STATE OF WEST VIRGINIA
 

SUPREME COURT OF APPEALS FILED 

June 10, 2014 

RORY L. PERRY II, CLERK 

MICHELLE ADKINS, SUPREME COURT OF APPEALS 

OF WEST VIRGINIA 

Claimant Below, Petitioner 

vs.) No. 13-0142 (BOR Appeal No. 2047614) 

(Claim No. 2009089707) 

LOGAN COUNTY EMERGENCY AMBULANCE SERVICE, 

Employer Below, Respondent 

MEMORANDUM DECISION 

Petitioner Michelle Adkins, by Wendle D. Cook, her attorney, appeals the decision of the 

West Virginia Workers’ Compensation Board of Review. Logan County Emergency Ambulance 

Service, by Bradley A. Crouser, its attorney, filed a timely response. 

This appeal arises from the Board of Review’s Final Order dated January 18, 2013, in 

which the Board affirmed an August 20, 2012, Order of the Workers’ Compensation Office of 

Judges. In its Order, the Office of Judges affirmed the claims administrator’s October 28, 2011, 

decision denying authorization for chiropractic treatment. 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. 

Ms. Adkins worked for Logan County Emergency Ambulance Service as an emergency 

medical technician. On April 27, 2009, she fell down a flight of stairs while trying to carry a 

patient from his home. She received several injuries, and her claim was held compensable for an 

intervertebral disc without myelopathy, a neck sprain, a lumbar sprain, and a thoracic sprain. Ms. 

Adkins began receiving chiropractic care from Cliff D. Hill, D.C., immediately following the 

injury. She then came under the care of Panos Ignatiadis, M.D., who performed an anterior 

discectomy and fusion surgery to repair the damage to her neck. Following the surgery, Robert 

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Walker, M.D., performed an independent medical evaluation and determined that Ms. Adkins 

had reached her maximum degree of medical improvement. Dr. Ignatiadis then requested 

authorization for additional chiropractic treatment from Dr. Hill. The claims administrator 

granted her authorization for twelve chiropractic visits over the next twelve weeks. Two months 

later, Dr. Ignatiadis again requested authorization for additional visits with Dr. Hill. Rebecca 

Thaxton, M.D., reviewed Dr. Ignatiadis’s request and found that the requested chiropractic visits 

should not be authorized. Dr. Thaxton determined that Ms. Adkins had already received sixtyfour chiropractic visits related to the compensable injury, and she opined that any additional 

visits would not be necessary. On October 28, 2011, the claims administrator denied Dr. 

Ignatiadis’s request for additional chiropractic visits. Michael R. Condaras, D.C., also reviewed 

the request. He found that Ms. Adkins’s condition had remained essentially stable for the last 

three months despite continued chiropractic treatment, and he opined that any additional 

treatment would not improve her condition. On August 20, 2012, the Office of Judges affirmed 

the claims administrator’s decision. The Board of Review affirmed the Order of the Office of 

Judges on January 18, 2013, leading Ms. Adkins to appeal. 

The Office of Judges concluded that the evidence in the record did not support 

authorizing the requested additional chiropractic treatment with Dr. Hill. The Office of Judges 

noted that Ms. Adkins had received over sixty separate chiropractic visits with Dr. Hill and 

determined that any additional visits would exceed the treatment guidelines provided under West 

Virginia Code of State Rules § 85-20-46 (2006). The Office of Judges further determined that 

Ms. Adkins’s treating physicians, Dr. Ignatiadis and Dr. Hill, did not provide sufficient 

documentation to justify authorizing treatment in excess of these guidelines. Finally, the Office 

of Judges found it particularly compelling that Dr. Condaras, a chiropractor, believed that the 

requested additional treatment would not improve Ms. Adkins’s condition. The Board of Review 

adopted the findings of the Office of Judges and affirmed its Order. 

We agree with the conclusions of the Board of Review and the findings of the Office of 

Judges. Ms. Adkins has not demonstrated that the requested chiropractic treatment with Dr. Hill 

is medically related and reasonably required to treat her compensable injury. Ms. Adkins has 

received over sixty chiropractic visits, including several visits after Dr. Walker determined that 

she had reached her maximum degree of medical improvement. Any additional chiropractic 

treatment would clearly exceed the provision of West Virginia Code of State Rules § 85-20-46.7 

(2006), which permits a maximum of twelve separate treatments within fourteen months of the 

date of injury. The evidence in the record does not indicate that this is an extraordinary case in 

which additional chiropractic treatment outside these limitations would be justified. Instead, the 

evidence supports the opinion of Dr. Condaras that the requested treatment is not likely to 

improve Ms. Adkins’s condition. 

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. 

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Affirmed. 

ISSUED: June 10, 2014 

CONCURRED IN BY: 

Chief Justice Robin J. Davis 

Justice Brent D. Benjamin 

Justice Margaret L. Workman 

Justice Menis E. Ketchum 

Justice Allen H. Loughry II 

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