Gary E. Hammons v. W. Va. Ofc. of Insurance Comm./A & R Transport, etc., 235 W. Va. 577

Two claimants (Hammons and Stinnett) sustained workplace injuries, received initial PPD awards for those injuries, then developed additional low‑back conditions they sought to add to their original claims.
Each claimant timely sought to add the new diagnoses, but compensability and/or treatment for the added back conditions were repeatedly denied and required lengthy litigation; this Court ultimately ruled the added conditions compensable and approved treatment.
While litigation was pending, the statutory reopening period in W. Va. Code § 23‑4‑16(a)(2) expired, and the Commission never referred either claimant for a mandatory PPD evaluation under W. Va. Code § 23‑4‑7a(f).
After the Court’s favorable rulings, each claimant requested a PPD evaluation for the newly added back condition; the Claims Administrator and Board of Review denied those requests as untimely reopenings under § 23‑4‑16(a)(2).
The Supreme Court reversed the Board of Review in both consolidated appeals, holding that where (1) an initial PPD award was previously made, (2) the claimant timely filed to add a related injury, (3) that additional injury was ruled compensable, and (4) the Commission failed to refer for a PPD evaluation as required, the claimant may request a PPD evaluation despite the expiration of the § 23‑4‑16(a)(2) reopening period.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether a claimant may request a PPD evaluation for an added, compensable injury after the five‑year reopening period of § 23‑4‑16(a)(2) has expired when the claimant timely sought to add the diagnosis and the Commission failed to refer for PPD evaluation under § 23‑4‑7a(f).	Claimants (Hammons, Stinnett): yes — they timely sought to add the new diagnoses, the injuries were later ruled compensable, and the Commission’s statutory duty to refer for PPD was not performed; denying PPD referrals because the reopening period expired would deprive them of statutory benefits.	Commission / employer: no — § 23‑4‑16(a)(2) bars reopening after five years from the initial PPD award; the statutory referral duty cannot be triggered after that period; allowing exceptions undermines the statutory time limit.	Court: held for claimants — where the four conditions are met (initial PPD award; timely reopening to add related injury; added injury ruled compensable; Commission failed to refer under § 23‑4‑7a(f)), the claimant may request a PPD evaluation notwithstanding § 23‑4‑16(a)(2)’s expiration.

Bowers v. West Virginia Office of the Ins. Comm’r, 224 W.Va. 398 (2009) (standard of review and deference to Board of Review).
Hardy v. Richardson, 198 W.Va. 11 (1996) (Commission must take initiative to process compensable claims, including referrals for disability evaluation).
Baker v. State Workmen’s Compensation Comm’r, 164 W.Va. 389 (1979) (it is the Commission’s obligation, not claimant’s, to initiate disability evaluation procedure).
Bowman v. Workmen’s Comp. Comm’r, 150 W.Va. 592 (1966) (worker’s compensation claim must be considered in entirety; cannot treat parts as barred while others remain litigable).
Pugh v. Workers’ Compensation Comm’r, 188 W.Va. 414 (1992) (distinguishable: reopening denied where claimant sought additional PPD for same injury previously awarded).
Sheena H. for Russell H. v. Amfire, LLC, 235 W.Va. 132 (2015) (tolling principle where an essential governmental delay prevented discovery of claim‑triggering evidence; used as persuasive context for excusing deadlines).