IN THE MATTER OF THE WORKER'S COMPENSATION CLAIM OF: MARGARITO CAMACHO, Appellant (Petitioner),
STATE OF WYOMING, ex rel. DEPARTMENT OF WORKFORCE SERVICES, WORKERS' COMPENSATION DIVISION, Appellee (Respondent).
from the District Court of Laramie County The Honorable
Steven K. Sharpe, Judge
Representing Appellant: Bernard Q. Phelan, Phelan Law
Offices, Cheyenne, Wyoming.
Representing Appellee: Bridget L. Hill, Attorney General;
Michael J. McGrady, Deputy Attorney General; James C. Demers,
Senior Assistant Attorney General; Kelly D. Mullen, Assistant
DAVIS, C.J., and FOX, KAUTZ, BOOMGAARDEN, and GRAY, JJ.
Margarito Camacho reported that he injured his back while
working in October 2011. The Department of Workforce
Services, Workers' Compensation Division (Division)
awarded him temporary benefits. After several years of
medical treatment without relief from his pain, Mr. Camacho
applied to the Division for permanent partial disability
benefits. The Division denied the application, the Office of
Administrative Hearings (OAH) upheld the denial, and the
district court affirmed the OAH's decision. We also
We address two issues:
1. Did the OAH correctly calculate the limitations period
under Wyo. Stat. Ann. § 27-14-405(h)(ii)?
2. Does substantial evidence support the OAH's conclusion
that Mr. Camacho failed to prove his 2011 injury was the
cause of his inability to return to work?
On October 14, 2011, Mr. Camacho reported that he injured his
lower back when he attempted to lift a heavy item while
working at Lowe's in Cheyenne, Wyoming. The Division
reviewed the report, deemed his injury compensable, and
opened a case. Over the next few years, Mr. Camacho visited
various doctors for physical and psychological evaluations,
pain management treatments, and physical therapy.
Dr. Eric Siiteri conducted several "pain psychological
consultations" with Mr. Camacho in December 2011 and
January 2012. He noted that Mr. Camacho had "undergone
neurosurgical evaluation with [another doctor] who documented
bulging in lumbar discs [that] did not warrant surgical
intervention" and that he had "undergone additional
diagnostic studies [that] ruled out significant neurological
injury." At a later pain management psychotherapy
session, Dr. Siiteri "had a long conversation with Mr.
Camacho about the role that emotional factors including
symptoms of depression and anxiety, psychosocial stress and
expectations have on the pain experience." Dr. Siiteri
stated that Mr. Camacho "understood my, and others,
observations of his expression of pain and related behaviors
in the absence of significant . . . medical findings."
In October 2012, Dr. Bruce Belleville evaluated Mr. Camacho
to determine his impairment rating. Dr. Belleville found that
Mr. Camacho was not a good candidate for surgery, had a
history of low-back pain dating back to 2006, and that he had
"twenty-six documented emergency room visits that
predated the injury of October 14, 2011," including an
"emergency room visit about low back pain . . . that
preceded the injury of record by less than two months."
(Emphasis omitted.) He also diagnosed Mr. Camacho with a
"profound anxiety disorder." Concluding that he
could not "assign an impairment rating for a pain
condition that appears to have been pre-existent," Dr.
Belleville assigned him a 0% whole person impairment rating.
In February 2013, Dr. Ricardo Nieves conducted a second
evaluation. Dr. Nieves rated him at 6% whole person
impairment and recommended various "light duty"
work restrictions. He noted that Mr. Camacho had a
"history of pre-existing lower back pain in 2006,"
and "preexisting chronic depression." His diagnosis
was "[c]hronic lower back pain with L5-S1 disc
protrusion and discogenic pain with non-verifiable radicular
In April 2013, Dr. Christopher Brigham reviewed Dr.
Belleville's and Dr. Nieves' impairment evaluations
at the request of the Division. He noted that Mr.
Camacho's "[m]edical records document extensive
emergency room visits  for a variety of problems, including
low back pain" and that "he was seen for low back
pain on August 28, 2011; e.g. approximately six weeks prior
to his more recent 'injury.'" According to Dr.
Brigham, imaging studies had been "unremarkable."
He stated that Mr. Camacho's chronic low-back pain was
"unsupported by objective findings" and that his
complaints of low-back pain dated "back to at least
2006." He believed "[t]he significance of the
October 14, 2011 'injury' [was] very
questionable." He noted that Mr. Camacho's imaging
studies showed "findings that are commonly seen [in]
asymptomatic individuals" and that it was
"inappropriate to label him [as] having degenerative
[disc] 'disease' or to identify this as the cause of
his pain." Therefore, Dr. Brigham concluded that there
was "no ratable impairment associated with [Mr.
Camacho's] October 14, 2011 injury."
Dr. Michael Janssen performed a review of Mr. Camacho's
medical records in August 2013. He found that the
"overall pattern of [Mr. Camacho's] underlying
symptoms, utilization of resources and emergency facilities
have been chronic in nature for many years, as clearly
indicated in all the extensive medical records." He had
"a high suspicion that the subjective symptoms  far
exceed the underlying objective inconsistent pathology."
In Dr. Janssen's opinion, surgery was "not
reasonable or necessary and [had] a very low yield of
improving [Mr. Camacho's] underlying condition."
Dr. Brian Wieder also reviewed Mr. Camacho's medical
records in August 2013. He concluded that it was unlikely
that the October 14, 2011 incident was the cause of Mr.
Camacho's symptoms. He noted that Mr. Camacho's
symptoms and pathology predated the October 14, 2011 incident
and had not changed after the incident. He also observed that
Mr. Camacho "appear[ed] fragile psychologically"
and "had more visits to the E.R. than any patient [he
had] ever seen." Thus, he believed Mr. Camacho would
likely be experiencing similar symptoms absent the injury in
October 2011. He recommended against surgery.
Nevertheless, Mr. Camacho underwent spinal fusion surgery in
October 2014. The surgery did not alleviate his pain, and he
continued to seek evaluations and pain management treatment.
Eventually, the Division referred Mr. Camacho to Dr. Greg
Reichhardt for an Independent Medical Evaluation. Dr.
Reichhardt noted that Mr. Camacho's reported symptoms
were "out of proportion to objective findings" and
were "difficult to explain on a medical basis." He
concluded that Mr. Camacho had reached ascertainable loss on
October 2, 2015, and assigned him a 6% whole person