Permissible Combination of Multi-Specialty Impairment Ratings for Whole Person Impairment Determination

Introduction

Arch Coal, Inc. v. Howard, 2025 WL ______ (W. Va. Apr. 16, 2025), represents a significant decision of the Supreme Court of Appeals of West Virginia concerning the calculation of Whole Person Impairment (WPI) for permanent total disability (PTD) eligibility under West Virginia Code § 23-4-6(n)(1). The case arises from a catastrophic 2010 workplace injury suffered by Jobie Howard while employed as an electrician by Arch Coal, Inc. The core dispute centers on whether the Workers’ Compensation Board of Review (the “Board”) may combine independent impairment ratings issued by physicians of different specialties—one assessing ocular impairment, the other orthopedic and dermatological impairment—through the American Medical Association’s Combined Values Chart to arrive at a total WPI percentage.

Key parties and procedural posture:

Petitioner: Arch Coal, Inc.
Respondent: Jobie Howard.
Lower tribunals: Workers’ Compensation Board of Review → Intermediate Court of Appeals (ICA).
Disposition: Board found 55% WPI by combining a 27% ocular rating and a 39% orthopedic/dermatological rating; ICA affirmed; Supreme Court of Appeals affirmed.

Summary of the Judgment

Justice Walker, writing for a unanimous Court, affirmed the ICA’s decision upholding the Board’s conclusion that Mr. Howard exceeded the 50% WPI threshold necessary to pursue a PTD award. The Court held that:

The Board may give deference to credible medical opinions under the statutory standard of review in W. Va. Code § 23-5-12a(b): questions of law de novo and factual findings for clear error (Duff v. Kanawha Cnty. Comm’n, 250 W. Va. 510, 905 S.E.2d 528 (2024)).
When multiple valid impairment ratings cover distinct body parts—each assessed by a physician qualified in that specialty—the Board can combine those ratings using the AMA’s Combined Values Chart to determine total WPI.
Precedent does not bar a factfinder from applying the ministerial step of combining two or more medical impairments from separate reports. Cases such as Miller v. Dynamic Energy, Inc., No. 20-0552 (W. Va. Nov. 5, 2021), support this practice.
Contrary authority in Magnetech Industrial Services v. York, No. 14-0386 (W. Va. Jan. 15, 2015) (memorandum decision), is distinguishable because there the factfinder pieced together portions of discredited reports rather than combining two reliable, specialty-specific ratings.

Analysis

Precedents Cited

Duff v. Kanawha County Commission, 250 W. Va. 510, 905 S.E.2d 528 (2024) – Synthesized in Syllabus Point 3: appellate review of Board decisions binds this Court to the statutory standards of W. Va. Code § 23-5-12a(b).
Repass v. Workers’ Compensation Division, 212 W. Va. 86, 569 S.E.2d 162 (2002) – Recognized that medical impairment now equals permanent partial disability and may not be adjusted by non-medical factors post-1995 amendments.
Lester v. Logan-Mingo Area Mental Health, Inc., 250 W. Va. 219, 902 S.E.2d 768 (2024) – Discussed “body parts” concept under AMA Guides and application of Combined Values Chart.
Miller v. Dynamic Energy, Inc., No. 20-0552, 2021 WL 5150063 (W. Va. Nov. 5, 2021) (memorandum) – Affirmed Board combining a 7% shoulder rating and a 9% spine rating for a 15% PPD award.
Magnetech Industrial Services v. York, No. 14-0386, 2015 WL 249263 (W. Va. Jan. 15, 2015) (memorandum) – Distinguished for its piecemeal selection of clinical findings from discredited reports.

Legal Reasoning

The Court’s reasoning unfolds in three steps:

Standard of Review: Under W. Va. Code § 23-5-12a(b), legal questions are reviewed de novo; factual findings are given deference absent clear error. The Board’s crediting and discrediting of medical opinions fall squarely within its fact-finding authority.
Authority to Combine Specialty Ratings: The Board relied exclusively on two physicians whose expertise aligns with separate injury domains—Dr. Dudee (ophthalmology) for ocular WPI; Dr. Soulsby (orthopedics/dermatology) for physical WPI. Both reports were deemed reliable; no physician offered a comprehensive single-report rating. Applying the AMA’s Combined Values Chart is a ministerial, non-discretionary step once reliable percentages exist.
Distinguishing Adverse Authority: Magnetech barred factfinders from concocting a rating by cherry-picking discredited report components. Here, all selected percentages derive from reliable physicians, and the Board did not invent any new medical evaluations.

Impact

This decision clarifies the permissible scope of the Board’s evaluative process in complex multi-injury claims:

It affirms that specialty-specific impairment assessments may be combined to reach a total WPI, provided each rating is credible and the AMA Combined Values Chart is correctly applied.
Boards and courts will likely see fewer remands for additional single-physician evaluations in medically complex cases where no one expert covers all injured regions.
The ruling guides claim administrators, employers, and injured workers in anticipating how WPI thresholds will be calculated, promoting consistency and predictability in PTD eligibility determinations.

Complex Concepts Simplified

Whole Person Impairment (WPI): A numerical percentage representing the extent of a person’s permanent medical impairment, used in West Virginia to quantify permanent partial disability and to determine eligibility for permanent total disability benefits.
Combined Values Chart: A tool in the AMA’s Guides to the Evaluation of Permanent Impairment that merges two impairment percentages (A and B) into a single value using the formula A + B × (1 – A), ensuring the combined figure never exceeds 100%.
De Novo vs. Deference: Legal questions (interpretation of statutes or regulations) are reviewed anew by the appellate court, while factual determinations (credibility of medical opinions, choice among competing expert reports) are upheld unless clearly erroneous.
Apportionment: The process of separating how much of an impairment stems from a compensable injury versus preexisting or nonoccupational conditions.

Conclusion

Arch Coal, Inc. v. Howard solidifies the principle that when reliable medical opinions exist for separate body systems, the Board of Review may combine those impairment ratings—via the AMA Combined Values Chart—to calculate total WPI under West Virginia’s workers’ compensation framework. This decision promotes judicial efficiency and fairness in multi-injury cases, aligns with established statutory standards, and reinforces the deference accorded to expert medical findings. Employers and claimants now have clear guidance on the permissible methodology for assessing permanent impairments across specialties.