Full Opinion

IN THE SUPREME COURT, STATE OF WYOMING 2026 WY 119 OCTOBER TERM, A.D. 2026 November 4, 2026 DAVID MARTINEZ, Appellant (Petitioner), v. S-26-0117 STATE OF WYOMING, ex rel. DEPARTMENT OF WORKFORCE SERVICES, WORKERS' COMPENSATION DIVISION, Appellee (Respondent). Appeal from the District Court of Laramie County The Honorable Catherine R. Rogers, Judge Representing Petitioner: Donna D. Domonkos, Domonkos Law Office, LLC, Cheyenne, Wyoming. Representing Respondent: Keith G. Kautz, Attorney General, Mark Klaassen, Deputy Attorney General, Peter Howard, Senior Assistant Attorney General. Before BOOMGAARDEN, C.J., and GRAY, FENN, JAROSH, and HILL, JJ. NOTICE: This opinion is subject to formal revision before publication in Pacific Reporter Third. Readers are requested to notify the Clerk of the Supreme Court, Supreme Court Building, Cheyenne, Wyoming 82002, of any typographical or other formal errors so that correction may be made before final publication in the permanent volume. BOOMGAARDEN, Chief Justice. [¶1] After a contested case hearing, the Medical Commission concluded the Wyoming Workers’ Compensation Division (Division) properly terminated Appellant David Martinez’s temporary total disability (TTD) benefits because he had reached maximum medical improvement (MMI) and suffered an ascertainable loss. The district court affirmed the Medical Commission’s decision, and Mr. Martinez appealed. We affirm. ISSUE [¶2] This appeal presents a single, dispositive issue: Did substantial evidence support the Medical Commission’s finding that Mr. Martinez reached MMI and had an ascertainable loss as of March 2023, thereby precluding continued TTD benefits? 1 FACTS [¶3] Mr. Martinez worked as a maintenance worker for a veterinary clinic in Cheyenne. In March 2022, Mr. Martinez injured his back at work. Following his injury, Mr. Martinez stopped working, filed an injury report with the Division, and sought treatment from Dr. Vincent Ross. Dr. Ross diagnosed Mr. Martinez with lumbar sprain, thoracic sprain, and muscle spasms and prescribed physical therapy, medication, and a temporary work restriction. The Division found Mr. Martinez’s injury compensable and began providing Mr. Martinez TTD benefits. [¶4] Mr. Martinez returned to Dr. Ross’s office several times over the following year, still complaining of moderate back pain. Although Dr. Ross noted improvements, he continued prescribing physical therapy, medication, and work restrictions due to Mr. Martinez’s ongoing pain. In December 2022, however, Dr. Ross noted Mr. Martinez was “doing well” and could likely return to work the following January 15. [¶5] A few months later, the Division sent Dr. Ross a form asking whether he believed Mr. Martinez had reached MMI and had suffered permanent partial impairment (PPI) because of his injury. On March 2, 2023, Dr. Ross completed the form, stating 1 Mr. Martinez also challenges the Division’s permanent partial impairment (PPI) benefits award, claiming it was premature because he had not yet achieved MMI when the Division awarded PPI benefits. Because substantial evidence supports the Medical Commission’s finding that Mr. Martinez achieved MMI as of March 2023, we need not address this issue. Mr. Martinez does not challenge the amount of the PPI benefits awarded, only whether they were premature given the Division’s conclusion as to MMI. 1 Mr. Martinez reached MMI as of that date and Mr. Martinez had no PPI. The Division then referred Mr. Martinez to Dr. Robert Monger for an independent medical examination (IME) and a PPI rating. [¶6] Following the IME, Dr. Monger issued a report to the Division, in which Dr. Monger also concluded Mr. Martinez achieved MMI as of March 2, 2023. Dr. Monger based this finding on his opinion that Mr. Martinez’s pain had stabilized “and no further recovery or deterioration [was] anticipated.” Dr. Monger further opined Mr. Martinez had an ascertainable loss resulting in a three percent Whole Person Impairment (WPI) rating for the purposes of PPI benefits, and “given [Mr. Martinez’s] lifting tolerance in therapy,” Mr. Martinez was ready to return to work with minimal restrictions. [¶7] Based on Dr. Monger’s finding