Hood v. Lincare Holdings, Inc.
| Docket Number | 21-0754 |
| Decision Date | 08 November 2023 |
| Parties | ROBERT HOOD, Petitioner, v. LINCARE HOLDINGS, INC., Respondent. |
| Court | West Virginia Supreme Court |
Submitted: October 31, 2023
Appeal from the Workers' Compensation Board of Review Case No 2056412 AFFIRMED
William C. Gallagher, Esq. CASSIDY, COGAN, SHAPELL & VOEGELIN, LC Wheeling, West Virginia Counsel for Petitioner
Jeffrey M. Carder, Esq. Lisa Warner Hunter, Esq. WILLIAM J. FERREN & ASSOCIATES Hartford, Connecticut Counsel for Respondent
1. "In order for a claim to be held compensable under the Workmen's Compensation Act, three elements must coexist: (1) a personal injury (2) received in the course of employment and (3) resulting from that employment." Syllabus Point 1, Barnett v. State Workmen's Comp. Comm'r, 153 W.Va. 796, 172 S.E.2d 698 (1970).
2. Syllabus Point 3, Casdorph v. W.Va. Off. Ins. Comm'r, 225 W.Va. 94, 690 S.E.2d 102 (2009).
3. "Whether an injury occurs . . . resulting from the employment so as to be compensable under the workmen's compensation act depends upon the particular facts in each case." Syl. Pt. 2, in part, Emmel v. State Comp. Dir., 150 W.Va. 277, 145 S.E.2d 29 (1965)." Syllabus Point 3, Morton v. W.Va. Off. of Ins. Comm'r, 231 W.Va. 719, 749 S.E.2d 612 (2013).
4. In the context of workers' compensation law, there are four types of injury-causing risks commonly faced by an employee at work: (1) risks directly associated with employment; (2) risks personal to the claimant; (3) mixed risks; and (4) neutral risks.
5. The factfinder may use the increased-risk test when deciding whether an employee sustained a compensable injury under West Virginia Code § 23-4-1(a) (2018), in cases where the injury occurred while the employee was engaged in a neutral risk activity. Under the increased-risk test, even if the risk faced by the employee is not qualitatively peculiar to the employment, the injury may be compensable if he faced an increased quantity of a risk.
While descending a short set of stairs from a customer's porch after making a delivery for his employer, Robert Hood felt a "pop" and pain in his right knee. He was later diagnosed with a right knee sprain. Mr. Hood did not slip, trip, or fall, and he was not carrying anything. The West Virginia Workers' Compensation Board of Review affirmed previous rulings rejecting the claim, and Mr. Hood appeals. Even though Mr. Hood was injured while working, he failed to show that his work caused the injury. We affirm.
On May 1, 2020, Robert Hood was delivering medical supplies for his employer, Lincare Holdings, Inc. On his third stop of the day, Mr. Hood greeted a customer, who was standing on his porch, gathered five empty oxygen bottles, and took them to the van he was driving. Mr. Hood retrieved five replacement oxygen bottles (that weighed in total about twenty-two pounds) from the van, walked up the stairs of the customer's porch, and set them inside the front door of the home.
As he was leaving the customer's residence and began descending the three wooden steps off the porch, Mr. Hood held the handrail. He placed his left foot on the first step with no issues. But Mr. Hood felt his right knee "pop" with "extreme burning" in his leg when he stepped down on the second step using his right foot. Mr. Hood did not slip, trip, or fall, and he was not carrying anything. Mr. Hood does not contend that the stairs were defective or slippery.
When Mr. Hood got to his van, he sent a text message his supervisor, Kim Harmon, stating She agreed. Mr. Hood made one more delivery that day because the next customer was just around the corner.[1] Mr. Hood then returned the employer's van to the shop and drove himself to Wheeling Hospital.
Mr. Hood completed a Report of Occupational Injury that same day stating that he injured his right knee while walking down steps. The physician's section of the application,[2] completed at the emergency department of Wheeling Hospital, indicated Mr. Hood had an occupational injury of a right knee sprain. The physician section stated that Mr. Hood did not aggravate a prior injury or disease. And at his deposition taken in August 2020, Mr. Hood denied any prior injuries or symptoms involving his knee.
