Ronald Hickman v. Kellogg, Brown & Root, Pacific Employers Insurance Company, Second Injury Fund, and Death & Permanent Total Disability Fund
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SUPREME COURT OF ARKANSAS
No. 07-680
Opinion Delivered February 28, 2008
RONALD HICKMAN,
APPELLANT,
VS.
APPEAL FROM THE WORKERS’
COMPENSATION COMMISSION,
NO. F204936,
KELLOGG, BROWN & ROOT, PACIFIC
EMPLOYERS INSURANCE COMPANY,
SECOND INJURY FUND, AND DEATH
& PERMANENT TOTAL DISABILITY
FUND,
APPELLEES,
COURT OF APPEALS AFFIRMED IN
PART; REVERSED IN PART;
WORKERS’ COM PENSATION
COMMISSION AFFIRMED.
JIM GUNTER, Associate Justice
This appeal arises from a petition for review filed by Appellee Kellogg, Brown & Root
from an unpublished decision of the Arkansas Court of Appeals, Hickman v. Kellogg, Brown &
Root, ___ Ark. App. ___ (June 6, 2007), which affirmed in part and reversed in part a decision
of the Arkansas Workers’ Compensation Commission (Commission). We granted Kellogg’s
petition for review, and we affirm the Commission’s decision.
Appellant Ronald Hickman worked for Kellogg, the employer, as a precision
millwright repairing large machinery. On April 26, 2002, while walking across some
machinery, Hickman slipped on some oil and fell, hitting his right knee against a platform and
falling on his back. He testified that he was “hurting all over” and noticed swelling and pain
in his knee. When this injury occurred, Hickman had worked for Kellogg for less than one
week.
On April 28, 2002, Hickman sought medical treatment for his injuries at Little River
Memorial Hospital in Ashdown. The emergency room notes state that Hickman complained
of pain in his right knee to his foot but make no mention of back pain. Swelling was noted
in the right knee, and x-rays revealed that he had severe multi-compartment osteoarthritis,
but there were no findings of acute traumatic injury. He was placed on medications and went
back to work where he was placed on light duty. Two days later, he sustained “another slip”
and has been out of work since that time. Hickman then sought treatment at the emergency
room at Morehouse General Hospital in Monroe, Louisiana. There, he relayed the April 25,
2002 injury involving the twisting of the right knee and lower back, but the emergency-room
notes mentioned an old knee injury and chronic back pain.
Kellogg accepted the knee injury as compensable. On June 5, 2002, Hickman saw Dr.
Sidney Bailey at the Orthopaedic Clinic of Monroe, Louisiana for both the knee injury and
back pain. Dr. Bailey noted that Hickman presented with “an immobilizer on the right leg”
and stated that he had pain “in his back all of the way down into his right leg.” Dr. Bailey
recommended electromyography of the lower extremities and Ultracet for pain.
On June 20, 2002, Hickman was involved in a motor vehicle accident and sought
emergency-room treatment for pain in his left arm, numbness in his left hand, back pain, and
headaches. In Dr. Bailey’s notes, dated July 31, 2002, he noted that he did not recommend
total knee replacement at that time “primarily due to the patient’s activity and age.” An MRI
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report, dated August 15, 2002, revealed that there was “small joint effusion” and degenerative
arthritic changes within the knee. Dr. Bailey noted in a follow-up progress report that an
arthroscopic debridement would have provided Hickman limited temporary relief, but he
would eventually require knee replacement.
In a subsequent progress report, dated
September 19, 2002, Dr. Bailey noted that he would “certainly attempt to delay a knee
replacement as the last option.” A CT scan of the lumbar spine, performed on October 10,
2002, revealed large disk bulges at L 1-2 and L 2-3, as well as surgical changes in the rest of
the spine. Hickman later sought treatment for his back pain, and on May 28, 2003, Dr.
Bernie McHugh performed back surgery, a procedure for which Kellogg accepted and paid.
