Pittsylvania Cnty. Bd. of Supervisors v. Hall

PITTSYLVANIA COUNTY BOARD OF SUPERVISORS AND NORTH RIVER INSURANCE COMPANY v. JANNA HALL

Record No. 1869-17-3

COURT OF APPEALS OF VIRGINIA

JUNE 12, 2018

UNPUBLISHED

Present: Judges Humphreys, Petty and AtLee

Argued at Lexington, Virginia

MEMORANDUM OPINION^* BY JUDGE RICHARD Y. ATLEE, JR.

FROM THE VIRGINIA WORKERS' COMPENSATION COMMISSION

Andrew H.D. Wilson (Two Rivers Law Group, P.C., on brief), for appellants.

Darren Shoen (Law Office of Darren Shoen, PLLC, on brief), for appellee.

The Pittsylvania County Board of Supervisors and North River Insurance Company (collectively, "employer") appeal a decision of the Commission in favor of claimant Janna Hall ("Hall"). We find no error and affirm the Commission's decision.

I. BACKGROUND

On appeal of Commission decisions, we view the facts in the light most favorable to the party that prevailed before the Commission, in this case Hall. Hess v. Va. State Police, 68 Va. App. 190, 194, 806 S.E.2d 413, 415 (2017). In 1978, Hall fell down several stairs at work, injuring her right knee. She was twenty years old at the time. Hall and employer endorsed a "Memorandum of Agreement as to Payment of Compensation" in 1979, describing the injury asa "[c]ontusion and hemarthrosis of [the] right knee.[¹]" Later that year, the Commission approved the parties' agreement and entered an award. The final sentence of that 1979 award stated: "Medical benefits are awarded for as long as necessary."²

In 1980, rheumatologist Vincent Giuliano examined Hall, and reviewed her medical records. He wrote that Hall had "a 2 year history of a chronic inflammatory arthritis[³] of both knees." He concluded:

Hall claims that she was well prior to the fall and since that time she has had arthritis in 2 knees and 1 elbow, all of which appear to have been traumatized at that time. If her story is accurate, and I have no reason to think otherwise, then clearly her arthritis is temporally related to her fall.

Dr. Giuliano also wrote that "laboratory data in November, 1979 . . . showed . . . a negative test for rheumatoid factor."

In 1985, orthopedic surgeon Paul Fitzgerald described Hall in a written report: "This is a 26 year old female with bilateral knee involvement secondary to inflammatory arthritis, most likely rheumatoid type, who underwent a left total knee replacement. . . . FINAL DIAGNOSIS: Rheumatoid arthritis[⁴] - inflammatory."⁵ In a 2006 letter to another doctor, Dr. Fitzgeralddescribed Hall as "a longtime patient of mine with rheumatoid arthritis and multiple joint replacements."

Between 1979 and approximately 2010, rheumatologist Jeffrey Wilson treated Hall. In 1998, Dr. Wilson wrote of Hall: "The patient certainly remains completely disabled from her chronic long standing inflammatory spondyloarthropathy.[⁶]" In 2008, Dr. Wilson opined that Hall "continued to have active inflammatory arthritis resulting from her fall as before." In a 2010 letter to employer, Dr. Wilson wrote that "Hall has been followed in our office for over 30 years with problems of inflammatory polyarthritis[⁷] which has been grossly deforming, requiring multiple joint replacements, and followed a traumatic injury and fall." During the time Dr. Wilson treated Hall, he prescribed various medications to treat her arthritis, and to alleviate the associated pain. Hall also underwent several surgeries in connection with her joints, including knee and hip replacements. Around 2010, Dr. Wilson retired. Hall's longtime primary care doctor, Michael Will, took over the management of the medication previously prescribed by Dr. Wilson.

At his deposition, Dr. Will stated that Hall had "been termed to have post-traumatic arthritis in multiple joints since" her work injury occurred. As a result of her accident, Dr. Will stated, Hall has experienced "chronic pain, particularly about her neck and about her lumbar spine," as well as "in her hips and knees, hands and feet and ankles." When presented with a report from one of the rheumatologists hired by employer (who believed that Hall actually suffered from rheumatoid arthritis unrelated to the work injury), Dr. Wilson stated:

Rheumatoid arthritis, you know, can be diagnosed at times by particular markers. To my knowledge, she didn't have those. You know, Dr. Wilson was the one that treated her, but he termed her a post-traumatic arthritis. His impression, it was my understanding from reading his records, was that he thought it did occur as a result of her injury, the accident.

He continued, stating "to the best of my knowledge, her arthritis problems started after she had the fall."

