Stephanie Lyons-Rochetti v. Bluefield State University

IN THE INTERMEDIATE COURT OF APPEALS OF WEST VIRGINIA

FILED
STEPHANIE LYONS-ROCHETTI, February 3, 2026
Claimant Below, Petitioner ASHLEY N. DEEM, CHIEF DEPUTY CLERK
INTERMEDIATE COURT OF APPEALS
OF WEST VIRGINIA
v.) No. 25-ICA-233 (JCN: 2019026095)

BLUEFIELD STATE UNIVERSITY,
Employer Below, Respondent

MEMORANDUM DECISION

Petitioner Stephanie Lyons-Rochetti appeals the May 8, 2025, order of the Workers’
Compensation Board of Review (“Board”). Respondent Bluefield State University
(“Bluefield”) filed a response.1 Ms. Lyons-Rochetti did not reply. The issue on appeal is
whether the Board erred in affirming the claim administrator’s order, which denied the
addition of left carpal tunnel syndrome, adhesive capsulitis of the left shoulder, scapular
dyskinesis, carpal instability of left wrist with dorsal intercalated segment instability, tear
of left scapholunate ligament, left cubital tunnel syndrome, and lateral epicondylitis to the
claim as compensable conditions.

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 that there is error in the Board’s order but no substantial
question of law. For the reasons set forth below, a memorandum decision vacating and
remanding for further proceedings is appropriate under Rule 21 of the Rules of Appellate
Procedure.

On June 20, 2019, the claim was held compensable for sprains of the left shoulder,
elbow, and wrist. Between October 7, 2019, and February 18, 2020, Ms. Lyons-Rochetti
was seen by Bart Eastwood, D.O., and Elizabeth Ashe, P-AC, for left shoulder pain,
adhesive capsulitis, a superior glenoid labrum lesion, lateral epicondylitis, a superior
glenoid labrum tear, and left-hand pain.

On October 22, 2019, an MR arthrogram of Ms. Lyons-Rochetti’s left shoulder
noted that the study was compromised by patient motion and had the impression of

1
Ms. Lyons-Rochetti is represented by Gregory S. Prudich, Esq. Bluefield is
represented by James W. Heslep, Esq.

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moderate degenerative changes and fluid in the acromioclavicular (“AC”) joint without
impingement, supraspinatus tendinosis without a discrete tear and an otherwise normal
rotator cuff, a probable transverse tear of the superior labrum, and possible adhesive
capsulitis. An MRI of Ms. Lyons-Rochetti’s left elbow, performed on January 28, 2020,
revealed normal bony alignment without fracture and a normal lateral collateral ligament
and common extensor tendon. On March 1, 2021, Ms. Lyons-Rochetti underwent an MRI
of the left wrist, revealing apparent dorsal angulation of the lunate, slight scapholunate
separation, and a suggestion of early dorsal intercalated segment instability. The previously
observed fluid in the radioulnar region was no longer evident, which is consistent with an
interval repair of a triangular fibrocartilage complex (“TFC”) tear. There were cystic
changes in the triquetrum and edematous changes medial to the triquetrum and proximal
to the pisiform, which were new changes from a prior exam, and there was mild
prominence of joint fluid.

Ms. Lyons-Rochetti was seen by multiple providers at Lewis Gale Physicians from
February 21, 2020, through May 17, 2023. Multiple diagnoses were noted including left
elbow pain, left wrist pain, upper limb pain, carpal instability of left wrist with dorsal
intercalated segment instability and bone bruise, complex tear of triangular TFC of the left
wrist, left de Quervain’s tenosynovitis, tear of left scapholunate ligament, scapular
dyskinesis, other meniscus derangements of the medial meniscus of the left knee, labral
tear of long head of left biceps tendon, left carpal tunnel syndrome, left cubital tunnel
syndrome, and stiffness of left wrist joint. On June 9, 2020, Ms. Lyons-Rochetti underwent
a left wrist arthroscopic radiocarpal joint debridement of the TFC tear to stable margins, a
left wrist arthroscopically assisted pinning of the scapholunate interval for carpal stability,
and a left wrist arthroscopic radiocarpal complete synovectomy. Also performed was a
separate left wrist incision and midcarpal partial joint synovectomy, injection of the left
wrist with venous autologous blood, and left wrist injection of the first dorsal compartment
sheath for de Quervain’s tenosynovitis.

