Joyce Anderson v. Consolidation Coal Company , 636 F. App'x 175 ( 2016 )


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  •                                UNPUBLISHED
    UNITED STATES COURT OF APPEALS
    FOR THE FOURTH CIRCUIT
    No. 14-2048
    JOYCE ANDERSON,
    Plaintiff – Appellant,
    v.
    CONSOLIDATION COAL COMPANY,
    Defendant – Appellee,
    and
    CONSOL ENERGY, INC.,
    Defendant.
    Appeal from the United States District Court for the Northern
    District of West Virginia, at Clarksburg.   Frederick P. Stamp,
    Jr., Senior District Judge. (1:11-cv-00138-FPS-JSK)
    Argued:   October 29, 2015                   Decided:   January 21, 2016
    Before WILKINSON, SHEDD, and WYNN, Circuit Judges.
    Affirmed by unpublished opinion. Judge Shedd wrote the majority
    opinion, in which Judge Wilkinson joined.   Judge Wynn wrote a
    dissenting opinion.
    ARGUED: Allan Norman Karlin, ALLAN N. KARLIN & ASSOCIATES,
    Morgantown, West Virginia, for Appellant.  Larry Joseph Rector,
    STEPTOE & JOHNSON, PLLC, Bridgeport, West Virginia, for
    Appellee. ON BRIEF: Jane E. Peak, ALLAN N. KARLIN & ASSOCIATES,
    Morgantown, West Virginia, for Appellant.   Denielle M. Stritch,
    STEPTOE & JOHNSON, PLLC, Morgantown,        West Virginia, for
    Appellee.
    Unpublished opinions are not binding precedent in this circuit.
    2
    SHEDD, Circuit Judge:
    While working in a coal mine operated by Consolidation Coal
    Company (“CCC”), Joyce Anderson fell and suffered multiple bone
    fractures.    Before     her    fall,       Anderson        had   been   diagnosed        as
    having osteoporosis. After her recovery, Anderson attempted to
    return to her former job. Presented with conflicting medical
    evidence about Anderson’s post-injury ability to work safely in
    the mine, CCC implemented a medical-review process dictated by
    its   collective    bargaining         agreement         (“CBA”)     with    her   union.
    Because two of the three doctors selected under the CBA process
    opined   against      Anderson’s       return        to     underground      work,       CCC
    prohibited her from returning to her former position. Anderson
    filed an unsuccessful labor grievance, and when CCC was unable
    to find a suitable alternative position for her, it terminated
    her   employment.     Anderson        then       filed    this    lawsuit    contending
    (among   other   things)       that    CCC       violated    West    Virginia      law    by
    retaliating against her for filing a workers’ compensation claim
    and by discriminating against her based on the fact that she has
    osteoporosis. The district court granted CCC’s summary judgment
    motion   on   these    claims,        and    Anderson       now     appeals.    For      the
    following reasons, we affirm.
    I
    Federal    Civil    Procedure          Rule        56(a)    provides     that      the
    district court “shall grant summary judgment if the movant shows
    3
    that there is no genuine dispute as to any material fact and the
    movant is entitled to judgment as a matter of law.” We review a
    summary judgment order de novo. Lee Graham Shopping Ctr., LLC v.
    Estate of Kirsch, 
    777 F.3d 678
    , 681 (4th Cir. 2015).
    West Virginia Code § 23-5A-1 provides that “[n]o employer
    shall discriminate in any manner against any of his present or
    former employees because of such present or former employee’s
    receipt    of     or    attempt     to     receive”          workers’    compensation
    benefits. West Virginia Code § 5-11-9(1) provides that it is
    unlawful      “[f]or    any      employer       to    discriminate           against     an
    individual with respect to compensation, hire, tenure, terms,
    conditions or privileges of employment if the individual is able
    and   competent    to   perform     the     services     required       even       if   such
    individual is blind or disabled.”
    For claims under either statute, the employee bears the
    ultimate burden of proving the employer’s illegal motive. See
    CSX Transp., Inc. v. Smith, 
    729 S.E.2d 151
    , 169 (W.Va. 2012)
    (retaliation); Hanlon v. Chambers, 
    464 S.E.2d 741
    , 748 (W.Va.
    1995)   (discrimination).         Where,       as    here,    there     is    no    direct
    evidence of retaliation or discrimination, the general scheme of
    proof   for     both    claims    is     substantially         the    same:     (1)      the
    employee bears the burden of presenting a prima facie case; (2)
    if she presents a prima facie case, the burden shifts to the
    employer to present a legitimate, nondiscriminatory reason for
    4
    her discharge; and (3) if the employer presents such a reason,
    the     employee     must     establish          that       the   proffered        reason      is
    pretextual. See Powell v. Wyoming Cablevision, Inc., 
    403 S.E.2d 717
    ,    721-22      (W.Va.     1991)     (retaliation);             Conaway       v.     Eastern
    Assoc.     Coal      Corp.,     
    358 S.E.2d 423
    ,      429-30     (W.Va.          1986)
    (discrimination).
    II
    The following material facts are not disputed. Anderson is
    a long-time CCC employee who was diagnosed with osteoporosis in
    2005.    In    November      2009,     while         Anderson      was     working       in    the
    Loveridge Mine, she fell and fractured her elbow and pelvis.
    Anderson      was    treated     by    Dr.       Nancy       McKinley,       an       orthopedic
    surgeon and also underwent physical therapy. Anderson filed a
    workers’      compensation          claim    for        this      injury     and       received
    workers’ compensation benefits.
