Hintz v. Farmers Co-op Assn. , 297 Neb. 903 ( 2017 )


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    www.nebraska.gov/apps-courts-epub/
    10/20/2017 09:12 AM CDT
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    Nebraska Supreme Court A dvance Sheets
    297 Nebraska R eports
    HINTZ v. FARMERS CO-OP ASSN.
    Cite as 
    297 Neb. 903
    Ian T. Hintz,      appellant, v. Farmers Cooperative
    Association, appellee.
    ___ N.W.2d ___
    Filed September 29, 2017.   No. S-16-267.
    1.	 Workers’ Compensation: Appeal and Error. Pursuant to 
    Neb. Rev. Stat. § 48-185
     (Cum. Supp. 2016), an appellate court may modify,
    reverse, or set aside a Workers’ Compensation Court decision only when
    (1) the compensation court acted without or in excess of its powers; (2)
    the judgment, order, or award was procured by fraud; (3) there is not
    sufficient competent evidence in the record to warrant the making of the
    order, judgment, or award; or (4) the findings of fact by the compensa-
    tion court do not support the order or award.
    2.	 ____: ____. Findings of fact made by the Workers’ Compensation Court
    have the same force and effect as a jury verdict and will not be set aside
    unless clearly erroneous.
    3.	 Workers’ Compensation: Evidence: Appeal and Error. When testing
    the sufficiency of the evidence to support findings of fact made by the
    Workers’ Compensation Court trial judge, the evidence must be consid-
    ered in the light most favorable to the successful party and the success-
    ful party will have the benefit of every inference reasonably deducible
    from the evidence.
    4.	 Workers’ Compensation. The Nebraska Workers’ Compensation Act
    provides that when an employee suffers personal injury caused by acci-
    dent or occupational disease, arising out of and in the course of his or
    her employment, such employee shall receive compensation from his or
    her employer if the employee was not willfully negligent at the time of
    receiving such injury.
    5.	 Workers’ Compensation: Proof. In order to recover under the Nebraska
    Workers’ Compensation Act, a claimant has the burden of proving by a
    preponderance of the evidence that an accident or occupational disease
    arising out of and occurring in the course of employment proximately
    caused an injury which resulted in disability compensable under the act.
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    HINTZ v. FARMERS CO-OP ASSN.
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    6.	 Workers’ Compensation: Expert Witnesses. If the nature and effect
    of a claimant’s injury are not plainly apparent, then the claimant must
    provide expert medical testimony showing a causal connection between
    the injury and the claimed disability.
    7.	 Expert Witnesses. Triers of fact are not required to take the opinions of
    experts as binding on them.
    8.	 Workers’ Compensation: Expert Witnesses. It is the role of the
    Nebraska Workers’ Compensation Court as the trier of fact to determine
    which, if any, expert witnesses to believe.
    9.	 Workers’ Compensation: Appeal and Error. Where the record pre­
    sents nothing more than conflicting medical testimony, an appellate court
    will not substitute its judgment for that of the Workers’ Compensation
    Court.
    10.	 Evidence: Words and Phrases. “Competent evidence” is defined as
    that which is admissible and relevant on the point in issue or, stated
    another way, admissible and tending to establish a fact in issue.
    11.	 Expert Witnesses. When the subject matter is wholly scientific or so far
    removed from the usual and ordinary experience of the average man that
    expert knowledge is essential to the formation of an intelligent opinion,
    only an expert can competently give opinion evidence as to the cause of
    the physical condition.
    12.	 Trial: Witnesses. The question as to the competency of a witness must
    be initially determined by the trial court.
    13.	 ____: ____. The credibility and weight of the testimony to be given to a
    witness are for the trier of fact to determine.
    14.	 Expert Witnesses: Physicians and Surgeons. For purposes of deter-
    mining whether a medical expert’s testimony is admissible, it is accept-
    able, in arriving at a diagnosis, for a physician to rely on examinations
    and tests performed by other medical practitioners.
