Pittman v. State Ex Rel. Wyoming Worker's Compensation Division

917 P.2d 614, 1996 Wyo. LEXIS 79, 1996 WL 288169
CourtWyoming Supreme Court
DecidedMay 31, 1996
Docket95-216
StatusPublished
Cited by17 cases

This text of 917 P.2d 614 (Pittman v. State Ex Rel. Wyoming Worker's 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
Pittman v. State Ex Rel. Wyoming Worker's Compensation Division, 917 P.2d 614, 1996 Wyo. LEXIS 79, 1996 WL 288169 (Wyo. 1996).

Opinion

LEHMAN, Justice.

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. § 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?

*616 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 entitled to have the Division pay for those medical expenses. Pittman did not appeal this order.

Pittman finally submitted claims for payment of the treatment of his cataracts on June 2, 1993. The Division denied the benefits, and the matter was set for a contested hearing. On October 20, 1994, the hearing examiner issued an Order Denying Benefits based on the following: 1) the claim for benefits for the treatment of the cataracts had been previously adjudicated in the October 1992 hearing, and thus was barred by the doctrine of res judicata; 2) the one-year statutory filing limit began to run when the condition was diagnosed in August 1991, and thus the claims were barred by the W.S. 27-14r-503(a) statute of limitations; and 3) Pittman’s private insurance carrier had paid the costs of Pittman’s eye surgeries, and thus Pittman was not the real party in interest. Pittman filed a petition for review in the district court. The district court affirmed the Order Denying Benefits, concluding that Pittman’s claims were outside the W.S. 27-14-503(a) statute of limitations for applying for benefits. Finding this to be dispositive of the case, the district court declined to address the other issues. Pittman timely appeals that determination.

STANDARD OF REVIEW

We will reverse a determination that a claimant is not entitled to worker’s compensation benefits only if it is arbitrary, capricious, an abuse of discretion, not in accordance with law, or is unsupported by substantial evidence. W.S. 16-3-114(c)(ii)(A) and (E) (1990); Stuckey v. State ex rel. Worker’s Compensation Div., 890 P.2d 1097, 1099 (Wyo.1995); Worfcer’s Compensation Claim of Taylor v. State ex rel. Worker’s Compensation Div., 890 P.2d 559, 560-61 (Wyo.1995); Bohren v. State ex rel. Worker’s *617 Compensation Div., 883 P.2d 355, 357-58 (Wyo.1994). We review factual issues and agency factual findings using the substantial evidence standard:

Our task is to examine the entire record to determine whether substantial evidence supported the hearing examiner’s findings. We will not substitute our judgment for that of the hearing examiner when substantial evidence supports his decision. Substantial evidence is relevant evidence which a reasonable mind might accept in support of the agency’s conclusions.

Matter of Worker’s Compensation Claim of Fisher, 914 P.2d 1224, 1226 (Wyo.1996) (quoting Latimer v. Rissler & McMurry Co., 902 P.2d 706, 708-09 (Wyo.1995)); see also City of Casper v. Haines, 886 P.2d 585, 587 (Wyo. 1994); Stuckey, 890 P.2d at 1099; and Aanenson v. State ex rel. Worker’s Compensation Div., 842 P.2d 1077, 1079 (Wyo.1992).

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917 P.2d 614, 1996 Wyo. LEXIS 79, 1996 WL 288169, Counsel Stack Legal Research, https://law.counselstack.com/opinion/pittman-v-state-ex-rel-wyoming-workers-compensation-division-wyo-1996.