Opinion

Jerrald Barker v. Rescare

Court
West Virginia Supreme Court
Filed
Nov 26, 2024
Status
Published
Nature of suit
Workers Compensation
Cited by
0 cases
Authority
More cited than 33.1%

The opinion

FILED

November 26, 2024

C. CASEY FORBES, CLERK

STATE OF WEST VIRGINIA SUPREME COURT OF APPEALS

OF WEST VIRGINIA

SUPREME COURT OF APPEALS

Jerrald Barker,

Claimant Below, Petitioner

v.) No. 22-0078 (BOR Appeal No. 2057260)

(JCN: 2018021286)

Rescare,

Employer Below, Respondent

MEMORANDUM DECISION

Petitioner Jerrald Barker appeals the decision of the West Virginia Workers’ Compensation

Board of Review (“Board of Review”). Respondent Rescare filed a timely response.1 The issue on

appeal is permanent partial disability. The claim administrator granted a 7% permanent partial

disability award on September 11, 2019. The Workers’ Compensation Office of Judges (“Office

of Judges”) affirmed the decision in its August 20, 2021, order. The order was affirmed by the

Board of Review on January 20, 2022. Upon our review, we determine that oral argument is

unnecessary and that this case satisfies the “limited circumstances” requirement of Rule 21(d) of

the Rules of Appellate Procedure and is appropriate for vacation in a memorandum decision rather

than an opinion. See W. Va. R. App. P. 21.

Mr. Barker, a clinical supervisor, injured his lower back on March 3, 2018, while moving

furniture and rehanging doors. The claim was held compensable for lower back strain on April 16,

2018. The claim administrator added lumbar intervertebral disc disorder with radiculopathy to the

claim on October 24, 2018. Mr. Barker has a history of preexisting and noncompensable lower

back conditions, which includes degenerative disease and diabetic peripheral neuropathy. In 1999,

he sustained a noncompensable injury to his lower back while lifting a couch, which required a

right L4-L5 laminectomy and L5-S1 discectomy.

On August 13, 2019, Marsha Bailey, M.D., performed an independent medical evaluation

in which she noted that Mr. Barker would have the permanent work restriction of lifting no more

than fifty pounds. Dr. Bailey placed him in Category II-E from Table 75 of the American Medical

Association’s Guides to the Evaluation of Permanent Impairment (4th ed. 1993) (“AMA Guides”)

for 10% impairment. He also qualified for 1% impairment under Category II-F for his lower back

surgery, and 2% under Category II-G for his second lower back surgery. Mr. Barker’s range of

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Petitioner Jerrald Barker is represented by counsel Reginald D. Henry, and Respondent

Rescare is represented by counsel Jeffrey B. Brannon.

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motion measurement was pain restricted and invalid for determining impairment. Sensory

examination of the left lower extremity showed decreased sensation in a distribution consistent

with diabetic peripheral neuropathy. Under the Range of Motion Model, Dr. Bailey found 13%

impairment. Dr. Bailey then placed Mr. Barker in Lumbar Category III from West Virginia Code

of State Rules § 85-20-C, which allows for 10% to 13% impairment. Dr. Bailey’s finding of 13%

impairment needed no adjustment. Dr. Bailey apportioned 50% of Mr. Barker’s impairment for

his first back surgery and for his age-related degenerative spine disease. Dr. Bailey found 7%

impairment for the compensable injury. Based on Dr. Bailey’s evaluation, the claim administrator

granted Mr. Barker a 7% permanent partial disability award on September 11, 2019.

Bruce Guberman, M.D., performed an independent medical evaluation on March 18, 2020,

in which he opined that Mr. Barker was possibly a surgical candidate and he was waiting for the

opinion of a neurosurgeon. Therefore, he had not yet reached maximum medical improvement and

an impairment rating was not recommended. In an August 3, 2020, supplemental independent

medical evaluation, Dr. Guberman noted that Mr. Barker was seen by a neurosurgeon, and surgery

was not recommended. Dr. Guberman opined that Mr. Barker had reached maximum medical

improvement, and placed him in Category II-E from Table 75 of the AMA Guides for 10%

impairment. From Table 82, Dr. Guberman found 5% impairment for abnormal lateral flexion

range of motion in the lumbar spine. He determined that Mr. Barker had weakness in dorsiflexion

of the left ankle of the left extensor hallucis longus due to residual radiculopathy at L5. He assessed

3% whole person impairment from Table 21 for the deficit. Dr. Guberman’s total combined whole

person impairment rating was 17%. Dr. Guberman placed Mr. Barker in Lumbar Category III from

West Virginia Code of State Rules § 85-20-C, which allows for between 10% and 13%, and

adjusted the rating to 13%. Regarding apportionment, it was determined that Mr. Barker had no

symptoms or limitations prior to the compensable injury, and Dr. Guberman declined to apportion

the claim. All of the 13% impairment was attributed to the compensable injury.

On October 28, 2020, Michael Kominsky, D.C., conducted an independent medical

evaluation, and opined that Mr. Barker had reached his maximum degree of medical improvement.

