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STATE OF WEST VIRGINIA

SUPREME COURT OF APPEALS

DERRICK WILLIAMS

Claimant Below, Petitioner

vs.) No. 19-0184 (BOR Appeal No. 2053361)

(Claim No. 2017010287)

 

CITY OF CHARLESTON, 

Employer Below, Respondent

MEMORANDUM DECISION

Petitioner Derrick Williams, by Counsel Patrick K. Maroney, appeals the decision of the 

West Virginia Workers’ Compensation Board of Review (“Board of Review”). The City of 

Charleston, by Counsel James W. Heslep, filed a timely response.

The issue on appeal is medical treatment of compensable injuries. On February 17, 2017, 

the claims administrator denied payment of billings for a hernia repair from Thomas Memorial 

Hospital. The Workers’ Compensation Office of Judges (“Office of Judges”) reversed the claims 

administrator’s decision and authorized payment by Order dated September 6, 2018. This appeal 

arises from the Board of Review’s February 6, 2019, Order, which reversed and vacated the 

decision of the Office of Judges. The Board of Review reinstated the February 17, 2017, Order of 

the claims administrator, denying the request from Thomas Memorial Hospital.

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. 

Mr. Williams is a police officer for the City of Charleston. On October 17, 2016, he 

completed an incident report stating that he had sustained a small laceration on his left elbow while 

chasing a suspect through a house. He was provided first aid and released to return to work on 

October 17, 2016, with no modifications to his duty.

Mr. Williams was treated by Kristen Eads, M.D., with Thomas Memorial Hospital Surgical 

Associates on October 26, 2016, upon a referral from John O. Frame, D.O. Mr. Williams presented 

FILED

February 13, 2020

EDYTHE NASH GAISER, CLERK

SUPREME COURT OF APPEALS

OF WEST VIRGINIA
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with a history consistent with pain in the right groin which he claimed to have experienced for a 

month. The assessment was reducible right inguinal hernia. The plan for treatment was to schedule 

robotic right inguinal hernia surgery with possible left repair. Mr. Williams underwent hernia 

repair surgery on November 2, 2016. After surgery, he missed six weeks of work. 

By letter dated November 14, 2016, the claims administrator requested that Mr. Williams 

complete a Report of Injury form with regard to the October 17, 2016, incident. The letter noted 

that the form must be completed within six months of the alleged date of injury. Mr. Williams did 

not submit this form to the claims administrator. 

Thomas Memorial Hospital subsequently submitted billing for the cost of the hernia repair. 

On February 17, 2017, the claims administrator denied the request received from Thomas 

Memorial Hospital. It was stated that the request was denied because there was information that 

the condition was pre-existing and not related to the event on October 17, 2016. Mr. Williams 

protested the claims administrator’s decision.

Mr. Williams offered testimony at deposition on January 23, 2018. He testified that he 

became engaged in a physical altercation with a criminal suspect on October 17, 2016. The 

following day, he noticed pain in his abdomen. Mr. Williams denied any prior hernia injuries. He 

testified that he amended his original incident report because of some abdominal pain he was 

experiencing. He scheduled an appointment with a clinic and was referred, by Dr. Frame, to a 

specialist at Thomas Memorial Hospital. Following surgery, he was off work for two weeks and 

on light duty for four weeks. Mr. Williams further testified that he received a letter from the claims 

administrator asking him to complete a Report of Injury form. He stated that he turned in all of his 

paper work to a representative of the City of Charleston named Tim Campbell. He testified that 

this is his only workers’ compensation claim, and he thought that he accurately reported the injury 

to his employer.

On September 6, 2018, the Office of Judges reversed the claims administrator’s decision 

and ordered the claim administrator to authorize payment for billings for his hernia repair from 

Thomas Memorial Hospital. The Office of Judges found no evidence of a pre-existing right 

inguinal hernia and concluded that Mr. Williams’s surgery related to the compensable event which 

occurred on October 17, 2016. The Office of Judges found that even though the claims 

administrator had not received a workers’ compensation application form, he had provided 

evidence that he turned in all of his paperwork to the proper representative of the City of Charleston

and that he accurately reported the injury to his employer. Further, the Office of Judges found that

the claims administrator did not deny the request for payment on the basis that Mr. Williams had 

not filed a Report of Injury form, but the claims administrator denied the request for payment on 

the basis that the hernia was a pre-existing condition.

By Order dated February 6, 2019, the Board of Review reversed the September 6, 2018, 

decision of the Office of Judges. The Board of Review found the analysis and conclusions of the 

Office of Judges to be clearly wrong in view of the reliable, probative and substantial evidence on 

the whole record. The Board of Review reasoned there was no mention of a hernia in the Report 

of Incident to the City of Charleston on October 17, 2016. It was found that the first medical 
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evidence of a hernia is in the report from Thomas Memorial Hospital’s Surgical Associates on 

October 26, 2016. In the report, it was noted that Mr. Williams had been referred with a history of 

pain in the right groin that had been present for one month beginning with an unknown event. 

Although surgery was recommended, the Board of Review concluded that the evidence does not 

show a causal connection between the October 17, 2016, incident and Mr. Williams’s hernia. The 

Board of Review found that Mr. Williams failed to establish that his hernia occurred in the course 

of and resulting from his employment. Based upon the evidence of the record, the Board of Review 

reversed and vacated the September 6, 2018, Order of the Office of Judges. The claims 

administrator’s Order dated February 17, 2017, denying the request from Thomas Memorial 

Hospital for payment of billings for a hernia repair, was reinstated.

After review, we agree with the decision of the Board of Review. The initial incident report 

and treatment records indicate that Mr. Williams sustained a laceration to his left elbow while 

working, not a hernia. The report of hernia symptoms existing in the weeks prior to the elbow 

laceration incident and the reporting that Mr. Williams had no known event causing his symptoms 

support the Board of Review’s decision that he failed to establish that the hernia occurred in the 

course of and resulting from his employment. 

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 so clearly wrong based upon the evidentiary record that even when all 

inferences are resolved in favor of the Board of Review’s findings, reasoning and conclusions, 

there is insufficient support to sustain the decision. Therefore, the decision of the Board of Review 

is affirmed.

 Affirmed.

ISSUED: February 13, 2020

CONCURRED IN BY:

Chief Justice Tim Armstead

Justice Margaret L. Workman

Justice Elizabeth D. Walker

Justice Evan H. Jenkins

Justice John A. Hutchison