In March 2016, Hall received a letter from employer notifying her that, "[b]ased upon medical peer review, please be advised that effective 04/15/2016 medications being prescribed by Dr. Will will no longer be covered under the workers['] compensation claim of 09/05/1978." In June 2016, Hall wrote to the Commission, enclosing employer's letter. Hall asked the Commission for "help in resolving this matter." The Commission treated Hall's letter as a claim for medical benefits, and eventually a deputy commissioner heard the matter.⁸

By letter to the deputy commissioner dated November 17, 2016, employer "move[d] the Commission to appoint a disinterested and duly qualified physician or surgeon to make a medical examination and to testify in respect thereto, pursuant to Va. Code § 65.2-606." The deputy commissioner denied this motion, with this explanation:

I will also indicate why I'm denying the motion to request for disinterested position [sic], even though the Act allows us to do it. I don't think it's proper for the [C]ommission [to] order a physician. I think that is almost a form of micromanagement bythe [C]ommission and I'm not fond of doing that. I certainly think that is something the parties should work out between themselves. They can obviously do independent medical examinations.

Employer filed an interlocutory appeal of this denial to the full Commission. The full Commission found "no basis for interlocutory review of the denial of [employer's] motion" and thus "decline[d] interlocutory review" and "returned [the matter] to the Deputy Commissioner's hearing docket."

At the hearing in front of the deputy commissioner, employer offered the written opinions of three rheumatologists. All three doctors had conducted record reviews on behalf of employer; none had ever examined or treated Hall. Dr. Blank opined that "the claimant did not have 'traumatic polyarthritis' but rather had an inflammatory autoimmune polyarthritis unrelated to the work comp injury from the beginning." Dr. Bello concluded that "the claimant has rheumatoid arthritis. . . . This is not related to the 9/5/78 injury." Thus, he wrote, "[n]one of the claimant's medications are causally related to the original workers' compensation injury." Finally, Dr. Patel stated:

In my opinion, the bilateral knee surgeries and continued knee issues are not related to the work compensation injury that was sustained in September of 1978. I do not believe that there is any direct permanent or long-term damage from the worker's compensation injury. The Rheumatoid Arthritis or Spondyloarthropathy are unrelated to the patient's fall in 1978.

Dr. Patel acknowledged that Hall "did not have blood tests that would indicate rheumatoid arthritis" but pointed out that "there are 15-20% of patient[s] with rheumatoid arthritis who do not have positive lab markers."

After hearing the evidence, the deputy commissioner entered a medical award in Hall's favor, and ruled that "medical benefits are continued for as long as necessary for reasonable, necessary and authorized treatment causally related to the claimant's September 05, 1978 injury and in particular, for payment of Celebrex, OxyContin, Pepcid and Vitamin D prescriptions."The deputy commissioner denied employer's renewed motion for a medical examination pursuant to Code § 65.2-606. Employer appealed these rulings to the full Commission, which affirmed the deputy commissioner. Employer then noted its appeal to this Court.

II. ANALYSIS

Employer assigns the following errors:

1. The Commission was plainly wrong and erred in making its findings without supporting credible evidence and erred in fundamentally misconceiving the significance of the evidence when it found that [Hall]'s medications were prescribed for injuries causally related to the accident and awarded [Hall]'s claim for continuing prescription medication benefits.

2. The Commission erred in relying on and misinterpreting the opinions and/or medical evidence of Drs. Will and Wilson and a November 4, 1980 letter from Dr. Guliano [sic], failing to consider and weigh the opinion of Dr. Fitzgerald, and discounting the opinions of Drs. Blank, Bello, and Patel in making its findings that [Hall]'s medications were prescribed for injuries causally related to the workplace accident and awarding continuing prescription medication benefits.

3. The Commission erred in denying [employer]'s request for appointment of a disinterested physician for a medical examination under Virginia Code § 65.2-606.

We address the first two assignments of error together in Part II.A. and the third assignment of error in Part II.B.

A. Award

Employer asserts that the Commission erred "when it found that [Hall]'s medications were prescribed for injuries causally related to the accident and awarded [Hall]'s claim for continuing prescription medication benefits." In making this error, employer argues, the Commission "misinterpret[ed] the opinions and/or medical evidence of Drs. Will and Wilson anda November 4, 1980 letter from Dr. Guliano [sic], fail[ed] to consider and weigh the opinion of Dr. Fitzgerald, and discount[ed] the opinions of Drs. Blank, Bello, and Patel."

"[T]he claimant has the burden to prove that the medical attention, for which payment is claimed . . . , was causally related to the industrial accident." Watkins v. Halco Eng'g, Inc., 225 Va. 97, 101, 300 S.E.2d 761, 763 (1983). And "[t]he...