JAMES P. MOYLE, Claimant Below, Petitioner
PATTON BUILDING SERVICES, INC., Employer Below, Respondent
Appeal No. 2051076, Claim No. 2015015153
James P. Moyle, by Robert L. Stultz, his attorney, appeals
the decision of the West Virginia Workers' Compensation
Board of Review. Patton Building Services, Inc., by Timothy
E. Huffman, its attorney, filed a timely response.
issues on appeal are whether Mr. Moyle is entitled to
additional temporary total disability benefits and whether he
is entitled to medical treatment for his lumbar spine. On
June 1, 2015 and June 15, 2015, the claims administrator
denied a request for payment of temporary total disability
benefits. On July 9, 2015, the claims administrator denied
authorization for an L3-L4 and L4-L5 decompressive
laminotomy. The Office of Judges affirmed the three decisions
in its February 1, 2016, Order. The Order was affirmed by the
Board of Review on July 8, 2016. The Court has carefully
reviewed the records, written arguments, and appendices
contained in the briefs, and the case is mature for
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
Moyle, a maintenance worker, slipped on a bumper getting out
of a truck on November 6, 2014. His claim was originally
denied by the claims administrator on December 8, 2014, but
was later held compensable for lumbar sprain/strain and
cervical sprain/strain by Order of the Office of Judges on
March 26, 2015. Prior to slipping on the bumper, Mr.
Moyle sought medical treatment with Bill Underwood, M.D., for
chronic lumbar spine pain in early 2013. A May 31, 2013,
lumbar MRI revealed disc bulging at L1-L2 and L3-L4 as well
as facet degenerative changes and disc herniation at L4-L5
with thickening of the ligamentum flavum and facet
degenerative changes. However, due to the severity of his
cervical spine condition, Dr. Underwood recommended he treat
the cervical spine first. On June 20, 2013, he underwent a
cervical spine fusion at C4-C7.
Moyle received epidural steroid injections at L4-L5 on August
15, 2013, and at L3-L4 on August 22, 2014. Mr. Moyle also had
a lumbar MRI on August 22, 2014, that revealed multilevel
degenerative changes including an L5-S1 disc herniation,
L1-L2 and L3-L4 disc bulges, an L4-L5 disc herniation, and
spinal stenosis. He was diagnosed with intractable low back
pain, degenerative lumbar spinal stenosis, lumbar disc
herniation, and right leg numbness.
November 6, 2014, Mr. Moyle slipped on a bumper getting off
of a truck. On December 1, 2014, he was seen by Dr. Underwood
for complaints of lumbosacral pain radiating to the right
anterior thigh, bilateral gluteal region, and down his right
leg. The results of a January 9, 2015, lumbar MRI were
essentially unchanged in appearance to the lumbar spine and
multilevel degenerative changes and associated disc
herniations seen on the August 22, 2014, lumbar MRI.
Moyle testified via deposition on January 30, 2015, that he
was injured on November 6, 2014, when he slipped on the
bumper of his truck and fell. He experienced immediate back
pain. Mr. Moyle sought medical treatment on November 13,
2014. He was assigned work restrictions and prescribed
medication. He returned to work on restricted duty. His last
day of work was November 20, 2014. He said he was treated by
Dr. Underwood in 2013 for back pain and right leg numbness.
Dr. Underwood told him his spinal cord was ready to snap.
Moyle was treated by Dr. Underwood on April 24, 2015, for
complaints of lumbar and cervical pain. Dr. Underwood noted
Mr. Moyle had cervical spine pain and had been experiencing
persistent left arm numbness and weakness since 2010. Dr.
Underwood noted Mr. Moyle had previously received lumbar
epidural steroid injections. The injections reportedly only
provided two weeks of relief. Additionally, Mr. Moyle had
been diagnosed with back pain and spinal stenosis in May of
2013. Dr. Underwood diagnosed lumbar spinal stenosis, lumbar
foraminal stenosis, lumbar disc herniation, lumbar
radiculopathy, severe lumbar pain, and paresthesia of the
right leg. He recommended a decompressive laminotomy of the
L3-L4, L4-L5, and right foraminotomy of L3-L4.
Thaxton, M.D., performed a medical records review on May 4,
2015. She recommended obtaining a second opinion regarding
the need for surgery as well as additional medical records
regarding Mr. Moyle's lumbar spine problem. She noted Mr.
Moyle had spine degeneration prior to the work injury as
evidenced by the August 22, 2014, lumbar spine MRI. The
January 9, 2015, lumbar MRI results were similar to the
August 22, 2014, results.
Grady, M.D., performed an independent medical evaluation on
May 14, 2015. Mr. Moyle's chief complaint was discomfort
in his neck and lower back. Dr. Grady noted that Mr. Moyle
was seen on October 16, 2014, for a constant aching sensation
in his lower back and numbness and needle like sensations in
his right leg. He had been prescribed Neurontin, Tramadol,
and Lyrica. Mr. Moyle understood that he needed surgery for
his back prior to the date of injury. Dr. Grady diagnosed
cervical myofascial sprain superimposed on previous fusion
from C4 to C7 and resolved lumbar sprain superimposed on
pre-existing multilevel degenerative spondylosis. He noted
Mr. Moyle had a longstanding history of symptoms related to
his neck and lower back with numerous imaging studies and
invasive procedures being done in those areas in the past. In
his opinion, Mr. Moyle had reached maximum medical
improvement for the neck sprain and lumbar sprain. The
surgery recommended by Dr. Underwood was not related to the
compensable conditions. It would address the diffuse
structural abnormalities found on imaging studies prior to
the work injury.
Watkins, M.D., completed an attending physician report on May
18, 2015, requesting that spinal stenosis, sciatica, and
cervicalgia be added as compensable diagnoses. She noted Mr.
Moyle had been prescribed Flexeril, Naproxen, and Neurontin.
She also noted that Mr. Moyle was temporarily and totally
disabled from November 6, 2014, through November 1, 2015,
based on her April 20, 2015, examination of him.
Moyle was seen by Russell Biundo, M.D., on May 27, 2015, for
a follow-up for lumbosacral stenosis. Dr. Biundo noted it was
difficult for him to return to work as he had a lot of back
pain. Dr. Biundo noted Mr. Moyle had received an epidural
injection in the past which provided temporary relief. He
completed an attending physician's report noting an
accepted diagnosis of cervical fusion and requesting an
additional diagnosis of lumbar stenosis. Dr. Biundo opined
Mr. Moyle was temporarily and totally disabled from May 27,
2015, through August 27, 2015.
1, 2015, the claims administrator denied a request for
temporary total disability benefits from Dr. Watkins as the
attending physician's report she submitted could not be
accepted because no medical documents had been received from
Dr. Watkins and disability could not be certified for periods