Appeal No. 2051030, Claim No. 2015031223
West Virginia University, by H. Dill Battle III, its
attorney, appeals the decision of the West Virginia
Workers' Compensation Board of Review.
issue on appeal is whether Mrs. Rodeheaver's claim is
compensable. On July 1, 2015, the claims administrator denied
compensability of the claim. The Office of Judges reversed
the decision and held the claim compensable for bilateral
knee injuries in its December 10, 2015, Order. The Order was
affirmed by the Board of Review on May 20, 2016. The Court
has carefully reviewed the records, written arguments, and
appendices contained in the briefs, and the case is mature
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 that the Board of Review's decision is
clearly wrong based upon the evidentiary record. This case
satisfies the "limited circumstances" requirement
of Rule 21(d) of the Rules of Appellate Procedure and is
appropriate for a memorandum decision rather than an opinion.
Rodeheaver, a cook, asserts she was injured on May 17, 2015,
when she was getting out of a van and twisted her knees. Ms.
Rodeheaver sought treatment for the first time on June 17,
2015, when she was treated by Lawrence Scalzo, D.O., with
MedExpress. Ms. Rodeheaver provided a history of having
twisted both knees while getting out of a van at work on May
17, 2015. She stated she had been in continuous pain since
that time. On examination, Ms. Rodeheaver had limited range
of motion on flexion and extension due to pain. X-rays
revealed no evidence of fracture or effusion. Dr. Scalzo
diagnosed knee pain of an uncertain cause. He prescribed
medication and recommended she follow-up with a specialist.
claims administrator rejected the claim on July 1, 2015, as
the medical records did not support that an achy pain in Ms.
Rodeheaver's bilateral knees was the result of the May
17, 2015, injury. On July 22, 2015, Erica Murray, PA-C, with
MedExpress, saw Ms. Rodeheaver who stated her knee was
getting worse as she felt it snapping. She also said the pain
was worse when she was on her feet for long periods of time.
Ms. Rodeheaver reported the pain was brought on suddenly, and
she denied twisting her knees or falling. She had a history
of similar symptoms in the past. On examination, Ms.
Rodeheaver had full range of motion on flexion and extension,
but it was painful. She also had swelling of the knees,
tenderness to palpation in both patella, and crepitus on
palpation of both patellas. Ms. Rodeheaver was given a shot
of Toradol. Ms. Murray diagnosed arthritis and knee pain and
recommended follow-up with physical therapy.
August 15, 2015, Ward Pain, M.D., provided Ms. Rodeheaver a
release to return to work with no restrictions. Ms.
Rodeheaver wrote on the slip that she had the doctor release
her because she could not afford to pay to keep going back
and forth for her knee since workers' compensation had
denied her benefits.
December 10, 2015, the Office of Judges reversed the claims
administrator's July 1, 2015, decision and held the claim
compensable for bilateral knee injury. It found the claim
should be held compensable for an injury to the knee,
although it was unknown exactly what the injury was. It
determined that it was very likely that Ms. Rodeheaver
sprained both knees but that the treating physician could
furnish evidence to the claims administrator at a later time
as to what the precise diagnosis is. The Office of Judges
also determined that the lack of a precise diagnosis should
not prevent the claim from being held compensable. It
concluded that Ms. Rodeheaver suffered a compensable injury
to both knees on May 17, 2015.
Board of Review adopted the findings of fact and conclusions
of law of the Office of Judges and affirmed its Order on May
20, 2016. After review, we disagree with the Board of Review.
Ms. Rodeheaver failed to prove she suffered a compensable
injury on May 17, 2015. The evidence shows she was seen for
pain in her knees on June 17, 2015, and July 22, 2015. A
preponderance of the evidence shows Ms. Rodeheaver had achy
knees. It does not show that the knee pain she was
experiencing was due to her twisting her knees while getting
out of a van. There is no evidence of medical treatment until
at least one month following the alleged injury, and there is
certainly no evidence that Ms. Rodeheaver experienced
sprained knees as the result of this alleged injury. It was
Ms. Rodeheaver's burden to prove she was injured at work,
and the submission of two medical records showing she had
pain in her knees is insufficient proof.
foregoing reasons, we find that the decision of the Board of
Review is clearly wrong based upon the evidentiary record.
Therefore, the decision of the Board of Review is reversed
and remanded with instructions to reinstate the claims
administrator's July 1, 2015, decision rejecting the
CONCURRED IN BY: Chief Justice Allen H. Loughry II Justice
Menis E. ...