    Several      months    later,     Dr.         McKinley     released        Anderson      to
    return to work. Before allowing her to return, CCC (through its
    workers’       compensation          administrator)               obtained        a     medical
    examination,        which     included       a       bone    density      scan.       Dr.     Dean
    Steinman      performed      this     examination           and   found     that       the    scan
    results, accompanied by other risk factors and the severity of
    her injuries from her relatively minor 2009 fall, presented too
    great a risk of re-fracture to return her to work in the coal
    mine. When Dr. Steinman’s report was presented to Dr. McKinley
    5
    for review, Dr. McKinley noted that although “common sense” may
    suggest that Anderson not return to work in the mine, J.A. 1262,
    she did not believe that Anderson was precluded from doing so.
    Faced    with    this     conflict      of   opinions,             CCC   approved         a    record
    review by Dr. Vincent Ripepi. Following his review, Dr. Ripepi
    agreed with Dr. Steinman.
    Anderson    disagreed         with   Dr.     Steinman’s           and   Dr.        Ripepi’s
    medical opinions. CCC therefore implemented Article III(j) of
    the CBA. In pertinent part, Article III(j) provides that “once
    employed, an Employee cannot be terminated or refused . . .
    recall from sick or injured status for medical reasons over his
    objection       without    the    concurrence           of     a    majority        of     a    group
    composed of an Employer-approved physician, an Employee-approved
    physician, and a physician agreed to by the Employer and the
    Employee,       that    there     has    been       a    deterioration              in    physical
    condition       which     prevents       the       Employee         from      performing            his
    regular work.” J.A. 861.
    Anderson    selected      Dr.    McKinley         as       the   “Employee-approved
    physician,”      and     CCC    selected       Dr.      Steinman         as   the        “Employer-
    approved    physician.”          By    agreement,         the       parties     then          met   to
    select the third physician, who would be the tiebreaker. Each
    party    proposed       four   doctors       at    this      meeting,         and    each      party
    struck three names proposed by the other, leaving each party
    6
    with       a    single     physician   remaining. 1      The   names    of     the   two
    remaining physicians, Dr. Sushil Sethi – who was CCC’s choice -
    and Dr. Shelly Kafka – who was Anderson’s choice - were placed
    in a hat. Anderson selected Dr. Kafka’s name out of the hat, and
    CCC agreed to use Dr. Kafka. However, Dr. Kafka declined to
    participate in the evaluation process.
    Anderson then put forth two additional doctors’ names. CCC
    struck         one    doctor,    leaving   Dr.   Brian    Houston      as    Anderson’s
    proposed doctor. Dr. Houston’s name was then placed in the hat
    with Dr. Sethi’s name. Anderson again selected a name from the
    hat, this time choosing Dr. Sethi. Anderson did not object to
    being          seen   by   Dr.    Sethi,   and   he      performed     her     physical
    examination. Thereafter, Dr. Sethi opined that Anderson was not
    able to work safely underground because of her high risk for
    repeat fracture. Specifically, Dr. Sethi stated:
    On the basis of my examination and review of                            the
    medical records as well as my thorough research                          of
    osteoporosis, it is my medical opinion that                             the
    deterioration of the bone due to early onset                             of
    1
    Helen Blevins, a registered nurse, testified on behalf of
    CCC that a limited number of area doctors were willing to engage
    in workers’ compensation and similar evaluative work. When she
    selected doctors for the CBA process, she looked at factors such
    as a doctor’s capability, knowledge, availability, willingness,
    and timeliness in an effort to obtain the best and most timely
    results. Anderson argues that proof of CCC’s improper motives
    lies in the fact that CCC proffered only doctors who were not
    osteoporosis specialists. However, CCC did proffer an orthopedic
    surgeon, but Anderson struck this doctor from the list.
    7
    menopause as well as aging and having caused a
    fracture with a very minor activity, is a very high
    risk factor in performing her regular work. The use of
    medication including Boniva as well as other listed
    medications that are available on the market, simply
    prevent some osteoclastic activity. It does not cure
    the problem of osteoporosis. After having reviewed the
    job duties and the risk factors as well as the
    description of the bunker employee including ability
    to have the capability of safely evacuating the mine
    in the event of an emergency, I can say with
    reasonable   degree   of   medical   probability   and
    certainty, that [Anderson] is not able to safely
    perform her regular work as a bunker attendant at
    Loveridge Mine. She is a very high risk for repeat
    fracture which can happen spontaneously or even from a
    minor tripping and would be a risk to herself as well
    as other fellow workers.
    J.A. 865-66.
    Thus, the majority of the medical opinions obtained under
    the CBA process recommended that Anderson’s high fracture risk
    made it unsafe for her to return to work in the coal mine. CCC
    attempted to accommodate Anderson with a surface position as a
    dispatcher. CCC’s effort, however, was precluded by seniority
    rules   in   the    CBA.   Anderson   then   filed   a   grievance   seeking
    reinstatement, but an arbitrator ruled against her, finding that
    CCC complied with the CBA. CCC encouraged Anderson to apply for
    an open above-ground position. Although Anderson applied and was
    interviewed for this position, she ultimately declined to pursue
    it.   Unable   to   find   a   satisfactory   alternative     position   for
    Anderson, CCC terminated her employment.
    8
    III
    Anderson       filed          this    action       asserting         several      state-law
    claims. Pertinent to this appeal, Anderson alleged that CCC (1)
    retaliated against her for filing a workers’ compensation claim,
    in    violation      of     §    23-5A-1         and     (2)    discriminated         against      her
    based    on    the     fact          that    she       has     osteoporosis       -    which       CCC
    perceived      to     be,       or    which       is     in    fact,    a    disability        -    in
    violation of § 5-11-9(1). At the close of discovery, CCC moved
    for    summary      judgment          on    several       grounds.       The     district      court
    granted the motion for the following reasons.
