Opinion ID: 1379394
Heading Depth: 2
Heading Rank: 1

Heading: Evaluating Impairment of Pulmonary Function

Text: In order to fully appreciate the facts of these consolidated cases, one needs at least a rudimentary understanding of how impairment of pulmonary function is evaluated under the workers' compensation law of this state. Impairment of pulmonary function, or breathing impairment, is assessed principally through ventilatory function testing. During this testing, the claimant exhales forcibly into an instrument called a spirometer. The spirometer records the [v]olume of air that can be forcefully exhaled from the lungs after a maximal inspiration, known as the forced vital capacity (FVC), and the [v]olume of air that can be exhaled forcefully from the lungs in one (1) second after a maximal inspiration, termed the forced expiratory volume in one (1) second (FEV1). 85 W. Va. C.S.R. § 85-1-20.8.4 (effective July 1, 1986). Ventilatory function test results are expressed as actual scores and as percentages of predicted normal values (e.g., FVC percent of predicted), which values are derived from a statistical analysis of persons with normal breathing. Once test results are obtained, the degree of breathing impairment is determined in accordance with the Table for Impairment of Pulmonary Function (Table 85-1A). 85 W. Va.C.S.R. § 85-1A-20.8.7. [2] The results of ventilatory function tests performed by Appellants Boggess and Payne were interpreted against two sets of predicted normal values: the Kory predicted normal values and the Morris predicted normal values. The Kory predicted normal values were established in 1961 by Ross C. Kory, M.D., and others, who tested the breathing of 468 normal men at fifteen medical facilities of the U.S. Army and the U.S. Veteran's Administration. The legislative rule now in questionsection 20.8.5(b)was adopted by the Legislature in 1986, [3] and since then, the Occupational Pneumoconiosis Board (OP Board), has used only the Kory predicted values to interpret the results of ventilatory function tests. The Morris predicted normal values were derived from a study published in 1971 by J.F. Morris, M.D., and associates. The Morris study population was rural, consisted of 517 nonsmoking men and 471 nonsmoking women, ages twenty to eighty-four, and contained a large number of Mormons. Test results obtained by Dominic Gaziano, M.D., and submitted by the Appellants in the administrative proceedings below, were calculated using the Morris predicted values.