Kellogg terminated Hickman’s indemnity benefits on October 28, 2003.
On March 12, 2004, Hickman sustained additional, severe, closed-head injuries in a
second motor-vehicle accident in which his wife was killed. Both parties stipulated that this
accident did not aggravate Hickman’s back or knee, and both parties stipulated that he was
not entitled to temporary total disability benefits for his work injuries between March 12,
2004, through May 25, 2004. On May 25, 2004, Dr. Earl Peeples filed an independent
medical evaluation in which he stated that Hickman had a “long history of back trouble” prior
to his fall in April 2002. Prior to his compensable injury, as a result of a prior accident
involving a dump truck, Hickman had numerous back surgeries, a prior knee surgery, and a
preexisting degenerative disease in his back and knee. In August of 2004, Hickman was
evaluated for cervical problems resulting from his March 2004 automobile accident. On
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September 29, 2004, Hickman underwent a right total-knee-replacement surgery that Kellogg
accepted and paid as compensable.
Kellogg subsequently challenged the permanent
impairment rating of thirty percent to the lower extremity assigned by Dr. Bailey for the knee
surgery. However, Dr. Bailey agreed that, by the time of his surgery, any evidence of
Hickman’s contusion from the April 2002 injury was gone.
Hickman filed a complaint with the Commission. On December 1, 2005, a hearing
was held, and the parties stipulated to the following facts: (1) that the Commission had
jurisdiction of the claim; (2) that the employee/employer/carrier relationship existed at all
relevant times; (3) that on April 26, 2002, Hickman sustained a compensable injury to his right
knee; (4) that Kellogg accepted this knee injury as compensable and paid benefits; (5) that
Hickman reached the end of his healing period for both his right knee and back injuries no
later than May 4, 2005; and (6) that Hickman earned wages sufficient to entitle him to a
compensation rate of $425.00 for total disability benefits. At the hearing, the parties further
stipulated (1) that Hickman was paid temporary-total-disability benefits through October 28,
2003; (2) that Kellogg was entitled to a credit for any temporary-total-disability payments
made after October 28, 2003; (3) that Hickman earned wages sufficient to entitle him to a
compensation rate of $319 for permanent partial disability benefits; (4) that Hickman was
involved in a motor-vehicle accident on March 12, 2004; and (5) that from March 12, 2004,
through May 25, 2004, the motor-vehicle accident was an independent intervening cause such
that Hickman would not be entitled to temporary-total-disability benefits for that two-month
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period of time. On January 25, 2006, the administrative law judge (ALJ) entered an order
finding that Hickman had proven by a preponderance of the evidence that he sustained
permanent impairment of 30% to the knee; that he proved entitlement to permanent-partial
disability benefits of 30% for his knee; that his healing period for his knee began on October
28, 2003, and ended on May 4, 2005; that he failed to prove his compensable injury was the
major cause of his permanent disability; and that he failed to prove he sustained a compensable
back injury. Kellogg appealed the decision of the ALJ.
On October 6, 2006, the Commission ruled that Hickman failed to prove that his
compensable injury was the major cause of the necessary knee-replacement surgery and
subsequent 30% impairment rating assigned by Dr. Bailey. The Commission also determined
that Hickman failed to prove that he was totally and permanently disabled as a result of any
compensable injury. Hickman appealed the Commission’s decision to the Arkansas Court of
Appeals.
In Hickman, supra, the court of appeals reversed the portion of the Commission’s order
denying permanent-partial-disability, temporary-total-disability, and permanent-total-disability
benefits and remanded for further proceedings in light of the parties’ stipulations. The court
reasoned that because the parties had stipulated that Hickman’s knee injury was compensable,
Kellogg could not avoid responsibility for the surgery and the impairment rating. Further, the
court of appeals affirmed the Commission’s determination that Hickman failed to prove that
he suffered a compensable back injury on April 26, 2002. The court reasoned that there was
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substantial evidence to support the Commission’s finding that Hickman’s back condition was
the result of prior back surgeries and degenerative conditions. Id.
