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Pittman v. State5/31/1996
Theodore W. Pittman (Pittman) appeals from an order of the district court affirming a denial of worker's compensation benefits, based upon the expiration of the one-year statutory filing limit prescribed by W.S. 27-14-503(a).
We affirm.
ISSUES
Pittman raises four issues:
1. Is the legal conclusion by the hearing examiner that employee-claimant is absolutely barred under the doctrine of res judicata on his claim for benefits for eye surgery legally correct and supported by substantial evidence?
2. Did the hearing examiner in invoking the doctrine of res judicata improperly place the burden of proof upon employee-claimant to establish what issues were actually and necessarily litigated in the October 1, 1992 contested case hearing?
3. Is the legal conclusion by the hearing examiner that employee-claimant is barred under the statute of limitations of W.S. ยง 27-14-503 legally correct and supported by substantial evidence?
4. Is the legal conclusion by the hearing examiner that employee-claimant is not the "real party in interest" regarding the payment for the medical expenses of the eye surgery legally correct and supported by substantial evidence?
The Worker's Compensation Division (Division) presents us with three issues:
A. Whether the hearing examiner's determination, that the claim for medical benefits arising from Claimant's 1991 cataract surgeries is barred by the doctrine of res judicata, is supported by substantial evidence and is in accordance with law.
B. Whether the hearing examiner's determination that Claimant's application for benefits was not made within the time limits prescribed by Wyo. Stat. 27-14-503(a) is supported by substantial evidence and is in accordance with law.
C. Whether the hearing examiner's determination, that if medical benefits were to be awarded for the costs of Claimant's eye treatment, payment should be made to the health care providers rather than to Claimant, is in accordance with law.
FACTS
On September 26, 1989, Pittman was working as a pipe fitter at the Dave Johnson Power Plant when a 800 pound valve fell, causing him to fall backwards and strike his head. Pittman sustained numerous injuries and was awarded medical and disability benefits for injuries to his neck, ribs and right leg.
In August 1991, Pittman sought treatment from an ophthalmologist for his deteriorating eyesight. On August 14, 1991, the ophthalmologist, Dr. Ellsworth, diagnosed Pittman with posterior subcapsular (PSC) cataracts in both of his eyes. Pittman underwent surgery for treatment of the cataracts on September 4, 1991 and December 16, 1991. Following surgery on his right eye, Pittman suffered a retinal detachment of the right eye as a result of a complication of the cataract surgery. Surgery was performed on Pittman's right eye to repair the retinal detachment on February 18, 1992.
On October 1, 1992, a hearing was held wherein the Division was contesting payment for medical costs unrelated to the cataracts. In the supplemental disclosure statement for this hearing, Pittman attached the medical records of Dr. Ellsworth relating to the cataracts although he had not previously filed any bills or claims. Subsequently, the Division, in its disclosure statement for this hearing, contended that the costs of the medical treatment for Pittman's eye problems were also at issue. In its Order Awarding Benefits, the hearing examiner concluded that the cataract operations had not been shown to be reasonably related to Pittman's September 26, 1989 injury, and accordingly, Pittman was not en
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