However, Dr. Kominsky recommended that Mr. Barker return to his neurosurgeon for a repeat

MRI and consultation to determine the best course for management of his continued lower back

pain and lower extremity weakness. With respect to impairment, Dr. Kominsky opined that Mr.

Barker had 13% whole person impairment and stated:

This patient did not have any pre-existing residual pain or loss of function prior to

the injury. He was functioning at a high level of his functional capacity during his

essential work task at his job. Also, he was not undergoing any treatments for his

low back prior to this injury. He also had no radicular symptoms, no interference

of activities of daily living and there was no impairment rating on record. Therefore,

in my opinion within a reasonable degree of medical certainty, the 13% whole

person impairment is entirely related to his 03/03/2018 injury and no apportionment

is considered in this case.

Dr. Kominsky further stated that if any previous awards have been given for the conditions that he

rated, they should be subtracted from the final impairment.

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Mr. Barker was seen by David Soulsby, M.D., on January 27, 2021, for an independent

medical evaluation. Dr. Soulsby reviewed the records, conducted an examination, and determined

that Mr. Barker had reached maximum medical improvement. In accordance with the AMA

Guides, Dr. Soulsby found 29% impairment. However, using Table § 85-20-C, the calculated

impairment was adjusted to 13%. In discussing apportionment, Dr. Soulsby noted that Mr. Barker

had previously undergone a lumbar laminectomy for herniated disc at L4-5, in addition to having

multilevel degenerative disc disease and spinal stenosis. Because of Mr. Barker’s preexisting

disease and comorbidities, Dr. Soulsby concluded that only 50% of the observed impairment was

found to be related to the injury which occurred on March 3, 2018. Therefore, he recommended

7% whole person impairment. Dr. Soulsby also reviewed the reports from Drs. Guberman and

Kominsky and opined that both doctors correctly found 13% impairment under the AMA Guides.

However, Dr. Soulsby found that both physicians failed to apportion for Mr. Barker’s prior disc

herniation requiring laminectomy and his other preexisting conditions and comorbidities.

The Respondent obtained a supplemental record review and opinion report from Dr.

Bailey. In her report dated May 7, 2021, Dr. Bailey opined that Dr. Guberman’s physical

examination findings were inconsistent with Mr. Barker’s known long standing history of chronic

diseases, which included chronic lower back pain, lower extremity radiculopathy, diabetic

peripheral neuropathy, and lower extremity vascular disease. Dr. Bailey concluded that Dr.

Guberman overlooked Mr. Barker’s substantial confounding personal medical conditions when he

made the decision not to apportion his impairment rating. It was Dr. Bailey’s opinion that Mr.

Barker’s most accurate and true impairment as a result of his March 3, 2018, injury was 7% whole

person impairment.

In a decision dated August 20, 2021, the Office of Judges affirmed the September 11, 2019,

order of the claim administrator awarding a 7% permanent partial disability award. The Office of

Judges noted that Mr. Barker had preexisting conditions unrelated to his work. It was noted that

he was evaluated by sound independent medical evaluators, all of whom found 13% whole person

impairment utilizing the AMA Guides. However, it was noted that both Drs. Soulsby and Bailey

apportioned half of Mr. Barker’s impairment of 13% to his preexisting non-compensable

conditions and determined 7% would be rating for the compensable injury. Referencing West

Virginia Code § 23-4-9b, the Office of Judges concluded that “it is clear in this case that the

claimant had pre-existing conditions related to the compensable body party and two medical

professionals opined as to the percentage unrelated to the injury at issue.” As such, the Office of

Judges determined that the physicians who apportioned presented a more reliable reflection of Mr.

Barker’s condition, and that he had 7% whole person impairment attributable to the injury on

March 3, 2018. On January 20, 2022, the Board of Review adopted the findings of facts and

conclusions of law of the Office of Judges and affirmed the decision.

This Court may not reweigh the evidentiary record, but must give deference to the findings,

reasoning, and conclusions of the Board of Review, and when the Board’s decision affirms prior

rulings by both the Workers’ Compensation Commission and the Office of Judges, we may reverse

or modify that decision only if it is in clear violation of constitutional or statutory provisions, is

clearly the result of erroneous conclusions of law, or is based upon a material misstatement or

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mischaracterization of the evidentiary record. See W. Va. Code § 23-5-15(c) & (d). We apply a de

novo standard of review to questions of law. See Justice v. W. Va. Off. Ins. Comm’n, 230 W. Va.

80, 83, 736 S.E.2d 80, 83 (2012).

Mr. Barker argues that the preponderance of the evidence establishes that he sustained

more than 7% whole person impairment from his compensable injury. He asserts that evidence

was ignored by the Office of Judges indicating that he had not had any symptoms or treatment for

his lower back since the time of his recovery from his 1999 surgery, and that he was working full-

time and performing laborious duties at the time of the instant injury. Mr. Barker maintains that

Dr. Guberman’s and Kominsky’s reports should have been given greater weight by the Office of

Judges. In contrast, the employer argues that when the applicable law to this claim is applied to

the facts and evidence of record, it is clear that the opinions of Dr. Guberman and Dr. Kominsky

are not reliable. The primary difference in the recommendations of permanent partial impairment

for the compensable injury was apportionment.