that Mr. Martinez had achieved MMI and suffered an ascertainable loss, the Division terminated Mr. Martinez’s TTD benefits on July 15, 2023. The Division likewise awarded Mr. Martinez PPI benefits totaling $5,642.28 based on Dr. Monger’s three percent WPI rating. [¶8] Mr. Martinez challenged the Division’s determinations, and at Dr. Ross’s suggestion, obtained a Functional Capacity Evaluation (FCE). The FCE revealed Mr. Martinez’s work status as “unable to perform Sedentary.” In light of this finding, Dr. Monger amended his original report, recommending Mr. Martinez be restricted to a sedentary job, be referred for vocational rehabilitation, and if Mr. Martinez could not successfully reenter the workforce, he should apply for permanent total disability benefits. Dr. Monger did not amend his findings relating to the date Mr. Martinez achieved MMI or Mr. Martinez’s WPI rating. [¶9] Mr. Martinez later underwent a second IME with Dr. Sateesh Devagupthapu. Following that IME, Dr. Devagupthapu issued a report agreeing Mr. Martinez reached MMI as of March 2, 2023, assigning Mr. Martinez a four percent WPI rating, and noting “no further treatment or interventions are necessary.” [¶10] Based on Dr. Devagupthapu’s report, the Division sent Mr. Martinez a final determination of PPI benefits. The Division informed Mr. Martinez he would receive additional PPI benefits totaling $1,880.76 to reflect the increase in his WPI rating from three to four percent. Mr. Martinez again objected, and the Division referred the case to the Medical Commission for a contested case hearing. [¶11] At the hearing, Mr. Martinez asserted the Division improperly terminated his TTD benefits on July 15, 2023, because he believed he had not achieved MMI as of that date. Mr. Martinez, however, offered no medical evidence supporting his challenges, instead resting his argument solely on his own testimony. The Division countered that while 2 Mr. Martinez’s “situation is certainly deserving of sympathy,” he failed to meet his burden of proving he was entitled to continued TTD benefits. [¶12] After the hearing, the Medical Commission upheld the termination of Mr. Martinez’s TTD benefits because the reports from Dr. Ross, Dr. Monger, and Dr. Devagupthapu all supported that Mr. Martinez reached MMI as of March 2023, and Mr. Martinez failed to prove otherwise. Mr. Martinez appealed, and the district court affirmed. This appeal followed. STANDARD OF REVIEW [¶13] “When an appeal is taken from a district court’s review of the Medical Commission’s decision, we examine the case as if it came directly from the Medical Commission, ‘giving no special deference to the district court’s decision.’” McDonald v. State ex rel. Dep’t of Workforce Servs., Workers’ Comp. Div., 2026 WY 70, ¶ 17, 591 P.3d 818, 823 (Wyo. 2026) (quoting Zheng v. State ex rel. Dep’t of Workforce Servs., Workers’ Comp. Div., 2024 WY 77, ¶ 18, 552 P.3d 818, 824 (Wyo. 2024)). Wyo. Stat. Ann. § 16-3-114(c) (2025) governs our review: (c) To the extent necessary to make a decision and when presented, the reviewing court shall decide all relevant questions of law, interpret constitutional and statutory provisions, and determine the meaning or applicability of the terms of an agency action. In making the following determinations, the court shall review the whole record or those parts of it cited by a party and due account shall be taken of the rule of prejudicial error. The reviewing court shall: . . . (ii) Hold unlawful and set aside agency action, findings and conclusions found to be: (A) Arbitrary, capricious, an abuse of discretion or otherwise not in accordance with law; . . . 