Thomas L. Cooper v. Appalachian Power Co.
15-1095
W. Va.Mar 10, 2017Background
- Thomas L. Cooper, long‑time Appalachian Power employee, suffered multiple work injuries, most recently a 2008 traumatic amputation of multiple right‑hand fingers; he never returned to work.
- Cooper previously received permanent partial disability awards totaling 63% (including 43% for the 2008 injury and separate awards for psychiatric, lumbar, cervical, and shoulder impairments).
- He applied for permanent total disability (PTD) benefits in 2012; statutory prerequisites required prior partial awards totaling 50% and a current whole‑body medical impairment of at least 50%.
- The PTD Review Board referred Cooper to Dr. Marsha Bailey for reevaluation; Dr. Bailey rated his whole‑body impairment at 43% after applying the §85‑20 “Rule 20” spinal tables which reduced lumbar and cervical ratings to fit the regulatory tables.
- The claims administrator denied PTD on May 21, 2014 (below 50%); the Office of Judges reversed and remanded for a new impairment exam, finding Dr. Bailey’s application of Rule 20 flawed; the Board of Review reversed the Office of Judges and reinstated the denial.
- Supreme Court affirmed the Board of Review: Rule 20 adjustments to lumbar and cervical range‑of‑motion ratings are required, and Cooper’s adjusted whole‑body impairment did not meet the 50% PTD threshold.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether prior partial awards bar reevaluation of whole‑body impairment | Cooper: prior awards totaling >50% mean his whole‑body impairment should not be reduced by a secondary exam | Appalachian Power: statute requires PTDRB reevaluation to determine current whole‑body impairment | Held: Reevaluation is required by statute; prior awards do not preclude reassessment |
| Whether Dr. Bailey improperly applied Rule 20 (85 C.S.R. §85‑20) to lumbar/cervical ratings | Cooper: Office of Judges—Dr. Bailey’s application of Rule 20 was flawed and her report not credible | Appalachian Power / Board: Rule 20 adjustments are required and Dr. Bailey properly applied them | Held: Dr. Bailey correctly applied Rule 20; lumbar and cervical impairments must be adjusted to table ranges |
| Whether Cooper met the 50% whole‑body impairment threshold for PTD after proper adjustments | Cooper: alternatively asks court to find he meets 50% and remand for vocational retraining | Appalachian Power: adjusted ratings produce <50% whole‑body impairment; no PTD eligibility | Held: Adjusted whole‑body impairment was below 50%; PTD denied |
| Standard of review for Board of Review reversal of Office of Judges | Cooper: Board reversal was erroneous | Appalachian Power: Board’s reversal consistent with law and precedent | Held: Under W.Va. Code §23‑5‑15(d), Board’s reversal not clearly wrong or legally erroneous; deference due |
Key Cases Cited
- Dunlap v. State Compensation Director, 149 W.Va. 266, 140 S.E.2d 448 (1965) (statutory nature of workers’ compensation rights; plain‑meaning statutory construction)
- Simpson v. West Virginia Office of Insurance Commissioner, 223 W.Va. 495, 678 S.E.2d 1 (2009) (upholding validity of W.Va. C.S.R. Table §85‑20 and the rulemaking authority to standardize spinal impairment ratings)
