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Wilkinson v. State ex rel. Wyoming Workers' Safety and Compensation Division12/7/1999
The Division paid Wilkinson extended benefits from January 28, 1996 through January 27, 1997, but refused to make further payment on the basis that Wyo. Stat. ' 27-14-403(g)(i)(G) restricted the Medical Commission=s award to twelve months of benefits. Although Wilkinson believed he had filed a claim for 1997 benefits in December 1996, before the Medical Commission issued its decision, the Division informed Wilkinson that it had no record of that claim. Relying on the Division=s representation, Wilkinson filed another claim for benefits for the period of January 27, 1997 through January 26, 1998. The Division received that claim on July 15, 1997.
The next day, July 16, 1997, the Division issued a Final Determination denying benefits for 1997, which stated in relevant part:
The Division determines the claimant is not entitled to permanent total extended benefits pursuant to Wyoming Statute 27-14- 403(g)(C). The Division determines claimant=s income . . . active or passive income, household income and any monthly income from any other governmental agency . . . to be adequate and meets the need for subsistence. Your income from social security of $12,000.00 exceeds the U S Department of Labor level of $10,860.00. Your adjusted annual award from the Division is $0.00.
This language reiterates the 1988 limitations on benefits, but there is no reference to the 1983 law found by the Medical Commission to be controlling in Wilkinson=s case only two months earlier.
Wilkinson then filed an objection, maintaining that he continued to be permanently disabled, the claim was previously determined in his favor by the Medical Commission, and the 1983 statute does not contemplate consideration of the Department of Labor subsistence levels. The matter was referred to the Office of Administrative Hearings, which set a hearing date for November 6, 1997. This was the beginning of case no. 98-251.
On October 9, 1997, the Division filed a Motion for Instruction on Applicable Law, arguing precisely the same issues which had been argued to the Medical Commission in the earlier proceeding. This motion did not refer to its argument to the Medical Commission or the Medical Commission=s recent holding on the matter. As Exhibit B to its motion, the Division included the affidavit of Marcia Price, the claims specialist responsible for Wilkinson=s file, which stated that Wilkinson had filed for extended benefits for the year 1997 on or about December 1, 1996.
On October 20, 1997, Division filed its disclosure statement in which it phrased its contentions as follows:
The Respondent contends that the Employee-Claimant=s entitlement to extended permanent total disability benefits should be considered under the law in effect in 1988. Under that law, the Employee- Claimant would be subject to the provisions of Wyo. Stat. ' 27-14- 403(g) (1988). Respondent would request that the Office of Administrative Hearings hold the Employee-Claimant to his strict burden of proof under this statute.
In the event the Office of Administrative Hearings should determine that the applicable law is Wyo. Stat. ' 27-12-405(d), the law in effect at the date of the accident, then the Respondent would contend that any extended permanent total disability benefits payable to the Employee-Claimant should be reduced to an amount necessary to qualify him for maximum state or federal governmental benefits.
Two days later, on October 22, Wilkinson filed a Motion for Summary Judgment claiming entitlement to the 1997 benefits as a matter of law. He argued the Medical Commission=s determination collaterally estopped the Division=s arguments on the applicabl
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