IN THE MATTER OF THE WORKER'S COMPENSATION CLAIM OF: TROY C. COGGINS, Appellant (Petitioner),
STATE OF WYOMING, ex rel., DEPARTMENT OF WORKFORCE SERVICES, WORKERS' COMPENSATION DIVISION, Appellee (Respondent).
from the District Court of Sheridan County The Honorable John
G. Fenn, Judge
Representing Appellant: Kenneth DeCock, Sheridan, Wyoming.
Representing Appellee: Peter K. Michael, Wyoming Attorney
General; Daniel E. White, Deputy Attorney General; J.C.
DeMers, Senior Assistant Attorney General.
DAVIS, C.J., and BURKE [*], FOX, KAUTZ, and BOOMGAARDEN, JJ.
After a contested case hearing, the Office of Administrative
Hearings (OAH) concluded that Appellee Wyoming Workers'
Compensation Division (Division) had properly terminated
Appellant Troy C. Coggins' temporary total disability
(TTD) benefits because he had reached maximum medical
improvement (MMI) and suffered an ascertainable loss. The
district court affirmed the OAH decision, and Mr. Coggins
appealed to this Court. We affirm.
Mr. Coggins presents the following issue for our review:
A. Whether the Office of Administrative Hearings['] . . .
determination that [Mr.] Coggins had reached MMI and no
longer qualified for TTD benefits conforms to current law and
is supported by substantial evidence.
Mr. Coggins injured his back on June 26, 2012, while working
as a truck driver for Mullinax Concrete Services. He filed a
report of injury, and the Division found his injury
compensable. Mr. Coggins was treated conservatively with pain
medication and physical therapy and went back to work about a
week after the accident. Mr. Coggins continued to work until
the end of 2014 when pain in his lower back and pain
radiating down his right leg became unbearable. He stopped
working and began receiving TTD benefits. An MRI showed a
right paracentral protrusion at L5-S1 with a tear at L5 and a
minimal disc bulge at L4-L5.
James Ulibarri, M.D. performed an L5-S1 discectomy on June
17, 2015. Mr. Coggins continued to have radicular pain down
his right leg after the surgery. Electrodiagnostic studies
confirmed he was suffering from radiculopathy. Radiculopathy
is defined as:
significant alteration in the function of a single or
multiple nerve roots and is usually caused by mechanical or
chemical irritation of one or several nerves. The diagnosis
requires clinical findings including specific dermatomal
distribution of pain, numbness, and/or parasthesias.
Subjective reports of sensory changes are more difficult to
assess; therefore, these complaints should be consistent and
supported by other findings of radiculopathy. There may be
associated motor weakness and loss of reflex. A root tension
sign is usually positive. The identification of a condition
that may be associated with radiculopathy (such as a
herniated disk) on an imaging study is not sufficient to make
a diagnosis of radiculopathy; clinical findings must
correlate with radiographic findings in order to be
Hurt v. State of Wyo., ex rel. Dep't of Workforce
Servs., Workers' Safety & Comp. Div., 2015 WY
106, ¶ 19, 355 P.3d 375, 381 (Wyo. 2015) (quoting the
AMA Guides to Evaluation of Permanent Impairment,
Sixth Edition). Tests showed Mr. Coggins' S1
nerve root was swollen and was likely causing his radicular
Dr. Ulibarri recommended Mr. Coggins undergo a trial with a
spinal cord stimulator to see if that would help his
radicular pain. Although the parties in this case do not
direct us to a description of a spinal cord stimulator in the
record, we explained its function in Morris v. State ex
rel. Dep't of Workforce Servs., Workers' Comp.
Div., 2017 WY 119, ¶ 10, 403 P.3d 980, 983 (Wyo.
2017): "[A] spinal cord stimulator is a mechanical
device with an electrical lead that is placed along the
spinal cord. The electrical impulse inhibits the amount of
pain signal that reaches the brain. In other words, it tricks
the nervous system into not recognizing the pain."
Dr. Ulibarri referred Mr. Coggins to Bradley McPherson, M.D.
for a spinal cord stimulator trial. Dr. McPherson stated that
the purpose of a spinal cord stimulator would be to decrease
Mr. Coggins' pain in his right lower extremity. Before a
spinal cord stimulator trial could be approved, Mr. Coggins
had to meet various requirements, including numerous tests, a
psychiatric evaluation and counseling. Mr. Coggins testified
that he had complied with the requirements, but, at the time
of the contested case hearing, the Division still had not
preauthorized the procedure.
In May 2016, the Division sent a form to Dr. Ulibarri asking
whether he believed Mr. Coggins had reached MMI and had
suffered a permanent partial impairment (PPI) as a result of
the work injury. Dr. Ulibarri responded that Mr. Coggins had
reached MMI on January 7, 2016, and that he had a PPI. The
Division, therefore, referred Mr. Coggins to Scott Johnston,
M.D. for an independent medical evaluation and permanent
impairment rating. Dr. Johnston reviewed Mr. Coggins'
medical records and examined him on August 10, 2016. He
concluded Mr. Coggins had reached MMI because there had been
"no significant change in his symptoms in the past
several months." Dr. Johnston assigned Mr. Coggins a
permanent impairment rating of 14% of the whole person. The
rating took into account Mr. Coggins' ongoing
radiculopathy. Mr. Coggins disagreed with the rating and the
Division referred him to Ricardo Nieves, M.D. for a second
opinion. Like Dr. Johnston, Dr. Nieves stated that Mr.
Coggins' was at MMI and rated him as having a 14% of the
whole person impairment. Dr. Nieves also stated that Mr.
Coggins may benefit from a spinal cord stimulator, but it
likely would not change his impairment rating.
[¶8] After Mr. Coggins was rated for PPI, the Division
issued a final determination terminating his TTD benefits,
effective August 15, 2016. He objected to the final
determination and requested a hearing. Mr. Coggins stated
that he was unable to work because his injury had caused
permanent nerve damage. The OAH held a hearing and concluded
the Division had properly ceased paying TTD benefits because
Mr. Coggins had reached MMI and had an ascertainable loss. He
filed a petition for judicial review of the OAH decision with
the district court, and it affirmed the agency decision. Mr.
Coggins filed a timely notice of appeal to this Court.
Wyo. Stat. Ann. § 16-3-114(c) (LexisNexis 2017) governs
judicial review of administrative decisions:
(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 and due account shall be
taken of the rule of prejudicial error. The reviewing court
(i) Compel agency action unlawfully withheld or unreasonably
(ii) Hold unlawful and set agency action, findings and
conclusions found to be:
(A) Arbitrary, capricious, an abuse of discretion or
otherwise not in accordance with law;
(B)Contrary to constitutional right, power, privilege or
(C) In excess of statutory jurisdiction, authority or
limitations or ...