Appeal No. 2051150) (Claim No. 2015026892)
Darrin Dillon, by Reginald D. Henry, his attorney, appeals
the decision of the West Virginia Workers' Compensation
Board of Review. Raleigh County Board of Education, by T.
Jonathon Cook, its attorney, filed a timely response.
issue on appeal is the compensability of the claim for carpal
tunnel syndrome. The claims administrator denied the claim on
April 29, 2015. The Office of Judges affirmed the denial of
the claim in its March 8, 2016, Order. The Order was affirmed
by the Board of Review on August 31, 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 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
Dillon worked for the Raleigh County Board of Education for
nineteen years as a custodian. He stopped working for the
Raleigh County Board of Education on March 17, 2013. On March
24, 2014, Mr. Dillon alleged he had bilateral carpal tunnel
syndrome due to his work as a custodian. On March 11, 2013,
about a week prior to his last day of employment with the
school board, Barry Vaught, M.D., performed an electromyogram
due to Mr. Dillon's complaints of numbness in his right
hand. The test was normal with no evidence of carpal tunnel
syndrome on either his right or left hand.
S. Saikali, M.D., started treating Mr. Dillon for rheumatoid
arthritis on June 19, 2013. Dr. Saikali noted tenderness on
the small joints of the hands and feet of Mr. Dillon.
the degree of pain exhibited was greater than it should have
been based on the objective findings. On July 31, 2013, Dr.
Saikali diagnosed osteoarthritis and chronic pain syndrome.
He found no clinical evidence of rheumatoid arthritis even
though Mr. Dillon's rheumatoid factor was elevated. On
November 14, 2013, Mr. Dillon advised Dr. Saikali that he was
experiencing pain and discomfort in the hands associated with
morning stiffness, which was worse on cold days. Dr. Saikali
again noted Mr. Dillon showed no evidence of rheumatoid
arthritis, even though his rheumatoid factor was positive.
Dillon continued to treat with Dr. Saikali in 2014. On May 5,
2014, Mr. Dillon told Dr. Saikali that he was having
bilateral hand pain and had problems gripping things. He was
given a Depo-Medrol injection and a prescription for Lodine
and Plaqueril. On July 7, 2014, Dr. Saikali noted Mr. Dillon
continued to experience hand pain and discomfort associated
with stiffness upon waking. Mr. Dillon denied any numbness or
tingling. Dr. Saikali diagnosed generalized osteoarthritis.
On October 7, 2014, Dr. Saikali noted Mr. Dillon continued to
complain of pain in his left hand. He has more pain around
the second and third metacarpophalangeal joints, as well as
stiffness and numbness at night. Dr. Saikali noted he was
tested for carpal tunnel syndrome two years ago and the
testing was normal. Dr. Saikali diagnosed generalized
osteoarthritis, but also noted possible carpal tunnel
syndrome as evidenced by the numbness and tingling. He
recommended a nerve test.
Vaught performed an electromyogram on October 24, 2014. The
testing revealed evidence of mild bilateral median
mononeuropathy at the wrists, consistent with carpal tunnel
syndrome. Dr. Vaught diagnosed carpal tunnel syndrome. On
January 7, 2015, Mr. Dillon was seen for follow-up of his
osteoarthritis by Ruth Rhodes, PA-C, in Dr. Saikali's
office. He complained of pain in his hands, hips, and feet.
The most pain was in his left arm where he underwent left
bicep tendon rupture repair the previous week. Ms. Rhodes
diagnosed osteoarthritis with history of positive rheumatoid
factor and recommended he continue taking Lodine.
March 11, 2015, Mr. Dillon submitted the Employee's and
Physicians' Report of Occupational Injury or Disease
stating he developed hand and wrist problems from repetitive
bending of the wrist and use of tools associated with his
work. Michael Kaminsky, D.C., completed the physician's
section of the form. He noted Mr. Dillon had a bilateral
repetitive stress injury as a result of his work.
Kaminsky stated in a narrative report dated April 6, 2015,
that Mr. Dillon sustained an occupational disease as a result
of his essential work tasks over several years while working
as a custodian/janitor. He started having numbness and
tingling in his hands several years ago. He started to
experience problems with gripping, pushing, pulling, and
working with tools. The numbness and tingling in Mr.
Dillon's hands eventually started waking him up at night.
He altered his activities and used ice and braces but the
symptoms progressed. In Dr. Kaminsky's opinion, Mr.
Dillon's use of power tools, repetitive pulling, and
gripping was the primary precipitating fact in the
development of median nerve neuropathy consistent with carpal
tunnel syndrome. In his opinion, the carpal tunnel syndrome
was directly related Mr. Dillon's occupational work
requirements. Dr. Kaminsky recommended physical medicine
treatments and an orthopedic evaluation.
claims administrator rejected the claim on April 29, 2015. On
June 18, 2015, Dr. Kaminsky completed the Physician Interview
Questions for Carpal Tunnel Claims which stated he examined
Mr. Dillon for the first time on March 11, 2015. Mr. Dillon
had a history of cervical spondylosis. Based on his
evaluation, Mr. Dillon had tenderness and a positive
Phalen's sign in the left hand, as well as tenderness, a
positive Tinel's sign, and a positive Phalen's sign
in the right hand. Dr. Kaminsky listed the diagnosis as
bilateral carpal tunnel syndrome and opined the condition was
a consequence of Mr. Dillon's work.
22, 2015, Dr. Saikali saw Mr. Dillon for follow-up of his
osteoarthritis and early rheumatoid arthritis seropositive.
He diagnosed osteoarthritis, rheumatoid factor, high tier
positive and early inflammatory arthritis secondary to
rheumatoid arthritis. Dr. Saikali did not see swelling or
synovitis. He prescribed Plaqueril. Mr. Dillon was seen by
Dr. Saikali again on October 22, 2015 for follow-up of his
osteoarthritis and early rheumatoid arthritis seropositive.
Dr. Saikali noted Mr. Dillon complained of pain and
discomfort in the hands, wrists, and elbows with stiffness
and swelling. Dr. Saikali diagnosed rheumatoid arthritis,
early disease. He noted most of Mr. Dillon's symptoms
were osteoarthritis and chronic pain.
November 20, 2015, Mr. Dillon testified at a hearing before
the Office of Judges.He stated that his job as a custodian
required him to maintain the school grounds, clean the inside
and outside of buildings, mow, sweep, and take out trash. He
used heavy duty mops, dust mops, and scrubbing machines. He
also used a propane buffer which had a seventeen horsepower
propane engine to polish and shine floors about one hour per
day. In 2010, he noticed pain and numbness in his hands and
felt like his hands quit functioning. He had pain in his
hands and he started to drop things. Surgery had been
recommended, but he did not want to have surgery. He
continued to have numbness and fatigue in his hands. He
stopped working in 2013 due to pain in his back and hands. He
has high blood pressure, high ...