Appeal No. 2052159 (Claim No. 2012034033)
Elaine Squire by Robert L. Stultz, her attorney, appeals the
decision of the West Virginia Workers' Compensation Board
of Review. Augmentation, Inc., by Steven Wellman, its
attorney, filed a timely response.
issue on appeal is the compensability of an additional
diagnosis. On January 23, 2017, the claims administrator
denied a request to add left shoulder impingement as a
compensable component of the claim. The Office of Judges
affirmed the claims administrator in its August 15, 2017,
Order. The Order was affirmed by the Board of Review on
January 31, 2018. 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
Squire, a laborer, injured her left thumb and elbow on
September 15, 2011, when she was using a drill and the drill
slipped and caught the glove on her left hand. The following
day she was treated in the emergency room at City Hospital
where she was diagnosed with a mild sprain/strain of her left
elbow. Her claim was held compensable for a left elbow
September 28, 2012, Thomas E. Knutson, D.O., treated Ms.
Squire for complaints of pain in the left wrist and elbow.
Dr. Knutson diagnosed lateral epicondylitis of the left
elbow, tendonitis of the left wrist, and left shoulder
impingement syndrome. He opined that he could not relate the
shoulder impingement syndrome to the work injury.
Grady, M.D., performed an independent medical evaluation on
March 12, 2014, during which he listed chief complaints of
left thumb, elbow, and shoulder discomfort. Ms. Squire
advised Dr. Grady that she was using a power drill to drill
holes in metal frames of vending machines when the glove on
her left hand got caught on the power drill. The spinning
drill jerked and twisted her left arm. She was able to return
to work until she was laid off in February of 2013. She was
working in a retail position at the time of the evaluation.
Ms. Squire reported difficulty using her left arm. Dr. Grady
noted most of Ms. Squire's tenderness was in the region
of the left trapezius, as well as mild tenderness to
palpation of the lateral epicondyle of the left elbow. Dr.
Grady diagnosed left elbow lateral epicondylitis, left thumb
myofascial sprain, and mild left shoulder impingement. In his
opinion, Ms. Squire originally injured her left thumb and
left elbow. There was no mention of the left shoulder being
involved until eight months later on May 12, 2012. He noted
that Ms. Squire had some mild impingement of the left
shoulder but he could not attribute that to her injury. He
opined that a left hand MRI would be appropriate to see if
she would be a surgical candidate for the left thumb or left
elbow. Treatment for the left shoulder would not be
reasonable as he could not relate it to her injury. Dr. Grady
also recommended physical therapy and opined Ms. Squire would
be at maximum medical improvement after the therapy.
August 28, 2014, Joseph Hahn, M.D., an orthopedist, evaluated
Ms. Squire for a chief complaint of shoulder pain involving
the left upper arm, left shoulder, and left hand. He noted
Ms. Squire had been treated with non-steroidal
anti-inflammatories, physical therapy for two weeks, and a
subacromial steroid injection, none of which relieved her
pain. Diagnostic studies including an MRI and x-rays were
negative. Dr. Hahn diagnosed left arm pain located on the
left wrist joint. He opined that there was significant
secondary gain with the injury. He did not recommend surgery.
He suggested an EMG or hand specialist to rule out reflex
sympathetic dystrophy or chronic regional pain syndrome.
March 25, 2015, Dr. Grady performed a second independent
medical evaluation for chief complaints of left thumb, left
elbow, and left shoulder discomfort. He noted a slight
decrease in range of motion of the left thumb and left elbow.
He saw no indication of reflex sympathetic dystrophy or
chronic regional pain syndrome. Dr. Grady diagnosed left
thumb strain with reported chronic avulsion of ulnar
collateral ligament on MRI, left elbow lateral epicondylitis,
left wrist de Quervain's tenosynovitis, and left elbow
pain with likely impingement. Dr. Grady believed Ms. Squire
has some impingement in the shoulder, but as there was no
documentation of any left shoulder symptoms until eight
months after the injury, he could not specifically attribute
the left shoulder symptoms to the injury.
September 19, 2015, Ms. Squire presented to the emergency
room at City Hospital with complaints of left arm pain and
swelling. She provided a history of having the pain for four
years with increased pain over the past few weeks. She was
diagnosed with acute exacerbation of chronic left elbow pain,
left shoulder pain, and hypertension. She was placed on an
oral steroid and Ultram and told to follow up with her family
Squire sought treatment from Dr. Knutson for the first time
in about a year on July 25, 2016. Dr. Knutson diagnosed
impingement syndrome of the left shoulder and lateral
epicondylitis of the left shoulder. He gave her injections in
both areas and advised she get a second opinion from an upper
extremity specialist or pain management physician.
Diagnosis Update Report dated December 9, 2016, Dr. Knutson
lists a primary diagnosis of left shoulder impingement
syndrome and secondary diagnoses of left elbow tendonitis and
left thumb sprain. The physician noted that the explanation
for the clinical findings on which the diagnoses were based
could be found in the dictation notes. The signature of the
physician is unintelligible. No notes were attached to the
December 29, 2016, Ms. Squire testified via deposition that
she had constant pain in her arm that extends to her
shoulder. Dr. Knutson referred her to pain management. She
saw Dr. Hahn one time and he suggested she see a reflex
sympathetic dystrophy or complex regional pain syndrome
specialist. She has received physical therapy and injections
to her elbow and shoulder. No treatment has helped her pain.
Ms. Squire denied having any previous injury to her left
upper extremity. There was a two-year period of time in which
she did not seek any medical treatment. She saw Dr. Knutson
in May of 2015 and did not return to see him until July of
2016. She was evaluated by Dr. Hahn in 2014.
January 23, 2017, the claims administrator denied Dr.
Knutson's request to add left shoulder impingement as a
compensable component of the claim. The Office of Judges
affirmed the claims administrator's decision in its
August 5, 2017, Order. It determined that Ms. Squire's
shoulder symptoms did not appear immediately following the
injury but appeared eight months later. Dr. Knutson, her
treating physician, originally opined that the left shoulder
impingement was unrelated to the injury. The Office of Judges
determined that no reasoning was given for Dr. Knutson's
request to now have the condition added as compensable.
Additionally, Dr. Grady, who performed two evaluations of Ms.
Squire, opined that the left shoulder impingement was not
related to the work injury. Therefore, the Office of Judges
found that it was unlikely that the left shoulder impingement
was part of the ...