Court Opinion

ID: 9385086
Source: CourtListenerOpinion
Date Created: 2023-04-05 20:09:58.59012+00
Date Added: 2024-06-11T17:17:58.721496
License: Public Domain

FILED
                                                                                April 5, 2023
                                                                             EDYTHE NASH GAISER, CLERK
                                                                             SUPREME COURT OF APPEALS
                                                                                 OF WEST VIRGINIA

                              STATE OF WEST VIRGINIA

                           SUPREME COURT OF APPEALS

MATTHEW LYDICK,
Claimant Below, Petitioner

vs.)   No. 21-0565 (BOR Appeal No. 2056361)
                   (Claim No. 2019023086)

MURRAY AMERICAN ENERGY, INC.,
Employer Below, Respondent

                              MEMORANDUM DECISION
      Petitioner Matthew Lydick, by Counsel J. Thomas Greene Jr., appeals the decision of the
West Virginia Workers’ Compensation Board of Review (“Board of Review”). Murray American
Energy, by Counsel Aimee M. Stern, filed a timely response.

        The issue on appeal is temporary total disability benefits. The claims administrator closed
the claim for temporary total disability benefits on July 23, 2020. The Workers’ Compensation
Office of Judges (“Office of Judges”) affirmed the decision in its February 4, 2021, Order. The
Order was affirmed by the Board of Review on June 16, 2021.

        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 W. Va. Code § 23-5-15, in relevant part, as follows:

              (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 . . . .

              (d) If the decision of the board represents an affirmation of a prior ruling by
       both the commission and the Office of Judges that was entered on the same issue
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       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 provision, is clearly the result of erroneous conclusions of law, or is
       based upon the board’s material misstatement or mischaracterization of particular
       components of the evidentiary record. 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).

         Mr. Lydick, a coal miner, suffered a left foot crush injury on May 3, 2019, when his foot
was crushed when it got caught in the hydraulics of a bucket scoop. A treatment note from
Wheeling Hospital Emergency Department that day indicates Mr. Lydick was seen for his left foot
crush injury. He was unable to walk. X-rays were negative for fractures. He was diagnosed with
the left foot crush injury. The Employees’ and Physicians’ Report of Injury, completed on May 3,
2019, indicates Mr. Lydick’s left foot was crushed in a piece of machinery. The physicians’ section
was completed at Wheeling Hospital and lists the diagnosis as occupational left foot crush injury.
Mr. Lydick was placed on modified duty with the restriction of no weight bearing on the left foot
for three days.

        In a May 6, 2019, treatment note, Clark Milton, D.O., stated that Mr. Lydick had difficulty
walking. Physical examination showed ecchymosis and tenderness in the left foot. Dr. Milton
diagnosed left foot metatarsals crush injury and stated that Mr. Lydick was unable to return to
work. Mr. Lydick was seen by Ross Tennant, nurse practitioner for Dr. Milton, on May 9, 2019,
and reported intermittent numbness and tingling in his left toes. However, the swelling and
bruising were resolving. A left foot x-ray was negative for fractures. Mr. Tennant diagnosed left
foot crush injury and recommended physical therapy, which Mr. Lydick declined. Mr. Tennant
stated that Mr. Lydick was unable to return to work. The claim was held compensable for left foot
crush injury on May 13, 2019.

       In a May 16, 2019, treatment note, Mr. Tennant noted that Mr. Lydick reported intermittent
numbness and tingling in his toes, however, the swelling and bruising had significantly improved.
Mr. Tennant again recommended physical therapy and stated that Mr. Lydick was unable to return
to work. Mr. Lydick attended physical therapy on May 20, 2019. A left foot MRI was performed
on May 29, 2019, and showed an abnormal signal at the base of the third metatarsal of uncertain
etiology. It was noted that it was nontraumatic in appearance. Mr. Lydick returned to Mr. Tennant
on May 30, 2019, who stated that the left foot MRI showed a possible enchondroma of the third
metatarsal. He believed Mr. Lydick was suffering from neuropraxia and recommended referral to
a podiatrist. Mr. Lydick attended physical therapy on May 30, 2019.

       In a June 25, 2019, treatment note, Danny Fljalkowski, D.P.M., noted that Mr. Lydick
reported left foot pain with extreme sensitivity, as well as discoloration at the top of the left
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forefoot. Physical examination revealed reduced sensation in the left forefoot as well as the second
and third toes. Dr. Fljalkowski diagnosed left foot neuritis and crush injury. He recommended
ultrasound and physical therapy. Mr. Lydick returned to Dr. Milton on July 11, 2019, and stated
that he attempted to return to work but was only able to complete two shifts due to left foot pain.
Mr. Lydick reported significant swelling as well as extreme sensitivity. Dr. Milton diagnosed left
foot neuritis and recommended additional physical therapy.