On March 8, 2022, Ms. Lyons-Rochetti underwent a left wrist open scapholunate
reconstruction, a left wrist posterior interosseous nerve neurectomy, extensor pollicis
longus transposition, lengthening of the dorsal retinaculum, and a synovectomy of the
extensor carpi radialis brevis. Separate procedures were performed for incision and first
dorsal compartment release of the left forearm, a radial synovectomy abductor pollicis
longus, a complete left wrist nine-tendon tenosynovectomy, a left wrist open carpal tunnel
release, a left elbow in situ cubital tunnel release, and an injection of the left wrist
ulnocarpal joint. On October 6, 2022, Ms. Lyons-Rochetti was referred to physical therapy
for adhesive capsulitis of the left shoulder, superior glenoid labrum lesion of the left
shoulder, left anterior shoulder pain, other meniscus derangements of the medial meniscus
of the left knee, and scapular dyskinesis. On February 27, 2023, Ms. Lyons-Rochetti
underwent a subpectoral biceps tenodesis and extensive arthroscopic debridement.

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David Soulsby, M.D., performed an independent medical evaluation (“IME”) of Ms.
Lyons-Rochetti on July 20, 2021. Dr. Soulsby opined that neither clinical examination nor
diagnostic studies support the diagnoses of cubital tunnel syndrome nor carpal tunnel
syndrome. Dr. Soulsby further opined that there were objective findings from MRI studies
and from arthroscopic observation of scapholunate ligament disruption, that the
scapholunate ligament reconstruction and pin neurectomy were necessary and appropriate
as it relates to the compensable conditions in this claim, and that the first dorsal
compartment release was likely also necessary, appropriate, and related to the claim.
Because Ms. Lyons-Rochetti needed additional treatment, including surgery, Dr. Soulsby
found that she had not achieved maximum medical improvement (“MMI”).

Derik Geist, M.D., authored a History & Physical Report dated October 26, 2022,
and he diagnosed Ms. Lyons-Rochetti with left shoulder pain, a Bankart lesion of the left
shoulder, and a SLAP tear of the left shoulder.

On December 15, 2022, Joseph Grady, M.D., performed an IME of Ms. Lyons-
Rochetti and found that she was at MMI for her compensable left elbow sprain and left
wrist sprain. With regard to the left shoulder, Dr. Grady noted that the MR arthrogram of
October 2019 revealed adhesive capsulitis and a labral tear and opined that it would be
reasonable to consider surgery for these conditions. However, Dr. Grady indicated that if
surgery was not going to be performed, Ms. Lyons-Rochetti would be at MMI, as he did
not anticipate that any other additional treatment would significantly change the underlying
conditions of the left arm. Dr. Grady performed a second IME of Ms. Lyons-Rochetti on
September 26, 2023, and found that Ms. Lyons-Rochetti was at MMI for her compensable
injuries.

The Board noted that Rebecca Thaxton, M.D., authored a Physician Review Report
dated May 21, 2024, considering whether the additional diagnoses listed in the letter from
Ms. Lyons-Rochetti’s counsel dated May 15, 2014, should be added to the claim. Dr.
Thaxton opined that the left biceps tendon tear, superior glenoid labrum lesion of the left
shoulder, left wrist radial-sided triangular TFC complex tear, left wrist synovitis, left wrist
first dorsal compartment de Quervain’s tenosynovitis, synovitis of the left wrist, and
scapholunate ligament tear are supported as additional compensable components in the
claim. Dr. Thaxton further opined that lateral epicondylitis, frozen shoulder/adhesive
capsulitis, scapular dyskinesia, carpal tunnel syndrome, and cubital tunnel syndrome are
not supported as additional diagnoses in this claim.

On July 23, 2024, the claim administrator issued an order denying the addition of
the following diagnoses as compensable diagnoses in this claim: left carpal tunnel
syndrome, adhesive capsulitis of the left shoulder, scapular dyskinesis, carpal instability of
left wrist with dorsal intercalated segment instability, tear of left scapholunate ligament,

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left cubital tunnel syndrome, and lateral epicondylitis. Ms. Lyons-Rochetti protested this
order.

On December 12, 2024, Ms. Lyons-Rochetti was deposed and testified that she fell
down steps at work on May 30, 2019, injuring her left shoulder, wrist, and hand. Ms.
Lyons-Rochetti stated that she underwent surgery on her left wrist, left elbow, and left
shoulder and that she has not fully recovered from her injuries as she continues to have
weakness, numbness, and stabbing, aching, and burning sensations in her arm when she
reaches. Ms. Lyons-Rochetti further testified that she cannot hold anything in her left hand,
that she used to be ambidextrous but is no longer, and that she did not have any problems
with her left shoulder, arm, or wrist prior to her fall at work and no reinjuries since May
30, 2019.

