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IN THE SUPREME COURT OF APPEALS OF WEST VIRGINIA
September 1999 Term
____________
No. 26197
____________
GEORGE W. THACKER,
Appellant,
v.
WORKERS' COMPENSATION DIVISION and
STEEL OF WEST VIRGINIA, INC.,
Appellees.
______________________________________________________
Appeal from the Workers' Compensation Appeal Board
Appeal No. 44111
Claim No. 92-39768
REVERSED AND REMANDED
______________________________________________________
Submitted: November 3, 1999
Filed: December 2, 1999
Robert M. Williams, Esq.
Douglas G. Lee, Esq.
Thomas P. Maroney, L.C.
Ancil G. Ramey, Esq.
Charleston, West Virginia
H. Toney Stroud, Esq.
Attorney for the Appellant
Steptoe & Johnson
Charleston, West Virginia
Attorneys for the Appellee
Steel of West Virginia, Inc.
The Opinion of the Court was delivered PER CURIAM.
JUDGE GARY JOHNSON, sitting by temporary assignment.
CHIEF JUSTICE STARCHER concurs and reserves the right to file a concurring opinion.
JUSTICE McGRAW concurs.
JUSTICE SCOTT did not participate in the decision of the Court.
SYLLABUS BY THE COURT
1. When conflicting medical evidence is presented concerning the degree
of impairment in an occupational pneumoconiosis claim, that medical evidence indicating
the highest degree of impairment, which is not otherwise shown, through explicit findings
of fact by the Occupational Pneumoconiosis Board, to be unreliable, incorrect, or clearly
attributable to some other identifiable disease or illness, is presumed to accurately represent
the level of pulmonary impairment attributable to occupational pneumoconiosis. Syllabus
Point 1, Javins v. Workers' Compensation Comm'r, 173 W.Va. 747, 320 S.E.2d 119 (1984).
2. An occupational pneumoconiosis award may not be calculated by
splitting the difference between initial findings or awards and subsequent findings or awards.
Rather, when conflicting findings or awards are presented to the Workers' Compensation
Appeal Board, those findings or awards indicating the highest degree of impairment, which
are not otherwise shown, through explicit findings of fact by the Appeal Board, to be
unreliable, incorrect, or clearly attributable to some other identifiable disease or illness, are
presumed to accurately represent the level of pulmonary impairment attributable to
occupational pneumoconiosis. Syllabus Point 3, Javins v. Workers' Compensation
Comm'r, 173 W.Va. 747, 320 S.E.2d 119 (1984).
Per Curiam:
This appeal from the Workers' Compensation Appeal Board (Appeal Board)
concerns the application of Javins v. Workers' Compensation Comm'r, 173 W.Va. 747, 320
S.E.2d 119 (1984), our seminal case on the interpretation of evidence in a workers'
compensation occupational pneumoconiosis claim. In this case -- as in many identical
workers' compensation cases -- both the Workers' Compensation Office of Judges (Office
of Judges) and the Appeal Board ignored the evidentiary rules for workers' compensation
claims set forth in the West Virginia Code, and ignored the plain terms of our interpretation
of those rules in Javins.
The Appeal Board in this case affirmed an order of the Office of Judges that
reduced a claimant's workers' compensation permanent partial disability award from 15%
to 5%, disregarding reliable evidence that the claimant had a 15% impairment to his
breathing capacity. Because of the Appeal Board's and the Office of Judges' failure to apply
the well-established evidentiary rules set forth below, we reverse the Appeal Board's
decision.
I.
Beginning in 1965, the appellant, George W. Thacker, was employed by
appellee Steel of West Virginia, Inc. at its facility in Huntington, West Virginia. In the
course of Mr. Thacker's employment as a machine operator he was routinely exposed to
substantial amounts of dust. As a result of this exposure to dust the appellant developed
occupational pneumoconiosis, a disease of the lungs caused by the inhalation of minute
particles of dust over a period of time due to causes and conditions arising out of and in the
course of the employment. W.Va. Code, 23-4-1 [1995].
