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Index of Cases
Drone v. Nestle USA
Burnett v. Mehaffy
Construction
Herman v. City of Searcy
Rassett v.
Utility Tri-State
Collins v. Lennox Industries (change of physician)
Pifer v. Single Source Transportation
Privett v. Excel Specialty Products
Taylor v. Jefferson Regional Medical Center
Drone v. Nestle
USA
Drone v. Nestle USA, Inc. Full Commission Opinion, July 28, 2008, (WCC
File No. F704816.
The
Commission affirmed the ALJ's decision that awarded the claimant
benefits under § 11-9-505 due to the employer's refusal to return the
claimant to work, without reasonable cause, while suitable employment
was available.
The
claimant sustained a compensable injury on October 21, 2005. A CT scan
from November 14, 2005, was essentially a negative exam with suggestion
of possible slight narrowing of some lumbar interspaces. The claimant
had some pain but was ambulating and had no acute findings on an x-ray
on November 18,2005. He was released to go back to work and the case was
closed. The claimant had already been back to work by this time. Dr.
Lack released the claimant with no permanent impairment. The respondents
denied. additional treatment following Dr. Lack's release. The claimant
then treated with his family physician, Dr. Ricca, and Dr. Kornblum. Dr.
Kornblum performed right L4 and L5 medial branch blocks on November 1,
2006. This helped the claimant for about 20 days.
On
May 3,2007, the claimant presented medical bills to the employer's human
resources manager. The claimant was told that the employer was going to
have to put him off work because the employer didn't want him to hurt
himself any further. The claimant was also told to get a release to come
back to work and to call every day. (The Full Commission pointed out
that Dr. Lack had released him to return to work on November 18,2005.)
On July 27, 2007, the claimant received a certified letter stating that
he needed to fill out a leave of absence and to come in to pick up the
papers. The claimant picked up paperwork given to him concerning FMLA
leave and short-term disability and was instructed to have the doctor
fill it out. The claimant went to all the doctors who had treated him
including the company doctor and was told by them that he had not been
taken off work so they couldn't fill out paperwork taking him off work.
The claimant returned to his company and told the company that none of
the doctors would fill out the paperwork taking him off work. At this
time the claimant was asked to resign and he refused. He was told that
he would be sent a letter of termination. The claimant was then
terminated on August 17, 2007.
The
Commission agreed with the ALJ that all elements were met under §
11-9-505 to qualify for benefits under this section. The claimant proved
a compensable injury, that there was suitable employment available when
the employer refused to allow the claimant to work after May 3, 2007,
and that the employer's refusal was without reasonable cause.
Burnett v.
Mehaffy Construction
BEFORE THE ARKANSAS
WORKERS’ COMPENSATION COMMISSION
CLAIM NO. F211602
TRAVIS BURNETTE,
EMPLOYEE CLAIMANT
MEHAFFY CONSTRUCTION CO.,
INC.,
EMPLOYER RESPONDENT NO. 1
BITUMINOUS INSURANCE
COMPANIES,
CARRIER RESPONDENT NO. 1
SECOND INJURY FUND
RESPONDENT NO. 2
ORDER FILED JANUARY 28, 2005
This case was reassigned
to my office on January 6, 2005 by the Clerk of the Commission, to
address the claimant’s December 22, 2004 Motion for
Reconsideration/Clarification.
An opinion had been
entered on December 16, 2004 addressing impairment, medical care, wage
loss and Fund liability. The claimant’s motion requests a ruling on the
claimant’s entitlement to vocational rehabilitation. The claimant had
indeed requested rehabilitation and it was my error to neglect this
issue, however, I find that I no longer have jurisdiction over this
claim.
Even if a Motion for
Reconsideration is timely filed within the thirty-day appeal period, the
decision will become final unless the Administrative Law Judge acts upon
the motion within the thirty day period or unless a timely notice of
appeal is filed with the Full Commission. Cooper Industrial Products v.
Meadows, 5 Ark. App. 205, 634 S.W.2d 400 (1982), Lloyd v. Potlatch
Corp., 19 Ark. App. 335, 721 S.W.2d 670 (1986), Walker v. J & J Pest
Control, 270 Ark. 941, 606 S.W.2d 597 (Ark. App. 1980), Hill v. Travenol
Laboratories, 24 Ark. App. 116, 748 S.W.2d 356 (1988).
Assuming arguendo, there
are no jurisdictional challenges, I find the claimant would be entitled
to a vocational rehabilitation evaluation. Whether or not he would be
entitled to a program of rehabilitation is a factual question depending
on the reasonableness of the plan selected by the claimant.
REHABILITATION
To be
entitled to a program of vocational rehabilitation, the claimant must
show he has a permanent injury, that the program is reasonable in
relation to the disability sustained, and he must show that the employer
was unwilling to make a job available within his work restrictions.
Tackett v. Hickory springs Manufacturing Company, Full Commission
opinion August 14, 1979 (C715817), Jones v. Tyson Foods, Inc., Full
Commission opinion October 4, 1985 (D100551), Coosenberry v.
McCroskey Sheet Metal, 6 Ark. App. 177,
639 S.W.2d 518 (1982), Ark. Code Ann. §11-9-505 (1987).
Rehabilitation has been
defined by the Full Commission as anything necessary to return the
claimant to the work force as soon as possible and as close as possible
to his pre-injury wages. Tackett v. Hickory Springs Manufacturing
Company, (1979)(C715817). This program may include any of the following
options:
a) reemployment by the
same employer either 1)modifying the claimant’s previous job, or 2)
moving the claimant to a different job
b) exploration of the
claimant’s transferable skills to another type of employment
c) placement assistance
or on-the-job training
d) retraining programs
suitable to the claimant’s intellectual and aptitudinal abilities which
would result in gainful employment
Act 796 of 1993 changed
the provisions of Ark. Code Ann. §11-9-505 prohibiting a claimant from
receiving wage loss disability benefits if rehabilitation is effectively
waived without good cause shown:
...The employee shall
not be required to enter any program of vocational rehabilitation
against his consent; however, no employee who waives rehabilitation or
refuses to participate in or cooperate for reasonable cause with
either an offered program of rehabilitation or job placement
assistance shall be entitled to permanent partial disability benefits
in excess of the percentage of permanent physical impairment
established by objective physical findings. A request for the program,
if elected by the claimant, must be filed with the Commission prior to
a determination of the amount of permanent disability benefits payable
to the employee.
