Quad Graphics, Inc. v. Rodney Hottle

IN THE INTERMEDIATE COURT OF APPEALS OF WEST VIRGINIA

FILED
QUAD GRAPHICS, INC., May 1, 2026
Employer Below, Petitioner ASHLEY N. DEEM, CHIEF DEPUTY CLERK
INTERMEDIATE COURT OF APPEALS
OF WEST VIRGINIA
v.) No. 25-ICA-356 (JCN: 2019014274)

RODNEY HOTTLE,
Claimant Below, Respondent

MEMORANDUM DECISION

Petitioner Quad Graphics, Inc. (“Quad”) appeals the August 6, 2025, order of the
Workers’ Compensation Board of Review (“Board”).1 Mr. Hottle did not respond. The
issue on appeal is whether the Board erred in modifying the claim administrator’s order,
which denied authorization of a platelet rich plasma (“PRP”) injection of the left
glenohumeral joint and denied physical therapy to the cervical spine. The Board ordered
Quad to authorize a PRP injection; however, it affirmed Quad’s denial of physical therapy
to the cervical spine.2

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 West Virginia Rules of Appellate Procedure.

Mr. Hottle submitted an Employees’ and Physicians’ Report of Occupational Injury
or Disease dated January 7, 2019, reporting that he injured his arm on January 4, 2019. The
physician’s section was completed by Nandita Subedi, M.D., who indicated that Mr. Hottle
injured his left arm as a direct result of an occupational injury. The claim administrator
issued an order dated January 16, 2019, which held the claim compensable for left elbow
and shoulder contusion.

1
Quad is represented by Aimee M. Stern, Esq.
2
The Board’s order also affirmed the claim administrator’s orders dated March 10,
2025, which denied the reopening of the claim for temporary total disability (“TTD”)
benefits, and dated March 24, 2025, which denied authorization for a left shoulder
injection. These portions of the Board’s order are not at issue in the instant appeal.

1
On February 16, 2019, Mr. Hottle underwent an MRI of the left shoulder revealing
a subchondral cyst with overlying chondrosis at the posterior/inferior glenoid, findings of
a tear accompanied by an adjacent posteroinferior paralabral cyst at the posterior-inferior
labrum, mild to moderate rotator cuff tendinopathy within the supraspinatus and
infraspinatus, and mild to moderate acromioclavicular (“AC”) joint arthrosis.

Mr. Hottle underwent an arthroscopy of the left shoulder with biceps tenodesis, a
labral repair of a SLAP lesion, subacromial decompression, and a distal clavicle resection
on June 10, 2020, performed by Garth Wright, M.D. The pre-operative diagnoses were
biceps tendinitis with superior labral tear, subacromial spur with rotator cuff impingement,
and degenerative arthritis of acromioclavicular joint of the left shoulder. The post-operative
diagnoses were partial tear of the biceps tendon near the labral anchor of the left shoulder;
Buford lesion of anterior labrum of the left shoulder; type 2 superior labral lesion, SLAP;
intact rotator cuff; subacromial spur with impingement of the rotator cuff; degenerative
arthritis of the left acromioclavicular joint; and morbid obesity with a BMI of 47.

On April 5, 2021, Mr. Hottle underwent an MR arthrogram of the left shoulder,
performed by John Carroll, M.D. Mr. Hottle reported left arm numbness, decreased range
of motion (“ROM”), pain with popping/clicking of the joint, and neck stiffness/muscle
spasms. It was reported that the study was limited by motion artifact. The arthrogram
revealed high-grade partial to complete intra-articular long head biceps tendon tear, with
retraction to the level of the proximal humeral metaphysis; probable prior high biceps
tenodesis; moderate full and partial thickness chondral loss along the posterior inferior
glenoid; posterior/inferior glenoid labral tear with a labral cyst; mild supraspinatus and
infraspinatus tendinosis; mild chronic subscapularis tendinosis; and widening of the AC
joint space which is most commonly postsurgical or posttraumatic.

