State v. Kringlie

1

2024 ND 26

State of North Dakota, by and through Workforce Safety and Insurance, Appellee v. Dale Kringlie, Appellant and Summit Siteworks LLC, Respondent

No. 20230184

Supreme Court of North Dakota

February 8, 2024

Appeal from the District Court of Cass County, East Central Judicial District, the Honorable Nicholas W. Chase, Judge.

Jacqueline S. Anderson (argued) and Cloe A. Kilwein (appeared), Fargo, ND, for appellee.

Daniel E. Phillips, Fargo, ND, for appellant.

OPINION

Bahr Justice.

[¶1] Dale Kringlie appeals from a district court judgment reversing an administrative law judge ("ALJ") final order that reversed a Workforce Safety and Insurance ("WSI") order awarding temporary partial disability benefits based upon completion of a vocational rehabilitation plan. We conclude the district court did not err in reversing the ALJ's final order. We affirm.

I

[¶2] On April 23, 2019, Kringlie suffered work-related injuries to his right shoulder and right wrist while using a concrete drill. WSI accepted the claim and paid the associated medical expenses and disability benefits.

[¶3] WSI issued a vocational rehabilitation report for Kringlie on April 30, 2021, and issued its Notice of Vocational Case Manager's Report ("vocational rehabilitation report") on May 11, 2021. Kringlie requested reconsideration, asserting he was not able to perform any of the jobs outlined in WSI's vocational plan due to a neuropsychological condition. In July 2021, WSI issued its administrative order awarding temporary partial disability benefits based upon completion of a vocational rehabilitation plan. Kringlie requested a rehearing.

[¶4] In March 2022, an ALJ held an administrative hearing on the appropriate rehabilitation option. In August 2022, the ALJ issued findings of fact, conclusions of law, and a final order reversing WSI's July 2021 order. Although the ALJ held no evidence established Kringlie's neuropsychological condition is work-related, the ALJ found his condition is degenerative and his capabilities are much less than his capabilities were on the date of the vocational rehabilitation report and on the date of his injury.

[¶5] Independent of the medical treatment and assessments provided by WSI, and unbeknownst to WSI, Kringlie presented to Dr Rodney Swenson for a neuropsychological consultation. Dr Swenson examined Kringlie on April 26, 2021, just days before WSI issued its vocational rehabilitation report on April 30, 2021. Dr. Swenson also saw Kringlie on May 3, 2021, and May 5, 2021. Dr. Swenson testified as Kringlie's expert witness at the hearing. The ALJ's final order relied heavily on the opinion of Dr. Swenson. The ALJ found Kringlie was incapable of performing "any work" and incapable of "returning to an occupation within the local job pool[.]" The ALJ held the greater weight of the evidence showed WSI's rehabilitation plan for Kringlie included jobs Kringlie was not "capable of performing" on both the vocational rehabilitation report date and the work-injury date. The ALJ concluded WSI failed to establish the "first appropriate rehabilitation option" for Kringlie is "return to an occupation within the local job pool of the locale in which the claimant was living at the date of injury[.]"

[¶6] WSI appealed to the district court and the court reversed the ALJ's decision. The court held the ALJ misapplied the law by requiring WSI to consider Kringlie's functional limitations at the time WSI issued the vocational rehabilitation report. The court held, as a matter of law, WSI's vocational rehabilitation report needed to reflect his functional limitations at the time of his work-related injury, not at the time WSI issued its vocational rehabilitation report. The court further held the ALJ misconstrued N.D.C.C. § 65-05-08.1 and erroneously relied on Dr. Swenson's opinion to establish Kringlie's disability approximately two years before Dr. Swenson examined him. The court concluded the record overwhelmingly contradicts the ALJ's ruling, and the ALJ's conclusion of law regarding whether WSI failed to establish "the first appropriate rehabilitation option" is not supported by the ALJ's findings of fact.

II

[¶7] Under the Administrative Agencies Practice Act, N.D.C.C. ch. 28-32, courts exercise only limited appellate review of administrative agency decisions. Provins v. Workforce Safety & Ins. Fund, 2022 ND 213, ¶ 5, 982 N.W.2d 559; Workforce Safety & Ins. v. Tolman, 2020 ND 223, ¶ 5, 950 N.W.2d 144. In an appeal, the reviewing court must affirm an administrative agency order unless it determines a statutory ground for reversal is present. N.D.C.C. § 28-32-46; N.D.C.C. § 28-32-49 ("The judgment of the district court in an appeal from an order . . . of an administrative agency or the commission may be reviewed in the supreme court on appeal in the same manner as provided in section 28-32-46[.]"). Grounds for reversal include if "[t]he order is not in accordance with the law," "[t]he findings of fact made by the agency are not supported by a preponderance of the evidence," and "[t]he conclusions of law and order of the agency are not supported by its findings of fact." N.D.C.C. § 28-32-46(1), (5), and (6). On appeal from the district court, this Court reviews the ALJ's decision. N.D.C.C. § 28-32-49. However, "[t]he district court's analysis is entitled to respect if its reasoning is sound, because the legislatively-mandated district court review cannot be ineffectual." Elshaug v. Workforce Safety & Ins., 2003 ND 177, ¶ 12, 671 N.W.2d 784.

