Court Opinion

ID: 9353291
Source: CourtListenerOpinion
Date Created: 2023-01-11 16:11:45.574726+00
Date Added: 2024-06-11T17:06:14.225706
License: Public Domain

IN THE INTERMEDIATE COURT OF APPEALS OF WEST VIRGINIA

                                                                              FILED
AMY C. HOLMAN,                                                            January 10, 2023
Claimant Below, Petitioner                                                 EDYTHE NASH GAISER, CLERK
                                                                         INTERMEDIATE COURT OF APPEALS
                                                                               OF WEST VIRGINIA
vs.) No. 22-ICA-107 (BOR Appeal No.: 2058160)
                      (JCN: 2021015502)

WEST VIRGINIA UNITED HEALTH SYSTEMS, INC.,
Employer Below, Respondent

                             MEMORANDUM DECISION

       Petitioner Amy C. Holman appeals the August 19, 2022, order of the Workers’
Compensation Board of Review (“Board”). Respondent West Virginia United Health
Systems, Inc., filed a timely response.1 Petitioner did not file a reply brief. The issue on
appeal is whether the Board erred in affirming the Office of Judges’ decision finding the
claim non-compensable.

       This Court has jurisdiction over this appeal pursuant to West Virginia Code § 5111-
4 (2022). After considering the parties’ arguments, the record on appeal, and the applicable
law, this Court finds no substantial question of law and no prejudicial error. For these
reasons, a memorandum decision affirming the Board’s order is appropriate under Rule 21
of the Rules of Appellate Procedure.

       On January 19, 2021, Ms. Holman presented to Garth B. Wright, M.D., an orthopedic
surgeon, with complaints of medial and posterior left knee pain. Dr. Wright’s clinical notes
indicated that Ms. Holman had a history of a right knee arthroscopy and partial medial
meniscectomy performed in 2020 and a left knee surgery performed at the age of twelve due
to a congenital problem with the patella. Dr. Wright assessed medial meniscus tear and
scheduled an MRI of the left knee on January 21, 2021, for verification.

       Subsequently, on the morning of January 21, 2021, Ms. Holman, a radiology
technologist, was at work and attempting to move a patient from a CT scan table to a stretcher
when she felt a popping sensation in her left knee accompanied by immediate pain. Ms.
Holman proceeded to the emergency department, and an x-ray performed of the left knee was
normal. The clinical impression was left knee strain. Later that same day, Ms. Holman
attended her previously scheduled MRI appointment. The MRI of the left knee

      Petitioner is represented by J. Thomas Greene, Jr., Esq., and T. Colin Greene, Esq.
       1

Respondent is represented by Jillian L. Moore, Esq., and Steven K. Wellman, Esq.
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revealed mild chondromalacia of the medial and lateral femoral condyles, mild to moderate
chondromalacia of the patella, mild arthritic degenerative changes, and a suspected medial
meniscus tear.

        At some point, an initial report of injury was completed by the employer. The report
of injury noted that a coworker heard Ms. Holman’s knee pop during the patient transfer
but stated that Ms. Holman had been complaining of knee pain for several weeks. By order
dated February 15, 2021, the claim administrator rejected the claim, finding that Ms.
Holman

       did not suffer a discrete new injury resulting from the alleged incident at
       work. [Ms. Holman’s] knee issue preexisted the alleged injury, as evidenced
       by Dr. Wright’s medical records, and the condition continued following the
       alleged injury. There was no change in [Ms. Holman’s] condition or treatment
       plan to constitute a discrete new injury.

Ms. Holman protested the order.

        On February 17, 2021, Dr. Wright performed a diagnostic arthroscopy of the left
knee and chondroplasty of the trochlea and patella of the left knee. The preoperative
diagnosis was degenerative meniscal tear of the left knee. However, upon performing the
procedure, Dr. Wright determined that the meniscus was intact and had no tears. Post-
operatively, Dr. Wright diagnosed “internal derangement of the left knee with lateral
patellar maltracking and grade 3-4 chondromalacia of the left knee and patellofemoral
joint.” Regarding maltracking, Dr. Wright reported that there was a groove in the lateral
facet of the patella.

        On April 30, 2021, Ameet Parikh, D.O., assisted Ms. Holman in completing an
Employees’ and Physicians’ Report of Occupational Injury and Disease, stating that she
had sustained a ligamentous tear of her left knee and opining that her injury was the direct
result of an occupational injury.2

       Ms. Holman testified via deposition on May 6, 2021. According to Ms. Holman, her
knee popped out of place while she was moving a patient from a scan table to a stretcher and
that she felt immediate pain. Ms. Holman claimed that Dr. Wright informed her that her
kneecap was displaced and that she may have a torn ligament, requiring a “Fulkerson
surgery” that was scheduled for July of 2021. Ms. Holman admitted that she saw Dr. Wright
two days prior to her alleged injury due to left knee pain that had presented a few days to a
week prior and that, at the time, she believed she might have had a torn meniscus.