    Regarding          Anderson’s          workers’          compensation          retaliation
    claim, the district court noted that Anderson was required to
    show three elements to establish a prima facie case: (1) she
    sustained      an    on-the-job             injury;       (2)    she    filed     a    claim       for
    workers’ compensation benefits; and (3) CCC treated her filing
    of a workers’ compensation claim as a significant factor in its
    decision to discharge her. See Powell, 
    403 S.E.2d at 721
    . The
    court found that although Anderson sufficiently showed the first
    two elements, she failed to show the third element. The court
    explained      that       CCC     “acted         under    the    CBA    which     governed         the
    procedure”       regarding            her    potential          return      to    work    and      “a
    majority of the necessary medical opinions found that [Anderson]
    should not return to work.” J.A. 1039. The court stated: “Simply
    put,    no    evidence          exists      to    demonstrate          or   imply     that   [CCC]
    9
    terminated [Anderson] with [workers’] compensation costs serving
    as a ‘significant’ factor.” J.A. 1039-40.
    Regarding Anderson’s disability discrimination claim, the
    district court noted that Anderson was required to show three
    elements to establish a prima facie case: (1) she is a member of
    a protected class; (2) CCC took an adverse action against her;
    and (3) but for her protected status, CCC would not have taken
    the adverse action. See Conaway, 358 S.E.2d at 429. Again, the
    court    found    that   Anderson    sufficiently         showed   the    first    two
    elements, but she failed to show the third element. The court
    explained        that    although     CCC     was      aware       of    Anderson’s
    osteoporosis, it did not base the decision to terminate her on
    the grounds that she is disabled. The court stated:
    Rather, in compliance with the CBA, [CCC and Anderson]
    received   three   medical   opinions    regarding  [her]
    ability to return to work. Of those three opinions,
    two   of  the    opinions  advised    the   parties  that
    [Anderson] should not return to work. Relying on these
    medical opinions, and not simply [her] status as
    “disabled” . . . [CCC] terminated her employment.
    J.A. 1044.
    The   district    court     addressed       and    rejected      Anderson’s
    argument that the doctors chosen by CCC for the CBA process were
    “company      doctors”    rather    than    osteoporosis        specialists.       The
    court    found    that   “insufficient      evidence      has   been     offered    to
    support these claims, and they are speculation at best.” J.A.
    1044. Further, the court stated that “the specialty-level of the
    10
    doctors     in    this    case    is    not    a    germane    issue    to   the    law    at
    issue.” J.A. 1044-45. Reiterating its earlier discussion of the
    workers’ compensation retaliation claim, the court explained:
    The facts show that [CCC] acted under an honest belief
    regarding whether to discharge [Anderson], basing the
    decision on the recommendations by licensed physicians
    with experience, though technically not specialties,
    in osteoporosis. Both parties together selected the
    third physician, meaning that [Anderson] herself
    agreed to be examined by this physician. More
    importantly, the terms of the CBA do not require the
    evaluating doctors be specialists in their field.
    Thus, the argument that the evaluating doctors did not
    practice in any medical specialty or possess any
    particular certification relating to osteoporosis is
    not relevant in this civil action, as such was not
    required under the CBA.
    J.A. 1045.
    The district court further concluded that even if Anderson
    had shown a prima facie case of disability discrimination, CCC
    offered a legitimate nondiscriminatory reason for her discharge:
    the   CBA    medical       review      process,        which    led    to    the   medical
    opinions advising that she not return to her former position.
    Finally,     the    court        found       that   Anderson     failed      to    present
    sufficient evidence of pretext to rebut CCC’s proffered reason.
    IV
    Anderson contends that the district court erred in several
    respects     by    granting      CCC’s       summary    judgment       motion.     Anderson
    primarily        argues    that        the    court     erred     in     assessing        her
    disability discrimination claim because it failed to conduct the
    11
    analysis set forth in West Virginia Code of State Rules § 77-1-
    4.8. She also argues with respect to both of her claims that the
    court     resolved      disputed     facts     against       her     and     failed    to
    recognize the existence of genuine issues of material fact. In
    response, CCC argues that the court correctly entered summary
    judgment on Anderson’s claims.
    Having       carefully        considered       this         matter     under     the
    appropriate       summary     judgment       standard,       we     agree     with    the
    district court that the undisputed material facts in the record
    establish as a matter of law that CCC’s decision to terminate
    Anderson’s       employment    was   not      based   on     a    discriminatory        or
    retaliatory      motive.    Instead,     those      facts    establish       that     when
    Anderson attempted to return to work following her work-related
    injury,    CCC    was    presented    with     conflicting         medical        opinions
    about whether she could do so safely. 2 For that reason, CCC
    implemented the CBA medical-review process, in which Anderson
    fully and     freely     participated,        and   two     of    the     three    doctors
    selected in that process opined against her return to the coal
    2 CCC’s decision to have Anderson evaluated before returning
    her to work did not violate West Virginia law. See, e.g., Stone
    v. St. Joseph’s Hosp. of Parkersburg, 
    538 S.E.2d 389
    , 407 (W.Va.
    2000) (“[T]he mere fact that the Hospital sent Mr. Stone for an
    independent medical examination did not prove a case of
    disability discrimination.”).
    12
    mine. 3     Consequently,           CCC    was     then       within        its    collectively
    bargained right to prohibit Anderson from returning to the coal
    mine.      Ultimately,        CCC     terminated            Anderson’s       employment      only
    after      it   was    unable    to       place    her      in    a    suitable     alternative
    position.
    Anderson has proffered evidence which she contends creates
    genuine issues of material fact about the qualifications and
    opinions of the doctors who examined her as part of the CBA
    medical-review process and about the purported motives of CCC
    personnel.       We    have     considered         this       evidence       in    our    summary
    judgment review. However, we conclude that Anderson has failed
    to   present      sufficient        evidence           to   create      a   genuine      issue   of
    material        fact    to    establish       that          her   filing      of   a     workers’
    compensation claim was a significant factor in CCC’s decision to
    terminate her. For this reason, we affirm the grant of summary
    judgment on the retaliation claim. See, e.g., Yoho v. Triangle
    PWC, Inc., 
    336 S.E.2d 204
    , 210 (W.Va. 1985) (affirming dismissal
    of § 23-5A-1 claim where the employee was discharged pursuant to
    a    “facially        neutral    provision             of   the       collective      bargaining
    3
    Dr. Ripepi also opined against Anderson’s return to work
    in the mine. Therefore, three doctors who considered the matter
    before Anderson was terminated believed that she should not
    return to the mine. Moreover, Dr. McKinley (who was Anderson’s
    choice in the Article III(j) process) equivocated, stating that
    “common sense” suggested that Anderson not return to the mine.
