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State11/19/2004
, 938 P.2d 851, 853 (Wyo. 1997). "To prove aggravation of a pre-existing injury, the claimant must demonstrate that the 'work effort contributed to a material degree to the . . . aggravation . . . of the existing condition of the employee.'" Frazier v. State ex rel. Wyoming Workers' Safety and Compensation Div., 997 P.2d 487, 490 (Wyo. 2000) (quoting Lindbloom v. Teton Intern., 684 P.2d 1388, 1389-90 (Wyo. 1984) (emphasis omitted).
"The causal connection between an accident or condition at the workplace is satisfied if the medical expert testifies that it is more probable than not that the work contributed in a material fashion to the . . . aggravation . . . of the injury . We do not invoke a standard of reasonable medical certainty with respect to such causal connection. Testimony by the medical expert to the effect that the injury 'most likely,' 'contributed to,' or 'probably' is the product of the workplace suffices under our established standard. . . .
Under either the 'reasonable medical probability' or 'more probable than not' standard, [a claimant succeeds] in demonstrating the causal connection by a preponderance of the evidence."
Hall v. State ex rel. Wyoming Workers' Compensation Div., 2001 WY 136, , 37 P.3d 373, 378 (Wyo. 2001) (quoting In re Pino, 996 P.2d 679, 685 (Wyo. 2000)).
Whether the employment "'aggravated, accelerated, or combined with the internal weakness or disease to produce the disability is a question of fact.'" Brees v. Gulley Enterprises, Inc., 6 P.3d 128, 131 (Wyo. 2000) (quoting Lindbloom, 684 P.2d at 1390).
Further, although the district court upheld the hearing examiner's determination, this court affords no deference to conclusions reached by the district court; we review the case as if it had come directly from the hearing examiner. State ex rel. Workers' Compensation Div. v. Brewbaker, 972 P.2d 962, 964 (Wyo. 1999).
DISCUSSION
[ ] The Division agrees with the finding of fact that Parrish's cervical and lumbosacral spine problems are an injury occurring over a substantial period of time. Indeed, the Division agrees with Dr. Stenfors-Dacre's opinion that the most likely cause of Parrish's present back condition is "the chronic repetitive heavy work that he had done from the time of 1976 onward" until 1994. However, the Division forcefully asserts "Parrish's back was damaged before he ever came to Excal." The Division supports this assertion with Dr. StenforsDacre's testimony that as early as 1994 Parrish had complaints about, and symptoms in, the lumbosacral spine and Dr. Stenfors-Dacre's opinion that, if Parrish developed such symptoms in 1994, then by 1994 the damage had been done to the structures of Parrish's back by the nature of the repetitive heavy lifting as revealed in Parrish's detailed work history. The Division submits that Parrish failed to present any evidence that his present back problems were caused by a material aggravation of his pre-existing degenerative back problem. Thus, the Division contends that the hearing examiner's finding that Parrish's spine problems are not the result of a pre-existing condition is not supported by substantial evidence.
[ ] In the alternative, the Division contends that the hearing examiner ignored the medical evidence that Parrish injured his back in two specific incidents, one in 1999 when he bent over and developed severe radiating pain in his left leg, and the other in November 2000 when he fell on ice and thereafter experienced drastic significant low-back pain alternating from side to side with increased pain radiating in the left leg. The Division argues that the hearing examiner's failure to consider such evidence constitute
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