Can a worker with a leg injury get additional workers’ compensation benefits if several doctors can’t agree on the severity of his disability?
The West Virginia Supreme Court found that one doctor’s opinions were backed by sufficient medical evidence to uphold the state Board of Review’s denial of additional benefits.
X-rays revealed damage from injury, pre-existing arthritis
Danny Perry was a fire boss for the Acracoma Coal Company when he injured his left knee Jan. 25, 2019, when he slipped and got his left leg trapped between a belt and a belt rail.
Perry was treated at a local hospital the day after the incident and was diagnosed with a sprain or strain of the left knee. X-rays revealed moderately advanced osteoarthritis of the knee along with a joint condition, according to the treating doctor.
On Jan. 31, a claims administrator ruled the claim compensable for a sprain to the left knee but excluded compensability for a crush injury and pain in the left knee.
Impairment was 4% from injury, 4% arthritis
Perry needed further medical treatment and was referred for a permanent total disability evaluation. The claims administrator asked that Perry be evaluated by Dr. David Soulsby.
Dr. Soulsby diagnosed:
- severe osteoarthritis of the left knee
- moderately severe osteoarthritis in the uninjured right knee
- torn medial meniscus in the left knee, and
- an insufficiency fracture of the left knee.
The doctor also found that Perry had reached maximum medical improvement with the symptoms attributed to osteoarthritis. Dr. Soulsby found 8% whole person impairment with 4% attributable to the compensable injury and 4% to pre-existing arthritis.
On Oct. 28, 2019, the claims administrator granted Perry a 4% permanent partial disability award based on Soulsby’s report. Perry protested the decision.
Doctor finds improvement in condition
Another evaluation by a different doctor occurred Feb. 18, 2020. This doctor found an 8% whole person impairment, but chose not to apportion impairment “due to a lack of evidence of pre-existing symptoms, and his belief that the mild range of motion abnormalities at the uninjured right knee did not translate to impairment under the mild category.”
A medical evaluation conducted on Aug. 31, 2020, by Dr. Prasadarao Mukkamala found a 4% whole person impairment rating. Dr. Mukkamala reported that the difference between his rating and the rating by the previous doctor was “accounted for by the difference in physical findings” they each found in the deformity of Perry’s injured joints.
Knee’s ‘better range of motion’ meant denial was justified
The West Virginia Office of Judges found Dr. Mukkamala’s evaluation to be the most representative of Perry’s permanent impairment due to his injury. As a result, the award based on the 4% rating was upheld. The Board of Review agreed and affirmed the decision.
On appeal, the West Virginia Supreme Court agreed with the reasoning of the Office of Judges and Board of Review.
By the time Dr. Mukkamala performed his examination, Perry’s left knee revealed “considerably better range of motion” than it did during prior exams. That improvement meant the Office of Judges didn’t err in its denial of an 8% rating, according to the court.