SHELIA M. BROWN, Claimant Below, Petitioner
CAMC TEAYS VALLEY HOSPITAL, Employer Below, Respondent
Appeal No. 2051166) (Claim No. 2013028806)
Shelia M. Brown, by Patrick K. Maroney, her attorney, appeals
the decision of the West Virginia Workers' Compensation
Board of Review. CAMC Teays Valley Hospital, by H. Dill
Battle III, its attorney, filed a timely response.
issue on appeal is whether Ms. Brown is entitled to
additional medical benefits. This appeal originated from the
May 6, 2015, claims administrator's decision denying
maintenance treatment. In its February 26, 2016, Order, the
Workers' Compensation Office of Judges affirmed the
decision. The Board of Review's Final Order dated August
2, 2016, affirmed the Order of the Office of Judges. The
Court has carefully reviewed the records, written arguments,
and appendices contained in the briefs, and the case is
mature for consideration.
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
M. Brown, a Health Unit Coordinator, was injured in the
course of her employment on April 3, 2013, when she attempted
to lift a patient and felt a pop in her lower back followed
by a burning sensation. Ms. Brown sought treatment a few
weeks later and was diagnosed with sprain of the lumbosacral
joint ligament, displacement of lumbar intervertebral disc
without myelopathy, sciatica, and spasm of muscle. An MRI of
the lumbar spine taken on April 29, 2013, revealed a small
central disc protrusion at L5-S1 touching the nerve roots at
this level, causing mild canal narrowing. On May 8, 2013, the
claims administrator held the claim compensable for sprain of
the lumbosacral joint ligament.
Brown sought the opinion of two neurosurgeons. On August 20,
2013, Panos Ignatiadis, M.D., evaluated Ms. Brown. He noted
that the MRI findings revealed mild degenerative changes at
L3-4 and L4-5 and a small central protrusion at L5-S1, which
were not sufficient to account for Ms. Brown's symptoms
or to render her for surgical proposition. Dr. Ignatiadis
recommended physical therapy and work conditioning, as well
as undergoing a functional capacity evaluation. He concluded
that Ms. Brown probably had a lumbar sprain with concomitant
central disc protrusion, albeit small at L5-S1, and dormant
pre-existing mild degenerative changes at L3-4 and L4-5,
aggravated by the work-related injury. On November 4, 2013,
Robert Crow, M.D., evaluated Ms. Brown and stated that he
would not suggest surgical intervention in the form of a
laminectomy, discectomy, or fusion without further imaging.
He recommended an injection on the right S1 nerve root along
with continued physical therapy.
November 5, 2013, Ms. Brown underwent an EMG study. The
report indicated that the study was normal for the legs and
neither neuropathy nor radiculopathy were demonstrated. On
November 12, 2013, an MRI was performed and compared to the
one taken on April 29, 2013. There was significant
improvement at the L5-S1 level.
January 9, 2014, Ms. Brown underwent an independent medical
evaluation performed by Marsha Bailey, M.D. Ms. Brown
reported constant right lower back pain with radiation into
her right buttocks, right posterior and lateral leg, and
right foot. She also complained of numbness and her leg
giving out, which resulted in repeated falls. Dr. Bailey
diagnosed Ms. Brown with a history of chronic lower back pain
without true radiculopathy. Dr. Bailey noted that Ms. Brown
had a substantial amount of symptom magnification at the time
of the evaluation. Ms. Brown's subjective complaints
grossly outweighed the objective findings and were
inconsistent with the MRI findings. Dr. Bailey opined that
Ms. Brown's repeated falls could not be attributed to the
compensable injury. Dr. Bailey stated that due to Ms.
Brown's substantial amount of symptom magnification,
meager MRI findings, normal nerve conduction studies, and
failure of all reasonable treatment to date, it was highly
unlikely that any further treatment would improve her
symptoms. Dr. Bailey felt that any treatment would not be
medically necessary for her compensable injury and found that
Ms. Brown had reached maximum medical improvement.
Brown underwent a functional capacity evaluation on February
19, 2014. Ms. Brown tested at the light physical demand level
with lifting of twenty pounds on an occasional and frequent
basis. The evaluator found that there were some remarkable
findings that may suggest symptom magnification and
submaximal effort, and a repeat evaluation may be warranted
for assessment of consistency.
the course of her injury, Ms. Brown sought treatment from
Anthony Erwin, D.C. Dr. Erwin assessed displacement lumbar
intervertebral disc, thoracic pain, sciatica, and cervical
disc bulge. He subsequently completed a diagnosis update in
an effort to have these diagnoses added to the claim. On July
22, 2014, the claims administrator denied the request to add
the secondary diagnoses to the claim, and the Office of
Judges subsequently affirmed the decision.
Erwin authored a letter on August 21, 2014, stating that Ms.
Brown's initial diagnoses were lumbar sprain/strain,
displaced lumbar intervertebral disc, sciatica, and muscle
spasm. A lumbar MRI taken on April 29, 2013, demonstrated
L3-4 mild diffuse posterior extension of the disc and L5-S1
seemed to have central disc protrusion, and the radiologist
said it touched the central nerve roots causing mild canal
narrowing. Dr. Erwin said there was no mention of
degenerative changes. A second lumbar MRI taken on November
12, 2013, found partial desiccation and narrowing with
central disc herniation at L5-S1. Dr. Erwin last saw Ms.
Brown on July 1, 2014, and she reported continued lower back
pain with radiation. He opined that the overall outlook for
Ms. Brown was poor and that she suffered from a permanent
disabling condition as a result of the work-related injury.
Dr. Erwin recommended periodic care for chronic flare-ups of
pain and thus requested authorization for continued
Brown testified in a deposition on October 30, 2014, that
prior to the compensable injury, she never had any problems,
nor had she been diagnosed with any degenerative back issues.
After the injury, her pain worsened so that she could not
sit, stand, or lay down. Ms. Brown stated that she continued
to have low back issues, with pain in her lower back into her
tailbone and pain into her buttocks, hip, and down her right
leg. Ms. Brown stated it constantly burns and she has
electric-like feelings and muscle spasms. She has difficulty
sleeping, walking, and performing many normal activities.
6, 2015, the claims administrator denied the maintenance
treatment requested by Dr. Erwin. The Order stated that the
request was denied on the basis that Dr. Bailey opined that
Ms. Brown had reached maximum medical improvement. Further,
it was found that Ms. Brown was far outside the guidelines
for a simple sprain/strain of the lumbar spine and that the
complaints could not be attributable to a simple
Bailey testified in a deposition on August 11, 2015, that she
agreed with the compensable diagnosis of lumbosacral joint
ligament sprain. She did not agree with the other diagnoses
Dr. Erwin was attempting to have added to the claim. Dr.
Bailey opined that the disc protrusions and bulges indicated
by the lumbar MRIs were normal, age-related findings and that
there were not any acute findings to suggest any type of
injury-related pathology. It was Dr. Bailey's opinion
that no additional ...