Court Case Update: West Virginia

On June 10, 2024, the Supreme Court of Appeals of West Virginia, in Logan-Mingo Area Mental Health, Inc. v. Lester, explained the proper benefit apportionment method when a workers' compensation (WC) claimant has preexisting impairments to multiple body parts and later sustains new compensable injuries affecting those same body parts.

In 1999, an employee suffered injuries to his lumbar and thoracic spine, which resulted in a 20% permanent partial disability (PPD) award. Then in 2017, the employee sustained compensable injuries that resulted in additional impairments to his lumbar and thoracic spine along with impairments to the cervical spine, shoulder, and knees. To determine the correct method for apportioning the employee's WC benefits award, the court relied on West Virginia statute 23-4-9b, which states that a prior injury, along with its effects and aggravation, shall not be taken into consideration in fixing the amount of compensation allowed by reason of the subsequent injury. The court reasoned that to accurately apportion preexisting impairments, a claimant's final degree of PPD from injuries to multiple body parts should be calculated by using the Combined Values Chart from the applicable American Medical Association (AMA) Guides. Then the amount of the claimant's preexisting impairments that have been definitely ascertained is deducted to determine the impairment that is attributable to the subsequent injury.

Applying this holding, the court found that the Workers' Compensation Board of Review erred when it granted the employee a PPD award that was based on an erroneous apportionment method that deducted preexisting impairments separately for each body part prior to establishing a final cumulative impairment using the Combined Values Chart.

For more information on other cases monitored by NCCI's Legal Division, visit previous Court Case Updates and Court Case Insights under the Legal section of INSIGHTS on ncci.com.

Share This Article: