Sea Ark Marine, Inc. v. Pippinger
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ARKANSAS COURT OF APPEALS
DIVISION I
CA08-776
No.
Opinion Delivered A PRIL 1, 2009
SEA ARK MARINE, INC. and AIG
CLAIM SERVICES, INC.
APPELLANTS
V.
APPEAL FROM THE WORKERS’
COMPENSATION COMMISSION
[NO. F405234]
JERRY PIPPINGER
APPELLEE
REVERSED AND REMANDED
ROBERT J. GLADWIN, Judge
This appeal follows the May 13, 2008 decision of the Workers’ Compensation
Commission (Commission) affirming and adopting the February 14, 2008 opinion of the
Administrative Law Judge (ALJ), finding that appellee was entitled to the implantation of
the dorsal-column stimulator if additional testing and examination showed it to be necessary.
On appeal, appellants argue that the Commission failed to hold appellee to his statutory
burden of proof by awarding additional medical care while simultaneously opining that he
needed to return to the doctor for further evaluation before that care could be deemed
reasonable and necessary. We agree and reverse and remand.
Appellee, age sixty-two, injured his left foot and ankle on May 1, 2004, after
becoming entangled in some hoses and falling from a large boat at the SeaArk Marine
production facility. Appellee was diagnosed with a comminuted and compressed fracture of
the left calcaneus bone. Orthopedic surgeon Dr. John Lytle performed surgery with external
fixation (plates & screws) on May 26, 2004, but appellee developed reflex-sympathetic
dystrophy (RSD) of the left-lower extremity.
In his report of September 2, 2004, Dr. Lytle noted evidence of RSD with atrophy, red
glow, and shiny skin. A report dated September 9, 2004, reflected symptoms of atrophy,
change in hair pattern, hyperhidrosis, and temperature changes. A recommendation was
made for confirmation with diagnostic studies. On September 13, 2004, a laser-doppler study
was performed, which was negative, but a triple-phase-bone scan was positive and an
EMG/NCV study was abnormal. Appellee received treatment to desensitize the scar.
Physical therapy improved, but did not eliminate, his pain.
Appellee began treatment with Dr. William Ackerman for continuing pain and RSD
in September 2004. Dr. Ackerman also ordered physical therapy, which appellee completed
with Nat Grubbs. Based on his reports of September 13, 2004, and October 28, 2004, Dr.
Ackerman determined there had been a resolution of the RSD, and he released appellee from
his care. However, Dr. Ackerman wanted appellee to see a foot and ankle surgeon for the
removal of the hardware, and on November 29, 2004, appellee returned due to pain and
explained to Dr. Ackerman that he was “unable to see Dr. Thomas, the chief of foot surgery
at UAMS,” because he had seen a “surgeon picked by the workers’ compensation.” That
surgeon was Dr. Larry Nguyen, and he first examined appellee on November 19, 2004. Dr.
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Nguyen continued appellee’s physical therapy into December 2004.
On February 15, 2005, Dr. Nguyen surgically removed the hardware previously
implanted by Dr. Lytle. The second surgery did not improve appellee’s RSD symptoms but
did improve the pain. During surgery, Dr. Nguyen clipped, or freed, a nerve trapped in scar
tissue (a sural-nerve resection), which had left the side of appellee’s foot numb. On March
30, 2005, Dr. Nguyen released appellee and rated appellee’s impairment at twenty-one
percent to the lower extremity, stating that maximum-medical improvement from the
orthopedic standpoint had been reached. He warned, however, that appellee would require
additional surgery, fusion with allograft, sometime in the future.
Before he closed his local practice and relocated out of the state, Dr. Ackerman saw
appellee for the last time on June 14, 2005, and indicated that the regional-pain syndrome had
resolved, but that appellee would be entitled to an impairment rating possibly based on his
RSD. Dr. Ackerman recommended a laser-doppler study to determine whether appellee had
additional symptoms of RSD, but that test was not approved by appellant AIG Claim
Services, Inc., (Carrier). On November 16, 2005, Dr. Nguyen suggested a referral to Dr.
Mahmood Ahmad, so that he could take over where appellee’s treatment with Dr. Ackerman
had ended.
Carrier agreed to send appellee to Dr. Ahmad for an initial visit to evaluate his RSD.
Appellee was seen by Dr. Ahmad on August 4, 2006; however, Carrier did not approve
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anything beyond the first doctor’s visit. Dr. Ahmad authored a letter dated June 27, 2007,
indicating that while RSD can wax and wane, it cannot be cured. He opined that appellee
needed additional pain treatment and was a candidate for a spinal-cord-stimulator trial.
Appellee then saw Dr. Whipple on August 21, 2007. Dr. Whipple also recommended
additional diagnostic testing (an MRI scan), which Carrier to date has not authorized. Dr.