    13
    agreement”).         Likewise,          we        conclude          that    even     if    Anderson
    presented sufficient evidence to establish a prima facie case of
    discrimination,             CCC        has        presented           a     legitimate,           non-
    discriminatory reason for terminating her employment (i.e., the
    CBA    medical-review            process),         and    she        has    failed    to    present
    sufficient evidence to establish pretext. Therefore, we affirm
    the grant of summary judgment on the discrimination claim. See,
    e.g., Bailey v. Norfolk and W. Ry. Co., 
    527 S.E.2d 516
    , 536
    (W.Va.      1999)     (noting      that       the       parties’       collective         bargaining
    agreement provided a legitimate, non-discriminatory reason for
    the challenged action).
    As noted, Anderson primarily argues that the district court
    failed to analyze her discrimination claim under West Virginia
    Code   of     State       Rules    §    77-1-4.8.         We    disagree       with       Anderson’s
    contention that § 77-1-4.8 dictates a different outcome.
    Rule      77-1-4           is      titled           “Employment             Discrimination
    Prohibited”         and     is    part       of    “a    detailed          explication       of   the
    general      anti-discrimination                  requirements         of    the    Human    Rights
    Act, [§ 5-11-9].” Stone, 
    538 S.E.2d at
    396 n.8. Section 77-1-4.1
    and    its     subsections             prohibit         disability          discrimination         in
    employment.         Various       other      sections          of    Rule    77-1-4       deal    with
    matters      that     are    unrelated            to    this    case,       but    two     sections,
    §§ 77-1-4.7 and 4.8, are pertinent to our discussion.
    14
    Section 77-1-4.7 provides that an “individual’s ability to
    perform     a    particular           job    must       be    assessed       on    an     individual
    basis,” and an employer “may discharge a qualified individual
    with a disability if, even after reasonable accommodation, the
    individual is unable to perform the essential functions of the
    job without creating a substantial hazard to his/her health and
    safety or the health and safety of others.” Section 77-1-4.7
    cautions        that    “any      such      decision         shall    be     [based]       upon       the
    individual’s actual abilities, and not upon general assumptions
    or stereotypes about persons with particular mental or physical
    disabilities.”
    Section 77-1-4.8 then provides that “[i]n deciding whether
    an individual poses a direct threat to health and safety, the
    employer        has    the     burden       of    demonstrating            that     a     reasonable
    probability of a materially enhanced risk of substantial harm to
    the    health     or    safety        of    the     individual        or     others       cannot       be
    eliminated        or    reduced        by    reasonable         accommodation.”             Further,
    § 77-1-4.8 specifies that “[t]he employer’s determination that
    an    individual       poses      a    ‘direct       threat’         shall    be        based    on    an
    individualized assessment of the individual’s present ability to
    safely      perform      the       essential            functions       of        the     job.    This
    assessment       shall       be   based      on     a    reasonable          medical       judgement
    [sic] that relies on the most current medical knowledge and/or
    on    the   best       available         objective           evidence.”      Section        77-1-4.8
    15
    concludes        by    listing        several      non-exclusive         factors    to   be
    considered in determining whether an individual would pose a
    direct threat.
    According         to      Anderson,      §    77-1-4.8       “is    an     affirmative
    defense that requires the employer to prove that the medical
    opinion upon which it relies was based on an ‘individualized
    assessment’ of the employee, on ‘competent medical advice’ and
    on the ‘most current medical knowledge’ in the relevant field.”
    Opening    Brief       of   Appellant,       at    8. 4    Anderson     argues    that   CCC
    failed     to    comply        with    §    77-1-4.8       because      it    selected   and
    recommended evaluators who “it knew or should have known had
    little    or     no    expertise       in   osteoporosis,         who    lacked    ‘current
    medical knowledge’ about the disease and who did not provide
    competent opinions about [her] risk of future injury.” Id. at 9.
    Although the role of § 77-1-4.8 within the shifting-burden
    analysis        used     for     employment        discrimination        claims    is    not
    entirely        clear,      we    will      assume        that   the    section     becomes
    applicable when, in response to an employee’s prima facie case,
    the employer asserts that an employee cannot safely perform her
    job as a legitimate, non-discriminatory reason for termination.
    4  In Stone, the court explained that “to satisfy the
    standard of a serious threat to one’s health or safety, the
    employer must establish that it relied upon competent medical
    advice that there exists a reasonably probable risk of serious
    harm.” 
    538 S.E.2d at 397
     (emphasis added and citation omitted).
    16
    As we have already held, the undisputed evidence establishes
    that CCC terminated Anderson as a result of the CBA medical-
    review   process,       which    is     unquestionably      a   legitimate,      non-
    discriminatory      reason.      Contrary       to   Anderson’s      argument,     we
    conclude that through its implementation of the CBA medical-
    review process, CCC met its burden under § 77-1-4.8. 5
    Fundamentally,        §    77-1-4.8       requires    that     the    employer’s
    decision must be made on “an individualized assessment of the
    individual’s     present       ability    to   safely     perform    the    essential
    functions   of    the    job.”     By    relying     on   the     various   specific
    medical opinions obtained before and during the CBA medical-
    review process, CCC made its decision about Anderson’s ability
    to return to the coal mine on an individualized assessment of
    her condition and ability rather than “upon general assumptions
    or stereotypes about persons” with osteoporosis. § 77-1-4.7.
