CHARLESTON — The West Virginia Supreme Court has sided with an injured auto technician in a workers’ compensation dispute, finding that medical evidence did not support cutting off his benefits or denying further diagnostic testing.
The April 2023 decision from the Intermediate Court of Appeals had upheld the termination of Roger Weese’s temporary total disability benefits and rejected a follow-up MRI of his lower back, according to an April 15 decision by the West Virginia Supreme Court.
The Supreme Court has now reversed that ruling, concluding the decisions were premature and not supported by the weight of medical evidence.
Weese, an auto technician at Harry Green Chevrolet, suffered a workplace injury on January 4, 2021, when his right hand was crushed between a moving car tire and a strut.
He also reported immediate pain radiating from his back into his right leg. Though he attempted to keep working, the pain became too severe within a week, prompting him to seek medical treatment.
Following initial evaluations, including an MRI in February 2021, Weese was diagnosed with lumbar radiculopathy and a possible herniated disc.
The claim administrator approved TTD benefits for a limited period and held the claim compensable for “low back” injury. However, by the end of 2021, the claim administrator closed the case for TTD benefits and denied a repeat MRI, relying on a medical report from Dr. Joseph Grady, who concluded Weese had reached maximum medical improvement and could return to full-duty work.
Dr. Grady’s assessment, however, came under scrutiny. The Supreme Court found his conclusions rested on a faulty premise: he repeatedly referred to Weese’s compensable condition as “lumbar sprain,” whereas the official claim recognized the broader term “low back.”
The court also noted that Dr. Grady had not reviewed the results of a recent functional capacity evaluation showing Weese was still physically limited and could not safely resume work duties.
In contrast, Weese’s treating physician, Dr. Russell Biundo, consistently documented ongoing symptoms and maintained that Weese had not reached MMI. He and his physician assistant assessed that a second MRI was necessary before determining if Weese could return to work.
This view was supported by a physical therapist who performed the functional evaluation, as well as another independent medical examiner, Dr. Christopher Martin, who suggested that imaging results might be linked to the injury.
The ICA had reasoned that a second MRI was not warranted because a herniated disc was not explicitly listed as a compensable injury. The Supreme Court rejected that reasoning, noting that the original diagnosis of “low back” encompassed a range of conditions, including the herniated disc, which had been noted from the start.
"Based on all of the foregoing, we conclude that the preponderance of the medical evidence demonstrates that Petitioner’s compensable “low back” injury had not reached MMI when the claim administrator entered the two orders closing his claim for TTD benefits and denying the requested MRI for the lumbar spine," the judges wrote in the decision. "Therefore, we reverse the ICA’s decision and remand this matter to the BOR with directions for entry of an order consistent with our rulings herein."
The court found the majority of medical evidence showed Weese’s condition had not stabilized and further diagnostic evaluation was necessary.
The case has been remanded to the Workers’ Compensation Board of Review with instructions to reopen the TTD benefits and approve the additional MRI.
West Virginia Supreme Court of Appeals case number: 23-340