Whipple noted coolness in appellee’s left foot and his restricted range of motion. Appellee
complained of pain in his foot and back at that time.
Medical expenses, temporary-total-disability benefits, and the twenty-one-percent
impairment rating, assessed by Dr. Larry Nguyen in his report of March 30, 2005, were
accepted. Additionally, appellee receives social-security-disability benefits.
A hearing was conducted on November 16, 2007, before ALJ Elizabeth W. Hogan,
to determine appellee’s entitlement to payment of additional medical expenses and attorney’s
fees. At issue was whether or not additional medical treatment is reasonable and necessary
pursuant to Arkansas Code Annotated section 11-9-508 (Supp. 2007). In her opinion dated
February 14, 2008, the ALJ noted that she found appellee to be a credible witness who has
cooperated with his physicians and treatment. She found that he is entitled to continuing
medical treatment with Dr. Ahmad and, if ultimately Dr. Ahmad needs to implant a
stimulator, that would be a reasonable and necessary medical expense. She noted Dr.
Ackerman’s diagnosis of “complex regional pain syndrome,” formerly known as RSD, after
diagnostic testing and noted that there was no evidence presented that appellee is
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malingering. The ALJ also noted Dr. Ahmad’s opinion that, although appellee’s pain
syndrome may wax and wane, it cannot be cured. She determined that appellee will need
follow-up pain management for the rest of his life. The ALJ made a specific finding that,
because Dr. Ahmad did not have all of appellee’s medical records at the time of the initial
evaluation, Dr. Ahmad needs to reevaluate appellee before proceeding; but she noted that a
stimulator implant is the preferred course of treatment. She specifically found that this painmanagement treatment is reasonable and necessary to address pain and to stop the syndrome
from progressing.
Appellants filed a timely notice of appeal to the Commission on February 27, 2008,
and on May 13, 2008, the Commission affirmed and adopted the decision of the ALJ. Timely
notice of appeal was filed on June 12, 2008, and this appeal followed.
Typically, on appeal to this court, we review only the decision of the Commission, not
that of the ALJ. Daniels v. Affiliated Foods S. W., 70 Ark. App. 319, 17 S.W.3d 817 (2000).
In this case, the Commission affirmed and adopted the ALJ’s opinion as its own, which it is
permitted to do under Arkansas law. See Death & Perm. Total Disab. Trust Fund v. Branum,
82 Ark. App. 338, 107 S.W.3d 876 (2003). Moreover, in so doing, the Commission makes
the ALJ’s findings and conclusions the findings and conclusions of the Commission. Id.
Therefore, for purposes of our review, we consider both the ALJ’s order and the
Commission’s majority order.
In appeals involving claims for workers’ compensation, this court views the evidence
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and all reasonable inferences deducible therefrom in the light most favorable to the
Commission’s decision and affirms the decision if it is supported by substantial evidence.
See Kimbell v. Ass’n of Rehab Indus. & Bus. Companion Prop. & Cas., 366 Ark. 297, 235
S.W.3d 499 (2006). Substantial evidence is evidence that a reasonable mind might accept
as adequate to support a conclusion. Id. The issue is not whether the appellate court might
have reached a different result from the Commission; if reasonable minds could reach the
result found by the Commission, the appellate court must affirm the decision. Id. We will
not reverse the Commission’s decision unless we are convinced that fair-minded persons
with the same facts before them could not have reached the conclusions arrived at by the
Commission. Dorris v. Townsends of Ark., Inc., 93 Ark. App. 208, 218 S.W.3d 351 (2005).
Questions concerning the credibility of witnesses and the weight to be given to their
testimony are within the exclusive province of the Commission. Patterson v. Ark. Dep’t of
Health, 343 Ark. 255, 33 S.W.3d 151 (2000). When there are contradictions in the evidence,
it is within the Commission’s province to reconcile conflicting evidence and to determine the
true facts. Id. The Commission is not required to believe the testimony of the claimant or
any other witness, but may accept and translate into findings of fact only those portions of
the testimony that it deems worthy of belief. Id. 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).
Thus, we are foreclosed from determining the credibility and weight to be accorded to each
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witness’s testimony. Arbaugh v. AG Processing, Inc., 360 Ark. 491, 202 S.W.3d. 519
(2005). As our law currently stands, the Commission hears workers’ compensation claims
de novo on the basis before the ALJ pursuant to Arkansas Code Annotated section
11-9-704(c)(2) (Repl. 2002), and this court has stated that we defer to the Commission’s
authority to disregard the testimony of any witness, even a claimant, as not credible. See
Bray v. Int’l Wire Group, 95 Ark. App. 206, 235 S.W.3d 548 (2006).
