CourtListener 10618757•Tammie Adams, Dependent of Kenneth D. Adams (Deceased) v. Greyhead Mining Company, Inc., Mahon Enterprises, Inc., and West Virginia Offices of the Insurance Commissioner, in its capacity as administrator of The Old Fund
Tammie Adams, Dependent of Kenneth D. Adams (Deceased) v. Greyhead Mining Company, Inc., Mahon Enterprises, Inc., and West Virginia Offices of the Insurance Commissioner, in its capacity as administrator of The Old Fund
CourtListener 10618757Wvactapp27 juin 2025
Texte intégral
IN THE INTERMEDIATE COURT OF APPEALS OF WEST VIRGINIA
TAMMIE ADAMS, DEPENDENT OF KENNETH D. ADAMS (DECEASED),
Claimant Below, Petitioner
FILED
v.) No. 24-ICA-510 (JCN: 900071148)
June 27, 2025
ASHLEY N. DEEM, CHIEF DEPUTY CLERK
GREYHEAD MINING COMPANY, INC., INTERMEDIATE COURT OF APPEALS
Employer Below, Respondent OF WEST VIRGINIA
and
MAHON ENTERPRISES, INC.,
Employer Below, Respondent
and
WEST VIRGINIA OFFICES OF THE INSURANCE COMMISSIONER, in its
capacity as administrator of The Old Fund,
Respondent
MEMORANDUM DECISION
Petitioner Tammie Adams, Dependent of Kenneth D. Adams (Deceased), appeals
the November 25, 2024, order of the Workers’ Compensation Board of Review (“Board”).
Respondent West Virginia Offices of the Insurance Commissioner, in its capacity as
Administrator of the Old Fund (“Old Fund”) filed a response.1 Ms. Adams did not reply.
The issue on appeal is whether the Board erred in affirming the claim administrator’s order,
which rejected Ms. Adams’ application for fatal dependents’ benefits.
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.
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Ms. Adams is represented by Reginald D. Henry, Esq., and Lori J. Withrow, Esq.
Old Fund is represented by Sean Harter, Esq. Greyhead Mining Company did not appear.
Mahon Enterprises, Inc. did not appear.
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Mr. Adams was evaluated by the Occupational Pneumoconiosis (“OP”) Board in
1992. The claim administrator issued an order dated December 30, 1992, granting no award
for OP. On June 14, 1995, the OP Board testified regarding its findings. The OP Board
testified that the x-rays showed no evidence of OP. The OP Board testified that Mr. Adams
had a traumatic event involving the left lower chest and diaphragm. The OP Board
concluded that the decedent had 10% pulmonary impairment due to the previous traumatic
injury. An Administrative Law Judge Decision dated October 3, 1995, affirmed the claim
administrator’s December 30, 1992, order.
A pulmonary function study performed on August 1, 2006, revealed mild reduction
in the DLCO and decreased airway restriction, consistent with mild emphysema. A CT of
Mr. Adams’ chest dated August 25, 2006, revealed patchy alveolar infiltrates in the right
upper and lower lobes suspicious for acute infiltrate such as pneumonia; tiny possibly acute
infiltrates in the left upper and lower lobes; mild scarring atelectasis or scarring in the base
of the left lower lobe; and mediastinal and mild right hilar lymphadenopathy. An x-ray of
Mr. Adams’ chest dated September 5, 2006, revealed complete resolution of previously
reported pneumonic infiltrate in the right upper lobe/apex, and chronic eventration of the
left hemidiaphragm with slight chronic linear atelectasis/scarring at the left lung base.
Between 2009 and 2019, Mr. Adams continued treatment with various physicians
for the following relevant diagnoses: idiopathic pulmonary fibrosis (“IPF”); severe chronic
GERD; chronic respiratory failure; pulmonary arterial hypertension; coal workers’
pneumoconiosis (“CWP”); severe chronic obstructive pulmonary disease (“COPD”) with
exacerbation, hypoxemia, dyspnea, and bronchospasm; bilateral pleural effusion;
pulmonary hypertension; diabetes mellitus type 2; non-sustained ventricular tachycardia
secondary to hypoxemia; congestive heart failure secondary to diastolic dysfunction;
elevated left hemidiaphragm; and implantation of a permanent pacemaker.
Mr. Adams underwent several x-rays between 2011 and 2018. An x-ray of the chest
performed on August 2, 2011, revealed no acute chest abnormality, no evidence of
metastatic disease, and stable elevation of the left diaphragm and compression atelectasis
in the left lower lung. X-rays of the chest dated October 21, 2013, revealed findings
consistent with CWP and moderate elevation of the left diaphragm. An x-ray of the chest
dated May 31, 2016, revealed chronic interstitial lung disease, greatest in the mid to lower
lung sounds; left hemidiaphragm eventration; and pleural spaces appear normal. An x-ray
of the chest dated December 7, 2018, revealed worsening bilateral patchy fibrosis and
fibronodular scars and chronic elevation of the left hemidiaphragm. An x-ray of the chest
dated December 12, 2018, revealed extensive reticulonodular interstitial changes of the
lungs predominantly in the mid and lower lung zones, and probable chronic elevation of
the left diaphragm. A Roentgenographic Interpretation report dated March 10, 2019,
reviewed the chest x-ray dated April 25, 2018. The film quality was a 1 and was interpreted
as showing parenchymal abnormalities consistent with pneumoconiosis but no pleural
abnormalities.