On June 25, 2007, Kellogg filed a petition for review with our court. In its petition,
Kellogg argues that the court of appeals’ decision conflicts with prior case law and Ark. Code
Ann. § 11-9-102(4)(F)(ii)(a) (Supp. 2007). Specifically, Kellogg asserts that the court of
appeals ignored the two-prong analysis requirement of (1) whether there is a compensable
injury and (2) whether that compensable injury was the “major cause” of the impairment.
On October 14, 2007, we granted Kellogg’s petition for review. After granting a petition for
review, this court considers the case as if it had originally been filed in this court. Riddle v.
Udouj, ___ Ark. ___, ___ S.W.3d ___ (Nov. 8, 2007).
I. “Major cause” of the knee injury
For his first point on appeal, Hickman argues that the Commission erred in finding that
he failed to prove by a preponderance of the evidence that he sustained an impairment rating
of 30% to his lower extremity as a result of his compensable knee injury. Specifically,
Hickman asserts that the Commission incorrectly concluded that he failed to prove that, but
for his knee injury in 2002, he would not have required a total knee replacement surgery.
In response, Kellogg argues that the Commission properly ruled that Hickman’s
compensable knee injury was not the major cause for his knee-replacement surgery. Kellogg
contends that Hickman’s preexisting condition, not the April 26, 2002 incident, was the major
cause of his right-knee replacement, and he should not have been entitled to permanent-
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disability benefits.
The Second Injury Fund requests that we affirm the Commission’s rulings, as Hickman
only proved a contusion, or bruise, that he sustained from the April 28, 2002 compensable
injury.
In appeals involving claims for workers’ compensation, our court views the evidence
in a light most favorable to the Commission’s decision and affirms the decision if it is
supported by substantial evidence. Moncus v. Billingsley Logging, 366 Ark. 383, 235 S.W.3d
877 (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. Where the Commission
denies a claim because of the claimant’s failure to meet his burden of proof, the substantial
evidence standard of review requires that we affirm the Commission’s decision if its opinion
displays a substantial basis for the denial of relief. Id.
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
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testimony that it deems worthy of belief. Id. Thus, we are foreclosed from determining the
credibility and weight to be accorded to each witness’s testimony. Arbaugh v. AG Processing,
Inc., 360 Ark. 491, 202 S.W.3d 519 (2005).
A compensable injury, found in Arkansas Code Annotated section 11-9-102(4)(A)(i),
is defined as “[a]n accidental injury causing internal or external physical harm to the body .
. . arising out of and in the course of employment and which requires medical services or
results in disability or death. An injury is ‘accidental’ only if it is caused by a specific incident
and is identifiable by time and place of occurrence[.]” A compensable injury must be
established by medical evidence supported by objective findings, which are findings that
cannot come under the voluntary control of the patient. Ark. Code Ann. § 11-9-102(4)(D)
and (16) (Supp. 2007). Additionally, permanent benefits shall be awarded only upon a
determination that the compensable injury was the major cause of the disability or
impairment. Ark. Code Ann. § 11-9-102(4)(F)(ii)(a) (Supp. 2007). The term, “major cause,”
means more than fifty percent of the cause, which must be established by a preponderance of
the evidence. Ark. Code Ann. § 11-9-102(14)(A) & (B) (Supp. 2007). Thus, in order for
Hickman to be entitled to permanent benefits, he was required to show: (1) that he suffered
an injury arising out of and in the course of his employment; (2) that the injury was caused
by a specific incident; (3) that the injury caused internal or external physical harm to his body;
(4) that the injury is supported by objective findings; (5) that the injury was the major cause
of the disability or need for medical treatment. Ark. Code Ann. § 11-9-102.
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Here, the first four factors are supported by the evidence and the parties’ stipulations.
