Brenda G. Blevins v. Princeton Community Hospital Association

IN THE INTERMEDIATE COURT OF APPEALS OF WEST VIRGINIA

BRENDA G. BLEVINS, FILED
Claimant Below, Petitioner
January 29, 2025
ASHLEY N. DEEM, CHIEF DEPUTY CLERK
v.) No. 24-ICA-299 (JCN: 2021009597) INTERMEDIATE COURT OF APPEALS
OF WEST VIRGINIA

PRINCETON COMMUNITY HOSPITAL ASSOCIATION,
Employer Below, Respondent

MEMORANDUM DECISION

Petitioner Brenda G. Blevins appeals the July 15, 2024, order of the Workers’
Compensation Board of Review (“Board”). Respondent Princeton Community Hospital
Association (“PCHA”) timely filed a response.1 Ms. Blevins did not file a reply. The issue
on appeal is whether the Board erred in affirming the claim administrator’s order, which
granted Ms. Blevins no permanent partial disability (“PPD”) award.

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.

Prior to the events leading to this claim, in November of 2016, Ms. Blevins was
treated by Kelsey Mills, PA-C, after being diagnosed with bronchitis. PA-C Mills
suspected that Ms. Blevins had underlying asthma and referred her to an allergy and asthma
specialist. Further, PA-C Mills recommended a pulmonary function test and a course of
Singulair. On November 21, 2016, Ms. Blevins treated with Ryan T. Runyon, D.O. She
complained of dyspnea/shortness of breath and wheezing. Dr. Runyon suspected a
pulmonary embolism and recommended several tests, stating he would refer her to a
pulmonologist if her condition did not improve.

On December 6, 2016, Ms. Blevins was examined by Tarun M. Kumar, M.D., at the
Asthma & Allergy Center in Charleston, West Virginia. Ms. Blevins complained of
shortness of breath and wheezing, and she indicated a twenty-five-year history of smoking
one pack of cigarettes a day. Ms. Blevins stated that she quit smoking eight to ten years
prior. Pulmonary function testing showed a normal airflow. Dr. Kumar diagnosed

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Ms. Blevins is represented by Reginald D. Henry, Esq., and Lori J. Withrow, Esq.
PCHA is represented by Steven K. Wellman, Esq., and James W. Heslep, Esq.

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intermittent asthma, allergic rhinitis due to animal hair and dander, allergic rhinitis due to
pollen, other allergic rhinitis, and cough.

Medical records from 2017 indicate that Ms. Blevins was referred to a
pulmonologist for exertional dyspnea and that she continued to experience occasional
wheezing. In February of 2018, Ms. Blevins returned to an allergy center, and complained
of wheezing, shortness of breath, and coughing. Ms. Blevins was directed to complete her
course of Prednisone and start Symbicort. By May of 2018, Ms. Blevins was experiencing
an improvement of her symptoms, and she reported no wheezing or shortness of breath,
although she continued to take Symbicort for asthma. In April of 2019, Ms. Blevins sought
treatment for cough and allergies. She was diagnosed with bronchitis and asthma.

Turning to the instant claim, Ms. Blevins was exposed to and contracted COVID-
19 while at work in October of 2020. Ms. Blevins was admitted to Charleston Area Medical
Center on October 26, 2020, and was diagnosed with acute respiratory failure with hypoxia,
SARS-associated coronavirus infection, pneumonia due to human coronavirus, history of
cardiac arrhythmia, and asthma. An x-ray of Ms. Blevins’ chest revealed no acute
cardiopulmonary abnormality. Ms. Blevins presented to the emergency room at Princeton
Community Hospital on October 29, 2020, and she was admitted through October 31, 2020.
Ms. Blevins was diagnosed with pneumonia due to COVID-19, asthma, and respiratory
failure with hypoxia.

