Worker's Compensation Claim of Guerrero v. State ex rel. Department of Workforce Services, Workers' Compensation Division
352 P.3d 262
| Wyo. | 2015Background
- June 8, 2011: Guerrero was struck in the lower left front of his body at work, treated for blunt abdominal trauma and a hematoma, and underwent surgery; Division approved benefits for groin/abdomen/leg/knee and paid temporary disability.
- While convalescing he had left leg numbness/pain; referred to neurologist(s) and diagnosed with meralgia paresthetica; no back complaints were reported to hospital staff immediately after the accident.
- Guerrero returned to work in September 2011; he first reported back pain to his treating physician in October 2011 and to specialists in November 2011; MRI showed multilevel degenerative disc disease and disc protrusion.
- Dr. Mosquera opined it was "possible" the accident caused or aggravated disc tears but could not state to a medical probability that the accident was the cause; his opinion relied in part on Guerrero’s history that he fell on his back, a history not reflected in earlier records.
- The Division denied coverage for lumbar evaluation/treatment; OAH held a hearing and denied Guerrero’s claim for the back injury for lack of causation; the district court affirmed and this appeal followed.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Guerrero proved direct causal link between June 8, 2011 accident and later lumbar condition | Guerrero: his back was asymptomatic before the accident; specialist testimony that injury could have caused discs supports causation | Division/OAH: medical testimony only said "possible," not "more likely than not," and timing/history undermines causation | Held: OAH decision affirmed — substantial evidence supports finding of no causation (medical probability lacking) |
| Whether the second compensable injury rule applies (initial injury ripened into lumbar injury) | Guerrero: initial compensable injuries ripened into a later back condition entitling him to benefits | Division/OAH: no evidence that initial front‑of‑body injury materially contributed to lumbar condition | Held: OAH applied rule and correctly ruled Guerrero failed to prove causal link required for second compensable injury |
Key Cases Cited
- Stevens v. State ex rel. Dep't of Workforce Servs., 338 P.3d 921 (Wyo. 2014) (medical probability standard for causation; timing of symptom reporting relevant)
- Boyce v. State ex rel. Wyo. Workers' Safety & Comp. Div., 105 P.3d 451 (Wyo. 2005) (expert opinions couched as "possible" are insufficient to meet claimant's burden)
- Thornberg v. State ex rel. Wyo. Workers' Comp. Div., 913 P.2d 863 (Wyo. 1996) (medical testimony not always required when injury is immediately and directly attributable to incident)
- Murray v. State ex rel. Wyo. Workers' Safety & Comp. Div., 993 P.2d 327 (Wyo. 1999) (prior good health and immediate symptom onset can establish causation without expert testimony)
- Dutcher v. State ex rel. Wyo. Workers' Safety & Comp. Div., 223 P.3d 559 (Wyo. 2010) (standard of review for agency decisions; aggravation of preexisting condition standard)
- Middlemass v. State ex rel. Wyo. Workers' Safety & Comp. Div., 259 P.3d 1161 (Wyo. 2011) (agency need not accept medical opinion based on incomplete/inaccurate history)