Temperance Hill Logging and Bituminous Casualty Corporation v. Lester Parker

ARKANSAS COURT OF APPEALS

NOT DESIGNATED FOR PUBLICATION

JOHN B. ROBBINS, JUDGE

DIVISION IV

TEMPERANCE HILL LOGGING and

BITUMINOUS CASUALTY

CORPORATION

APPELLANTS

V.

LESTER PARKER

APPELLEE

CA 02-271

NOVEMBER 13, 2002

APPEAL FROM THE WORKERS'

COMPENSATION COMMISSION

[NO. F013379]

AFFIRMED

Appellee Lester Parker sustained an injury to his right knee while working for appellant Temperance Hill Logging on November 1, 2000. Mr. Parker's workers' compensation claim was controverted by appellants, but after a hearing the Commission found that the injury was compensable and that Mr. Parker is entitled to continuing medical treatment and temporary total disability benefits through a date yet to be determined. On appeal, Temperance Hill Logging does not challenge the Commission's finding of compensability. Rather, appellants argue that the Commission erred in awarding medical and TTD benefits beyond January 24, 2001. We affirm.

This court reviews decisions of the Arkansas Workers' Compensation Commission to see if they are supported by substantial evidence. Smith v. County Market/Southeast Foods, 73 Ark. App. 333, 44 S.W.3d 737 (2001). Substantial evidence is that relevantevidence

which a reasonable mind might accept as adequate to support a conclusion. Wheeler Constr. Co. v. Armstrong, 73 Ark. App. 146, 41 S.W.3d 822 (2001). If reasonable minds could reach the result found by the Commission, we must affirm the decision. Wal-Mart Stores, Inc. v. Brown, 73 Ark. App. 174, 40 S.W.3d 835 (2001).

At the hearing held June 7, 2001, Mr. Parker testified that he worked for Temperance Hill Logging moving logs with a skidder. On November 1, 2000, he was working in that capacity when his right leg was pinched by a log that had come through the open door of the skidder. Mr. Parker stated, "When the log hit my knee, I thought it had broke." The incident occurred at around noon and he reported it to his supervisor. Mr. Parker worked until 2:00 p.m. that day, and worked two more days before seeking medical attention. He has not worked since.

After visiting the Cabun Clinic and having his knee wrapped, Mr. Parker was referred to an orthopaedic specialist, Dr. Dwayne Daniels. Mr. Parker testified that his knee has not progressed since he has been seeing Dr. Daniels, and that it "goes out on him" when he walks. He further testified that he experiences steady pain and swelling at night. He was later referred to Dr. James Mulhollan, but indicated that no surgery was scheduled because it was not accepted by the workers' compensation insurance carrier. Mr. Parker testified that he is still unable to work.

Mr. Parker acknowledged having past knee problems for which he sought treatment. However, he stated that he was not having continued problems with swelling before the work-related accident. He further testified that he had no problem walking on his kneebefore the accident. Mr. Parker stated, "It sometimes gave me problems, but not much."

In regard to Mr. Parker's pre-existing knee problems, an April 6, 1999, medical report documented "internal derangement" and "laxity of the right knee without evidence of any swelling, redness, or tenderness." On May 28, 1999, it was reported that, "He apparently buckled his right knee and fell onto his left knee sustaining an injury approximately one week ago." On June 15, 2000, Mr. Parker visited a doctor complaining of "right knee pain for several weeks."

Soon after the compensable injury, an x-ray of Mr. Parker's knee revealed "possible internal derangement." On November 15, 2000, Dr. Daniels reported that x-rays of the knee were within normal limits except for a possible bone chip, and he suspected "anterior cruciate ligament disruption with possible medial meniscus damage." However, after reviewing a subsequent MRI, Dr. Daniels reported on November 20, 2000, that there was no evidence of an ACL tear or medial meniscus damage. He diagnosed a sprain of the right medial collateral ligament.

In a letter to Mr. Parker dated January 24, 2001, Dr. Daniels stated:

Your medial collateral ligament in your right knee still continues to demonstrate some laxity. I don't think it is fully healed. You need to continue to wear your hinged-knee brace at all times, especially when weightbearing on your right leg. Hopefully, the Vioxx samples will help with the inflammatory pain that you have had. I would not be surprised that you would not be able to continue on with your former type of employment where you were quite active on your leg for at least another three months.

In a letter to Dr. Mulhollan dated March 14, 2001, Dr. Daniels stated that Mr. Parker is still having problems with his knee and that he may be a candidate for MCLreconstruction, but that he has no experience performing that procedure and "would rather have someone like you take care of that." Dr. Mulhollan examined Mr. Parker soon thereafter, and found his right knee to be very abnormal. After conducting an MRI, Dr. Mulhollan detected a torn MCL and deficient ACL. He reported:

I think the appropriate care for your knee is to examine it under general anesthesia and then perform an arthroscopy. I think you should have a medial meniscectomy if that structure is indeed torn. I think that if the anterior cruciate ligament is deficient it should be reconstructed. I doubt that the medial collateral ligament will need to be repaired, at least if the remainder of these problems are taken care of. Needless to say, this is quite a bit of treatment, and it will be relatively expensive.

