Daiss v. Division of Workers' Safety & Compensation, Department of Employment

965 P.2d 692, 1998 Wyo. LEXIS 154, 1998 WL 718235
CourtWyoming Supreme Court
DecidedOctober 15, 1998
Docket97-341
StatusPublished
Cited by3 cases

This text of 965 P.2d 692 (Daiss v. Division of Workers' Safety & Compensation, Department of Employment) 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
Daiss v. Division of Workers' Safety & Compensation, Department of Employment, 965 P.2d 692, 1998 Wyo. LEXIS 154, 1998 WL 718235 (Wyo. 1998).

Opinion

MACY, Justice.

The medical commission granted Appellee Division of Workers’ Safety and Compensation’s (the division) motion to dismiss the issue of whether surgery on Appellant Sally Daiss’ (the employee) back was necessary because the medical commission lacked subject matter jurisdiction. The employee petitioned the district court for a review of the medical commission’s order, and the district court certified the case to the Wyoming Supreme Court pursuant to W.R.A.P. 12.09(b).

We affirm the medical commission’s order.

ISSUE

The employee presents one issue for our review:

1. Whether the Medical Commission had jurisdiction to rule on the compensa-bility of p[ro]posed surgery.

FACTS

The employee suffered a compensable, work-related, lower back injury on or about March 22, 1996. On July 16, 1996, she visited Kenneth Pettine, M.D., an orthopedic surgeon, who determined that she had a torn disk. He opined that the disk was desiccated, or dried out, before the injury occurred and that the injury to the disk caused the onset of the employee’s pain. Dr. Pettine recommended that the desiccated disk be conservatively treated but advised the employee that surgery was an elective option. Although Dr. Pettine had not recommended surgery, he believed that the employee had reached maximum medical improvement from a “nonoperative standpoint.” The doctor indicated that surgery would be a reasonable choice and suggested that the employee “obtain administrative approval” for it.

Apparently in response to some sort of inquiry, the division sent a letter to the employee on September 24, 1996, stating that it would probably deny future claims that may be submitted for the proposed surgery. The letter stated, however, that “[t]his is not a final determination as no claim has been submitted for payment at this time.” On November 14, 1996, the employee submitted a claim for surgical benefits to the office of administrative hearings, requesting payment of all reasonable and necessary expenses that would be incurred from the proposed surgery. The claim was not submitted on the division’s form. The division objected to the claim, arguing that there had not been a final determination and the matter had not been referred to the office of administrative hearings and that, therefore, the office of administrative hearings did not have subject matter jurisdiction over the matter. The employee filed a traverse to the division’s objection, claiming that the office of administrative hearings had subject matter jurisdiction pursuant to Wyo. Stat. Ann. § 27-14^601 (1997).

The employee had an independent medical examination done on April 26, 1997. As a result of that examination, the division issued a final determination, finding that the employee was not entitled to receive benefits because she had already been awarded a five percent permanent physical impairment rating and her impairment rating remained the same. The employee objected to the final determination and requested a hearing, arguing that she was a surgical candidate who had not yet reached maximum ascertainable loss or maximum medical improvement and that the proposed surgery should be compen-sable. The division referred the case to the medieal commission. The notice of referral for hearing listed three issues to be decided by the medical commission: whether surgery on the employee’s back was necessary; whether the employee was at an ascertainable loss; and whether the permanent physical impairment rating was correct.

*694 The division subsequently asked the medical commission to dismiss the issue of whether the proposed surgery was necessary because the commission lacked subject matter jurisdiction, given that the employee had failed to submit a proper claim as was prescribed in the division’s rules, and because a claim could not be filed for services that had not yet been provided. The medical commission granted the division’s request, reasoning that the employee had not filed a formal claim for the proposed surgery but had merely inquired into the compensability of the proposed procedure and that, consequently, the division had not made a final determination on this issue. The employee petitioned the district court for a review of this order, and the district court certified the case to the Wyoming Supreme Court.

STANDARD OF REVIEW

When a case has been certified to the Wyoming Supreme Court pursuant to W.R.A.P. 12.09(b), we review the case by applying the appellate standards that are applicable to a reviewing court of the first instance. Weaver v. Cost Cutters, 953 P.2d 851, 854 (Wyo.1998); Fansler v. Unicover Corporation, 914 P.2d 156, 158 (Wyo.1996). Judicial review of administrative decisions is limited to a determination of the matters specified in Wyo. Stay. Ann. § 16-3-114(c) (1997). W.R.A.P. 12.09(a); Everheart v. S & L Industrial, 957 P.2d 847, 851 (Wyo.1998).

We do not disturb an agency’s findings of fact unless they are clearly contrary to the overwhelming weight of the evidence. Weaver, 953 P.2d at 855; Nelson v. Sheridan Manor, 939 P.2d 252, 255 (Wyo.1997). We do not, however, grant the same deference to an agency’s conclusions of law. Id. We affirm an agency’s conclusions of law if they are in accordance with law. Corman v. State ex rel. Wyoming Workers' Compensation Division, 909 P.2d 966, 970 (Wyo.1996). When an agency has not invoked and properly applied the correct rule of law, we correct the agency’s errors. Gneiting v. State ex rel. Wyoming Workers’ Compensation Division, 897 P.2d 1306, 1308 (Wyo.1995).

DISCUSSION

The employee contends that the fact that she did not use the division’s form in submitting her claim should not be of any consequence because the requirement that she submit her claim on a form provided by the division is “an exercise in meaninglessness.” The division’s rules require claimants to submit their claims on forms provided by the division. Those rules provide in pertinent part: “Claims for Benefits. A person seeking an award of benefits under the Act must submit a written application for benefits on a form provided by the division. (A report for injury is not a claim for benefits. W.S. 27-14-503(a)).” Wyoming WoRkbes’ Compensation Rules, Regulations and Fee Schedules ch. 5, § 2 (1995). The Wyoming Worker’s Compensation Act (the Act) directs the division to prepare and print the necessary forms to be used in all procedures under the Act and to instruct claimants on how to make correct claims. Wyo. Stat. Ann. § 27-14-508 (1997).

In Manning v. State ex rel. Wyoming Worker’s Compensation Division, 938 P.2d 870

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965 P.2d 692, 1998 Wyo. LEXIS 154, 1998 WL 718235, Counsel Stack Legal Research, https://law.counselstack.com/opinion/daiss-v-division-of-workers-safety-compensation-department-of-wyo-1998.