Risk & Insurance Online

The Wyoming Supreme Court held that the Office of Administrative Hearings erred in denying the claimant benefits related to a back injury.

Case name:Gray a/k/a McGuffin v. State of Wyoming, ex rel., Wyoming Workers' Safety and Compensation Division, No. S-07-0143 (Wyo. 10/03/08).

What it means: Under Wyoming law, a claimant is not required to prove causation conclusively through medical testimony -- he may present other evidence that, when combined with the medical testimony, establishes the necessary causal relationship.

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Summary: The claimant was bucked off a horse in the course of his work as a trail guide. After he fell, the horse stomped him repeatedly, which caused multiple injuries, including a back strain and contusion. A few months later, he informed his orthopedic physician that his back "popped," and he felt immediate pain in his legs. He was diagnosed with a large herniated disk. After receiving an anonymous telephone call in which the caller stated that the claimant was moving hay when his back popped, the Workers' Safety and Compensation Division refused further payment of benefits. The OAH concluded that the claimant failed to establish that his herniated disk was causally related to the original incident. The Supreme Court reversed, finding that the OAH's denial of benefits was not supported by substantial evidence.

In reversing the OAH's decision, the Supreme Court had to resolve two evidentiary issues: whether the claimant was required to prove causation conclusively through medical testimony, and whether the OAH committed error when it relied upon hearsay statements for several of its findings and conclusions. The court found that the OAH erred on both fronts.

Although the medical testimony the claimant presented may not have been enough to meet his burden of proof on causation, the court stated that he should have been permitted to fill in the gaps with evidence of his symptoms between the work-related incident and his herniated disk diagnosis. Two witnesses corroborated the claimant's testimony that "his discomfort was ongoing from the date of the original injury."

The court also stated that although it was not erroneous for the OAH to admit the hearsay statements of the anonymous caller, the hearing examiner should not have relied upon those statements to support his conclusions "when it turned out they were not corroborated by any credible evidence."

November 4, 2008

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