STATE OF WEST VIRGINIA
 

SUPREME COURT OF APPEALS FILED 

December 2, 2014 

RORY L. PERRY II, CLERK 

CONNIE FERGUSON, SUPREME COURT OF APPEALS 

OF WEST VIRGINIA 

Claimant Below, Petitioner 

vs.) No. 13-0846 (BOR Appeal No. 2048157) 

(Claim No. 880012206) 

WEST VIRGINIA OFFICE OF 

INSURANCE COMMISSIONER 

Commissioner Below, Respondent 

and 

JII/SALES PROMOTION ASSOCIATION, INC., 

Employer Below, Respondent 

MEMORANDUM DECISION 

Petitioner Connie Ferguson, by J. Robert Weaver, her attorney, appeals the decision of 

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

Insurance Commissioner, by Brandolyn N. Felton-Ernest, its attorney, filed a timely response. 

This appeal arises from the Board of Review’s Final Order dated July 24, 2013, in which 

the Board affirmed a January 31, 2013, Order of the Workers’ Compensation Office of Judges. 

In its Order, the Office of Judges affirmed the claims administrator’s September 21, 2011, 

decision to not authorize bilateral knee replacements. 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. Ferguson, an employee of JII/Sales Promotion and Associates, Inc., injured her knee 

in 1987. Ms. Ferguson filed for workers’ compensation benefits based upon her 1987 injury, and 

her claim was held compensable for an old disruption of the left knee lateral collateral ligament. 

Thereafter, Ms. Ferguson underwent a partial meniscectomy, which resulted in slow 

improvement of her symptoms. On March 12, 2012, Ms. Ferguson reported to Prakash Puranik, 

M.D., who opined that Ms. Ferguson would be a good candidate for bilateral knee replacements 

due to her osteoarthritis. Dr. Puranik requested bilateral knee replacements be authorized under 

Ms. Ferguson’s claim. Dr. Puranik’s report was never introduced into the record. As a result, it is 

uncertain whether Dr. Puranik opined that the 1987 injury caused Ms. Ferguson’s osteoarthritis. 

Ms. Ferguson reported to David C. Shamblin, M.D., who also opined that she was a good 

candidate for bilateral knee replacements. The claims administrator denied Ms. Ferguson’s claim 

because osteoarthritis was never ruled a compensable condition under the claim. Ms. Ferguson 

protested. 

The Office of Judges concluded that bilateral knee replacements were not medically 

necessary or reasonable in relation to the 1987 left sided old disruption of the lateral collateral 

ligament. The Office of Judges noted that there is no indication in Dr. Shamblin’s report of a 

causal connection between Ms. Ferguson’s symptoms and the compensable condition. Dr. 

Shamblin notes that Ms. Ferguson was diagnosed with rheumatoid arthritis and her knee joint 

has deteriorated since that time. However, the Office of Judges found that neither rheumatoid nor 

osteoarthritis has been ruled a compensable condition of the claim. Accordingly, the Office of 

Judges denied authorization for bilateral knee replacements as it related to Ms. Ferguson’s 1987 

compensable diagnosis of left sided disruption of the lateral collateral ligament. The Board of 

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

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

Review. Ms. Ferguson has failed to show how bilateral knee replacements are medically related 

or reasonably necessary in relation to the 1987 left sided disruption of the lateral collateral 

ligament. The only report in the record that concludes Ms. Ferguson would need bilateral knee 

replacements is the report of Dr. Shamblin. Dr. Shamblin does not indicate with clarity what 

precipitated Ms. Ferguson’s need for bilateral knee replacements. However, he did note that the 

left knee joint deteriorated in the time period after Ms. Ferguson was diagnosed with rheumatoid 

arthritis. Since rheumatoid arthritis was never found to be a compensable condition of this claim, 

any treatment related to it 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: December 2, 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