State v. Lysne (In re Lysne)
426 P.3d 290
Wyo.2018Background
- July 22, 2013: Lysne injured his left knee at work while carrying shingles; initial conservative care failed.
- He underwent two arthroscopic surgeries (Feb and July 2014), injections, extensive physical therapy, and continued to have disabling pain and dysfunction.
- Multiple surgeons (three) recommended further surgery: two recommended total knee arthroplasty and one recommended partial knee replacement; other IME physicians (non-orthopedists) opined against total knee replacement and assessed MMI with a 1% impairment.
- The Division denied preauthorization for total knee replacement and issued a 1% impairment determination; the Medical Commission reversed, finding the 1% rating premature and preauthorizing total knee replacement as causally related to the work injury.
- The district court affirmed the Commission; the Division appealed to the Wyoming Supreme Court.
Issues
| Issue | Plaintiff's Argument (Lysne) | Defendant's Argument (Division) | Held |
|---|---|---|---|
| Whether the Commission had substantial evidence to find work injury caused need for total knee replacement | Lysne: his July 2013 work injury led to ongoing knee pathology and, after failed conservative and surgical treatment, the replacement is causally related | Division: Lysne failed to prove causation; IME opinions show no causal link and MMI was reached before recommended treatments concluded | Held: Commission's finding of causation supported by substantial evidence and not contrary to law |
| Whether medical expert proof of causation was required here | Lysne: not required because injury and need for replacement were immediately and naturally the result of the single work incident | Division: complex medical issues required expert medical testimony to establish causation | Held: Medical proof not required here—this was not a complex case and fell within exceptions where causation is obvious |
| Whether the Commission permissibly discounted IME opinions (Nieves, Reichardt) | Lysne: Commission could credit treating surgeons and his testimony over IMEs and found IMEs flawed | Division: Commission improperly substituted its judgment for medical experts, discounted IMEs without adequate reason | Held: Commission validly weighed evidence, identified flaws in IME reports, and permissibly favored treating surgeons and claimant testimony |
| Whether preexisting degeneration or other factors defeat compensability | Lysne: even if degeneration existed, work injury substantially aggravated or materially contributed to need for replacement | Division: degeneration undermines causal link to the work incident | Held: Wyoming law allows recovery where employment substantially aggravates preexisting conditions; Commission's conclusion supported by evidence |
Key Cases Cited
- Morris v. State ex rel. Dep't of Workforce Servs., Workers' Comp. Div., 403 P.3d 980 (Wyo. 2017) (standard of appellate review of agency decisions)
- Guerrero v. State ex rel. Dep't of Workforce Servs., Workers' Comp. Div., 352 P.3d 262 (Wyo. 2015) (medical expert proof of causation generally required)
- Beall v. Sky Blue Enterprises, Inc., 271 P.3d 1022 (Wyo. 2012) (causal nexus requirement for compensability)
- Dale v. S & S Builders, 188 P.3d 554 (Wyo. 2008) (substantial-evidence review of Commission findings)
- Thornberg, 913 P.2d 863 (Wyo. 1996) (when single-incident injuries obviate need for medical testimony)
- Gray v. State ex rel. Wyoming Workers' Safety & Comp. Div., 193 P.3d 246 (Wyo. 2008) (claimant testimony plus medical evidence can suffice for causation)
- Hansen v. Mr. D's Food Center, 827 P.2d 371 (Wyo. 1992) (single-incident reoccurrence may not require medical testimony)
- Straube v. State ex rel. Wyoming Worker's Safety & Comp. Div., 208 P.3d 41 (Wyo. 2009) (preexisting conditions do not bar recovery where work materially aggravates)
- Hurley v. PDQ Transport, Inc., 6 P.3d 134 (Wyo. 2000) (agency as factfinder weighs medical testimony)