Appeal Nos. 2051735, 2051804, (Claim No. 2015013891)
Steve Dolin, by Reginald Henry, his attorney, appeals the
decision of the West Virginia Workers' Compensation Board
of Review. Ramsey Tire, Inc., by Melissa Blatt, its attorney,
filed a timely response.
issues on appeal are the termination of Mr. Dolin's
temporary total disability benefits and the denial of
requested medical treatment. The claims administrator closed
the claim for temporary total disability benefits on July 12,
2016; denied a request for authorization of a spinal cord
stimulator on July 28, 2016; and issued a second closure of
the claim for temporary total disability benefits on
September 22, 2016. The Office of Judges affirmed the
decisions of the claims administrator in its December 16,
2016, and January 31, 2017, Orders. The Orders were affirmed
by the Board of Review on June 5, 2017. 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
Dolin, a tire technician, was injured on October 9, 2014,
while stacking tires. On October 12, 2014, he was treated in
the emergency room for pain in his mid to lower back area.
Lumbar spine x-rays showed minimal degenerative changes, no
fractures, and no spondylolysis. Mr. Dolin was diagnosed with
lumbar and thoracic back sprain. The claims administrator
held the claim compensable for a sprain of the upper and
lower back on November 12, 2014.
December 4, 2014, lumbar spine MRI revealed a posterior
central annular tear at L5-S1 with a central disc herniation
and mild disc bulges at L3-L4 and L4-L5. On January 21, 2015,
Richard Knapp, M.D., completed an attending physician's
report which noted Mr. Dolin continued to have low back pain
and numbness into his bilateral lower extremities.
Walker, M.D., performed an independent medical evaluation on
April 16, 2015. Mr. Dolin told him that surgery had not been
recommended and that he had been treated with two epidural
steroid injections. He opted not to have a third injection
because the injections did not help his pain. Dr. Walker
recommended a second consultation with a neurosurgeon along
with diagnostic testing to "definitively determine"
if Mr. Dolin had L5-S1 radiculopathy. He opined that Mr.
Dolin should be considered for a laminectomy for the disc
herniation with persistent symptoms if it was determined he
Thymius, D.O., saw Mr. Dolin for an initial consultation on
August 20, 2015. He noted that Mr. Dolin was not a surgical
candidate from a neurosurgical perspective, but a spinal cord
stimulator had been recommended. Dr. Thymius diagnosed
thoracic sprain/strain, lumbar sprain/strain, lumbar
radiculitis, intervertebral disc displacement, degenerative
lumbar intervertebral disc, and chronic pain syndrome. He
opined that it was reasonable for Mr. Dolin to be treated
with the spinal cord stimulator for back and leg pain relief.
He also opined that a discectomy with anterior cage and
posterior facet screws would be reasonable medical treatment.
16, 2016, the Office of Judges ordered the conditions of
thoracic or lumbosacral neuritis or radiculitis and
displacement of the intervertebral disc without myelopathy be
added as compensable components of the claim. Prasadarao
Mukkamala, M.D., performed an independent medical evaluation
on June 9, 2016, at which time Mr. Dolin complained of pain
in the low back with radiation into both lower extremities.
In Dr. Mukkamala's opinion, Mr. Dolin was not a candidate
for a spinal cord stimulator because his pain complaints were
mostly axial back pain, not radicular; he exhibited an
extreme degree of symptom magnification; and the epidural
steroid injections were not effective. Dr. Mukkamala also
opined that Mr. Dolin had reached maximum medical
improvement. Based on his report, the claims administrator
closed the claim for temporary total disability benefits on
July 12, 2016.
28, 2016, the claims administrator denied Dr. Thymius's
request for authorization for the spinal cord stimulator. The
claims administrator closed the claim for temporary total
disability benefits for the second time on September 22,
2016, because insufficient medical evidence of continued
temporary total disability had been provided.
Miller, M.D., performed an independent medical evaluation on
September 15, 2016, and issued his report on September 29,
2016. Dr. Miller was asked to evaluate whether Mr. Dolin was
a good candidate for a spinal cord stimulator. Dr. Miller
noted that Mr. Dolin was given a urine drug screen the
morning of his evaluation, which was positive for THC and
negative for Norco, which was prescribed and which Mr. Dolin
said he took prior to the evaluation. Dr. Miller diagnosed
Undifferentiated Somatoform Disorder. He opined that Mr.
Dolin was not a good candidate for the placement of the
spinal cord stimulator because no treatment had been of
benefit; Mr. Dolin was insistent on having surgery; he was in
no physical distress during the evaluation; he may have been
a substance abuser; and because he had Somatoform Disorder,
which had a negative impact on the perception of pain. In Dr.
Miller's opinion, Mr. Dolin exhibited symptom
magnification. He did not anticipate that Mr. Dolin would
have a good result from the placement of the spinal cord
December 16, 2016, the Office of Judges affirmed the claims
administrator's July 12, 2016, closure of the claim for
temporary total disability benefits and the July 28, 2016,
denial of authorization of a spinal cord stimulator. It then
affirmed the claims administrator's September 22, 2016,
second closure of the claim for temporary total disability
benefits on January 31, 2017.
Office of Judges noted the spinal cord stimulator was
recommended by Drs. Knapp and Walker and that Drs. Mukkamala
and Miller evaluated Mr. Dolin in reference to the
recommendation. Dr. Mukkamala opined that Mr. Dolin's
dependent characteristics would not make him a good candidate
for a spinal cord stimulator. Dr. Miller found Mr. Dolin was
not a good candidate for the spinal cord stimulator for a
number of reasons, including Dr. Miller's diagnosis of
Somatoform Disorder. Based on those opinions, the Office of
Judges determined it was more likely than not that Mr. Dolin
was not a candidate for a spinal cord stimulator. Turning to
the temporary total disability benefits, the Office of Judges
noted Dr. Mukkamala determined Mr. Dolin reached maximum
medical improvement on June 8, 2016. As such, the claims
administrator properly terminated the temporary total
disability benefits. The Office of Judges also found that Mr.
Dolin had submitted no new evidence in support of his protest
regarding the September 22, 2016, closure of the claim.
Therefore, it found closure of claim was proper.
Board of Review adopted the findings of fact and conclusions
of law of the Office of Judges and affirmed the December 16,
2016, and January 31, 2017, Orders on June 5, 2017. After
review, we agree with the Board of Review. The claim was
properly closed for temporary total disability benefits and
the request for authorization of the spinal cord stimulator
was properly denied based upon the ...