Appellants’ primary concern appears to be that the Commission awarded appellee
additional medical benefits despite the concession that additional medical proof would be
necessary to support their decision. By affirming and adopting the ALJ’s decision, the
Commission also adopted the ALJ’s ruling that the medical evidence should be developed
more fully before the treatment and procedures requested by appellee can be deemed
reasonable and necessary. Appellants contend that doing so constituted a failure to hold
appellee to the burden of proof placed upon him by the Arkansas Workers’ Compensation
statutes. They maintain that the finding that another evaluation needs to occur is a tacit
admission that the record did not contain evidence sufficient to rule outright that additional
treatment, including the implantation of a dorsal-column stimulator was reasonable and
necessary. Accordingly, they urge that the decision should be reversed.
We agree. Arkansas Code Annotated section 11-9-704(c)(2) requires ALJs and the
Commission to determine, on the basis of the record as a whole, whether the party having
the burden of proof on the issue has established their case by a preponderance of the
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evidence. (Emphasis added.) Additionally, section 11-9-705(c)(1)(A) (Supp. 2007) specifies
that all oral or documentary evidence shall be presented to the designated representative of
the Commission at the initial hearing on a controverted claim. (Emphasis added.) See also
Gencorp Polymer Prods. v. Landers, 36 Ark. App. 190, 820 S.W.2d 475 (1991).
Additionally, appellants argue that the ALJ, and later the Commission, issued what
was, in effect, an advisory opinion in finding that “a stimulator is the preferred course of
treatment.” The Commission was not asked to determine the preferred treatment for any one
given condition; rather, the Commission was asked to determine whether appellee proved his
entitlement to additional medical treatment by a preponderance of the evidence. Appellants
assert that appellee has been given the “second bite at the apple” the court warned of in
Landers, supra. If the physicians’ opinions were lacking, or if the Commission felt a more
in-depth examination was necessary, the time for that to have occurred should have been
prior to the hearing.
The record is replete with records, opinions, and recommendations documenting
appellant’s condition from Drs. Lytle, Ackerman, Nguyen, and Ahmad from which the ALJ
and the Commission were required to make their determinations. We recently stated in
Burkett v. Exxon Tiger Mart, Inc., __ Ark. App. __, __ S.W.3d __ (Feb. 18, 2009), that we
do not interfere with the actions of the Commission unless we find that it has acted without
or in excess of its authority. See Landers, supra.
Arkansas Code Annotated section 11-9-811 (Repl. 2002) provides:
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Upon its own initiative at any time where compensation payments are being made
without an award, the Workers’ Compensation Commission may and in any case
where the right to compensation has been controverted or where payments of
compensation have been suspended, or where an employer seeks to suspend payments
made under an award, or on application of an interested party, the commission shall
make such investigation, cause such medical examination to be made, hold such
hearings, and take such further action as the commission deems proper for the
protection of the rights of all parties.
The plain language of section 11-9-811 does not authorize the Commission to reserve making
determinations on compensability and additional benefits when those were the only issues
litigated by the parties. Based upon the evidence in the record before us, we hold that the
record was sufficiently complete to allow a determination that would be fair and just to all
parties concerned. In Landers, supra, this court expressly stated,
It is the duty of the Workers’ Compensation Commission to translate the evidence on
all issues before it into findings of fact. The Commission’s statutory obligation is to
make specific findings of fact and to decide the issues before it by determining
whether the party having the burden of proof on an issue has established it by a
preponderance of the evidence.
....
Ark. Code Ann. § 11-9-705(c)(1) provides that all evidence shall be presented to the
Commission at the initial hearing on the controverted claim. The burden of proving
a case beyond speculation and conjecture is on the claimant.
....
By reserving the issue of whether the appellee was entitled to temporary total
disability benefits for the period from February to June 1989, the Commission simply
declined to say that the appellee failed to meet her burden of proof on this issue. This
constitutes error on the part of the Commission as our workers’ compensation statute
states that the evidence shall be weighed impartially, and without giving the benefit
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of the doubt to any party. Ark. Code Ann. § 11-9-704(c)(4). The Commission has
allowed the appellee a “second bite at the apple” by giving her another opportunity
to present evidence substantial enough to carry her burden.
Landers, 36 Ark. App. at 194-95, 820 S.W.2d at 477-78 (internal citations omitted). In this
case, it was the statutory obligation of the Commission to make findings of fact and to decide
the issue of additional benefits by determining whether appellee met his burden of proof.
Pursuant to Landers, we hold that the ALJ and Commission erred by ordering an additional
evaluation and reserving a decision on the primary issue in the litigation.
Reversed and remanded.
P ITTMAN and H ENRY, JJ., agree.
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