West Virginia Record

Friday, November 15, 2019

Supreme Court: Claims administrator rightfully denied Swanson's employee's request after fall

Lawsuits

By Kyla Asbury | Sep 27, 2019

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CHARLESTON – The West Virginia Supreme Court of Appeals backed the West Virginia Workers' Compensation Board of Review and the Office of Judges in turning down a man's worker's compensation claim after he slipped in a puddle of oil.

The evidence supports the Board of Review’s decision to affirm the decision of the Office of Judges, the Sept. 3 decision stated, to deny Howard Postlethwait's request for lumbar injections.

Postlethwait, an employee of Swanson Industries, alleged that he suffered injuries on June 16, 2014, to his back, knee and ribs when he slipped and fell in a puddle of oil. He was treated by Dr. Perry Hall following the fall, as he was already being treated by Hall for other injuries from as far back as 2010. After some treatment, Hall suggested lumbar injections, and the request was sent to the claims administrator.

The claims administrator denied Postlethwait’s request on July 18, 2017, and the Board of Review affirmed the claims administrator’s order on Feb. 23, 2018. Postlethwait appealed that decision.

The court found that it was reasonable for the claims administrator to conclude that Howard Postlethwait failed to establish that the requested treatment was related to and necessary to treat the compensable injury in the claim.

"It must be noted that Mr. Postlethwait has a history of longstanding treatment for lumbar spine pain dating back to 1993," the decision said.

The Office of Judges found that Postlethwait failed to show that the request for lumbar injections is medically necessary and reasonably required for treatment of his compensable injury, and the Board of Review adopted the findings of fact and conclusions of law of the Office of Judges and affirmed that decision.

"The evidence supports the Board of Review’s decision to affirm the decision of the Office of Judges," the decision said. "It was reasonable for the claims administrator to conclude that Mr. Postlethwait failed to establish that the requested treatment is related to and necessary to treat the compensable injury in this claim."

West Virginia Supreme Court of Appeals case No. 18-0796

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