Background
Brett Blackwell had pre-existing bilateral shoulder pain dating to 2022, with documented acromioclavicular degeneration and a superior glenoid labrum tear. In July 2024, Dr. Stover diagnosed adhesive capsulitis in his right shoulder. On August 2, 2024, while operating an excavator at work, Blackwell sustained a work-related compensable injury when the vehicle rolled, causing a right arm laceration and left shoulder trauma. The claim administrator initially accepted only the laceration and left shoulder sprain as compensable.
Blackwell’s left shoulder symptoms worsened post-injury, and subsequent imaging and clinical evaluation by Dr. Stover and Dr. Lavender revealed left shoulder adhesive capsulitis and subacromial impingement—conditions not diagnosed prior to the work accident. Dr. Stover diagnosed these new left shoulder conditions months after the injury and opined they were causally related to the compensable injury. Blackwell sought to add these diagnoses as compensable conditions and requested temporary total disability (TTD) benefits from September 21, 2024, through March 12, 2025. The claim administrator denied both requests.
The Court’s Holding
The Intermediate Court of Appeals affirmed the Workers’ Compensation Board of Review’s reversal of the claim administrator. The court held that left shoulder adhesive capsulitis and subacromial impingement are compensable conditions causally related to the August 2, 2024 work injury, applying the standard established in Moore v. ICG Tygart Valley, LLC. Under Moore, when a claimant’s preexisting condition was asymptomatic before injury and symptoms appear and continually manifest after injury, disability is presumed to result from the compensable injury if sufficient medical evidence establishes causation or the nature of the accident raises a natural inference of causation. Although Blackwell had pre-existing right shoulder pathology, the left shoulder conditions were never diagnosed before the compensable injury. Dr. Stover’s and Dr. Lavender’s post-injury diagnoses and opinions establishing causation were found persuasive, and no medical evidence showed these left shoulder conditions predated the accident.
On the TTD benefits claim, the court affirmed the Board’s grant of benefits from September 21, 2024, through March 12, 2025. West Virginia Code § 23-4-1c provides for TTD payment during the healing and recovery period until a claimant reaches maximum medical improvement, returns to work, or is released to work. The Board found no medical evidence that Blackwell met any of these conditions prior to March 12, 2025, and Dr. Stover’s opinion that Blackwell was unable to work due to his compensable injury during this period was credible and supported by the record. The court rejected Mastec’s argument that the inability to work resulted from a prior unrelated right shoulder surgery.
Key Takeaways
- Pre-existing asymptomatic conditions become compensable when symptoms first manifest after a work injury and medical evidence demonstrates causation.
- The critical distinction is whether the specific condition at issue was diagnosed or symptomatic before the work injury; newly diagnosed conditions post-injury are treated differently than pre-existing ones, even in the same anatomical region.
- TTD benefits continue through the healing period absent evidence that the claimant reached maximum medical improvement or was released to return to work; claims of disability from unrelated prior treatment are insufficient to cut off benefits if the compensable injury remains disabling.
- Medical provider testimony establishing causation between a work injury and claimed conditions receives substantial deference on appellate review under the “clearly wrong” standard.
Why It Matters
This decision clarifies the treatment of pre-existing shoulder pathology in workers’ compensation claims, resolving a recurring tension between honoring legitimate preexisting conditions and preventing employers from using that history to avoid responsibility for newly injury-related diagnoses. The court’s application of Moore establishes that employers cannot simply deny compensability for newly diagnosed conditions merely because the claimant had documented shoulder problems beforehand. The distinction between Blackwell’s pre-existing right shoulder adhesive capsulitis (not claimed as compensable) and his post-injury left shoulder adhesive capsulitis and impingement (found compensable) turns on temporal causation: conditions that first appear or are first diagnosed after a work injury are presumptively related to that injury if medical evidence supports the nexus.
The decision reinforces that TTD benefits are tied to objective medical findings regarding capacity to work—not the claimant’s subjective report—and that employers cannot offset compensable-injury-related disability by pointing to prior unrelated medical treatment. For claimants with pre-existing musculoskeletal conditions, the holding creates a clear framework: demonstrating that a specific diagnosis or worsening of symptoms post-injury, supported by credible medical testimony, shifts the burden and permits recovery for compensable new injuries arising from the same accident.