Leib was employed as a maintenance worker for Laramie County Community College and began working on the College grounds in April 2012. As part of her duties as a groundskeeper, she was required to work with dirt that was mixed with untreated manure from livestock kept on campus and from traveling circus animals. Two weeks after she began working in the dirt, she started experiencing pain and swelling in both of her breasts. She sought emergency room treatment twice in June 2012 and eventually developed a bacterial infection. During early August, “[a] subsequent culture indicated that several different types of peptostreptococcus bacteria were present.” The claim was eventually denied. The Medical Commission (the neutral medical body presiding over cases in Wyoming when medical evidence conflicts) concluded:

“The Medical Panel finds that the employee/claimant has not met her burden of proof in establishing that the workplace was the cause of her breast infections. Evidence was not provided that would credibly establish that the streptococcus was actually determined to exist in the dirt/manure that she was working with. As Dr. Dowell indicated, those organisms are found in a wide variety of locations, and cannot be specifically attributed to her workplace. In addition, we weighed the relative credibility and qualifications of the competing expert medical opinions in this matter and find that Dr. Dowell, as a board-certified infectious disease specialist, has far more credibility on these issues than Dr. Willis, who is far more generally trained as an osteopathic physician, and he does not carry the board certifications provided by Dr. Dowell.”

Although there is authority in Wyoming holding that “the claimant’s inability to identify the specific source of his injury did not preclude a finding of causation as a matter of law” and that“[p]roof of prior good health and change immediately following and continuing after an injury may establish that an impaired condition was due to the injury,” it remains true that, “where a medical question is complex, and the fact finding must be done in a realm that appropriately relies upon technical medical knowledge and expertise, medical testimony should not be ignored.” The Supreme Court concluded that the Medical Commission’s crediting of Dr. Dowell’s opinion that the streptococcus did not exist in the dirt/manure was sufficient to uphold its ultimate determination of non-compensability.