Torres v. STATE EX REL. WYOMING WORKERS'SAFETY AND COMPENSATION DIVISION

2005 WY 7, 105 P.3d 101, 2005 Wyo. LEXIS 9, 2005 WL 171487
CourtWyoming Supreme Court
DecidedJanuary 27, 2005
Docket04-43
StatusPublished
Cited by8 cases

This text of 2005 WY 7 (Torres v. STATE EX REL. WYOMING WORKERS'SAFETY AND 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
Torres v. STATE EX REL. WYOMING WORKERS'SAFETY AND COMPENSATION DIVISION, 2005 WY 7, 105 P.3d 101, 2005 Wyo. LEXIS 9, 2005 WL 171487 (Wyo. 2005).

Opinion

HILL, Chief Justice.

[¶ 1] Appellant, Lillian Torres (Torres), sought worker’s compensation benefits claiming that she suffered a .hernia while lifting heavy wet laundry at her workplace, Sage Holiday Inn, LLC, in Cheyenne. Benefits were denied by the Wyoming Workers’ Safety and Compensation Division (Division) on the basis that Torres failed to timely report the injury and because she failed to meet the very specific burden of proof that pertains to hernia injuries. Torres objected to the Division’s decision to deny benefits and requested a contested case hearing before the Office of Administrative Hearings. The presiding hearing examiner determined that Torres’ claim was not timely filed and that she otherwise had not met her burden of proof. Torres then filed a petition for review in the district court and the district court affirmed, embracing the hearing examiner’s findings of fact and conclusions of law. We also affirm.

ISSUES

[¶ 2] Torres raises these issues:

1. Is the hearing officer’s finding that there was insufficient evidence showing “injury” under Wyo. Stat. § 27-14-603(c) supported by substantial evidence?
2. May a hearing officer find that a claimant has failed to overcome the statutory presumption of prejudice due to “late filing” without notice of the specific nature of the claims and a prehearing determination, or is such a conclusion contrary to law?

The State enlarges on those issues:

I. A claimant seeking workers’ compensation benefits for a hernia must meet the heightened burden of proof pursuant to Wyo. Stat. § 27-14-603(e), by clearly proving the hernia is work-related. Substantial evidence supports the hearing examiner’s decision Ms. Torres failed to prove her hernia is work-related.
II. Wyo. Stat. § 27-14-502(c) provides a presumption that a claim will be denied if an employee’s notice of injury is untimely filed. A claimant may overcome the presumption if a lack of prejudice to the employer and Division is proven by clear and *103 convincing evidence. Ms. Torres claims she made no effort to show the absence of prejudice because she did not receive notice of the timeliness issue, although, the Workers’ Compensation Division’s Disclosure Statement included the timeliness issue, and the Division included this issue in the Initial Review issued nine months prior to the contested case hearing. The hearing examiner’s determination Ms. Torres failed to overcome the presumption of prejudice due to untimely filing is in accordance with law.

FACTS

[¶ 3] On April 25, 2002, Torres submitted a report of injury form to the Division claiming that she suffered a work-related injury on February 20, 2002. Torres worked in the laundry/housekeeping department at the Cheyenne Holiday Inn. The injury suffered was an incisional hernia 1 and its cause, according to Torres, was pulling and tugging at heavy laundry items in order to remove them from washing machines. Management at the Holiday Inn did not believe the injury was work-related.

[¶ 4] In a letter dated May 10, 2002, Laurie Tucker, Human Resources Director of the Holiday Inn, related this information to the Division:

The Holiday Inn-Cheyenne is disputing the Workers’ Compensation Claim filed by Lillian Torres as we feel this is not a work-related injury:
• Ms. Torres never at any time told her supervisors or the HR Director that she had been injured on the job.
• On 2/18 Ms. Torres left for lunch, called at the end of her break and told her supervisor she was not coming back as she had a doctor’s appointment.
• 2/19 Ms. Torres left for lunch, called at the end of her break and told her supervisor she had a doctor’s appointment and was not coming back to work that day.
•2/20 Ms. Torres left for lunch, called at the end of her break and told her supervisor she was not coming back because she didn’t feel well.
• 2/21 Ms. Torres called in sick. She did not speak to her supervisor as required by company policy; instead she left a message with an associate that she had to have an operation and would not be back for awhile.
• 2/21/02 an unidentified female entered the HR office and tossed a doctor’s note on the desk. The note simply stating Ms. Torres could not work until further notice and no further information was provided to us.
• Ms. Torres never filed a report of injury at the time she claims she was injured.
• Ms. Torres did not notify this office until 4/25/02, which was 2 months after she went on leave to have surgery.
• Ms. Torres has received training on the proper procedures in reporting a work-related injury.
• Ms. Torres signed a Workers’ Compensation Policy which outlines the company policies on work-related injuries.
• Workers’ Compensation informational posters are posted throughout the hotel where all associates can read it. These posters are located next to the time clock and in the break rooms.

[¶ 5] On April 29, 2002, the Division sent Torres a Notice of Lack of Information that contained these directions:

*104 This is not a denial of benefits. The Workers’ Compensation Division has received and reviewed your employer’s report of yonr Yeport of injury’ and needs the following information to make a determination:
• The Division needs additional information to help determine the compensability of your claim. The Division is requesting all medical treatment records based on your report of “abdominal pain” to the claims analyst per phone conversation on 4/23/02 @ 9:30 a.m. Please contact your health care provider about submitting all medical records related to your Abdomen prior to and subsequent of the injury on 2/20/2002. Wyoming Statute 27-14-102(a)(xi).
The Division is unable to process claims until the enclosed copy of your injury report is reviewed, signed by you and returned to the Division. Your signature is a release of information for medical records. (Wyoming Statute 27-14-502)
■ If an employee suffers a hernia, he!she is entitled to compensation if he/she clearly proves that:
(i) The hernia is of recent origin.
(ii) Its appearance was accompanied by pain.
(iii) It was immediately preceded by some accidental strain suffered in the course of the employment.
(iv) It did not exist prior to the date of the alleged injury.

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2005 WY 7, 105 P.3d 101, 2005 Wyo. LEXIS 9, 2005 WL 171487, Counsel Stack Legal Research, https://law.counselstack.com/opinion/torres-v-state-ex-rel-wyoming-workerssafety-and-compensation-division-wyo-2005.