Cathie M. Shelley v. Van Buren School District and Risk Management

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ARKANSAS COURT OF APPEALS  NOT DESIGNATED FOR PUBLICATION  LARRY D. VAUGHT, JUDGE  DIVISION II  CA07­461  December 19, 2007  CATHIE M. SHELLEY  APPELLANT  V. VAN BUREN SCHOOL DISTRICT and  RISK MANAGEMENT  APPELLEES  APPEAL FROM THE WORKERS’  COMPENSATION COMMISSION  [NO. F513396]  AFFIRMED  Appellant Cathie Shelley argues on appeal that the Arkansas Workers’ Compensation  Commission erred in its conclusion that she did not sustain compensable injuries to her left  hip and back on November 9, 2005. We affirm the Commission’s decision.  At the hearing, Shelley testified that, while working as a janitor for the Van Buren  School District, she pulled a heavy garbage bag of magazines from a garbage can in the  library of the school and then dragged the bag downstairs. She testified that her pain started  when she was attempting to get the garbage bag out of the can and, by the time she got the  bag downstairs, she was hurting so badly that she “couldn’t hardly walk.” She describes her  pain as starting in the left “groin area,” like a “severe catch.” She stated that the pain then  went into her left hip and into her back, and also down her left leg to about her knee. She described the pain in her groin as being “real severe,” especially whenever she tried to move  her leg, and the pain into her hip and leg as a “solid ache.”  Shelley further testified that following the onset of these difficulties, she went to the  breakroom and took her regular break. While in the breakroom, Shelley allegedly told two  co­employees that she was “hurting real bad” and that she thought that she had hurt herself  when she had pulled on the garbage bag. She identified these co­employees as Sheila and  Leon.  Despite  the  pain,  Shelley  admitted  that  she  completed  the  remainder  of  her  shift  (approximately six hours) and her entire shift the following day. However, she testified that  on the third day her pain was so bad that she did not go into work but rather consulted her  family doctor, Dr. Paul E. Bean. She further stated that she was not sure why she failed to  report her accident or injury to anyone in a supervisory position or request medical treatment  through workers’ compensation at that time. She acknowledged that she did not report any  employment­related injury to her employer until the following week.  Although Shelley initially denied any prior difficulties with her left hip, she ultimately  conceded that she may have suffered some prior difficulties. However, it was her testimony  that if she had had any prior difficulties with her left hip, they were “totally different” from  what she experienced after she “hurt” herself. She also conceded that she did not experience  any pain  or  symptoms at the actual time she pulled the heavy trash bag from the barrel.  Rather,  she  described  her  difficulties  as  beginning  sometime  before  she  could  “get  downstairs” with the trash. 2  Shelley  also  offered  the  testimony  of  her  co­worker  Sheila  Pinkerton.  Pinkerton  testified that she had known Shelley for six years. Pinkerton further testified that she recalled  one morning when Shelley complained about the trash being heavy in the library. Pinkerton  testified that about that time she noticed Shelley “hurting more than other times.” She further  testified that later that day Shelley made the statement to her: “I kind of wonder if I might  have  hurt  myself.”  However,  Pinkerton  also  conceded  that  over  the  course  of  their  relationship Shelley made numerous complaints about her back and various other portions  of her body, which Shelley attributed to her arthritis.  Shelley’s husband testified that when he picked Shelley up from work on November  9, she was complaining of pain and had difficulty walking. He stated that these problems had  not been present when he had dropped her off at work that morning. He further testified that  she was “moving different” and that the area of her pain was different from her usual and  customary  pain  areas.  However,  he  did  acknowledge  that  his  wife  has  had  a  long  and  extensive history of back and hip trouble.  Based on this testimony, which was the only evidence causally linking Shelley’s hip  fracture to a work­place event, the ALJ determined that Shelley had failed to prove by a  preponderance of the credible evidence that she sustained a compensable injury arising out  of  and  during  the  scope  of  her  employment.  The  opinion  of  the  ALJ  was  affirmed  and  adopted by the full Commission. It is from the Commission’s ultimate resolution of her claim  that Shelley appeals. 3  When the Workers’ Compensation Commission denies coverage because the claimant  fails to meet her burden of proof, the substantial­evidence standard requires that we affirm  the Commission’s decision if its opinion displays a substantial basis for denial of  relief.  McMillian v. U.S. Motors, 59 Ark. App. 85, 953 S.W.2d 907 (1997). The burden rests on  Shelley  to  prove  each  of  the  elements  necessary  to  establish  these  alleged  work  related  injuries as “compensable injuries” under the terms of the Arkansas Workers’ Compensation  Act. See Ark. Code Ann. § 11­9­102 (4)(A) (Repl. 1996).  First,  Shelley  was  required  to  prove  by  medical  evidence,  which  is  supported  by  objective findings, the actual existence of the physical injuries or conditions alleged to be  compensable. She easily clears this first hurdle. The medical evidence presented showed that  Shelley had extensive degenerative or osteoarthritic changes involving the L­4, L­5, and S­1  vertebra, as well as the L4­5 and L5­S1 intervertebral discs. Further, the existence of these  extensive  degenerative  or  osteoarthritic  changes  was  supported  by  purely  objective  findings—as noted on a CT scan of the lumbar spine that was performed on November 21,  2005.  