In the Matter of the Worker's Compensation Claim of Harold F. Vandre, an Employee of Mcmurry Ready Mix Company: Harold F. Vandre, 346 P.3d 946

Background

In August 2007 Harold F. Vandre suffered catastrophic workplace injuries (including right leg amputation, rib fractures, collapsed right lung, and closed head injury) while working for McMurry Ready Mix.
Vandre had preexisting, documented COPD (moderate–severe) and had been prescribed oxygen and inhalers before the accident, though he testified he rarely used them while working.
After the 2007 injury Vandre’s respiratory symptoms and reliance on oxygen/CPAP increased; he was treated for recurrent right‑side lung infections and remained on multiple medications (including narcotics) and CPAP with oxygen bleed.
Vandre sought coverage for several 2012 respiratory‑related medical charges; the Workers’ Compensation Division denied coverage as unrelated to the 2007 compensable work injury.
The OAH upheld the denial, finding Vandre’s COPD was preexisting and worsened by smoking and noncompliance; the district court affirmed.
The Wyoming Supreme Court reversed, holding the record (including treating‑physician opinion) supports that the 2007 work injuries materially aggravated Vandre’s COPD and need for treatment.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether OAH had substantial evidence to deny coverage for COPD treatments as unrelated to the 2007 workplace injury	Vandre: his work injuries (lung trauma, amputation, pain/narcotics, sleep disturbance) materially aggravated/accelerated his preexisting COPD, increasing need for oxygen/therapy; treating physician so opined	Division: COPD is preexisting and caused/worsened by long‑term heavy smoking and patient noncompliance; treating physician’s opinion is inadequately explained and biased	Reversed — OAH decision not supported by substantial evidence; treating physician’s explained opinion and the before/after functional decline permit finding the work injury materially aggravated COPD
Whether treating physician’s opinion may be rejected for lack of specialization or advocacy	Vandre: Dr. Berry (family practitioner) provided reasoned causation linking injury sequelae (pain meds, decreased activity, sleep apnea) to worsening COPD	Division: Berry is not a pulmonologist, was unaware of smoking extent, and his opinion was conclusory/advocacy	Rejected — court held lack of pulmonology specialty or treating relationship advocacy did not justify wholesale rejection; opinion was adequately explained
Whether employee must apportion the relative contributions of smoking vs. work injury	Vandre: not required to apportion; need only show work injury materially aggravated preexisting condition	Division: argued smoking was the cause and OAH relied on that	Held: Apportionment not required; material aggravation by work injury is sufficient
Whether change in underlying pathology is required to show material aggravation	Vandre: functional worsening and increased need for treatment suffice even without new pathology	Division: noted no new or increased COPD pathology documented	Held: No new pathology required — combining/aggravating effect that creates need for treatment meets the standard

Key Cases Cited

Vernon Bailey v. Wyo. ex rel. Dep’t of Workforce Servs., 342 P.3d 1210 (Wyo. 2015) (explains burden to prove work activities were a significant factor in worsening a preexisting condition)
Judd v. State ex rel. Wyo. Workers’ Safety & Comp. Div., 233 P.3d 956 (Wyo. 2010) (work injury need not change pathology to be compensable; material aggravation shown by increased symptoms/functional loss)
Slaymaker v. State ex rel. Wyo. Workers’ Safety & Comp. Div., 156 P.3d 977 (Wyo. 2007) (post‑injury deterioration in functioning can show material aggravation of preexisting condition)
Montoya v. State ex rel. Wyo. Workers’ Safety & Comp. Div., 203 P.3d 1083 (Wyo. 2009) (employee not required to apportion relative contributions of preexisting disease and work injury)
Ramos v. State ex rel. Wyo. Workers’ Safety & Comp. Div., 158 P.3d 679 (Wyo. 2007) (work injury may combine with preexisting disease to necessitate treatment)
Salas v. General Chemical, 71 P.3d 708 (Wyo. 2003) (compensability where work injury aggravated preexisting degenerative condition)
Leavitt v. State ex rel. Wyo. Workers’ Safety & Comp. Div., 307 P.3d 835 (Wyo. 2013) (deference to hearing examiner's weight determinations for medical evidence, but not when contrary to overwhelming weight)
Spletzer v. State ex rel. Wyo. Workers’ Safety & Comp. Div., 116 P.3d 1103 (Wyo. 2005) (hearing examiner has wide latitude to assign probative value to medical evidence)
Glaze v. State, 214 P.3d 228 (Wyo. 2009) (treating physician advocacy alone does not justify wholesale disregard)
Hoffman v. State ex rel. Wyo. Workers’ Safety & Comp. Div., 291 P.3d 297 (Wyo. 2012) (reiterates principle that claimants need not apportion causes; need show material aggravation)