Worker's Compensation Claim of Newman v. State Rel. Department of Workforce Services, Worker's Safety & Compensation Division
2015 WY 14
| Wyo. | 2015Background
- In December 2008 Wanda Newman slipped at work and injured her lumbar spine (L5-S1); she underwent an L5-S1 microdiscectomy with fusion in September 2009 that the Division preauthorized and paid for.
- Post‑fusion she improved, but developed increased back pain by mid‑2011; imaging showed an L4-5 disc herniation above the prior fusion.
- Dr. Mary Neal (treating surgeon) opined the L4-5 herniation was directly related to biomechanical changes from the prior L5-S1 fusion (adjacent‑segment effect).
- The Division’s IME, Dr. Paul Ruttle, concluded the L4-5 herniation was due to preexisting degenerative changes, not the work injury or prior fusion; Dr. Michael Kaplan noted pre‑fusion degeneration at multiple levels.
- The hearing examiner credited Dr. Ruttle over Dr. Neal (finding Dr. Neal’s causation explanation insufficient) and denied coverage for the 2011 surgery and temporary benefits; the district court affirmed and the Supreme Court affirmed on appeal.
Issues
| Issue | Newman’s Argument | Division’s Argument | Held |
|---|---|---|---|
| Whether there is substantial evidence to support denial of benefits for the 2011 L4-5 surgery | Dr. Neal’s opinion ties the L4-5 herniation to the prior work‑related fusion so benefits should be allowed | Dr. Ruttle and record imaging show preexisting degeneration caused the L4-5 herniation; Dr. Neal’s rationale was insufficient | Affirmed — substantial evidence supports the hearing examiner’s choice to credit Dr. Ruttle and deny benefits |
| Whether the decision was arbitrary, capricious, or unlawful (including application of the second compensable injury rule) | The second compensable injury rule applies because the initial work injury ripened into a later condition requiring more surgery; Dr. Neal’s opinion satisfies causation | The examiner correctly applied the rule and found plaintiff failed to prove causal connection; contrary medical opinion and records support denial | Affirmed — examiner applied the rule correctly and decision was not arbitrary or contrary to law |
Key Cases Cited
- CalCon Mut. Mortg. Corp. v. State ex rel. Wyo. Dep’t of Audit, 323 P.3d 1098 (Wyo. 2014) (administrative‑record review standard)
- Dale v. S & S Builders, LLC, 188 P.3d 554 (Wyo. 2008) (substantial evidence standard for agency findings)
- Leavitt v. State ex rel. Wyo. Workers’ Safety & Comp. Div., 307 P.3d 835 (Wyo. 2013) (deference to hearing examiner credibility determinations)
- Judd v. State ex rel. Wyo. Workers’ Safety & Comp. Div., 233 P.3d 956 (Wyo. 2010) (worker‑takes‑employee‑as‑found / inevitability principles)
- Hoffman v. State ex rel. Wyo. Workers’ Safety & Comp. Div., 291 P.3d 297 (Wyo. 2012) (second compensable injury rule described)
- Trump v. State, 312 P.3d 802 (Wyo. 2013) (burden of proof for second compensable injury equals general causation burden)
- Kaczmarek v. State ex rel. Wyo. Workers’ Safety & Comp. Div., 215 P.3d 277 (Wyo. 2009) (discussion of second compensable injury doctrine)
- Pino v. State ex rel. Wyo. Worker’s Safety & Comp. Div., 996 P.2d 679 (Wyo. 2000) (limits on causation standards for second‑injury claims)
- State ex rel. Wyo. Workers’ Comp. Div. v. Roggenbuck, 938 P.2d 851 (Wyo. 1997) (preexisting condition may be compensable if work effort hastened need for surgery)