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Zander v. Workforce Safety and Insurance12/19/2003
REVERSED AND REMANDED.
[ ] Martin Zander appealed from a district court judgment affirming an order of North Dakota Workforce Safety and Insurance ("WSI") refusing to reopen Zander's claim for benefits. We reverse and remand, concluding WSI applied an erroneous legal standard in denying Zander's request to reopen his claim.
I.
[ ] Zander suffered a work-related back injury in 1991. WSI accepted his claim and paid medical expenses. Zander's symptoms worsened and he eventually had surgery in 1993. WSI paid Zander temporary total disability benefits after the surgery until Zander returned to work approximately three weeks later. Zander's doctor ultimately determined Zander had reached maximum medical improvement, and WSI had Zander undergo a permanent partial impairment evaluation. On July 28, 1994, WSI issued an order awarding benefits for a five percent whole body permanent partial impairment.
[ ] Zander did not seek further medical treatment for his back or any further benefits from WSI for more than seven years, although he testified he had recurring problems with his back during that time. In July 2001, Zander saw his doctor for back and leg pain, and requested payment by WSI for those medical expenses. WSI informed Zander that, because his claim had been inactive for longer than four years, his claim was presumed closed and he could only receive further benefits if he established by clear and convincing evidence that his current condition was caused solely by his original work injury.
[ ] Zander underwent further medical testing, and provided to WSI records and letters from his treating doctors indicating his current condition was caused by his original work injury. On October 18, 2001, WSI informed Zander the additional information did not provide clear and convincing evidence that his current condition was solely caused by the work injury. Zander's subsequent request that WSI pay for additional testing to establish that his condition was solely caused by the work injury was also denied.
[ ] On December 11, 2001, WSI issued its order denying reopening of Zander's claim. Zander requested a hearing, which was held before an administrative law judge ("ALJ") on September 24, 2002. The ALJ determined there was not clear and convincing evidence that Zander's 1991 work injury was the sole cause of his current condition and recommended that the prior order denying reopening of Zander's claim be affirmed. WSI adopted the ALJ's recommended findings, conclusions, and order on November 4, 2002. Zander appealed to the district court, which affirmed WSI's order.
II.
[ ] Under N.D.C.C. ยง 28-32-46, the district court must affirm an order of an administrative agency unless it finds any of the following are present:
. The order is not in accordance with the law.
. The order is in violation of the constitutional rights of the appellant.
. The provisions of this chapter have not been complied with in the proceedings before the agency.
. The rules or procedure of the agency have not afforded the appellant a fair hearing.
. The findings of fact made by the agency are not supported by a preponderance of the evidence.
. The conclusions of law and order of the agency are not supported by its findings of fact.
. The findings of fact made by the agency do not sufficiently address the evidence presented to the agency by the appellant.
. The conclusions of law and order of the agency do not sufficiently explain the agency's rationale for not adopting any contrary recommendations by a hearing officer or an administra
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