          Prasadarao Mukkamala, M.D., performed an Independent Medical Evaluation on July
31, 2019, in which he found reduced range of motion in the left ankle and foot as well as significant
pain with stimuli. Dr. Mukkamala opined that Mr. Lydick may have complex regional pain
syndrome and recommended a three phase bone scan. He did not believe Mr. Lydick had reached
his maximum medical improvement.

          A left foot X-ray was negative on August 9, 2019. On August 15, 2019, a three phase
bone scan showed a possible radio occult fracture. An MRI was recommended. Mr. Lydick treated
with Michael Bowman, M.D., of the Pittsburgh Foot and Hand Center, on August 30, 2019. Mr.
Bowman diagnosed left foot crush injury which caused hypersensitivity to the superficial and deep
perineal nerve. It was opined that Mr. Lydick could work sedentary duties and desensitization
therapy was recommended as well as medications. In a September 25, 2019, treatment note, Dr.
Milton diagnosed post traumatic metatarsalgia of uncertain etiology. He recommended Mr. Lydick
undergo the desensitization therapy recommended by Dr. Bowman.

           On October 23, 2019, Dr. Bowman stated that Mr. Lydick previously underwent therapy
which provided no pain relief. Physical examination showed altered sensation at the dorsum of the
left foot as well as a positive Tinel’s sign at the deep perineal nerve and superficial perineal nerve.
Dr. Bowman again diagnosed crush injury and recommended pain management. Dr. Milton
diagnosed post traumatic metatarsalgia with symptoms potentially consistent with post traumatic
neuropraxia on November 18, 2019. He recommended referral to pain management and stated Mr.
Lydick was unable to work. Mr. Lydick was discharged from physical therapy on December 11,
2019. It was noted that he had reduced symptoms, but his foot remained hypersensitive.

          In a December 16, 2019, Independent Medical Evaluation, Dr. Mukkamala noted that
Mr. Lydick had limited activities of daily living. Physical examination showed reduced left ankle
and foot range of motion, as well as hypersensitivity in the top of the left foot. Dr. Mukkamala
disagreed with Dr. Bowman’s recommendation for pain management and instead recommended
Elavil.

          On February 9, 2020, Dr. Milton agreed with Dr. Bowman’s recommendation for a nerve
block. Mr. Lydick returned to Mr. Tennant on April 6, 2019. It was noted that the left foot was
tender, but Mr. Lydick was walking with a steady gait. He diagnosed post traumatic neuropraxia
and stated Mr. Lydick was unable to work. On June 1, 2020, the diagnosis remained the same, and
Mr. Lydick was still unable to return to work. Mr. Tennant completed an Attending Physician’s
Report on June 1, 2020, in which he opined that Mr. Lydick would remain temporarily and totally
disabled through July 3, 2020.

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          Dr. Mukkamala performed an Independent Medical Evaluation on June 10, 2020, in
which he noted that Mr. Lydick was not working and had limited activities of daily living.
Examination showed reduced range of motion in the foot and ankle as well as hypersensitivity. Dr.
Mukkamala diagnosed left foot crush injury with nonspecific pain complaints unsupported by
objective pathology. He noted that Mr. Lydick had a significant degree of symptom magnification.
He opined that Mr. Lydick had reached maximum medical improvement and needed no further
treatment. Dr. Mukkamala further opined that Mr. Lydick was capable of returning to work and if
he chose not to it was not the result of the compensable injury. Dr. Mukkamala assessed 4%
impairment. Temporary total disability benefits were suspended on June 16, 2020, based on Dr.
Mukkamala’s evaluation.

          In a July 1, 2020, treatment note, Mr. Tennant stated that Mr. Lydick reported no
improvement. He had a resolving bruise on his second toe. Mr. Tennant again diagnosed post
traumatic neuropraxia. He noted that Dr. Mukkamala found Mr. Lydick had reached maximum
medical improvement. Mr. Tennant noted that Mr. Lydick stated he was unable to return to work
as a coal miner. The claims administrator closed the claim for temporary total disability benefits
on July 23, 2020. A July 29, 2020, treatment note from Wheeling Hospital Emergency Department
indicates Mr. Lydick was seen for increased left foot pain for the past two days.

        Mr. Lydick testified in an October 15, 2020, deposition that he was not receiving any
medical care at that time. He asserted that his left foot was too sensitive to be touched and that he
had constant foot pain with swelling after activity. Mr. Lydick stated that he was unable to do his
normal activities of life and that he had sleep disturbances due to his left foot issues. He asserted
that he had no prior left foot symptoms or injuries. In a treatment note dated November 2, 2020,
Dr. Bowman noted that Mr. Lydick continued to have hypersensitivity in the top of the left foot.
He again recommended desensitization therapy as well as medication.

