FOX, Justice.
[¶ 1] The Office of Administrative Hearings (OAH) denied Mr. Jensen's worker's compensation claim on the grounds that he failed to prove a causal relationship between his automobile accident and his prior work-related accident. The district court upheld that decision. We affirm.
[¶ 2] 1. Did the OAH properly apply the second compensable injury rule?
[¶ 3] On October 13, 2011, Mr. Jensen suffered a work-related injury when he climbed from the bed of a dump truck and fell onto a rock, fracturing his right hip. Dr. Brian Tallerico performed surgery on the hip, inserting a nail into the femur to repair the fracture. The Department of Workforce Services, Workers' Compensation Division (the Division) approved benefits for the injury to Mr. Jensen's right hip.
[¶ 4] After surgery, Mr. Jensen's legs were different lengths, causing a limp and constant pain in both hips. The pain eventually became unbearable, and on July 12, 2012, Dr. Tallerico and Dr. Aaron Altenburg performed a total hip replacement in Pocatello, Idaho. After his hip replacement, Mr. Jensen remained in pain, had bursitis, and was pigeon-toed. This caused him to trip and fall down when he walked.
[¶ 5] Mr. Jensen sought treatment for the symptoms he was experiencing. He began seeing pain specialist Dr. Holly Zoe in Idaho Falls, Idaho. He also revisited Dr. Tallerico, with whom he discussed the possibility of returning to work and the performance of a functional capacity evaluation and an impairment rating examination, which were subsequently scheduled. Dr. Tallerico noted: "Musculoskeletal: gait and station — [c]onventional walking: abnormal toe off." He performed an impairment rating examination in April of 2013. During that examination, Dr. Tallerico noted:
[¶ 6] On June 3, 2013, Mr. Jensen notified the Division that he was having difficulty
Dr. Tallerico's notes go on to state:
[¶ 7] On June 10, Mr. Jensen saw Dr. Altenburg and his assistant, Matthew McKinlay, PA-C. Mr. McKinlay's notes state that Mr. Jensen "complains of soreness in his lateral hip that has caused him to walk with pinching toe gait and he is also starting to go over the lateral aspect of his foot." The physical examination revealed the following:
The note concluded that Mr. Jensen "has developed greater trochanteric bursitis and intoeing." Going forward, their plan was to "get [Mr. Jensen] set up for some gait training and physical therapy focusing on externally rotating the foot and leg to get into more of a neutral alignment."
[¶ 8] The day after Mr. Jensen saw Dr. Altenburg, he was scheduled for appointments with Idaho Prosthetics & Orthotics to be fitted with orthotics, and with East Idaho Interventional Pain Center. En route to those appointments, Mr. Jensen was in an automobile accident which resulted in a shattered right ankle, broken left arm, and a broken pelvis.
[¶ 9] Immediately before the accident, Mr. Jensen was traveling north on Highway 89. As he approached the bridge over the Salt River, the vehicle in front of him began to turn right onto Lincoln County Road 128, and Mr. Jensen slowed down to allow room for the vehicle to turn. At the hearing, Mr. Jensen testified regarding what happened next:
[¶ 10] Immediately after the accident, UPS driver John Pittman arrived on the scene and helped Mr. Jensen out of his truck. Mr. Jensen laid his head on Mr. Pittman's lap until the ambulance arrived. At that time, he also called his wife from his cell phone. Mrs. Jensen testified that he spoke to her on the phone and told her that the accident happened when his foot got lodged between the brake and gas pedals and he could not get it out.
[¶ 11] An ambulance transferred Mr. Jensen to the Star Valley Medical Center, and he was ultimately life-flighted to the University of Utah Hospital in Salt Lake City, Utah, where he received treatment for his injuries. The Division denied Mr. Jensen's request for worker's compensation benefits for the injuries sustained in the automobile accident. After a contested case hearing, the OAH again denied his request. Mr. Jensen appealed that decision to the Sublette County District Court, which affirmed the OAH's decision. Mr. Jensen timely filed this appeal.
[¶ 12] Our standard of review of a district court's review of an administrative agency's decision in worker's compensation cases is:
Guerrero v. State ex rel. Dep't of Workforce Servs., Workers' Comp. Div., 2015 WY 88, ¶ 11, 352 P.3d 262, 265 (Wyo. 2015).
