No Carpal Tunnel Recovery for West Virginia Embalmer

Illustrating the broad discretion that the state’s Workers’ Compensation Board of Review has when it comes to making factual determinations—including those regarding medical causation—the Supreme Court of Appeals of West Virginia recently affirmed a decision denying a carpal tunnel syndrome claim filed by an apprentice funeral director and embalmer who claimed that his work activities of suturing incisions, carry caskets, serving as a pallbearer, typing reports, and doing other paperwork led to his carpal tunnel syndrome and need for surgery [Davidson v. Blue Ridge Crematory, 2019 W. Va. LEXIS 502 (Nov. 1, 2019)].

Background

Beginning in mid-January 2016, Davidson worked as an apprentice funeral director and embalmer for a funeral home. As part of his duties, Davidson performed suturing and dressing tasks, lifting and removing bodies, completing paperwork and logging data into a computer. He began experiencing numbness and pain in his hands in February 2017. In March 2017, a surgeon requested authorization for carpal tunnel syndrome surgery through the claims administrator. The request was denied and Davidson appealed.

Independent Medical Evaluation

Davidson acknowledged that he had previously been diagnosed with hypothyroidism, Addison’s disease, and low testosterone. Davidson was referred for an IME who diagnosed Davidson with bilateral carpal tunnel syndrome (CTS). However, in his professional opinion, the IME physician concluded that Davidson’s condition was not causally related to his occupational activities, because Davidson did not report work activities that involved the degree of repetition and force required to cause CTS. The IME physician also found that Davidson’s increased body mass index, as well as his hypothyroidism, were important risk factors for the development of the disease. Thus, it was the physician’s opinion that the CTS was not causally related to Davidson’s occupational activities.

Office of Judges Decision

The Office of Judges reversed the claims administrator’s prior ruling and held Davidson’s claim compensable for bilateral carpal tunnel syndrome. The Office of Judges found that the type of work performed by Davidson met the type of work setting noted in West Virginia Code of State Rules § 85-20-41.5 (2006) that can contribute to CTS. The Office of Judges reasoned that there was no medical evidence to support the IME’s theories that nonoccupational-risk factors caused Mr. Davidson’s CTS. The funeral home appealed to the Board of Review.

Board of Review Reverses

The Board of Review reversed, finding that the Office of Judges’ analysis and conclusions were clearly wrong in view of the reliable, probative and substantial evidence on the whole record. The Board relied upon the IME physician’s opinion and concluded that Davidson’s work activities did not fall into the high-risk categories for development of CTS. Accordingly, the Board reinstated the claims administrator’s order, which rejected the claim.

High Court’s Decision

The Supreme Court of Appeals agreed with the Board of Review, noting that in the IME physician’s medical evaluation, the doctor had found nonoccupational-risk factors for the development of CTS in the form of excessive weight and hypothyroidism. The Court further observed that the Board had noted that West Virginia Code of State Rules § 85-20-41.4 (2006) included hypothyroidism and obesity as abnormalities and conditions that could precipitate CTS symptoms. The Court noted that the Board found that Davidson’s job duties did not fall in the high-risk categories for the development of CTS. Given the evidence of record, the Court said the Board did not err in concluding that Davidson’s employment duties had no relationship to his carpal tunnel syndrome.