CLAIM NO. E113361

DAVID ADAMS, EMPLOYEE, CLAIMANT v. DAVID ADAMS OLYMPIC POOLS, EMPLOYER, RESPONDENT NO. 1, and U.S.F. G., INSURANCE CARRIER, RESPONDENT NO. 1, and SECOND INJURY FUND, RESPONDENT NO. 2

Before the Arkansas Workers’ Compensation Commission
OPINION FILED FEBRUARY 2, 1995

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

Claimant represented by the HONORABLE SHERMAN KUSIN, Attorney at Law, Texarkana, Texas.

Respondents No. 1 represented by the HONORABLE ROBERT TRAMMELL, Attorney at Law, Little Rock, Arkansas.

Respondent No. 2 represented by the HONORABLE MARK LONG, Attorney at Law, Little Rock, Arkansas.

Decision of Administrative Law Judge: Reversed.

[1] OPINION AND ORDER
[2] The respondents appeal an opinion and order filed by the administrative law judge on May 31, 1994. In that opinion and order the administrative law judge found that the respondents are liable for medical expenses which the claimant contended that he paid personally or that remained unpaid. After considering this matter, we find that the claimant failed to prove by a preponderance of the evidence that these medical expenses were reasonably necessary for treatment of his compensable injury.

[3] Initially, we note that this claim was consolidated with David Adams v. Commercial Interiors, Claim No. E115040, for purposes of the hearing. We also note that the claimant has a long history of physical problems involving his cervical and lumbar spine. That history is set forth in our opinion in David Adams v. Commercial Interiors, Full Workers’ Compensation Commission, (Claim No. E115040), and we will not repeat that history in this opinion except as necessary to resolve the issues presented. With regard to the current claim, on August 20, 1987, the claimant was working for David Adams Olympic Pools, a company he owned, when he sustained an admittedly compensable injury to his neck. At the time, he was using a fire hose attached to a fire hydrant when workers turned on the water with too much pressure, jerking the claimant and his neck. Two weeks later, on September 5, 1987, the claimant was traveling to Dallas in the company truck to pick up supplies when he was hit from the rear by another vehicle. He continued to Dallas, and he experienced such problems as a result of this accident that he checked into the hospital when he arrived in Dallas. The evidence in the record before us indicates that the claimant complained of severe and disabling neck pain after these incidents, and the evidence shows that the claimant received extensive medical treatment for his cervical complaints. However, the medical records pertaining to the treatment he received for these injuries are grossly incomplete. The claimant indicated that he was treated at the emergency room after the August 20, 1987, injury, but there are no records in the evidence pertaining to this treatment or to his treatment at the hospital in Dallas. Likewise, there is some indication that he subsequently came under the care of Dr. John Heuter, but none of Dr. Heuter’s records are in evidence. Likewise, the evidence indicates that the claimant was also treated for these injuries by a Dr. Taylor, but no records related to treatment by Dr. Taylor were submitted into evidence. The claimant also saw Dr. Contreras for these problems, but there is only one report from Dr. Contreras in evidence which pertains to these injuries. Moreover, the claimant testified that he was involved in another rear-end vehicular accident on February 2, 1988. Again, he was treated at the emergency room, but there is no record of this treatment in the evidence. Nevertheless, the claimant testified that the accident was not a “hard wreck,” and he testified that the emergency room physician advised him that he did not see any change in his condition.

[4] The first mention in the medical records of either the August 20, 1987, injury or the vehicular accidents is found in the March 11, 1988, report of Dr. Wilbur Giles, a neurosurgeon. Dr. Giles’ report indicates that the claimant was complaining of neck pain, suboccipital headaches, left shoulder pain, and bilateral arm pain. Although the claimant apparently continued to receive treatment for these problems, the next record of medical treatment is found in records from the Houston Diagnostic Clinic. On February 6, 1990, Dr. Richard Zimmerman and Dr. Donald Russell of the clinic indicate that the claimant was complaining of neck pain and headaches which began with the August 20, 1987, accident. The claimant’s testimony and the medical records indicate that he was treated by Dr. Warren Boop for his neck problems until January of 1991. However, none of Dr. Boop’s medical records are in evidence. Likewise, the medical records indicate that the claimant received substantial treatment from Dr. John Goodman, but there is only one report from Dr. Goodman in the evidence.

[5] 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).

[6] In the present matter, the claimant contends that the respondents are liable for payment of $840.00 to Wadley Hospital in Texarkana, $1,030.00 to University of Arkansas Medical Center in Little Rock, and he contends that he is entitled to reimbursement for $480 for expenses related to expenses he personally paid for treatment by Dr. Warren Boop in Little Rock. However, due to the absence of significant medical records pertaining to the claimant’s cervical condition, we are unable to determine whether this condition and the treatment provided was necessitated by the compensable injury, the vehicular accidents, or the preexisting condition alone. Moreover, the claimant indicates that the outstanding bill to Wadley Hospital is for therapy ordered by Dr. Goodman. However, no records pertaining to this therapy was submitted into evidence. Consequently, there simply is no evidence other than the claimant’s testimony upon which to base a finding that this therapy was reasonably necessary for treatment of the compensable injury. Likewise, the claimant testified that the outstanding bill at the University of Arkansas Medical Center was for a MRI. However, he testified he was not sure which physician ordered the MRI, although he thought it might have been Dr. Boop. Furthermore, none of Dr. Boop’s records were submitted into evidence. Therefore, again, there is no evidence other than the claimant’s testimony to support a finding that Dr. Boop’s treatment or diagnostic tests ordered by him were reasonably necessary for the treatment of the compensable injury.

[7] In short, there simply is no evidence other than the claimant’s testimony, to support his contention that the expenses at issue were provided for a condition causally related to the compensable injury. Furthermore, even assuming that the treatment was provided for a condition causally related to the compensable injury, the lack of supporting medical documentation impedes our ability to assess whether the medical procedures were reasonably necessary for treatment of the compensable injury. Consequently, we find that the claimant failed to prove by a preponderance of the evidence that the respondents are liable for the asserted medical expenses.

[8] 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 the respondents are liable for these medical expenses. Therefore, we find that the administrative law judge’s decision in this regard must be, and hereby is, reversed.

[9] IT IS SO ORDERED.

JAMES W. DANIEL, Chairman ALLYN C. TATUM, Commissioner

[10] Commissioner Humphrey dissents.