The Board noted that Mr. Hottle submitted excerpts from a Decision of
Administrative Law Judge (“ALJ”), which reversed the claim administrator’s order dated
October 20, 2021, denying arthroscopy of the left shoulder, and the ALJ authorized the
treatment. The ALJ found Mark A. Rowley, M.D.’s opinion in his report dated November
10, 2021, that the surgery was related to non-compensable arthritis and age-related
degeneration of the rotator cuff and glenoid labrum, to be unreliable.3

The Board took judicial notice of an ALJ Decision dated March 10, 2022. The ALJ
authorized repeat arthroscopy of the left shoulder and reopened the claim for TTD benefits.
The ALJ noted that the claim administrator’s order dated October 20, 2021, indicated that
the claim was compensable for a left shoulder contusion, left shoulder labral tear, and

3
This Decision was submitted into the lower record but was not submitted to this
Court. We note the Board’s discussion of this evidence.

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rotator cuff tendinopathy. The ALJ noted that the claim administrator’s order dated April
3, 2020, granted authorization for left shoulder arthroscopy with SLAP repair vs.
debridement and biceps tenodesis, possible subacromial decompression, and distal
resection.

On September 5, 2023, Dr. Rowley performed an independent medical evaluation
(“IME”) of Mr. Hottle, who reported left shoulder pain and numbness of the left hand. Dr.
Rowley diagnosed Mr. Hottle with post-traumatic arthritis of the left shoulder and related
the diagnosis to the compensable injury. Dr. Rowley opined that the diagnosis of carpal
tunnel syndrome was pre-existing and not related to the compensable claim. It was reported
that Mr. Hottle’s examination revealed no findings consistent with cubital tunnel. Dr.
Rowley opined that Mr. Hottle had reached MMI from the post-traumatic arthritis of the
left shoulder.

Mr. Hottle was seen by C. Gregory Kang, M.D., on June 12, 2024, for cervical, left
shoulder, left hand, and left arm symptoms. Mr. Hottle reported that his symptoms returned
despite an injection he received in the left shoulder. An examination of the left shoulder
revealed tenderness, limited ROM, and a positive impingement sign. The assessment was
left shoulder arthroscopy with chronic pain, history of labral tear and bicep tendon tear,
and possible cervical radiculopathy. Mr. Hottle received a depo-medrol and lidocaine left
shoulder injection.

On July 12, 2024, Dr. Rowley performed a second IME of Mr. Hottle, who reported
left shoulder pain radiating into the neck. Dr. Rowley noted that an MRI of Mr. Hottle’s
cervical spine performed on April 2, 2016, revealed a prominent right foraminal protrusion
at C6-C7, causing severe right neuroforaminal stenosis. Dr. Rowley explained that the
decreased ROM of the left shoulder was causing mechanical strain on the cervical spine,
aggravating the cervical radiculopathy. Dr. Rowley opined that Mr. Hottle’s cervical spine
condition had reached MMI.

Mr. Hottle had a telehealth visit with Dr. Wright on February 4, 2025. They
discussed an MRI of the left shoulder, which revealed an intact rotator cuff but local
susceptibility artifact within the glenoid probably related to the labral repair, attenuation of
the labral substance, and moderate to advanced articular cartilage loss of the glenohumeral
joint.4 Dr. Wright recommended a PRP injection of the glenohumeral joint and physical
therapy for the neck. The assessment was post-traumatic osteoarthritis of the left shoulder;
a left glenoid labral tear; status post arthroscopy of the left shoulder; and morbid obesity.

4
It’s unclear from the medical records the date of the MRI being discussed at this
visit, as the most recent MRI identified in the lower record is from 2021, four years prior
to this visit.

3
Dr. Rowley authored a report dated February 25, 2025. After a review of additional
medical records, Dr. Rowley opined that his finding of MMI for the left shoulder on
September 5, 2023, and his finding of MMI for the cervical spine on July 12, 2024, did not
warrant a change. Dr. Rowley opined that there was no medical necessity for additional
treatment related to the compensable injury.

On August 6, 2025, the Board modified the claim administrator’s February 10,
2025, order, which denied authorization of a PRP injection of the left glenohumeral joint,
to reflect that the request for a PRP injection was granted; and affirmed the modified order.
Quad now appeals the Board’s order.

