CLAIM NOS. E511432 E511433
LORI CARNETT, EMPLOYEE, CLAIMANT v. SWIFT-ECKRICH, INC., SELF-INSURED EMPLOYER, RESPONDENT
Before the Arkansas Workers’ Compensation Commission
OPINION FILED JUNE 11, 1997
Upon review before the FULL COMMISSION, Little Rock, Pulaski County, Arkansas.
Claimant represented by PHILLIP WELLS, Attorney at Law, Jonesboro, Arkansas.
Respondent represented by CURTIS NEBBEN, Attorney at Law, Fayetteville, Arkansas.
Decision of Administrative Law Judge: Affirmed as Modified.
[1] OPINION AND ORDER
[2] Respondent appeals from a decision of the Administrative Law Judge filed September 11, 1996 finding that the treatment rendered by Dr. Brooks Holifield was reasonable and necessary and ordering the respondent to pay Dr. Holifield $1,483.11. Based upon our de novo review of the entire record, we find that only four weeks of Dr. Holifield’s treatment for the claimant’s compensable injury is reasonable and necessary medical treatment. We do not condone Dr. Holifield’s billing of both workers’ compensation carrier and private insurance carrier for the same office visits. Therefore, the respondents are only responsible for four weeks of chiropractic charges that aredirectly related to the treatment of the claimant’s compensable injury. The respondents are also only responsible for 1/2 of the maximum fee schedule allowance of $32.86 for each of the claimant’s office visits where she was treated for both her compensable injury and her unrelated cervical or lumbar injuries.
[3] The claimant began working for the respondent in 1994. She testified that she “started out injecting the product, which was pushing the meat. Went to cutting and sculling of the product, placing the products in pockets, and racking the product.” In May of 1995 the claimant began complaining of left wrist pain. She was referred by the respondent to Dr. K.A. Carpenter on May 26, 1995 wherein Dr. Carpenter noted a history of the claimant having injured her left wrist while performing repetitive work. He placed the claimant in a wrist splint for three days and returned her to work with no restriction. The claimant subsequently was assigned to the job as training coordinator, which involved extensive typing. In June of 1995 she began developing problems with both hands and the respondent referred her to Dr. Terrence Braden. The claimant sought treatment from Dr. Braden on July 21, 1995 with complaints of bilateral wrist pain and finger numbness. Dr. Braden noted that objective testing revealed no evidence of atrophy or fasciculation, no evidence of erythema or any other marked abnormality. He also noted that the claimant has full range of motion of her hands, wrists and fingers. In addition, Dr. Braden noted that the examination revealed no tender areas of the hands and that the Finkelstein’s testing was negative. Dr. Braden diagnosed the claimant with bilateral hand and wrist pain with finger numbness with probable carpal tunnel syndrome. He treated the claimant conservatively with bilateral wrist splints and anti-inflammatory medication. In addition, he recommended that the claimant use a foam pad while typing. He scheduled her to return on August 4, 1995 for electrodiagnostic studies of her upper extremities.
[4] The respondent accepted the claimant’s bilateral carpal tunnel syndrome injury and paid the related medical expenses incurred at the direction of Dr. Braden. On August 4, 1995, the claimant underwent nerve conduction velocity studies of her upper extremities by Dr. Braden. At the time Dr. Braden noted that the findings were essentially normal. Dr. Braden recommended that the claimant rest her hands for one week and he scheduled her for out-patient therapy at Northeast Arkansas Hand Therapy Center. The claimant failed to keep her therapy appointment scheduled for August 18, 21, 23 and 25, 1995, and she did not reschedule. In addition, the claimant did not return for her follow-up appointment with Dr. Braden.
[5] On the recommendation of a fellow co-worker, the claimant sought treatment from Dr. Brooks Holifield, a chiropractor, in Paragould. Dr. Holifield initially came to the claimant’s home where she filled out paperwork to see if he would treat her. Dr. Holifield agreed to treat the claimant and she filed a proper change of physician request and switched to Dr. Holifield.
