Frank Mayer v. City of Clarksburg
Court
Intermediate Court of Appeals of West Virginia
Decided
June 27, 2025
Jurisdiction
SA
Importance
46%
Practice Areas
Case Summary
IN THE INTERMEDIATE COURT OF APPEALS OF WEST VIRGINIA FILED FRANK MAYER, June 27, 2025 Claimant Below, Petitioner ASHLEY N. DEEM, CHIEF DEPUTY CLERK INTERMEDIATE COURT OF APPEALS OF WEST VIRGINIA v.) No. 24-ICA-462 (JCN: 2023021874) CITY OF CLARKSBURG, Employer Below, Respondent MEMORANDUM DECISION Petitioner Frank Mayer appeals the October 30, 2024, order of the Workers’ Compensation Board of Review (“Board”). Respondent City of Clarksburg (“Clarksburg”) filed a response.1 Mr. Mayer did not reply. The issue on appeal is whether the Board erred in affirming the claim administrator’s order, which denied authorization for a right reverse total shoulder arthroplasty. This Court has jurisdiction over this appeal pursuant to West Virginia Code § 51- 11-4 (2024). After considering the parties’ arguments, the record on appeal, and the applicable law, this Court finds no substantial question of law and no prejudicial error. For these reasons, a memorandum decision affirming the Board’s order is appropriate under Rule 21 of the Rules of Appellate Procedure. On May 24, 2023, while employed by Clarksburg, Mr. Mayer was mowing when he slipped and fell, landing with his leg bent underneath him. Mr. Mayer was seen at the United Hospital Center Emergency Room on the date of the injury, with a chief complaint of left knee pain and right shoulder pain. The assessment was a patella fracture and right shoulder strain. Mr. Mayer filed an Employees’ and Physicians’ Report of Occupational Injury dated May 24, 2023, indicating that he suffered an injury to his right shoulder and left leg when he was cutting grass on a hillside, and he fell when the bank gave way. The physician’s portion was signed at United Hospital Center and notes an occupational injury to the right shoulder and left knee. On May 26, 2023, Mr. Mayer was seen by William Dahl, M.D., who assessed a rupture of the left quadricep, a closed fracture of the left patella, and an injury of the right shoulder. Dr. Dahl opined that Mr. Mayer would benefit from surgical fixation of the left 1 Mr. Mayer is represented by J. Thomas Greene, Jr., Esq., and T. Colin Greene, Esq. Clarksburg is represented by James W. Heslep, Esq. 1 quadriceps rupture. The claim administrator issued an order dated May 31, 2023, holding the claim compensable for a strain of muscle, fascia, and tendon involving the right shoulder and upper arm; a strain of the left quadriceps; and a closed fracture of the left patella. Mr. Mayer was seen by Joshua Sykes, M.D., on November 27, 2023, for a follow up subsequent to a left quadriceps repair performed on June 1, 2023. Mr. Mayer reported a constant sharp, burning, and throbbing pain that he rated 5/10, and is worse with activity; that he had numbness and tingling when sitting; that his knee continued to swell; and that he was progressing with physical therapy. On December 28, 2023, Mr. Mayer underwent a CT of his right shoulder, which had the impression of severe acromioclavicular and mild glenohumeral osteoarthritis, retracted tears of the supraspinatus and infraspinatus tendons, a suspected full thickness tear of the superior bundle of the subscapularis, and suspected extensive degenerative labral tearing. On January 23, 2024, Dr. Sykes assessed Mr. Mayer with status post tendon repair, rupture of left quadriceps, and right rotator cuff tear. Dr. Sykes noted that Mr. Mayer has had a work-related shoulder tear for over twenty years that had progressed from his previous MRI. On February 7, 2024, Mr. Mayer was evaluated by Kelly Agnew, M.D. Dr. Agnew noted that Mr. Mayer has a large retracted, irreparable right rotator cuff tear, that was documented in 2003, and that this tear was never repaired. Dr. Agnew opined that there was nothing on the recent CT scan with arthrogram of the right shoulder to suggest an acute injury and that all the changes were chronic. Dr. Agnew further opined that there was no evidence of a lingering strain and that the findings were expected from the chronic rotator cuff disruption. Dr. Agnew found that Mr. Mayer had reached maximum medical improvement from the shoulder and upper arm portion of his injury. Dr. Agnew noted that Mr. Mayer had been offered total shoulder arthroplasty by Dr. Sykes, and he opined that any such treatment would be for the underlying chronic pathology that dates back to 2003; and that arthroplasty could not possibly be ascribed to any identifiable injury involving the right shoulder from May 24, 2023. Mr. Mayer followed u
Case Details
Case Details
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Status
Decided
Date Decided
June 27, 2025
Jurisdiction
SA
Court Type
federal
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Case Summary
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Case Overview
Case Name: Frank Mayer v. City of Clarksburg
Court: Intermediate Court of Appeals of West Virginia
Date: June 27, 2025
Citation: Unknown
Jurisdiction: SA
In this case, Frank Mayer appeals an order from the Workers’ Compensation Board of Review which denied authorization for a right reverse total shoulder arthroplasty following an injury sustained while mowing. The central issue is whether the Board erred in affirming the claim administrator's denial based on the medical evidence presented.
Key Legal Issues
- Authorization for Medical Treatment: Whether the requested shoulder surgery was medically necessary and related to the compensable injury.
- Preexisting Conditions: The impact of Mayer's prior shoulder injury on the current claim.
Court's Decision
The Intermediate Court of Appeals affirmed the Board’s order, concluding that the requested surgery was not medically related to the compensable injury sustained on May 24, 2023.
Legal Reasoning
The Court reviewed the evidence and determined that:
- The medical evidence indicated a preexisting rotator cuff tear documented as early as 2003.
- Dr. Kelly Agnew opined that the changes in Mayer’s shoulder were chronic and not related to the recent injury.
- The Board found that Mayer did not establish a causal link between the compensable injury and the need for the surgery.
The Court applied a deferential standard of review, affirming the Board's findings as not being clearly wrong or arbitrary.
Key Holdings
- The Court upheld the Board's decision that the right reverse total shoulder arthroplasty was not medically necessary for the compensable injury.
- The existence of a preexisting condition does not automatically negate a claim for treatment related to a compensable injury, but in this case, it did not support Mayer's request.
Precedents and Citations
- West Virginia Code § 51-11-4 (2024): Jurisdictional basis for the appeal.
- West Virginia Code § 23-5-12a(b) (2022): Standards for reviewing Workers’ Compensation Board decisions.
- Duff v. Kanawha Cnty. Comm’n, 250 W. Va. 510, 905 S.E.2d 528 (2024): Outlines the review standards for the Board’s decisions.
- In re Queen, 196 W. Va. 442, 473 S.E.2d 483 (1996): Establishes the deferential standard of review.
Practical Implications
This case underscores the importance of establishing a clear medical link between a compensable injury and the requested treatment in workers' compensation claims. Legal practitioners should be aware of the implications of preexisting conditions on claims and the necessity of comprehensive medical documentation to support treatment requests.
The decision also highlights the deferential nature of appellate review in workers' compensation cases, emphasizing that findings by the Board will often be upheld unless there is clear evidence of error or abuse of discretion.
Legal professionals should ensure that clients with preexisting conditions are thoroughly evaluated and that all medical opinions are well-documented to avoid similar denials in future claims.
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Case Details
Legal case information
Status
Decided
Date Decided
June 27, 2025
Jurisdiction
SA
Court Type
federal
Legal Significance
Case importance metrics
Metadata
Additional information
Quick Actions
Case management tools