William Boyko v. Blue Creek Mining, LLC
21-0123
| W. Va. | Apr 20, 2022Background
- William Boyko, a coal miner, sustained a lumbar and left knee injury on November 20, 2015; claim held compensable for lumbar sprain and left knee meniscus tear.
- MRIs showed significant knee chondromalacia and lumbar degenerative changes; he underwent left partial medial meniscectomy in June 2016.
- Multiple independent medical evaluations (IMEs) produced differing whole-person impairment ratings: 4% (Dr. Grady, 2017), 12% (Dr. Walker, 2017), 5% (Dr. Mukkamala, 2018). Office of Judges awarded 5% PPD in July 2018.
- Dr. Kominsky (March 18, 2020) rendered an IME assessing 12% whole-person impairment (8% lumbar, 4% knee), mirroring Dr. Walker’s earlier opinion.
- Claims administrator denied reopening for additional permanent partial disability (PPD) on April 6, 2020; the Office of Judges (Sept. 23, 2020) and Board of Review (Jan. 22, 2021) affirmed. The Supreme Court affirmed the Board’s decision.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the claim may be reopened for additional PPD based on Dr. Kominsky’s IME | Boyko: Kominsky’s 12% rating shows aggravation/progression warranting reopening | Employer: Kominsky’s opinion duplicates Dr. Walker’s previously considered and rejected opinion and does not show new progression | Denied — reopening requires new/progressive evidence; claimant failed to meet burden |
| Whether a duplicative IME suffices to reopen a previously adjudicated impairment award | Boyko: new IME constitutes new evidence supporting greater benefits | Employer: duplicative opinions already evaluated cannot justify reopening | Held that duplicative, previously-rejected medical opinions do not justify reopening; Office of Judges’ and Board’s conclusions upheld |
Key Cases Cited
- Hammons v. W. Va. Off. of Ins. Comm’r, 235 W. Va. 577, 775 S.E.2d 458 (2015) (sets out deference and review standards for Board of Review decisions)
- Justice v. W. Va. Off. Ins. Comm’r, 230 W. Va. 80, 736 S.E.2d 80 (2012) (explains de novo review for legal questions)
- Davies v. W. Va. Off. of Ins. Comm’r, 227 W. Va. 330, 708 S.E.2d 524 (2011) (addresses appellate review standards in workers’ compensation appeals)