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Mr. Adams also underwent several CT scans between 2011 and 2019. A CT of the
chest performed on August 2, 2011, revealed elevation of the left diaphragm, previous right
hemicolectomy, and multiple cysts in both kidneys. A CT of the chest dated August 22,
2013, revealed no local alveolar infiltrate or suspicious pulmonary parenchymal mass,
findings consistent with centrilobular emphysema and possible chronic interstitial lung
disease with increased involvement since the last study. A CT of the chest dated August
13, 2014, revealed cicatricial emphysematous changes versus honeycombing in the
posterior basilar portions of the left lower lobe; pulmonary fibrosis consistent with a history
of CWP; and pulmonary arterial hypertension secondary to pulmonary fibrosis. The chest
portion of a CT from the skull base to the mid-thigh performed on October 2, 2014,
revealed heterogeneous scattered ground glass opacities throughout both lungs with
peripheral fibrosis and possible basilar honeycombing and no metabolically active
pulmonary masses or nodules. A CT of the chest dated February 2, 2018, revealed
increased pulmonary fibrosis with increased honeycombing; increased size of mediastinal
lymph nodes and hilar nodal calcifications; increased cardiac enlargement; increased size
of the main pulmonary artery; increased size of a left renal lesion; and new mild perihepatic
ascites and pericholecystic fluid. A CT of the chest performed on June 1, 2019, revealed
COPD and interstitial fibrotic changes, especially in the right lower lung zone. A CT of the
chest performed on October 5, 2019, revealed COPD and interstitial fibrotic changes,
especially right lower lung zone; prominent elevation of left hemidiaphragm; cardiomegaly
with pacemaker; and no definite superimposed consolidated infiltrate.
Records from the United States Department of Labor dated March 25, 2014, indicate
that Mr. Adams was diagnosed with restrictive disease and hypoxemia due to CWP. A
radiologic interpretation report dated March 21, 2014, reviewed the film dated February
27, 2014, and determined that the film quality was a 1. The report found that there were
parenchymal abnormalities consistent with pneumoconiosis but no pleural abnormalities.
Mr. Adams underwent two additional pulmonary function studies between 2014 and
2019. A pulmonary function study dated August 13, 2014, revealed lung volumes
consistent with moderate restrictive lung disease. A pulmonary function study from
Carilion Clinic dated April 5, 2019, revealed the presence of a moderate restrictive pattern.
Correspondence from Stephen Bergin, M.D., of Duke University, dated February 9,
2018, indicated that Mr. Adams suffered from advanced fibrotic lung disease caused by
CWP. Dr. Bergin opined that Mr. Adams’ CWP was caused by his occupational exposures.
Dr. Bergin further opined that as a result of the parenchymal lung disease, Mr. Adams
developed severe pulmonary arterial hypertension for which there were no viable treatment
options, and that Mr. Adams’ occupational exposures directly caused his advanced
cardiopulmonary disease which would likely result in a premature demise.
In a United States Department of Labor record dated April 25, 2018, Esther S.
Ajjarapu, M.D., reported a cardiopulmonary diagnosis of chronic bronchitis/legal
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pneumoconiosis and simple CWP. Dr. Ajjarapu opined that Mr. Adams’ CWP/chronic
bronchitis developed from his coal dust exposure. Correspondence from Dr. Ajjarapu dated
October 12, 2018, indicated that Mr. Adams had no tobacco history or congestive heart
failure history. Dr. Ajjarapu opined that Mr. Adams had clinical pneumoconiosis, legal
pneumoconiosis, and an abnormal physical exam. Dr. Ajjarapu reported that Mr. Adams’
pulmonary impairment was due to his work in the mines and coal dust exposure.
Correspondence from Shambhu Aryal, M.D., dated June 18, 2019, indicated that Mr.
Adams had severe CWP which led to advanced pulmonary fibrosis, pulmonary
hypertension, and chronic respiratory failure. Dr. Aryal reported that the diseases were in
their advanced stages and were life-limiting.
Mr. Adams died on October 8, 2019, his Certificate of Death dated October 10,
2019, listed his immediate cause of death as right heart failure and noted interstitial lung
disease as a condition that led to the cause of death. The OP Board released Findings dated
April 14, 2022, in which the OP Board determined that OP was not a material contributing
factor in Mr. Adams’ death.
On April 4, 2024, Stephen G. Basheda, D.O., completed a Record Review report.
