Appeal No. 2051971) (Claim No. 2012029112)
David Adams, by Robert Stultz, his attorney, appeals the
decision of the West Virginia Workers' Compensation Board
of Review. Northern Clearing, Inc., did not file a response
to the petition for appeal.
issue on appeal is the addition of compensable components to
the claim. On June 29, 2016, the claims administrator denied
a diagnosis update request to add cervical disc displacement
and lumbosacral spondylosis without myelopathy as compensable
diagnoses in the claim. On April 17, 2017, the Workers'
Compensation Office of Judges affirmed the claims
administrator's decision to deny the request to add the
additional components. This appeal arises from the Board of
Review's Final Order dated October 20, 2017, in which the
Board 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
Court has considered the petitioner's brief 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 petitioner's brief, 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
Adams, a timber cutter, injured his right shoulder and upper
back while cutting down trees for the employer on March 4,
2012. Mr. Adams sought treatment at Med-Express Urgent Care,
where he was diagnosed with a contusion of the shoulder and
back. He participated in physical therapy for several months
as a result of the injury, and he subsequently underwent
surgery for his right shoulder at West Virginia University
report dated January 22, 2014, Sanford Emery, M.D., of West
Virginia University Hospitals, noted that Mr. Adams had
voiced complaints of cervical radicular pain into his left
upper extremity since September 2013. Mr. Adams also stated
during the examination that his neck has continued to hurt
since his accident. He reported that he uses a cane to get
around because of his back pain and leg pain. Mr. Adams
stated that around September of 2013, he started having left
arm pain, which did not bother him until that point. The pain
goes into his triceps, lateral forearm, and into his middle
and ring fingers. Dr. Emery listed Mr. Adams's pain as
cervical radicular pain. Mr. Adams was anxious to know
whether he had suffered a cervical disc herniation. Dr. Emery
noted that surgery might help to alleviate some of Mr.
Adams's arm pain. However, Dr. Emery cautioned that there
would be no guarantee that the arm pain would go away. Dr.
Emery ordered a cervical MRI without contrast and scheduled
Mr. Adams for another appointment in order to discuss the
findings of the MRI.
Diagnosis Update form dated June 24, 2015, was submitted by
Mr. Adams in an attempt to add cervical herniated disc and
lumbar spondylosis as compensable diagnoses in the claim. The
form was signed by Gary Barcinnas, PA-C, who diagnosed Mr.
Adams with a cervical herniated disc and lumbar spondylosis.
When asked to provide clinical findings on which the current
diagnosis is based and how his present condition is related
to the compensable injury, Mr. Barcinnas simply stated,
"neck, low back pain - chronic."
29, 2016, the claims administrator denied Mr. Adams's
request to update his diagnosis to include cervical disc
displacement and lumbosacral spondylosis without myelopathy.
The claims administrator denied the request because the
Diagnosis Update form does not contain clinical findings
relating such conditions to the compensable injury in the
claim. The claims administrator also stated that the findings
of the Diagnosis Update are too dated for the condition
requested. The claims administrator noted that nine months
had elapsed between the findings and the request. Mr. Adams
protested the claims administrator's decision.
record contains treatment notes from Advanced Pain and Rehab
Clinic in Bridgeport, West Virginia. Ahmed Mahmoud, M.D.,
performed a cervical examination on July 27, 2016, and
reported that Mr. Adams was experiencing severe tenderness at
the cervical spine and paraspinal area. His range of motion
had decreased in all movement planes. Dr. Mahmoud diagnosed
Mr. Adams with prolapsed cervical intervertebral disc,
cervical radiculopathy, degeneration of the cervical
intervertebral disc, and myofascial pain dysfunction
syndrome. Mr. Adams again treated with Dr. Mahmoud on August
10, 2016. Once again, Dr. Mahmoud's assessment was
prolapsed cervical intervertebral disc, cervical
radiculopathy, degeneration of the cervical intervertebral
disc, and myofascial pain dysfunction syndrome. Dr. Mahmoud
referred Mr. Adams for an IT Morphine pump evaluation.
October 13, 2016, Mr. Adams testified at deposition that he
was cutting trees down for a pipeline when a tree limb hit
him in the back and knocked him to the ground. He hit his arm
on a locust tree during the incident and developed pain in
his right shoulder and lower back. He later developed pain in
his neck and left shoulder following surgery on his right
shoulder. Mr. Adams testified that he continues to have pain
in his neck and left arm.
Order dated April 17, 2017, the Office of Judges concluded
that Mr. Adams failed to show by a preponderance of evidence
that his requested diagnoses are causally related to his
compensable injury of March 4, 2012. Specifically, the Office
of Judges held that there is no medical evidence to support a
causal relationship between the diagnosis of cervical
herniated disc and the compensable injury. In regard to the
requested diagnosis of lumbosacral spondylosis, the Office of
Judges also reasoned that there is no medical evidence to
support a finding that the diagnosis is causally related to
the compensable injury. The only medical evidence of record
pertaining to the diagnosis of lumbosacral spondylosis is the
treating physician's diagnosis update form of June 24,
2015. However, the Office of Judges noted that Mr.
Adams's treating physician does not explain how the
diagnosis of lumbosacral spondylosiss is related to the
compensable injury, nor does he provide any clinical findings
to support the requested diagnosis. Because the Office of
Judges did not find a causal connection to the compensable
injury, the claims administrator's Order of June 29,
2016, was affirmed.
Board of Review adopted the findings and reasoning of the
Office of Judges and affirmed its Order. After reviewing the
evidence of record, we agree with the decision of the Board
of Review. The evidence is insufficient to conclude that the
requested diagnoses are causally related to Mr. Adams's
compensable injury of March 4, 2012.
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 ...