[¶8] "When reviewing an appeal from a final order issued by an independent ALJ, courts apply the same deferential standard of review to the ALJ's factual findings as used for agency decisions." Provins, 2022 ND 213, ¶ 6 (quoting Tolman, 2020 ND 223, ¶ 6).

Recognizing the ALJ had the opportunity to observe witnesses and the responsibility to assess the credibility of witnesses and resolve conflicts in the evidence, in reviewing the ALJ's findings of fact we do not make independent findings or substitute our judgment for that of the ALJ; we determine only whether a reasoning mind reasonably could have determined the findings were proven by the weight of the evidence from the entire record.

Id. (quoting Tolman, at ¶ 6). This Court does not give deference to an independent ALJ's legal conclusions. Id. Questions of law are fully reviewable on appeal. Id.

III

[¶9] Chapter 65-05.1, N.D.C.C., governs WSI's vocational rehabilitation services. "The purpose of [N.D.C.C. ch 65-05.1] is to ensure that injured employees covered by this title receive services, so far as possible, necessary to assist the employee and the employee's family in the adjustments required by the injury to the end that the employee receives comprehensive rehabilitation services, including medical, psychological, economic, and social rehabilitation." N.D.C.C. § 65-05.1-01(2) (emphasis added). Section 65-05.1-01(3), N.D.C.C., provides, in part:

It is the goal of vocational rehabilitation to return the disabled employee to substantial gainful employment with a minimum of retraining, as soon as possible after an injury occurs. "Substantial gainful employment" means bona fide work, for remuneration, which is reasonably attainable in light of the individual's injury, functional capacities, education, previous occupation, experience, and transferable skills[.]

[¶10] "A rehabilitation plan is appropriate if it meets the requirements of N.D.C.C. ch. 65-05.1 and gives the injured worker a reasonable opportunity to obtain substantial gainful employment." Beam v. N.D. Workforce Safety & Ins. Fund, 2020 ND 168, ¶ 15, 946 N.W.2d 486. "The Legislature intended for claimants to be provided with actual rehabilitation, with a realistic opportunity to return to work, and not a theoretical rehabilitation on paper only." Anderson v. Workforce Safety & Ins., 2015 ND 205, ¶ 10, 868 N.W.2d 508 (quoting Genter v. Workforce Safety & Ins. Fund, 2006 ND 237, ¶ 14, 724 N.W.2d 132). However, "[a] rehabilitation plan need not guarantee a claimant either a job or a predetermined weekly wage." Beam, at ¶ 15 (quoting Welch v. Workforce Safety & Ins., 2017 ND 210, ¶ 15, 900 N.W.2d 822). WSI has the burden to establish a vocational rehabilitation plan is appropriate for the claimant. Id.; see also Shotbolt v. N.D. Workforce Safety & Ins., 2010 ND 13, ¶ 20, 777 N.W.2d 853. "WSI's selection of a vocational rehabilitation plan will not be reversed when there is evidence from which a reasoning mind could have reasonably concluded that the rehabilitation plan would return the injured worker to substantial gainful employment which was reasonably attainable in light of his injury[.]" Anderson, at ¶ 11 (quoting Higginbotham v. Workforce Safety & Ins., 2014 ND 147, ¶ 8, 849 N.W.2d 233).

[¶11] Here, the ALJ determined, regardless of whether Kringlie's capabilities are assessed as of the date of his work injury or as of the date of WSI's vocational rehabilitation report, WSI failed to establish the first appropriate rehabilitation option for Kringlie is to "return to an occupation within the local job pool of the locale in which the claimant was living at the date of injury." The district court held the ALJ erred as a matter of law to the extent he relied on the date of WSI's vocational rehabilitation report. The court held "WSI's [vocational rehabilitation report] needed to reflect Kringlie's functional limitations at the time of his work-related injury and not Kringlie's functional limitations at the time WSI issued its [vocational rehabilitation report]." The court further held "the ALJ's conclusion of law that 'WSI has failed to establish that the first appropriate rehabilitation option for Kringlie is "return to an occupation within the local...