    Petition for further review from the Court of Appeals, Inbody
    and Pirtle, Judges, and McCormack, Retired Justice, on appeal
    thereto from the Workers’ Compensation Court, Thomas E.
    Stine, Judge. Judgment of Court of Appeals reversed, and
    cause remanded with direction.
    Thomas R. Lamb and Richard W. Tast, Jr., of Anderson,
    Creager & Wittstruck, P.C., L.L.O., for appellant.
    Jason A. Kidd, of Engles, Ketcham, Olson & Keith, P.C.,
    for appellee.
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    Nebraska Supreme Court A dvance Sheets
    297 Nebraska R eports
    HINTZ v. FARMERS CO-OP ASSN.
    Cite as 
    297 Neb. 903
    Heavican, C.J., Wright, Miller-Lerman, Cassel, Stacy,
    K elch, and Funke, JJ.
    Funke, J.
    The issues in this litigation were the nature and extent of
    a work-related injury sustained by Ian T. Hintz, an employee
    of Farmers Cooperative Association (Farmers). The Nebraska
    Workers’ Compensation Court found that Hintz’ work-related
    injury was fully resolved within 3 days of the work accident
    and that Hintz’ need for additional medical treatment was the
    result of a non-work-related injury. Upon appeal, the Nebraska
    Court of Appeals reversed the decision and remanded the
    cause with directions for the court to reconsider the claim
    in light of competent medical opinion of causation and con-
    sidering the beneficent purpose of the Nebraska Workers’
    Compensation Act.1
    We hold that there was sufficient competent evidence in the
    record to support the Workers’ Compensation Court’s determi-
    nation that Hintz’ work-related injury was fully resolved prior
    to his fall on December 4, 2014. Therefore, we reverse the
    holding of the Court of Appeals.
    BACKGROUND
    On Thursday, November 13, 2014, Hintz was employed by
    Farmers as a tire technician and was repairing a semitrailer
    tire, when the tire exploded. At the time of the explosion, Hintz
    was kneeling directly in front of the tire. As a result of the
    explosion, Hintz was thrown approximately 10 feet and landed
    on his back. He could not feel his legs, had pain in his groin
    and hips, and heard “a whistling” in his ears. Within a few
    minutes, Hintz was able to get up and walk, but he had limited
    use of his right leg.
    Due to the pain Hintz was experiencing, he left work
    immediately after the explosion and did not return until the
    1
    Hintz v. Farmers Co-op. Assn., 
    24 Neb. App. 561
    , 
    891 N.W.2d 716
     (2017).
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    HINTZ v. FARMERS CO-OP ASSN.
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    following Monday. However, Hintz did not seek medical care
    for his injuries in the days immediately following the incident.
    Hintz indicated that upon returning to work, he was able to
    work only “a little” at that time.
    To the contrary, Farmers offered evidence which suggested
    that in the days and weeks after Hintz returned to work, he
    was able to complete all of his job requirements. Such evi-
    dence included Hintz’ payroll records and the testimony of his
    coworkers that Hintz resumed his normal job duties without
    any notable problems.
    On December 4, 2014, while walking up a set of stairs at
    home, Hintz tripped and fell, hitting his hip. Hintz sought
    medical treatment the next day with Dr. James Gallentine, an
    orthopedic doctor. Hintz told Gallentine that he was suffering
    from pain in his right leg which began the night before, when
    he tripped on his stairs and hit his right hip and knee. Hintz
    also told Gallentine about the November 13 incident at work;
    however, he said that since that incident, he had returned to
    work and “was jumping on and off trucks without any diffi-
    culty.” Based upon his evaluation, Gallentine prescribed pain
    medication for Hintz and told him not to return to work for a
    few days.
    The pain in Hintz’ right hip and leg did not resolve, and
    as a result, Gallentine ordered an MRI, which revealed that
    Hintz was suffering from a “superior labral tear and also some
    irregularity in the posterior labrum with a possible paralabral
    cyst forming.” Gallentine referred Hintz to Dr. Justin Harris,
    an orthopedic doctor, “for a possible hip arthroscopy” and
    directed Hintz to remain off work until further notice. Hintz
    then completed an application for short-term disability benefits
    from Farmers. On the application, Hintz indicated that he was
    temporarily, totally disabled and that his condition was not
    related to his occupation.
