Articles Posted in Wyoming Supreme Court

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Appellant was injured in an accident that occurred during the course of her employment. After receiving a permanent partial impairment award from the Wyoming Worker's Compensation Division, Appellant sought permanent partial disability benefits. The Division denied Appellant's application, stating that she had not complied with the statutory work search requirements. After a contested case hearing, the Office of Administrative Hearings granted summary judgment for the Division, concluding that Appellant had not timely submitted documentation showing she had sought work. The district court affirmed. The Supreme Court reversed, holding (1) Appellant's work search submission was timely; and (2) Appellant was entitled to a hearing and the opportunity to present evidence showing that she actively sought work. View "Stallman v. State ex rel. Wyo. Workers' Safety & Comp. Div." on Justia Law

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This appeal arose out of Ryan Dorman's petition for an extension of his worker's compensation temporary total disability (TTD) benefits and for reimbursement of travel expenses incurred in travelling from Idaho to Cheyenne to obtain medical care. In May 2006, Dorman sought treatment from an Idaho physician for treatment of his alleged work-related injury. Due to the nature of Dorman's injury, he consulted multiple physicians, first in Idaho, then in Wyoming. With each consultation, the doctors indicated that the injury was outside of their scope of expertise, and referred Doman to another specialist. During the period that Dorman was changing physicians, the Division and Dorman negotiated a stipulation concerning his TTD benefits and other benefits. This followed OAH and district court decisions that largely reversed the Division's earlier determinations concerning TTD benefits and Dorman's need for continued medical treatment. The Stipulated Order also provided that medical benefits would be paid as directed by the district court's order. After the Division paid the stipulated TTD benefits, Dorman submitted a letter to the Division requesting extended benefits The Division thereafter issued a final determination denying them, and further denied several applications for travel expense reimbursement for Dorman's trips to Idaho and Cheyenne. The matters were referred to the OAH where a combined hearing was held on the denial of TTD benefits, denial of travel reimbursement, and denial of diagnostic testing related to Dorman's injury. The OAH upheld the denial of TTD benefits on the ground that Dorman had failed to make the required showing that the Idaho and Cheyenne doctors were the closest available medical providers. Dorman appealed the portion of the OAH order denying extended TTD benefits and travel reimbursement to the district court. Upon review, the Supreme Court affirmed the OAH denial of the travel reimbursement: Dorman could not prove that reimbursement of travel expenses was not supported by substantial evidence and in accordance with law. View "Dorman v. Wyoming" on Justia Law

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The Wyoming Workers' Safety and Compensation Division awarded benefits to Appellant Gary Mitcheson after he fell at work and injured his tailbone in July of 2007. Approximately two years later, the Division issued a final determination denying payment for medical care that Appellant claimed was related to his workplace injury. Appellant requested a contested case hearing, and the Office of Administrative Hearings (OAH) upheld the Division's determination. Appellant appealed to the district court, which upheld the OAH's order. On appeal, Appellant challenged the OAH order contending: (1) the order was arbitrary and unsupported by substantial evidence; (2) the OAH's denial of payment for treating Appellant's tailbone was arbitrary; and (3) the OAH order denying payment for medical care contrary to the "Rule Out" rule was contrary to law. Finding the issues Appellant raised on appeal to be without merit, the Supreme Court affirmed the OAH's decision. View "Mitcheson v. Wyoming" on Justia Law

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Appellant was injured when she was involved in a motor vehicle accident. The other vehicle involved in the accident, a truck, was listed on two different insurance policies: an Allstate policy issued to Jeremy Lucas and a Mountain West policy issued to Wyoming Electric Company. Appellee, Mountain West, filed a complaint for declaratory judgment, requesting that the district court find Mountain West did not have to cover the truck under the policy. The district court granted summary judgment in favor of Mountain West, finding that the owner of Wyoming Electric had given the truck to Lucas and, therefore, the truck was no longer covered under the company's insurance policy. The Supreme Court affirmed, holding that although the truck was titled and registered in the name of Wyoming Electric and was still listed as a specific vehicle on the Mountain West Policy, Mountain West was not required to pay under the policy because, on the date of the accident, Wyoming electric no longer owned the truck and the truck was no longer covered under the Mountain West insurance policy.

