ANDERSON v. WYNWOOD NURSING CENTER, 1995 AWCC 204


CLAIM NO. E205952

GLENOUS ANDERSON, EMPLOYEE, CLAIMANT v. WYNWOOD NURSING CENTER, EMPLOYER, RESPONDENT and SISCO, INSURANCE CARRIER, RESPONDENT

Before the Arkansas Workers’ Compensation Commission
OPINION FILED OCTOBER 3, 1995

Upon review before the FULL COMMISSION in Little Rock, Pulaski County, Arkansas.

Claimant represented by the HONORABLE ZAN DAVIS, Attorney at Law, Little Rock, Arkansas.

Respondents represented by the HONORABLE WALTER A. MURRAY, Attorney at Law, Little Rock, Arkansas.

Decision of Administrative Law Judge: Affirmed in part and reversed in part.

[1] OPINION AND ORDER
[2] The respondents appeal an opinion and order filed by the administrative law judge on June 28, 1994. In that opinion and order, the administrative law judge found that the respondents are responsible for medical expenses related to the claimant’s hospitalization on May 17, 1993, and that the claimant is entitled to additional temporary total disability compensation. After conducting a de novo review of the entire record, we find that the administrative law judge’s decision must be affirmed in part and reversed in part.

[3] The claimant was employed by the respondent employer as a licensed practical nurse. On April 1, 1992, he sustained an admittedly compensable back injury when he fell over a chair. He was first treated for this injury on April 3, 1992, by Dr. W. G. Burks, a general practitioner. Dr. Burks diagnosed a lumbar strain, and he treated the claimant conservatively. However, when the claimant continued to complain of significant pain in his back and left leg, Dr. Burks referred him to Dr. Joseph Miller, a neurosurgeon. A MRI ordered by Dr. Miller showed some chronic degenerative disc changes, but there was no evidence of a ruptured disc. Nevertheless, the claimant continued to complain of pain, and, on April 27, 1992, Dr. Miller performed a myelogram. However, neither the myelogram nor the post myelogram CT scan revealed any herniated nucleus pulposus, bulging disc, neuroforaminal encroachment, canal stenosis, or any abnormality other than degenerative changes. Thus, Dr. Miller concluded that the claimant was suffering from degenerative spine disease with a lumbar strain.

[4] The claimant soon became dissatisfied with Dr. Miller, and he petitioned for a change of physicians. Based on the mutual agreement of the parties, an order was entered granting the claimant a change of physicians to Dr. John Wilson, an orthopedic specialist. Based on the previous diagnostic studies and his clinical examination, Dr. Wilson concluded that the claimant was suffering from nerve root irritation, which was resolving, but Dr. Wilson concluded that there was no nerve root impingement. He treated the claimant conservatively with medication and physical therapy. Dr. Wilson released the claimant to return to work at his regular duties on July 20, 1992, and he assigned a 5% permanent impairment rating based on the claimant’s “persistent sciatica and decreased S1 nerve root function.”

[5] The claimant returned to work in a position that did not require any lifting. However, he testified that he has continued to experience pain in his low back that radiates into his extremity, along with muscle spasms, swelling, numbness, and tingling. The claimant’s son, ex-wife, and former neighbor each testified that he has demonstrated physical limitations since the injury that he did not previously demonstrate. The claimant was hospitalized on May 17, 1993, by Dr. Burks, and he contends that he was hospitalized as a result of his low back problems. However, the respondents have refused to pay for the expenses resulting from this hospitalization.

[6] Employers must promptly provide medical services which are reasonably necessary for treatment of compensable injuries. Ark. Code Ann. § 11-9-508 (a) (1987). However, injured employees have the burden of proving by a preponderance of the evidence that medical treatment is reasonably necessary for treatment of the compensable injury. Norma Beatty v. Ben Pearson, Inc., Full Workers’ Compensation Commission, Feb. 17, 1989 (Claim No. D612291). In assessing whether a given medical procedure is reasonably necessary for treatment of the compensable injury, we analyze both the proposed procedure and the condition it is sought to remedy. Deborah Jones v. Seba, Inc., Full Workers’ Compensation Commission, Dec. 13, 1989 (Claim No. D511255).

