraska
trip, he returned to his home in Idaho, and on Monday May 13,
2013, he saw his primary care physician, Dr. Bailey. Dr.
Bailey suspected Mr. Boyce had a hernia and referred him to a
surgeon for further evaluation.
On May 17, 2013, Halliburton submitted a report of injury to
the Division, which stated, "Employee was lifting a
placard rack back onto a truck and strained groin." On
May 24, 2013, the Division issued a Final Determination of
Compensability, which stated:
The Workers' Compensation Division has reviewed your
injury report and related documents for the injury of May 11,
2013 and has determined it is compensable and has opened your
claim. The body part(s) to be covered are: Right Groin
Mr. Boyce was ultimately diagnosed with a right inguinal
hernia and referred to Dr. Gregg Marshall for surgery. Due to
intervening medical issues, Mr. Boyce's hernia surgery
was delayed until June 17, 2013. Nine days after surgery, on
June 26, 2013, Mr. Boyce saw Dr. Marshall for a post surgery
follow-up and reported substantial pain that he was able to
control with medication. Mr. Boyce did not report low back
pain during that visit. Dr. Marshall's June 26th post
surgery plan was for Mr. Boyce to resume regular activity
three weeks after his surgery and to return to work July 22,
On July 9, 2013, Mr. Boyce spoke with a Division claims
analyst and informed her that he had been released to return
to work on July 22nd, but he "has been having a lot of
pain in [his] siatic nerve." On July 11, 2013, Mr. Boyce
again saw Dr. Marshall. During that appointment, he
complained of "pain in his right gluteus maximus. A
pelvic sharp stabbing pain down the hip joint." Dr.
Marshall assessed Mr. Boyce:
59-year-old male status post right inguinal hernia repair.
From the hernia standpoint he is doing very well. He has some
musculoskeletal pain in his right hip joint and into his
gluteus maximus. I think that this is related to him walking
with poor posture prior to his hernia repair.
Dr. Marshall referred Mr. Boyce to physical therapy and then
saw him again on July18, 2013. By then Mr. Boyce had
undergone two physical therapy treatments "with a small
amount of improvement." Dr. Marshall's assessment of
Mr. Boyce on that date was "musculoskeletal pain in his
right hip joint and into his gluteus maximus, " and he
recommended continued physical therapy. Mr. Boyce saw Dr.
Marshall again on August 1, 2013, and Dr. Marshall noted that
Mr. Boyce "continues to have persistent pain radiating
from his back and down into his gluteus maximus, " and
"occasional pain down into his thigh." He further
[Mr. Boyce] is undergoing [a] modest course of physical
therapy to see if his symptoms improve. They have not.
I'm concerned about possible disc herniation or lung
nerve entrapment. I will obtain an MRI and [have] referred
him to a neurosurgeon for further evaluation.
On August 20, 2013, Mr. Boyce saw Dr. Gregory Harrison, a
neurosurgeon. Dr. Harrison noted, in part:
** * Since hernia surgery, the patient reports the
right-sided groin pain has improved though is not gone. The
right-sided hip/buttock pain has persisted. The pain does not
radiate into the thigh or calf nor does he have any
paresthesias. * * *
Dr. Harrison reviewed an August 8, 2013 MRI of Mr.
Boyce's spine, which showed:
1. Levoscoliosis with rotary component and leftward
spondylolisthesis of L4.
2. Multilevel discogenic disease most pronounced at the L3-4
and L4-5 levels and to a lesser degree at L5-S1.
3. Mild canal stenosis at L3-4 and L4-5.
4. Diffuse posterior disc bulge with focal extrusion right
paracentrally to posterolaterally of the L5-S1 disc extending
into the lateral canal.
5. Multilevel neuroforaminal narrowing as described.
6. Bilateral synovial cysts posterolaterlly off the 4-5
facets which do no[t] encroach into the canal.
Dr. Harrison diagnosed Mr. Boyce with "a right S1
radiculopathy due to the small but significant disc
herniation on the right at L5-S1. He certainly has
degenerative changes at L3-4 and L4-5, as noted on the
report." Dr. Harrison recommended steroid injections,
noting "a fair chance that he may resolve this disc
herniation on his own and without surgery."