3 (E) Unsupported by substantial evidence in a case reviewed on the record of an agency hearing provided by statute. To prevail on a workers’ compensation claim, a claimant must prove all essential elements by a preponderance of the evidence. McDonald, 2026 WY 70, ¶ 18, 591 P.3d at 824 (quoting Zheng, 2024 WY 77, ¶ 19, 552 P.3d at 824). If the [Medical Commission] determined that the burdened party failed to meet her burden of proof, we will decide whether there is substantial evidence to support the [Medical Commission’s] decision to reject the evidence offered by the burdened party by considering whether that conclusion was contrary to the overwhelming weight of the evidence in the record as a whole. If, in the course of its decision making process, the [Medical Commission] disregards certain evidence and explains its reasons for doing so based upon determinations of credibility or other factors contained in the record, its decision will be sustainable under the substantial evidence test. Importantly, our review of any particular decision turns not on whether we agree with the outcome, but on whether the [Medical Commission] could reasonably conclude as it did, based on all the evidence before it. McDonald, 2026 WY 70, ¶ 18, 591 P.3d at 824 (quoting Zheng, 2024 WY 77, ¶ 19, 552 P.3d at 824) (modifications in original). [¶14] “Even if an agency record contains sufficient evidence to support the [Medical Commission’s] decision under the substantial evidence test, this Court applies the arbitrary-and-capricious standard as a ‘safety net’ to catch other [Medical Commission] action that may have violated the Wyoming Administrative Procedures Act.” McDonald, 2026 WY 70, ¶ 19, 591 P.3d at 824 (quoting Zheng, 2024 WY 77, ¶ 20, 552 P.3d at 825) (modifications in original). The arbitrary-and-capricious standard “is more lenient and deferential to the [Medical Commission] than the substantial evidence standard because it requires only that there be a rational basis for the [Medical Commission’s] decision.” McDonald, 2026 WY 70, ¶ 19, 591 P.3d at 824 (quoting Zheng, 2024 WY 77, ¶ 20, 552 P.3d at 825) (internal quotation marks omitted) (modifications in original). [¶15] We review the Medical Commission’s conclusions of law de novo. McDonald, 2026 WY 70, ¶ 20, 591 P.3d at 824. 4 Substantial evidence supports the Medical Commission’s finding that Mr. Martinez had achieved MMI as of March 2023, thereby precluding continued TTD benefits. [¶16] Mr. Martinez presents a single, dispositive claim on appeal, which challenges the Medical Commission’s determination that he was not entitled to TTD benefits after July 2023 because he achieved MMI as of March 2023. Mr. Martinez alleges the Medical Commission’s MMI finding is unsupported by substantial evidence because Mr. Martinez “knew he was not at [MMI]” in March 2023, when Dr. Ross, Dr. Monger, and Dr. Devagupthapu stated he was, and because Mr. Martinez’s self-guided recovery efforts improved his condition after those doctors stated he reached MMI. [¶17] Having reviewed the record, we determine the Medical Commission reasonably concluded Mr. Martinez reached MMI as of March 2023, and for that reason, we affirm. McDonald, 2026 WY 70, ¶ 18, 591 P.3d at 824 (quoting Zheng, 2024 WY 77, ¶ 19, 552 P.3d at 824). [¶18] “The concepts of temporary total disability, maximum medical improvement, ascertainable loss, and permanent partial impairment are interrelated.” Coggins v. State ex rel. Dep’t of Workforce Servs., Workers’ Comp. Div., 2018 WY 77, ¶ 12, 421 P.3d 555, 559–60 (Wyo. 2018) (quoting Morris v. State ex rel. Dep’t of Workforce Servs., Workers’ Comp. Div., 2017 WY 119, ¶ 27, 403 P.3d 980, 987 (Wyo. 2017)). Wyo. Stat. Ann. § 27- 14-404 (2025) governs TTD benefits and provides, in relevant part: (a) If after a compensable injury is sustained and as a result of the injury the employee is subject to temporary total disability as defined under W.S. 27-14-102(a)(xviii), the injured employee is entitled to receive a temporary total disability award for the period of temporary total disability as provided by W.S. 27-14-403(c) . . . (c) Payment under subsection (a) of this section shall cease prior to expiration of the twenty-four (24) month maximum period specified under subsection (a) of this section if: . . . (ii) The employee has an ascertainable loss, qualifies for benefits under W.S. 27-14-405 or 27-14-406 and the first monthly payment pursuant to either of those sections has been issued to the employee. 