Pain Following Asymptomatic Condition Points to Treatment Need for Workplace Injury

November 26, 2025

Case File

A worker had a preexisting knee problem that was asymptomatic, but the pain he experienced after a workplace injury meant that he had a viable workers' compensation claim for treatment. Simply Research subscribers have access to the full text of the decision.

Case

Comas v. Bass Pro Group, LLC, No. 24-290 (W. Va. 11/12/25)

What Happened?

A retail worker injured his left knee after he slipped and fell on a wet concrete loading dock at work. X-rays showed the existence of mild degenerative joint disease but no fracture.

Later, a nurse practitioner opined that the worker might have had a medical meniscus tear and advised the worker to elevate the left knee and apply ice. The worker was placed on light-duty restrictions at work, and therapy was ordered and approved by the claim administrator.

An MRI revealed degenerative tearing of the posterior horn of medial meniscus with associated mild cartilage loss and osseous edema.

The claim administrator held the worker's claim compensable for left knee sprain and authorized an orthopedic consultation. The orthopedic physician diagnosed the worker with an acute medial meniscus tear and osteoarthritis.

The claims administrator denied authorization for left knee arthroscopy. The Board of Review affirmed the claim administrator order and, without addressing whether the meniscal tear was related to the worker's work-related injury, stating that the compensable condition of the claim was left knee sprain, surgery was an inappropriate, and the requested treatment was not medically related and reasonably required for the compensable injury.

The Intermediate Court of Appeals affirmed, so the worker appealed to the West Virginia Supreme Court of Appeals.

Rule of Law

Under West Virginia law, as announced in Moore v. ICG Tygart Valley, LLC, 879 S.E. 2d (W. Va. 2022), a when a preexisting condition is involved, 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.

(2) Following the injury, the symptoms of the disabling disease or condition appeared and continuously manifested themselves afterwards.

What the West Virginia Supreme Court of Appeals Said

The court agreed with the worker that unrefuted evidence showed that the meniscus tear was asymptomatic until he fell and twisted his knee at work and that afterword, he experienced continuous pain and swelling despite undergoing conservative treatments.

The court found that the Moore holding required the BOR to consider that the unrefuted evidence showed that prior to the workplace injury, the meniscal tear of the left knee was asymptomatic, and following the injury, the worker experienced continuous pain, swelling, and discomfort.

Verdict: The court reversed the ICA decision and remanded to the BOR.

Takeaway

A preexisting injury may not defeat compensability for treatment in West Virginia if it was asymptomatic before the workplace injury but became symptomatic after.