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Appellant Michael Beall received preauthorization from the Wyoming Workers' Safety and Compensation Division for an orchiectomy, a procedure to remove his left testicle, which he claimed was related to a workplace injury. Beall's employer, Sky Blue Enterprises, objected to the preauthorization and the matter was referred to the Medical Commission Hearing Panel for a contested case hearing. Beall elected to undergo the surgery prior to the scheduled hearing. The Commission denied Beall's claim for reimbursement of medical expenses on the basis that the surgery was not reasonable or necessary medical care resulting from his workplace injury. The district court affirmed. The Supreme Court affirmed, holding (1) the burden of proving that the orchiectomy was reasonable and necessary medical care as related to Beall's alleged workplace injury rested with Beall; and (2) substantial evidence supported the Commission's determination that Beall failed to meet this burden.

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Appellant was physically injured as a result of an accident caused by an underinsured motorist. Prior to the accident, Appellant purchased a Dairyland Insurance Policy through his insurance agent, Jonathan Schrack. Although Appellant requested full coverage, the policy did not include underinsured motorist coverage. When the other driver's insurance did not fully cover Appellant's damages, Appellant sued Dairyland and Schrack (Defendants), raising numerous theories as to why he should recover under the Dairyland policy. The district court granted Defendants' motions for summary judgment. The Supreme Court affirmed, holding, inter alia, (1) Wyoming's uninsured motorist statutes unambiguously do not require insurers to provide underinsured motorist liability coverage; (2) Appellant's failure to read the policy was available as a defense to Defendants as to Appellant's negligence and contract claims against them and barred application of the doctrine of promissory estoppel; and (3) the doctrine of reasonable expectations was not available to alter the unambiguous terms of the policy.

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Appellant Steven DeLoge, an inmate in the state penitentiary, was working in the kitchen when he was injured in an altercation with another inmate. Appellant filed a workers' compensation claim based on the injuries sustained from a head-butt from the other inmate. The Wyoming Workers' Safety and Compensation Division (Division) denied the claim. The Office of Administrative Hearings (OAH) concluded that Appellant's injuries were the result of illegal activity and were therefore not compensable under the Wyoming Worker's Compensation Act. The district court affirmed. The Supreme Court affirmed, holding that because the head-butt was a battery under the criminal statute then existing, and therefore an illegal activity, Appellant was not eligible for workers' compensation benefits.

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Shannon Cave suffered a work-related injury and was awarded temporary total disability (TTD) benefits during her recovery. After Cave rejected an offer of temporary light duty work from her employer, the Wyoming Workers' Safety and Compensation Division (Division) reduced Cave's TTD benefits to one-third of the previously authorized amount in accordance with Wyo. Stat. Ann. 27-14-404(j). The Office of Administrative Hearings (OAH) upheld the reduction of TTD benefits. The district court reversed the OAH decision. The Supreme Court reversed the district court's order, holding that the OAH decision was supported by substantial evidence and was not contrary to law as the hearing examiner properly determined that the offer of light duty employment tendered to Cave was bona fide, and therefore, the OAH was obligated to reduce Cave's TTD benefits.

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Kelly Shaffer received breast reduction surgery for medical purposes, after which she was hospitalized for a methicillin-resistant stophylococcus aureaus (MRSA) infection. Shaffer's insurer, WINhealth Partners (WIN), refused to pay for the treatment Shaffer received for her MRSA infection on the basis that it arose from treatment to improve appearance. Shaffer subsequently sued WIN, alleging breach of contract and bad faith contract. The trial court granted summary judgment in favor of WIN, concluding that the insurance contract language clearly and unambiguously excluded coverage for Shaffer's breast reduction surgery as well as treatment of complications arising from non-covered services. The Supreme Court reversed, holding that the district court erred in granting summary judgment to WIN because, based on the evidence in the record, the language of the insurance contract unambiguously provided coverage to Shaffer's non-cosmetic breast reduction surgery. Remanded with directions for the district court to enter summary judgment in favor of Shaffer on her claims for treatment of her MRSA infection.

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Employee injured his knee while climbing into his employer-provided truck as he was preparing to leave on a work-related trip. The Wyoming Workers' Safety and Compensation Division (Division) denied Employee's requested workers' compensation benefits related to his injury. The Office of Administrative Hearings (OAH) granted summary judgment in favor of the Division. The district court affirmed the OAH's decision. At issue on appeal was whether Employee's injury was sustained while he was being transported by a vehicle of the employer as the statute requires. The Supreme Court affirmed, holding (1) the statute plainly and unambiguously requires that for an injury sustained during travel to be compensable, it must occur as the employer's vehicle is carrying the employee from one place to another; and (2) because Employee here was entering the vehicle in preparation for that transportation when he was injured, the injury he sustained was not compensable.