Sherry L. Key v. W. Va. Office of Insurance Commissioner/Wal-Mart
Docket: 11-1021
Court: West Virginia Supreme Court; April 19, 2013; West Virginia; State Supreme Court
Original Court Document: View Document
Sherry L. Key appeals a decision from the West Virginia Workers’ Compensation Board of Review regarding her claim for a referral to a pain clinic following injuries sustained at work on August 26, 2009, due to a falling security gate. Key suffered injuries to her right hand, back, and right ankle, received initial treatment at an emergency room, and subsequently followed up with her family physician. After missing two days of work, she returned without limitations and underwent various therapies. The claims administrator denied her request for a pain clinic referral, which was upheld by the Office of Judges based on West Virginia Code of State Rules §85-20-49.5(d). This regulation stipulates that a referral requires evidence of significant temporary total disability or psychosocial barriers to rehabilitation. Key did not meet these criteria, as she returned to work quickly and there was no evidence of psychosocial issues affecting her recovery. The Board of Review affirmed the Office of Judges' findings, concluding that the referral was not medically necessary. The Supreme Court of Appeals reviewed the case and found no substantial legal questions or prejudicial errors in the lower decisions. Consequently, the Board of Review's decision was upheld, affirming the denial of Key's request for a pain clinic referral. The ruling was issued on April 19, 2013, with all justices concurring.