In late 1991, while the appellant was still working for the appellee, he filed a
claim seeking workers' compensation benefits for his occupational pneumoconiosis. On
September 21, 1992, the West Virginia Workers' Compensation Division (Division) ruled
that the appellant met the statutory requirements to be eligible for workers' compensation
benefits. The Division referred the appellant to the Occupational Pneumoconiosis Board
(OP Board) for medical testing to determine whether, and if so to what extent, the
appellant had a lung injury caused by the inhalation of dust.
The OP Board examined the appellant on February 16, 1993. By the
examination of x-ray films, the OP Board diagnosed the appellant with occupational
pneumoconiosis. Pulmonary function testing was also performed by the OP Board, and
based upon these test results the OP Board concluded that the appellant had sustained a 15%
impairment as a result of his lung injury.See footnote 1
1
Based upon the OP Board's conclusions, the
Division entered an order on March 8, 1993 granting the appellant a 15% permanent partial
disability award.
The appellee-employer protested the Division's order to the Office of Judges,
compelling the appellant to submit to a second pulmonary function test on October 11, 1995.
At a hearing held on August 20, 1997 before an administrative law judge, the OP Board
reviewed the employer's pulmonary function test results as well as the Board's pulmonary
function test results. The OP Board did not specifically find that its own earlier test results,
which formed the basis for the appellant's initial 15% permanent partial disability award,
were unreliable. Instead, the chairman of the OP Board, Dr. James H. Walker, testified that
he thought the employer's pulmonary function test was the best study and that the
employer's test was the most reliable and accurate study to show any pulmonary
impairment. Based upon the employer's pulmonary function test results, the members of
the OP Board testified that there is no valid evidence of any pulmonary impairment in the
appellant.
On October 20, 1997, the Office of Judges entered an order reversing the
Division's Order of March 8, 1993. The Office of Judges concluded, based upon the OP
Board's testimony, that the appellant has no impairment of pulmonary function. The order
therefore concluded that the appellant could only receive a 5% permanent partial disability
award on the basis of his x-ray diagnosis of occupational pneumoconiosis.See footnote 2
2
The appellant appealed the order of the Office of Judges to the Workers'
Compensation Appeal Board. On May 29, 1998, the Appeal Board, in a one-page order,
affirmed the decision of the Office of Judges. This appeal was then filed.
II.
The Workers' Compensation Act specifically provides that the Division, the
Office of Judges, and the Appeal Board are to construe the evidence in workers'
compensation claims in a manner that ensures that the rights of the claimant are protected.
W.Va. Code, 23-1-15 [1923] states:
The [workers' compensation] commissioner shall not be bound
by the usual common-law or statutory rules of evidence, but
shall adopt formal rules of practice and procedure as herein
provided, and may make investigations in such manner as in his
judgment is best calculated to ascertain the substantial rights of
the parties and to carry out the provisions of this chapter.
Since the passage of W.Va. Code, 23-1-15 in 1913, this Court has interpreted
the statute to require that a spirit of liberality in favor of the claimant be employed in
applying the provisions of the Workers' Compensation Act. [W]e must remember that our
legislature has shown an earnest endeavor above everything else to give material justice its
due while formal rules of jurisprudence are pushed aside. Machala v. State Compensation
Comm'r, 109 W.Va. 413, 415, 155 S.E. 169, 170 (1930).
Under the provisions of W.Va. Code, 23-1-15, the Division is required in
administering the workmen's compensation fund to ascertain the substantial rights of the
claimants in such manner as will 'carry out justly and liberally the spirit of the act[.]'