Our standard of review is set forth in West Virginia Code § 23-5-12a(b) (2022), in
part, as follows:

The Intermediate Court of Appeals may affirm the order or decision of the
Workers’ Compensation Board of Review or remand the case for further
proceedings. It shall reverse, vacate, or modify the order or decision of the
Workers’ Compensation Board of Review, if the substantial rights of the
petitioner or petitioners have been prejudiced because the Board of Review’s
findings are:

(1) In violation of statutory provisions;
(2) In excess of the statutory authority or jurisdiction of the Board of Review;
(3) Made upon unlawful procedures;
(4) Affected by other error of law;
(5) Clearly wrong in view of the reliable, probative, and substantial evidence
on the whole record; or
(6) Arbitrary or capricious or characterized by abuse of discretion or clearly
unwarranted exercise of discretion.

Syl. Pt. 2, Duff v. Kanawha Cnty. Comm’n, 250 W. Va. 510, 905 S.E.2d 528 (2024).

Quad argues that the evidence indicates that Mr. Hottle’s compensable injury has
reached MMI and further treatment is unlikely to result in a significant change in his
condition. Quad notes that Mr. Hottle was found to have reached MMI by Dr. Rowley on
September 5, 2023. Finally, Quad argues that Dr. Rowley re-affirmed his conclusion that
Mr. Hottle’s compensable injury had reached MMI and required no further treatment on
February 25, 2025, after Dr. Wright recommended the PRP injection. We disagree.

The claim administrator must provide a claimant with medically related and
reasonably necessary treatment for a compensable injury. See West Virginia Code § 23-4-
3 (2005) and West Virginia Code of State Rules § 85-20 (2006).

4
Here, the Board found that:

Regarding the PRP injection of the left glenohumeral joint, Dr. Wright
requested the injection after a review of the left shoulder MRI which showed
an intact rotator cuff but local susceptibility artifact within the glenoid
probably related to the labral repair, attenuation of the labral substance, and
moderate to advanced articular cartilage loss of the glenohumeral joint. Dr.
Wright assessed the claimant with post-traumatic osteoarthritis, left
shoulder; glenoid labral tear, left; and S/P arthroscopy of the left shoulder.
The evidence also establishes that the claimant has continued left shoulder
pain. The left shoulder labral tear and rotator cuff tendinopathy are
compensable components of the claim and labral repair was authorized, and
since the claimant continues to have left shoulder pain, it is determined that
the PRP injection is medically related and reasonably required for the
compensable injury.

Upon review, we conclude that the Board was not clearly wrong when it relied on
the opinion of Dr. Wright, who is Mr. Hottle’s treating physician. The evidence shows that
Mr. Hottle’s left shoulder symptoms are related to the compensable injury, and that even
though Mr. Hottle is at MMI, left shoulder PRP injections will treat the compensable
condition. As the Supreme Court of Appeals of West Virginia has set forth, “[t]he ‘clearly
wrong’ and the ‘arbitrary and capricious’ standards of review are deferential ones which
presume an agency’s actions are valid as long as the decision is supported by substantial
evidence or by a rational basis.” Syl. Pt. 3, In re Queen, 196 W. Va. 442, 473 S.E.2d 483
(1996). With this deferential standard of review in mind, we cannot conclude that the Board
was clearly wrong in modifying the claim administrator’s February 10, 2025, order to
reflect that the request for a PRP injection is a medical treatment related to the compensable
injury.

We find no merit in Quad’s argument that Dr. Rowley’s finding of MMI should
affect Mr. Hottle’s ability to continue to receive treatment for pain that is related to the
compensable injury. Further, we note that Mr. Hottle is not precluded from seeking further
treatment for pain and any other symptoms or complications found to be related to the
compensable injury.

Accordingly, we affirm the Board’s August 6, 2025, order.

Affirmed.

ISSUED: May 1, 2026

5
CONCURRED IN BY:

Chief Judge Daniel W. Greear
Judge Charles O. Lorensen
Judge S. Ryan White

6