Back injury not compensablePosted On: Sep. 23, 2021 2:23 PM CST
The West Virginia Supreme Court of Appeals on Wednesday affirmed judgments by the state Workers' Compensation Board of Review and Office of Judges that an employee’s suspicious back injury claim was not compensable.
James Ramey, a machine operator at Steel of West Virginia Inc., alleged he injured his lower back at work on June 19, 2017, but inconsistently described how the injury was sustained in multiple reports following the incident. Further, the Office of Judges noted the date of injury to be significant as a collective bargaining agreement between the union and the employer was set to expire the following day, according to documents in James Ramey v. SWVA, Inc., filed in the Supreme Court of Appeals of West Virginia in Charleston.
Mr. Ramey sought treatment on the day of the alleged incident for “an acute low back injury sustained while lifting a heavy object at work,” documents state. However, a discharge report states Mr. Ramey said he injured his back while bending over to pick up pieces of metal.
Later reports and testimony from Mr. Ramey document further inconsistencies in his account of the injury and medical conditions, some of which were not introduced into the record, documents state.
The Office of Judges found that the only diagnostic testing of record were scans taken on the date of injury, which showed degenerative changes and no acute findings.
The Office affirmed the claims administrator's decision, citing, “The inconsistencies in the mechanism of injury, the exaggeration of CT scan findings, and the absence of care after the union contract was ratified, […] indicate a lack of credible evidence to justify reversal of the rejection of the claim.”
The Board of Review affirmed the Office’s ruling in May 2020, which was upheld this week by the Supreme Court of Appeals.