Syllabus, Culurides v. Ott, 78 W.Va. 696, 90 S.E. 270 (1916). To put this statutory intent
into practice, this Court has repeatedly held that the statute imposes upon the Division a
duty . . . to give the claimant the benefit of inferences arising in his favor from the facts
proved . . . Syllabus Point 3, Poccardi v. Public Service Commission, 75 W.Va. 542, 84
S.E. 242 (1915). When the Division is presented with conflicting evidence, the
presumptions should be resolved in favor of the employee rather than against him. Syllabus
Point 1, Pripich v. State Compensation Comm'r, 112 W.Va. 540, 166 S.E. 4 (1932).
More recently, this Court has summarized this rule of liberality in the
following manner: In all types of compensation cases, conflicts in evidence, medical or
otherwise, are to be construed in favor of the claimant. Javins v. Workers' Compensation
Comm'r, 173 W.Va. 747, 758, 320 S.E.2d 119, 130 (1984). See also, Workman v.
Workmen's Compensation Comm'r, 160 W.Va. 656, 236 S.E.2d 236 (1977); Myers v. State
Workmen's Compensation Comm'r, 160 W.Va. 766, 239 S.E.2d 124 (1977); Pennington v.
State Workmen's Compensation Comm'r, 154 W.Va. 378, 387, 175 S.E.2d 440 (1970);
McGeary v. State Compensation Director, 148 W.Va. 436, 438-39, 135 S.E.2d 345 (1964);
Demastes v. State Compensation Comm'r, 112 W.Va. 489, 165 S.E. 667 (1932).
In Persiani v. SWCC, 162 W.Va. 230, 248 S.E.2d 844 (1978) we specified that
the rule of liberally interpreting evidence in favor of the claimant is to be applied
in
occupational pneumoconiosis claims. We described the liberality rule as one which
mandates that reputable evidence favorable to the claimant be considered and the claimant
treated as generously as any reasonable view of the evidence would justify. 162 W.Va. at
236, 248 S.E.2d at 848 (1978).
Persiani presented the Court with the question of how the rule of liberality
should be applied when the claimant introduces expert testimony on disability to the
Occupational Pneumoconiosis Board who, as experts themselves, disbelieve the claimant's
evidence and find the evidence of the employer's examining experts more credible[.] The
question raised in Persiani is nearly identical to the issue in this case, where the OP Board
similarly concluded that the employer's pulmonary function tests, which indicated that the
appellant had no respiratory impairment, were more reliable than the OP Board's test
results indicating a 15% impairment.
This approach used by the OP Board in Persiani for interpreting evidence in
pneumoconiosis claims was specifically rejected by this Court. We specified that the
Division may not accept the OP Board's recommendation to arbitrarily choose to disbelieve
any competent medical testimony in its entirety or to exclude it from consideration altogether,
absent credible evidence in the record that the suspect testimony is unreliable. Syllabus,
Persiani.See footnote 3
3
Persiani concerned the use of blood gas studies as evidence of breathing
impairment in an occupational pneumoconiosis claim. The rule of liberality discussed in
Persiani has at times been mistakenly interpreted as being limited only to evidence of blood
gas studies, and this Court has seen argument to the effect that the rule does not apply to
other types of evidence in occupational pneumoconiosis claims. See, e.g., Kubachka v. State
Workmen's Compensation Comm'r, 163 W.Va. 601, 259 S.E.2d 21 (1979).
In Javins v. Workers' Compensation Comm'r, 173 W.Va. 747, 320 S.E. 119
(1984), we made absolutely clear that the rule of liberality applies to all types of evidence
concerning the degree of impairment caused by an occupational pneumoconiosis. When the
parties in a workers' compensation claim introduce reliable, conflicting medical reports
regarding the degree of impairment caused by occupational pneumoconiosis, the Division,
Office of Judges and Appeal Board must give the claimant the benefit of all reasonable
inferences the record will allow; and any conflicts must be resolved in favor of the claimant.
