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Casteel-Ellison v. New River Health Association, Inc.

Supreme Court of West Virginia

September 15, 2017

DEBRA L. CASTEEL-ELLISON, Claimant Below, Petitioner
v.
NEW RIVER HEALTH ASSOCIATION, INC., Employer Below, Respondent

         BOR Appeal No. 2051257, Claim No. 2015009955

          MEMORANDUM DECISION

         Petitioner Debra L. Casteel-Ellison, pro-se, appeals the decision of the West Virginia Workers' Compensation Board of Review. New River Health Association, Inc., by Lisa Warner Hunter, its attorney, filed a timely response.

         The issue on appeal is the compensability of the claim. On October 3, 2014, the claims administrator denied compensability of Ms. Casteel's claim for right carpal tunnel syndrome. The Office of Judges reversed the claims administrator's decision in its April 11, 2016, Order and held the claim compensable for right carpal tunnel syndrome. The Order was reversed by the Board of Review on September 1, 2016. The Board of Review vacated the Office of Judges' Order and reinstated the claim administrator's rejection of the claim. 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 that the Board of Review's decision is not supported by a preponderance of the evidence. 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.

         Ms. Casteel-Ellison, who is employed in data entry for New River Health Association, filed an application for workers' compensation benefits arising from a diagnosis of right carpal tunnel syndrome she sustained during the course of her employment. On September 16, 2014, Ms. Casteel-Ellison was seen by Whitney Boggs, M.D., for complaints of right hand swelling and pain. She provided a history of working on a computer, typing, and using a mouse. Dr. Boggs diagnosed carpal tunnel syndrome and recommended she wear splints. She saw Dr. Boggs again on September 25, 2014, when she reported that she had been icing her wrist at least once a day and that her hand first started hurting about six months ago. Dr. Boggs recommended she undergo nerve conduction velocity testing.

         The employee's and physician's report of occupational injury form was completed by Ms. Casteel-Ellison and Dr. Boggs on September 24, 2014. Ms. Casteel-Ellison alleged right and left hand injuries due to computer work and data entry. Dr. Boggs stated that he first treated Ms. Casteel-Ellison on September 16, 2014, when he diagnosed carpal tunnel syndrome and indicated both of her hands were injured. On October 3, 2014, the claims administrator denied compensability due to lack of testing to establish the diagnosis of carpal tunnel syndrome.

         Barry Vaught, M.D., performed EMG/NCV testing on November 19, 2014. The testing revealed electrophysiologic evidence for mild right median mononeuropathy at the wrist consistent with carpal tunnel syndrome. Ms. Casteel-Ellison was seen by Matthew Nelson, M.D., on February 4, 2015, for moderate pain and numbness in her right hand. She reported loss of grip strength. Dr. Nelson diagnosed carpal tunnel syndrome and recommended a right carpal tunnel release.

         Ms. Casteel-Ellison testified at a hearing before the Office of Judges on April 2, 2015. She stated she works as a "comm" center representative, which is a clerical position. Her job duties included adding information to medical records by inputting information and transferring faxes, mail, and e-mails into the medical record. She had been working at this job for three years. She believes the carpal tunnel syndrome was work-related because she spends all day using a keyboard and mouse and moved her thumb and finger constantly. She is five feet six inches tall and weighs 223 pounds. She has high blood pressure for which she takes medication. Dr. Boggs did grip strength testing and some other testing and diagnosed her with carpal tunnel syndrome. Dr. Boggs prescribed ibuprofen, an anti-inflammatory, and wrist splints. She denied having any hobbies that involved the use of her wrists.

         Marsha Bailey, M.D., performed a medical records review and provided a report dated July 1, 2015. Dr. Bailey opined that the physical examinations by Dr. Boggs were nonspecific and not supportive of median neuropathy or carpal tunnel syndrome. The thenar atrophy documented by Dr. Boggs supported a diagnosis of severe, long standing median nerve compression. The muscle hypertrophy of the right hand, right hand edema, and osteoarthritic joints of both hands were not consistent with the diagnosis of carpal tunnel syndrome. Dr. Bailey acknowledged that the information provided suggested Ms. Casteel-Ellison had right carpal tunnel syndrome. However, Dr. Bailey opined that the right carpal tunnel syndrome was not work-related. Ms. Casteel-Ellison's clerical activities did not show a relationship with causing carpal tunnel syndrome. Her weight problem contributed to the carpal tunnel syndrome. While Dr. Bailey found Ms. Casteel-Ellison had no occupational risks associated with carpal tunnel syndrome, there were personal risk factors including her obesity and osteoarthritis of both hands.

         Ms. Casteel-Ellison underwent the carpal tunnel release and was healing well when she was seen by Nathan Doctry, M.D., on June 28, 2016. He recommended occupational therapy on August 1, 2016.

          The Office of Judges reversed the claims administrator's October 3, 2014, decision and held the claim compensable for right carpal tunnel syndrome on April 11, 2016. It noted the claims adjuster originally denied the claim due to a lack of testing to establish a diagnosis. However, that problem was satisfied through the introduction of valid EMG/NCV testing. The employer relied on the opinion of Dr. Bailey who did not examine Ms. Casteel-Ellison, but instead provided a medical records review. Dr. Bailey was hesitant to confirm the diagnosis of carpal tunnel syndrome due to the findings of muscle atrophy, edema, and osteoarthritic joints in Ms. Casteel-Ellison's right hand. Dr. Bailey also opined that the carpal tunnel syndrome was not work-related because Ms. Casteel-Ellison did not have occupational responsibilities that were highly repetitious, highly forceful, or extremely awkward. Dr. Bailey opined the Ms. Casteel-Ellison's weight and/or osteoarthritis could have been the cause of the carpal tunnel syndrome.

         The Office of Judges also noted that Dr. Vaught, a neurologist, and Dr. Nelson, an orthopedic surgeon who examined Ms. Casteel-Ellison, had no hesitancy in diagnosing right carpal tunnel syndrome. Additionally, while she may have had a weight problem, her weight did not vary more than twenty pounds over seven years. Additionally, Ms. Casteel-Ellison had no documented symptoms of carpal tunnel syndrome prior to working for the employer, even though her weight problem existed for four years prior. The Office of Judges found the employer was asking it to find that a medical report from a physician who never examined the Ms. Casteel-Ellison constituted a preponderance of the evidence. The Office of Judges declined to do so and found the carpal tunnel syndrome compensable.

         The Board of Review reversed the Office of Judges and found that its analysis and conclusions were clearly wrong in view of the reliable, probative and substantial evidence of the whole record. The Board of Review referred to West Virginia Code of State Rules § 85-20-41(2006) regarding conditions that can precipitate carpal tunnel syndrome, as well as the occupational groups at high risk for carpal tunnel syndrome. It found Ms. Casteel-Ellison's job duties were normal clerical activities that did not fall into the high risk categories. Additionally, she had increased body mass, which was a non-occupational risk factor. It concluded that the preponderance of the evidence failed to demonstrate Ms. Casteel-Ellison's employment duties had any relationship to her carpal tunnel syndrome.

         After review, we find the Board of Review erred in reversing the Office of Judges' Order. Ms. Casteel-Ellison did not have any problems with her right hand until she started using the mouse in order to transfer medical information into the charts every day, all day while she was at work. She has no other conditions that contribute to the development of carpal ...


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