Georgia-Pacific Corp. v. Dickens

GEORGIA-PACIFIC CORP. v. Laurin DICKENS

CA 97-74                                           ___ S.W.2d ___

                  Court of Appeals of Arkansas
                          Division III
              Opinion delivered September 10, 1997


1.   Workers' compensation -- reasonable and necessary treatment -- question of
     fact for Commisssion. -- What constitutes reasonable and necessary
     treatment under Arkansas Code Annotated  11-9-508 (a) (1996)
     is a question of fact for the Workers' Compensation
     Commission.

2.   Workers' compensation -- standard of review. -- When reviewing
     decisions from the Workers' Compensation Commission, the
     appellate court views the evidence and all reasonable
     inferences deducible therefrom in the light most favorable to
     the Commission's findings and affirms if supported by
     substantial evidence; the issue is not whether the court might
     have reached a different result from that reached by the
     Commission or whether the evidence would have supported a
     contrary finding; if reasonable minds could reach the result
     shown by the Commission's decision, the court must affirm the
     decision.

3.   Workers' compensation -- substantial evidence existed that appellee's
     follow-up medical care was reasonably necessary for treatment of
     compensable injury. -- Where, regarding appelleeþs motivation for
     seeking follow-up care, the Workers' Compensation Commission
     stated that the issue was whether she was entitled to the
     follow-up care, not her reasons for seeking it, and concluded
     that she was so entitled, the appellate court held that there
     was substantial evidence from which the Commission could find
     that appelleeþs follow-up medical care was reasonably
     necessary for treatment of her compensable injury.


     Appeal from the Workers' Compensation Commission; affirmed.
     Wright, Lindsey & Jennings, by:  John D. Davis, for appellant.
     Compton, Prewett, Thomas & Hickey, P.A., by:  Floyd M. Thomas,
Jr., for appellee.

     Andree Layton Roaf, Judge.
     Georgia-Pacific Corporation appeals a ruling by the Workersþ
Compensation Commission that the appellee Laurin P. Dickens was
entitled to compensation for routine medical care provided to her
in 1993, 1994, and 1995, for a compensable injury which she
sustained in 1984.  On appeal, Georgia-Pacific argues that there is
no substantial evidence to support the Commissionþs findings 1)
that the medical care was reasonably necessary for the treatment of
Dickensþs injury, and 2) that Dickensþs claim, which was filed in
1995 for additional benefits, is not barred by the statute of
limitations.  We affirm.
     Dickens sustained a compensable right elbow injury in 1984. 
Surgery was performed on her elbow in 1986, 1988, and 1989, and
Dickens returned to work at Georgia-Pacific in 1989.  In 1991, her
treating physician determined that her healing period had ended and
assigned a permanent impairment rating to her right elbow and
shoulder.  Although Dickens was administratively terminated by
Georgia-Pacific in 1992, the company continued to pay for Dickensþs
routine follow-up visits to the University of Arkansas for Medical
Sciences (UAMS) in 1992 and 1993.
     On March 12, 1993, the administrative law judge (ALJ) issued
an opinion in a separate claim, finding that Dickens had not
sustained a right shoulder injury in addition to her compensable
right elbow injury.  Dickens did not appeal that ruling. 
Subsequently, Georgia-Pacific paid for Dickensþs May 21, 1993,
visit to UAMS for treatment of her elbow, but failed to pay for any
further visits, although they acknowledged that they had received
bills for Dickensþs office visits on April 21, 1994, and March 31,
1995.  Dickens was not charged for a visit on November 4, 1993,
and, therefore, no bill was sent by UAMS for this service.
     After receiving the bill for the March 31, 1995, examination,
Georgia-Pacific sent a letter to Dickens on May 18, 1995, informing
her that they would not pay any additional medical bills because
the statute of limitations had run on her workersþ compensation
claim.  Dickens filed a claim on May 24, 1995, for additional
benefits, which gives rise to this appeal.   
     The ALJ denied Dickensþs claim for additional benefits,
finding that the medical services provided on November 4, 1993, and
April 21, 1994, did not constitute reasonably necessary medical
treatment because the record reflected that Dickensþs visits to
UAMS at approximately six-month intervals were for the purpose of
keeping her workersþ compensation claim open.  The ALJ also found
that Dickensþs claim filed in 1995 was barred by the statute of
limitations, because the visits in 1993 and 1994 were not
reasonably necessary for the treatment of her injury and thus did
not toll the statute of limitations.
     The Commission reversed the decision of the ALJ, finding that
the medical care provided to Dickens in 1993, 1994, and 1995, was
reasonably necessary for treatment of her compensable injury.  The
Commission also found that the statute of limitations had not run
on Dickensþs claim because Georgia-Pacific was deemed to have
continued to provide medical treatment to Dickens until they
informed her that they would no longer do so in the letter of May
1995.
     Georgia-Pacific first argues that there is not substantial
evidence to support the Commission's finding that Dickens's visits
to UAMS on November 4, 1993, and April 21, 1994, were reasonably
necessary for the treatment of her injury.  Arkansas Code Annotated
 11-9-508 (a) (1996) states that an employer shall provide þsuch
medical . . . services . . . as may be reasonably necessary in
connection with the injury received by the employee.þ  What
constitutes reasonable and necessary treatment under this section
is a question of fact for the Commission. Gansky v. Hi-Tech Engþg,
325 Ark. 163, 924 S.W.2d 790 (1996) (citing Arkansas Dep't of
Correction v. Holybee, 46 Ark. App. 232, 878 S.W.2d 420 (1994));
see also Morgan v. Desha County Tax Assessor's Office, 45 Ark. App.
95, 871 S.W.2d 429 (1994).
     It is well settled that when reviewing decisions from the
Workers' Compensation Commission, this court views the evidence and
all reasonable inferences deducible therefrom in the light most
favorable to the Commission's findings and affirms if supported by
substantial evidence.  Crawford v. Pace Indus., 55 Ark. App. 60,
929 S.W.2d 727 (1996) (citing Welch's Laundry & Cleaners v. Clark,
38 Ark. App. 223, 832 S.W.2d 283 (1992)).  The issue is not whether
this court might have reached a different result from that reached
by the Commission or whether the evidence would have supported a
contrary finding.  If reasonable minds could reach the result shown
by the Commission's decision, the court must affirm the decision.
Bradley v. Alumax, 50 Ark. App. 13, 899 S.W.2d 850 (1995).
     In support of its argument that the visits were not reasonably
necessary for the treatment of the 1984 injury, Georgia-Pacific
relies upon the testimony of Dickens and upon notes made by the
treating physicians during the disputed medical visits.  During the
hearing before the ALJ, Dickens testified that she began seeing the
doctor at six-month intervals because she was advised by her
attorney that she should always go back to the doctor every six
months until her workersþ compensation claim was settled.
     The medical records of the office visits in dispute state in
part:     