[¶ 13] We review the agency's findings of fact by applying the substantial evidence standard. Wyo. Stat. Ann. § 16-3-114(c)(ii)(E) (LexisNexis 2015); see also Dale v. S & S Builders, LLC, 2008 WY 84, ¶ 22, 188 P.3d 554, 561 (Wyo. 2008).
Guerrero, 2015 WY 88, ¶¶ 12-13, 352 P.3d at 266.
[¶ 14] We review an agency's conclusions of law de novo, and will affirm those conclusions only when they are in accordance with the law. Id., 2015 WY 88, ¶ 14, 352 P.3d at 266 (citing Middlemass v. State ex rel. Wyo. Workers' Safety & Comp. Div., 2011 WY 118, ¶ 13, 259 P.3d 1161, 1164 (Wyo. 2011)).
[¶ 15] Mr. Jensen argues that the Hearing Examiner failed to properly apply the second compensable injury rule. Mr. Jensen takes issue with the Hearing Examiner's comments that he had failed to pursue the "but for" theory of analysis. The Hearing Examiner stated: "Jensen has alleged only that the residual injuries caused the automobile accident. He has not alleged a theory, similar to that of In re Fisher [Fisher v. State ex rel. Wyo. Workers' Safety & Comp. Div., 2008 WY 89, 189 P.3d 866 (Wyo. 2008)] that `but for' the work related accident he would not have suffered the degree of injuries he did in the automobile accident." She also stated that "[t]he court in Fisher and Alvarez [v. State ex rel. Wyo. Workers' Safety & Comp. Div., 2007 WY 126, 164 P.3d 548 (Wyo. 2007)] found in both cases that `but for' the work related injuries the subsequent injuries would not have occurred," and that "Jensen has not alleged or attempted to prove that `but for' his prior work related injury he would not have suffered the same or as severe of injuries in the car accident." Although Mr. Jensen is correct that the "but for" analysis does not govern the determination of a second compensable injury, the evidence shows that the Hearing Examiner applied the correct standard in reaching her conclusion.
[¶ 16] To qualify for worker's compensation, an employee must show that he suffered a compensable injury. Guerrero, 2015 WY 88, ¶ 15, 352 P.3d at 266. An "injury is not compensable if it cannot fairly be traced to the employment as a contributing cause and if it comes from a hazard that the employee would have been equally exposed to outside of the employment." Ball v. State ex rel. Wyo. Workers' Safety & Comp. Div., 2010 WY 128, ¶ 23, 239 P.3d 621, 628 (Wyo. 2010) (citing Finley v. State ex rel. Wyo. Workers' Safety & Comp. Div., 2006 WY 46, ¶ 8, 132 P.3d 185, 188 (Wyo. 2006)) (quoting State ex rel. Wyo. Workers' Safety & Comp. Div. v. Bruhn, 951 P.2d 373, 377 (Wyo. 1997)).
[¶ 17] The second compensable injury rule applies when "an initial compensable injury has resulted in an injury or condition that requires additional medical intervention." Ball, 2010 WY 128, ¶ 24, 239 P.3d at 628. See also Alvarez, 2007 WY 126, ¶ 18, 164 P.3d at 552; Yenne-Tully v. Workers' Safety & Comp. Div., 12 P.3d 170, 172 (Wyo. 2000). "Under the rule, a subsequent injury is compensable if it is causally related to the initial compensable work injury." Alvarez, 2007 WY 126, ¶ 18, 164 P.3d at 552 (citing Yenne-Tully, 12 P.3d at 172); see also Ball, 2010 WY 128, ¶ 24, 239 P.3d at 628. In order to prove a second compensable injury, the employee must prove, "by a preponderance of the evidence, that it is more probable than not that there exists a causal connection between the first and second injuries." Guerrero, 2015 WY 88, ¶ 29, 352 P.3d at 271 (citing State ex rel. Wyo. Workers' Safety & Comp. Div. v. Kaczmarek (In re Kaczmarek), 2009 WY 110, ¶ 11, 215 P.3d 277, 282-83 (Wyo. 2009)). In order to establish that causal connection,
Ball, 2010 WY 128, ¶ 24, 239 P.3d at 628 (quoting Kaczmarek, 2009 WY 110, ¶ 11 n.3, 215 P.3d at 282 n.3).