In summary, the claimant
has a permanent impairment and his employer has not offered him a job.
Therefore, I find the claimant would be entitled to a vocational
rehabilitation evaluation at the respondents’ expense.
IT IS SO ORDERED.
ELIZABETH W. HOGAN
Administrative Law Judge
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Herman v. City of
Searcy
BEFORE THE ARKANSAS
WORKERS’ COMPENSATION COMMISSION
CLAIM NUMBER F310555
JERRY L. HERMAN,
EMPLOYEE CLAIMANT
CITY OF SEARCY,
EMPLOYER RESPONDENT #1
ARKANSAS MUNICIPAL
LEAGUE, CARRIER RESPONDENT #1
SECOND INJURY FUND
RESPONDENT #2
DEATH & PERMANENT TOTAL
DISABILITY TRUST FUND
RESPONDENT #3
OPINION FILED FEBRUARY 9,
2005
A hearing in this case
was conducted on November 15, 2004, before ADMINISTRATIVE LAW JUDGE D.
FRANKLIN AREY, III, at Searcy, White County, Arkansas.
Claimant was represented
by Neal L. Hart, Attorney at Law, Little Rock, Arkansas.
Respondent #1 was
represented by J. Chris Bradley, Attorney at Law, North Little Rock,
Arkansas.
Respondent #2 was
represented by David L. Pake, Attorney at Law, Little Rock, Arkansas.
Respondent #3 was
represented by Judy W. Rudd, Attorney at Law, Little Rock, Arkansas.
STATEMENT OF THE CASE
A prehearing telephone
conference was held on this claim on September 7, 2004; a Prehearing
Order was filed in this matter on that same date. A copy of the
Prehearing Order was admitted into the record as Commission Exhibit #1.
The parties agreed to ten
stipulations. Four of these stipulations are set forth in the
Prehearing Order and were confirmed by
the parties at the hearing; the parties agreed to the remaining
stipulations at the hearing. The following stipulations are hereby
accepted.
1. Claimant sustained a
compensable injury on May 13, 2003.
2. The
employee-employer-carrier
relationship existed on May 13, 2003, and at all other relevant times.
3. Claimant’s rate for
temporary total
disability benefits is $433.00 per week; his rate for permanent partial
disability benefits is $325.00.
4. Claimant reached maximum medical improvement and the
end of his healing period on December 17, 2003.
5. Appropriate temporary
total disability benefits have been paid to Claimant.
6. Permanent partial
disability benefits based upon an 8% permanent impairment rating to the
body as a whole have been paid in full to Claimant.
7. Respondent #1
controverts permanent total disability benefits, and permanent partial
disability benefits in excess of the 8% permanent impairment rating.
8. Respondent #2
controverts liability for wage-loss disability benefits.
9. Respondent #1 has not
offered a program of vocational rehabilitation to Claimant.
10. Claimant’s average
weekly wage is $650.21.
At the November 15, 2004
hearing, the parties discussed the issues set forth in the
Prehearing Order. The parties agreed that
the issues to be litigated and resolved are limited to the following:
1. Whether Claimant is entitled to
an anatomical impairment rating of 20% to the body as a whole, or 8% to
the body as a whole.
2. Whether Claimant is permanently
and totally disabled.
3. If Claimant does not submit a
program of vocational rehabilitation, whether he’s constructively waived
wage-loss benefits under
Ark. Code Ann. § 11-9-505.
4. In the alternative, whether Claimant is entitled to
wage-loss disability benefits.
5. Whether Claimant is entitled to
an attorney’s fee based upon controversion, and if so, from which
Respondent(s).
6. Whether the Second Injury Fund
is liable to Claimant for benefits.
7. Whether the Death and Permanent
Total Disability Trust Fund is liable to Claimant for benefits.
8. Whether Respondent #1 must
first pay any permanent partial anatomical ratings to Claimant before it
pays permanent total disability benefits.
9. Whether Respondent #1 is
entitled to a credit for any permanent partial anatomical ratings paid
to Claimant against its $75,000.00 maximum liability.
Claimant contends that he
is entitled to the permanent impairment rating of 20% assigned by Dr.
Terry Green. He claims that he is permanently and totally disabled, or
in the alternative, that he is entitled to wage-loss disability
benefits. Citing the opinions of two doctors that he is totally
disabled, Claimant argues that he is not required to submit a program of
vocational rehabilitation, nor did he abandon his employment after his
release to return to full duty. Claimant seeks an attorney’s fee based
upon controversion.
Respondent #1 contests
Dr. Green’s rating, because it is based upon the Fifth Edition of the
Guides. Respondent #1 presented evidence that Claimant is not
permanently and totally disabled; further, Respondent #1 contends that
Claimant abandoned his employment after his release to return to full
duty on December 17, 2003, and therefore is not entitled to wage-loss
disability benefits. Respondent #2, citing Ark. Code Ann. § 11-9-505,
contends that Claimant waived wage-loss disability benefits by failing
to submit a program of vocational rehabilitation before the
determination of the extent of his disability. Respondent #2 further
contends that there is no combination of disabilities or impairments
such as were contemplated by the Second Injury Fund law.
Respondent #3 defers to
the outcome of litigation on issues 1 through 7; it contends that issue
number 8 must be answered in the affirmative and that issue number 9
must be answered in the negative.
DISCUSSION
In March 1995 Claimant
began to work for the respondent employer. Shortly thereafter, he was
assigned to its transfer station; he described his duties as follows:
We unload trucks or see
that the trucks are unloaded in the proper places.
