Valencia v. State

545 P.3d 415

2024 WY 29

Judy VALENCIA, Appellant (Petitioner),

v.STATE of Wyoming, EX REL. DEPARTMENT OF WORKFORCE SERVICES, WORKERS’ COMPENSATION DIVISION, Appellee (Respondent).

S-23-0174

Supreme Court of Wyoming.

March 21, 2024

Appeal from the District Court of Campbell County, The Honorable James Michael Causey, Judge

Representing Appellant: Donna D. Domonkos, Domonkos & Thorpe, LLC, Cheyenne, Wyoming.

Representing Appellee: Bridget Hill, Wyoming Attorney General; Mark Klaassen, Deputy Attorney General; Peter Howard, Senior Assistant Attorney General; Holli J. Welch, Senior Assistant Attorney General.

Before FOX, C.J., and KAUTZ, BOOMGAARDEN, GRAY, and FENN, JJ.

KAUTZ, Justice.

[¶1] Judy Valencia suffered an injury to her right knee which was covered by workers’ compensation. She later sought workers’ compensation benefits for injuries to her left foot, ankle, and hammertoe, claiming they were causally related to her compensable right knee injury. The Wyoming Department of Workforce Services, Workers’ Compensation Division (Division) disagreed and denied benefits. The Wyoming Medical Commission upheld the denial, concluding Ms. Valencia had failed to satisfy her burden of showing her compensable right knee injury caused her left foot, ankle, and hammertoe injuries. The district court affirmed the Commission’s decision. We also affirm.

ISSUES

[¶2] Ms. Valencia raises two issues which we re-state as one: Was the Medical Commission’s decision that Ms. Valencia had not met her burden of showing her left foot, ankle, and hammertoe injuries were caused by her compensable right knee injury supported by substantial evidence?

FACTS

[¶3] On August 21, 2020, Ms. Valencia was working as an administrative assistant at R&G Electric, Inc., in Gillette, Wyoming, when she went outside to take pictures of hail damage to the building for R&G Electric’s insurer. She stepped in an indentation in the grass and hyperextended her right knee. Dr. Mark Murphy diagnosed her with a right knee meniscus tear, which he surgically repaired on September 24, 2020. Four days after surgery, Ms. Valencia began physical therapy twice per week with Brandy Johnson, PT, DPT. On that date, Dr. Johnson noted, among other things, that Ms. Valencia had an "impaired gait." On December 17, 2020, Dr. Johnson documented that Ms. Valencia’s gait had "normalized." Ms. Valencia concluded physical therapy for her right knee on December 30, 2020. Ms. Valencia applied for and received workers’ compensation benefits for her right knee injury.

[¶4] On March 31, 2021, Ms. Valencia returned to Dr. Murphy complaining of right knee pain. Dr. Murphy noted Ms. Valencia "was doing [physical therapy] until the end of December and started walking[,] was doing okay walking 3 to 4 miles but went bowling … about a week ago and subsequently could not walk[,] … has difficulty with stairs[, and] the pain wakes her up at night and is around her patella on the right knee and her anterior knee." Dr. Murphy treated her right knee with an anti-inflammatory injection.

[¶5] In the meantime, on March 9, 2021, Ms. Valencia visited Dr. Robert Grunfeld for left foot pain. According to Dr. Grunfeld’s notes:

Patient is here for left foot pain. This has been going on for several years but she has noticed worsening … pronation … the last few months. Last summer she twisted her ankle and now has pain with walking longer distances. Her ankle feels unstable. She states that "bone in the middle arch has moved"….

Dr. Grunfeld diagnosed her with left calcaneal valgus alignment, left equinus contracture, left posterior tibial tendinitis, and left fourth hammertoe. On April 14, 2021, he performed reconstructive surgery on Ms. Valencia's left foot, ankle, and hammertoe. In his post-operative notes, with respect to his correction of her left hammertoe, he stated: "Her toe was previously corrected, but it fused in an uncomfortable position[.]" Ms. Valencia again began physical therapy with Dr. Johnson.

[¶6] On June 8, 2021, Ms. Valencia had a post-operative visit with Dr. Grunfeld. He noted:

[Ms. Valencia] had some concerns with regards to her Worker’s Compensation claim. In August 2020, specifically August 21, 2020[,] she had an injury while she was walking at work into a divot and her right knee gave out. She had a right knee surgery on 9/24/2020 with Dr. Murphy. Due to the alteration in her gait her favoring her operative side she ended up developing severe left foot pain. Patient states that she noticed that she was "walking funny" after the knee surgery. This does appear to be related to the patient’s original Worker’s Comp. claim with regards to the right knee surgery that she needed on 9/24/2020. She developed … progressive … left foot pain and deformity along with posterior tibial tendinitis. Surgery was successfully completed on April 14, 2021[,] of this year and she has been doing well. Patient states that she had no previous injury to the left foot but does have a history of a remote left ankle injury, which is not related to the problem that I’m currently treating her for.

