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Armstrong v. State11/30/1999
W.R.A.P. 12.09(b) Certification from the District Court of Laramie County The Honorable Edward L. Grant, Judge
NOTICE: This opinion is subject to formal revision before publication in Pacific Reporter Second. Readers are requested to notify the Clerk of the Supreme Court, Supreme Court Building, Cheyenne, Wyoming 82002, of any typographical or other formal errors in order that corrections may be made before final publication in the permanent volume.
HILL, Justice.
A contested case hearing was held to review the Wyoming Workers= Safety and Compensation Division=s denial of Appellant Brian Armstrong=s request for payment of certain medical benefits. The hearing examiner determined that Appellant failed to establish a causative connection between his claims and a work injury and, rather, that his medical treatment was due to a pre-existing condition. We affirm.
ISSUES
Appellant presents the following issues for review:
I. Whether the actions and final determinations of Appellee,
Workers= Compensation Division, denying medical benefits to Appellant, Brian J. Armstrong, are arbitrary, capricious or an abuse of discretion[.]
II. Whether the actions and final determinations of Appellee,
Workers= Compensation Division, denying medical benefits to Appellant, Brian J. Armstrong, are contrary to law[.]
III. Should the Division be estopped from denying payment of
Mr. Armstrong=s medical bills incurred after his compensable injury?
Appellee (the Division) provides a single issue:
A. Was the Hearing Examiner=s decision within her discretion and in accordance with law?
FACTS
On December 27, 1997, Appellant saw Dr. Giltner at Health Reach for an existing problem with back pain. As a result of that visit, Appellant received a prescription for Percocet to relieve the pain. Several days later, on December 31, 1997, Appellant fell, injuring his ankle and back, when leaving a restaurant during his lunch hour while employed at United Blood Services. He then timely filed a report of the injury with the Division. On January 8, 1998, the Division issued an Initial Review: Notice of Lack of Information, which Appellant claims he never received. However, Appellant did receive the Division=s Final Determination letter dated
February 3, 1998, which stated, A ased on the Division=s investigation, the injury is covered by the Wyoming Workers= Compensation Act and claims for medical or disability benefits will be reviewed and paid if compensable.@ Neither Appellant nor his employer filed an appeal in response to the final determination.
Fourteen days later, on February 17, 1998, the Division issued another Initial Review: Notice of Lack of Information seeking information regarding the possibility of a pre-existing condition. On February 18, 1998, before receiving the latest notice from the Division, Appellant was admitted to Poudre Valley Hospital and underwent emergency back surgery the next day. Just prior to surgery, Appellant informed his surgeon, Dr. Turner, that payment for the surgery would be made by the Division. Dr. Turner had his nurse telephone the Division to verify this statement. She was told that Appellant had an open and active case for lumbar injury.
On May 5, 1998, the Division requested its physician, Dr. Kline, to review the medical information which had been submitted. Dr. Kline recommended A n back: pay for the initial examination [plus] 10 days for re-exam etc. No more.@ As Appellant sent his claims to the Division, his claim analyst, Beverly Johnson, determined whether
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