CHARLESTON — The West Virginia Supreme Court of Appeals ruled that a claim for vocational rehabilitation benefits was rightfully reversed and awarded to a McElroy Coal employee.
The claims administrator closed a claim for vocational rehabilitation on Feb. 5, 2018, but the Office of Judges reversed and remanded the decision in its July 13, 2018, order with instructions to form a rehabilitation plan and pay Joshua Richards temporary total disability benefits until completion of the rehabilitation plan or rejection of the plan, according to the memorandum decision.
The order was affirmed by the Board of Review on Dec. 21, 2018.
Richards, a track man, was injured in the course of his employment on July 19, 2012, when the man bus he was operating was struck by another bus. An Employees’ and Physicians’ Report of Injury was filled out two days later and indicated he injured his lower back and neck.
The claim was held compensable for post-concussion syndrome, neck sprain, headache, unspecified head injury and lumbar sprain and Richards underwent a left L4-5 microdiscectomy for a herniated disc in 2015.
About two years later, he underwent lumbar spine surgery due to a recurrent herniated disc, radiculopathy and lower back pain and he was referred for a permanent partial disability evaluation. The claims administrator granted 20 hours of plan development if it was determined by a rehabilitation evaluation that he would benefit from the services.
After that, on Jan. 16, 2018, counsel sent another letter, this time asking if Richards would be receiving temporary partial rehabilitation benefits and nine days later the claims administrator determined that Richards was not eligible for temporary partial rehabilitation benefits because a rehabilitation plan was not written or implemented.
A closure report was then prepared, citing that he was not eligible for vocational services and the claim was officially closed on Feb. 5, 2018. After the Office of Judges reversed and remanded the decision on July 13, 2018, and the Board of Review adopted the Office of Judges' conclusion, McElroy appealed.
"After review, we agree with the reasoning and conclusions of the Office of Judges as affirmed by the Board of Review," the decision states.
The court found that the Board of Review did not violate any laws with its ruling and affirmed the decision by the board.
West Virginia Supreme Court of Appeals Case number: 19-0038