Court Opinion

ID: 9385986
Source: CourtListenerOpinion
Date Created: 2023-04-10 21:10:42.758581+00
Date Added: 2024-06-11T17:17:27.686563
License: Public Domain

IN THE INTERMEDIATE COURT OF APPEALS OF WEST VIRGINIA

                                                                                FILED
DAVID JUSTICE,                                                               April 10, 2023
Claimant Below, Petitioner                                                 EDYTHE NASH GAISER, CLERK
                                                                         INTERMEDIATE COURT OF APPEALS
                                                                                OF WEST VIRGINIA
vs.) No. 22-ICA-196           (JCN: 2019017131)

BONDED FILTER COMPANY LLC,
Employer Below, Respondent

                               MEMORANDUM DECISION

       Petitioner David Justice appeals the September 27, 2022, order of the Workers’
Compensation Board of Review (“Board”). Respondent Bonded Filter Company LLC
(“Bonded”) filed a timely response.1 Petitioner filed a timely reply. The issue on appeal is
whether the Board erred in affirming the claim administrator’s order dated August 21,
2021, which addressed the calculation of temporary partial rehabilitation benefits and
granted additional temporary partial rehabilitation benefits (“TPR”).

       This Court has jurisdiction over this appeal pursuant to West Virginia Code § 51-
11-4 (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.

       Mr. Justice was injured on February 8, 2019, while working for Bonded when a
strong gust of wind blew over the ladder he was climbing. He landed on his left arm and
shoulder and sustained injuries which were eventually determined to be compensable.
Protracted litigation ensued regarding payment of various benefits and his claim has been
subject to multiple protests and appeals before the Workers’ Compensation Office of
Judges (“OOJ”) and the Board. This case is one of two currently pending before this court.2

       1
           Petitioner is self-represented. Respondent is represented by Melissa M. Stickler,
Esq.
       2
        Mr. Justice has also filed case number 22-ICA-273, currently pending before this
Court. That appeal pertains to the October 26, 2022, order of the Board in the same
workers’ compensation claim.

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        The Board’s order on appeal in this case concerns a claim administrator’s order
dated August 21, 2021, which addressed the calculation of TPR benefits. In December of
2020, the OOJ ordered the claim administrator to calculate and pay temporary total
disability (“TTD”) and TPR benefits from the date of Mr. Justice’s injury through
December 9, 2019. Mr. Justice later alleged that despite that order, the claim administrator
failed to make timely and accurate payments of benefits owed to him. By decision dated
July 29, 2021, the OOJ found some of Mr. Justice’s allegations to be credible and remanded
the claim to the claim administrator with instructions to timely review the documentation
Mr. Justice submitted and ensure that appropriate TPR payments had been made for all
hours Mr. Justice worked. The claim administrator was also instructed to address whether
it had properly accounted for Mr. Justice’s time off work during the applicable time period
and to issue a detailed written report and protestable order describing this accounting. In
response, the claim administrator, by order dated August 21, 2021, awarded Mr. Justice
TPR benefits in the amount of $15,325.35, and attached a spreadsheet to the order showing
the claim administrator’s calculations in reaching that amount. The total amount of TPR
benefits due were offset by the amount of TPR benefits previously paid in the claim, and
Mr. Justice was paid the difference. Mr. Justice protested the claim administrator’s order
and argued that he still was not compensated fully by the claim administrator for the
benefits owed to him. He claimed that the employer provided false and incorrect wage
information, but the only evidence he timely submitted in support of that protest was a
copy of the OOJ’s December 11, 2020, decision. The Board found in its September 27,
2022, order that by submitting only the OOJ’s December 2020 decision, Mr. Justice failed
to carry his burden of proof that his TPR benefits were improperly calculated.
Consequently, the Board affirmed the claim administrator’s August 21, 2021, order. It is
from that order that Mr. Justice now appeals.

      The standard of review applicable to this Court’s consideration of workers’
compensation appeals has been set out under West Virginia Code § 23-5-12a(b) (2022), 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

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       (6)    Arbitrary or capricious or characterized by abuse of discretion or
       clearly unwarranted exercise of discretion.

Duff v. Kanawha Cnty. Comm’n, __ W. Va. __, __, 882 S.E.2d 916, 921 (Ct. App. 2022).

       At the outset, we note that Mr. Justice’s arguments on appeal are either difficult to
decipher or outside the scope of the Board’s September 27, 2022, order on appeal. The gist
of Mr. Justice’s relevant argument seems to be that the claim administrator never correctly
calculated the benefits it owes him because it relied on incorrect data that he claims has
been deliberately and intentionally provided by the employer and used to wrongfully
withhold payment. Mr. Justice argues that the documents he submitted as evidence in
support of his claims are proof of the “undeniable facts.” In response, Bonded argues that
Mr. Justice is now attempting to submit pages of irrelevant evidence and argue matters
which were not before the Board, both of which must be denied as they are not properly
before this Court. In fact, the sole issue before the Board was whether the claim
administrator erred in calculating and granting Mr. Justice $15,325.35 in TPR benefits in
compliance with the OOJ decision dated July 29, 2021. Mr. Justice now asks this Court to
reverse the Board’s order, to reimburse him for the paid time off benefits he used after his
work injury, to reinstate all vocational rehabilitation benefits owed to him, and pay him
damages for unnecessary suffering.

        Upon review, we find no error in the Board’s order affirming the claim
administrator’s award of TPR benefits and finding that it was in substantial compliance
with the OOJ’s decision of July 29, 2021. The Board found that the claim administrator
reviewed the documentation that Mr. Justice had submitted on the issue of TPR benefits
and calculated Mr. Justice’s TPR benefits using the wage information Mr. Justice
submitted. The claim administrator attached a spreadsheet showing the calculations used
in determining the TPR benefits award. The Board found this to be compliant with the
instructions provided by the OOJ. Therefore, the Board did not err in affirming the claim
administrator’s order calculating and awarding TPR benefits, and Mr. Justice is not entitled
to the relief he seeks herein.

       Accordingly, we affirm the Board’s September 27, 2022, order.

                                                                                 Affirmed.

ISSUED: April 10, 2023

CONCURRED IN BY:

Chief Judge Daniel W. Greear
Judge Thomas E. Scarr
Judge Charles O. Lorensen

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