[¶ 18] Here, the Hearing Examiner recognized that the second compensable injury rule applies in this instance. She stated: "This case concerns the second compensable injury rule." She went on to properly identify the relevant issue as "whether [Mr. Jensen's] work related injury caused the accident as he suggests in that due to his work related hip injury his foot was not functioning properly and slipped off the brake pedal and got stuck." She also stated that "[t]he causal connection ... is dependent upon whether or not the work related injuries were the cause of the accident."
[¶ 19] The Hearing Examiner then applied the second compensable injury rule, finding that "[w]hile the Office finds and concludes that Jensen did have residual problems from the work related injury, i.e., the in toeing and even rolling of the foot, the Office does not find that the preponderance of the evidence shows that those residual problems were the cause of the automobile accident."
[¶ 20] The second compensable injury rule was applicable in this case and the Hearing Examiner applied that rule. Therefore, Mr. Jensen's claim that "[t]he wrong rule of law was applied" cannot be sustained.
[¶ 21] Mr. Jensen argues that the OAH's findings were not supported by substantial evidence. As we explained in the preceding section, in order to receive worker's compensation benefits, Mr. Jensen had to prove by a preponderance of the evidence that the injuries he suffered in the automobile accident on June 11, 2013, were causally connected to his 2010 work-related injury. Guerrero, 2015 WY 88, ¶ 29, 352 P.3d at 271; Hoffman v. State ex rel. Wyo. Workers' Safety & Comp. Div., 2012 WY 164, ¶ 9, 291 P.3d 297, 301-02 (Wyo. 2012).
[¶ 22] In his endeavor to make that showing, Mr. Jensen relied on his medical records prior to the accident, testimony of his treating physicians, statements he made immediately after the accident in the presence of Mr. Pittman and to his wife, and his testimony at the hearing before the OAH, as well as his affidavit. That evidence consists of the following:
[¶ 23] In his deposition, Dr. Altenburg testified regarding hip weakness:
(Emphasis added.)
[¶ 24] In his affidavit, Mr. Jensen stated that when he saw the vehicle in front of him, he attempted to slow his truck down:
Similarly, at the hearing, Mr. Jensen testified:
[¶ 25] Statements made by Mr. Jensen immediately after the accident corroborate his testimony. Mr. Pittman testified that at the scene Mr. Jensen stated that "he reached down, pulled his foot out from underneath the brake pedal and lost control...." Mrs.
[¶ 26] In rejecting this evidence, the Hearing Examiner ruled:
(Emphasis added.)
[¶ 27] We have held that "[i]n a second compensable injury case, the causal connection between the work injury and the second injury is satisfied if the medical expert testifies that the work injury contributed to the second injury." Hoffman, 2012 WY 164, ¶ 17, 291 P.3d at 303. "Our precedent establishes that medical testimony stating the claimant's work `contributed to' the injury or the injury was `most likely' or `probably' the product of the workplace is sufficient to satisfy the requirements." Middlemass, 2011 WY 118, ¶ 28, 259 P.3d at 1168 (citing Boyce v. State ex rel. Wyo. Workers' Safety & Comp. Div., 2005 WY 9, ¶ 21, 105 P.3d 451, 458 (Wyo. 2005); Jim's Water Serv. v. Eayrs, 590 P.2d 1346, 1349 (Wyo. 1979); Claim of Vondra, 448 P.2d 313 (Wyo. 1968)).
[¶ 28] Here, Dr. Altenburg "surmised" that Mr. Jensen "could" have difficulty in lifting his knee and moving it outward. "[S]peculative medical testimony is insufficient to satisfy a claimant's burden of proof." Jacobs v. State ex rel. Wyo. Workers' Safety & Comp. Div., 2013 WY 62, ¶ 24, 301 P.3d 137, 147 (Wyo. 2013) (citing Anastos v. General Chemical Soda Ash, 2005 WY 122, 120 P.3d 658, 666-67 (Wyo. 2005)). The OAH found that Dr. Altenburg's testimony was speculative and did not satisfy Mr. Jensen's burden of proof. We have held that "opinions expressed by medical experts in terms of `can,' `could,' or `possibly' are not sufficient to meet an employee's burden of proof." Middlemass, 2011 WY 118, ¶ 28, 259 P.3d at 1168 (quoting Boyce, 2005 WY 9, ¶ 22, 105 P.3d at 458); see also Guerrero, 2015 WY 88, ¶ 19, 352 P.3d at 268 (physician's statement that it was "possible" claimant's back problems were related to his work injury was not sufficient proof of causation). Thus, Dr. Altenburg's testimony that Mr. Jensen "could"
[¶ 29] Dr. Altenburg's testimony was not the only medical testimony presented to the OAH. As early as February of 2013, Dr. Zoe noticed that Mr. Jensen had a "decreased [range of motion] with right hip flexion, extension, adduction, abduction, internal rotation, and external rotation." And, Dr. Tallerico's records indicate that Mr. Jensen's walk was "abnormal" with his "toe off" and that he had "weakness in basically all major motor groups in the right lower extremity." He also noted that the tendency of Mr. Jensen's foot to rotate inward occurred in a seated position: "As he sits in the examination chair [it] appears that he does have inversion and internal rotation of his right foot." This evidence, however, does not even reach the point of speculation regarding whether Mr. Jensen's work-related injury caused the accident.