First, Hickman suffered the compensable injury while at the workplace. Second, the injury
was caused by slipping on the oil spill. Third, the accident caused an injury to his knee that
required him to seek medical treatment. Fourth, this injury was stipulated by the parties as
compensable. With regard to the fifth factor, the key issue is whether, pursuant to Ark. Code
Ann. § 11-9-102(4)(F)(ii)(a), Hickman’s compensable knee injury, stemming from his workrelated April 26, 2002 accident, was the “major cause” of his resultant impairment rating.
In the case sub judice, there was substantial evidence that Hickman had a preexisting
degenerative knee condition. Dr. Sid Bailey, Hickman’s treating physician, testified that he
examined Hickman’s right knee on June 5, 2002, and Hickman had “significant past history”
of a “previous injury to that knee” from a dump-truck accident in 1984. Hickman had a
previous right-knee surgery, a healed surgical scar, and “mild to moderate synovitis
[inflammation] and pain with any attempted active or passive range of motion.” According
to Dr. Bailey’s testimony, Hickman’s range of motion was restricted to “thirty percent
estimated overall.” Dr. Bailey also testified that x-rays revealed “moderate to severe posttraumatic degenerative arthritis with no fracture.” He further testified that Hickman’s
arthritis, as shown on the x-ray, would have existed prior to his April 25, 2002 injury. The
arthritis shown on the x-ray included bone spurs and “narrowing.”
Dr. Bailey also testified about the findings of the MRI to Hickman’s right knee.
According to Dr. Bailey’s interpretation of the MRI, the “medial meniscus and also the ACL
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[anterior cruciate ligament]” were absent from the knee prior to the accident on April 25,
2002. He speculated that they were removed by surgery or the knee was injured prior to that
time. He added that “[t]he ACL . . . gives stability to the knee so that you don’t plant, pivot,
turn and collapse with a trick knee that you’ve seen. And the medial meniscus also gives
stability and functions as a pad, if you will, cushion or support between the two bones the
femur and the tibia.” Based upon these findings, Dr. Bailey concluded that Hickman had a
“painful and very inefficient right knee.” Dr. Bailey read the report of Dr. John Ledbetter,
an anaesthesiologist with a fellowship in pain management, who testified that the contusion
and “all physical evidence” from Hickman’s work-related injury resolved itself by the time
Hickman’s knee-replacement surgery took place on September 29, 2004. Finally, in the
following colloquy, Dr. Bailey admitted that Hickman’s “severe preexisting degenerative
changes” in his knee were the major cause of his surgery:
Q: Doctor, using Mr. Giles’s definition of major cause supplied to you
in this letter as being more than fifty percent of the cause it remains your
opinion today as you told me earlier that Mr. Hickman’s severe preexisting
degenerative changes of the right knee was the major cause of the surgery and
his impairment rating, is that correct.
A: Yes.
Q: And this is in your opinion to a reasonable degree of medical
certainty?
A: Yes.
Hickman relies upon Pollard v. Meridian Aggregates, 88 Ark. App. 1, 193 S.W.3d 738
(2004), for the proposition that “[t]he major cause requirement is satisfied where a
compensable injury aggravates an asymptomatic preexisting condition such that the condition
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becomes symptomatic and requires treatment.” However, Hickman’s argument is misplaced
because, unlike the appellant in Pollard, there was evidence that his knee caused him problems
prior to the April 2002 compensable injury, particularly in light of his prior knee surgery,
degenerative arthritis, and absence of the medial meniscus and the ACL prior to the surgery.
Further, there is no evidence that the need for Hickman’s knee-replacement surgery and the
resulting impairment would not have occurred but for the work-related injury.1
Based upon the foregoing analysis, as well as our standard of review in viewing the
evidence in a light most favorable to the Commission’s decision, we conclude that there was
substantial evidence to support the Commission’s finding that Hickman failed to prove that
the April 2002 incident was the major cause of his total-knee-replacement surgery and
resulting impairment rating. Accordingly, we affirm the Commission’s decision on this point.