173 W.Va. at 758, 320 S.E.2d at 130. As we stated, in Syllabus Points 1 and 3 of Javins
[with a footnote added]:
1. When conflicting medical evidence is presented concerning
the degree of impairment in an occupational
pneumoconiosis
claim, that medical evidence indicating the highest degree of
impairment, which is not otherwise shown, through explicit
findings of fact by the Occupational Pneumoconiosis Board,See footnote 4
4
to
be unreliable, incorrect, or clearly attributable to some other
identifiable disease or illness, is presumed to accurately
represent the level of pulmonary impairment attributable to
occupational pneumoconiosis.
* * *
3. An occupational pneumoconiosis award may not be
calculated by splitting the difference between initial findings or
awards and subsequent findings or awards. Rather, when
conflicting findings or awards are presented to the Workers'
Compensation Appeal Board, those findings or awards
indicating the highest degree of impairment, which are not
otherwise shown, through explicit findings of fact by the Appeal
Board, to be unreliable, incorrect, or clearly attributable to some
other identifiable disease or illness, are presumed to accurately
represent the level of pulmonary impairment attributable to
occupational pneumoconiosis.
We interpret the rule set forth in W.Va. Code, 23-1-15 and Javins to be quite
simple: if the parties to a workers' compensation claim introduce reliable, conflicting
evidence about the degree of respiratory impairment caused by or attributable to occupational
pneumoconiosis, then the Division, the Office of Judges and the Appeal Board must award
the claimant benefits based upon the reliable evidence that shows the highest degree of
impairment. The claimant must be given the benefit of all reasonable inferences the record
will allow, and any conflicts in the evidence must be resolved in favor of the claimant.
The basis for our ruling in Javins is that it is difficult, if not impossible, to
precisely determine the degree of a claimant's breathing impairment caused by occupational
pneumoconiosis, or to separate out non-occupational causes. Each method of testing for
pulmonary impairment involves a combination of human skill and medical technology.
Associated with this combination is not only the possibility of accuracy, but also the
possibility of inaccuracy due to technician error, faulty equipment, or any number of other
potential problems. Javins, 173 W.Va. at 757, 320 S.E.2d at 129.See footnote 5
5
In accord, Persiani, 162
W.Va. at 236, 248 S.E.2d at 848. (All tests are performed by men and women who are
subject to human error, philosophical predisposition, and even, occasionally, unimaginative
cupidity.)
Accordingly, because it is impossible to measure and account for these
variations between test results, when confronted with conflicting medical evidence on the
existence, cause or degree of impairment, the Division, Office of Judges and Appeal Board
may not base a disability determination on evidence that the OP Board suggests is the most
reliable. Disability determinations must be made upon that evidence that is reliable and
most favorable to the claimant.
In the case before us today, the pulmonary function testing performed by the
OP Board supported a 15% permanent partial disability award. There is nothing in the record
to suggest that the OP Board's test was unreliable. The subsequent pulmonary function test
performed on behalf of the employer supported the existence of occupational
pneumoconiosis with no breathing impairment, or a 5% permanent partial disability award.
Again, there is nothing in the record to suggest that this test was unreliable.
Applying the plain language of the West Virginia Code and Javins to the facts
in this case, it is clear that on this evidence the appellant is entitled to a 15% permanent
partial disability award. The testimony by the members of the Occupational Pneumoconiosis
Board that the evidence supporting the 15% permanent partial disability award was less
reliable than the employer's evidence is irrelevant. The Office of Judges and the Appeal
Board are charged with operating independently from the Occupational Pneumoconiosis
Board, and should have weighed the Board's testimony in its proper context. Because the
evidence that the appellant has a 15% permanent partial disability as a result of exposure to
occupational pneumoconiosis hazards was reliable, the Division's original award in favor of
the appellant should have been affirmed.
III.
We therefore reverse the May 29, 1998 decision of the Workers' Compensation
Appeal Board, and remand the claim for entry of a 15% permanent partial disability award.
Reversed and Remanded.
