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WEST VIRGINIA RECORD

Tuesday, March 19, 2024

State Supreme Court affirms Office of Judges decision

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CHARLESTON – The West Virginia Supreme Court of Appeals affirmed a 2014 decision made by the Office of Judges in regard to a man’s 2012 injury.

The court found that the decision of the Board of Review was not in clear violation of any constitutional or statutory provision, according to the Feb. 4 memorandum decision.

This appeal arises from the Board of Review’s Final Order dated Nov. 24, 2014, in which the Board affirmed a May 5, 2014, Order of the Workers’ Compensation Office of Judges.

“In its Order, the Office of Judges affirmed the claims administrator’s August 14, 2013, decision to deny a request for steroid injections of the left knee and to deny a request for a cervical MRI, a neurological consult, and twelve chiropractic visits,” the decision states. “The court has carefully reviewed the records, written arguments, and appendices contained in the briefs, and the case is mature for consideration.”

Beckett, a dozer operator for Argus Energy, fell on March 8, 2012, while trying to fix an electrical problem with his dozer. Beckett injured his neck, left shoulder, and left knee in the process.

A report dated April 3, 2013, from Dr. Stanley Tao indicated that Beckett was seen with complaints of left knee pain, which he related to his work injury of March 8, 2012.

“Dr. Tao advised that workers’ compensation had not responded to his January 2013 request for a left knee injection,” the decision states. “Mr. Beckett complained of locking, catching, and an occasional sensation of his knee ‘giving way.’”

Physical examination of the left knee revealed no evidence of swelling or discoloration and there was mild crepitus of the left knee with motion and mild tenderness in the left medial joint line.

Tao’s assessment was osteoarthritis and left rotator cuff sprain and tear and he again requested a steroid injection for pain for inflammation of the left knee. By report dated June 19, 2013, Dr. Paul Bachwitt had performed an independent medical evaluation.

Bachwitt commented that Beckett injured his neck, left shoulder and left knee after falling off a dozer at work.

On Aug. 14, 2013, the claim administrator denied a request from Thompson Chiropractic for a repeat cervical MRI, a neurosurgical consult, and 12 chiropractic visits.

“This denial was also based upon Dr.Bachwitt’s finding that Mr. Beckett had reached his maximum degree of medical improvement and required no further treatment.”

The Office of Judges determined that left knee injections were not medically related and reasonably required to treat his compensable injuries. The Office of Judges found that Tao requested authorization for steroid injections of the left knee because of exacerbations of osteoarthritis of the left knee from injury.

The Office of Judges also opined that in reviewing the evidence of record, there was no evidence that osteoarthritis or injury-related aggravation of osteoarthritis has been added as a compensable diagnosis in the claim.

“We agree with the consistent decisions of the Office of Judges and Board of Review,” the decision states. “Mr. Beckett carries the burden of showing that his requested treatments are medically related and reasonably required to treat his compensable diagnosis.”

Because there is no evidence that osteoarthritis or injury-related aggravation of osteoarthritis has been added as a compensable diagnosis in the claim, it was proper for the Office of Judges and Board of Review to deny treatment. The authorization denial for a cervical MRI, a neurosurgical consult and 12 chiropractic visits was also proper because Mr. Beckett did not submit sufficient evidence to show that such treatments were related to the compensable injury.

“As a result, the Office of Judges and Board of Review were not in error for denying all requested medical treatment,” the decision states. “For the foregoing reasons, we find that the decision of the Board of Review is not in clear violation of any constitutional or statutory provision, nor is it clearly the result of erroneous conclusions of law, nor is it based upon a material misstatement or mischaracterization of the evidentiary record.”

Beckett is represented by Edwin H. Pancake. Argus is represented by T. Jonathan Cook.

W.Va. Supreme Court of Appeals case number: 14-1309

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