Walter S. Alexander v. Snyder Industries, Inc
20-0299
| W. Va. | Jun 23, 2021Background
- Claimant Walter S. Alexander alleged an August 8, 2018 work injury when his arm jerked/rotated while exiting a forklift, causing neck, upper back, and right arm pain and numbness.
- Initial treating providers diagnosed brachial plexus/cervical radiculopathy; imaging (MRI 9/12/2018) and EMG showed multilevel chronic degenerative cervical disease, most significant at C6–C7, and right C7–C8 radiculopathy.
- Claims administrator denied compensability (Sept. 7, 2018) and later denied authorization for CT myelogram, fluoroscopic myelogram, and brain MRI (Jan. 16, 2019).
- An IME (Dr. Jin) and an age-of-injury review (Dr. Luchs) concluded the cervical findings were chronic/degenerative and not causally related to employment; Dr. Jin found requested imaging not medically necessary.
- The Office of Judges affirmed the denials, finding preexisting degenerative cervical disease caused the symptoms; the Board of Review adopted those findings and denied the claim and treatment authorization.
- The Supreme Court of Appeals affirmed the Board, agreeing the degenerative condition was preexisting and unrelated to the workplace incident, so the claim and requested testing were properly denied.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Compensability: whether the August 8, 2018 workplace event caused a compensable injury to claimant's cervical spine | Alexander: symptoms began at work after the forklift incident and reflect work-related cervical radiculopathy | Employer: cervical findings are chronic degenerative disease predating the event and not caused by work | Held: Claim denied—evidence shows preexisting degenerative disease caused symptoms, not the employment incident |
| Medical treatment: whether CT myelogram, fluoroscopic myelogram, and brain MRI were medically necessary for the alleged work injury | Alexander: treating surgeons requested advanced imaging to evaluate nerve root impingement and neurologic symptoms | Employer: tests not reasonably required because injury is not work-related and imaging would not change compensability | Held: Denial of requested imaging affirmed as not medically necessary in light of finding the condition was degenerative and nonwork-related |
Key Cases Cited
- Hammons v. W. Va. Office of Ins. Comm’r, 775 S.E.2d 458 (2015) (describes appellate deference to the Board of Review and standards limiting reversal)
- Justice v. W. Va. Office Ins. Comm’n, 736 S.E.2d 80 (2012) (applies de novo review to questions of law arising from Board decisions)
- Davies v. W. Va. Office of Ins. Comm’r, 708 S.E.2d 524 (2011) (confirms de novo standard for legal issues in workers’ compensation appeals)