       2
        It is unknown why Dr. Parikh filled out this form after the claim had already been
denied or why he listed a ligamentous tear as the injury when the February 17, 2021,
arthroscopy performed by Dr. Wright showed no evidence of tears.
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However, Ms. Holman testified that her knee pain was worse after the alleged injury and
that she could not walk for a few days.

        On May 18, 2021, Ms. Holman was examined by E. McDonough, M.D. Dr.
McDonough advised Ms. Holman that she did not need a Fulkerson surgery and could
return to work immediately. Dr. McDonough assessed chondromalacia of the patella with
left knee pain and prescribed a lateral buttress brace. Ms. Holman attended a follow-up visit
with Dr. McDonough in July of 2021 and reported that she had no pain. As such, Dr.
McDonough discharged her from his care.

        In September of 2021, Ms. Holman was examined by Jennifer L. Lultschik, M.D.
According to Dr. Lultschik’s notes, Ms. Holman reported her current symptoms as an
occasional locking sensation in her left knee or pain while walking downstairs or downhill.
Ms. Holman also reported that she returned to work after seeing Dr. McDonough and that
she had no difficulty performing all tasks at her job. Dr. Lultschik diagnosed Ms. Holman
with osteoarthritis, patellar maltracking, chondromalacia of the patella, and patellar
instability. Dr. Lultschik opined, given the fact that Ms. Holman’s osteoarthritis was a grade
3-4 in severity, it preexisted the alleged injury of January 21, 2021. Dr. Lultschik also found
that the chondromalacia of the patella was present prior to the alleged injury, likely for
decades based upon Ms. Holman’s congenital problem with her patella. According to Dr.
Lultschik, neither the radiologist nor the two treating surgeons noted any evidence of an acute
injury from either the imaging or the arthroscopy. As such, in Dr. Lultischik’s opinion, Ms.
Holman had sustained no discrete new injury to her knee.

        By order dated March 11, 2022, the Office of Judges (“OOJ”) affirmed the claim
administrator’s order rejecting the claim. The OOJ found that Ms. Holman presented with
left knee pain two days prior to the alleged injury and that an MRI was recommended at that
time—not after the injury. The OOJ found that the evidence failed to establish that Ms.
Holman sustained a compensable injury from the incident. While a meniscus tear was
initially suspected, an arthroscopy of the knee revealed no tears. Rather, Ms. Holman was
diagnosed with osteoarthritic degenerative changes, mild patellar retinaculum sprain of
uncertain chronicity, chondromalacia, and internal derangement of the knee with lateral
patellar maltracking which had created a groove. The OOJ noted that Dr. Lultschik opined
that the maltracking and chondromalacia predated the alleged injury and that there was no
evidence they were causally related to the incident. Lastly, the OOJ noted that while the
impression from Ms. Holman’s emergency room visit was a left knee strain, the records did
not provide a mechanism of injury, and the MRI performed later that day revealed that the
sprain was of uncertain chronicity. In sum, no physician of record reported that Ms. Holman
sustained a left knee sprain as a result of her reported mechanism of injury. Accordingly, the
OOJ found that there was insufficient evidence to find the claim compensable and affirmed
the claim administrator’s order. On August 19, 2022, the Board adopted the findings of fact
and conclusions of law of the OOJ and affirmed its March 11, 2022, order. Ms. Holman now
appeals.

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        Our standard of review is set forth in West Virginia Code § 23-5-12a(b) (2022), in
part, as follows:

       The Intermediate Court of Appeals may affirm the order or decision of the
       Workers’ Compensation Board of Review or remand the case for further
       proceedings. It shall reverse, vacate, or modify the order or decision of the
       Workers’ Compensation Board of Review, if the substantial rights of the
       petitioner or petitioners have been prejudiced because the Board of Review’s
       findings are:
       (1) In violation of statutory provisions;
       (2) In excess of the statutory authority or jurisdiction of the Board of Review;
       (3) Made upon unlawful procedures;
       (4) Affected by other error of law;
       (5) Clearly wrong in view of the reliable, probative, and substantial evidence
       on the whole record; or
       (6) Arbitrary or capricious or characterized by abuse of discretion or clearly
       unwarranted exercise of discretion.

        On appeal, Ms. Holman argues that the lower tribunals wrongly held that she did not
sustain an injury in the course of and as a result of her employment when the evidence below
establishes that she was moving a patient and felt a pop, followed by immediate pain, in her
left knee. Ms. Holman contends that prior to the injury, she had no restrictions or limitations
at work. While Ms. Holman admits she may have had preexisting conditions, she states that
she had not had treatment for her congenital condition of the left knee since she was twelve
years old and was asymptomatic leading up to the injury. Further, Ms. Holman notes that her
treatment with Dr. Wright two days prior to the injury included different parts of her knee
than where the injury occurred. Following the injury, Ms. Holman claims she experienced
severe pain, was assessed with a knee sprain, underwent an arthroscopy of the left knee, and
needed physical therapy in order to return to work. Ms. Holman argues that she demonstrated
new symptoms, such as locking of her knee, crepitus, limited range of motion, and atrophy,
all of which demonstrated an injury. However, the treating physicians wrongly attributed
these new symptoms to preexisting conditions. According to Ms. Holman, Dr. Parikh
completed the physician’s section of her workers compensation claim form and diagnosed
her with a ligamentous tear and attributed it to her occupational injury. While the diagnosis
was incorrect, Ms. Holman contends that Dr. Parikh’s opinion is still evidence of an
occupational injury. Accordingly, she argues that the OOJ as affirmed by the Board clearly
erred in rejecting the claim.