Jeffrey Abbott, D.O., examined Mr. Hood on May 5, 2020, for right knee symptoms. Dr. Abbott diagnosed a tear of the right medial meniscus and recommended an MRI. On May 11, 2020, Mr. Hood was treated by Ross Tennant, a nurse practitioner. He also diagnosed a right knee sprain and recommended that Mr. Hood undergo an MRI.
The employer's claim administrator denied Mr. Hood's application for workers' compensation benefits, concluding that Mr. Hood did not sustain an injury in the course of and as a result of his employment. Mr. Hood protested that decision to the West Virginia Workers' Compensation Office of Judges.
In February 2021, an Administrative Law Judge with the Office of Judges affirmed the claim administrator's decision. The ALJ stated that Mr. Hood "developed pain in his right knee while engaging in an ordinary activity of daily life," and that no evidence was presented that his "work activities either caused or contributed to the injury." The ALJ concluded that Mr. Hood failed to show by a preponderance of the evidence that he sustained an injury in the course of and as a result of employment.
Mr. Hood appealed the decision of the Office of Judges. On August 23, 2021, the Board of Review adopted the findings of fact and conclusions of law of the ALJ and affirmed the ruling rejecting the claim. Mr. Hood appeals that order to this Court.
Mr. Hood contends that the Board of Review committed clear error when determining that his knee injury was not a result of his employment. In a workers' compensation appeal, we give deference to the Board of Review's "findings, reasoning, and conclusions[,]"8 and apply the criteria set forth in West Virginia Code § 23-5-15 (2021):
(d) If the decision of the board represents an affirmation of a prior ruling by both the commission and the Office of Judges that was entered on the same issue in the same claim, the decision of the board may be reversed or modified by the Supreme Court of Appeals only if the decision is in clear violation of constitutional or statutory provision, is clearly the result of erroneous conclusions of law, or is based upon the board's material misstatement or mischaracterization of particular components of the evidentiary record. The court may not conduct a de novo re-weighing of the evidentiary record. . . .
This Court applies a de novo standard of review to questions of law arising from appeals of the Board of Review's decisions.[3]
As this Court has previously recognized, the workers' compensation system is a no-fault system.[4] When an employee is injured in the course of and resulting from his covered employment, it does not matter whether the employer or employee was at fault.
"In order for a claim to be held compensable under the Workmen's Compensation Act, three elements must coexist: (1) a personal injury (2) received in the course of employment and (3) resulting from that employment."[5] Applying those elements, we have explained that the "in the course of" prong of the compensability phrase refers to "the time, place, and circumstances of the accident in relation to the employment" and the "resulting from" prong refers to "causal origin" of the injury.[6] While these distinct prongs must be met, "it should never be forgotten that the basic concept of compensation coverage is unitary, not dual, and is best expressed in the term 'work connection.'"[7]
There is no dispute that Mr. Hood's knee injury occurred in the course of his employment when he was delivering medical supplies on May 1, 2020. The issue here is whether it "resulted from" that employment, that is, whether it was "work connected." This Court has held that "[i]n determining whether an injury resulted from a claimant's employment, a causal connection between the injury and employment must be shown to have existed."[8] So, even though an employee need not establish fault, he must establish a connection between his work and his injury. Put differently, although workers' compensation benefits are payable irrespective of fault, they are not payable irrespective of cause. "Whether an injury occurs . . . resulting from the employment so as to be compensable under the workmen's compensation act depends upon the particular facts in each case."[9] And this Court affords great deference to the factfinder.[10]
Mr. Hood argues that the Board of Review erred when affirming the previous rulings rejecting his claim because he was injured while descending the stairs of a customer's porch after making a delivery. Because this activity is a regular and ordinary part of his job, Mr. Hood reasons that he was injured as a result of his employment. Lincare responds that the Board of Review properly affirmed the denial of the claim because Mr. Hood failed to establish that he sustained an injury resulting from his employment-that is, there was a lack of a causal connection between his work and his knee sprain.
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