When the compactor bins
are full, we pull them out with a truck and close the heavy metal doors and
chain them up and move them out - just change out the compactor bins.
There was a lot more
heavy stuff to lift, like the doors on the bins, very heavy steel doors. Plus, I did
the repair work. There was a lot of heavy steel to be lifting, and I helped
people unload their - we took furniture, refrigerators, all appliances.
Claimant explained how he
sustained his compensable injury on May 13, 2003.
I was changing out a
compactor bin. ... [The compactor doors] are steel doors that are
approximately eight foot wide, and they fold in half. So we had to fold them up and
then lift it up and hold it with one hand and hook a chain to it to hold it
up. So I was doing that. When I got it up, I reached to get the chain and the
door slipped a little bit; and when it did, I held it.
I didn’t let it fall all
the way, and I shoved it back up. When I did, I felt a pop in my hip and my lower
back over here. When I did that, I started walking off. I couldn’t get back
up in the truck. So I walked up to the building and told my partner and asked
him to put the bin in for me.
I was hurting and
everything. I waited a while, trying to see if I could walk it off, but it was getting
worse. So I called the office and reported it.
Claimant experienced pain
in his back, left hip, and left leg. At the respondent employer’s direction, he sought
medical treatment.
Despite conservative
treatment, Claimant’s pain persisted. Claimant was initially treated by Dr. Paul
Ramirez; he was then referred to Dr. Terry Green. Claimant underwent an MRI of his lumbar
spine on July 7, 2003; the study resulted in the following impression:
“Annular disk at L3-4,
L4-5 with right sided affects on the exiting nerve rootlets at those levels. The right L3
nerve rootlet appears to be more affected than the right L4-5.” Dr. Green interpreted this
study in a letter dated July 28, 2003.
His MRI was interpreted
by the radiologist as an annular disc at 4-5 and 3-4 to the right. I really
don’t think those discs are symptomatic or significant at this stage. He has
radicular pain down the back of the left leg and I think it is likely spondylitic
changes and foraminal stenosis at 5-1.
Dr. Green did not
recommend surgery; he scheduled Claimant for an epidural steroid injection. This
procedure, performed July 31, 2003, did not reduce Claimant’s pain.
On September 22, 2003,
Dr. Green noted “an established diagnosis of lateral recess stenosis at L5-S1 on the
left.” Dr. Ramirez concurred with Dr. Green’s opinion that an operation was needed. On
September 26, 2003, Claimant underwent a “[l]aminotomy and oraminotomy, left
L5-S1.” Despite this procedure, Claimant reported to Dr. Green on October 3, 2003
complaining of pain that “aches down the side of his left leg, a
stabbing type pain.” Claimant
underwent physical therapy and continued with his medications.
In late November 2003, an
insurance investigation company videotaped Claimant’s activity around his
residence. A copy of this video, transferred to disc, was admitted into the record as Respondent
#1's Exhibit #2. A segment of this video was played at the hearing and again
reviewed in preparation for this opinion. Claimant was questioned about his activity on November
21, 2003 as depicted by the video, while it played at the hearing.
Q. Okay. You’re lifting -
what was that big old piece of something?
A. That is a fiberglass
seat.
Q. You’re not walking
with your cane; are you?
A. No. I’m just limping.
Q. So you lifted that
out. And you’re going to go back to your truck, aren’t you, and work some more?
A. Yes, sir.
Q. You’ve [sic] bending
over there a little bit; aren’t you?
A. Just a little bit
there. I’m not bending that much.
Q. You’re kinda doing
some work in the back of the bed of the truck; right?
A. Okay. I know what that
is. I had a trailer on there.
Q. Now you’ve got a piece
of plywood or something?
A. I don’t know what that
was.
Q. Well, it’s a big bulky
object; isn’t it?
A. Yes.
As indicated, the video
reveals Claimant removing at least two large, bulky objects from the bed of his truck. At
some points in the video he is using his cane; at others, he is not. The video depicts
Claimant walking with a limp, bending, lifting, and carrying.
Claimant presented to Dr.
Reginald Rutherford on November 25, 2003, to undergo electrodiagnostic
testing. Dr. Rutherford concluded:
The nerve conduction
study is normal other than inability to obtain an H reflex either lower
extremity which correlates with clinical examination pertaining to absent
reflexes. Nerve conduction study yields normal motor and sensory responses.
There is no evidence to suggest diabetic neuropathy. On
electromyographic examination there is no evidence to suggest radiculopathy or
plexopathy.
Dr. Rutherford suggested
that Claimant undergo a functional capacity evaluation, which he did on December 11,
2003. The evaluator concluded that Claimant “underwent functional evaluation
this date with unreliable results for effort. [Claimant] put forth very inconsistent effort and
demonstrates many inconsistencies with inappropriate illness responses.” He opined
that Claimant “did demonstrate the ability to perform Lifting activities at the Light
level with a maximal lift of 21 lbs as well as carry of 11 lbs.”
In a clinic note dated
December 17, 2003, Dr. Rutherford made reference to the “invalid FCE” and advised
Claimant that he believed Claimant could return to “regular work duties without
restriction.” Claimant did not agree, “advising that he was unable to
walk.”
From my perspective,
there is no objective basis to support this allegation.
From my perspective,
[Claimant] may return to full work duties without restriction. Secondarily
there is no objective abnormality identified which would warrant
consideration of a permanent partial impairment rating.
However, when Claimant
presented to Dr. Green that same date, Dr. Green recommended that Claimant apply for
Social Security disability benefits.
Dr. Brent Sprinkle
examined Claimant on February 3, 2004. Dr. Sprinkle did not believe that Dr.
Rutherford’s nerve conduction study was conclusive, in that it did “not definitely exclude the
diagnosis of diabetic peripheral neuropathy.” Dr. Sprinkle offered some treatment, including
a TENS unit; on March 2, 2004, Dr. Sprinkle recommended that Claimant continue the
TENS unit, but otherwise released Claimant from his care.