[7] In the present claim, we find that the claimant failed to prove by a preponderance of the evidence that his hospitalization was reasonably necessary for treatment of the compensable injury. With regard to this hospitalization, Dr. Burks’ admission report states the following:

The patient is a white male who comes in with history of pain in the back radiating down into the left leg. The patient states that over the last 2-3 days he has had increasing pain and severity. He still persists in having pain. It appears that his out patient care has not been satisfactory. He is admitted for intensive conservative therapy. The patient also gives history of having approximately 33 lb. weight loss.

[8] However, although this report and other reports drafted by Dr. Burks indicate that the claimant’s back problems were the purpose of the hospitalization, the claimant had seen Dr. Burks on May 16, 1993, the day before the hospitalization, and Dr. Burks’ report of that visit indicates that the claimant’s primary complaint involved “migraine headaches”. Although the report does indicate that the claimant was also complaining of back problems to some extent, little emphasis is placed on the back related complaints. Furthermore, the claimant’s ex-wife advised the respondent employer that the claimant had been hospitalized due to migraine headaches. At the hearing, she admitted doing so. She testified that she did this because the respondent carrier refused to authorize the treatment, and she testified that she related the hospitalization to headaches so that she could file the expenses under a group insurance plan. However, the claimant’s testimony indicates that he was not sure whether his group plan was in effect at the time. Furthermore, his testimony indicates that he had suffered from frequent migraine headaches since he sustained a neck injury while employed by a different employer, and he testified that he thought that the headaches would have been excluded as a preexisting condition even if the policy was in effect.

[9] Consequently, we find that the evidence suggests that complaints other than back complaints may have been the primary reason for the claimant’s hospitalization. Furthermore, although the medical records indicate that he did receive some treatment for his back while he was hospitalized, there is nothing to suggest that this treatment differed to any great extent from the treatment that he received as an outpatient both before and after the hospitalization. In this regard, the only treatment provided to the claimant for his back while he was in the hospital consisted of medication and physical therapy. However, he was prescribed the same medication when he was discharged from the hospitalization, and the record indicates that he had previously received essentially the same type of physical therapy as an outpatient.

[10] In short, we find that the preponderance of the evidence fails to show that the claimant received any treatment for the compensable injury while hospitalized that he could not have received as an outpatient. Furthermore, the evidence indicates that the claimant may have been hospitalized primarily for conditions unrelated to the compensable injury. Therefore, we find that the claimant failed to prove by a preponderance of the evidence that the hospitalization was reasonably necessary for treatment of the compensable injury. Therefore, we find that the administrative law judge’s decision in this regard must be reversed.

[11] However, the preponderance of the evidence does indicate that he was experiencing temporary back problems which were related to the compensable injury during the time he was in the hospital from May 17, 1993, through May 24, 1993, that would have prevented him from working even if he had not been experiencing other problems or if he had not been hospitalized. Likewise, he was off work from July 24, 1993, through August 17, 1993, due to back problems related to the compensable injury. Therefore, we find that the claimant is entitled to temporary total disability compensation for these periods of time. Thus, we find that the administrative law judge’s decision in this regard must be affirmed.

[12] Accordingly, based on our de novo review of the entire record, and for the reasons discussed herein, we find that the claimant failed to prove by a preponderance of the evidence that his hospitalization was reasonably necessary for treatment of the compensable injury. Therefore, we find that the administrative law judge’s decision in this regard must be reversed. However, we find that the claimant proved by a preponderance of the evidence that he is entitled to temporary total disability compensation for the period extending from May 17, 1993 through May 24, 1993, and from July 24, 1993 through August 17, 1993. Therefore, we find that the administrative law judge’s decision in this regard must be affirmed.

