The West Virginia Supreme Court of Appeals is reviewing a workers' compensation dispute involving a Division of Highways employee who challenges the termination of his disability benefits and the denial of additional medical conditions related to his workplace injury.
Brian Lester filed an appeal with the state's highest court on Nov. 25, 2025, challenging a June 6, 2025, memorandum decision by the Intermediate Court of Appeals. The West Virginia Division of Highways has filed a timely response to Lester's petition.
The case stems from a Sept. 24, 2024, order by the Workers' Compensation Board of Review, which the intermediate appeals court affirmed. The board's decision had three key components that negatively affected Lester's workers' compensation claim.
First, the board closed Lester's claim for temporary total disability benefits. The decision was based on a finding that medical evidence did not indicate Lester continued to be disabled from his compensable injury. This closure effectively ended his ongoing disability payments.
Second, the board denied the addition of three medical conditions to Lester's claim as compensable conditions. These conditions include bilateral S1 radiculitis, thoracic myelopathy, and S1 sprain. Under workers' compensation law, compensable conditions are those injuries or medical issues that are directly related to a workplace incident and for which the employer's insurance must provide coverage.
Third, the board denied authorization for physical therapy treatment. This denial prevented Lester from receiving what he argued was necessary medical treatment for his work-related conditions.
The central issue before the Supreme Court is whether the Intermediate Court of Appeals erred in affirming the Workers' Compensation Board of Review's comprehensive order against Lester.
Lester's appeal focuses heavily on medical testimony from Rajesh Patel, M.D., who served as his treating surgeon. According to the court documents, Lester argues that Dr. Patel provided medical opinions that should have supported his claims.
Specifically, Lester contends that Dr. Patel opined that the preponderance of the evidence established that he developed S1 radiculitis, thoracic myelopathy, and sustained an S1 sprain as a direct result of his compensable workplace injury. In workers' compensation cases, the preponderance of evidence standard requires showing that it is more likely than not that the conditions are work-related.
Lester's legal argument emphasizes the special weight that should be given to his treating physician's opinions. He argues that Dr. Patel, as his treating surgeon, was in the best position to determine which diagnoses were related to the compensable injury and whether Lester continues to be disabled from work.
The treating physician rule in workers' compensation law generally gives significant deference to the opinions of doctors who have ongoing relationships with injured workers, as they are presumed to have the most comprehensive understanding of the patient's condition and its relationship to workplace injuries.
Regarding the denied physical therapy, Lester asserts that Dr. Patel's medical opinion established that the three disputed diagnoses require additional treatment. Based on this medical recommendation, Lester argues that physical therapy should have been approved as both reasonably related to his compensable injury and medically necessary for his treatment.
The case illustrates common disputes in workers' compensation law, where injured employees and their employers often disagree about the scope of compensable conditions and the duration of disability benefits. These disputes frequently turn on competing medical opinions about causation and the need for ongoing treatment.
Workers' compensation systems are designed to provide medical coverage and wage replacement for employees injured on the job, but determinations about which conditions are covered and for how long can be complex and contentious.
The Supreme Court's review will examine whether the lower courts properly applied legal standards for evaluating medical evidence in workers' compensation cases. The court will consider whether the Intermediate Court of Appeals gave appropriate weight to the treating physician's opinions versus other medical evidence in the record.
The outcome could affect how future workers' compensation cases handle disputes over the addition of related medical conditions to existing claims and the weight given to treating physicians' opinions about ongoing disability.
The case also highlights the multi-layered appeal process in West Virginia's workers' compensation system, where claimants can challenge adverse decisions through the Board of Review, then the Intermediate Court of Appeals, and finally the Supreme Court of Appeals.
Lester's case demonstrates the challenges injured workers face in proving that additional medical conditions are related to their original workplace injuries and in maintaining disability benefits over time as their medical conditions evolve.