The  medical  evidence  also  showed  that  Shelley  had  significant  physical  defects  involving her left and right hip. The existence of these physical defects were objectively  noted on x­ray films. Finally, Shelley presented medical evidence showing that she suffered  a fracture to the left iliac wing of her pelvis. The existence of this fracture was also supported  by objective findings noted in radiographic studies, including both plain x­rays and a CT  scan. 4  The  fact  that  Shelley  established  an  injury  does  not  necessarily  mean  that  it  is  a  “compensable injury” as defined by our Workers’ Compensation Act. She claims on appeal  that she met that burden by showing that her injuries were the result of a specific incident  that occurred on or about November 9, 2005. However, a cursory look at Shelley’s burdens  under Ark. Code Ann. §11­9­102(4)(A)(i) demonstrates why she cannot clear this hurdle.  She was required to prove:  (1)  That  the  physical  injury  or  condition  arose  out  of  and  occurred  in  the  course of the employment;  (2) That the physical injury or condition was caused by a specific incident;  (3) That the physical injury or condition is identifiable by time and place of  occurrence;  (4) That the physical injury or condition caused internal or external physical  harm to the claimant’s body;  (5) That the physical injury or condition required medical services or resulted  in disability.  Therefore, Shelley was required to establish the existence of a causal relationship between  her physical injuries and a specific employment­related incident or accident on November  9, 2005. Here, Shelley’s own testimony is the only direct evidence she has presented to prove  the existence of a causal relationship  between a specific employment­related incident or  accident, on November 9, 2005, and her subsequent difficulties with her low back and left  hip.  The initial medical report of Dr. Paul Bean, dated November 11, 2005, indicated that  Shelley’s primary complaints involved pain in her left hip that radiates down into her thigh.  He  did  mention  some  complaints  of  pain  in  the  lower  back  but  indicated  that  these  complaints were less severe. Although he noted that Shelley reported that she had lifted some 5  heavy  trash  bags  “yesterday”  (November  10),  he  did  not  record  any  history  of  a  close  temporal  relationship  between  this  activity  and  the  initial  onset  of  Shelley’s  current  symptoms. While he noted that Shelley gave a history of a sudden onset of pain “yesterday”  (November  10),  he  also  indicated  that  Shelley  did  not  “remember  any  specific  trauma”  occurring at that same time.  Further, a CT scan of Shelley’s lumbar spine was performed on November 21, 2005.  This test was interpreted as revealing only extensive degenerative arthritic changes from L4  through  L5,  and  the  possibility  or  “suggestion”  of  a  disc  protrusion,  but  no  definitive  showing of recent or acute injury.  The first record of a history of a close temporal relationship between an employment­  related lifting and the onset of Shelley’s symptoms does not appear until the report of Dr.  Keith Holder on December 6, 2005. In his note of December 6, 2005, Dr. Holder stated:  This  is  the  initial  narrative  summary  on  Ms.  Shelley,  an  employee  of  Butterfield Junior High in Van Burn, who reports she was lifting a bag of trash  in normal duties as custodian. She had actually taken weight out of the trash  can in the bag before she lifted it, but she felt pain in the left groin at that time  that has continued to increase since the initial date of injury on 11­9­05. She  reports this happened at approximately 6:00 a.m. in the morning.  Dr. Holder was the first to diagnosis Shelley’s pelvic fracture. This diagnosis was  based on x­rays performed at Dr. Holder’s request on December 6, 2005. However, the x­  rays alone were not sufficient to determine the age of the fracture. A CT scan of the pelvis  was  recommended  for  this  purpose  and  was  performed  on  December  8,  2005.  This  test  indicated that the fracture was of recent origin and that it was likely not pathologic. The 6  radiologist’s interpretation of the CT scan indicated that for a “simple fracture” of this type  to occur, there must have been “significant trauma to this region.”  Subsequent studies performed by Dr. James Deneke, a rheumatologist, all showed no  evidence that Shelley suffered from osteoporosis, or increased risk for fracture. However,  as noted by the ALJ:  Dr. Deneke does make a rather curious and apparent inconsistent statement:  “If indeed, the patient had a pelvic fracture with minimal trauma, then she does  have  osteoporosis.”  Such  a  diagnosis  of  osteoporosis  would  appear  to  be  clearly contrary to all of his prior conclusions and stated test results. There is  clearly  no  objective  findings  to  support  the  existence  of  osteoporosis,  involving the claimant’s pelvis or to indicate that this fracture was due to any  inherent weakness of this portion of her body.  Based on this medical evidence, Shelley’s failure to report the “incident,” and her  decision to continue working after the “accident,” the Commission adopted the ALJ’s finding  that  Shelley  failed  to  prove  the  causal  link  between  her  injury  and  the  workplace.  It  concluded, based on the testimony and medical evidence, that her current difficulties were  primarily, if not solely, the result of a fracture to the left wing of her pelvis—which could  not “reasonably or logically” have been produced by the lifting incident described by Shelley  during her testimony. The Commission also ruled out any argument that Shelley’s injury was  caused by an aggravation of a pre­existing condition when it noted that the medical evidence  failed  to  support  the  existence  of  any  pre­existing weakening of  Shelley’s  pelvis  due  to  tumor, osteoporosis, or any other pre­existing condition. In reaching this conclusion, the  ALJ—and ultimately the Commission—relied heavily on a  note by Dr. David Diment, the 7  radiologist, stated his opinion that “significant trauma” directly to the pelvic region would  be required to produce this fracture.  In conclusion, there is substantial evidence to support the Commission’s conclusion  that “lifting and pulling on a trash bag of magazines, regardless of the weight, would not  reasonably or logically result in any direct trauma to or significant stress on [Shelley’s] left  iliac crest of her pelvis.” Even Dr. Bean, Shelley’s family physician, conceded that “there  is no obvious source for why she had her fracture.” The Commission’s decision, therefore  displays a substantial basis for the denial of the claim, and we affirm.  Affirmed.  MARSHALL  and MILLER, JJ., agree. 8 

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