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 STATE OF WEST VIRGINIA 

SUPREME COURT OF APPEALS 

 

LYNESE DANFORD, 

Claimant Below, Petitioner 

vs.) No. 16-1196 (BOR Appeal No. 2051370) 

 (Claim No. 2014019237) 

 

KANAWHA HOSPICE CARE, INC., 

Employer Below, Respondent 

MEMORANDUM DECISION 

 Petitioner Lynese Danford, by Edwin H. Pancake, her attorney, appeals the decision of the 

West Virginia Workers’ Compensation Board of Review. Kanawha Hospice Care, Inc., by H. Dill 

Battle III, its attorney, filed a timely response.

The issue on appeal is whether cubital tunnel syndrome and brachial plexus injury should 

be added to the claim. The claims administrator denied the addition of the conditions on September 

8, 2015. The Office of Judges affirmed the decision in its May 27, 2016, Order. The Order was 

affirmed by the Board of Review on November 21, 2016. 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. Danford, a registered nurse, was injured in the course of her employment on 

November 13, 2013, while lifting an unconscious patient. A treatment note by Charles Shuff, M.D., 

the following day indicates Ms. Danford reported a new work-related injury to her neck. She 

indicated she lifted a patient, felt a pop in her neck, and her entire right arm went numb. Dr. Shuff’s 

impression was poly-dermatomal/atypical radiculopathy of the right extremity. A cervical x-ray 

showed stable findings. Ms. Danford’s report of injury indicates she injured her neck and right arm 

while transferring a patient. She felt a pop and pull in her neck and developed immediate numbness 

in her right arm. The diagnosis was listed as a cervical strain that did not aggravate a prior injury 

FILED 

September 15, 2017 

RORY L. PERRY II, CLERK 

SUPREME COURT OF APPEALS 

OF WEST VIRGINIA
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or disease. The claims administrator held the claim compensable for neck sprain/strain on 

December 31, 2013. 

 Ms. Danford had a pre-existing history of cervical and right upper extremity problems. A 

March 13, 2013, treatment note by Dr. Shuff indicates she was seen for new onset of pain in the 

right side of the neck, right arm, right forearm, and fingers following a car crash four weeks prior. 

The impression was degenerative disc disease of the cervical spine with C7 radiculopathy. A pain 

assessment completed by Nurse Mary Beth Merritt on April 18, 2013, indicates Ms. Danford was 

evaluated for complaints of neck pain and right arm numbness and tingling. A May 16, 2013, 

medical report from St. Mary’s Medical Center indicates she received a cervical epidural steroid 

injection for neck pain with radiculopathy. On August 17, 2013, Ms. Danford underwent a cervical 

discectomy and fusion for neck pain, numbness, tingling, and paresthesia of the right arm 

performed by Dr. Shuff. The post-operative diagnosis was right-sided C6 and C7 radiculopathy 

secondary to cervical canal stenosis and spondylosis. A November 6, 2013, treatment note by Dr. 

Shuff, one week prior to the compensable injury, indicates Ms. Danford was seen for follow up 

with complaints of new pain on the right side. 

An EMG/NCS of the right upper extremity performed on January 15, 2014, was essentially 

within normal limits. There was no evidence of carpal tunnel syndrome, ulnar neuropathy, or radial 

sensory neuropathy. There was no evidence of right cervical radiculopathy or myopathy. A January 

22, 2014, treatment note by Dr. Shuff indicates Ms. Danford was currently dealing with two 

problems. First, she had cervical spondylosis with radiculopathy status post-surgery. Second, she 

developed right arm and shoulder pain after pulling on a patient at work. She continued to have 

numbness, tingling, and loss of strength in the right arm. Dr. Shuff’s impression was C8 neuritis 

versus peripheral nerve based ulnar lesion/stretch. He recommended a C8 steroid injection for 

diagnosis and therapy. On March 26, 2014, Ms. Danford’s neck was doing well but she continued 

to have numbness, tingling, and paresthesia, particularly in the right pinky finger. She had 

difficulty with fine motor skills and repetitive activity. 

Prasadarao Mukkamala, M.D., performed an independent medical evaluation on May 7, 

2014, in which he noted diminished sensation over the right upper extremity in a global and nonanatomic pattern. Dr. Mukkamala diagnosed the work injury as a cervical sprain. He found Ms. 

Danford had reached maximum medical improvement and assessed 6% whole person impairment. 