5 “The purpose of [TTD] benefits is to provide income for an employee during the time of healing from his injury and until his condition has stabilized.” Coggins, 2018 WY 77, ¶ 12, 421 P.3d at 560 (quoting Phillips v. TIC-The Indus. Co. of Wyo., Inc., 2005 WY 40, ¶ 27, 109 P.3d 520, 532 (Wyo. 2005)) (internal quotation marks omitted) (citation modified). TTD benefits are not perpetual, however; they terminate when an employee has an ascertainable loss and qualifies for PPI benefits under Wyo. Stat. Ann. § 27-14-405 (2025). § 27-14-404(c)(ii); Coggins, 2018 WY 77, ¶ 13, 421 P.3d at 560. [¶19] A claimant has suffered an ascertainable loss when “it is apparent that permanent physical impairment has resulted from a compensable injury, the extent of the physical impairment due to the injury can be determined and the physical impairment will not substantially improve or deteriorate because of the injury.” Wyo. Stat. Ann. § 27-14- 102(a)(ii) (2025); Coggins, 2018 WY 77, ¶ 14, 421 P.3d at 560. “An employee is considered to have suffered an ascertainable loss when his condition is at MMI.” Coggins, 2018 WY 77, ¶ 14, 421 P.3d at 560. “[A]n injured employee is considered at MMI or has an ascertainable loss even if he still has pain which may need further medical treatment so long as substantial improvement of the underlying condition would not result from such treatment.” Coggins, 2018 WY 77, ¶ 15, 421 P.3d at 561. [¶20] The Division terminated Mr. Martinez’s TTD benefits on July 15, 2023, based on reports from Dr. Ross and Dr. Monger, which stated Mr. Martinez achieved MMI as of March 2023. After Mr. Martinez objected to this termination, Mr. Martinez underwent another IME with Dr. Devagupthapu. Dr. Devagupthapu agreed Mr. Martinez achieved MMI as of March 2023. [¶21] Following a contested case hearing during which Mr. Martinez presented only his own testimony, the Medical Commission found, based on the opinions of Dr. Ross, Dr. Monger, and Dr. Devagupthapu, Mr. Martinez reached MMI in March 2023, and he failed to satisfy his burden of proving he was entitled to continued TTD benefits beyond July 15, 2023. [¶22] Substantial evidence supports these findings. On December 13, 2022, Dr. Ross noted Mr. Martinez suffered from moderate pain and spasms in his back but was otherwise “doing well.” On February 1, 2023, Mr. Martinez was found to “present[] with little to no thoracic joint and soft tissue restriction” and “able to return to work with minimal restrictions.” On March 2, Dr. Ross, who had been treating Mr. Martinez for nearly a year, declared Mr. Martinez had achieved MMI as of that date. On May 15, Dr. Monger found Mr. Martinez could “easily move on and off the exam table,” his gait was normal, and he had moderate tenderness in the thoracic spine. Dr. Monger similarly noted Mr. Martinez’s “pain symptoms have now stabilized, and no further recovery or deterioration is anticipated. It is my professional opinion within a reasonable degree of medical probability that Mr. Martinez reached the point of [MMI] on 3/2/23 as it relates to the 3/28/22 work injury.” On August 2, after his FCE, Mr. Martinez reported he was 6 “in a little pain, but it is my normal.” And on September 16, 2023, Dr. Devagupthapu found that “[a]s per a reasonable degree of medical opinion and as per Dr. Vincent Ross, MD, Mr. Martinez reached [MMI] on 03/02/2023, and no further treatment or interventions are necessary or indicated.” Mr. Martinez presented no evidence besides his own testimony to contradict these findings. [¶23] These facts show substantial evidence supported the Medical Commission’s finding that Mr. Martinez’s achieved MMI as of March 2, 2023, because his condition had stabilized and no further treatments were necessary. Coggins, 2018 WY 77, ¶ 15, 421 P.3d at 561 (“[A]n injured employee is considered at MMI or has an ascertainable loss even if he still has pain which may need further medical treatment so long as substantial improvement of the underlying condition would not result from such treatment.”) Once Mr. Martinez achieved MMI, he could no longer receive TTD benefits. Wyo. Stat. Ann. §§ 27-14-404(c)(ii), -405(f); Coggins, 2018 WY 77, ¶ 13, 421 P.3d at 560. Therefore, based on the evidence in the record, the Medical Commission reasonably upheld the Division’s termination of Mr. Martinez’s TTD benefits as of July 15, 2023. McDonald, 2026 WY 70, ¶ 18, 591 P.3d at 824. [¶24] Affirmed. 7