Background
Joshua Plumley injured his back while pulling a curtain as a mine scoop operator in February 2020. The claim was initially held compensable for lumbar strain. Although Plumley had earlier head, neck, and back injuries and imaging showing degenerative changes, he developed persistent lower-extremity symptoms after the 2020 incident, including instability, weakness, gait dysfunction, bilateral ankle clonus, and bilateral Hoffmann’s reflexes.
Plumley later underwent right sacroiliac-joint fusion and his treating neurosurgeon, James Harman, M.D., diagnosed sacrococcygeal disorder and disease of the spinal cord. Dr. Harman requested repeat cervical and thoracic MRIs to investigate progressive myelopathic symptoms. The claim administrator denied the additional diagnoses and MRI requests and suspended temporary total disability benefits after an independent medical examiner found Plumley had reached maximum medical improvement.
The Court’s Holding
The Intermediate Court of Appeals affirmed the Workers’ Compensation Board of Review’s reversal of those denials. The Board was not clearly wrong in finding, by a preponderance of the evidence, that sacrococcygeal disorder and disease of the spinal cord were causally related to the compensable 2020 injury.
The court also upheld authorization for cervical and thoracic MRIs as medically necessary to evaluate and treat the newly compensable spinal-cord condition. Given the added compensable conditions, the Board permissibly found that Plumley had not reached maximum medical improvement or been released to return to work, and was entitled to TTD benefits from the last payment through January 23, 2024, and thereafter upon proper substantiation.
Key Takeaways
- The court deferred to the Board’s factual findings because substantial evidence supported causal connection between the work injury and the added conditions.
- Evidence of prior degenerative changes did not rebut the Board’s finding of a discrete new sacrococcygeal injury where the relevant symptoms and diagnosis had not existed before the accident.
- Diagnostic imaging may be authorized when reasonably required to evaluate a compensable condition, even when the imaging concerns cervical and thoracic regions not independently added as claim diagnoses.
Why It Matters
The decision illustrates the deferential review applied to West Virginia workers’ compensation Board decisions. It also confirms that preexisting conditions do not necessarily defeat compensability when post-injury symptoms, clinical findings, and credible medical evidence support a new injury or causally related condition.