Court Opinion

ID: 9364625
Source: CourtListenerOpinion
Date Created: 2023-01-19 19:16:30.026447+00
Date Added: 2024-06-11T17:15:39.420438
License: Public Domain

FILED
                                                                            January 19, 2023
                                                                             EDYTHE NASH GAISER, CLERK
                                                                             SUPREME COURT OF APPEALS
                                                                                 OF WEST VIRGINIA

                              STATE OF WEST VIRGINIA

                           SUPREME COURT OF APPEALS

BOB EVANS FARMS, INC.,
Employer Below, Petitioner

vs.)   No. 21-0509 (BOR Appeal No. 2055980)
                   (Claim No. 2019024709)

KIMBERLY M. WOOLFORD,
Claimant Below, Respondent

                              MEMORANDUM DECISION

       Petitioner Bob Evans Farms, Inc., by Counsel Jane Ann Pancake and Jeffrey B. Brannon,
appeals the decision of the West Virginia Workers’ Compensation Board of Review (“Board of
Review”). Kimberly M. Woolford, by Counsel T. Colin Greene, filed a timely response.

        The issues on appeal are compensability and medical benefits. The claims administrator
rejected the claim on June 6, 2019. In a separate decision that day, the claims administrator also
denied a request for an orthopedic referral. The Workers’ Compensation Office of Judges (“Office
of Judges”) affirmed the compensability decision in its November 18, 2020, Order, and dismissed
the request for an orthopedic referral as moot. In a May 24, 2021, decision, the Board of Review
reversed the November 18, 2020, Office of Judges Order, held the claim compensable, granted the
request for an orthopedic referral, and remanded the case for additional evidence, as well as an
Order stating the compensable diagnosis.

        The Court has carefully reviewed the records, written arguments, and appendices contained
in the briefs, and the case is mature for consideration. 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.

       The standard of review applicable to this Court’s consideration of workers’ compensation
appeals has been set out under West Virginia Code § 23-5-15, in relevant part, as follows:

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              (c) In reviewing a decision of the Board of Review, the Supreme Court of
       Appeals shall consider the record provided by the board and give deference to the
       board’s findings, reasoning, and conclusions . . . .

               (e) If the decision of the board effectively represents a reversal of a prior
       ruling of either the commission or the Office of Judges that was entered on the same
       issue in the same claim, the decision of the board may be reversed or modified by
       the Supreme Court of Appeals only if the decision is in clear violation of
       constitutional or statutory provisions, is clearly the result of erroneous conclusions
       of law, or is so clearly wrong based upon the evidentiary record that even when all
       inferences are resolved in favor of the board’s findings, reasoning, and conclusions,
       there is insufficient support to sustain the decision. The court may not conduct a de
       novo reweighing of the evidentiary record . . . .

See Hammons v. W. Va. Off. of Ins. Comm’r, 235 W. Va. 577, 582-83, 775 S.E.2d 458, 463-64
(2015). As we previously recognized in Justice v. West Virginia Office Insurance Commission,
230 W. Va. 80, 83, 736 S.E.2d 80, 83 (2012), we apply a de novo standard of review to questions
of law arising in the context of decisions issued by the Board. See also Davies v. W. Va. Off. of
Ins. Comm’r, 227 W. Va. 330, 334, 708 S.E.2d 524, 528 (2011).

        Ms. Woolford, a waitress, injured her right knee in the course of her employment on May
26, 2019. She sought treatment that day from L. Hiles, M.D., at MedExpress. Dr. Hiles noted that
Ms. Woolford injured her right knee that morning when she got dizzy and lost her footing at work,
falling on her right knee. Ms. Woolford was diagnosed with right knee pain and referred to an
orthopedist. It was noted that x-ray was not available that day. Ms. Woolford was taken off of
work.

        The Employees’ and Physicians’ Report of Injury, completed May 29, 2019, indicates Ms.
Woolford injured her right knee when she became dizzy at work and lost her footing. The
physician’s section was completed at MedExpress and indicates Ms. Woolford sustained an
occupational right knee injury. A Workplace Injury Triage and Employer’s Report of Injury was
also completed that day and indicates Ms. Woolford was employed as a part-time server. She
injured her right knee that day while walking between the kitchen prep and breakroom. Ms.
Woolford reported that she got dizzy and lost her footing. Ms. Woolford attributed the dizziness
to being overheated because the air conditioner was not properly working that day. The claims
administrator rejected the claim on June 6, 2019. In a separate decision that day, the claims
administrator denied a request for an orthopedic referral.

