Charles G. Delbert v. Consolidation Coal Co.

Summary

The Supreme Court of Appeals of West Virginia affirmed the denial of attorney’s fees and costs following the reversal of a claims administrator’s denial of Gabapentin and Metaxalone in a workers’ compensation claim. The Court held that the denial was not unreasonable under West Virginia Code § 23-2C-21(c) because the medications had also been requested in a separate claim involving a different injury. The Court found no clear legal or factual error in the Board of Review’s decision.

Holdings

1. A claimant's successful reversal of a denial of medical benefits does not automatically entitle the claimant to attorney’s fees and costs; the denial must have been unreasonable under West Virginia Code § 23-2C-21(c).
2. The Board of Review did not clearly violate a constitutional or statutory provision, clearly err in its legal conclusions, or materially misstate or mischaracterize the evidentiary record; therefore, its decision was affirmed.

Questions Presented

1. Whether Delbert was entitled to attorney’s fees and costs under West Virginia Code § 23-2C-21(c) after successfully obtaining reversal of the denial of workers’ compensation medications.
2. Whether the claims administrator’s denial of Gabapentin and Metaxalone was unreasonable when made.

Disposition

affirmed