Appeal No. 2052753) (Claim No. 2016021952)
Spartan Mining Company, by Counsel Sean Harter, appeals the
decision of the West Virginia Workers' Compensation Board
of Review ("Board of Review").
issues on appeal are medical benefits and temporary total
disability benefits. The claims administrator denied a
request for referral to pain management on January 30, 2017.
In two separate Orders dated March 6, 2017, the claims
administrator closed the claim for temporary total disability
benefits and denied a request for physical therapy. The
Office of Judges reversed the decisions in its March 5, 2018,
Order, authorized pain management and physical therapy, and
granted temporary total disability benefits. The Order was
affirmed by the Board of Review in its Order entered on
September 24, 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
Hatfield, a shuttle car driver, was injured in the course of
his employment on February 25, 2016, when a large rock fell
on his left foot. The rock had to be removed from his foot
with a pry bar. A treatment note from Raleigh General
Hospital Emergency Department that day indicates Mr. Hatfield
reported that a large rock fell on his foot in the coal
mines. A CT scan showed minimally displaced fractures of the
first through fourth metatarsals, a fracture in the planar
margin of the cuboid, and a questionable, tiny fracture in
the plantar surface of the lateral cuneiform. Mr. Hatfield
also completed a report of injury that day.
Hatfield was treated for the compensable injury by Blake
Weeks, D.P.M. On March 1, 2016, Dr. Weeks indicated Mr.
Hatfield fractured the second, third, and fourth metatarsals
of his left foot. He also had a chip fracture of the lateral
cuneiform. Dr. Weeks diagnosed metatarsal bone fractures,
swelling of the left foot, crush injury, acute foot pain, and
a blister. He recommended a compression splint and a bone
stimulator. On March 8, 2016, he placed Mr. Hatfield in a
boot. Mr. Hatfield returned on March 15, 2016, and reported
decreased foot swelling but stated that he had foot and calf
pain. The claim was held compensable for fractures of the
second, third, and fourth metacarpals of the left foot and
fracture of the left lateral cuneiform.
Weeks applied a cast to Mr. Hatfield's foot on March 29,
2016. The following day, he noted that Mr. Hatfield would be
temporarily and totally disabled from March 1, 2016, through
May 2, 2016. On April 12, 2016, Dr. Weeks put Mr. Hatfield in
a short leg splint. He was still reporting moderate pain and
tingling. His symptoms remained unchanged on April 26, 2016,
and Dr. Weeks recommended a CAM walker and suggested Mr.
Hatfield begin weight bearing as tolerated. On April 29,
2016, Dr. Weeks stated that Mr. Hatfield was temporarily and
totally disabled until July 15, 2016. Mr. Hatfield reported
no improvement and continued tingling in his left leg/foot on
May 10, 2016.
24, 2016, Dr. Weeks completed an attending physician's
report stating that Mr. Hatfield was temporarily and totally
disabled until December 30, 2016. Dr. Weeks performed a left
foot fusion, Lisfranc fusion, intercuneiform fusion, and a
left third tarsometatarsal joint arthrodesis on August 5,
2016. The pre- and post-operative diagnoses were left foot
first tarsometatarsal joint arthritis, a left Lisfranc
fracture dislocation, intercuneiform osteoarthritis of the
left foot, and a third metatarsal dislocation of the left
Weeks underwent physical therapy. On October 20, 2016, he
reported that he could not move his toes, his left foot pain
was aggravated by movement, and he had decreased range of
motion and strength in the left foot. Mr. Hatfield returned
to Dr. Weeks on November 21, 2016, and reported increased
pain in his fifth left toe after striking it on a bed. Dr.
Weeks diagnosed left foot phalanx fracture, status post foot
surgery; edema of the left foot; crush injury; acute left
foot pain; blister; routine healing of left foot metatarsal
fractures; neuralgia; and plantar fasciitis. On November 21,
2016, Dr. Weeks recommended continued physical therapy and
gait training. On November 29, 2016, he completed an
attending physician's report stating that Mr. Hatfield
was temporarily and totally disabled until January 30, 2017.
On December 19, 2016, Dr. Weeks noted that Mr. Hatfield was
making slow progress in physical therapy and had improved
Bailey, M.D., performed an independent medical evaluation on
January 9, 2017, in which Mr. Hatfield reported poor balance,
occasional falls, an inability to walk without the CAM
walker, decreased bilateral hip range of motion, and reduced
activities of daily living. Dr. Bailey noted that sensory
examination was inconsistent in both legs and that the left
leg strength was reduced at a level that was not consistent
with his ambulation. Mr. Hatfield had left calf atrophy and
reduced range of motion in the left foot. Dr. Bailey
diagnosed chronic left foot pain and found Mr. Hatfield to be
at maximum medical improvement. She opined that his
subjective complaints far outweigh the objective findings and
that there is no medical explanation to support his
complaints of lack of balance and inability to move his left
ankle and toes. Dr. Bailey assessed 5% whole person
impairment for calf atrophy. She noted that the range of
motion measurements for the left extremity were invalid.
Hatfield returned to Dr. Weeks on January 10, 2017, and
reported significant pain during physical therapy. He was
still using crutches. Dr. Weeks diagnosed crush injury,
healed left toe fractures, foot swelling, acute foot pain,
neuralgia, and plantar fasciitis. Dr. Weeks recommended long
term pain management and stated that Mr. Hatfield should
remain off of work. On February 2, 2017, Dr. Weeks indicated
Mr. Hatfield's symptoms remained unchanged. He
recommended a transfer to a pain management physician but the
request was refused because his pain was found to be
unrelated to the compensable injury. Dr. Weeks disagreed and
stated that all of Mr. Hatfield's pain is related to the
compensable injury. Dr. Weeks wrote a letter on March 22,
2017, stating that Mr. Hatfield requires authorization for
physical therapy because he had not yet reached maximum
medical improvement. If he does not continue therapy, Dr.
Weeks stated that his condition may decline.
Mukkamala, M.D., performed an independent medical evaluation
on May 9, 2017, in which he noted that Mr. Hatfield's
only symptom was balance issues with the left foot. On
examination, he had reduced range of motion in the left ankle
and foot. Dr. Mukkamala noted that Mr. Hatfield had atrophy
of the left calf and walked with a limp. Dr. Mukkamala found
that he had reached maximum medical improvement. He opined
that Mr. Hatfield showed a significant degree of symptom
magnification. He stated that physical therapy and pain
medication are not reasonably required treatment for the
compensable injury. Dr. Mukkamala concurred with Dr.
Bailey's findings and conclusions.
June 29, 2017, treatment note, Dr. Weeks stated that Mr.
Hatfield was progressing well with weight-bearing but still
had some balance issues. On August 3, 2017, Mr. Hatfield
reported the new symptom of left heel pain that had been
present and progressively worsening for ten weeks. Dr. Weeks
recommended injections, exercises, and physical therapy. On
August 31, 2017, Mr. Hatfield had a new complaint of first
metatarsophalangeal joint pain. His heel pain had improved.
Dr. Weeks reported that Mr. Hatfield's joint pain had
improved approximately 75% on October 5, 2017. He again
recommended physical therapy and injections.
claims administrator denied a request for referral to pain
management on January 30, 2017. On March 6, 2017, in two
separate decisions, it closed the claim for temporary total
disability benefits and denied a request for physical
therapy. The Office of Judges reversed the decisions in its
March 5, 2018, Order, ...