Background
Amanda McCormick filed a workers’ compensation claim after suffering a work-related right shoulder injury in January 2024 while pushing freight on a conveyor belt. The claim administrator initially rejected the claim as non-occupational. An October 2024 MRI revealed a full-thickness retracted biceps tendon tear with degenerative changes. Ms. McCormick underwent surgery on November 11, 2024, for subpectoral biceps tenodesis and underwent physical therapy from December 2024 through February 2025.
On January 22, 2025, the Workers’ Compensation Board reversed the claim administrator’s rejection and declared the claim compensable for right shoulder sprain and adhesive capsulitis. The Board remanded for determination of Ms. McCormick’s entitlement to temporary total disability (TTD) benefits. On March 13, 2025, the claim administrator closed the TTD claim, reasoning that Ms. McCormick failed to submit medical evidence showing she remained disabled. On October 14, 2025, the Board affirmed the closure, observing that although medical evidence showed disability through February 12, 2025, no evidence was submitted for periods after March 13, 2025.
The Court’s Holding
The Intermediate Court of Appeals found error in the Board’s decision. The court held that the Board focused on the wrong time period. Ms. McCormick was not requesting TTD benefits for periods after March 13, 2025; rather, she was requesting benefits for November 11, 2024 (the date of her surgery) through February 11, 2025 (when her physician indicated she remained disabled). The Board’s decision addressed whether she submitted evidence of disability for a period she never claimed.
The court vacated the Board’s October 14, 2025 order and remanded the case with instructions that the Board review the evidentiary record and make a proper determination whether Ms. McCormick was temporarily and totally disabled due to her compensable injury during the November 11, 2024 through February 11, 2025 period that she actually requested.
Key Takeaways
- A decision-maker must address the specific period of benefits claimed, not a different period the claimant did not request
- Under West Virginia law, TTD benefits cease when a claimant reaches maximum medical improvement, is released to return to work, or returns to work—whichever occurs first
- Procedural errors that result in addressing the wrong issues warrant remand for proper consideration of the actual claim
Why It Matters
This decision protects injured workers from losing benefits due to administrative error. When a claimant identifies a specific period for which disability benefits are sought, the Workers’ Compensation Board must address that precise period and the medical evidence relevant to it. This decision ensures that injured workers cannot be denied TTD benefits based on their failure to submit evidence for a time period they never claimed.
The case also illustrates the importance of precision in workers’ compensation litigation: distinguishing between the date of initial injury, the date a condition worsened or progressed (requiring treatment), and the periods for which benefits are actually claimed. These temporal distinctions directly affect entitlement to temporary disability benefits, and decision-makers must carefully match the evidentiary record to the claimed period.