        Ms. Woolford testified in an October 23, 2019, deposition that she had no preexisting
health issues. She stated that she injured her right knee at work on May 26, 2019, when she fell
while walking to the breakroom. Ms. Woolford asserted that she became overheated, got dizzy,
and fell on her right knee. The air conditioning system was malfunctioning that day. Ms. Woolford
stated that May 26, 2019, was a warm day, and she denied ever having experienced dizziness in
the past. Ms. Woolford stated that when she initially sought treatment at MedExpress, the x-ray
machine was not working. When she was treated at the hospital, an x-ray showed a fractured knee.
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Ms. Woolford sought treatment from an orthopedist, Dr. Wright, who ordered an MRI. The MRI
showed that Ms. Woolford’s right knee was broken with fragments. Dr. Wright recommended
physical therapy, which Ms. Woolford could not afford. Ms. Woolford admitted that she was
diabetic and took two medications for the condition.

        In its November 18, 2020, Order, the Office of Judges affirmed the claims administrator’s
rejection of the claim and dismissed the request for an orthopedic referral as moot. The Office of
Judges found that there were no witnesses to the alleged injury. Ms. Woolford did not slip or trip.
Instead, she became overheated due to a malfunctioning air conditioner, got dizzy, and fell. The
Office of Judges found that the record shows the incident happened at 7:15 a.m. in late May. The
Office of Judges concluded that May 26 would be a day in late spring and the incident happened
before the heat of the day would be anticipated. Ms. Woolford did not allege that the heat resulted
from the kitchen. Further, there was no testimony from Ms. Woolford’s coworkers regarding the
temperature in the building. The Office of Judges found that Ms. Woolford failed to show that she
became dizzy and fell as a result of being overheated and it was just as likely that she became
dizzy for an idiopathic reason. The Office of Judges found no indication that when Ms. Woolford
hit the floor that there was anything unique about the employer’s floor which would present an
unusual risk of injury. The Office of Judges noted this Court’s past decisions establish that an
injury is not compensable merely because it happens on the employer’s property, such injury must
also be the result of Ms. Woolford’s employment. 1 The Office of Judges concluded that Ms.
Woolford’s assertion that she fell and injured her right knee due to being overheated was not
persuasive. Therefore, the rejection of the claim was affirmed, and the request for medical
treatment was dismissed as moot.

        On May 24, 2021, the Board of Review reversed the Office of Judges’ Order, held the
claim compensable, granted the requested treatment, and remanded the case for additional medical
evidence as well as an Order listing the compensable conditions. The Board of Review found that
the Office of Judges took judicial notice that May 26 would be a day in late springtime and that
the incident occurred before the heat of the day would have arrived. The Office of Judges
concluded that Ms. Woolford could have become dizzy due to an idiopathic reason. The Board of
Review concluded that the Office of Judges’ findings were speculative. There was no evidence
submitted to refute Ms. Woolford’s testimony that she became overheated due to a malfunctioning
air conditioner, got dizzy, and fell on her right knee. The Board of Review noted that a Medcor
Workplace Injury Triage & Reporting from stated the same. Further, the physician who completed
the Report of Injury diagnosed a work-related right knee injury. The Board of Review concluded
that the claim was compensable, authorized the requested treatment, and remanded the case for
additional evidence and an Order listing the compensable diagnosis.

       After review, we agree with the reasoning and conclusions of the Board of Review. For an
injury to be compensable it must be a personal injury that was received in the course of
employment, and it must have resulted from that employment. Barnett v. State Workmen’s Comp.

       1
       See Stone v. W. Va. Office of Insurance Commissioner, No. 10-1386, 2012 WL 2924144
(Feb. 22, 2012) (memorandum decision) and Ware v. State Workmen’s Compensation
Commissioner, 160 W. Va. 382, 234 S.E.2d 778 (1977).
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Comm’r, 153 W. Va. 796, 172 S.E.2d 698 (1970). The evidence shows that Ms. Woolford fell and
injured her right knee at work due to becoming overheated because the air conditioner was
malfunctioning. The employer submitted no evidence refuting Ms. Woolford’s testimony and the
Report of Injury, which states she sustained an occupational right knee injury. West Virginia Code
§ 23-4-3(a)(1) provides that the claims administrator must provide medically related and
reasonably required sums for healthcare services, rehabilitation services, durable medical and other
goods, and other supplies. The requested referral to an orthopedist is both reasonable and
necessary.

                                                                                         Affirmed.
ISSUED: January 19, 2023

CONCURRED IN BY:

Chief Justice Elizabeth D. Walker
Justice Tim Armstead
Justice John A. Hutchison
Justice William R. Wooton
Justice C. Haley Bunn

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