[¶ 30] We have held that "the causal connection between the work injury and the second injury is satisfied if the medical expert testifies that the work injury contributed to the second injury." Hoffman, 2012 WY 164, ¶ 17, 291 P.3d at 303. In Hoffman, the claimant's treating physician testified that his second injury was "clearly related to" and "more probably resulted from" his original work injury and the treatment of that injury. We held that this testimony satisfied the causal connection requirement under the second compensable injury rule. Id. Here, however, none of this medical evidence relied upon by Mr. Jensen establishes a causal connection between Mr. Jensen's work-related injury and his subsequent accident.
[¶ 31] In addition, Mr. Jensen points to the testimony of other witnesses regarding the cause of the accident. He correctly states that both Mrs. Jensen and Mr. Pittman testified that shortly after the accident he told them his foot had become lodged between the brake and gas pedals, and he was unable to get it out. He also highlights his own testimony where he described his foot falling from the brake pedal, getting stuck, and his unsuccessful attempts at removing it as the cause of the accident.
[¶ 32] We have recognized that
Ikenberry v. State ex rel. Wyo. Workers' Comp. Div. (In re Ikenberry), 5 P.3d 799, 803 (Wyo. 2000); see also Seherr-Thoss v. Teton Cty. Bd. of Cty. Comm'rs, 2014 WY 82, ¶ 15, 329 P.3d 936, 944 (Wyo. 2014) ("An individual's testimony alone is sufficient to carry the individual's burden if there is nothing to impeach or discredit the individual's testimony and the individual's statements are corroborated by surrounding circumstances.").
[¶ 33] The Hearing Examiner found Mr. Pittman's testimony to be "compelling," however she noted that the theory advanced by Mr. Jensen was not supported by the circumstances and his testimony did not establish causation. She observed that Mr. Pittman "did not mention any statements Jensen made ... that his foot had rolled off the pedal." It was this lack of evidence of Mr. Jensen's foot rolling off the pedal that led the OAH to conclude that the foot rolling was a theory developed later in the case. The OAH rejected Mr. Jensen's testimony that his foot rolled off the pedal due to a lack of prior complaints about his foot while seated and because there was no evidence that he "told anyone at the time or within the month after the accident that his foot had slipped off the pedal." While the record is replete with uncontested evidence that Mr. Jensen complained of weakness, intoeing, and foot rolling in the months prior to the accident, and his doctor also noted his foot's tendency to rotate inward while he was in a seated position, we cannot say that the hearing examiner's
[¶ 34] Evidentiary findings are not supported by substantial evidence when they are "contrary to the overwhelming weight of the evidence in the record as a whole." Dale, 2008 WY 84, ¶ 22, 188 P.3d at 561 (citations omitted). "If, in the course of its decision making process, the agency 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." Id. at ¶ 22, 188 P.3d at 561. Here, the OAH provided its reasons for rejecting the testimony of Mr. Jensen that his foot had slipped off the pedal. We find that the OAH could reasonably have concluded that Mr. Jensen did not meet his burden of proving by a preponderance of the evidence that his accident was causally connected to his original work-related hip injury.
[¶ 35] The OAH properly applied the second compensable injury rule in this case. The OAH also reasonably concluded, based upon all of the evidence in the record, that Mr. Jensen had not established by a preponderance of the evidence that his automobile accident was causally connected to his original work-related injury. Affirmed.
