Summary
The Supreme Court of Appeals of West Virginia affirmed a Workers’ Compensation Board of Review decision reinstating temporary total disability benefits for Charles Richardson and authorizing right shoulder arthroscopy. The court held that the evidence supported the finding that Richardson remained temporarily and totally disabled and that the surgery was medically related and reasonably required to treat his compensable shoulder injury.
Topics
Practice areas
Questions Presented
- Whether the Board of Review properly affirmed the determination that Richardson remained temporarily and totally disabled after the claims administrator closed his temporary total disability benefits.
- Whether the Board of Review properly affirmed authorization of right shoulder arthroscopic surgery as medically related and reasonably required to treat Richardson’s compensable injury.
- Whether the Board of Review’s decision was clearly erroneous under the applicable deferential standard of review.
Holdings
- The Board of Review properly affirmed the determination that Richardson continued to be temporarily and totally disabled because the treating physician’s notes showed that he could not raise his arm above his head and that the limitation prevented him from performing his job.
- The Board of Review properly affirmed authorization of right shoulder arthroscopic surgery because the procedure was medically related and reasonably required to treat Richardson’s compensable shoulder injury.
- The Board of Review’s decision was not in clear violation of a constitutional or statutory provision, was not clearly the result of erroneous conclusions of law, and was not based on a material misstatement or mischaracterization of the evidentiary record.
Key quotations
“For the foregoing reasons, we find that the decision of the Board of Review is 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.” (2-3)
Factual background
Charles Richardson, a United Parcel Service driver, injured his right shoulder on July 2, 2010, while pulling a dolly loaded with packages. He was diagnosed with a partial rotator cuff tear and impingement syndrome, and the claim was held compensable. Although one independent medical evaluator concluded that Richardson had reached maximum medical improvement and another physician questioned whether surgery would help, Richardson’s treating physician documented continuing range-of-motion limitations, inability to raise his arm above his head, and the need for arthroscopic surgery to investigate and treat the condition.
Procedural history
The claims administrator closed Richardson’s temporary total disability claim and denied authorization for arthroscopic shoulder surgery on September 1, 2011. The Workers’ Compensation Office of Judges reversed both decisions on May 10, 2012, and ordered payment of benefits supported by proper medical evidence and authorization of the surgery. The Board of Review affirmed on October 25, 2012. The Supreme Court of Appeals affirmed the Board’s decision.