Ritter Communications v. Roger Rhea

 Annotate this Case
Download PDF
ARKANSAS COURT OF APPEALS  NOT DESIGNATED FOR PUBLICATION  SARAH J. HEFFLEY, JUDGE  DIVISION I  CA 07­563  December 19, 2007  RITTER COMMUNICATIONS APPELLANT  APPEAL  FROM  THE  ARKANSAS  W O R K E R S ’   C O M P E N S A T I O N  COMMISSION  [NO. F601584]  V. ROGER RHEA  AFFIRMED  APPELLEE  The appellant, Ritter Communications, appeals a finding of the Workers’ Compensation  Commission  that  a  second  surgery is  reasonable  and  necessary  for  the  treatment  of  appellee’s  compensable injury. Appellant argues that substantial evidence does not support the Commission’s  decision.  We affirm.  Appellee, Roger Rhea, is employed by appellant as a telecommunications technician.  On  January 20, 2006, appellee was installing wire from inside a cage that was perched atop a forklift,  six feet off the ground, when the cage fell off the forklift.  Appellee, who is right­hand dominant,  1  sustained lacerations to the first, second, and third fingers of his left hand.  He was taken to the  emergency room and received stitches  in all three fingers. 1  Appellee also injured his right shoulder, but this litigation does not involve that injury.  Most prominent was the laceration to appellee’s left middle finger.  Within days of the  accident, he was seen by his family physician, who referred him to Dr. Henry Stroope, an orthopedic  surgeon.  Dr. Stroope reported in regards to the left middle finger an obvious transection of the  flexor digitorum profundus tendon in Zone 2 with intact flexor digitorum superficialis function. He  referred appellee to Dr. Michael Moore, a hand specialist, for consideration of the repair of the flexor  digitorum profundus tendon.  On February 1, 2006, Dr. Moore performed surgery to repair the left long finger FDP tendon.  Dr. Moore wrote the following in his operative report.  Mr. Rhea is a pleasant gentleman who sustained a laceration over the  volar aspect of the left long finger approximately 1 ½ weeks ago.  Since this incident, he has not been able to flex the DIP joint.  The  sensation in his finger is intact.  There is a transverse wound just  proximal to the PIP joint flexion crease.  The wound is clean and  without evidence of infection.  Mr. Rhea is admitted for repair of the  left  long finger  FDP  tendon.  The  indications,  risk  and  potential  complications  of  surgical  treatment  were  discussed.    The  complications include but are not limited to neurovascular injury,  infection,  finger  stiffness  and  reflex  sympathetic  dystrophy.    In  addition, Mr. Rhea understands that there is a chance that he may  require a flexor tenolysis following healing of the flexor tendon.  Appellee was seen by Dr. Moore for follow­up care on February 6, 2006.  Dr. Moore sent appellee  to occupational therapy for PROM exercises as per the Duran protocol, which appellee attended  three times a week from February 13 to February 24, and from April 5 to April 26.  Appellee was seen by Dr. Moore on February 16 and again on March 30.  In a letter to  appellant’s plan administrator on March 30, Dr. Moore noted that it had been two months since  appellee’s surgery and that although his pain had subsided he still had residual stiffness in his fingers  and limited active motion of the left long finger DIP joint.    In another letter dated April 26, Dr.  Moore  wrote  that appellee had regained full passive motion of the  left long finger  but that he ­2­  CA 07­563  continued  to  have  limited  active  motion  in  that  finger.    He  discussed  treatment  options  with  appellee,  which  included  accepting  the  final  result  of  stiffness  and  limited  active  motion,  or  proceeding with a left long finger flexor tenolysis.  Dr. Moore reported that appellee had chosen to  undergo surgery which was planned for June.  At the request of appellant’s plan administrator, appellee was seen by Dr. David M. Rhodes  on June 5.  Dr. Rhodes noted that appellee had an active range of motion of the left long finger of  0 to 82 degrees at the PIP joint with a passive range of motion there of 0 to 98 degrees.  At the DIP  joint, appellee had no active range of motion with a passive range of motion of 0 to 60 degrees.  In  terms of a plan, Dr. Rhodes stated in his report:  I told the patient that there is a possibility of adhesion formation  versus  a  possible  failure  of  repair  of  the  FDP  tendon.    I  would  recommend  that  the  patient  continue  with  therapy  to  possibly  increase his range of motion.  If after a few more months of therapy,  he still lacks range of motion then he may opt for a tenolysis at that  time.  Appellee returned to Dr. Moore for a check up on July 20, 2006.  During this visit, Dr.  Moore noted that appellee had completed his therapy program and that he continued to have limited  active motion of the left long finger.  Dr. Moore further noted that appellee desired to regain more  motion in the left long finger and wanted to proceed with a flexor tenolysis.  In a September 8 letter  to the plan administrator, Dr. Moore wrote:  Following surgery, he developed residual stiffness at the DIP joint,  which is not uncommon following flexor tendon surgery.  Mr. Rhea  has completed therapy treatments.  The treatment options at this point are to accept the final result or  proceed with a left long finger flexor digitorum profundus tenolysis,  which may improve the active motion of the finger.  The surgery is  elective in the sense that Mr. Rhea has the option of accepting the  final  result  or  proceeding  with  treatment  that  may  improve  the ­3­  CA 07­563  motion of the finger. He felt that the limited motion of the finger did  significantly  affect  the  function  of  his  left  hand.  Therefore,  he  elected to proceed with the flexor tenloysis, which is a reasonable  treatment option.  