Dr. Basheda noted that Mr. Adams was in the coal mining industry for 16 years and that
this exposure put him at risk for coal dust-induced pulmonary disease. Dr. Basheda opined
that Mr. Adams had clinical and radiographic findings of IPF, but no radiographic findings
of CWP. Dr. Basheda explained that CWP clinically presents as multiple nodules
beginning in the upper lobes and progressing to the lower lobes; while IPF presents with
subpleural reticular changes that begin in the lower lobes and progress superiorly. Dr.
Basheda further explained that IPF was associated with the presence of bronchiectasis,
honeycombing, and groundglass changes. Dr. Basheda stated that his review of Mr.
Adams’ CT scans of the chest revealed classic radiographic findings of IPF and no findings
of CWP. Dr. Basheda noted that although there were positive x-rays of the chest for CWP,
the CT scan was the more sensitive test for evaluating the lungs. Dr. Basheda concluded
that Mr. Adams passed away from IPF and that Mr. Adams’s death was not caused by,
contributed to, or hastened by CWP/OP.
On September 18, 2024, a final hearing was held to take the OP Board’s testimony.
The OP Board testified that imaging evidence showed pulmonary fibrosis, most likely IPF
but that the films did not show any findings suggestive of CWP, as there was no nodular
fibrosis, pleural plaques, or pleural calcifications. The OP Board testified that the basis of
their opinion was the CT scans of the chest which showed reticular fibrosis with
honeycombing as well as bronchiectasis, which are the hallmarks of IPF, not OP. The OP
Board opined that occupational dust exposure would not have caused IPF. The OP Board
testified that Mr. Adams’ immediate cause of death was right heart failure caused by his
lung disease. The OP Board testified that x-ray evidence up to some 18 years after his last
exposure showed no evidence of OP and that it was not until 2011 that Mr. Adams started
being labeled as having OP. The OP Board agreed with Dr. Basheda’s opinion that CWP
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typically begins in the upper lobes and that IPF typically begins in the lower lobes as well
as his opinion that Mr. Adams’ death was not caused by, contributed to, or hastened by any
OP. The OP Board testified that Mr. Adams’ exposure to occupational dust did not
contribute in any material degree to Mr. Adams’ death.
On November 25, 2024, the Board affirmed the claim administrator’s order, which
rejected Ms. Adams’ application for fatal dependents’ benefits. The Board found that OP
did not materially contribute to Mr. Adams’ death based on the findings of the OP Board.
Ms. Adams 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).
On appeal, Ms. Adams argues that Mr. Adams experienced sixteen years of
occupational dust exposure due to employment as a coal miner. Ms. Adams further argues
that the medical evidence establishes that Mr. Adams suffered from the typical symptoms
of OP for many years, with increasing severity, which his treating physician “believed
would lead to his premature demise.” Ms. Adams also argues that Mr. Adams’ death
certificate indicated that interstitial lung disease was a secondary condition that led to his
death. Finally, Ms. Adams argues that the OP Board and the Board disregarded the medical
evidence establishing that Mr. Adams’ OP directly caused his cardiac and lung disease. We
disagree.
The Supreme Court of Appeals of West Virginia held in Syllabus Point 3 of
Bradford v. Workers’ Comp. Comm’r, 185 W. Va. 434, 408 S.E.2d 13 (1991), “we find
5
that the appropriate test under W. Va. Code 23-4-10(b) (1978) is not whether the
employee’s death was the result of the occupational injury or disease exclusively, but
whether the injury or disease contributed in any material degree to the death.” In Rhodes
v. Workers’ Comp. Div., 209 W. Va. 8, 17, 543 S.E.2d 289, 298 (2000), the Supreme Court
of Appeals of West Virginia held that the party protesting the findings of the OP Board has
the burden to establish that the OP Board was clearly wrong.
Here, the Board determined that the OP Board was not clearly wrong in finding that
OP did not contribute in any material way to Mr. Adams’ death. The Board noted that Mr.
Adams was last exposed to the hazards of OP in 1989 and there is no diagnosis of OP on
record until 2011. The Board further noted that the OP Board testified that the decedent
was incorrectly labeled as having OP when the lung condition was actually related to
pulmonary fibrosis rather than OP. The Board found that, although there are x-rays
indicating a diagnosis of OP, the CT scans are more reliable and did not reveal evidence of
OP. Ultimately, the Board concluded that OP was not a material contributing factor in Mr.
Adams’ death.
Upon review, we conclude that the Board was not clearly wrong in finding that OP
did not materially contribute to Mr. Adams’ death based on the findings of the OP Board.
Further, we conclude that the Board was not clearly wrong in finding that Ms. Adams failed
to establish that the OP Board was clearly wrong. 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 affirming the
claim administrator’s order denying Ms. Adams’ application for fatal dependents’ benefits.
Accordingly, we affirm the Board’s November 25, 2024, order.
Affirmed.
ISSUED: June 27, 2025
CONCURRED IN BY:
Chief Judge Charles O. Lorensen
Judge Daniel W. Greear
Judge S. Ryan White
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