STATE OF WEST VIRGINIA
 

SUPREME COURT OF APPEALS FILED 

November 4, 2015 

RORY L. PERRY II, CLERK 

ANITA K. SPROUSE, SUPREME COURT OF APPEALS 

OF WEST VIRGINIA 

Claimant Below, Petitioner 

vs.) No. 14-0414 (BOR Appeal No. 2048797) 

(Claim No. 960034808) 

WEST VIRGINIA OFFICE OF 

INSURANCE COMMISSIONER 

Commissioner Below, Respondent 

and 

CALHOUN COUNTY EMERGENCY MED SQUAD, 

Employer Below, Respondent 

MEMORANDUM DECISION 

Petitioner Anita K. Sprouse, by Robert L. Stultz, her attorney, appeals the decision of the 

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

Commissioner, by Noah A. Barnes, its attorney, filed a timely response. 

This appeal arises from the Board of Review’s Final Order dated March 31, 2014, in 

which the Board affirmed a September 19, 2013, Order of the Workers’ Compensation Office of 

Judges. In its Order, the Office of Judges affirmed the claims administrator’s March 27, 2012, 

decision to deny a permanent total disability award. 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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Ms. Sprouse, a paramedic for Calhoun County Emergency Med Squad, was involved in 

an ambulance accident while on duty on February 10, 1996. In the accident, Ms. Sprouse injured 

her head, neck, back, shoulder, spleen, and ankle. Her injuries also included a psychiatric 

component. On June 22, 1999, Ms. Sprouse was evaluated by Albert F. Heck, M.D. Dr. Heck 

opined that she was at her maximum degree of medical improvement. Dr. Heck felt the change in 

Ms. Sprouse’s mental status represented 3% whole person impairment based on the American 

Medical Association’s Guides to the Evaluation of Permanent Impairment (4th ed. 1993). He 

also opined that Ms. Sprouse’s problem with opticomotor nerve function represented 24% whole 

person impairment. On September 13, 1999, the claims administrator granted Ms. Sprouse a 24% 

permanent partial disability award. 

On December 6, 1999, Ms. Sprouse was seen by Paul Bachwitt, M.D., for evaluation. Dr. 

Bachwitt opined she was at her maximum degree of medical improvement and suffered 15% 

whole person impairment. On March 1, 2000, the claims administrator granted Ms. Sprouse a 

15% permanent partial disability award. Of the 15% permanent partial disability granted: 7% 

was for the neck, 5% was for the back, and 3% was for the shoulder. On June 7, 2004, Ms. 

Sprouse underwent a psychiatric independent medical evaluation performed by Patricia W. 

Williams, M.D. Dr. Williams opined that her psychiatric conditions were related to her accident 

on February 10, 1996. Dr. Williams recommended 6% whole person impairment related to her 

psychiatric conditions. 

Thereafter on July 14, 2005, Ms. Sprouse was evaluated by Ghassan Y. Dagher, M.D. Dr. 

Dagher opined that she essentially had no vision in one eye due to her ocular immobility, which 

equated to 24% whole person impairment. On September 6, 2005, the claims administrator 

granted Ms. Sprouse a 6% permanent partial disability award based upon her psychiatric 

impairment. On September 8, 2005, the claims administrator found that Ms. Sprouse was not 

entitled to any more than a 24% permanent partial disability award based upon the report of Dr. 

Dagher. On September 13, 2005, Ms. Sprouse applied for permanent total disability alleging that 

her previous awards amounted to 69% disability. On December 3, 2010, Ms. Sprouse reported to 

Kevin Cox, M.D., for an independent medical evaluation. He opined just as the other doctors 

have that she has no vision in one of her eyes due to ocular immobility, which equated to 24% 

whole person impairment. On December 6, 2010, Ms. Sprouse underwent psychological and 

psychiatric evaluations. Rosemary Smith, PsyD, opined that she suffered from 10% whole 

person impairment related to all her psychological and psychiatric conditions. 