On October 1, 2013, after two epidural steroid injections,
Mr. Boyce again saw Dr. Harrison. Dr. Harrison noted the
injections "modestly helped with [Mr. Boyce's]
global pain." He concluded:
** * He is struggling with his right S1 radiculopathy and a
bit of back pain. He has tried a number of
conservative/nonsurgical measures and he is doing poorly
overall regarding pain control. I think it is reasonable to
say he has failed conservative measures and I would certainly
offer him surgery at this time. I can offer him excellent
outcomes, particularly regarding his radicular leg pain, in
the situation. * * *
On October 16, 2013, Dr. Harrison submitted to the Division a
request for preauthorization to perform an L3-L5 laminectomy
and an L5-S1 discectomy. On October 24, 2013, the Division
issued a final determination denying the preauthorization
request on the ground that the surgery was not related to the
original groin injury. Mr. Boyce objected to the final
determination, and on November 14, 2013, the matter was
referred to the Medical Commission for a
After Mr. Boyce's claims were referred to the Medical
Commission for hearing, Mr. Boyce underwent two independent
medical evaluations (IMEs). On December 20, 2013, Mr. Boyce
was examined by Dr. Brian Tallerico, a general orthopedic
surgeon. Based on his record review and examination of Mr.
Boyce, Dr. Tallerico opined that Mr. Boyce's spine
conditions were not work related. More particularly, Dr.
Tallerico felt that Mr. Boyce's spine was not in fact
symptomatic and that the pain he was experiencing was
muscular, which he described as "[r]ight gluteal pain
and tenderness of unclear origin." Based on his
assessment that Mr. Boyce's spine was not symptomatic, he
disagreed with Dr. Harrison's surgery recommendation.
Additionally, I respectfully disagree that he is a candidate
for an L3 to L5 laminectomy with L5-S1 diskectomy for several
reasons. First, he had little, if any relief during the
diagnostic and therapeutic phase of his multiple epidural
steroid injections. If he had significant stenosis
necessitating an L3-5 laminectomy, I would imagine that he
would have some relief during the local anesthetic phase of
his pain. Additionally, he describes purely gluteal pain with
muscular tenderness. This is not radiculopathy.
Although he did have some episodes last Friday of the pain
going down his entire right leg, that would be seven months
following his injury, and therefore, would be unrelated
temporally. Furthermore, he has a completely normal
neurologic examination in the right lower extremity. He has
no orthopedic impairment rating relating to the industrial
claim. His degenerative findings in his lumbar spine are
pre-existing and in my opinion, actually incidental, and
certainly not related to the industrial injury.
On February 27, 2014, Mr. Boyce underwent a second IME, this
one performed by Dr. Gary Walker, a physiatrist who described
his specialty as physical medicine rehabilitation. Based on
his record review and examination of Mr. Boyce, Dr. Walker
opined that the L3-L5 stenosis was not work related, but the
L5-S1 disc protrusion was work related.
It is my opinion that any treatment for L3-L4 and L5
laminectomy would be unrelated to his work injury and rather
related to preexisting, although previously asymptomatic,
degenerative disc disease at the L3-L4 and L5 levels
primarily. He does, however, have a right L5-S1 acute
appearing focal disc protrusion with extruded fragment in the
lateral recess impacting the descending S1 root. It is a very
focal protrusion and matches his pain. It also matches with
his sensory change in the right lateral foot. It is my
opinion that it is more probable than not that the right
L5-S1 disc extrusion is indeed work related. The initial
pathology indeed may have come on associated with the
lifting; however, may also have come on with the bending over
and walking flexed associated with his right inguinal hernia.
Either way, the causation would be industrial related. I
disagree with Dr. Tallerico's independent medical
examination. In fact in Dr. Tallerico's independent
medical examination, he does not even comment that the
patient has a right L5-S1 disc extrusion as seen on the MRI
scan. He comments only about degenerative changes; therefore
I do not think that Dr. Tallerico's opinion is complete
as it does not even consider the L5-S1 disc extrusion.
The Medical Commission held an evidentiary hearing on March
27, 2015. The evidence presented to the Medical Commission
included Mr. Boyce's medical records, Dr. Harrison's
deposition testimony, Dr. Tallerico's IME report and
deposition testimony (submitted by the Division), and Dr.
Walker's IME report and deposition testimony (submitted
by Mr. Boyce). On May 7, 2015, the Medical Commission issued
its Findings of Fact, Conclusions of Law, and Order of
Medical Commission Hearing Panel, which upheld the
Division's denial of benefits for Mr. Boyce's spine
conditions. In so ruling, the Medical Commission found, in
15. The Medical Hearing Panel herein finds that the opinion
of Dr. Harrison is quite equivocal. He was unable to clearly
document radiculopathy on August 20, 2013, several months
after the reported work injury. In addition, we note that he
had taken a very poor history from Mr. Boyce, and had an
inadequate working knowledge of the mechanism of injury,
and/or any preexisting problems that may have existed. When
asked why he had indicated in his records that the proposed
surgery was a Workers' Compensation injury, Dr. Harrison
indicated it was because Mr. Boyce had told him it was.
We find that Dr. Harrison's opinion is equivocal and
nonspecific, and is nonsupportive of Mr. Boyce going through
the requested surgery as a ...