TERESA G. FIFE, Claimant Below, Petitioner
SHOE SHOW, INC., Employer Below, Respondent
Appeal No. 2052621) (Claim No. 2017015187).
Teresa G. Fife, by Counsel Gregory S. Prudich, appeals the
decision of the West Virginia Workers' Compensation Board
of Review ("Board of Review"). Shoe Show, Inc., by
Counsel Lindsay S. Brennan, filed a timely response.
issue on appeal is the authorization for medical treatment.
The claims administrator denied Ms. Fife's request for a
total knee replacement on December 6, 2017. The Workers'
Compensation Office of Judges ("Office of Judges")
affirmed the claims administrator's decision in an Order
dated February 16, 2018. This appeal arises from the Board of
Review's Final Order dated August 1, 2018, in which the
Board of Review affirmed the decision 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 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
Fife indicated in her Employees' and Physicians'
Report of Occupational Injury or Disease that on December 13,
2016, she slipped and fell over boxes while working for Shoe
Show, Inc. She sought medical treatment at Princeton
Community Hospital. During treatment, Ms. Fife reported that
she had injured the same knee a few months earlier. An x-ray
of her right knee showed mild hypertrophic degenerative bony
changes and narrowing on the medial femorotibial joint space,
progressed in the interval. The X-ray also showed soft tissue
swelling, but no fracture. The treating physician indicated
that the injury on December 13, 2016, aggravated Ms.
Fife's prior knee injury. On December 22, 2016, the
claims administrator held the claim compensable for right
January 23, 2017, Ms. Fife sought treatment with Gary
McCarthy, M.D., from Bluefield Orthopedics. He treated her
with a cortisone injection to her right knee. Ms. Fife
returned to Dr. McCarthy on February 13, 2017, and reported
that the injection helped for a little while. Dr. McCarthy
diagnosed Ms. Fife with a tear of the medial meniscus of the
right knee. She underwent a right knee MRI on April 12, 2017.
April 21, 2017, Ms. Fife was seen by Dr. McCarthy to discuss
the results of her MRI. The MRI revealed moderate
degenerative changes with joint space narrowing and
osteophyte formation predominately involving the medial
compartment. The MRI did not visualize the body of the medial
meniscus, but the posterior horn of the medial meniscus was
small. The radiologist conducting the study stated that the
findings were compatible with a medial meniscus tear. Dr.
McCarthy's assessment/plan was for Ms. Fife to continue
her home exercise program.
McCarthy treated Ms. Fife again on May 22, 2017. There was
tenderness of the medial femoral condyle, lateral joint line,
medial joint line, medial tibial plateau, lateral femoral
condyle and lateral tibial plateau. The assessment was
idiopathic osteoarthritis. Dr. McCarthy recommended a total
knee replacement. On May 23, 2017, Dr. McCarthy requested
authorization for a total knee replacement and the addition
of idiopathic osteoarthritis as a compensable diagnosis.
Fife was referred for an independent medical evaluation by
Prasadarao B. Mukkamala, M.D. In his report dated September
21, 2017, he opined that Ms. Fife continues to have
significant symptoms with relation to the right knee, and her
ongoing symptoms are causally related to noncompensable
underlying preexisting degenerative arthrosis. Dr. Mukkamala
diagnosed Ms. Fife with sprain/contusion of the right knee
and stated that she had reached her maximum degree of medical
improvement. It was Dr. Mukkamala's professional opinion
that the total knee replacement was requested to address
preexisting noncompensable arthritis and is not required
because of the compensable injury.
Fife testified at deposition on September 22, 2017, that she
had worked for Shoe Show for twenty-eight years. As a
manager, her responsibility was to help unload trucks, move
merchandise, and stock, all while constantly walking. She
stated that she had no prior pain, issues, or limitations
with her right knee before her compensable injury of December
13, 2016. She testified that her knee was not working and she
missed a lot of work due to her injury. She also testified
that she only had one prior workers' compensation claim
for her back and shoulder.
McCarthy was also deposed on September 22, 2017. When asked
why Ms. Fife required a total knee replacement, Dr. McCarthy
[w]ell, in addition to her meniscal tear, she has joint space
narrowing with osteophyte formation. She has a degenerative
marrow signal in that part of the knee. Now if I was just to
treat the meniscal tear, it would probably be unsuccessful.
In other words, she would still complain of pain over the
medial side because of those degenerative changes.
McCarthy further testified that he relates the meniscal tear
to her work-related fall. He stated that the osteoarthritis
in the knee was probably preexisting. He testified that her
problem is compounded in that she has a meniscal tear on a
degenerative knee in the medial compartment. Dr. McCarthy was
of the opinion that if you do not treat everything, then you
are not going to get a good result. He testified that but for
the injury of December 13, 2016, Ms. Fife would not need a
total knee replacement. He stated that without surgery, she
could expect deterioration.
Fife's prior medical records and the workers'
compensation claim index demonstrate prior right knee
injuries and diagnoses of preexisting degenerative
osteoarthritis of the right knee. A medical report dated
January 22, 2004, from Robert P. Kropac, M.D., of the
Orthopedic Center of the Virginias, indicated a diagnosis of
contusion of the right knee superimposed on preexisting
degenerative arthritis and patellofemoral chondromalacia of
the right knee. On April 3, 2008, Ms. Fife was treated at
Bluefield Regional Medical Center for right knee pain and
left heel pain after losing her balance ...