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WEST VIRGINIA RECORD

Thursday, March 28, 2024

Supreme Court says claim for temporary total disability benefits was properly closed

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CHARLESTON – The West Virginia Supreme Court of Appeals issued a decision ruling that a claim for temporary total disability benefits was properly closed.

Ronnie Lucas appealed the decision of the West Virginia Workers’ Compensation Board of Review and the issue on appeal was whether the claim was properly closed for temporary total disability benefits, according to the Dec. 19 memorandum decision.

The claims administrator closed the claim for temporary total disability benefits on April 12, 2016, and the Office of Judges affirmed the claims administrator’s decision on Dec. 6, 2016. The Board of Review affirmed the order of the Office of Judges on May 26.

Lucas, a section foreman for Patriot Coal Corporation, injured his head, neck, shoulder and back in a rock fall at work on June 14, 2015.

He was seen at Med-Express the same day and diagnosed with an occupational injury described as a concussion, contusion of head and a cervical and lumbar sprain/strain.

Five days later, the claims administrator held the claim compensable for a concussion, shoulder strain, cervical strain, thoracic strain and lumbar strain.

An MRI performed on July 7, 2015, was interpreted as showing right posterolateral bulging of the C3-C4 intervertebral disc along with small marginal osteophytes resulting in mild encroachment in the lateral recess.

There were also posterior left lateral findings at the C5-C6 intervertebral disc with marginal osteophytes resulting in effacement of the cervical sac and mild encroachment on the left C5-C6 lateral recess. The MRI of the thoracic spine was interpreted as showing no evidence of thoracic intervertebral disc herniation, spinal stenosis, or spinal cord compression.

On March 14, 2016, the claims administrator granted Lucas a 10 percent permanent partial disability award. And, on April 12, 2016, the claims administrator closed the claim for temporary total disability benefits.

The Office of Judges determined that Lucas was not entitled to additional temporary total disability benefits because he was at his maximum medical improvement. The Board of Review adopted the findings of the Office of Judges and affirmed its order.

“After review, we agree with the reasoning of the Office of Judges as affirmed by the Board of Review,” the decision states.

The Supreme Court found that the decision of the Board of Review was 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. Therefore, the decision of the Board of Review is affirmed.

W.Va. Supreme Court of Appeals case number: 17-0517

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