Dr. William Blankenship
reviewed Claimant’s medical records on March 4, 2004.
He noted Claimant’s “long
history of diabetes mellitus.” After summarizing Claimant’s various medical records,
including his July 7, 2003 MRI study, Dr. Blankenship opined:
There are questions that
need to be answered in that it appears from the objective findings of the
MRI, everything that was found tended to be on the right side and this man’s
symptoms were on the left side. Even the EMG and nerve conduction study
that was done postoperatively did not reveal any essential neurological
disease, either from a neuropathy standpoint which could possibly be caused
by his diabetes, or nerve problems that could be due to stenosis or any
type of nerve encroachment.
Also with regard to an
opinion regarding a rating, the complaints of pain with regard to the spine as
well as limitation of motion regarding the spine are considered not objective
findings and therefore can [not?] be considered in a rating impairment.
In the view of this
examiner, in light of the objective findings, it would appear there is no objective
basis of any impairment as a result of his work-related injury. However, he has
had a surgical procedure done on his back, which was a left L5-S1
foraminotomy. According to the American Medical Association Guides to the
Evaluation of Permanent Impairment, 4th Edition, located on page 3/113,
table 75, under IV, titled “Spinal Stenosis,
Segmented Instability,
Spondylolisthesis, Fracture or Dislocation, Operated On”, under “A”, Single
level decompression without spinal fusion and without residual signs and
symptoms would be 8% to the body as a whole.
Dr. Ramirez continued to
treat Claimant. He doubted that Claimant’s condition was related to his diabetes,
“because his pain is basically... located in his legs and low back.
If this were to be
diabetes, is [sic] should be generalized neuropathy.” On May 4, 2004,
Dr. Ramirez offered the
following assessment:
1. Status post lumbar
fusion and decompression.
2. Radicular pain left
lower extremity.
3. Diabetes mellitus type
II noninsulin dependent complicated with neuropathy.
4. Essential
hypertension.
5. Obesity.
Dr. Ramirez opined that
Claimant “is currently totally disabled to perform any kind of job.”
He repeated this opinion
in a letter dated May 5, 2004, stating: “[I]t is my personal opinion that I do agree with Dr.
Green in that this patient is unable to carry on a gainful job.”
Claimant’s attorney wrote
to Dr. Green on January 4, 2004, seeking his opinion as to the extent of
Claimant’s permanent impairment, if any. Dr. Green responded on February 11, 2004. Where
Claimant’s attorney made reference to “ AMA
Guides, 4th Edition,” Dr. Green struck out “4th” and wrote in “5th.”
He rated Claimant’s permanent impairment as 20% to the
body as a whole.
A. Additional Permanent Partial Impairment Benefits
Benefits based upon an 8%
permanent impairment rating have been paid in full to Claimant. Claimant seeks
additional permanent partial impairment benefits, arguing his entitlement to a
permanent impairment rating of 20% to the body as a whole.
There are three statutory
requirements to establish an entitlement to benefits for a permanent impairment. See
Excelsior Hotel v. Squires, 83 Ark. App. 26, 33-34, 115
S.W.3d 823, (2003);
Schalski v. Family Cleaners & Laundry, Full Workers’ Compensation Commission
Opinion filed March 3, 2004 (E711809). First, it must be determined that the
compensable injury was the major cause of the impairment at issue.
Ark. Code Ann. §
11-9-102(4)(F)(ii)(a). “Major cause” means more than fifty percent of
the cause. Ark. Code Ann. §
11-9-102(14)(A). Second, any determination of the existence or extent of physical
impairment shall be supported by objective and measurable physical findings. Ark. Code Ann.
§ 11-9-704(c)(1)(B). Third, benefits for permanent impairment must be based on an
impairment rating using the American Medical Association’s Guides to the Evaluation to
Permanent Impairment (4th ed. 1993) (hereinafter “Guides”). Ark. Code Ann. § 11-9-522(g);
Workers’ Compensation Commission Rule 34.
A claimant must prove by
a preponderance of the evidence that he is entitled to an award of permanent
physical impairment. Schalski, supra; see Ark. Code Ann. § 11-9-704(c)(2). “Preponderance
of the evidence” means evidence of greater convincing force; the term does not mean
preponderance in amount, but implies an overbalancing in weight.
Smith v. Magnet Cove
Barium Corp., 212 Ark. 491, 496-97, 206 S.W.2d 442, (1947).
Dr. Green’s rating of 20%
permanent impairment to the body as a whole offered on February 11, 2004, is of
little assistance. Obviously, his reliance upon the Fifth Edition of the Guides is contrary to
law. Dr. Green did not identify any supporting objective findings or address the causation
requirement. However, this does not resolve the issue; the Commission is authorized
to assess its own impairment rating rather than rely solely on ratings assigned by
physicians. See Polk County v. Jones, 74 Ark. App. 159, 164-65, 47 S.W.3d 904, (2001).
I find that Claimant has
not sustained his burden of proving by a preponderance of the evidence that he is
entitled to additional permanent partial impairment benefits.
Specifically, without
addressing the other two factors, Claimant has not demonstrated that the compensable injury
was the major cause of any additional impairment at issue. The MRI of Claimant’s lumbar
spine taken July 7, 2003 revealed “[a]nnular disk at L3-4, L4-5.”
However, as Dr.
Blankenship noted on March 4, 2004, “it appears from the objective findings of the MRI,
everything that was found tended to be on the right side and this man’s symptoms were on the left
side.” Since Claimant’s immediate and following symptoms were in his back, left
hip, and left leg, it would require speculation to find that these discs with “right sided
affects” did not preexist his May 13, 2003 compensable injury.