On December 2, 2020, Ms. Blevins was treated by Rachel Ann Leonard, M.D., a
pulmonologist at WVU Medicine. Ms. Blevins complained of persistent fatigue, dyspnea,
cough, intermittent chest pains, and exertional dyspnea. Dr. Leonard noted that Ms. Blevins
had undergone a Troponin EKG, which revealed that the left ventricle ejection fractions
were preserved with the “only abnormality being hypertension.” Dr. Leonard opined that
Ms. Blevins’ symptoms were related to post-COVID infection, superimposed on a history
of asthma. Dr. Leonard suggested the addition of Spiriva to Ms. Blevins’ Symbicort and
Singulair regimen. Per Ms. Blevins’ request, Dr. Leonard referred her to a cardiologist.

Ms. Blevins completed an Employees and Physician’s Report of Occupational
Injury dated January 26, 2021. The injury was listed as COVID-19. The physician’s section
of the form was completed by personnel at Tazewell Community Hospital and described
the injury as exposure to a patient or staff with COVID-19.

By order dated February 15, 2021, the claim administrator held the claim
compensable for exposure to COVID-19. By order dated October 26, 2021, the claim
administrator added post COVID-19 condition as a compensable condition in the claim.

On September 28, 2022, Ms. Blevins underwent an independent medical evaluation
(“IME”) performed by George Zaldivar, M.D. Dr. Zaldivar conducted a six-minute walk
test, and Ms. Blevins’ results were normal. Dr. Zaldivar stated that Ms. Blevins did not

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need any treatment with respect to her pulmonary system, and that there were no limitations
to her pulmonary system. Further, Dr. Zaldivar noted that Ms. Blevins did have
tachycardia, but opined that her symptoms may be due to her extreme anxiety. Dr. Zaldivar
concluded that Ms. Blevins had 0% impairment according to the American Medical
Association’s Guides to the Evaluation of Permanent Impairment (4th ed. 1993)
(“Guides”).

On October 17, 2022, Dr. Zaldivar authored a supplemental report regarding Ms.
Blevins’ claim. Dr. Zaldivar stated that the dyspnea of which Ms. Blevins complained is
the result of anxiety or deconditioning, and that she does not have any pulmonary disease
or condition that would cause any shortness of breath. Dr. Zaldivar opined that from a
pulmonary standpoint, Ms. Blevins does not require any treatment or rehabilitation, and
that her lungs had returned to normal after the previous episode of COVID-19.

By order dated October 26, 2022, the claim administrator closed the claim for
permanent partial disability benefits, on the basis that Dr. Zaldivar’s IME indicated that no
permanent partial disability had resulted from the compensable injury.

On May 11, 2023, Bruce Guberman, M.D., performed an IME of Ms. Blevins. Ms.
Blevins presented with post-COVID syndrome, and reported shortness of breath, chronic
cough, chest pains, palpitations, joint symptoms, and sleep apnea. Dr. Guberman assessed
history of COVID-19 infection due to exposure at work, post-COVID syndrome with
shortness of breath, arthralgias, myalgias, rash, intermittent tachycardia, autoimmune
syndrome, and sleep apnea, and documented hyperventilation at peak exercise with
increased dead space and decreased oxygen diffusion. Dr. Guberman opined that the
iCPET results were consistent with dyspnea, which was to a reasonable degree of medical
probability, related to the long-term effects of the COVID-19 infection in her lungs.
Further, Dr. Guberman stated that Ms. Blevins had reached MMI from the COVID-19
infection and post-Covid syndrome. Using the Guides, Dr. Guberman opined that Ms.
Blevins had a 3% whole person impairment due to the compensable injury.