In a May 14, 2014, treatment note, Alan Koester, M.D., found that Ms. Danford sustained 

a work-related traction injury to her right arm. He noted that Dr. Shuff did not believe her current 

problems were related to her pre-existing conditions. Ms. Danford reported persistent right arm 

and elbow pain with a tingling sensation into the fingers. There was also tenderness around the 

brachial plexus. Dr. Koester’s impression was a likely double crush phenomenon with right cubital 

tunnel syndrome and brachial plexopathy. He did not believe the symptoms were related to the 

cervical spine. 

Paul Bachwitt, M.D., performed an independent medical evaluation on June 10, 2014, in 

which he opined that the medical documentation supports a causal relationship between the 

compensable injury and Ms. Danford’s cervical spine; however, he found no such connection 
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between the compensable injury and the right arm/elbow complaints. He specifically noted that 

seven days before the injury occurred, Dr. Shuff diagnosed Ms. Danford with a new onset of C8 

radiculopathy. Dr. Bachwitt opined that the mechanism of injury, pulling on a patient, would not 

cause an injury to the ulnar nerve. In that regard, he noted that ulnar nerve injuries are usually the 

result of a contusion or striking type injury to the elbow. Dr. Bachwitt diagnosed the compensable 

injury as a cervical strain. 

In a June 23, 2014, physician review, Randall Short, M.D., was asked to comment on 

whether cubital tunnel syndrome and brachial plexopathy should be compensable diagnoses in the 

claim. Dr. Short found that according to Dr. Shuff’s November 6, 2013, treatment note, Ms. 

Danford’s right upper extremity symptoms predated the compensable injury. Dr. Short additionally 

noted that Dr. Bachwitt determined that her right upper extremity symptoms are unrelated to the 

compensable injury. Dr. Short concluded that cubital tunnel syndrome and brachial plexopathy 

should not be added as compensable conditions in the claim. 

A medical report by Dr. Shuff dated June 25, 2014, indicates Ms. Danford continued to 

have a brachial-plexus pattern of pain in the right arm. His assessment was resolved cervical 

radiculopathy and brachial plexus stretch injury with lower trunk abnormality. He additionally 

opined that Ms. Danford’s right arm symptoms are the result of her compensable injury. 

The claims administrator denied the addition of cubital tunnel syndrome and injury of 

brachial plexus to the claim on September 8, 2015. The Office of Judges affirmed the decision in 

its May 27, 2016, Order. It found that Drs. Shuff and Koester both opined that Ms. Danford’s 

cubital tunnel syndrome and brachial plexus nerve injury were a result of her compensable injury. 

Their findings were determined by the Office of Judges to be inconsistent with the medical 

evidence of record. Dr. Shuff’s November 6, 2013, treatment note clearly states that Ms. Danford’s 

right upper extremity symptoms predated the compensable injury of November 13, 2013. He noted 

on November 6, 2013, that she was being evaluated for complaints of new pain following a C8 

distribution on the right side. Physical examination revealed light touch discrepancy behind the 

right elbow into the forearm. Though Dr. Shuff initially diagnosed these symptoms as a new onset 

of C8 radiculopathy, they are the same symptoms which later led both Dr. Shuff and Dr. Koester 

to diagnose cubital tunnel syndrome and brachial plexus injury. The Office of Judges further found 

that while there is evidence to suggest that Ms. Danford’s right upper extremity conditions were 

aggravated by the compensable injury, a non-compensable pre-existing injury cannot be added as 

a compensable component of a claim merely because it may have been aggravated by a 

compensable injury. Gill v. City of Charleston, 236 W. Va. 737, 783 S.E.2d 857 (2016). The Office 

of Judges found that Drs. Bachwitt and Short concluded that Ms. Danford’s right arm symptoms 

predated the compensable injury. Additionally, Drs. Bachwitt, Short, and Mukkamala all opined 

that the compensable injury resulted in nothing more than a cervical strain. Their opinions were 

determined to be consistent with the medical evidence of record. The Board of Review adopted 

the findings of fact and conclusions of law of the Office of Judges and affirmed its Order on 

November 21, 2016. 

After review, we agree with the reasoning and conclusions of the Office of Judges as 

affirmed by the Board of Review. Ms. Danford’s right upper extremity symptoms clearly predated 
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the compensable injury as is evidenced by Dr. Shuff’s treatment notes. Though the conditions may 

have been aggravated by the compensable injury, the addition of cubital tunnel syndrome and 

brachial plexus nerve injury to the claim was properly denied. 

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: September 15, 2017 

CONCURRED IN BY:

Chief Justice Allen H. Loughry II 

Justice Robin J. Davis 

Justice Margaret L. Workman 

Justice Menis E. Ketchum 

Justice Elizabeth D. Walker