It should be noted that
Dr. Rutherford’s November 25, 2003 EMG report observed an “inability to obtain
an H reflex either lower extremity....” According to Table 71, differentiator 4, found
on page 3/109 of the Guides, this could be a significant objective finding. However,
Claimant offered no evidence, in the medical record or otherwise, to establish that his
compensable injury was the major cause of this finding. Indeed, to the contrary, Dr. Rutherford
discounted this finding by later noting “no objective abnormality identified which would
warrant consideration of a permanent partial impairment rating.”
Likewise, Dr. Blankenship
noted this finding in his March 4, 2004 letter, but did not use it as a basis for an
impairment rating.
B. Permanent Total Disability Benefits
Claimant seeks a
determination that he is permanently and totally disabled.
“Permanent total
disability” means inability, because of compensable injury, to earn any meaningful wages in the
same or other employment. Ark. Code Ann. § 11-9-519(e)(1).
Claimant has the burden
of proving his inability to earn any meaningful wage in the same or other employment; he
must sustain this burden by a preponderance of the evidence. Ark. Code Ann. §§
11-9-519(e)(2) and 11-9-704(c)(2).
Claimant’s injury is not
scheduled under the Act; therefore, his entitlement to permanent disability
benefits is controlled by Ark. Code Ann. § 11-9-522. Pursuant to this statute, when a claimant
has been assigned an anatomical impairment rating to the body as a whole, the
Commission has the authority to increase the anatomical rating, and it
can find a claimant
permanently and totally disabled based upon wage-loss factors. Whitlatch v. Southland Land & Dev.,
84 Ark. App. 399, 405, 141 S.W.3d 916, (2004).
The wage-loss factor is
the extent to which a compensable injury has affected the claimant’s
ability to earn a livelihood. The Commission is charged with the duty of
determining disability based upon a consideration of medical evidence and
other matters affecting wage-loss, such as the claimant’s age,
education, and work experience. In considering factors that may affect an employee’s
future earning capacity, the court considers the claimant’s motivation to
return to work, since a lack of interest or a negative attitude impedes our
assessment of the claimant’s loss of earning capacity. Lee v. Alcoa Extrusion,
Inc., Ark. App. , S.W.3d (January 26, 2005) (citations omitted). In addition,
Ark. Code Ann. § 11-9-102(4)(F)(ii)(a) provides that: “[p]ermanent benefits shall be awarded
only upon a determination that the compensable injury was the major cause of the
disability or impairment.” “Major cause” is defined as more than fifty percent of the cause.
Ark. Code Ann. § 11-9-102(14)(A).
As an initial matter,
Claimant has been assigned an anatomical impairment rating to the body as a whole.
The parties stipulated that Claimant has been paid benefits based upon an 8% permanent
impairment rating to the body as a whole.
Nonetheless, I find that
Claimant has not sustained his burden of proving by a preponderance of the
evidence that he is not able, because of his compensable injury, to earn any meaningful wages
in the same or any other employment. The video of Claimant’s
November 21, 2003
activity, entered into the record, demonstrates that Claimant is able to bend, lift, and carry
large bulky objects without the use of his cane. Claimant’s December 11, 2003
functional capacity evaluation, taken less than a month after the video, concludes that Claimant
“did demonstrate the ability to perform Lifting activities at the Light level with a maximal lift
of 21 lbs as well as carry of 11 lbs.” Claimant is clearly able to engage in some activity;
his compensable injury does not prevent him from earning any meaningful wages. I
acknowledge the contrary opinions of Dr. Green and Dr. Ramirez that
Claimant “is unable to
carry on a gainful job”; of course, Dr. Rutherford released Claimant to full work duties
without restriction. Given the conflicting medical opinions, the video
of Claimant’s activities
coupled with the functional capacity evaluation persuasively demonstrate that Claimant
is not permanently totally disabled.
C. Constructive Waiver under Section 11-9-505(b)
Respondent #2, citing
Ark. Code Ann. § 11-9-505(b), contends that Claimant waived wage-loss disability
benefits by failing to submit a program of vocational rehabilitation before the determination
of the extent of his disability. At the hearing, Respondent #2's attorney argued:
[B]ecause Section
505(b)(4) requires that the claimant submit a program of vocational rehabilitation
before the determination and extent of disability, if he continues on with his
extent of disability hearing not having presented a program of vocational
rehabilitation, he has passively waived it or waived it as a matter of law.
Apparently, no respondent
offered Claimant a program of rehabilitation or job placement; Respondent #1 stipulated
that it has not offered Claimant a program of vocational rehabilitation.
Claimant testified that
he visited his local Arkansas Rehabilitation Services office three times, seeking
assistance in finding a job; that office did not provide him with a list of jobs. He testified
that if he had been offered retraining, he would have been cooperative and met with a vocational
rehabilitation specialist. Claimant reiterated that no one has offered him a program of
vocational rehabilitation. On the other hand, Claimant has not filed such a program, nor
did he ask the respondent employer to provide such a program prior to the hearing.
Ark. Code Ann. §
11-9-505(b)(3) and (4) state:
(3) The employee shall
not be required to enter any program of vocational rehabilitation against
his or her consent; however, no employee who waives rehabilitation or refuses
to participate in or cooperate for reasonable cause with either an offered
program of rehabilitation or job placement assistance shall be entitled to
permanent partial disability benefits in excess of the percentage of permanent
physical impairment established by objective physical findings.
(4) A request for the
program, if elected by the claimant, must be filed with the commission prior to a
determination of the amount of permanent disability benefits
payable to the employee.
