The Supreme Court of Appeals of West Virginia held that where a claimant delays the filing of a workers’ compensation death benefits claim because she was unaware, and could not have learned through reasonable diligence, that her husband’s cause of death was work-related, and the delay was due to the medical examiner completing and making available an autopsy report, the six-month time limitation on filing a claim in West Virginia Code § 23–4–15(a)  is tolled until the claimant, through reasonable diligence, could have learned of the autopsy report finding that the decedent’s death was, in any material degree, contributed to by an injury or disease that arose in the course of and resulting from the decedent’s employment [see Sheena H. v. West Va. Office of Ins. Comm’r, 2015 W. Va. 521 (Apr. 10, 2015)]. The high court acknowledged that no such exception existed in the statute, but added that it was the duty of a court to disregard a construction, though apparently warranted by the literal sense of the words in a statute, when such construction would lead to injustice and absurdity.
Mr. H., a coal miner, suffered a work-related injury in 2009, when a wrench fell from a coal mine’s ceiling and hit him on the head. He remained unconscious for one minute and had a golf-ball-size knot on his head. Even though he was transported to the local hospital, neither he, his employer, nor his treating physicians recognized the magnitude of the injury. Mr. H did not stay in the hospital overnight. The treating physicians prescribed pain medication and told him to return to the walk-in clinic for a follow up visit if he deemed it necessary. He did not seek additional medical treatment for this injury or for health-related issues arising out of the injury. Mr. H. returned to work a couple of days later, and in May 2009, his claim for temporary total disability benefits was closed because he was off work for less than three days.
Twenty-one months later, Mr. H. died in his sleep. The medical examiner performed an autopsy on Mr. H. the following day but, for unknown reasons, the autopsy report was not completed and made available to Mr. H’s family until more than eight months after his death. The autopsy report declared that Mr. H’s 2010 death was the result of a traumatic seizure disorder that stemmed from the 2009 work-related injury. Claimant then filed a claim on behalf of Mr. H’s minor child. The Workers’ Compensation Office of Judges affirmed the claims administrator denial of the claim on the ground that the application was filed more than six months after Mr. H’s death. The Workers’ Compensation Board of Review affirmed the Office of Judges and claimant appealed.
Insurance Commissioner’s Position Might Lead to Absurd Result
The Court held that the insurance commissioner’s argument that West Virginia Code § 23–4–15(a)‘s time limitation could never be tolled was inconsistent with other provisions in the Workers’ Compensation Act and that adopting the commissioner’s position would bring about an “absurd and unjust result” that was surely unintended by the Legislature.
The Court attempted to narrow its ruling by cautioning that the six-month time limitation was jurisdictional and a condition of the right to compensation under the Act. It added that the appeal did not encompass whether there was sufficient, credible evidence linking Mr. H’s death to the work-related injury or whether Mr. H’s family should have reasonably known at the time of his death that the cause of death was work-related. On remand, the parties would have the opportunity to develop those issues.