    5 CCC unsuccessfully argued below that Anderson’s claims are
    preempted by the Federal Labor Management Relations Act
    (“LMRA”). CCC reiterates this argument as one of several
    alternate bases for affirming the summary judgment. We need not
    decide the issue, but we note that Anderson’s reliance on § 77-
    1-4.8 does raise a significant LMRA preemption question. See
    Barton v. House of Raeford Farms, Inc., 
    745 F.3d 95
    , 107 (4th
    Cir.), cert. denied, 
    135 S.Ct. 160
     (2014) (stating the general
    rule that when the evaluation of the state law claim is
    inextricably intertwined with consideration of the terms of the
    labor contract, such that it is necessary to interpret the
    collective-bargaining agreement to resolve the claim, the claim
    is preempted).
    17
    Moving forward in the analysis, § 77-1-4.8 specifies that
    the individualized assessment must be based on a “reasonable”
    medical    judgment   (from   a   competent        medical    practitioner)   who
    relies on “the most current medical knowledge” or on “the best
    available    objective    evidence.” 6        We    believe     the   undisputed
    material evidence in the record establishes that CCC met this
    standard. CCC utilized doctors who had the ability to conduct
    the medical testing specific to Anderson’s condition and who
    were experienced in providing occupational medical evaluations.
    These doctors assessed Anderson’s bone density scans, along with
    other risk factors, and examined extensive details regarding the
    specific job requirements of her position. To be sure, Anderson
    points to conflicting evidence regarding her ability to return
    to   her   former   position,     but   the   fact    that    medical   opinions
    differ does not establish that CCC’s reliance on Dr. Steinman’s
    and Dr. Sethi’s assessments was unreasonable. 7 Moreover, although
    6Section 77-1-4.8 states that the assessment “shall be
    based on a reasonable medical judgement [sic] that relies on the
    most current medical knowledge and/or on the best available
    objective evidence.” The term “and/or” typically means “or.” See
    Curry v. W.Va. Consol. Pub. Retire. Bd., 
    778 S.E.2d 637
    , 642 n.4
    (W.Va. Oct. 7, 2015); Dynalectron Corp. v. Equitable Trust Co.,
    
    704 F.2d 737
    , 739 (4th Cir. 1983).
    7As noted, Anderson recommended both Dr. McKinley and Dr.
    Kafka during the CBA medical-review process, but Dr. Kafka
    declined to participate. Dr. Kafka did examine Anderson at a
    later time, and Anderson now relies on Dr. Kafka’s opinion to
    support her case. Had Dr. Kafka rendered her opinion during the
    (Continued)
    18
    Anderson contends that CCC was required to utilize and rely only
    on   osteoporosis    specialists      in     making     its    individualized
    assessment, we find nothing to establish that § 77-1-4.8 imposes
    such a rigid requirement. See generally Farley v. Shook, 
    629 S.E.2d 739
    , 746 (W.Va. 2006) (“While a physician does not have
    to be board certified in a specialty to qualify to render an
    expert   opinion,   the   physician       must   have   some   experience   or
    knowledge on which to base his or her opinion.”).
    V
    We are not unsympathetic to Anderson’s desire to return to
    her job. However, West Virginia law recognizes “the right of an
    employer to protect employees, the public, and the workplace
    from danger or injury that might occur as a result of a person’s
    possible impairments, when such protection is done in a fashion
    that is consistent with the duty of reasonable accommodation.”
    Stone, 
    538 S.E.2d at 397
    . This right is also embodied in the
    CBA. Based on the record before us, we agree with the district
    court that the undisputed material evidence establishes that CCC
    CBA process, she would have cast the tiebreaking vote in
    Anderson’s favor, and CCC presumably would have been obligated
    under the CBA to return Anderson to work. These facts highlight
    the role of the CBA process in Anderson’s termination and
    undercut her claims of retaliation and discrimination.
    19
    did   not   illegally   retaliate    or   discriminate   against   her.
    Therefore, we affirm the judgment.
    AFFIRMED
    20
    WYNN, Circuit Judge, dissenting:
    Joyce     Anderson          was     fifty-two        years        old    and      had     a
    satisfactory        work       record     nearly        three        decades     long        when
    Consolidation         Coal      Company    (“CCC”)         terminated         her,     on     the
    grounds that her osteoporosis prevented her return to work after
    recovering      from       a     fracture.            Ostensibly,        CCC     based        her
    termination      on     company-directed             medical     evaluations         rendered
    after      Anderson’s          treating     orthopedic          surgeon        had     already
    unreservedly        cleared        her     to        return     to    work,      and        those
    evaluations appear to have been based largely on an erroneous
    interpretation of a single study found through Google or similar
    search engines.
    The majority opinion nevertheless concludes that there is
    no genuine factual dispute regarding whether CCC’s termination
    decision satisfied the relevant state standards—that is, whether
    it   was    based     on   a    “reasonable”          medical     judgment,       one       “that
    relie[d] on the most current medical knowledge and/or on the
    best available objective evidence.”                     Ante, at 18; 
    W. Va. Code R. § 77-1-4.8
    .         I   cannot     reach     the       same    conclusion.           For     this
    reason and those elaborated below, I dissent.
    I.
    A.
    The     majority         opinion     assumes,           without     deciding,          that
    Anderson      has     successfully        made       out   a    prima     facie      case      of
    21
    disability discrimination.              Ante, at 14.       In my view, the issue
    is simple enough to decide.               Anderson provided abundant evidence
    that she was “regarded as” disabled by CCC, 
    W. Va. Code § 5-11
    -
    3(m)(3); Stone v. St. Joseph’s Hosp. of Parkersburg, 
    538 S.E.2d 389
    , 399 (W. Va. 2000), and that “but for” that perception of
    her disability, she would not have been terminated.                       See Conaway
    v. E. Associated Coal Corp., 
    358 S.E.2d 423
    , 429 (W. Va. 1986)
    (enumerating the elements of a prima facie discrimination claim
    under    West       Virginia     Code     § 5-11-9).        The    district     court
    therefore erred in concluding that Anderson failed to make out a
    prima facie case of disability discrimination. 1
    B.
