Background
Ryan Hill was injured while operating heavy equipment in a coal mine on April 11, 2024. The claim administrator held his claim compensable for a thoracic-wall contusion and a concussion without loss of consciousness and granted temporary total disability benefits from April 12 through April 29, 2024. Hill’s symptoms included headaches, dizziness, light sensitivity, neck pain, and ringing in his ears.
At the claim administrator’s request, Dr. Gerald Steiman performed an independent medical evaluation and found that Hill had reached maximum medical improvement with no whole-person impairment. Dr. Joseph Grady, who later evaluated Hill at Hill’s request, agreed that the thoracic contusion produced no ratable impairment but recommended 2% impairment for bilateral tinnitus. The claim administrator denied permanent partial disability benefits, and the Workers’ Compensation Board of Review affirmed.
The Court’s Holding
The Intermediate Court of Appeals affirmed, holding that the Board was not clearly wrong in relying on Dr. Steiman’s assessment and declining to adopt Dr. Grady’s 2% tinnitus rating. The record documented tinnitus before the compensable 2024 injury, including complaints in 2022 and 2023, and Dr. Grady did not address that history.
The court also agreed that Dr. Grady did not adequately explain how he derived the 2% rating under Section 9.1 of the AMA Guides. Applying deferential review, the court concluded that substantial evidence supported the Board’s finding that Dr. Steiman’s report was more persuasive. The court declined, however, to adopt the Board’s broader conclusion that tinnitus resulting from a compensable concussion cannot be evaluated for impairment unless tinnitus is separately recognized as a compensable condition.
Key Takeaways
- A permanent-impairment opinion may carry little weight when it does not address evidence that the claimed symptom existed before the compensable injury.
- An impairment rating must include sufficient reasoning explaining how the evaluator applied the AMA Guides.
- The court affirmed the denial based on the evidentiary record without endorsing a categorical rule requiring tinnitus to be separately added as a compensable condition before it may be rated.
Why It Matters
The decision underscores the importance of a reasoned medical analysis connecting a claimed impairment to the compensable injury, particularly when the medical record documents similar preexisting symptoms. It also leaves open the possibility that tinnitus caused by a compensable concussion may be evaluated for impairment even if tinnitus was not separately recognized as compensable.