As this statute is
interpreted by the Arkansas Court of Appeals and the Full Commission, a claimant’s mere failure
to offer a program of vocational rehabilitation, standing alone, does not constitute a
waiver of rehabilitation. See Second Injury Fund v. Stephens, 62 Ark. App. 255, 264, 970 S.W.2d
331, (1998) (rejecting “an identical argument by the Fund that a claimant had a
duty to pursue rehabilitation and that he failed to do so”); Second Injury Fund v. Furman, 60
Ark. App. 237, 245, 961 S.W.2d 787, (1998) (section 11-9- 505(b)(4) “does not stand
for the proposition that every claimant must formally file for rehabilitation with the
Commission or waive entitlement to disability benefits”); Craig v. Beaty Logging Company,
Full Workers’ Compensation Commission Opinion filed June 4, 2004 (F113089) (finding
that the record is void of any offer of vocational rehabilitation from the respondents “and, at
most, merely shows that claimant was not interested in pursuing the vocational
rehabilitation on his own volition nor was he informed of rehabilitation opportunities”); Bruton
v. Baltz, Full Workers’ Compensation Commission Opinion filed April 24, 2000 (E707801).
In Bruton, the Commission wrote:
As an initial matter, we
note that respondent seems to suggest that claimant should be barred from
receiving wage loss benefits under Ark. Code Ann. § 11-9-505(b)(3) and (4),
because the claimant did not request a rehabilitation program. Even if the
respondents were correct that the claimant did no request a rehabilitation
program, the fact that a claimant does not propose a rehabilitation program
has previously been held not to be grounds for barring wage loss
benefits under the Arkansas Workers’ Compensation Law as amended by Act 796 of
1993. Bruton, supra I find that Claimant’s
failure to submit a program of vocational rehabilitation does not constitute constructive
waiver of wage-loss benefits under Ark. Code Ann. § 11-9-505(b)(3) and (4). Claimant did
seek assistance from an Arkansas Rehabilitation Services office.
He testified to
willingness to cooperate if Respondents offered a program of vocational rehabilitation; no such
offer has been forthcoming. In light of the authorities cited above, and these facts,
Claimant’s failure to submit a program of vocational rehabilitation does
not constitute a waiver of
his wage-loss disability benefits.
D. Wage-loss Disability Benefits
Claimant seeks wage-loss
disability benefits in the alternative. Respondent #1 contends that Claimant
abandoned his employment after his release to return to full duty on December 17, 2003, and
therefore is not entitled to wage-loss disability benefits. Claimant has been
assessed an 8% permanent impairment rating to the body as a whole; therefore, the Commission
may consider his claim for wage-loss disability in excess of permanent physical
impairment. See Ark. Code Ann. § 11-9-522(b)(1).
The wage-loss factor is
the extent to which a compensable injury has affected the claimant’s ability to
earn a livelihood. Emerson Elec. v. Gaston, 75 Ark. App. 232, 237, 58 S.W.3d 848, (2001).
In determining wage loss
disability, the Commission may take into consideration the
worker’s age, education, work experience, medical evidence and any other
matters which may reasonably be expected to affect the worker’s future
earning power. Such other matters are motivation, postinjury income, credibility,
demeanor, and a multitude of other factors. A claimant’s lack of
interest in pursuing employment with her employer and negative attitude in
looking for work are impediments to our full assessment of wage-loss. McKinney v. Plastics
Research & Development, Full Workers’ Compensation Commission Opinion filed November
10, 2004 (E901881); see Ark. Code Ann. § 11-9-522(b)(1); Emerson Elec., 75 Ark.
App. at 237, 58 S.W.3d at . In addition, 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); see McKinney, supra. “Major
cause” is defined as more than fifty percent of the cause. Ark. Code Ann. §
11-9-102(14)(A).
However, so long as an
employee, subsequent to his injury, has returned to work, has obtained other
employment, or has a bona fide and reasonably obtainable offer to be employed at wages equal
to or greater than his average weekly wage at the time of the accident, he shall not be
entitled to permanent partial disability benefits in excess of the percentage of permanent
physical impairment established by a preponderance of the medical testimony and
evidence. Ark. Code Ann. § 11-9-522(b)(2). The employer or its workers’ compensation
insurance carrier has the burden of proving the employee’s employment, or the
employee’s receipt of a bona fide offer to be employed, at wages equal to or greater than his
average weekly wage at the time of the accident. Ark. Code Ann. § 11-9-522(c)(1).
I find that Respondent #1
did not sustain its burden of proving that Claimant is barred from receiving
wage-loss disability benefits under Ark. Code Ann. § 11-9-522(b)(2).
Dr. Rutherford opined
that Claimant could return to his regular work duties without restriction, as of
December 17, 2003. However, the video of Claimant’s November 21, 2003 activities, while
demonstrating that he is not permanently and totally disabled, also demonstrates his
consistent limping and affected movement. Claimant’s December 11, 2003 functional capacity
evaluation restricted Claimant’s lifting activities to the “light”
level, less than the job
Claimant was performing at the time of his compensable injury. Claimant testified that, at his
meeting with his supervisor and others after the December 17, 2003 release, he was informed
there were no “light positions” available; since Claimant did not believe he could return
to his former job, the respondent employer terminated his employment. Under the
terms of the statute, Claimant did not return to work, he has not obtained other
employment, and Respondent #1 did not prove a reasonably obtainable offer to be employed at
wages equal to or greater than Claimant’s average weekly wage at the time of the
accident. Claimant did not abandon his employment.
Turning to the question
of wage-loss disability benefits, at the time of the hearing Claimant was 48 years of
age, had a tenth-grade education, and had failed the GED examination twice. His
employment history involves fields requiring manual labor; he confirmed that he has
never had a desk job. Claimant has undergone surgery at L5-S1, which failed to alleviate
his complaints of pain and resulted in an 8% permanent impairment rating to his
body as a whole. Two doctors agree that Claimant is unable to carry on gainful
employment. On the other hand, the video of Claimant’s activity on November 21, 2003, and
Claimant’s functional capacity evaluation, both indicate that
Claimant has some ability
to engage in work activity. Claimant’s motivation to return to work is questionable; at
the hearing he confirmed his belief that he will not be able to work again. At his deposition,
he admitted that he has not completed any employment applications or otherwise
made any effort to seek employment. Claimant apparently does not believe that he is
able to undergo vocational rehabilitation.
After considering all
relevant wage-loss factors, I find that the Claimant has established a decrease in
his wage earning capacity equal to 15% to the body as a whole.
