Worker's Compensation Claim of Bailey v. State Ex Rel. Department of Workforce Services
2015 WY 20
| Wyo. | 2015Background
- Vernon Bailey slipped and fell at work on February 7, 2011 and sought treatment for multiple injuries including his cervical spine; initial imaging showed multilevel degenerative changes and prior cervical studies existed from 2010.
- Division denied preauthorization for a C5-6 and C6-7 anterior cervical discectomy and fusion; Bailey requested a hearing before the Medical Commission.
- Three physicians offered opinions: Dr. Kopitnik (neurosurgeon) and independent IME Dr. Ritterbusch found no acute or appreciable post‑fall change and attributed pathology to degenerative disease; Dr. Schubert (neurologist) recommended surgery but conceded causation would be conjectural and relied in part on Bailey’s subjective history.
- The Medical Commission credited Kopitnik and Ritterbusch, found Bailey had preexisting cervical pathology, and concluded the February 2011 fall did not materially aggravate that condition.
- District court affirmed the Commission; the Supreme Court reviewed de novo on law and for substantial evidence on factual findings and affirmed the denial of additional cervical benefits.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Bailey proved his 2011 work accident materially aggravated his preexisting cervical condition | Bailey: Dr. Schubert’s opinion supports that the fall aggravated his neck and justifies surgery/benefits | Medical Commission/Division: Pre‑ and post‑fall imaging and testimony show degenerative, preexisting pathology without appreciable change; causation opinions were speculative | Held: Substantial evidence supports the Commission’s finding that Bailey did not prove a material aggravation and benefits were properly denied |
Key Cases Cited
- Kenyon v. State ex rel. Wyo. Workers’ Safety & Comp. Div., 247 P.3d 845 (Wyo. 2011) (standard of review for agency decisions and substantial evidence test)
- Dale v. S & S Builders, LLC, 188 P.3d 554 (Wyo. 2008) (review of agency credibility determinations and burden of proof analysis)
- Bush v. State ex rel. Workers’ Comp. Div., 120 P.3d 176 (Wyo. 2005) (definition of substantial evidence)
- Boyce v. State ex rel. Wyo. Workers’ Safety & Comp. Div., 105 P.3d 451 (Wyo. 2005) (proof required to show work materially aggravated a preexisting condition)
- Lindbloom v. Teton Int’l, 684 P.2d 1388 (Wyo. 1984) (employee taken as found; preexisting condition may be compensable if materially aggravated)
- Dutcher v. State ex rel. Wyo. Workers’ Safety & Comp. Div., 223 P.3d 559 (Wyo. 2010) (preexisting disease not disqualifying if employment aggravated condition)