[13] All accrued benefits shall be paid in a lump sum without discount and with interest thereon at the lawful rate from the date of the Administrative Law Judge’s decision in accordance with Ark. Code Ann. § 11-9-809
(1987). For prevailing in part on this appeal before the Full Commission, claimant’s attorney is hereby awarded an additional attorney’s fee in the amount of $250.00 in accordance with Ark. Code Ann. 11-9-715 (b) (1987).

[14] IT IS SO ORDERED.

JAMES W. DANIEL, Chairman

[15] Commissioner Tatum concurs and dissents.

[16] CONCURRING AND DISSENTING OPINION
[17] I concur with part and dissent with part of the majority’s decision. Specifically, I concur with the decision finding that claimant has failed to prove by a preponderance of the credible evidence that he is entitled to additional medical benefits related to a hospitalization on May 17, 1993 through May 24, 1993. However, I respectfully dissent from the majority’s determination finding that claimant is entitled to additional temporary total disability benefits.

[18] In my opinion, it should be noted that the Administrative Law Judge in her opinion writes:

The evidence shows that the claimant became dissatisfied with Dr. Miller in June of 1992 and entered into a mutually agreed upon a [sic.] change of physician to Dr. John Wilson, an orthopedic specialist. (Respondents’ Exhibit 1, Page 11) See: Magic Mart vs. Little, 12 Ark. App. 325, 676 S.W.2d 756 (1984). This change of physician did not negate claimant’s right to seek occasional care from the local, company physician when claimant’s symptoms became acute.

[19] A review of Magic Mart, indicates that this is not the proposition for which this case is cited. The Administrative Law Judge seemingly implies that Magic Mart
holds that whenever there is a mutually agreed upon change of physician, it is not or does not qualify as a statutory change of physician or that a claimant can continue to see a company physician regardless of who the primary treating physician is. This is not accurate. Magic Mart pre-exists the 1986 revisions, as well as, the most recent revisions of the aforementioned statute. Magic Mart stands for the proposition that under prior law whenever there is a mutually agreed upon change of physician from a company physician to a physician that does not constitute claimant’s one time only change of physician. Magic Mart does not state that anytime there is a mutually agreed upon change of physician that it is outside the change of physician rules. Additionally, Magic Mart does not hold that a claimant can indefinitely continue to return to a company physician who is no longer the primary treating physician. Thus, in my opinion, the Administrative Law Judge is misleading in use of the cite.

[20] I concur in part and dissent in part with the majority’s determination and include my opinion concerning the Administrative Law Judge’s use of Magic Mart.

[21] ALLYN C. TATUM, Commissioner

[22] Commissioner Humphrey concurs in part and dissents in part.

[23] CONCURRING AND DISSENTING OPINION
[24] I concur with the finding in the principle opinion that claimant is entitled to benefits for temporary total disability from May 17 to May 24, 1993 and July 24 to August 17, 1993. However, I must respectfully dissent from the finding that claimant’s hospitalization was not reasonably necessary and related to the compensable injury.

[25] On April 1, 1994 claimant sustained an admittedly compensable lower back injury when he fell over a chain at work. He experienced lower back pain, swelling, muscle spasms, numbness and tingling. Claimant continued to experience these symptoms but eventually returned to work. The credible testimony indicates that in May 1993, claimant experienced a significant increase in the pain and swelling in his back, buttocks and leg. Along with these symptoms, claimant also experienced a migraine headache, with nausea and vomiting. This evidence is corroborated by claimant’s ex-wife as well as his son, who is an LPN. Claimant presented to Dr. Burks and was admitted into the hospital with complaints of migraine headache and left hip, lower back and left leg pain. Dr. Burks’ records indicate that the principal diagnosis was a lumbar herniated nucleus pulposus with symptoms of positive straight leg raising and decreased range of motion. Claimant was discharged from the hospital on May 24, 1993 with an improved back condition. Based on this evidence, I find that the hospitalization from May 17 through May 24, 1993 was reasonably necessary and related to the compensable injury.

[26] PAT WEST HUMPHREY, Commissioner