Worker's Compensation Claim of Stevens v. State Ex Rel. Department of Workforce Services, Workers' Safety & Compensation Division
2014 WY 153
| Wyo. | 2014Background
- On Oct. 25, 2010, Phylis Stevens slipped and fell down concrete steps outside her workplace; immediate documented complaints and treatment focused on a fractured left hand.
- Stevens later reported right hip soreness; first hip complaint to treating orthopedist (Dr. Rork) was Nov. 29, 2010; x‑rays on Jan. 13, 2011 were normal but MRI on Jan. 17, 2011 showed findings interpreted as possible/atypical AVN of the right femoral head; April 2011 MRI showed more characteristic AVN and possible bilateral involvement.
- Dr. Rork (treating physician) opined the AVN was post‑traumatic from the fall, possibly due to a transient subluxation; he recommended treatment and eventual right total hip replacement was performed Dec. 14, 2011.
- The Division obtained an independent evaluation from Dr. Newton, who concluded trauma‑induced AVN was unlikely because (1) no immediate documented hip injury, (2) traumatic AVN typically appears later than the 3‑month interval here, (3) traumatic AVN ordinarily follows femoral‑neck fracture or dislocation (not a contusion), and (4) bilateral AVN favors a nontraumatic/systemic cause.
- The Office of Administrative Hearings credited Dr. Newton over Dr. Rork, concluded the fall did not cause Stevens’s AVN, denied hip benefits; the district court affirmed and the Supreme Court of Wyoming affirmed on appeal.
Issues
| Issue | Stevens' Argument | Division's Argument | Held |
|---|---|---|---|
| Whether substantial evidence supports the finding that the October 2010 fall did not cause Stevens’s right‑hip AVN | Fall caused AVN (treating Dr. Rork): immediate/early hip pain and plausible transient subluxation from the fall | Evidence shows no documented immediate hip injury, timing and mechanism inconsistent with trauma‑induced AVN; Division expert more persuasive | Affirmed: substantial evidence supports the hearing officer’s finding for the Division |
| Whether temporal absence of prior disease plus later onset is sufficient to establish causation under Murray | Murray principle: prior good health + change after incident can establish causation without definitive medical proof | This case is medically complex and differs from Murray; conflicting expert opinions require medical evidence; Langberg controls | Affirmed: timing alone insufficient here; Murray distinguishable; Langberg applicable |
Key Cases Cited
- Murray v. State ex rel. Wyoming Workers’ Safety & Comp. Div., 993 P.2d 327 (Wyo. 1999) (temporal proximity between work incident and immediate onset of symptoms can support causation when medical proof is inconclusive)
- Langberg v. State ex rel. Wyoming Workers’ Safety & Compensation Div., 203 P.3d 1098 (Wyo. 2009) (absence of pre‑existing symptoms plus later disease presence does not automatically establish causation when medical testimony is inconclusive or speculative)
- Anastos v. Gen. Chem. Soda Ash, 120 P.3d 658 (Wyo. 2005) (speculative medical testimony is insufficient to meet claimant’s burden of proof)