[6] Dr. Holifield diagnosed the claimant with “acute moderate cervical brachial neurovascular compression syndrome complicated by myofascitis, stiffness, and tendinitis resulting in carpal tunnel syndrome, cervigalgia, and muscle spasms treated.” The claimant began treating with Dr. Holifield on August 17, 1995 and continued treating with him until November of 1995. Dr. Holifield’s treatment consisted of manipulations, massages, ultrasounds, and therapeutic exercises.
[7] The record reveals that Dr. Holifield began rendering treatment for the claimant’s nonwork-related problems with her neck and lower back. Neck and lower back treatments occurred during the same office visits for the claimant’s work-related hand and wrist problems. The record further reveals that Dr. Holifield’s son, Stewart Holifield, performed claimant’s massage therapy and ultrasounds. We note that Stewart is not a chiropractor nor is he licensed as a physical therapist or a massage therapist.
[8] The claimant testified that her hands and wrist improved immediately after she saw Dr. Holifield and that she was able to perform her job eight hours a day without restriction and without any problems. The claimant testified that she did not realize that she was having any problems with her neck, but that Dr. Holifield informed her that he needed to treat her neck to help her wrists. The claimant has not missed any time from work in connection with her wrists problems.
[9] Dr. Braden was consulted as to whether Dr. Holifield’s prolonged treatment of the claimant was unreasonable and unnecessary for the treatment of the claimant’s compensable wrist problem. In a letter dated June 5, 1996, Dr. Braden stated:
It would be my opinion, within a reasonable degree of medical certainty, that his chiropractic treatment was excessive, prolonged and falls outside of the usual treatment of carpal tunnel syndrome and cumulative trauma disorders of the upper extremity.
One could reasonably expect that within the first four to six weeks of treatment if no significant improvement had occurred that alternative forms of treatment should take place and that the treatment being supplied was ineffective and should have been redirected.
[10] It is interesting to note that Dr. Braden prescribed physical therapy for the claimant prior to her beginning treatment with Dr. Holifield. However, the claimant did not follow through with the physical therapy regimen prescribed by Dr. Braden but instead sought treatment from Dr. Holifield. The testimony of Dr. Braden is entitled to greater weight than the testimony of Dr. Holifield. The Commission has the authority to accept or reject medical opinions, and its resolution of the medical evidence has the force and effect of a jury verdict.McClain v. Texaco, Inc.,
29 Ark. App. 218,
780 S.W.2d 34
(1989). In addition, the claimant testified that her condition improved immediately after Dr. Holifield starting treating her and that she was able to perform her job eight hours a day without restriction or problems. Therefore, we find the chiropractic treatment after four weeks to be excessive, prolonged and unreasonable and unnecessary treatment for the claimant’s compensable injury.
[11] In addition to finding only four weeks of Dr. Holifield’s treatment reasonable and necessary, we further find that the respondents are only responsible for four weeks of chiropractic charges that are directly related to the treatment of the claimant’s compensable injury. The respondents are also only responsible for 1/2 of the maximum fee schedule allowance of $32.86 for each of the claimant’s office visits where she was treated for both her compensable injury and her unrelated cervical or lumbar injuries.
[12] Based upon our de novo review of the record, and for the reasons discussed herein, we affirm the decision of the Administrative Law Judge as modified.
[13] IT IS SO ORDERED.
ELDON F. COFFMAN, Chairman MIKE WILSON, Commissioner
[14] Commissioner Humphrey concurs in part and dissents in part.
[15] CONCURRING AND DISSENTING OPINION
[16] I must respectfully dissent from the majority’s finding that chiropractic treatment rendered by Dr. Holifield, beyond a four-week period, was not reasonably necessary for the treatment of claimant’s compensable injury. However, to the extent Dr. Holifield may have billed both claimant’s private health insurer and respondent employer’s workers’ compensation carrier for the same services, I join the majority’s refusal to condone such conduct.
[17] PAT WEST HUMPHREY, Commissioner