    On December 30, 2014, Harris examined Hintz. In his
    examination notes, Harris indicated that Hintz had been expe-
    riencing pain in his right hip since December 4, when he
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    HINTZ v. FARMERS CO-OP ASSN.
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    “tripped going up stairs.” Harris’ notes did not mention the
    November 13 work incident.
    On February 25, 2015, Harris performed surgery on Hintz
    to repair the injuries to his hip. The surgical procedures per-
    formed included a right hip arthroscopy and labral repair.
    Harris directed Hintz to remain off work until at least his next
    scheduled appointment, 6 weeks postsurgery.
    After the surgery, Hintz participated in physical therapy. He
    continued to complain of pain in his right hip and leg and, as
    a result, was prescribed pain medication. Hintz did not report
    any notable improvements to his condition.
    Farmers terminated Hintz in March 2015 because he had not
    been to work since December 4, 2014. Within days of being
    fired, Hintz attended an appointment with Harris, at which
    time he told Harris that his hip injury was caused by a “tire
    [blowing] up on him two weeks prior to . . . seeking medi-
    cal care.”
    On April 21, 2015, Hintz filed his petition with the Workers’
    Compensation Court, in which he alleged that he had sustained
    personal injury in an accident arising out of and in the course
    of his employment on or about November 13, 2014, and that as
    a result, he was entitled to disability benefits.
    On May 7, 2015, Farmers answered Hintz’ petition, denying
    most of Hintz’ assertions. In addition, Farmers affirmatively
    alleged that any injury or disability Hintz was suffering from
    was not caused by a “work-related accident.”
    On May 18, 2015, Harris authored a letter to Hintz’ counsel,
    discussing Hintz’ injury to his right hip and the cause of that
    injury. Harris stated:
    I understand that causation is an issue in this case.
    When the patient initially presented to me on December
    30, 2014, the history that was entered into our notes
    states that the patient had tripped up his stairs on
    December 4 . . . . The work injury was not documented
    at that time.
    ....
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    HINTZ v. FARMERS CO-OP ASSN.
    Cite as 
    297 Neb. 903
    As I have had the opportunity to discuss the case with
    [Hintz] since our initial visit, he makes it very clear to
    me that his symptoms all started with his work injury
    and that he was basically trying to deal with these on his
    own in order to keep working until the symptoms became
    unrelenting in December.
    Unfortunately, the documentation that we have in
    our notes does not necessarily corroborate what [Hintz]
    is currently stating. It should be noted, however, that
    the labral tear that we found at surgery was relatively
    severe and the mechanism of injury seems much more
    likely to be a high energy work injury as opposed to
    simply falling up the steps in order to create this type of
    labral tear.
    On that same day, Gallentine also authored a letter to Hintz’
    counsel, discussing the cause of Hintz’ injury. Gallentine
    stated:
    It is very difficult to specifically assign causation to one
    event versus the other in the case of . . . Hintz. An indi-
    vidual could certainly have hip related pain and labral
    pathology from the injury as reported at work on the 13th
    of November. He also could have similar findings from
    a fall as he noted having on December 5 [sic], 2014. I
    do not know that there is any reasonable degree of medi-
    cal certainty that would specifically assign his injury to
    one event versus the other. I would certainly be willing
    to defer to . . . Harris’ opinion as he did perform a hip
    arthroscopy on . . . Hintz and would have had a more
    direct evaluation of the actual intraarticular pathology
    noted at that time and whether this could be assigned
    more directly to one event or the other.
    Dr. Dennis Bozarth, an orthopedic doctor, reviewed Hintz’
    medical records at the request of Farmers’ counsel and, on
    June 8, 2015, authored a letter concerning the cause of Hintz’
    injury. In the letter, Bozarth states that although he “can’t
    say to a reasonable degree of medical certainty that the work
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    HINTZ v. FARMERS CO-OP ASSN.
