Appeal No. 2052752) (Claim No. 2017003211)
Arcelormittal Weirton, LLC, by Jeffrey B. Brannon, its
attorney, appeals the decision of the West Virginia
Workers' Compensation Board of Review. A response was not
filed on behalf of Mr. Prentice.
issue on appeal is compensability. The claims administrator
rejected the claim on October 25, 2016. The Office of Judges
reversed the decision in its March 1, 2018, Order and held
the claim compensable for bilateral carpal tunnel syndrome
and ulnar neuropathy. The Order was affirmed by the Board of
Review on July 19, 2018.
Court has carefully reviewed the records, written arguments,
and appendices contained in the briefs, and the case is
mature for consideration. 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
Prentice, a crane repairman, alleges that he developed carpal
tunnel syndrome and ulnar neuropathy in the course of and
resulting from his employment. An EMG performed on July 27,
2016, showed bilateral ulnar sensory and motor neuropathies,
severe on the right and moderate to severe on the left. Mr.
Prentice was treated by William Hagberg, M.D., on August 26,
2016, and reported tingling in both of his ring and small
fingers. Dr. Hagberg reviewed the EMG and noted that carpal
tunnel syndrome was not diagnosed. On examination, Mr.
Prentice had positive Tinel's and Phalen's signs over
the median nerves of the wrists and positive Tinel's sign
over the ulnar nerves in the elbows. Dr. Hagberg noted that
he has a history of rheumatoid arthritis, bilateral ulnar
nerve neuropathy at the elbow, and an exam suggestive of
carpal tunnel syndrome. He recommended a repeat EMG. Dr.
Hagberg diagnosed rheumatoid arthritis, bilateral
post-traumatic osteoarthritis, bilateral ulnar neuropathy,
and bilateral carpal tunnel syndrome. A repeat EMG was
performed on September 2, 2016, and showed marked bilateral
Employee's and Physician's Report of Injury was
completed on September 2, 2016, and indicates Mr. Prentice
alleged injuries to both wrists due to repetitive carrying of
tools while working as a crane repairman. The physician's
section was completed by Dr. Hagberg and listed the diagnoses
as lesion of right ulnar nerve, lesion of left ulnar nerve,
mononeuropathies of both arms, and primary osteoarthritis in
both wrists. He opined the conditions were the direct result
of an occupational injury due to repetitive use.
October 5, 2016, Dr. Hagberg performed left carpal tunnel
release surgery, neuroplasty of the left ulnar nerve at the
wrist, neuroplasty of the left ulnar nerve at the elbow, and
left flexor origin lengthening. The pre and post-operative
diagnoses were left carpal tunnel syndrome, left ulnar
neuropathy at the wrist, and left ulnar neuropathy at the
elbow. The claims administrator rejected the claim on October
September 5, 2017, letter, Dr. Hagberg noted that Mr.
Prentice underwent left wrist and elbow surgery on January
25, 2017. On September 5, 2017, he presented with continued
improvement in his hands. His grip and pinch strength had
improved on both the right and left. The diagnosis was
bilateral carpal tunnel syndrome and bilateral ulnar nerve
neuropathy. Dr. Hagberg opined that the diagnoses were
work-related. He noted that Mr. Prentice worked in the steel
mill for thirty-five years. His work duties involved
significant lifting and repetitive activities involving both
arms. Despite normal nerve conduction studies, the clinical
examination and symptoms were suggestive of carpal tunnel
syndrome. The fact that the symptoms improved after surgery
further confirms the diagnoses. Dr. Hagberg opined that Mr.
Pretnice was temporarily and totally disabled from October 5,
2016, through July 13, 2017, when he was released to return
record review dated November 15, 2017, Dr. Mukkamala noted
that Mr. Prentice has type II diabetes, edema of the lower
extremities, low potassium, and obesity. Dr. Mukkamala
diagnosed diabetic peripheral neuropathy. He opined that
there is no evidence of carpal tunnel syndrome or ulnar nerve
neuropathy at the wrist or elbow. He reviewed the EMG and
opined that it was indicative of peripheral neuropathy but
not entrapment neuropathy. Carpal tunnel syndrome is caused
by entrapment of a nerve. Dr. Mukkamala did find ulnar
neuropathy but opined that it was generalized neuropathy and
there was no focal entrapment of the ulnar nerve at the wrist
or elbow. Dr. Mukkamala stated that the upper extremity
release surgeries were unnecessary because there was no
entrapment neuropathy. He also found significant risk factors
for carpal tunnel syndrome in the form of diabetes and
obesity. He opined that Mr. Prentice's symptoms are
causally related to his diabetic neuropathy. He also noted a
history of rheumatoid arthritis.
Office of Judges reversed the claims administrator's
rejection of the claim and held the claim compensable for
bilateral carpal tunnel syndrome and ulnar neuropathy on
March 1, 2018. The Office of Judges noted that Dr. Mukkamala
opined that Mr. Prentice had diabetic peripheral neuropathy
instead of entrapment neuropathy. It noted that his opinion
was supported by Mr. Prentice's diagnosis of type II
diabetes. However, the Office of Judges found that Dr.
Hagberg's opinion that he suffers from bilateral carpal
tunnel syndrome and ulnar neuropathy was also well supported.
Though neither EMG showed carpal tunnel syndrome, Dr.
Hagberg's examination showed positive Tinel's and
Phalen's signs over the median nerves in the wrists.
Further, after the surgeries, Mr. Prentice's pinch and
grip strengths improved, indicating the neuropathy was more
than likely the result of entrapment. The Office of Judges
also found that his work history is consistent with the type
of activities that cause carpal tunnel syndrome and ulnar
neuropathy. He worked in the steel mills for thirty-five
years doing significant lifting and repetitive activities
with both arms. The Office of Judges noted that Dr. Hagberg
was familiar with the medical history, performed examinations
of Mr. Prentice, and performed surgery on his wrists and
elbows. Dr. Mukkamala merely performed a record review. The
Office of Judges therefore concluded that Dr. Hagberg's
opinion was more credible than that of Dr. Mukkamala. The
Board of Review affirmed the decision on July 19, 2018.
review, we agree with the reasoning and conclusions of the
Office of Judges as affirmed by the Board of Review. The
Office of Judges, and by extension the Board of Review,
committed no reversible error in finding that Dr.
Hagberg's opinion was more persuasive than that of Dr.
Mukkamala. Dr. Hagberg was more familiar with Mr.
Prentice's history, examined him on multiple occasions,
and performed surgery on his wrists and elbows. Dr.
Mukkamala, on the other hand, merely performed a review of
Mr. Prentice's records. Further, Mr. Prentice has shown
that his job requires repetitive heavy manual lifting, which
pursuant to West Virginia Code of State Rules §
85-20-41.5, has been shown to contribute to the development
of carpal tunnel syndrome.
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 evidentiary
record. Therefore, the decision of the Board of Review is
CONCURRED IN BY: Chief Justice Elizabeth D. Walker Justice
Margaret L. Workman Justice Tim Armstead Justice Evan ...