Hausauer v. North Dakota Workers Compensation Bureau

1997 ND 243, 572 N.W.2d 426, 1997 N.D. LEXIS 305, 1997 WL 778768
CourtNorth Dakota Supreme Court
DecidedDecember 19, 1997
DocketCivil 970128
StatusPublished
Cited by30 cases

This text of 1997 ND 243 (Hausauer v. North Dakota Workers Compensation Bureau) is published on Counsel Stack Legal Research, covering North Dakota Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Hausauer v. North Dakota Workers Compensation Bureau, 1997 ND 243, 572 N.W.2d 426, 1997 N.D. LEXIS 305, 1997 WL 778768 (N.D. 1997).

Opinion

MARING, Justice.

[¶ 1] Dan Hausauer appeals from a district court judgment affirming a Workers Compensation Bureau order dismissing his claim for benefits. The Bureau could have reasonably reached its factual conclusion that Hau-sauer willfully made false statements in connection -with Ms claim. We, therefore, affirm the decision.

I.

[¶ 2] On November 14, 1995, Hausauer injured Ms spine as a result of a fall while employed by Coca-Cola as a route merchandiser. On November 30, 1995, Hausauer filed an imtial “Worker’s Claim For Injury” form for workers’ compensation benefits. Because Hausauer failed to sign the imtial claim form, the Workers Compensation Bureau sent Mm a second claim form and a “Prior Injury Questionnaire.” Hausauer completed the Prior Injury Questionnaire, and on December 13, 1995, Hausauer filed both the signed claim form and the Prior Injury Questionnaire with the Bureau.

[¶3] On the imtial claim form, Hausauer indicated he had injured his middle and lower back and left hip. On the second signed claim form, he stated the exact part of Ms body injured was his lower back. Both claim forms, after askmg what part of the body was injured, ask “[h]ave you had prior problems or injuries to that part of the body?” 1 On both forms, Hausauer cheeked the box stating, “No.”

[¶ 4] Hausauer also answered two relevant questions on the one-page Prior Injury Questionnaire, which he filed with the Bureau. The first question asks, “[h]ave you ever had any prior problems or mjuries with the area of the body injured?” Hausauer checked the box indicating, “No.” The next question asks, “[hjave you ever had medical or chiropractic treatment for that part of the body prior to your current treatment?” Hausauer again checked the box stating, “No.”

[¶5] Upon further investigation, the Bureau discovered Hausauer made two previous workers’ compensation claims regarding his back in 1989 and 1990, received previous chiropractic treatment for his back in 1989, 1990, 1994, and September 1995, and had *428 been diagnosed with degenerative disc disease of the back in March 1995. The record below reveals the following relevant facts.

[¶ 6] On October 30, 1989, Hausauer injured his right, middle back while working for a previous employer. A chiropractor treated him on three occasions subsequent to this injury, and the Bureau accepted Hau-sauer’s claim and paid benefits. On July 3, 1990, Hausauer injured his left leg while working for the same employer and consulted a physician regarding this injury. This physician noted Hausauer also had some hip and low back discomfort at that time. Hau-sauer then received chiropractic treatment on eight occasions between July 3, 1990, and August 1, 1990. The Bureau again accepted Hausauer’s claim and paid benefits.

[¶ 7] On February 21, 1994, Hausauer received additional chiropractic treatment for back pain. Hausauer again received chiropractic treatment for his back on January 7 and January 9, 1995. In January of 1995, Hausauer also received treatment from his family physician, and on January 24, 1995, his back pain was noted as probably muscular and secondary to a history of strep pharyngitis.

[¶8] Hausauer sought subsequent treatment from his family physician after again experiencing back pain in February and March of 1995. In March 1995, lumbo-sacral x-rays were completed and revealed apparent degenerative changes in Hausauer’s spine. Based on the March 23, 1995, x-rays, Hau-sauer’s physician noted “[sjlight disk space narrowing at L4-L5 with some minor end plate irregularity of LI, consistent with old discitis, questionable spondylolisthesis at L4.” Hausauer met with his physician the next week, on March 30, 1995, to discuss the results of the x-rays. At this time, his physician also noted Hausauer had “some degenerative changes in his disks at the T12-L1 interspace suggestive of some old discitis which is very consistent with his symptoms.”

[¶ 9] Hausauer sought treatment again on August 7, 1995, after he telephoned his physician indicating his back pain had started again. Hausauer next received chiropractic treatment for low back soreness on September 20,1995, less than two months before his accident on November 14,1995.

[¶ 10] After considering Hausauer’s history of treatment, the Bureau dismissed Hau-sauer’s claim on March 7, 1996, for the November 14,1995, injury concluding Hausauer had willfully made a false statement about his prior back problems. Hausauer requested a hearing. After the hearing, the administrative law judge issued the recommended findings of fact, conclusions of law, and order on November 25, 1996, denying Hausauer’s claim. The Bureau affirmed the order on December 11, 1996. Hausauer appealed to the district court, and the district court affirmed the Bureau’s decision. Hausauer appeals from the district court judgment.

II.

[¶ 11] On appeal, we review the Bureau’s decision, not the decision of the district court. Dean v. North Dakota Workers Comp. Bureau, 1997 ND 165, ¶14, 567 N.W.2d 626. Under N.D.C.C. § 28-32-19, we affirm the Bureau’s decision unless:

its findings of fact are not supported by a preponderance of the evidence, its conclusions of law are not supported by its findings of fact, its decision is not supported by its conclusions of law, or its decision is not in accordance with the law.

Id. (citing Lucier v. North Dakota Workers Comp. Bureau, 556 N.W.2d 56, 59 (N.D. 1996)). In reviewing the Bureau’s findings of fact, we do not make independent findings, nor do we substitute our judgment for the Bureau’s judgment. Id. We determine only “whether the Bureau reasonably reached its factual conclusions from the weight of the evidence on the entire record.” Id.

[¶ 12] The Bureau denied Hausauer’s claim for benefits based upon a finding that Hausauer had willfully made false statements under N.D.C.C. § 65-05-33. 2 To trigger the *429 statutory consequences under § 65-06-33 for a false claim or false statement by a person claiming benefits or payment of services, the Bureau must prove: (1) there is a false claim or false statement; (2) the false claim or false statement is -willfully made; and (3) the false claim or false statement is made in connection with any claim or application under this title. We additionally require the Bureau to prove the false statement is material. Dean, 1997 ND 165, ¶ 15, 567 N.W.2d 626 (citing F.O.E. Aerie 2337 v. Workers Comp. Bureau, 464 N.W.2d 197, 201 (N.D.1990)). We have defined “willfully” in the context of this statute’s civil penalties as conduct engaged in intentionally, not inadvertently. Id.

[¶ 13] Once triggered, N.D.C.C. § 65-05-33 provides for both criminal and civil penalties.

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Bluebook (online)
1997 ND 243, 572 N.W.2d 426, 1997 N.D. LEXIS 305, 1997 WL 778768, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hausauer-v-north-dakota-workers-compensation-bureau-nd-1997.