II. Temporary-total-disability benefits for the knee injury
For his second point on appeal, Hickman argues that the Commission’s decision to
limit the award for temporary total disability is not supported by the evidence. Specifically,
Hickman contends that the Commission erred in reversing the ALJ and in awarding benefits
1
We note that when a compensable injury combines with a preexisting condition
to cause the need for treatment, such as knee surgery, permanent benefits are payable for
the resulting impairment only if the injury is the major cause of the permanent disability or
need for treatment. Ark. Code Ann. § 11-9-102(4)(F)(ii)(b) (Supp. 2007) (emphasis
added). Thus, the evidence of a causal connection between the employment-related
injury and the need for surgery, which was sufficient for purposes of determining the
compensability of the knee injury and the knee surgery, did not automatically resolve the
key issue in determining entitlement to permanent benefits: whether the compensable
knee injury was the major cause of Hickman’s eventual need for a total knee replacement.
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from September 29, 2004, the date of his knee-replacement surgery, through May 4, 2005,
the date the parties stipulated that Hickman reached the end of his healing period for his right
knee and back. Hickman asserts that the Commission should have awarded temporary-totaldisability benefits from October 28, 2003, the date that Hickman’s total-disability benefits
were terminated, through May 4, 2005.
To receive temporary-total-disability benefits, Hickman had to prove by a
preponderance of the evidence that he was within a healing period and was totally
incapacitated from earning wages. Searcy Industrial Laundry, Inc. v. Ferren, 92 Ark. App. 65, 211
S.W.3d 11 (2005). When an injured employee is totally incapacitated from earning wages and
remains in his healing period, he is entitled to temporary-total disability. Id. The healing
period ends when the employee is as far restored as the permanent nature of his injury will
permit, and if the underlying condition causing the disability has become stable and if nothing
in the way of treatment will improve that condition, the healing period has ended. Id. The
determination of when the healing period has ended is a factual determination for the
Commission and will be affirmed on appeal if supported by substantial evidence. Id. These are
matters of weight and credibility, and thus lie within the exclusive province of the
Commission. Id.
In the present case, the Commission modified the ALJ’s findings and ruled that
Hickman reached the end of his first healing period for his right knee before October 28,
2003, and it was not until September 29, 2004, that he underwent total knee-replacement
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surgery, when a second healing period began. The Commission awarded these benefits from
September 29, 2004, through May 4, 2005.
We agree with the Commission’s findings. Here, while it is true that Hickman did not
return to work after October 28, 2003, there was substantial evidence to reflect that Hickman
reached the end of his first healing period before October 28, 2003. Hickman’s compensable
injury occurred on April 26, 2002. In a progress note, dated March 5, 2003, Dr. Bailey opined
that Hickman’s right-knee condition was due to post-traumatic degenerative arthritis and that
he would need knee-replacement surgery “at some point.” Dr. Bailey noted in another
progress note, dated September 2, 2003, that the only procedure that would give him relief
would be a right-knee replacement. Additionally, in a letter dated March 10, 2004, Dr.
Bailey wrote that “knee replacement surgery is necessary as Mr. Hickman has marked posttraumatic degenerative arthritis of the right knee and has failed other nonsurgical treatment
options.” Throughout this time period, Hickman suffered numerous problems with chronic
back pain and had previously undergone multiple lumbar surgeries. For these reasons, we
conclude that the Commission correctly determined that Hickman’s right-knee condition
“plateaued” well before the last date of his employment on October 28, 2003, and that the
Commission correctly limited the award for temporary-total-disability to the time period after
his knee-replacement surgery from September 29, 2004, through May 4, 2005. Accordingly,
we affirm on this point.
