James D. White v. Consolidation Coal Company ( 2017 )


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  •                               STATE OF WEST VIRGINIA
    SUPREME COURT OF APPEALS
    FILED
    September 15, 2017
    JAMES D. WHITE,                                                                   RORY L. PERRY II, CLERK
    Claimant Below, Petitioner                                                      SUPREME COURT OF APPEALS
    OF WEST VIRGINIA
    vs.)   No. 16-1096 (BOR Appeal No. 2051184)
    (Claim No. 860042131)
    CONSOLIDATION COAL COMPANY,
    Employer Below, Respondent
    MEMORANDUM DECISION
    Petitioner James D. White, by William B. Talty, his attorney, appeals the decision of the
    West Virginia Workers’ Compensation Board of Review. Consolidation Coal Company, by
    Bradley A. Crouser, its attorney, filed a timely response.
    The issue on appeal is the amount of permanent partial disability Mr. White sustained as a
    result of his compensable right knee injury. The claims administrator granted a 4% permanent
    partial disability award on July 11, 2013. The Office of Judges affirmed the decision in its March
    2, 2016, Order. The Order was affirmed by the Board of Review on September 27, 2016. The
    Court has carefully reviewed the records, written arguments, and appendices contained in the
    briefs, and the case is mature for consideration.
    This Court has considered the parties’ briefs and the record on appeal. The facts and legal
    arguments are adequately presented, and the decisional process would not be significantly aided
    by oral argument. Upon consideration of the standard of review, the briefs, and the record
    presented, the Court finds no substantial question of law and no prejudicial error. For these reasons,
    a memorandum decision is appropriate under Rule 21 of the Rules of Appellate Procedure.
    Mr. White, a coal tipple operator and mechanic, was injured in the course of his
    employment on January 18, 1986, when his right knee was struck by a heavy pipe. The claim was
    originally held compensable for sprain/strain of the knee/leg and later for loose body in knee and
    lesion in lateral peroneal nerve.
    A February 23, 2012, treatment note by Yogesh Chand, M.D., indicates Mr. White was
    doing much better after right knee surgery. He had no numbness or tingling of his right foot but
    did still experience a burning sensation. He indicated that Mr. White had arthritis of the knee and
    as a result of loose bodies digging into the articular surface, the condition was steadily
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    degenerating. He did not require a total arthroplasty at that time. Dr. Chand opined that Mr. White
    had reached maximum medical improvement.
    On June 26, 2013, Joseph Grady, M.D., performed an independent medical evaluation in
    which he found that Mr. White had reached maximum medical improvement. At that time, the
    compensable conditions in the claim were lesion of lateral popliteal nerve, loose body of knee,
    sprain of unspecified sites of the knee and leg, and sprain/strain of the knee and leg. Mr. White
    worked until November 10, 1999, when he sustained a lower back injury. A July 6, 2009, MRI of
    the right knee showed myxoid degeneration of the medial meniscus without a definite tear. An
    EMG revealed right peroneal neuropathy. On November 16, 2011, Mr. White underwent a right
    knee arthroscopy. He continued to treat with Dr. Chand on a regular basis. On examination, Dr.
    Grady noted Mr. White’s right knee flexion was 115 degrees for the right knee and 130 for the
    left. Knee extension was normal. Dr. Grady diagnosed status post right knee arthroscopy and
    repositioning of the peroneal nerve with some residual peroneal neuropathy. Using the American
    Medical Association’s Guides to the Evaluation of Permanent Impairment (4th ed. 1993), Dr.
    Grady found no specific ratable impairment for Mr. White’s knee surgery under Table 64. Based
    on range of motion, he assessed a 0% impairment rating. For the peroneal nerve injury, he found
    0% for the common peroneal nerve but did find 20% motor deficit. This equates to 3% whole
    person impairment. He also assessed 1% for abnormal sensation in the right foot. His total
    recommendation was 4% impairment. The claims administrator granted a 4% permanent partial
    disability award on July 11, 2013. On March 3, 2014, the claims administrator authorized a right
    foot brace requested by Dr. Chand.
    In a June 4, 2014, report, Dr. Chand estimated Mr. White’s impairment using the American
    Medical Association’s Guides. He indicated Mr. White had gait derangement for which he was
    using a cane and right knee brace, both on a full time basis. Using Table 36-F of the Guides, Dr.
    Chand assessed 30% whole person impairment. He made no mention of impairment for muscle
    atrophy. For range of motion he assessed 4% impairment. He recommended 8% impairment for
    right knee arthritis which he described as mild. Per Table 64, he assessed 5% impairment for Mr.
    White’s patella fracture. Dr. Chand also assessed 7% impairment for minor loss of function on
    dorsiflexion of the ankle due to the constant use of a brace. His total combined recommendation
    was 36% impairment.
    On July 7, 2014, Mr. White requested that the Office of Judges take judicial notice of a
    February 19, 2013, Order which added loose body in knee and lesion in lateral peroneal nerve as
    compensable components of the claim. He also asked that the March 21, 2013, Order authorizing
    arthroscopic surgery for the right knee, peroneal nerve entrapment release, and physical therapy
    be recognized.
    Syam Stoll, M.D., performed a medical record review on March 12, 2015, in which he