Footnote: 1
1A pulmonary function test is a test that measures the maximum amount of air that a
claimant can inhale and exhale. Those test results are then compared against the predicted
breathing results of an average person. Predicted breathing results are derived from a
statistical analysis of a population of persons with normal breathing. If the breathing
results of the claimant are significantly less than the predicted results, and that difference
between the results can be linked to the claimant's exposure to dust, mist, fumes or other
occupational lung hazards, then the claimant is considered to be impaired.
The precise percentage of impairment, for purposes of workers' compensation
benefits, is determined by consulting a chart in regulations promulgated by the Workers'
Compensation Commissioner. See 85 Code of State Regulations 1, § 20.8.7, Table for
Impairment of Pulmonary Function.
Footnote: 2
2The 5% award for a diagnosis of occupational pneumoconiosis without breathing
impairment is established by W.Va. Code, 23-4-6a [1995], which states, in pertinent part,
that:
. . . if it shall be determined by the division in accordance with
the facts in the case and with the advice and recommendation of
the occupational pneumoconiosis board that an employee has
occupational pneumoconiosis, but without measurable
pulmonary impairment therefrom, such employee shall be
awarded and paid twenty weeks of benefits[.]
Every workers' compensation award is computed on the basis of four weeks' compensation
for each percent of disability[.] W.Va. Code, 23-4-6 (e)(1) [1995]. Combining the two
statutes, because the claimant was diagnosed with occupational pneumoconiosis with no
measurable pulmonary impairment, he was entitled to 20 weeks of benefits, or a 5%
permanent partial disability award.
Footnote: 3
3We held in the Syllabus of Persiani that:
In claims under the Workmen's Compensation Act, W.Va.
Code, 23-1-1, [1971] et seq. for disability resulting from
occupational pneumoconiosis where conflicting results from
blood gas studies are introduced into evidence, one of which is
favorable to the claimant and one of which is unfavorable, the
Commissioner is required to apply the liberality rule in the same
manner as in other cases involving the evaluation of medical
evidence, and while he is not required under the liberality rule
to accept any particular result as dispositive of the case, he may
not arbitrarily choose to disbelieve any competent medical
testimony in its entirety or to exclude it from consideration
altogether, absent credible evidence in the record that the
suspect testimony is unreliable.
Footnote: 4
4This language in Syllabus Point 1 of Javins, that the unreliability of evidence must
be shown through explicit findings of fact by the Occupational Pneumoconiosis Board,
is technically incorrect. The OP Board does not statutorily make legal findings of fact in a
claim.
W.Va. Code, 23-4-8c [1993] only authorizes the OP Board to make a report of its
findings and conclusions on every medical question in controversy, and to inform the
Division of those findings and conclusions. The Division is ultimately responsible for
reviewing and investigating the claimant's condition, taking into account the OP Board's
report. W.Va. Code, 23-5-1 [1995].
When the parties protest a decision made by the Division in an occupational
pneumoconiosis claim, it is the administrative law judges employed by the Office of Judges,
not the members of the OP Board, who are charged with independently making findings of
fact and conclusions of law[.] W.Va. Code, 23-5-9 [1995].
Footnote: 5
5The American Thoracic Society has also recognized that pulmonary function test
results may vary for a host of different, uncontrollable reasons. The Society recognizes that
equipment used to measure breathing impairment has substantial variability, and that an
accurate measure of impairment with such equipment is not easy to establish. American
Thoracic Society, Lung Function Testing: Selection of Reference Values and Interpretive
Strategies, 144 Am.Rev. of Resp. Disease 1202, 1203 (1991). The Society has found that
a piece of pulmonary function testing equipment can be precise, meaning it consistently
repeats measurements, but can still be inaccurate in that those measurements cannot be
repeated on another machine. Because most instruments have better precision than
accuracy, between-instrument variation usually contributes more to total measurement
variability than within-instrument variation. Id.
The Society has identified many of the factors that can cause differences between
pulmonary function test results, including the instrument used, the subject's posture, the
person observing the test, the software used in the equipment, the temperature and altitude
where the test is performed, and diurnal, seasonal and endocrinologic effects on the patient.
Id.