William L. Gill v. City of Charleston, 236 W. Va. 737

Claimant William L. Gill injured his back at work on Feb. 8, 2012 lifting a training dummy; Claim Administrator allowed lumbar and thoracic sprains as compensable.
Gill had a long preexisting history of back problems (dating to 1985 and a major 1992 fall) with prior treatment records showing diagnoses including radiculopathy, degenerative disc disease, disc displacement, sciatica, and facet syndrome.
In August 2012 a chiropractic clinic sought authorization for injections for four diagnoses (neuritis/radiculitis; sciatica; degeneration of lumbosacral IVD; facet syndrome); the request was denied and appealed.
The Office of Judges (OOJ) sua sponte treated the protest as a request to add those four diagnoses as compensable components and granted the addition, finding the compensable injury had aggravated the preexisting conditions.
The Workers’ Compensation Board of Review reversed the OOJ, concluding the four diagnoses were noncompensable preexisting conditions; Gill appealed to the Supreme Court of Appeals of West Virginia.
The Supreme Court affirmed the Board: Gill failed to prove aggravation by a preponderance of the evidence, and the law does not convert an existing noncompensable condition into a compensable one merely because it was aggravated unless the aggravation produced a discrete new injury.

Issue	Plaintiff's Argument (Gill)	Defendant's Argument (City)	Held
Whether OOJ properly added four preexisting diagnoses to the compensable claim	OOJ correctly found the Feb. 8, 2012 injury aggravated preexisting conditions, so the diagnoses should be added as compensable	No formal request was made to add diagnoses; evidence does not show aggravation or causal connection to work	OOJ’s addition reversed: Board’s reversal affirmed (issue of administrative conversion waived below; in any event no evidence of aggravation)
Whether the compensable injury aggravated preexisting conditions	Gill relies on a March 2012 note (Dr. Weinsweig) saying pain was temporally related to work injury	City points to independent evaluations (Drs. Hennessey and Mukkamala) finding full recovery from sprain and no aggravation of preexisting pathologies	Held: Gill did not meet preponderance of evidence; independent IMEs show no aggravation; OOJ misread the medical evidence
Whether aggravation of a noncompensable preexisting condition makes that preexisting condition compensable	OOJ: aggravation by work injury permits adding preexisting diagnoses as compensable elements	City: aggravation alone does not convert a prior noncompensable condition into a compensable one; must show a discrete new injury caused by work	Held: A noncompensable preexisting injury is not made compensable solely because it was aggravated; only a discrete new injury resulting from aggravation may be compensable

Barnett v. State Workmen’s Compensation Commissioner, 153 W. Va. 796, 172 S.E.2d 698 (W. Va. 1970) (three elements for compensability: personal injury, in course of employment, resulting from employment)
Emmel v. State Comp. Dir., 150 W. Va. 277, 145 S.E.2d 29 (W. Va. 1965) (causal connection required between injury and employment)
Charlton v. State Workmen’s Compensation Commissioner, 160 W. Va. 664, 236 S.E.2d 241 (W. Va. 1977) (preexisting disease does not bar compensation for a new injury that superinduces disability)
Jordan v. State Workmen’s Compensation Commissioner, 156 W. Va. 159, 191 S.E.2d 497 (W. Va. 1972) (preexisting condition does not eliminate need to show a definite, isolated work-related incident causing injury)
Dunlap v. State Workmen’s Compensation Commissioner, 152 W. Va. 359, 163 S.E.2d 605 (W. Va. 1968) (distinguishing compensable new sprain from preexisting condition when diagnoses are distinct)
Gallardo v. Workers’ Comp. Comm’r, 179 W. Va. 756, 373 S.E.2d 177 (W. Va. 1988) (apportionment statute separates preexisting impairment from impairment due to current occupational injury)