Malinda M. Mills v. McDowell County Commission on Aging, Inc.
20-0407
W. Va.Sep 22, 2021Background
- Malinda M. Mills, a personal care aide, suffered a compensable low-back sprain at work on May 27, 2017; she had a prior work-related lower-back injury on April 8, 2016.
- Imaging (CT and MRI) showed multilevel disc bulges/herniations that were unchanged from preinjury studies; treating physician Dinkar Patel treated Mills for both 2016 and 2017 events.
- Mills sought to add diagnoses of dorsalgia (unspecified backache) and right sciatica to the 2017 claim; the claims administrator denied the addition on October 24, 2018.
- Record reviewers and IMEs (Drs. Thaxton, Grady, Bailey) concluded the imaging showed no new/worsened disc pathology and found no clinical evidence of a new radiculopathy attributable to the 2017 event.
- Dr. Patel testified the 2017 injury did not change Mills’s diagnoses from those already present after the 2016 injury; dorsalgia was characterized as a symptom rather than a discrete diagnosis.
- The Office of Judges affirmed the denial (Nov. 4, 2019); the Board of Review affirmed (May 21, 2020); the Supreme Court of Appeals affirmed on review.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether dorsalgia (unspecified backache) may be added as a compensable diagnosis to the 2017 claim | Mills: back pain following the 2017 injury should be added as a compensable condition | Employer: dorsalgia is a symptom, not a diagnosis; no new injury shown | Denied — dorsalgia is a symptom, not an appropriate compensable diagnosis |
| Whether right sciatica should be added as a new/worsened compensable condition from the 2017 injury | Mills: right sciatica resulted from the May 27, 2017 work injury | Employer: sciatica and imaging findings preexisted from the 2016 injury; no objective change on imaging or clinical evidence of new radiculopathy | Denied — sciatica preexisted the 2017 event and no new/worsened injury shown |
Key Cases Cited
- Hammons v. W. Va. Off. of Ins. Comm’r, 235 W. Va. 577, 775 S.E.2d 458 (2015) (standard of review and deference to Board of Review findings)
- Justice v. W. Va. Office Ins. Comm’n, 230 W. Va. 80, 736 S.E.2d 80 (2012) (de novo review applies to legal questions from board decisions)
- Davies v. W. Va. Off. of Ins. Comm’r, 227 W. Va. 330, 708 S.E.2d 524 (2011) (clarifies standards for review of board decisions)
- Barnett v. State Workmen’s Comp. Comm’r, 153 W. Va. 796, 172 S.E.2d 698 (1970) (defining compensable personal injury in the course of employment)