In his deposition, Dr. Daniels testified that the most common cause for MCL sprain is trauma to the knee and that the normal healing period "can be upwards of six months." Although Dr. Mulhollan reported that he doubted the MCL will need to be repaired, Dr. Daniels testified that orthopaedic literature indicates that "if you tighten the ACL, the MCL gets well." He further testified that Mr. Parker has an MCL-deficient knee and that, "I think Dr. Mulhollan is trying to get around fixing the MCL by thinking all he has to do is tighten the ACL and the MCL will heal."

For reversal, Temperance Hill Logging contends that the Commission erred in awarding medical and TTD benefits beyond January 24, 2001. Pursuant to Ark. Code Ann. § 11-9-508(a) (Repl. 2002), an employer is responsible for medical services that are reasonably necessary in connection with the employee's injury, and what constitutes reasonable and necessary treatment under this statute is a question of fact for the Commission. Geo Specialty Chem. Inc. v. Clingan, 69 Ark. App. 369, 13 S.W.3d 218(2000). In this case the Commission found the injury to be a scheduled one, and under such circumstances the claimant is entitled to TTD benefits during his healing period or until he returns to work. See Wheeler Constr. Co. v. Armstrong, supra. The appellants argue that the compensable injury was only a temporary aggravation of a pre-existing knee condition, and that as of January 24, 2001, the aggravation had resolved, and thus Mr. Parker was no longer in his healing period. Appellants further maintain that any additional treatment is for conditions unrelated to the compensable incident. Thus, appellants assert, the award of continuing TTD benefits and medical treatment must be reversed.

In their brief, appellants note that the problems of internal derangement and joint laxity of the right knee were documented before the compensable injury occurred. Appellants further assert that evidence of an ACL deficiency was not noted in the original MRI conducted after the compensable injury, and submit that it should not be responsible for any related treatment. As for the duration of Mr. Parker's healing period, appellants direct us to Dr. Daniels's testimony that, on January 24, 2001, Mr. Parker "seemed to have plateaued." Finally, appellants submit that this case requires reversal because, as the Commission noted in its opinion, Mr. Parker was untruthful in his communications with Dr. Daniels and in his deposition about his prior knee problems.

We hold that substantial evidence supports the Commission's finding that Mr. Parker remains in his healing period and is entitled to additional treatment for his compensable injury. Although Dr. Daniels testified that Mr. Parker's condition had "plateaued" on January 24, 2001, contrary to appellants' position, he did not state that Mr. Parker was nota surgical candidate. In his letter to Dr. Mulhollan dated March 14, 2001, he gave the opinion that Mr. Parker may be a candidate for MCL reconstruction, and in his deposition he reiterated this opinion. The Commission found that Dr. Daniels's statement that the condition had plateaued was not an opinion that the healing period had ended, but only that conservative treatment had failed, and the evidence supports this conclusion. In his January 24, 2001, letter to Mr. Parker, Dr. Daniels clearly suggested that the healing period had not ended because he informed Mr. Parker that he might be unable to return to employment for at least another three months. This demonstrated the opinion that further treatment could help resolve the injury. If Dr. Daniels thought nothing further in the way of treatment could help resolve the knee condition, surely he would not have referred Mr. Parker to Dr. Mulhollan for further treatment.

Since there was substantial evidence that Mr. Parker remains in his healing period, there was substantial evidence to support an award for additional medical treatment to resolve his compensable condition. Although Dr. Mulhollan proposed a procedure to repair an ACL injury, Dr. Daniels gave the opinion that this procedure is also capable of resolving the compensable MCL injury. Dr. Mulhollan also proposed an arthroscopy to further diagnose Mr. Parker's knee, and in light of the failed conservative treatment, such a procedure was properly authorized by the Commission. Mr. Parker testified that his prior knee condition caused no significant problems, but that since the accident at work he has been unable to return to employment due to his limitations. Mr. Parker continues to suffer from an MCL injury related to the trauma sustained at work, and we affirm theCommission's award for continuing TTD and reasonable and necessary medical benefits associated with the work-related injury.

As for appellants' contention that Mr. Parker's lack of credibility mandates reversal, we agree with Mr. Parker that his credibility goes more to whether a compensable injury occurred than to the extent of benefits to which he is entitled. There was ample medical evidence before the Commission documenting the pre-existing knee condition, so the Commission was presented with sufficient evidence to determine whether Mr. Parker's continuing need for treatment was the result of the compensable injury or instead related to the prior condition. Since compensability is not at issue on appeal, the credibility concerns expressed in the Commission's opinion do not affect our disposition of this case.

Affirmed.

Vaught and Baker, JJ., agree.