Appeal No. 2052542) (Claim No. 2017018968)
Kim Bowles, by Counsel John H. Shumate Jr., appeals the
decision of the West Virginia Workers' Compensation Board
of Review ("Board of Review"). The West Virginia
Office of the Insurance Commissioner, by Counsel Henry C.
Bowen, filed a timely response.
issue presented in this case is the compensability of the
claim for carpal tunnel syndrome. The claims administrator
rejected the claim for the occupational disease on July 7,
2017. The West Virginia Workers' Compensation Office of
Judges ("Office of Judges") affirmed the claims
administrator's decision in an Order dated February 6,
2018. This appeal arises from the Board of Review's Final
Order of August 17, 2018, in which the Board affirmed the
decision of the Office of Judges.
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
Bowles worked as a coal miner for many years, the last five
of which was as a fire boss for Pine Ridge Coal Company,
He last worked for Pine Ridge Coal on February 3, 2012. On
August 9, 2016, he was evaluated by Syed A. Zahir, M.D., due
to pain and numbness in both of his hands. Dr. Zahir
diagnosed Mr. Bowles with bilateral carpal tunnel syndrome.
An EMG report from Barry K. Vaught, M.D., with Vaught
Neurological Services, PLLC, dated October 17, 2016, revealed
electrophysiological evidence of mild bilateral median
mononeuropathy at the wrist, consistent with carpal tunnel
syndrome. Mr. Bowles completed an application for
workers' compensation benefits for carpal tunnel syndrome
on December 27, 2016. He alleged that he developed the
disease due to his performance of repetitive wrist motions
during his employment. Dr. Zahir completed the
physician's section of the form and checked the box
indicating that his carpal tunnel condition was an
claims administrator referred Mr. Bowles for an independent
medical evaluation with Prasadaro B. Mukkamala, M.D., on June
6, 2017. In his report, Dr. Mukkamala reviewed Mr.
Bowles's work history and medical history. At the time of
the evaluation, Mr. Bowles complained of tingling and
numbness in both hands and stated that he had been
experiencing symptoms for many years. He also reported that
his symptoms had increased over the last three or four years.
Dr. Mukkamala was not conclusive whether a diagnosis of
carpal tunnel syndrome had been established. However, Dr.
Mukkamala opined that Mr. Bowles had two nonoccupational risk
factors that could cause the disease, in-diabetes mellitus
and obesity. Dr. Mukkamala also noted that Mr. Bowles ceased
his employment in 2012 and, in his opinion, his work
activities were not occupational-risk factors for the
development of carpal tunnel syndrome.
claims administrator rejected the application for benefits on
July 7, 2017. In its Order, the claims administrator stated
that the claim was rejected based upon several factors.
First, the claims administrator stated,
[o]ffice notes from Dr. Zahir dated August 9, 2017, describe
the onset of your symptoms, bilateral pain and numbness of
your hands, was a couple of months prior, with problems for
the past year or so. This places the onset of your symptoms
during 2015. You stopped working in 2012, with symptoms
developing three years later.
the claims administrator stated, "[y]ou possess two
significant non-occupational risk factors for the development
of carpal tunnel syndrome, diabetes mellitus and excess
weight." Finally, the claims administrator relied upon
the opinion of Dr. Mukkamala and his June 6, 2017,
independent medical evaluation report which documented
significant nonoccupational risk factors for development of
carpal tunnel syndrome in the form of diabetes mellitus and
excess weight. He protested the rejection of his claim.
support of his protest, Mr. Bowles testified at a November
28, 2017, evidentiary hearing that he last worked on February
3, 2012, and he did not seek medical attention until 2015. He
also testified that he had difficulties with his hands while
he was working for the employer, but he has developed
additional problems since he ceased working for the employer.
In support of the claims administrator's decision, the
employer submitted progress notes from Samar Sankari, M.D.,
of SFH Professional Endocrinology Associates, indicating that
Mr. Bowles has been managing his diabetes since 1998. The
progress notes also show that Dr. Sankari questioned Mr.
Bowles about any additional complaints at the time of
evaluation and Mr. Bowles responded that he had no particular
complaints. He denied numbness, tingling, and pain.
February 6, 2018, decision of the Office of Judges, the
claims administrator's rejection of the claim was
affirmed. The Office of Judges concluded that the evidence
shows that it is more likely than not that Mr. Bowles's
carpal tunnel syndrome is not related to his occupation. The
Office of Judges noted that Mr. Bowles ceased his employment
with Pine Ridge Coal in 2012, and he was not diagnosed until
three years later. The Office of Judges also noted that Dr.
Mukkamala was of the opinion that if Mr. Bowles had carpal
tunnel syndrome, he did not develop the disease as a result
of his occupational activities. Dr. Mukkamala found that Mr.
Bowles has significant risk factors for developing carpal
tunnel syndrome, which included diabetes and obesity. The
Board of Review adopted the findings and conclusions of the
Office of Judges and affirmed the decision in an Order dated
August 17, 2018.
review, we agree with the findings of fact and conclusions of
law of the Office of Judges, as affirmed by the Board of
Review. Mr. Bowles has failed to establish that he suffers
from work-related carpal tunnel syndrome. Although Mr. Bowles
presented evidence of a diagnosis of carpal tunnel syndrome
by Dr. Zahir, the only opinion as to causation within the
record is from Dr. Mukkamala, who opined that the carpal
tunnel syndrome was not causally related to Mr. Bowles's
occupational activities. Instead, Dr. Mukkamala was of the
opinion that Mr. Bowles has two important and significant
nonoccupational risk factors for the development of carpal
tunnel syndrome, diabetes mellitus and obesity. The fact that
Mr. Bowles ceased work in 2012 and experienced increased
symptoms for three to four years before filing for benefits
is consistent with Dr. Mukkamala's opinion. The record
supports the decision of the Board of Review.
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 ...