    The majority opinion concludes that Anderson failed to make
    out a prima facie case of workers’ compensation retaliation,
    ante,    at   13,     which    requires    an   employee    to    offer    sufficient
    evidence      that:    “(1)    an   on-the-job    injury     was   sustained;     (2)
    proceedings were instituted under the Workers’ Compensation Act
    1  The district court arguably should have applied a
    different    prima   facie    test,  specific    to   disability
    discrimination suits in West Virginia, which requires that the
    plaintiff (1) satisfy the definition of “handicapped” or
    “disabled,”    (2)  be   able    to perform,   with   reasonable
    accommodation, the relevant job, and (3) was discharged.
    Hosaflook v. Consolidation Coal Co., 
    497 S.E.2d 174
    , 179–80 (W.
    Va. 1997).    Anderson provided sufficient evidence to satisfy
    these elements, too.     Cf. Morris Mem’l Convalescent Nursing
    Home, Inc. v. W. Va. Human Rights Comm’n, 
    431 S.E.2d 353
    , 357–59
    (W. Va. 1993).
    22
    . . . ; and (3) the filing of a workers’ compensation claim was
    a significant factor in the employer’s decision to discharge or
    otherwise discriminate against the employee.”                           Powell v. Wyo.
    Cablevision,       Inc.,    
    403 S.E.2d 717
    ,     721   (W.    Va.   1991).      The
    majority opinion states that Anderson “has failed to present
    sufficient evidence to create a genuine issue of material fact”
    regarding the third, “nexus” element, i.e., whether “her filing
    of a workers’ compensation claim was a significant factor in
    CCC’s decision to terminate her.”                  Ante, at 13.        I disagree.
    Due to the typical lack of direct evidence in employment
    retaliation      cases,     we    are    to     examine     circumstantial        evidence
    when evaluating the third element of a plaintiff’s prima facie
    case,   including        “[p]roximity         in   time     of   the    claim     and   the
    firing,”    “[e]vidence           of    satisfactory           work    performance      and
    supervisory        evaluations         before      the      accident,”      and      “[a]ny
    evidence    of      an     actual       pattern        of   harassing       conduct     for
    submitting the claim.”            Powell, 
    403 S.E.2d at 721
    .
    Here, Anderson offered evidence with respect to each of
    these factors.           First, with respect to the “proximity in time”
    factor, Anderson began receiving workers’ compensation benefits
    on November 4, 2009, was released to return to work by her
    physician     on    March     24,       2010,      effective      March     29,   without
    restrictions, was informed on April 25 that she would not be
    allowed to return to work, and was terminated on June 22.                               The
    23
    proximity among these various dates contributes to a permissible
    inference        that     the      workers’      compensation          claim        was     a
    “significant factor” in Anderson’s termination.                       
    Id.
    Second,    the     record     contains    “[e]vidence          of    satisfactory
    work    performance         and     supervisory        evaluations           before       the
    accident.”        
    Id.
          Anderson was employed continuously with CCC
    from October 15, 1981, through the date of her termination; in
    that time, she established a “good work record” and was “well
    thought of by both Management and her fellow employees.”                                 J.A.
    858.
    Third,     although      there      was   no    “pattern       of      harassment”
    following    the    submission        of    Anderson’s       workers’       compensation
    claim, Powell, 
    403 S.E.2d at 721
    , there is evidence that before
    learning    of    the     initial    return-to-work          examination,         Anderson
    received a call from an employee of Wells Fargo, CCC’s workers’
    compensation       administrator,          advising        Anderson    that       CCC     was
    “going to make an issue of the osteoporosis” and “was going to
    put the screws to” her.            J.A. 136–37.
    Finally, in addition to the above factors, a trier of fact
    is permitted to consider any circumstantial evidence relevant to
    the “nexus” prong.          Such evidence includes the fact that CCC is
    self-insured,       and     that     CCC    regularly        sends     to     its       human
    resources       managers    workers’        compensation       claim        reports     that
    include    information       about    the     cost    of    benefits       paid   to     each
    24
    injured miner.           Such evidence suggests that CCC may have been
    unusually concerned about the costs of its workers’ compensation
    program.       See Nestor v. Bruce Hardwood Floors, L.P., 
    558 S.E.2d 691
    , 695–96 (W. Va. 2001) (finding a triable question of fact
    where “[the employer’s] supervisor bonus system could encourage
    a supervisor to discriminate against an employee who files for
    workers’ compensation benefits, even if . . . the bonus system
    helps reduce workplace injuries”).
    In sum, Anderson presented sufficient evidence to establish
    all    three    elements      of    a   prima    facie   workers’       compensation
    retaliation       case,       including     evidence      that      her     workers’
    compensation filing was a significant factor in CCC’s decision
    to fire her.
    II.
    Both parties appear to concede, and the majority assumes,
    that    the    requirements        of   section    77-1-4.8   apply       “when,   in
    response to an employee’s prima facie case, the employer asserts
    that an employee cannot safely perform her job as a legitimate,
    non-discriminatory reason for termination.”                   Ante, at 16.         I
    agree.     See Ranger Fuel Corp. v. W. Va. Human Rights Comm’n, 
    376 S.E.2d 154
    , 160 (W. Va. 1988) (“The fact that an applicant’s
    handicap       creates    a   reasonable        probability   of    a     materially
    enhanced risk of substantial harm to the handicapped person or
    others is a legitimate, nondiscriminatory reason [for an adverse
    25
    employment action].”); Syl. Pt. 3, Davidson v. Shoney’s Big Boy
    Rest., 
    380 S.E.2d 232
    , 233 (W. Va. 1989) (“[T]o satisfy the
    standard of a serious threat to one’s health or safety, the
    employer must establish that it relied upon competent medical
    advice that there exists a reasonably probable risk of serious
    harm.”).      In short, it is quite clear that CCC was required to
    meet   the    standards          of    section 77-1-4.8              for    its     termination
    decision to be “legitimate” and “non-discriminatory.”