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    event on November 13, 2014 had any factor in [Hintz’] com-
    plaints of right hip pain,” he believes that “more likely than
    not, [Hintz’ hip injury] is related to a trip and fall at home.”
    Bozarth concluded:
    Therefore after review of the available medical records,
    more likely than not, my opinion is that . . . Hintz did
    have an accident at work where a tire did blow up, injur-
    ing his left lower extremity. This did resolve, and he was
    working without restrictions. A new incident occurred on
    November 25 [sic], 2014, causing his right hip to become
    symptomatic.
    After a hearing on Hintz’ petition for disability benefits, the
    compensation court entered an order denying Hintz any work-
    ers’ compensation benefits. The court noted that both parties
    agreed that Hintz had a work accident on November 13, 2014.
    However, the court found that any injury Hintz suffered as a
    result of the work accident was resolved within 3 days. It fur-
    ther found that Hintz’ right hip injury which required surgery
    was the result of a fall on his stairs at home and not the work
    accident. Hintz appealed.
    The Court of Appeals concluded that the trial court erred in
    finding that there was no medical evidence to support Hintz’
    contention that his injury was caused by the tire explosion
    at Farmers, and as a result, the Court of Appeals reversed
    the decision of the compensation court and remanded the
    cause with directions for the court to reconsider the claim in
    light of competent medical opinion of causation. The appel-
    late court concluded that the finding by the compensation
    court—wherein the court rejected Harris’ opinions because
    they were “based on an inconsistent history given by [Hintz]
    and, therefore, [his] opinions lack a credible foundation”—was
    clearly wrong.
    Specifically, the appellate court determined that Harris’
    opinion was based upon his personal observations of the injury
    during surgery. The court also noted that Gallentine deferred
    to Harris’ opinion, because Harris performed the surgery.
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    HINTZ v. FARMERS CO-OP ASSN.
    Cite as 
    297 Neb. 903
    The Court of Appeals further determined that Bozarth’s
    opinion was not based on any medical conclusions, but merely
    the review of Hintz’ medical records. Thus, the court con-
    cluded that Bozarth’s opinion did not constitute competent
    medical testimony.
    ASSIGNMENTS OF ERROR
    Hintz did not specifically assign errors in his brief before
    the Court of Appeals, but argued that the compensation court
    erred (1) in finding that there was not a causal relationship
    between his injuries and the November 13, 2014, incident at
    Farmers and (2) in finding that he was not entitled to any dis-
    ability benefits.
    In its petition for further review, Farmers assigns that the
    Court of Appeals erred (1) by misapplying the clear error
    standard of review, in that it did not weigh the evidence in
    the light most favorable to the successful party and substituted
    its judgment for that of the trial court; (2) by holding that the
    opinion of Farmer’s expert witness, Bozarth, was “‘not com-
    petent medical testimony’”; (3) by applying the rule of liberal
    construction of the Nebraska Workers’ Compensation Act to
    evidence; and (4) in considering Hintz’ appeal, given Hintz’
    failure to specifically assign any errors within his brief.
    STANDARD OF REVIEW
    [1] Pursuant to 
    Neb. Rev. Stat. § 48-185
     (Cum. Supp. 2016),
    an appellate court may modify, reverse, or set aside a Workers’
    Compensation Court decision only when (1) the compensa-
    tion court acted without or in excess of its powers; (2) the
    judgment, order, or award was procured by fraud; (3) there is
    not sufficient competent evidence in the record to warrant the
    making of the order, judgment, or award; or (4) the findings
    of fact by the compensation court do not support the order
    or award.2
    2
    Nichols v. Fairway Bldg. Prods., 
    294 Neb. 657
    , 
    884 N.W.2d 124
     (2016).
