Murray American Energy, Inc v. Connie Titus
21-0026
| W. Va. | Apr 20, 2022Background
- Connie Titus, a coal-miner bus driver, was injured in a workplace bus collision on January 12, 2018; claim held compensable for low back strain, right hip strain/labral tear, right knee sprain, cervical sprain, and left shoulder sprain.
- She underwent right hip arthroscopy (Sept. 2018) and left shoulder surgery (Jan. 29, 2019) and received extensive physical therapy and PRP injections for persistent shoulder and hip symptoms.
- Treating surgeon Dr. Schweizer repeatedly excused Titus from work, recommended additional PT and repeat PRP, and ultimately stated she reached MMI on February 24, 2020 and could not return to her former job.
- Independent medical examiner Dr. Soulsby concluded MMI earlier (Oct. 2019) and assigned permanent impairment but recommended PRP and found noncompensable conditions contributing to disability; the Office of Judges found his opinions unreliable for TTD determination.
- Procedural history: claims administrator denied temporary total disability (TTD) benefits (Feb. 25, 2020) and denied additional physical therapy (Mar. 10, 2020). The Office of Judges reversed the TTD denial (granting TTD from July 8, 2019 through Feb. 25, 2020 or until the 104-week cap) but affirmed denial of further PT beyond prior authorization; the Board of Review and the Supreme Court of Appeals affirmed.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Entitlement to temporary total disability (TTD) benefits for period after July 8, 2019 | Titus contended treating surgeon excused her from work through Feb. 24, 2020 and she had not reached MMI until that date, so she is entitled to TTD through MMI (or 104-week maximum). | Employer/claims administrator relied on IME (Dr. Soulsby) finding MMI by May/Oct. 2019 and attributed remaining disability to noncompensable conditions, arguing TTD should cease earlier. | Court affirmed Office of Judges: Titus reached MMI on Feb. 24, 2020 per treating physician; TTD awarded from July 8, 2019 until MMI or the 104-week cap. |
| Authorization of additional physical therapy | Titus sought continued PT and repeat PRP after prior treatments and surgeries; argued further PT was reasonable for remaining symptoms. | Employer/claims administrator denied additional PT as unnecessary and relied on prior PT authorizations and completion; also cited stacked requests after COVID shutdown. | Court affirmed denial of additional PT beyond what had been authorized: limited PT warranted for right hip, but further PT beyond prior authorization unnecessary given prior extensive therapy and COVID-related stacking of requests. |
Key Cases Cited
- Hammons v. W. Va. Off. of Ins. Comm’r, 235 W. Va. 577, 775 S.E.2d 458 (W. Va. 2015) (standards of appellate 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 (W. Va. 2012) (de novo review of legal questions from board decisions)
- Davies v. W. Va. Off. of Ins. Comm’r, 227 W. Va. 330, 708 S.E.2d 524 (W. Va. 2011) (clarifying standards of review for workers’ compensation appeals)