    Those standards are detailed and rigorous.                                 See ante, at
    15–16.       And    at    summary       judgment         this   Court        is    tasked    with
    determining, inter alia, if there is any “genuine dispute,” Fed.
    R. Civ. P. 56(a), as to whether CCC’s termination decision was
    “based on a reasonable medical judgement,” one founded “on the
    most   current      medical       knowledge         and/or      on    the        best   available
    objective evidence.”             
    W. Va. Code R. § 77-1-4.8
    .
    Significant to my disagreement with the majority view, the
    dispositive        question       is    not,        as   the     majority’s             discussion
    suggests, whether CCC “utilized doctors who had the ability to
    conduct the medical testing specific to Anderson’s condition and
    who    were        experienced         in     providing          occupational             medical
    evaluations.”            Ante,    at    18.         Rather,      by        its    plain    terms,
    section 77-1-4.8         requires       that    the      assessment          be    “reasonable”
    26
    and based on “the most current medical knowledge” or the “best
    available objective evidence.” 2
    Nor      is     the        dispositive        question,      as    the     majority’s
    discussion        elsewhere         suggests,    whether      CCC    complied      with    the
    terms of its collective bargaining agreement.                            See ante, at 14,
    17.        That is not what section 77-1-4.8 says.                       Indeed, on more
    than one occasion, West Virginia’s highest court has recognized
    that       a   facially      neutral     company       policy    can     be    exploited    to
    achieve a discriminatory objective.                          Skaggs v. E. Associated
    Coal Corp., 
    569 S.E.2d 769
    , 777 (W. Va. 2002) (noting that “the
    employer’s           use     of     a   system       of     preferred         providers    for
    rehabilitation services . . . could be interpreted as a pretext
    for a scheme to terminate employees who had received workers’
    compensation          benefits”);        Wriston       v.    Raleigh      Cty.     Emergency
    Servs. Auth., 
    518 S.E.2d 650
    , 659 (W. Va. 1999) (“[W]hile an
    employment policy may be facially neutral, it cannot be applied
    in a manner that nullifies or trumps the protective requirements
    of [a statutory prohibition on discriminatory practices].”).
    2
    The majority opinion posits that “and/or” should be read
    simply as a disjunctive “or.”     Ante, at 18 n.6.   I will not
    quibble with the majority’s interpretation, because in this
    case, there is a genuine dispute as to whether the judgment in
    question was based on either the most current medical knowledge
    or the best available objective evidence.
    27
    Section 77-1-4.8 did not require that CCC get the approval
    of a specialist or that it comply with the terms of its own
    policies.          It did require that CCC’s termination decision be
    “based on a reasonable medical judgement,” one founded “on the
    most       current       medical   knowledge     and/or    on   the   best    available
    objective evidence.”               
    W. Va. Code R. § 77-1-4.8
    .         Here, there is
    clearly at least a genuine dispute as to whether those standards
    were met.
    In countering the initial medical evaluation by Anderson’s
    treating orthopedic surgeon, who cleared Anderson for work, 3 CCC
    relied upon the evaluations of three doctors, none of whom had
    any special expertise in osteoporosis, and all of whom relied
    heavily       on     a    single    study   that    they    appear    by     their   own
    3
    Anderson has presented the evaluations of two doctors with
    specialized expertise in osteoporosis concurring with Dr.
    McKinley’s initial clearance of Anderson for work. One of these
    doctors—Dr. Bellantoni—has “23 years of experience as a faculty
    physician at Johns Hopkins University School of Medicine with an
    expertise in the evaluation and treatment of metabolic bone
    disorders including osteoporosis.”      J.A. 703.     This expert
    evidence is not necessary to or sufficient for my analysis, and
    I do not intend to convert every “direct threat” case into a
    battle of the experts. Nevertheless, Anderson’s expert evidence
    is at least relevant in determining whether there is a genuine
    dispute regarding whether the medical judgment CCC relied upon
    in terminating Anderson complied with the standards outlined in
    section 77-1-4.8,    including   whether    that   judgment   was
    “reasonable.”    See Echazabal v. Chevron USA, Inc., 
    336 F.3d 1023
    , 1033 (9th Cir. 2003) (explaining the relevance of a
    plaintiff’s expert evidence in an analogous federal suit,
    brought under the Americans with Disabilities Act of 1990).
    28
    admission either to have misunderstood or to have never read in
    the first place.        To illustrate why there is at the very least a
    genuine dispute as to whether these evaluations were based on
    “the   most    current    medical       knowledge”       or   the    “best       available
    objective     evidence,”        
    W. Va. Code R. § 77-1-4.8
    ,        I    briefly
    discuss each.
    Dr. Steinman was the first CCC doctor to examine Anderson.
    His conclusion that Anderson’s osteoporosis prevented her return
    to work was discussed in a single paragraph, and his discussion
    of Anderson’s fracture risk relied upon a single study peddling
    a   particular       fracture    risk      score   (“FRISK”)        for    osteoporosis
    patients      (the    “FRISK     study”).          Dr.    Steinman’s         deposition
    testimony suggests that a Google search led him to this study. 4
    In applying the FRISK study to Anderson, Dr. Steinman self-
    admittedly     committed        several      errors.          First,      although     Dr.
    4 “Q. Well, you could have gone on – back in 2010, you could have
    gone on medical journal databases and done some additional
    research, couldn’t you?