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    [2,3] Findings of fact made by the Workers’ Compensation
    Court have the same force and effect as a jury verdict and will
    not be set aside unless clearly erroneous.3 When testing the
    sufficiency of the evidence to support findings of fact made
    by the Workers’ Compensation Court trial judge, the evidence
    must be considered in the light most favorable to the success-
    ful party and the successful party will have the benefit of every
    inference reasonably deducible from the evidence.4
    ANALYSIS
    This case involves two contradictory factual scenarios: (1)
    whether Hintz fully recovered from the workplace accident and
    was then reinjured at home or (2) whether Hintz continued to
    experience pain from the accident and was then reinjured as
    a result.
    [4] The Nebraska Workers’ Compensation Act provides that
    when an employee suffers personal injury caused by accident
    or occupational disease, arising out of and in the course of his
    or her employment, such employee shall receive compensation
    from his or her employer if the employee was not willfully
    negligent at the time of receiving such injury.5
    [5] In order to recover under the Nebraska Workers’
    Compensation Act, a claimant has the burden of proving by a
    preponderance of the evidence that an accident or occupational
    disease arising out of and occurring in the course of employ-
    ment proximately caused an injury which resulted in disability
    compensable under the act.6
    [6-8] If the nature and effect of a claimant’s injury are not
    plainly apparent, then the claimant must provide expert medi-
    cal testimony showing a causal connection between the injury
    3
    See Hull v. Aetna Ins. Co., 
    247 Neb. 713
    , 
    529 N.W.2d 783
     (1995).
    4
    Nichols, 
    supra note 2
    .
    5
    
    Neb. Rev. Stat. § 48-101
     (Reissue 2010).
    6
    Hynes v. Good Samaritan Hosp., 
    291 Neb. 757
    , 
    869 N.W.2d 78
     (2015).
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    and the claimed disability.7 The rule in this jurisdiction is that
    triers of fact are not required to take the opinions of experts
    as binding on them.8 It is the role of the Nebraska Workers’
    Compensation Court as the trier of fact to determine which, if
    any, expert witnesses to believe.9
    Sufficiency of Evidence
    Here, the compensation court considered the expert medical
    opinions of three orthopedic doctors and noted that there was
    conflicting medical evidence presented concerning the nature
    and extent of Hintz’ injuries. Harris opined that Hintz’ labral
    tear which was found at surgery was relatively severe and that
    the mechanism of injury seemed much more likely to be a
    “high energy work injury” as opposed to simply falling on the
    stairs; Bozarth opined that more likely than not, Hintz’ work
    accident injuring his left lower extremity fully resolved prior
    to his fall at home and that his fall at home caused his right
    hip to become symptomatic; and Gallentine opined that Hintz
    could have suffered his hip injury from either the work-related
    incident or the fall at home.
    The compensation court rejected Harris’ opinion, finding it
    not credible that Hintz could have returned to work full duty
    for several weeks with such a severe tear. Noting that “[t]he
    value of an expert witness’ opinion is no stronger than the
    facts upon which it is based,” the trial court rejected Harris’
    testimony as lacking a “credible foundation,” because it was
    premised upon an “inconsistent history.”
    [9] Where the record presents nothing more than conflicting
    medical testimony, this court will not substitute its judgment
    for that of the Workers’ Compensation Court.10
    7
    Owen v. American Hydraulics, 
    258 Neb. 881
    , 
    606 N.W.2d 470
     (2000).
    8
    Hamer v. Henry, 
    215 Neb. 805
    , 
    341 N.W.2d 322
     (1983).
    9
    Owen, 
    supra note 7
    .
    10
    Nichols, 
    supra note 2
    .
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    The evidence also showed that Hintz sought no medical
    treatment after the first injury, but immediately sought medical
    treatment after the second injury. Further, upon seeking that
    medical treatment, he repeatedly told his medical care provid-
    ers that his injury was the result of falling on the stairs. When
    asked whether the injury was work related, he repeatedly said
    it was not. Only after Hintz was terminated from his employ-
    ment did he begin stating that the injury was the result of the
    tire exploding.
    The compensation court found the evidence that Hintz had
    returned to full-duty work and was experiencing no pain from
    the accident was more credible than Hintz’ version that he con-
    tinued to experience pain from the accident, which pain first
    surfaced weeks later.
