Narrative Opinion Summary
The petitioner sought to appeal a decision from the West Virginia Workers’ Compensation Board of Review regarding the closure of his temporary total disability benefits, initially granted following a lumbar sprain sustained in April 2014. The petitioner received benefits from April 25, 2014, to May 12, 2014, and underwent various treatments, including chiropractic care and physical therapy, but continued to experience pain. An independent medical evaluation suggested he had reached maximum medical improvement with light-duty restrictions. Despite a 6% impairment assessment and a permanent partial disability award, his benefits were terminated on August 27, 2014. The Office of Judges and the Board of Review supported the claims administrator's decision, finding no legal or procedural errors, and their decision was affirmed by the Court. The Court determined that the petitioner reached maximum medical improvement, returned to work, and did not identify any constitutional or statutory violations in the adjudication process.
Legal Issues Addressed
Maximum Medical Improvement and Termination of Benefitssubscribe to see similar legal issues
Application: The petitioner was found to have reached maximum medical improvement, which justified the closure of his temporary total disability benefits.
Reasoning: The claims administrator denied Dr. Young’s request for additional steroid injections on July 22, 2014, asserting Mr. Thompson had reached maximum medical improvement by June 30, 2014, and citing minimal degenerative changes in the MRI.
Permanent Partial Disability Awardsubscribe to see similar legal issues
Application: The petitioner was assessed with a 6% impairment and granted a permanent partial disability award following the diagnosis of a lumbar sprain.
Reasoning: Mr. Thompson was assessed with a 6% impairment under West Virginia Code of State Rules 85-20-C (2006) following a lumbar sprain diagnosis by Dr. Young on June 10, 2014.
Requirement for Reevaluation of Extended Treatmentsubscribe to see similar legal issues
Application: The petitioner was not reevaluated as required under West Virginia Code 85-20-37.6 for strains/sprains exceeding eight weeks of treatment.
Reasoning: West Virginia Code 85-20-37.6 (2006) required reevaluation for strains/sprains exceeding eight weeks of treatment, which was not provided.
Review and Affirmation by Judicial Bodiessubscribe to see similar legal issues
Application: The Office of Judges and the Board of Review upheld the claims administrator's decision to close the claim, finding no substantial legal questions or prejudicial errors.
Reasoning: The case was reviewed by the Office of Judges and the Board of Review, both of which upheld the claims administrator's decision to close the claim, finding no substantial legal questions or prejudicial errors in the process.