Appleby v. State ex rel. Wyoming Workers' Safety & Compensation Division

2002 WY 84, 47 P.3d 613, 2002 Wyo. LEXIS 89
CourtWyoming Supreme Court
DecidedJune 5, 2002
DocketNo. 00-273
StatusPublished
Cited by16 cases

This text of 2002 WY 84 (Appleby v. State ex rel. Wyoming Workers' Safety & Compensation Division) is published on Counsel Stack Legal Research, covering Wyoming Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Appleby v. State ex rel. Wyoming Workers' Safety & Compensation Division, 2002 WY 84, 47 P.3d 613, 2002 Wyo. LEXIS 89 (Wyo. 2002).

Opinion

GOLDEN, Justice.

[¶ 1] Appellant Irene Aaker Appleby (Ap-pleby) challenges a decision by the Appellee Department of Employment Workers' Safety and Compensation Division's (Division) Internal Hearing Unit (IHU) that she did not file a timely request for hearing from the Division's final determination denying benefits. Before the IHU, Appleby contended that the Division was equitably estopped from denying her a contested case hearing for failure to timely file, and the hearing examiner for [615]*615the IHU initially agreed with that contention and recommended a contested case hearing. The Division objected to that recommendation, and the matter was referred to the Interim Director of the Department of Employment (Director) who concluded that equitable estoppel did not apply, and denied Ap-pleby a contested case hearing.

[¶ 2] We reverse and remand for a contested case hearing before the appropriate hearing authority, either the Office of Administrative Hearings or the Medical Commission, in accordance with Wyo. Stat. Ann. § 27-14-601(kK)(v).

ISSUES

[¶ 3] Appleby presents these issues for our review:

1. Whether the Final Agéncy Order issued by the Interim Director of the Department of Employment, State of Wyoming rejecting the Hearing Officer's Report and Recommended Findings of Fact, Conclusions of Law, and Order dated December 14, 1999 was arbitrary, capricious, and an abuse of discretion, or otherwise not in accordance with law. 2. Whether the July 19, 2000 Order Affirming Agency Decision of the Seventh Judicial District was arbitrary, capricious, and an abuse of discretion and otherwise not in accordance with law.

The Division rephrases the issues:

I. Does equitable estoppel excuse Appellant's failure to file a timely objection to the Division's final Determination?
II. Did Appellant establish all the elements of her claim for equitable estoppel?

FACTS

[¶ 4] Appleby has been a checker for Safeway for twenty-five years. While performing those duties, Appleby began to experience aching wrists and arms and sought medical attention. She was treated conservatively and continued to work. In April of 1999, her doctors informed her that she would need surgery and would miss twelve to fourteen weeks of work. Her medical insurer informed her that worker's compensation benefits were available, and Appleby filed an injury report. In the small box on the report form that asked for date of injury, Appleby wrote October 26, 1998. In the small box asking time of injury and time of shift, Ap-pleby wrote "n/a."

[¶ 5] On April 20, 1999, the Division issued its final determination letter informing her it had denied benefits for these reasons:

Your claim for benefits was not filed within the statute of limitations pursuant to Wyoming Statute 27-14-508(a).
The burden of proof in contested cases involving injuries which occur over a substantial period of time is on the employee to prove by competent medical authority that his/her claim arose out of and in the course of his/her employment and to prove by a preponderance of evidence that:
a. -There is a direct causal connection between the condition or cireumstances under which the work is performed and the injury.
b. The injury can be seen to have followed as a natural incident of the work as a result of the employment.
c. The injury can fairly be traced to the employment as a proximate cause.
d. The injury does not come from a hazard to which employees would have been equally exposed outside of the employment.
e. The injury is incidental to the character of the business and not independent of the relation of employer and employee. (Wyoming Statute 27-14-603(a)).
Definition of injury does not include: Any injury resulting primarily from the natural aging process or from the normal activities of day-to-day living, as established by medical evidence supported by objective findings. (Wyoming Statute 27-14-102(a)(xi)(G)).
The burden is on the claimant to prove each essential element of his or her claim by a preponderance of the evidence.
Either the injured worker or the employer may object to this determination and request a hearing. Affected parties have a right to a hearing before a hearing examiner as provided by the Wyoming Workers' [616]*616Compensation Act and to legal representation. We must receive a written request, stating your reason(s) for objecting on or before 5-14-99. If a timely written request for hearing is not filed with this division, the final determination by the Division pursuant to W.S. 27-14-601(k) shall not be subject to further administrative or judicial review.
If there are any questions, please contact me at (807)777-5677.

The letter was signed by the claims analyst. Appleby had not filed a claim before, and, before the May 14, 1999, deadline passed, Appleby's husband called the claims analyst and asked why benefits had been denied. According to Mr. Appleby, the claims analyst explained that October 26, 1998, was a significant date, and while the final determination could be appealed, it would be useless because the October 26, 1998, date meant that it was filed too late to be approved. The claims analyst testified that he did recall speaking with Mr. Appleby on one occasion, but did not specifically recall this conversation. He guessed that he would have explained the need for an appeal. During examination at the hearing, the claims analyst admitted that he handles several hundred cases at any given time and spends a great deal of time on the phone answering questions similar to those posed here. He stated that he would have explained to Appleby that the Division's rationale for denying benefits here was essentially that her injury report was untimely, and her injury was a preexisting condition.

[¶ 6] On September 8, 1999, the Division received Appleby's written request for a hearing. The Division sent her notice that she was no longer entitled to a hearing because her response was late; however, she could object to the finding that her response was late and request a hearing only on that particular determination. Appleby did request a hearing, and the matter was set before the IHU.

[¶ 7] The IHU's hearing examiner heard evidence from both Appleby and the claims analyst concerning statements made during the telephone conversation. Appleby testified that the claims analyst informed her agent that it would be fruitless to request a hearing because her injury report was untimely. Based on this conversation, Appleby did not request a hearing by the deadline. After the deadline had passed, Appleby consulted an attorney who requested a hearing on the final determination's denial of benefits The hearing examiner concluded that the claims analyst's misleading statement regarding the futility of Appleby's objection to the final determination, although unintentional, was sufficient to constitute estoppel and prevent the Division from invoking untimeliness as the basis for denying a hearing. The hearing examiner cited Bauer v. Workers' Compensation Div., 695 P2d 1048, 1053 (Wyo.1985), as authority for this conclusion.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

In the Matter of Guardianship of Meo
2006 WY 87 (Wyoming Supreme Court, 2006)
Bell v. Schell
2004 WY 153 (Wyoming Supreme Court, 2004)
STATE EX REL. DIVISION v. Savicki
2004 WY 71 (Wyoming Supreme Court, 2004)
Taylor v. STATE EX REL. DIV.
2003 WY 83 (Wyoming Supreme Court, 2003)
Appleby v. WORKERS'SAFETY & COMP. DIV.
2002 WY 84 (Wyoming Supreme Court, 2002)

Cite This Page — Counsel Stack

Bluebook (online)
2002 WY 84, 47 P.3d 613, 2002 Wyo. LEXIS 89, Counsel Stack Legal Research, https://law.counselstack.com/opinion/appleby-v-state-ex-rel-wyoming-workers-safety-compensation-division-wyo-2002.