On December 21, 2010, Ms. Sprouse was seen by Charles Werntz III, M.D., for a 

comprehensive independent medical evaluation. He opined that she was at her maximum degree 

of medical improvement for all of her medical conditions. Using the American Medical 

Association’s Guides, he found Ms. Sprouse suffered from 1% whole person impairment for 

facial asymmetry, 0% for the cervical spine, 0% for the shoulder, 0% for the spleen, and 1% for 

the right ankle. Using the Combined Values Chart of the American Medical Association’s 

Guides, he found 2% whole person impairment. Dr. Werntz noted Ms. Sprouse has significant 

ophthalmic condition that would require a separate impairment rating. He also noted that his 

report did not cover psychiatric impairment. On February 3, 2011, Ms. Sprouse underwent a 

functional capacity evaluation from Kevin C. Boring, P.T. Ms. Sprouse performed at the light 

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physical demand levels based on occasional material handling levels. It was found that Ms. 

Sprouse may be an excellent candidate for improving her current physical demand level through 

a supervised work conditioning program. 

On October 13, 2011, the Permanent Total Disability Review Board made its initial 

recommendation. According to the Permanent Total Disability Review Board, Ms. Sprouse 

suffered 24% impairment for visual issues, 1% impairment for facial asymmetry, 2% impairment 

for the cervical spine, 1% impairment for the ankle, and 10% impairment for the psychiatric 

component of the injury. The Permanent Total Disability Review Board found Ms. Sprouse 

suffered from a total of 35% whole person impairment. The Permanent Total Disability Review 

Board found that Ms. Sprouse did not suffer from a medical impairment of at least 50% on a 

whole person basis and has not sustained a 35% or greater statutory disability. It recommended 

that she be denied any permanent total disability award. On March 15, 2012, the Permanent Total 

Disability Review Board issued its Final Recommendation. This report mirrored its initial 

recommendations. As a result the claims administrator denied Ms. Sprouse’s application for 

permanent total disability on March 27, 2010. Ms. Sprouse protested. 

The Office of Judges determined that Ms. Sprouse failed to meet the 50% whole person 

impairment threshold required for further consideration for a permanent total disability award. 

The Office of Judges noted that the Permanent Total Disability Review Board determined that 

she suffered from 24% whole person impairment related to the vision loss, 1% whole person 

impairment for facial asymmetry, 2% whole person impairment for the cervical spine, 1% whole 

person impairment for the ankle, and 10% whole person impairment for the psychiatric 

impairment. When combined utilizing the Combined Values Chart of the American Medical 

Association’s Guides, these ratings equates to 35% whole person impairment. The Office of 

Judges then noted that West Virginia Code § 23-4-6(n)(1) (2005), requires that in order to be 

eligible for a permanent total disability award Ms. Sprouse must have suffered whole person 

impairment of 50%. The Permanent Total Disability Review Board relied on the findings from 

the reevaluations of Ms. Spouse by Drs. Werntz, Dagher, and Cox and determined her whole 

person impairment to be 35%. Because Ms. Sprouse could not show that she suffered at least 

50% whole person impairment from her injuries, the Office of Judges determined that the 

Permanent Total Disability Review Board’s recommendation was not clearly wrong. The Board 

of Review adopted the findings of the Office of Judges and affirmed its conclusions. 

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

Review. The Permanent Total Disability Review Board determined that Ms. Sprouse only 

suffered from 35% whole person impairment related to all her compensable conditions. Because 

she did not introduce sufficient evidence to show that she did suffer at least 50% whole person 

impairment, the Office of Judges and Board of Review were correct in affirming the 

recommendations of the Permanent Total Disability Review Board. 

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: November 4, 2015 

CONCURRED IN BY: 

Chief Justice Margaret L. Workman 

Justice Robin J. Davis 

Justice Brent D. Benjamin 

Justice Menis E. Ketchum 

Justice Allen H. Loughry II 

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