    A. What I did, I thought, was the – everything that I could do.
    Q. Sir, couldn’t you have gone on PubMed – PubMed, P-U-B,
    capital P, M-E-D, capital M?
    A. It’s my understanding that what I normally do in looking for
    things is actually bigger than PubMed –
    Q. Where did you normally go – you go?
    A. – because I – I get things that are above and beyond PubMed.
    Q. Where did you go? Where did you do the research where you
    came up with this article as the state of the art?
    A. Just do database –
    Q. What database? Google? You just Google?
    A. Google, Bing, anything that’s available.” J.A. 578.
    29
    Steinman intended to cite the study that developed the FRISK
    score, he instead cited a letter to the editor critiquing that
    study    on    the    grounds      that    it    over-predicted              fracture   risk.
    Second,   while       Dr.    Steinman      previously          interpreted        the   FRISK
    study    to    mean    that     Anderson        had     at    least      a    fifty-percent
    probability     of    a     fracture      within      two    years,      he    now    concedes
    gross error: It turns out that figure was only ten percent.
    Finally, it appears that the FRISK study’s findings were at
    best marginally relevant to Anderson.                        The study was based on a
    cohort    of    subjects      significantly           older        and   less    physically
    active than Anderson, facts Dr. Steinman was unaware of at the
    time,    and    the    fracture      risk       score    the       study      developed   was
    intended for use in the context of making treatment decisions,
    not fitness-for-work evaluations.
    CCC also relied upon Dr. Ripepi’s “chart review” of Dr.
    Steinman’s report, which was limited to examining that report
    and the four corners of Anderson’s medical records.                              Dr. Ripepi
    noted that he agreed completely with Dr. Steinman’s conclusions,
    and specifically that Anderson would be at a high risk of repeat
    fracture, a conclusion Dr. Steinman had based primarily on his
    self-admittedly           flawed    understanding             of     the      FRISK     study.
    However, in his deposition, Dr. Ripepi admitted that he never
    30
    read that study. 5    Rather, he assumed Dr. Steinman was “familiar
    with that literature”: in Dr. Ripepi’s words, it “is a pretty
    good assumption, that if you’re going to quote something, then
    you’re pretty darn sure of it.”        J.A. 780.   Here, that was not a
    good assumption to make.
    Finally,   CCC    relied   upon     Dr.   Sethi’s   evaluation   of
    Anderson, which in turn relied upon the previous evaluations by
    Drs. Steinman and Ripepi.       In his deposition, Dr. Sethi also
    admitted that he never read the FRISK study. 6           Indeed, he too
    5 “Q. Did you review the article – literature [Dr. Steinman]
    relied on at the time you rendered your opinion that you agreed
    with him?
    A. No. I agreed with his report.
    Q. Did you review the literature that he relied on? . . .
    A. No.
    Q. Have you ever reviewed the literature he relied on?
    A. No.” J.A. 772.
    6 “Q. Doctor, when you said the fracture risk was developed by
    Dr. J. Gorricho, published by the Journal of Radiologists on
    October 1, 2007, before you put that in your report, did you
    check out and see if that was true?
    A. Doctor – I am simply – I am reporting in the context of a
    review of the medical records. I’m not treating physician. I’m
    not criticizing. I do not need to look up that. I am simply
    going by what is in the record and simply quoting another
    person’s – what they said. And the review of the record is only
    a review of the records. It is –
    Q. Did you check – I’m sorry.
    A. I don’t know – I do not need to check anything.
    Q. But my question is did you check and see if what Dr. Steinman
    said about the Gorricho fracture risk was true? Did you check
    and see if it was true?
    A. I do not need to check it because my role is only reviewing
    the record and quoting what is in the record.
    (Continued)
    31
    erroneously cited the letter to the editor critiquing the study
    he meant to cite.        Although Dr. Sethi reviewed Dr. McKinley’s
    evaluation of Anderson, clearing her for work, he discredited
    that   evaluation   on    the   grounds—now    somewhat     ironic—that    Dr.
    McKinley    did   not    base   her   conclusion    on    specific     medical
    studies.    Much of Dr. Sethi’s analysis had nothing to do with
    Anderson    specifically.       The   rest    was   based   on   the    errant
    assessments of fracture risk made by Drs. Steinman and Ripepi,
    or what Dr. Sethi later admitted to relying on: “common sense.”
    J.A. 823.    Although Dr. Sethi attached to his evaluation a copy
    of one medical article on osteoporosis and a partial copy of
    another, these studies are nowhere referenced or discussed in
    his evaluation.
    In sum, CCC’s doctors relied on an inapplicable study and
    on each others’ faulty evaluations to conclude that Anderson’s
    osteoporosis precluded her from returning to work.                   I simply
    cannot join the majority opinion in concluding that there exists
    no genuine dispute as to whether those troubled evaluations were
    “reasonable” and based on “the most current medical knowledge”
    Q.   So the answer then is, no, you did not check it?
    A.   I do not need to check it.
    Q.   And so you did not check it?
    A.   I did not.” J.A. 810–11.
    32
    or the “best available objective evidence.”                    
    W. Va. Code R. § 77-1-4.8
    .
    III.
    In conclusion, in my view, Anderson has made out a prima
    facie     case     of      disability         discrimination        and     workers’
    compensation retaliation.         Additionally, material issues of fact
    remain regarding whether CCC has met West Virginia’s mandatory
    standards for what constitutes a legitimate, non-discriminatory
    basis   for    termination     under     these    circumstances.           Where   an
    evaluating doctor has himself conceded that his methodology was
    erroneous, I cannot conclude that it is beyond dispute that such
    a   judgment     was    “reasonable”     and    based   on   “the    most   current
    medical knowledge” or “the best objective evidence.”                      Therefore,
    summary   judgment       should   have    been     denied.      Accordingly,        I
    respectfully dissent.
    33