Appeal No. 2051950 (Claim No. 2014027360)
Mickey Massey, by Edwin H. Pancake, his attorney, appeals the
decision of the West Virginia Workers' Compensation Board
of Review. Pepsi-Cola Metropolitan Bottling Co., Inc., by
Bradley K. Shafer, its attorney, filed a timely response.
issue on appeal is whether Mr. Massey is entitled to the
requested medical benefits. The claims administrator denied a
request for a consultation with Allen Young, M.D., on August
3, 2016. The Office of Judges affirmed the decision in its
April 13, 2017, Order. The Order was affirmed by the Board of
Review on October 4, 2017. 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
Massey, a bulk driver, was injured in the course of his
employment on March 15, 2014, while lifting a seventy-five
pound dock plate. The employee's and physician's
report of injury indicates Mr. Massey sustained a lumbar
sprain/strain. It was noted that he had a prior low back
injury earlier that year.
March 17, 2014, treatment note, Linda Eakle, M.D., indicated
Mr. Massey reported low back pain radiating into the right
leg following a work-related lifting injury. There was a
history of recurrent back sprains. X-rays showed mild
degenerative changes and no evidence of an acute injury. Dr.
Eakle assessed acute back pain and acute muscle spasm. A
treatment note from MedExpress dated March 19, 2014, stated
that Mr. Massey reported a work-related low back injury on
March 15, 2014. He had sustained a back injury six months
prior. He was diagnosed with lumbar sprain/strain,
radiculopathy of the trunk/leg, and muscle spasms. The claim
was held compensable for lumbar sprain/strain on March 25,
treatment note from MedExpress on April 2, 2014, indicated
Mr. Massey had somewhat improved. The assessment remained
lumbar sprain/strain and an MRI was ordered. The lumbar MRI
showed degenerative changes at L3-4 and L5-S1, mild disc
bulges at L3-4 and L4-5 with no herniation or stenosis, and
decreased disc space height at L5-S1 with mild bilateral
stenosis. Mr. Massey was treated by Dr. Young on April 17,
2014, for the compensable injury. Dr. Young recommended
steroids and physical therapy and took Mr. Massey off of work
for several weeks.
Ignatiadis, M.D., saw Mr. Massey on July 23, 2014, and
indicated a neurological examination revealed no evidence of
motor or sensory defects in the legs. Imaging studies showed
minimal disc bulging, no evidence of herniation, and no
evidence of neurological compromise. Dr. Ignatiadis diagnosed
severe lumbar sprain with minimal radiculopathy. He
recommended epidural steroid blocks.
Mukkamala, M.D., performed an independent medical evaluation
on August 27, 2015, in which he noted that Mr. Massey had
returned to work. Dr. Mukkamala concluded that the
compensable injury resulted in a lumbar sprain. Mr. Massey
was determined to be at maximum medical improvement and in no
further need of treatment. Dr. Mukkamala assessed 5%
8, 2016, Mr. Massey sent a letter to his attorney stating
that he had a flare-up of back pain and wanted to reopen his
case. Mr. Massey then testified in a deposition on December
29, 2016, that he developed low back pain in July of 2016,
during the Fourth of July weekend when he was extremely busy
at work and performed a lot of heavy lifting. He stated that
there was no specific activity or incident that caused the
onset of the pain and that his lower back pain gradually
worsened over the weekend.
claims administrator denied a request for a consultation with
Dr. Young on August 3, 2016. The Office of Judges affirmed
the decision in its April 13, 2017, Order. It found that Mr.
Massey sustained a work-related low back injury on March 15,
2014, received treatment, and was off of work for over a
year. He returned to work sometime prior to August 27, 2015,
when Dr. Mukkamala noted that he had resumed working, had
reached maximum medical improvement, and required no further
treatment. Mr. Massey testified in his deposition that his
back was doing well and he did not miss any work after
returning in August of 2015. In July of 2016, he stated that
his back began to hurt again. He denied any new injuries,
specific events, or incidents. The Office of Judges found
that a preponderance of the evidence indicates the requested
treatment is not medically necessary or reasonably required
to treat the compensable injury. The lumbar sprain at issue
was over two years old and pursuant to West Virginia Code of
State Rules § 85-20-37.5 (2006), the estimated duration
of care for a sprain should not exceed eight weeks. The
Office of Judges concluded that Mr. Massey submitted no
evidence showing that this was an extraordinary case that
requires additional treatment outside of the guidelines.
Further, Dr. Mukkamala evaluated him and concluded that Mr.
Massey had reached maximum medical improvement and no
additional treatment was necessary.
Office of Judges further found that Mr. Massey returned to
work for a year following the compensable injury with no
problems until the July of 2016 onset of pain. He testified
that he had no back problems from August of 2015 through July
of 2016. The Office of Judges determined based on the
evidence that the compensable sprain/strain resolved
completely prior to the new onset of lower back pain in July
of 2016. The only evidence submitted in support of Mr.
Massey's protest was his handwritten letter in which he
requested that his claim be reopened for a flare-up of his
old injury. There was no medical evidence submitted to
support a causal connection between the new symptoms and the
compensable sprain/strain. The Board of Review adopted the
findings of fact and conclusions of law of the Office of
Judges and affirmed its Order on October 4, 2017.
review, we agree with the reasoning and conclusions of the
Office of Judges as affirmed by the Board of Review. Nearly a
year passed between the time Mr. Massey's lumbar
sprain/strain symptoms resolved and the new onset of pain in
July of 2016. Further, he submitted no medical evidence
linking the new symptoms to the prior injury.
foregoing reasons, we find that the decision of the Board of
Review is not in clear violation of any constitutional or
statutory provision, nor is it clearly the result of
erroneous conclusions of law, nor is it based upon a material
misstatement or mischaracterization of the ...