He is entitled to
benefits for this decrease in his wage earning capacity. Further, I find
that Claimant did prove by a
preponderance of the evidence that his compensable injury is the major cause of his
decrease in earning capacity. Claimant could perform his job prior to his compensable injury;
since then, two doctors agree with Claimant’s belief that he cannot perform any employment.
Claimant’s compensable injury is the sole, and thus the major, cause for his decrease in
earning capacity.
E. Second Injury Fund Liability
In 1992 Claimant
sustained a compensable injury to his neck while working for another employer.
Claimant underwent surgery to treat his condition, spent some time off work, and settled his
subsequent claim. Claimant believed it took about a year before he could return to work. He
testified during his August 9, 2004 deposition that he did not miss any time from work
between 1995 and 2003 due to his neck injury; he confirmed that this injury did not keep him
from doing a full day’s work for the respondent employer. When asked at the hearing what
symptoms currently bother him, Claimant replied: I just have - in my back,
I still have a lot of pain in my hip and everything; and my leg goes numb all the
way to my foot, and it stings and burns at different times. If I sit too long
without my leg up, like right now, my foot goes to swelling and starts
getting numb.
As can be seen, Claimant
did not mention his neck as being symptomatic. Respondent #2 argues that
there is no combination of disabilities or impairments necessary to impose
liability. The conditions for imposing liability upon the Second Injury Fund are as follows:
First, the employee must
have suffered a compensable injury at his present place of employment.
Second, prior to that injury the employee must have had a permanent partial
disability or impairment. Third, the disability or impairment must have
combined with the recent compensable injury to produce the current
disability status. Second Injury Fund v.
Stephens, 62 Ark. App. 255, 259, 970 S.W.2d 331, (1998) (citations omitted); see
Ark. Code Ann. § 11-9-525.
I find that Respondent #2
is not liable for wage-loss disability benefits. The medical records relating to the
May 13, 2003 compensable injury do not support a finding that Claimant’s 1992 and 2003
injuries combined to produce his current disability status.
Claimant testified that
he did not miss a day of work from 1995 until 2003 due to his 1992 compensable neck injury.
And, Claimant did not indicate that his neck injury was symptomatic after his May
13, 2003 compensable injury. Under the third part of the test recited above, there
simply is no evidence that Claimant’s 1992 disability or impairment combined with his 2003
compensable injury to produce his current disability status.
F. Issues Seven, Eight, and Nine
This opinion finds that
Claimant did not sustain his burden of proving that he is permanently and totally
disabled. Therefore, it is not necessary to discuss issues 7, 8, and 9, relating to the
liability of the Death and Permanent Total Disability Trust Fund.
Compare Ark. Code Ann. §
11-9-502(b) (providing for payments by the Fund if benefits for death or permanent total
disability have been paid to the claimant).
G. Attorney’s Fee
Attorney’s fees shall
only be allowed on the amount of compensation for indemnity benefits controverted and
awarded. Ark. Code Ann. § 11-9-715(a)(2)(B)(ii). This opinion awards Claimant wage-loss
disability benefits based upon the relevant factors. The parties stipulated that
Respondent #1 controverted permanent partial disability benefits in
excess of the 8% permanent
impairment rating previously paid to Claimant. As noted above, Respondent #2 and
Respondent #3 are not liable for the payment of benefits to Claimant. Thus, Claimant is
entitled to an award of an attorney’s fee pursuant to the statute to be paid by Respondent #1.
FINDINGS OF FACT AND CONCLUSIONS OF LAW
1. The stipulations agreed upon by the parties are
reasonable and are approved.
2. Claimant sustained a
compensable injury on May 13, 2003.
3. The
employee-employer-carrier
relationship existed on May 13, 2003, and at all other relevant times.
4. Claimant’s rate for temporary
total disability benefits is $433.00 per week; his rate for permanent partial disability
benefits is $325.00.
5. Claimant reached maximum
medical improvement and the end of his healing period on December 17, 2003.
6. Appropriate temporary total
disability benefits have been paid to Claimant.
7. Permanent partial disability
benefits based upon an 8% permanent impairment rating to the body as a whole have
been paid in full to Claimant.
8. Respondent #1 controverts
permanent total disability benefits, and permanent partial disability benefits in
excess of the 8% permanent impairment rating.
9. Respondent #2 controverts
liability for wage-loss disability benefits.
10. Respondent #1 has not offered
a program of vocational rehabilitation to Claimant.
11. Claimant’s average weekly wage
is $650.21.
12. Claimant did not sustain his
burden of proving by a
preponderance of the
evidence that he is
entitled to additional permanent partial impairment benefits. Dr.
Green’s
20% permanent impairment rating to
the body as a whole is flawed, due to its reliance upon the Fifth Edition of the Guides.
Claimant otherwise failed to demonstrate that the compensable injury was the major
cause of his “[a]nnular disk at L3-4, L4-5" or his absent H reflex. The record does not
reflect whether these two impairments preexisted Claimant’s compensable injury or not.
13. Claimant did not sustain his
burden of proving by a preponderance of the
evidence that he is
permanently and totally disabled. The video of Claimant’s November 21, 2003 activities, as well as his December 11, 2003
functional capacity evaluation, both demonstrate that Claimant is able
to earn meaningful wages in some employment.
14. Claimant did not waive
wage-loss disability benefits by failing to submit a program of vocational
rehabilitation before the determination of the extent of his disability. The applicable statute is not
interpreted to equate the mere failure to offer a program of vocational rehabilitation with a
waiver of rehabilitation.
15. Upon consideration of all
relevant wage-loss factors, I find that Claimant established a decrease in his wage
earning capacity equal to 15% to the body as a whole, and that he is therefore entitled
to wage-loss disability benefits. Claimant did prove by a
preponderance of the evidence that
his compensable injury is the major cause of his
decrease in earning capacity. I also find that
Respondent #1 did not prove that Claimant abandoned his employment after his
release to return to full duty on December 17, 2003.