In addition, the tenolysis is necessary in order to  improve the motion of the left long finger. Mr. Rhea understands the  risks of surgery, which include flexor tendon rupture, neurovascular  injury,  infection,  and  residual  finger  stiffness.    Furthermore,  he  understands  that  the  surgery  may  not  significantly  improve  the  motion in the long finger.  Following a discussion of the treatment  options and risk of surgery, Mr. Rhea felt the benefit of potentially  improving the left long finger motion was worth the risk of surgery.  These statements are made within a reasonable degree of medical  certainty.  Dr. William C. Collins, who had thirty­five years of experience in hand surgery, reviewed  appellee’s  medical  records.  In  a  one­page  report  written  in  October  2006,  he  expressed  the  following opinions:  It is my considered opinion that any tendon repair may be offered a  tenolysis to improve function, but in a patient with an intact and well  functioning sublimis tendon the patient should be  sure that he is  willing to run the risk of actual decrease in the flexor function of this  digit from additional surgery.  If the patient were a guitar picker, violinist, or had other specific DIP  joint needs, he might think it worth the risk, otherwise he might best  be served by accepting this minimal limitation and substituting for  this problem with other adaptive means.  The hearing before the administrative law judge was held on November 3, 2006.  Appellee  had returned to work, but he testified that the joint was stiff and that he was not able to touch his  palm with his left middle finger.  In describing his work, he stated:  Every part of my job requires I use my hands.  Manipulating small  telephone  wires  into  tight  spaces,  connect  blocks,  very  small,  delicate  instruments and screws, connections in tight, very tight  spaces, sometimes where you can’t get in with your right hand, you  have to use your left hand.  You have to guarantee use of both left  and  right  hands.    I  am  right  handed.    I  use  both  hands  as  a  communications specialist.  There is delicate work that is required ­4­  CA 07­563  in my job using my left hand. ... The dexterity involved with placing  wires into connections and putting them into a form and connect box  requires the use of all your fingers.  Appellee further testified that the lack of range of motion in his left long finger slowed him down  in his work.  He also said it was his understanding from the outset that two surgical procedures  would  be  performed.  Appellee  understood  that  the  tenolysis  might  not  succeed  and  that  the  procedure may result in decreased range of motion, but he believed that the benefit of improving the  range of motion in his finger would give him the ability to do his job better.  Appellee also testified  that therapy had helped, and he continued to do exercises at home.  He was not aware that Dr.  Rhodes had recommended more therapy before proceeding with surgery.  The  administrative  law  judge  found  that  the  tenolysis  procedure  was  reasonable  and  necessary for the treatment of appellee’s injury, and the Commission affirmed and adopted that  decision.  Appellant  contends  that  the  Commission’s  decision  is  not  supported  by  substantial  evidence.  Appellant argues that the surgery only has a chance of improving appellee’s condition  and that it might make his condition worse.  Appellant also maintains that the better course of  treatment was additional occupational therapy.  Under Arkansas law, the employer must “promptly provide for an injured employee such  medical, surgical ... services and medicine as may be reasonably necessary in connection with the  injury received by the employee.”  Ark. Code Ann. § 11­9­508(a) (Supp. 2007).  The employee has  the burden of proving by a preponderance of the evidence that medical treatment is reasonable and  necessary.  Wal­Mart Stores, Inc. v. Brown, 82 Ark. App. 600, 120 S.W.3d 153 (2000).  What  constitutes reasonably necessary treatment under the statute is a question of fact for the Commission  to decide.  Hamilton v. Gregory Trucking, 90 Ark. App. 248, 205 S.W.3d 181 (2005). ­5­  CA 07­563  In  reviewing  decisions  from  the  Commission,  we  view  the  evidence  in  the  light  most  favorable to the Commission’s findings, and we affirm if the decision is supported by substantial  evidence.  Smith v. City of Fort Smith, 84 Ark. App. 430, 143 S.W.3d 593 (2004).  If reasonable  minds  could  reach  the  conclusion  of  the  Commission,  its  decision  must  be  affirmed.  KII  Construction Co. v. Crabtree, 78 Ark. App. 222, 79 S.W.3d 414 (2002).  The Commission has the  authority to accept or reject medical opinions, and its resolution of the medical evidence has the  force and effect of a jury verdict.  Poulan Weed Eater v. Marshall, 79 Ark. App. 129, 84 S.W.3d 878  (2002).  In this case, appellee’s injury and first surgical procedure left him with a marked decrease  in the range of motion in his left middle finger that impaired his ability to perform his job.  The  Commission accepted the opinion of Dr. Moore that the tenolysis procedure was both reasonable  and necessary, giving his opinion more weight than those offered by Drs. Rhodes and Collins, upon  which appellant’s argument relies.  The Commission resolved the conflict in the medical evidence  in appellee’s favor, and thus we are not able to say that the Commission’s decision is not supported  by substantial evidence.  Accordingly, we affirm.  Affirmed.  GLOVER  and BAKER, JJ., agree. ­6­  CA 07­563 

Some case metadata and case summaries were written with the help of AI, which can produce inaccuracies. You should read the full case before relying on it for legal research purposes.

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.