On September 21, 2023, Chuan Fang Jin, M.D., completed a medical evaluation
report regarding Ms. Blevins’ claim. Dr. Jin’s assessment was a history of COVID-19
infection and post-COVID syndrome. Dr. Jin noted that Ms. Blevins had persistent
symptoms involving multiple systems, was evaluated by many physicians/specialists, had
extensive work-ups with minimal findings, and was diagnosed with post-COVID
syndrome. Dr. Jin opined that the medical evidence indicated that Ms. Blevins had
preexisting respiratory disease and asthma, which she received treatment for prior to her
COVID-19 infection. Dr. Jin noted that Ms. Blevins had a normal pulmonary function test.
Further, Dr. Jin opined that Ms. Blevins had reached MMI for the compensable injury, and
using the Guides, she concluded that Ms. Blevins had no WPI due to the compensable
injury. Regarding Dr. Guberman’s finding of 3% WPI, Dr. Jin opined that the medications
Ms. Blevins was taking could be discontinued if her symptoms improved. Further, Dr. Jin

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noted that page 9 of the Guides regarding “Adjustments for Effects of Treatment or Lack
of Treatment” pertains to medications for diseases that caused permanent loss of some
function. Dr. Jin opined that Ms. Blevins’ medications did not fall into this category.

By order dated July 15, 2024, the Board affirmed the claim administrator’s order
which granted Ms. Blevins no PPD award.2 The Board found that Dr. Guberman’s 3%
impairment rating was not reliable, as he did not identify specific medications or treatment
that had been authorized for the compensable COVID-19 and post-Covid syndrome.
Further, the Board noted that Dr. Jin opined that Ms. Blevins had no WPI based upon a
normal pulmonary function test, and she opined that Dr. Guberman’s finding of 3% WPI
was misplaced per the Guides. Based on the foregoing, the Board concluded that the
evidence does not establish a greater WPI than the 0% PPD award granted by the claim
administrator.

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

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By separate order dated January 19, 2023, the Board also affirmed the claim
administrator’s separate orders in this claim, which denied reopening the claim for
temporary total disability benefits, and denied authorization for a referral to a
rheumatologist, a C-PAP machine, Melatonin, Spiriva inhaler, and Prednisone. This Court
affirmed the Board’s order in Blevins v. Princeton Cmty. Hosp. Ass’n., No. 23-ICA-56,
2023 WL 5695428 (W. Va. Ct. App. Sept. 5, 2023) (memorandum decision). This decision
was affirmed by the Supreme Court of Appeals of West Virginia in Blevins v. Princeton
Cmty. Hosp. Ass’n., No. 23-614, 2024 WL 4274135 (W. Va. Sept. 23, 2024) (memorandum
decision).

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(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).

On appeal, Ms. Blevins argues that the evidence establishes that she sustained more
than a 0% whole person impairment due to the compensable injury.3 Further, Ms. Blevins
avers that the Board erred in finding that Dr. Guberman’s report was not reliable because
he did not list specific medications or authorized treatment. We disagree.

As set forth by the Supreme Court of Appeals of West Virginia, “[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 affirming the claim administrator’s order, which granted no PPD
award.

Here, the Board noted that Dr. Jin opined that Ms. Blevins had no WPI based upon
a normal pulmonary function test, and she concluded that Dr. Guberman’s finding of 3%
WPI was misplaced per the Guides. Dr. Zaldivar also concluded that Ms. Blevins had 0%
WPI using the Guides. The Board also noted that although Dr. Guberman stated that Ms.
Blevins required medications to maintain her current level of functioning, he did not
identify specific medications or treatment that had been authorized for the compensable
COVID-19 and post-COVID syndrome. Based on the foregoing, the Board concluded that
the evidence of record does not establish a greater WPI than the 0% PPD award granted by
the claim administrator. Finding no error, we defer to the Board’s credibility
determinations. See Martin v. Randolph Cnty. Bd. of Educ., 195 W. Va. 297, 306, 465
S.E.2d 399, 408 (1995) (“We cannot overlook the role that credibility places in factual
determinations, a matter reserved exclusively for the trier of fact. We must defer to the
ALJ’s credibility determinations and inferences from the evidence . . . .”).

Accordingly, we affirm the Board’s July 15, 2024, order.

Affirmed.

ISSUED: January 29, 2025

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We note that the compensability of COVID-19 is not at issue in this appeal.

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CONCURRED IN BY:

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

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