III. Total-permanent-disability benefits for the back injury
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For his third point on appeal, Hickman argues that the Commission erred in finding
that he did not have a compensable back injury and that he failed to prove total-permanent
disability. Specifically, he contends that prior to the April 26, 2002 incident, no doctor
identified a back problem at the L1-2 or L2-3 levels, and that the accident aggravated his
condition. Kellogg counters by arguing that Hickman failed to prove that he sustained a
compensable back injury or permanent total disability. Kellogg asserts that there is substantial
evidence supporting the Commission’s finding that Hickman’s back injury was the result of
a preexisting degenerative disc disease and prior back surgeries.
Permanent benefits are only awarded upon a determination that the compensable
injury was the major cause of a disability or impairment. Ark. Code Ann. § 11-9102(4)(F)(ii)(a).
Permanent impairment, which is usually a medical condition, is any
permanent functional or anatomical loss remaining after the healing period has been reached.
Ouachita Marine v. Morrison, 246 Ark. 882, 440 S.W.2d 216 (1969). An injured employee is
entitled to the payment of compensation for the permanent functional or anatomical loss of
use of the body as a whole whether his earning capacity is diminished or not. Id. In the case
of Wilson & Co. v. Christman, 244 Ark. 132, 424 S.W.2d 863 (1968), we stated that the
Commission is “not limited, and never has been limited, to medical evidence only in arriving
at its decision as to the amount or extent of permanent partial disability suffered by an injured
employee as a result of injury.” It is the duty of the Workers’ Compensation Commission to
translate the evidence on all issues before it into findings of fact. Gencorp Polymer Products v.
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Landers, 36 Ark. App. 190, 820 S.W.2d 475 (1991).
Regarding an aggravation, an employer takes the employee as he finds him, and
employment circumstances that aggravate preexisting conditions are compensable. See Parker
v. Atlantic Research Corp., 87 Ark. App. 145, 189 S.W.3d 449 (2004). A preexisting disease
or infirmity does not disqualify a claim if the employment aggravated, accelerated, or
combined with the disease or infirmity to produce the disability for which workers’
compensation is sought. Actronix, Inc. v. Curtis, ___ Ark. App. ___, ___ S.W.3d ___ (Sept.
26, 2007). An aggravation is a new injury resulting from an independent incident, and being
a new injury with an independent cause, it must meet the definition of a compensable injury
in order to establish compensability for the aggravation. Id.
We agree with the Commission’s decision that Hickman failed to prove that he
suffered a compensable back injury on April 26, 2002. Hickman testified that he first injured
his back in 1984 in a work-related injury. Subsequently, he underwent two neck surgeries
and four back surgeries. Additionally, in May of 1997, Hickman sustained another workrelated injury to his shoulder and hip, but medical records reflected that he received extensive
treatment for his back. Prior to that injury, a myelogram detected a small disk bulge and
ligamentous hypertrophy at the L2-3 level. Prior to the 2002 accident at issue, Hickman had
hardware installed at every level of his lumbar spine other than L1-2 and L2-3. One doctor
stated that the degeneration of Hickman’s lumbar spine was “some of the most severe that I
have ever seen.” More significantly, on May 28, 2003, Dr. Bernie McHugh performed a
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lumbar decompression surgery at L2-3. Dr. McHugh testified that Hickman’s “facet
hypertrophy and ligamentous hypertrophy” compressed the L2 and L3 levels. Further, Dr.
McHugh testified that, when he performed the surgery, he found “progressive degenerative
changes” rather than “any acute traumatic injury.” Dr. McHugh’s finding was corroborated
with Dr. Peeples’s medical examination in 2004 about which Dr. Peeples testified, “I believe
his back situation would be impossible to apportion out to his different episodes of surgery and
to his degenerative condition.”
Thus, based upon this evidence before the Commission, we hold that there was not
substantial evidence to support a finding that Hickman’s back injury was related to his April
2002 compensable injury. Accordingly, we affirm the Commission’s ruling that he failed to
prove by a preponderance of the evidence that he sustained a compensable back injury or a
total permanent disability.
Affirmed.
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