Hammertoe correction with [proximal interphalangeal] joint resection and pinning was completed at time of surgery due to progressive deformity from an antalgic gait, related to the knee surgery that the patient underwent on the contralateral lower extremity.

[¶7] Ms. Valencia submitted the bills for the treatment she received on her left foot, ankle, and hammertoe to the Division, claiming her altered gait following her August 2020 right knee injury caused her left foot, ankle, and hammertoe injuries. The Division denied payment because Ms. Valencia's left foot, ankle, and hammertoe injuries were not related to her right knee injury. Ms. Valencia objected to the Division’s determination and requested a hearing. The Division transferred the matter to the Medical Commission for a contested case hearing.

[¶8] Prior to the hearing, the Division referred Ms. Valencia to Dr. Ricardo Nieves for an independent medical evaluation (IME), which was completed on September 17, 2021. After examining Ms. Valencia and reviewing her medical records, he opined: "In my professional opinion within a reasonable degree of medical probability there is no causal relationship between the 8/21/2020 work injury and the left ankle-foot surgeries performed by Dr. Grunfeld on 4/14/2021." He determined Dr. Grunfeld’s assessment that Ms. Valencia developed severe left foot pain and progressive deformity from her antalgic gait following her right knee surgery was "unfounded," "not supported by evidence-based medicine," and was contradicted by Dr. Grunfeld’s March 9, 2021, report wherein he stated Ms. Valencia’s left foot pain had been ongoing for several years, the pain had worsened in the last few months, and she had problems walking after twisting her ankle the previous summer. Dr. Nieves also noted Dr. Murphy’s records showed that upon completing physical therapy for her right knee injury, Ms. Valencia was "walking 3 to 4 miles with no evidence on the medical records of problems with the left foot." Dr. Nieves recognized Ms. Valencia had a significant past medical history of foot problems, including bunionectomies on her right and left feet in 1985 and 1986, respectively; a corn removal on her left fifth toe in 1992; hammertoe correction on the right and left fourth toes in 1992; surgery to release plantar fascia on both the right and left sides in 2009; and a left ankle sprain in the summer of 2019. He opined that "within a reasonable degree of medical probability the 8/21/2020 workplace incident did not cause any temporary exacerbations of pre-existing conditions of the left foot and ankle" or "any permanent material aggravation of pre-existing conditions of the left foot and ankle." Dr. Nieves further stated the medical literature does not support a causal relationship between an injury to a lower limb based upon an individual favoring the opposite lower extremity.

[¶9] On September 30, 2021, Dr. Johnson authored a written opinion regarding the cause of Ms. Valencia’s left foot, ankle, and hammertoe injuries. She stated that when Ms. Valencia began physical therapy on September 28, 2020, she was "limping significantly … to the point she was also complaining of back pain." According to Dr. Johnson, Ms. Valencia continued to limp for the next couple of months as she worked on getting her right knee to move correctly and to tolerate full weight while walking. "In that process, [Ms. Valencia] began to have left foot pain and … splaying of her left toes." Dr. Johnson stated Ms. Valencia continued to have left foot pain even after her gait normalized and even after she had no further issues with her right knee. She noted

Altered gait pattern over several months can frequently cause foot pain and changes in the feet as clearly stated in a PubMed article as follows: "In a normal, healthy person, gait is cyclical and symmetric process. However, when an abnormality is present in one of the joints, muscles, or bones of the complex system that regulates gait, this process is disrupted." "Very small variations in these things are usually nothing to worry about. However, if your foot shape or gait mechanics deviate too far from a ‘normal,’ neutral stride, you can start to become more susceptible to things like heel pain, shin splints, stress fractures, bunions, and other deformities or sports injuries." … Waco Foot and Ankle[,] January 2020.

Dr. Johnson opined Ms. Valencia’s "[l]eft foot pain and damage very well could be the result of her altered gait pattern following her injury in August of 2020."

[¶10] After holding a contested case hearing on August 3, 2022, the Medical Commission affirmed the Division’s denial of benefits. It concluded Ms. Valencia had failed to prove she suffered a second compensable injury to her left foot, ankle, and hammertoe as a result of her August 2020 workplace accident or that her August 2020 right knee injury caused a material...