Betty Fletcher v. Baxter County Regional Hospital and Risk Management Resources

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March 31, 2004


[NO. F003312]


Robert J. Gladwin, Judge

Appellant Betty Fletcher appeals from a decision of the Workers' Compensation Commission finding that she failed to prove by a preponderance of the evidence that the total knee replacement surgery performed by Dr. Doug Foster was reasonably necessary treatment for her compensable injury. On appeal, appellant argues that the Commission erred in failing to make specific findings of fact in regard to a particular issue and that the Commission's decision denying benefits was not supported by substantial evidence. We affirm.

Appellant sustained a compensable injury to her knee on March 13, 2000, while she was employed by the appellee hospital as a nurse's aide. Appellant was treated by Dr. Foster, who performed arthroscopic surgery to repair a meniscal tear on April 3, 2000. Appellees accepted liability for the meniscal repair surgery. Dr. Foster later performed the total knee replacement surgery at issue on November 19, 2000.

When appellant sought medical benefits for the total knee replacement surgery and permanent partial disability benefits, appellees controverted the claim. The Administrative

Law Judge found that appellees were liable for appellant's knee replacement surgery and for associated benefits. In reversing the ALJ, the Commission found that knee replacement surgery was not reasonably necessary treatment for the compensable injury suffered by appellant.

Appellant first contends that the Commission erred in failing to make specific findings of fact on her argument that her twenty-seven years of work for the appellee hospital contributed to her preexisting arthritis and combined with the compensable knee injury to require the total knee replacement surgery. We disagree. The law requires that the Commission render findings adequate for appellate review; this does not require the Commission to render findings on every conceivable point of contention and dispute between the parties. Williams v. Prostaff Temporaries, 64 Ark. App. 128, 979 S.W.2d 911 (1998). Here the Commission made specific findings and discussed several reasons in support of its decision, and these findings were adequate for appellate review.

Appellant's second argument is that there is no substantial evidence to overcome the finding that appellant's twenty-seven-year employment with the appellee hospital combined with the compensable injury to require the total knee replacement surgery. There is no such finding on the record, and no burden on appellees to overcome such. We agree with appellees' statement that the record is completely void of any evidence demonstrating that the length of appellant's employment had any effect on her compensable injury or need for surgery.

Even if we give appellant the benefit of the doubt and assume that her second argument challenges whether the decision of the Commission is supported by substantial evidence, we must affirm. In determining the sufficiency of the evidence to support the findings of the Workers' Compensation Commission, we view the evidence and all reasonable inferences deducible therefrom in the light most favorable to the Commission's findings, and we will affirm if those findings are supported by substantial evidence. Winslow v. D & B Mech. Contrs., 69 Ark. App. 285, 13 S.W.3d 180 (2000). Substantial evidence is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion. Id. Where the Commission denies benefits because the claimant has failed to meet his burden of proof, the substantial-evidence standard of review requires us to affirm if the Commission's decision displays a substantial basis for the denial of relief. Hill v. Baptist Med. Ctr., 74 Ark. App. 250, 48 S.W.3d 544 (2001). A substantial basis exists if fair-minded persons could reach the same conclusion when considering the same facts. Id. The issue is not whether the appellate court might have reached a different result or whether the evidence would have supported a contrary finding; if reasonable minds could reach the Commission's conclusion, then we must affirm. Id. The Commission has the authority to accept or reject medical opinion and the authority to determine its medical soundness and probative force. Id.

Arkansas Code Annotated section 11-9-508 (Repl. 1996) states that employers must provide all medical treatment that is reasonably necessary for the treatment of a compensable injury. What constitutes reasonably necessary treatment under this statute is a question of fact for the Commission. Id.

The Commission found that appellant had failed to establish by a preponderance of the evidence that the total knee replacement surgery was reasonably necessary to treat her work-related injury. In support of this decision, the Commission cited five reasons: 1) the Commission interpreted Dr. Foster's testimony to mean that the surgery was necessary mainly because of a preexisting degenerative chondromalacia condition in appellant's knee; 2) Dr. Foster acknowledged that appellant elected to have the knee replacement surgery, and that he agreed to perform the surgery when he did because of appellant's concern that she would soon be losing group insurance coverage; 3) a written report by Dr. Lowry Barnes, an orthopedic specialist who reviewed appellant's records, indicated that appellant did not have significant trauma to the knee to lead to significant enough post-traumatic arthritis so that she would require total knee replacement for her on-the-job injury; 4) a "CORE" peer review analysis report in the record reflected the opinion that a total knee replacement was not medically indicated when performed by Dr. Foster, and was not related to the work related injury; and 5) Appellant had seen essentially no improvement in her knee symptoms since the time of knee replacement surgery. These findings display a substantial basis for the denial of relief, and, accordingly, we affirm.

In the argument section of the appellate brief, attorney for appellant cites several cases from the Workers' Compensation Commission and quotes at length from them. We take this opportunity to point out that although we may consider such opinions for historical background and other such purposes, opinions of the Commission have no precedential value and are not binding on this court. See Taylor v. Pfeiffer Plbg. & Htg. Co., 8 Ark. App. 144, 648 S.W.2d 526 (1983); City of Humphrey v. Woodward, 4 Ark. App. 64, 628 S.W.2d 574 (1982).


Pittman and Baker, JJ., agree.