Austin Nabet, D.O., performed an IME of Ms. Lyons-Rochetti on January 24, 2025.
Dr. Nabet listed the following diagnoses as related to the work-related injury of May 30,
2019: left biceps tendinitis with a SLAP tear, left elbow sprain, and status post open left
biceps tenodesis and labral debridement, left wrist triangular TFC complex injury with
scapholunate ligament disruption, and status post left wrist triangular TFC complex
debridement, open scapholunate ligament reconstruction, posterior interosseous nerve
neurectomy, and carpal and cubital tunnel releases. Dr. Nabet also found that Ms. Lyons-
Rochetti has congenital bilateral cubital valgus with symmetric measurements of her
underlying normal variant cubital elbow alignment, which is unrelated to her compensable
injuries. Dr. Nabet opined that Ms. Lyons-Rochetti had reached MMI for her compensable
injuries.

On May 8, 2025, the Board affirmed the claim administrator’s order denying the
addition of left carpal tunnel syndrome, adhesive capsulitis of the left shoulder, scapular
dyskinesis, carpal instability of the left wrist with dorsal intercalated segment instability,
tear of the left scapholunate ligament, left cubital tunnel syndrome, and lateral epicondylitis
to the claim as compensable conditions. The Board found that Dr. Thaxton’s report was
persuasive and that Ms. Lyons-Rochetti did not establish that there are additional diagnoses
related to the claim.2 Ms. Lyons-Rochetti 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

2
We note that Dr. Thaxton’s report was not submitted for this appeal.
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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).

Ms. Lyons-Rochetti argues that, prior to the compensable injury, she had no injuries,
symptoms, or treatment related to her left arm, shoulder, and hand; thus, the presumption
set forth in Moore v. ICG Tygart Valley, LLC, 247 W. Va. 292, 879 S.E.2d 779 (2022)
should apply.3 Ms. Lyons-Rochetti further argues that it is clear from the medical records
that the tear of the left scapholunate ligament is related to the compensable injury, as noted
by Bluefield’s own experts. Ms. Lyons-Rochetti also argues that the other diagnoses have
been noted by her primary care physician and are related to the compensable injury.
Finally, Ms. Lyons-Rochetti argues that the Board did not adequately discuss the
diagnoses, and further, it failed to adequately consider the medical evidence.

Here, based on the Board’s analysis of the evidence, we conclude that the Board’s
conclusion was clearly wrong. We note that Dr. Soulsby opined that a scapholunate

3
The Supreme Court of Appeals of West Virginia held in Moore:

A claimant’s disability will be presumed to have resulted from the
compensable injury if: (1) before the injury, the claimant’s preexisting
disease or condition was asymptomatic, and (2) following the injury, the
symptoms of the disabling disease or condition appeared and continuously
manifested themselves afterwards. There still must be sufficient medical
evidence to show a causal relationship between the compensable injury and
the disability, or the nature of the accident, combined with the other facts of
the case, raises a natural inference of causation. This presumption is not
conclusive; it may be rebutted by the employer.

Moore at 294, 879 S.E. 2d at 781, syl. pt. 5.

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ligament reconstruction, which likely coincides with a scapholunate tear, was related to the
compensable injury. Dr. Nabet also listed conditions he thought were compensable.
Relevant to this case, Dr. Nabet believed that a left wrist triangular TFC complex injury
with scapholunate ligament disruption and open scapholunate ligament reconstruction and
carpal and cubital tunnel releases were related to the compensable injury. Despite these
opinions, the Board either failed to reconcile conflicting evidence or did not address
unopposed opinions when it affirmed the order denying additional compensable
conditions. As a result, we find the Board’s order is clearly wrong and must be reversed. 4
On remand, the Board should consider all opinions regarding the medical conditions caused
by the May 30, 2019, workplace injury and issue another order addressing the issue of
compensable conditions.

Accordingly, we vacate the Board’s May 8, 2025, order and remand the claim to the
Board for additional analysis.

Vacated and Remanded.

ISSUED: February 3, 2026

CONCURRED IN BY:

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

4
The Supreme Court of Appeals of West Virginia has emphasized the need for the
Board to perform an adequate analysis of the evidence in every claim. See Workman v.
ACNR Resources, Inc., 251 W.Va. 796, 916 S.E.2d 638 (2025), and Gwinn v. JP Morgan
Chase, No. 23-172, 2024 WL 4767011 (W. Va. Nov. 13, 2024) (memorandum decision).

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