Wade v. Ohio Valley Med. Ctr., Inc.

Decision Date27 June 2014
Docket NumberNo. 13-0212,13-0212
CourtSupreme Court of West Virginia
PartiesDIANA S. WADE, Claimant, Petitioner v. OHIO VALLEY MEDICAL CENTER, INC., Employer, Respondent

(Claim No. 2011024596)

MEMORANDUM DECISION

Petitioner Diana S. Wade, by William C. Gallagher, her attorney, appeals the decision of the West Virginia Workers' Compensation Board of Review. Ohio Valley Medical Center, Inc., by Toni J. Minner, its attorney, filed a timely response.

This appeal arises from the Board of Review's Final Order dated January 31, 2013, in which the Board affirmed, in part, and reversed, in part, a July 6, 2012, Order of the Workers' Compensation Office of Judges. In its Order, the Office of Judges reversed the claims administrator's September 28, 2011, decision which held the claim closed and found that there was no causal relationship between neck complaints and the compensable injury. The Court has carefully reviewed the records, written arguments, and appendices contained in the briefs, and the case is mature for consideration.

This Court has considered the parties' briefs and the record on appeal. The facts and legal arguments are adequately presented, and the decisional process would not be significantly aided by oral argument. For these reasons, a memorandum decision is appropriate under Rule 21 of the Rules of Appellate Procedure.

Ms. Wade, a registered nurse, was injured in the course of her employment on January 13, 2011, while lifting a patient. Her claim was held compensable for lumbosacral and thoracic sprain/strain. Ms. Wade alleges that she developed cervical pain shortly after the compensable injury. She was thereafter diagnosed with cervical and trapezius sprain/strain and it was requested that the conditions be added to the claim. On September 28, 2011, the claims administrator held the claim closed based upon an independent medical evaluation by Bill Hennessey, M.D., finding that she had reached maximum medical improvement for hercompensable conditions. In its decision, the claims administrator also stated that there was no causal relationship between the complaints of neck pain and the compensable injury.

The Office of Judges reversed the claims administrator's decision in its July 6, 2012, Order. It held that a claim cannot be administratively closed for treatment until barred by West Virginia Code § 23-4-16(a)(4) (2005). It found that the claims administrator's decision closed the claim but did not specifically state what the claim was being closed for. The Office of Judges found that Ms. Wade was not receiving temporary total disability benefits and had not received a permanent partial disability award at that time. Therefore, it was determined that the claims administrator intended to close the claim for further treatment. In Lovas v. Consolidation Coal Company, 222 W.Va. 91, 662 S.E.2d 645 (2008) this Court stated that a claim remains open for medical benefits on an unlimited basis until it satisfies the statutory requirement for permanent closure for treatment as set forth in West Virginia Code § 23-4-16(a)(4). The Office of Judges found that the claims administrator's attempt to administratively close the claim was specifically disavowed in Lovas. Pursuant to West Virginia Code § 23-4-16(a)(4), a claim will be closed for further treatment only when no substantial treatment or durable medical...

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