       After review, we find no error in the OOJ’s order as affirmed by the Board. At the
outset we note that Ms. Holman fails to include a distinct assignment of error in her brief
on appeal in violation of Rule 10 of the West Virginia Rules of Appellate Procedure.
Additionally, Ms. Holman fails to identify what diagnosis she is asking this Court to hold

                                              4
as compensable. Ms. Holman generally refers to a knee injury but does not state specifically
what diagnosis should have been compensable. Importantly, the Employee’s and
Physician’s Report submitted by Ms. Holman lists only a ligamentous tear as being an
occupational injury. However, Dr. Wright’s post-operative notes demonstrate that Ms.
Holman sustained no tear to her meniscus. In reviewing the record, no other injuries were
attributed to Ms. Holman’s occupation. Rather, the only other diagnoses given to Ms.
Holman during the proceedings below were preexisting conditions. Specifically, Ms.
Holman was diagnosed with osteoarthritis, patellar maltracking, chondromalacia of the
patella, and patellar instability. Dr. Lultschik opined that the severity of Ms. Holman’s
osteoarthritis indicated that it significantly predated the alleged injury. Likewise, Ms.
Holman’s issues with the patella were present prior to the alleged injury and were likely
due to her congenital issues. Further, the presence of a groove with the patellar maltracking
suggested that the issues had been ongoing for some time. Dr. Lultschik further explained
that no physician of record had found any evidence of acute injury. Finally, the last
diagnosis received by Ms. Holman during the proceedings below was left knee strain by
the attending physician at the emergency room. However, as noted by the OOJ, the clinical
notes from that visit do not describe the mechanism of injury and do not attribute the injury
to Ms. Holman’s occupation, simply noting that she was at work when she felt sudden onset
knee pain.

       To the extent that Ms. Holman argues that her preexisting knee condition was
aggravated by a work-related injury, we find that she is entitled to no relief. The Supreme
Court of Appeals of West Virginia has previously held that

              [a] noncompensable preexisting injury may not be added as a
       compensable component of a claim for workers’ compensation medical
       benefits merely because it may have been aggravated by a compensable
       injury. To the extent that the aggravation of a noncompensable preexisting
       injury results in a [discrete] new injury, that new injury may be found
       compensable.

Syl. Pt. 3, Gill v. City of Charleston, 236 W. Va. 737, 783 S.E.2d 857 (2016). However,

               [a] claimant’s disability will be presumed to have resulted from the
       compensable injury if: (1) before the injury, the claimant’s preexisting disease
       or condition was asymptomatic, and (2) following the injury, the symptoms
       of the disabling disease or condition appeared and continuously manifested
       themselves afterwards. There still must be sufficient medical evidence to
       show a causal relationship between the compensable injury and the disability,
       or the nature of the accident, combined with the other facts of the case, raises
       a natural inference of causation. This presumption is not conclusive; it may
       be rebutted by the employer.

                                              5
Syl. Pt. 5, Moore v. ICG Tygart Valley, LLC, No. 20-0028, -- W. Va. --, 879 S.E.2d 779,
2022 WL 1262269 (W. Va. Apr. 28, 2022).

       Here, Ms. Holman fails to demonstrate that any preexisting conditions are
compensable under Gill or Moore. Per Gill, Ms. Holman must demonstrate a discrete new
injury which, as noted by Dr. Lultschik, is not established by the medical evidence of record.
Likewise, per Moore, Ms. Holman must demonstrate that her preexisting condition was
asymptomatic. However, the record demonstrates that Ms. Holman’s knee conditions were
symptomatic prior to the alleged injury. The first report of injury filed by the employer shows
that Ms. Holman’s coworker reported that Ms. Holman had been complaining of knee pain
for weeks prior to the incident, and Ms. Holman sought treatment from Dr. Wright for knee
pain two days prior to the alleged injury.

       In sum, the only diagnosis attributed to Ms. Holman’s occupation was a ligamentous
tear, which was determined to be an inaccurate diagnosis. Accordingly, when viewing the
evidence before us, we are unable to find that the OOJ as affirmed by the Board was clearly
wrong in finding that Ms. Holman failed to demonstrate a compensable injury occurred
below.

       Accordingly, we affirm.

                                                                                    Affirmed.
ISSUED: January 10, 2023

CONCURRED IN BY:

Chief Judge Daniel W. Greear
Judge Charles O. Lorensen

Judge Thomas E. Scarr, not participating.

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