STATE OF WEST VIRGINIA
 

SUPREME COURT OF APPEALS FILED 

May 24, 2016 

RORY L. PERRY II, CLERK 

JAMES O. BURFORD, SUPREME COURT OF APPEALS 

OF WEST VIRGINIA 

Claimant Below, Petitioner 

vs.) No. 15-0480 (BOR Appeal No. 2050030) 

(Claim No. 920061544) 

WEST VIRGINIA OFFICE OF 

INSURANCE COMMISSIONER 

Commissioner Below, Respondent 

and 

KANAWHA COUNTY BOARD OF EDUCATION, 

Employer Below, Respondent 

MEMORANDUM DECISION 

Petitioner James O. Burford, by Patrick K. Maroney, his attorney, appeals the decision of 

the West Virginia Workers’ Compensation Board of Review. West Virginia Office of the 

Insurance Commissioner, by Anna L. Faulkner, its attorney, filed a timely response. 

This appeal arises from the Board of Review’s Final Order dated April 23, 2015, in 

which the Board affirmed a November 7, 2014, Order of the Workers’ Compensation Office of 

Judges. In its Order, the Office of Judges affirmed the claims administrator’s March 11, 2014, 

decision denying Tramadol, Neurontin, and Zanaflex. The Court has carefully reviewed the 

records, written arguments, and appendices contained in the briefs, and the case is mature for 

consideration. 

This 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 

Procedure. 

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Mr. Burford worked in the maintenance department for the Kanawha County Board of 

Education. On June 24, 1992, he suffered a laceration when a knife punctured his right forearm. 

Mr. Burford was treated at Thomas Memorial Hospital where the wound was repaired, and he 

returned to work two days later. The claims administrator held the claim compensable. In the 

beginning of 2000, Mr. Burford came under the care of Timothy Deer, M.D., who treated him for 

right arm pain for over a decade. Dr. Deer prescribed several medications to treat Mr. Burford’s 

complaints of pain including Zanaflex, Klonopin, Ultracet, and Neurontin. Eventually, on 

November 18, 2009, Prasadarao B. Mukkamala, M.D., performed an independent medical 

evaluation of Mr. Burford. He recommended denying the addition of several compensable 

conditions to the claim related to Mr. Burford’s right shoulder. Dr. Mukkamala also found that 

the medications Ultracet, Neurontin, Zanaflex, and Clonazepam were not needed to treat the 

compensable injury. Dr. Mukkamala specifically stated that Ultracet was a narcotic medication 

that should not be prescribed, especially because Mr. Burford’s forearm pain was non-specific. 

Dr. Mukkamala also noted that Zanaflex was a muscle relaxer and should not be authorized 

because there was no evidence of muscle spasms in Mr. Burford’s medical records. 

On August 27, 2010, the claims administrator denied a request for Zanaflex, Klonopin, 

Ultracet, and Neurontin. This decision was affirmed by the Office of Judges and ultimately 

affirmed by the Board of Review on October 26, 2011. On February 6, 2013, Dr. Deer requested 

the medications Gabapentin, Tizanidine, and Ultracet. On August 26, 2013, he requested 

authorization for the medication Zanaflex, Neurontin, and Tramadol. The claims administrator 

denied authorization for Zanaflex, Neurontin, and Tramadol on August 29, 2013, and Tramadol, 

Neurontin, and Zanaflex on March 11, 2014. 

On June 13, 2014, Mr. Burford testified at a deposition that he was employed in general 

maintenance by the Kanawha County Board of Education when he injured his right arm on June 

24, 1992. He was installing a glass and framing when the knife he was working with slipped and 

sliced into his arm. Since the injury, he has experienced pain in his arm and has difficulty using 

it. He asserted that he has suffered no other injuries to his right arm since the work incident. He 

testified that his physician has prescribed Tramadol, Neurontin, and Zanaflex for relief of his 

symptoms. Mr. Burford asserted that the Tramadol relieves the pain in his arm, the Neurontin 

helps his aches and sharp pains and allows him to rest, and Zanaflex relaxes his muscles. 

The Office of Judges determined that the requested medications were not medically 

related and reasonably required to treat his compensable diagnoses on November 7, 2014. The 

Office of Judges found that in a previous appeal, the claims administrator, Office of Judges, and 

Board of Review all denied the medications Zanaflex, Klonopin, Ultracet, and Neurontin 

because Dr. Mukkamala found that they were not required. The Office of Judges noted that the 

current request was for Tramadol, Neurontin, and Zanaflex. As there was not persuasive 

evidence to show that these medications were required, the Office of Judges relied on Dr. 

Mukkamala’s opinion and denied authorization. The Board of Review adopted the findings of 

the Office of Judges and affirmed its Order on April 23, 2015. 

After review, we agree with the consistent decisions of the claims administrator, Office 

of Judges, and Board of Review. In relation to the medications Neurontin and Zanaflex, this 

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Court has already spoken. In Burford v. West Virginia Office of the Insurance Commissioner, 

No. 14-1223 (W. Va. Supreme Court, September 16, 2015) (memorandum decision), this Court 

held that the Board of Review properly denied the medications Neurontin and Zanaflex. In 

addition, there is no persuasive evidence in the record to show that Tramadol is medically related 

and reasonably required, especially considering Dr. Mukkamala’s persuasive report. Therefore, it 

was proper for the Office of Judges and Board of Review to deny authorization for all three 

medications. 

For the 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 affirmed. 

Affirmed. 

ISSUED: May 24, 2016 

CONCURRED IN BY: 

Chief Justice Menis E. Ketchum 

Justice Robin J. Davis 

Justice Brent D. Benjamin 

Justice Margaret L. Workman 

Justice Allen H. Loughry II 

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