    noted that Mr. White was examined on January 19, 1986, and diagnosed with a right knee sprain.
    Dr. Stoll found per West Virginia Code of State Rules § 85-20 (2006) that the claim was beyond
    the treatment guidelines by twenty-nine years. He believed the present right knee issues were due
    to the natural aging process. He stated that loose bodies in the knee can be caused by degenerative
    joint disease. Based on Dr. Chand’s operating note, Dr. Stoll concluded Mr. White has a moderate
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    tricompartmental chondromalacia grade three, which would be a normal finding in a man of his
    age. He further concluded that the lack of medical records and treatment since 1986 leads to the
    conclusion that Dr. Chand’s assumption that Mr. White’s condition is work related is clearly not
    medically plausible or supported by the evidence.
    In a July 16, 2015, independent medical evaluation, Michael Condaras, M.D., concluded
    that Mr. White’s knee flexion was 112 degrees on the right. His range of motion was normal per
    the American Medical Association’s Guides. Dr. Condaras concluded Mr. White sustained a
    sprain/strain to the right knee twenty-nine years prior. He had returned to full duty work in July of
    1986 and did not seek further treatment until 2009. Any issues in the right knee are related to the
    normal aging process.
    In an August 6, 2015, letter, Dr. Chand challenged aspects of Dr. Condaras’s report,
    indicating that there are thirteen categories of impairment in the American Medical Association’s
    Guides which if not inclusive, need to be combined. In a second letter dated September 11, 2015,
    Dr. Chand stated that there are thirteen categories for determining impairment under the Guides.
    Only the highest of the non-inclusive ones should be given and then combined. Based on his
    reading of Dr. Condaras’s report, he only considered one aspect of the categories. Dr. Chand
    challenged Dr. Condaras’s findings. He noted that Dr. Condaras did not evaluate Mr. White’s
    peroneal nerve. He stated that the peroneal nerve injury was not an integral part of range of motion,
    loss of limb, or atrophy of the thigh. Therefore, the gait derangement method should be combined
    with the peroneal nerve injury.
    In a letter dated October 14, 2015, Dr. Condaras responded to Dr. Chand’s correspondence.
    He indicated that he saw no atrophy or muscle weakness in the knee or any evidence of gait
    derangement which would be attributable to Mr. White’s 1986 injury. Sensory testing showed
    some diminished sensation of an inconsistent pattern. Dr. Condaras agreed with Dr. Grady that
    there was 3% impairment for the peroneal nerve. He stated that the only viable category for rating
    Mr. White’s impairment was range of motion.
    The Office of Judges affirmed the claims administrator’s grant of a 4% permanent partial
    disability award on March 2, 2016. It found that the issue at hand is with regard to the technique
    employed to determine Mr. White’s right knee impairment. The only medical report suggesting
    that he should receive an impairment rating for gate derangement is that of Dr. Chand. Dr. Chand
    awarded 30% impairment for gait derangement based on Mr. White’s assertion that he uses a short
    leg brace and cane full-time. The Office of Judges found that the Americana Medical Association’s
    Guides state that for moderate severity, if the claimant requires the use of a cane or a crutch and
    short leg brace, 30% impairment is appropriate. However, the Office of Judges determined that
    while the short leg brace was authorized under the claim, there is no indication a cane was ever
    authorized. Also, Mr. White provided no report by Dr. Chand recommending the use of a cane.
    Therefore, the sole basis for Dr. Chand’s recommendation of 36% impairment is Mr. White’s
    assertion that he requires a brace and cane full time. Since the record contains no such
    representation from a physician, he was found to not fall into the moderate range of impairment
    and Dr. Chand’s report was determined to be unreliable. The Office of Judges further determined
    that he received minimal treatment for his 1986 injury until 2009. The compensable injury did not
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    cause Mr. White to cease his employment. Dr. Grady’s report was found to be a credible
    assessment of impairment, and Dr. Condaras’s report generally supports Dr. Grady’s findings. The
    Board of Review adopted the findings of fact and conclusions of law of the Office of Judges and
    affirmed its Order on September 27, 2016.
    After review, we agree with the reasoning and conclusions of the Office of Judges as
    affirmed by the Board of Review. Dr. Grady’s report is the most reliable of record and is supported
    by a preponderance of the evidence. Dr. Chand’s report is based upon nothing more than Mr.
    White’s assertion that he requires a brace and cane on a full-time basis. There is no medical
    evidence of record showing that a physician has ever reached that conclusion or made that
    recommendation. Dr. Chand’s report is therefore unreliable and Dr. Grady’s credible report was
    properly relied upon.
    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. Therefore, the decision of the Board of Review is affirmed.
    Affirmed.
    ISSUED: September 15, 2017
    CONCURRED IN BY:
    Chief Justice Allen H. Loughry II
    Justice Robin J. Davis
    Justice Margaret L. Workman
    Justice Menis E. Ketchum
    Justice Elizabeth D. Walker
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Document Info

Docket Number: 16-1096

Filed Date: 9/15/2017

Precedential Status: Precedential

Modified Date: 9/15/2017