16. Respondent #2 is not liable
for wage-loss disability benefits payable to Claimant. There is no evidence in the record
that Claimant’s 1992 disability or impairment combined with his 2003 compensable injury
to produce his current disability status.
17. Because this opinion finds
that Claimant did not sustain his burden of proving
that he is permanently and totally
disabled, it is not necessary to determine issues 7, 8, and 9, relating to the liability of
the Death and Permanent Total Disability Trust Fund.
18. Claimant’s attorney is
entitled to the maximum prescribed attorney’s fee under Ark. Code Ann. § 11-9-715, to be
paid by Respondent #1.
AWARD
Respondent #1 is directed
to pay benefits in accordance with the Findings of Fact and Conclusions of Law
set forth herein.
Claimant’s attorney is
entitled to the maximum statutory attorney’s fee on benefits awarded herein, one-half
of which is to be paid by Claimant and one-half to be paid by Respondent #1 in
accordance with Ark. Code Ann. § 11-9-715 and Death and Permanent Total Disability Trust
Fund v. Brewer, 76 Ark. App. 348, 65 S.W.3d 463 (2002).
IT IS SO ORDERED.
D. FRANKLIN AREY, III,
Administrative Law Judge
DFA/ml
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Rassett v. Utility
Tri-State
The respondent
accepted a permanent partial disability benefit based on a 15%
impairment rating. Mr. Rassett contended that he was entitled to
permanent partial disability benefits in excess of the 15% impairment
rating. He is 36 years old and suffered a compensable injury to his low
back while working for the employer on January 12, 2002. He underwent a
two-level lumbar diskectomy, followed by a fusion, with Dr. Arthur
Johnson assigning an impairment rating of 15% to the body. Judge Stewart
limited the additional wage loss disability to 25% to the body as a
whole, and referenced vocational consultant Heather Naylor's vocational
work—which included job history, documented physical restrictions, a
Labor Market Survey, identification of potential job openings and the
pay ranges. The ALJ also noted distinctly different opinions in the
psychological area from Dr. Douglas Brown and Dr. Judy White Johnson.
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Collins v. Lennox
Industries
(change of physician)
In Collins v. Lennox Ind., the claimant
sustained a low back injury. The employer had an MCO. They sent him to
the company doctor who said he had a strain. The claimant demanded a MRI
and a myleogram. He was referred to Dr. John Wilson who ordered the MRI
and said that it showed only degenerative problems and nothing surgical.
The claimant then demanded a myleogram and Dr. Wilson said that it was
not necessary. The claimant then asked for another doctor.
The employer then agreed to an IME by Dr.
Bruce Safman. He agreed with Dr. Wilson. He reported that the claimant
appeared to be angry that there was nothing wrong with him that was work
related. The claimant then got an attorney who requested a change of
physicians. The employer refused and the ALJ and the full commission
agreed that it was not reasonable or necessary to have a change or
further treatment.
The Court of Appeals reversed. They said
that when the employer chooses the first doctor and the claimant wants
to change to a different doctor, then there is an absolute right to
change physicians. They said it does not matter whether it is reasonable
or necessary or not. The right to a one time change is mandatory and not
discretionary.
Comment: You can still negotiate which
doctor the claimant will change to, but be sure to get an order from the
AWCC so that the claimant's change is recorded. Without an order, the
claimant can change again.
Michael E. Ryburn, Ryburn Law Firm
Phone: 501-228-8100
Email:
complawyer@sbcglobal.net
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Pifer v. Single Source
Transportation
Claimant was injured at work while returning to his truck from the
restroom. He was hit on the side of his back by a co-worker’s pickup,
which knocked him five to six feet. The Court used the same test to
determine whether the employee was performing "employment services" as
it does when determining whether an employee was acting within "the
course of employment." The test is whether the injury occurred "within
the time and space boundaries of the employment, when the employee [was]
carrying out the employer’s purpose or advancing the employer’s interest
directly or indirectly."
The Supreme Court had not addressed the
personal-comfort doctrine since the enactment of Act 796. Instead of
accepting a personal-comfort activity as providing employment services
or rejecting a personal-comfort activity as not providing employment
services, the Court focused on whether the employer’s interests were
being advanced either directly or indirectly by Claimant at the time of
the injury. The Court also declined to adopt the factors set out in
Matlock v. Blue Cross, 74 Ark. App. 322 (2001). It held that
Claimant’s injury was compensable; he was engaged in conduct permitted
by the employer, if not specifically authorized by the employer, as the
employer provided restroom facilities on its premises.
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Privett v. Excel Specialty Products
In an effort to circumvent the exclusive remedy provisions, Claimant
contended that she was not performing employment services at the time of
her accident. Claimant worked at a meat-processing facility and was
required to wear certain clothing and to have a knife scabbard. On the
day she was injured, Claimant forgot her knife scabbard in the laundry
room, so she exited the production room, slipped and fell. Claimant’s
contention was that because her work day had not yet begun, her injury
could not be compensable.
The Court held that the injury was
compensable. The fact that a worker is not directly compensated for the
activity engaged in when an accident occurs is not controlling as to
whether the worker is performing employment services. By getting the
necessary equipment, Claimant was manifestly advancing the employer’s
interest. She was engaged in incidental activities that were necessary
for the performance of the primary activity she was hired to perform.
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Taylor v. Jefferson
Regional Medical Center
Claimant was told by her employer to arrive
early to get her department ready for patients. She had already clocked
in when she unlocked the back door to the neurology department. Claimant
could not remember whether she turned on the lights or whether they were
already on, but she slipped and fell while on her way to turn on the
computers and fax machines. The activities were performed in an effort
to carry out her employer’s interest and were found to be employment
services, despite the fact that she testified that she "never made it to
start the day" before she was injured.
Carol Worley
Phone: 501-374-6535
Email:
carol.worley@hmrtlaw.com
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