The controlling statute for apportionment is West Virginia Code § 23-4-9b (2003), which

provides, in part:

Where an employee has a definitely ascertainable impairment resulting

from an occupational or a nonoccupational injury, disease or any other cause,

whether or not disabling, and the employee thereafter receives an injury in the

course of and resulting from his or her employment, unless the subsequent injury

results in total permanent disability within the meaning of section one, article three

of this chapter, the prior injury, and the effect of the prior injury, and an

aggravation, shall not be taken into consideration in fixing the amount of

compensation allowed by reason of the subsequent injury. Compensation shall be

awarded only in the amount that would have been allowable had the employee not

had the preexisting impairment.

This Court has previously held that,

[t]he purpose of W. Va. Code § 23-4-9b (2003) is to disallow any

consideration of any preexisting definitely ascertainable impairment in determining

the percentage of permanent partial disability occasioned by a subsequent

compensable injury, except in those instances where the second injury results in

total permanent disability[.]

Syl. Pt. 2, in part, SWVA, Inc. v. Birch, 237 W. Va. 393, 787 S.E.2d 664 (2016).

In a recent case, this Court established a new standard for evaluating definitely

ascertainable preexisting impairment under West Virginia Code § 23-4-9b. See Syl. Pt. 6, Duff v.

Kanawha Cnty. Comm’n, 250 W. Va. 510, 905 S.E.2d 528 (2024). In Duff, we held:

Under West Virginia Code § 23-4-9b (2003), the employer has the burden

of proving apportionment is warranted in a workers’ compensation case. This

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requires the employer to prove the claimant “has a definitely ascertainable

impairment resulting from” a preexisting condition(s). This requires that employer

prove that the preexisting condition(s) contributed to the claimant’s overall

impairment after the compensable injury and prove the degree of impairment

attributable to the claimant’s preexisting condition(s).

Id.

The record indicates that Mr. Barker has a history of preexisting conditions. Drs. Guberman

and Kominsky did not apportion in this case, but Drs. Soulsby and Bailey apportioned half of Mr.

Barker’s impairment of 13% to his preexisting noncompensable conditions. However, the issue of

whether or not Mr. Barker has a definitely ascertainable impairment resulting from his preexisting

conditions, and how those conditions contributed to his overall impairment, must still be

determined. Accordingly, we vacate the Board of Review’s decision and remand the case to the

Board for further development of the evidentiary record and analysis under Duff.

Vacated and remanded with directions.

ISSUED: November 26, 2024

CONCURRED IN BY:

Justice Elizabeth D. Walker

Justice John A. Hutchison

Justice William R. Wooton

Justice C. Haley Bunn

DISSENTING:

Chief Justice Tim Armstead

Armstead, Chief Justice, dissenting:

The majority determines that under the Court’s holding in Duff v. Kanawha Cnty. Comm’n,

250 W. Va. 510, 905 S.E.2d 528 (2024), the Board of Review’s ruling must be vacated and the

case must be remanded for further evidentiary development. See Syl. Pt. 6, Duff (“Under West

Virginia Code § 23-4-9b (2003), the employer has the burden of proving apportionment is

warranted in a workers’ compensation case. This requires the employer to prove the claimant ‘has

a definitely ascertainable impairment resulting from’ a preexisting condition(s). This requires that

employer prove that the preexisting condition(s) contributed to the claimant’s overall impairment

after the compensable injury and prove the degree of impairment attributable to the claimant’s

preexisting condition(s).”). While I agree that applying our ruling in Duff leads to this result, I

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dissent because I disagree with the Court’s holding in Duff. As I explained in my separate opinion

in that case:

the majority’s interpretation of West Virginia Code § 23-4-9b is not

supported by the plain language of the statute or by our long-

standing recognition that a workers compensation claimant has the

burden of proof, [therefore] I disagree with the majority’s ruling that

the employer bears the burden to prove (1) that the claimant has a

definitely ascertainable impairment resulting from a preexisting

condition; (2) that the preexisting condition contributed to the

claimant's overall impairment after the compensable injury; and (3)

the precise degree of impairment that is attributable to the

preexisting condition.

By shifting the burden to the employer, the majority is

treating apportionment as an affirmative defense. West Virginia

Code § 23-4-9b does not contain any language providing that

apportionment should be treated as an affirmative defense that the

employer is responsible for asserting.

Duff, 250 W. Va. at ____, 905 S.E.2d at 542-43 (Armstead, C.J., concurring, in part, and

dissenting, in part).

By applying our ruling in Duff to the present case, I believe that this Court continues to

misapply the plain language of West Virginia Code § 23-4-9b. Therefore, I dissent.

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This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.

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