Murray American Energy, Inc. v. Timothy Myers ( 2022 )


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  •                                                                                   FILED
    April 20, 2022
    EDYTHE NASH GAISER, CLERK
    SUPREME COURT OF APPEALS
    OF WEST VIRGINIA
    STATE OF WEST VIRGINIA
    SUPREME COURT OF APPEALS
    MURRAY AMERICAN ENERGY, INC.,
    Employer Below, Petitioner
    vs.)   No. 21-0126 (BOR Appeal No. 2055651)
    (Claim No. 2020001574)
    TIMOTHY MYERS,
    Claimant Below, Respondent
    MEMORANDUM DECISION
    Petitioner Murray American Energy, Inc., by Counsel Aimee M. Stern, appeals the decision
    of the West Virginia Workers’ Compensation Board of Review (“Board of Review”). Timothy
    Myers, by Counsel J. Thomas Greene Jr. and T. Colin Greene, filed a timely response.
    The issue on appeal is attorney’s fees. On November 13, 2019, Mr. Myers petitioned the
    Office of Judges for attorney’s fees and costs associated with the claims administrator’s August 2,
    2019, rejection of the claim. The Workers’ Compensation Office of Judges (“Office of Judges”)
    granted the request in its August 20, 2020, Order. The Order was affirmed by the Board of Review
    on January 21, 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 . . . .
    1
    (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
    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. Myers, a coal miner, struck his right eye with a screwdriver in the course of his
    employment on July 17, 2019. He sought treatment that day from Wheeling Hospital Emergency
    Room where he was seen for right eye pain. It was noted that he nicked the upper part of his eyelid.
    The Employees’ and Physicians’ Report of Injury was also completed that day and indicates Mr.
    Myers injured his right eye. The diagnosis was listed as right eye pain.
    A July 17, 2019, Marshall County Coal Company Report of Investigation indicates Mr.
    Myers stated that he injured his eye while trying to open his locker. There was a washer stuck in
    the crease of the locker, and he was attempting to remove the washer when he struck his eye.
    A July 19, 2019, treatment note from C. Clark Milton, M.D., indicates Mr. Myers was
    treated for right eye trauma. Dr. Milton stated that the injury was mostly to the upper eye lid, but
    the globe was also involved. He noted that a foreign body was removed from Mr. Myers’s eye
    with a cotton swab at the emergency room and he was given antibiotic drops. Dr. Milton diagnosed
    right eye foreign body trauma and superior orbit contusion and abrasion. He recommended a
    follow-up with ophthalmology. Joseph Myers, D.O., diagnosed corneal abrasion on July 23, 2019.
    The claims administrator rejected the claim on August 2, 2019, stating that Mr. Myers was
    not in the course of his employment at the time of the injury. On November 20, 2019, the claims
    administrator issued a Corrected Order holding the claim compensable for laceration of the eyelid
    and periocular area. On November 13, 2019, Mr. Myers petitioned the Office of Judges for
    attorney’s fees and costs associated with the claims administrator’s August 2, 2019, rejection of
    the claim.
    The Office of Judges granted Mr. Myers’s request for attorney’s fees and costs on August
    20, 2020. The Office of Judges began by noting that West Virginia Code § 23-2C-21(c) provides
    that upon a determination by the Office of Judges that the claims administrator’s denial of
    compensability was unreasonable, attorney’s fees and costs incurred as a result of appealing such
    decision, shall be awarded to the claimant. A denial is considered unreasonable if the employer is
    unable to show that such denial had a legal basis supported by legal authority.
    2
    West Virginia Code of State Rules § 93-1-19.4 defines unreasonable:
    A denial shall be unreasonable if the denial by the private carrier or self-
    insured employer is without a legal or factual basis. The legal basis for a denial may
    be based upon any of the following:
    A) Statutes;
    B) Rules of the Insurance Commissioner;
    C) Case law; or
    D) In the absence of relevant West Virginia Case law
    recognized legal treatises on workers’ compensation.
    The mere fact that a denial is reversed is not, in itself, proof that such denial was unreasonable.
    The Office of Judges found that Mr. Myers was clearly in the course of his employment at
    the time of his injury. He was attempting to open his locker to obtain his equipment when he
    injured his eye. The Office of Judges determined that there is no dispute that Mr. Myers was injured
    in the course and result of his employment. The claims administrator’s decision seems to be based
    on the misunderstanding that Mr. Myers was engaged in horseplay at the time of his injury. The
    Office of Judges found no evidence in support of such assertion. It therefore found that the
    rejection of the claim was unreasonable and ordered that attorney’s costs and fees be paid. The
    Board of Review adopted the findings of fact and conclusions of law of the Office of Judges and
    affirmed its Order on January 21, 2021.
    After review, we agree with the decision of the Office of Judges as affirmed by the Board
    of Review. The evidence clearly indicates that Mr. Myers was injured while attempting to open
    his locker to retrieve his work equipment. The claims administrator’s rejection of the claim was
    unreasonable, and attorney’s fees and costs are appropriate in this case.
    Affirmed.
    ISSUED: April 20, 2022
    CONCURRED IN BY:
    Chief Justice John A. Hutchison
    Justice Elizabeth D. Walker
    Justice Tim Armstead
    Justice William R. Wooton
    Justice Alan D. Moats, sitting by temporary assignment
    3
    

Document Info

Docket Number: 21-0126

Filed Date: 4/20/2022

Precedential Status: Precedential

Modified Date: 4/20/2022