        The Office of Judges affirmed the claims administrator’s closure of the claim for temporary
total disability benefits in its February 4, 2021, Order. It found that Mr. Lydick has consistently
reported hypersensitivity, swelling, occasional bruising, altered gait, and reduced activities of daily
living. However, the Office of Judges found that Mr. Lydick failed to introduce sufficient evidence
to show that his foot would improve with additional treatment or that Dr. Mukkamala’s finding of
maximum medical improvement was wrong. Lastly, the Office of Judges noted his condition had
not changed in many months, which strongly suggests that the condition has plateaued. It therefore
concluded that the claim was properly closed for temporary total disability benefits. The Board of
Review affirmed the Office of Judges’ Order on June 16, 2021.

        After review, we agree with the reasoning and conclusions of the Office of Judges as
affirmed by the Board of Review. Pursuant to West Virginia Code § 23-4-7a, temporary total
disability benefits will cease when Mr. Lydick has reached maximum medical improvement, has
been released to return to work, or has returned to work, whichever occurs first. A preponderance
of the evidence indicates Mr. Lydick’s condition has plateaued. He has seen no improvement for
several months, as noted by his treating physician. Mr. Lydick has failed to introduce sufficient
evidence to refute Dr. Mukkamala’s finding of maximum medical improvement. Therefore, the
closure of the claim for temporary total disability benefits is affirmed.
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                                                                                           Affirmed.
ISSUED: April 5, 2023

CONCURRED IN BY:
Chief Justice Elizabeth D. Walker
Justice Tim Armstead
Justice John A. Hutchison
Justice C. Haley Bunn

DISSENTING:

Justice William R. Wooton

WOOTON, J., dissenting:

        The petitioner, a coal miner, suffered a serious crush injury to his left foot when it was
caught in the hydraulics of a bucket scoop, resulting in debilitating pain and sensitivity of the foot
to even the slightest touch.1 Notwithstanding the treating physicians’ attempts to find a treatment
modality that afforded greater relief to the petitioner – because they hadn’t given up on him, see
text infra – his claim for temporary total disability benefits was closed on the basis of one
physician’s opinion that he had reached maximum medical improvement.

        In this regard, this case follows what is becoming a disturbing pattern in cases involving
work-related injuries: if an independent medical evaluator opines that a claimant has reached
maximum medical improvement, or is exaggerating his or her symptoms, or is suffering from the
effects of some other, pre-existing, condition, the claims administrator finds that single opinion to
be more “reliable” than the combined opinions of all the other health care providers involved in
the claimant’s care. I find this trend very concerning, as it gives the appearance of “Have Gun Will
Travel” justice in workers’ compensation cases, with the opinions of treating physicians being shot
down by those of physicians whose examinations of the claimants are focused on forensic issues,
not treatment issues.

       Even more concerning is that in its opinion, the majority bases its decision largely on the
finding of the Board of Review that “a preponderance of the evidence indicates Mr. Lydick’s
condition has plateaued. He has seen no improvement for several months, as noted by his treating
physician.” (Emphasis added). My research indicates that only once before has this Court
mentioned that a condition has plateaued, see Blankenship v. Schneider Const. Co., No. 13-0444,

       1
         The record indicates that at one point the petitioner attempted to return to work but was
only able to complete two shifts due to left foot pain caused by the compression of his work boots.
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2014 WL 3953978 (W. Va. Aug. 13, 2014) (memorandum decision), and in Blankenship there was
no discussion as to the significance of this finding in determining whether a claimant is entitled to
additional medical care under the Act. One can reasonably infer from the majority’s opinion in
this case that the door has now been opened to a new, and potent, defense in workers’
compensation cases: if, after a period of treatment, a claimant’s symptoms haven’t improved for
three to four months, the underlying condition has “plateaued” and there exists a presumption that
the claimant has reached maximum medical improvement. Such a presumption presupposes that
treatment of injuries will result in a steady, predictable, linear, and non-stop abatement of
symptoms, a theory that is wholly unsupported in this record. Indeed, Dr. Milton, a treating
physician, observed that “[t]his is a difficult situation. If indeed [petitioner’s condition] is a
complex regional pain syndrome, these cases tend to improve, but the timeframe is unclear.”
(Emphasis added).

       In viewing the record as a whole, I am convinced that the petitioner was unfairly denied
the desensitization therapy and medications his treatment physician recommended, and that his
claim for temporary total disability benefits should not have been closed under the facts and
circumstances of this case. For these reasons, I respectfully dissent.

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