    Although the version of facts found by the compensation
    court must be accepted on appeal, the Court of Appeals appears
    to have reweighed the evidence by focusing on the opinion of
    Harris and rejecting the opinion of Bozarth. Further, the Court
    of Appeals reweighed the evidence as to the inconsistent state-
    ments made by Hintz to both of his doctors, the testimony of
    his coworkers, and the payroll records.
    Since there was competent testimony to support the deter-
    mination that Hintz’ work-related injury fully resolved before
    the injury he sustained at home, the decision of the compensa-
    tion court was not clearly erroneous, and therefore, the holding
    of the Court of Appeals is reversed.
    Effect of R ecords R eview
    The Court of Appeals also determined that Bozarth’s opin-
    ion was not based on any medical conclusions, but merely
    the review of Hintz’ medical records. As a result, the court
    concluded that his opinion did not constitute competent medi-
    cal testimony.
    In doing so, the appellate court stated that “[t]he sufficiency
    of an expert’s opinion is judged in the context of the expert’s
    entire statement” and that “the value of an expert witness’
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    opinion is no stronger than the facts upon which it is based”11—
    two contentions with which we agree. However, the Court of
    Appeals went on to state that “[b]ecause . . . Bozarth’s opinion
    is not based on any medical conclusions, we conclude that his
    opinion does not constitute competent medical testimony.”12
    With this contention we cannot agree.
    [10,11] We have defined “competent evidence” to be that
    which is admissible and relevant on the point in issue or,
    stated another way, admissible and tending to establish a
    fact in issue.13 When the subject matter is wholly scientific
    or so far removed from the usual and ordinary experience
    of the average man that expert knowledge is essential to the
    formation of an intelligent opinion, only an expert can com-
    petently give opinion evidence as to the cause of the physical
    condition.14
    [12,13] The question as to the competency of a witness
    must be initially determined by the trial court.15 However, the
    credibility and weight of the testimony to be given to a wit-
    ness are for the trier of fact to determine.16
    [14] The Court of Appeals misstated our prior jurisprudence
    when it concluded that Bozarth’s expert medical opinion was
    not competent because he merely reviewed Hintz’ medical
    records. To the contrary, we have routinely held that for pur-
    poses of determining whether a medical expert’s testimony
    is admissible, it is acceptable, in arriving at a diagnosis, for
    a physician to rely on examinations and tests performed by
    other medical practitioners.17
    11
    Hintz, supra note 1, 24 Neb. App. at 570, 891 N.W.2d at 723.
    12
    Id.
    13
    See Mathes v. City of Omaha, 
    254 Neb. 269
    , 
    576 N.W.2d 181
     (1998).
    14
    Hohnstein v. W.C. Frank, 
    237 Neb. 974
    , 
    468 N.W.2d 597
     (1991).
    15
    See State v. Earl, 
    252 Neb. 127
    , 
    560 N.W.2d 491
     (1997).
    16
    See Nichols, 
    supra note 2
    .
    17
    Hynes, supra note 6.
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    In the instant case, the Workers’ Compensation Court
    appropriately received into evidence the opinions of both
    Harris and Bozarth as competent medical evidence. The court
    then correctly considered the conflicting opinions and made
    a determination as to the weight and credibility to be given
    each of the opinions. As a result, we disapprove of the Court
    of Appeals’ determination that Bozarth’s opinion was not
    competent.
    CONCLUSION
    In the case at bar, the facts were in dispute as to whether
    Hintz fully recovered from the workplace accident and was
    then reinjured at home or whether Hintz continued to experi-
    ence pain from the accident and was then reinjured as a result.
    The extent of Hintz’ injuries was a question of fact to be
    determined by the trier of fact. The Workers’ Compensation
    Court was not clearly wrong in finding that Hintz did not
    meet his burden of proving that his subsequent injury was
    the result of his workplace accident. We reverse the holding
    of the Court of Appeals and remand the cause to the Court of
    Appeals with direction to affirm the decision of the Workers’
    Compensation Court.
    R eversed and remanded with direction.