Sara P. Stevens v. Logan Regional Medical Center ( 2013 )


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  •                              STATE OF WEST VIRGINIA
    SUPREME COURT OF APPEALS
    FILED
    SARA P. STEVENS,                                                               December 20, 2013
    RORY L. PERRY II, CLERK
    Claimant Below, Petitioner                                                SUPREME COURT OF APPEALS
    OF WEST VIRGINIA
    vs.)   No. 12-0424 (BOR Appeal No. 2046342)
    (Claim No. 2010132670)
    LOGAN REGIONAL MEDICAL CENTER,
    Employer Below, Respondent
    MEMORANDUM DECISION
    Petitioner Sara P. Stevens, by Phillip R. Amick, her attorney, appeals the decision of the
    West Virginia Workers’ Compensation Board of Review. Logan Regional Medical Center, by
    Lynn Photiadis, its attorney, filed a timely response.
    This appeal arises from the Board of Review’s Final Order dated March 8, 2012, in
    which the Board reversed an August 8, 2011, Order of the Workers’ Compensation Office of
    Judges. In its Order, the Office of Judges reversed the claims administrator’s November 20,
    2010, Order denying Ms. Stevens’s request for an arthroscopic evaluation of her left knee. The
    Court has carefully reviewed the records, written arguments, and appendices contained in the
    briefs, and the case is mature for consideration.
    This Court has considered the parties’ briefs and the record on appeal. 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 that the Board of Review’s decision is based upon a material
    misstatement or mischaracterization of the evidentiary record. This case satisfies the “limited
    circumstances” requirement of Rule 21 (d) of the Rules of Appellate Procedure and is
    appropriate for a memorandum decision rather than an opinion.
    Ms. Stevens sustained an injury to her left knee on April 26, 2010, while working as a
    registered nurse for Logan Regional Medical Center. Her claim was held compensable for sprain
    of the medial collateral ligament. Ms. Stevens’s MRI, on May 5 2010, showed moderate joint
    effusion. On May 15, 2010, Dr. McCleary found large amounts of swelling and reported that Ms.
    Stevens could not fully extend her knee. Dr. Tao found effusion on July 12, 2010. On August 16,
    2010, he opined that an arthroscopic evaluation of Ms. Stevens’s left knee was possibly
    necessary and that the compensable injury exacerbated an underlying condition. On August 20,
    2010, Dr. Ranavaya opined that Ms. Stevens suffered from left knee osteoarthritis that was
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    naturally occurring and chronic in nature, which was not contributed to or aggravated by her
    work-related injury. Dr. McCleary noted that Ms. Stevens had persistent knee pain that began
    with her April 26, 2010, work-related injury. The claims administrator denied Ms. Stevens’s
    request for an arthroscopic evaluation of her left knee.
    The Office of Judges reversed the claims administrator’s Order and held that pursuant to
    West Virginia Code of State Rules § 85-20-44.2.e (2006), Ms. Stevens is entitled to a diagnostic
    arthroscopy of her left knee as reasonably required medical treatment of her work-related injury.
    The Board of Review relied on Dr. Ranavaya’s opinion and held that the requested diagnostic
    arthroscopy is related to conditions that have not been held compensable in this claim and that an
    arthroscopic evaluation was not medically necessary or reasonably required in the course of
    treatment for the work-related injury. Ms. Stevens disagrees and asserts that the Office of Judges
    held an arthroscopic evaluation of her left knee to be an appropriate allowable treatment for her
    work-related injury, and she further argues that Logan Regional Medical Center failed to
    demonstrate that the decision of the Office of Judges was clearly wrong. Logan Regional
    Medical Center argues that the requested arthroscopic evaluation of Ms. Stevens’s left knee is
    related to preexisting degenerative diseases in her knee and not to the work-related injury in this
    claim.
    The Office of Judges gave greater weight to the opinions of Dr. McCleary and Dr. Tao,
    both orthopedic physicians, who had examined Ms. Stevens. The Board of Review’s Order was
    clearly the result of an erroneous conclusion of law. According to West Virginia Code of State
    Rules § 85-20-44.1 (2006), meniscal injuries occur when symptoms of pain and swelling fail to
    resolve in the anticipated period of time, and clinical findings may include joint space
    tenderness, a mild effusion and restricted range of motion. Appropriate diagnostic tests for
    meniscal injuries are x-rays, arthrocentesis, MRI, and diagnostic arthroscopy. West Virginia
    Code of State Rules § 85-20-44.2.e (2006). Dr. McCleary and Dr. Tao diagnosed Ms. Stevens
    with effusion and her x-ray showed effusion. Dr. McCleary noted that Ms. Stevens could not
    fully extend her leg and he requested an arthroscopic evaluation of Ms. Stevens’s left knee. Dr.
    Tao opined that Ms. Stevens’s work-related injury on April 26, 2010, exacerbated an underlying
    condition. Dr. McCleary observed that Ms. Stevens’s persistent knee pain began with her work-
    related injury. We agree with the reasoning and conclusions of the Office of Judges and find that
    the record reflects significant evidence that justify an inference that Ms. Stevens’s work-related
    injury accelerated an underlying condition causing a disability sooner than would otherwise have
    occurred. Therefore, Ms. Stevens is entitled to the requested arthroscopic evaluation of her left
    knee.
    For the foregoing reasons, we find that the decision of the Board of Review was clearly
    the result of an erroneous conclusion of law. Therefore, the decision of the Board of Review is
    reversed and remanded.
    Reversed and Remanded.
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    ISSUED: December 20, 2013
    CONCURRED IN BY:
    Chief Justice Brent D. Benjamin
    Justice Robin J. Davis
    Justice Margaret L. Workman
    Justice Menis E. Ketchum
    Justice Allen H. Loughry II
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Document Info

Docket Number: 12-0424

Filed Date: 12/20/2013

Precedential Status: Precedential

Modified Date: 10/30/2014