     November 4, 1993:  Ms. Dickens RTC here today for follow
     up of right cubital tunnel syndrome. . . .  She has been
     given a permanent impairment rating.  She thinks she is
     about the same. . . .  She is still a little tender about
     the elbow and there is no really appreciable Tinel. 
     Status about the same with s/p anterior transposition of
     ulnar nerve.  RTC six months for follow up.  

     April 24, 1994: Pt. is being followed on a bi-annual
     basis until her Workerþs Compensation claim is settled. 
     PE - She is no better or worse than she was six months
     ago.  She has a slight pain around the cubital tunnel
     area, tenderness proximally and Tinel sign at Guyonþs
     canal. . . .  We will see this pt. again in six months
     for repeat clinical exam.
     
     December 4, 1994: . . . This is a workmanþs compensation
     case and settlement has not been completed.  She has
     symptoms of numbness to the ulnar distribution
     bilaterally, and it has remained stable.  She is
     complaining of some new pain in the right shoulder.... 
     Stable post-op course s/p bilateral cubital tunnel
     release.  Due to her previous treatment by Dr. Hixson, I
     recommended to her that she should be followed by Dr.
     Hixson and a referral will be made for her to see Dr.
     Hixson.  She will also be referred to Dr. Tom Roberts in
     the shoulder clinic.
     
     March 31, 1995:  Ms. Dickens was reexamined on March 30,
     1995.  Her injury appears to be stable since my last
     examination.  Her main complaints are those of right
     elbow and shoulder pain and irritation along the course
     of the ulnar nerve. . . .  She still uses her TENS unit
     and takes medication for her pain. . . .  Ms. Dickens has
     remained approximately stable since her last
     examination....  I will be happy to examine her on an as-
     needed basis.
     Dickens also testified at length about ongoing problems with
her elbow, and stated that she continued to take medication and to
use a TENS unit for pain.  She testified that her treating
physician advised her to return every six months, or earlier, if
she had any problems.
     In fact, the disputed visits were at intervals of six, six,
eight, and three months, respectively.  The records describe the
ongoing nature of Dickensþs symptoms, and indicate that she
continued to use a TENS unit and take medication.  In its decision,
the Commission considered the multiple surgeries, Dickensþs
persistent symptoms of pain, irritation, and limitation of motion
in her elbow, and her continued use of medication and a TENS unit
for pain control, in finding that the office visits to UAMS in 1993
through 1995 were reasonably necessary.  The Commission further
found that the medical evidence indicated that Dickens received
examinations, diagnoses, and proposals for additional follow-up
treatment during each of the disputed office visits.
     As to Dickensþs motivation for seeking follow-up care, the
Commission stated that the issue was whether she was entitled to
the follow-up care, not her reasons for seeking it, and concluded
that she was so entitled.  We agree, and hold that there was
substantial evidence from which the Commission could find that
Dickensþs follow-up medical care was reasonably necessary for
treatment of her compensable injury.
     Although Georgia-Pacific also argues that there is not
substantial evidence to support the Commission's finding that
Dickensþs claim for additional benefits is not barred by the
statute of limitations, it concedes that this court should not
reach this argument if we affirm the Commissionþs findings on its
first point on appeal.  In so doing, Georgia-Pacific acknowledges
that it þcannot start the running of the statute of limitations by
refusing to pay what it owes.þ  See Conway Printing Co. v. Higdon,
45 Ark. App. 188-A, 878 S.W.2d 4 (1994).
     Affirmed.
     Jennings and Meads, JJ., agree.