CLAIM NO. E308896
Before the Arkansas Workers’ Compensation Commission
OPINION FILED OCTOBER 22, 1996
Upon review before the FULL COMMISSION in Little Rock, Pulaski County, Arkansas.
Claimant represented by ROBERT B. BUCKALEW and WILLIAM C. FRYE, Attorneys at Law, Little Rock, Arkansas.
Respondents represented by ROBERT T. DAWSON, Attorney at Law, Fort Smith, Arkansas.
Decision of Administrative Law Judge: Affirmed.
[1] OPINION AND ORDER
[2] An Administrative Law Judge entered an opinion and order in the above captioned claim on February 29, 1996, and found therein that claimant had proven, by a preponderance of the evidence, that he was entitled to continued medical treatment for his compensable injury of June 2, 1993, from Dr. Wilbur M. Giles, including surgery as recommended by Dr. Giles, and that he was further entitled to continued temporary total disability benefits from February 3, 1994, until a date yet to be determined (with respondents allowed a credit for any permanent partial disability benefits paid from February 3, 1994, through May 22, 1995).
[6] Claimant’s injury was to his neck and shoulder, and he initially sought medical treatment from Dr. Donald Pentecost in Ft. Worth, who performed x-rays and gave claimant permission to return to Little Rock “and be followed there.” [7] After returning home, claimant consulted Dr. Ralph Izard, his personal physician, on June 3, 1993. Dr. Izard initially suspected a bursitis problem in claimant’s left shoulder, and attempted conservative management. This did not prove to be successful, and claimant received a referral to Dr. William A. Runyan, whom he visited on June 21, 1993. [8] Dr. Runyan recommended that a cervical MRI be performed to “rule out any possible disc problems.” This procedure, performed on June 22, 1993, revealed a “small left lateral HNP at the C4-C5 level of uncertain significance.” On July 7, claimant returned to Dr. Runyan with continued “intermittent numbness in his left upper extremity, with pain and discomfort in his neck and aching down his arm.” Dr. Runyan thereafter referred claimant to Dr. Wilbur M. Giles for a neurological evaluation, and the latter first examined claimant on July 19, 1993. [9] Dr. Giles managed claimant conservatively, but without lasting success. On August 9, 1993, Dr. Giles suggested that claimant consider an anterior cervical diskectomy and fusion if he did not improve over the next two weeks. One month later, on September 9, Dr. Giles reported that:There was a load that I was having to unload myself, put on pallets. The boxes were stacked all the way to the ceiling. As I started to bring them down, some of them on the top would slide off and hit me in the head.
[10] Claimant’s post myelogram CT scan on September 16 revealed “significant spurring” at the C5-C6 level as well as a “herniated disc centrally and to the right that is causing indentation on (sic) thecal sac and involvement of the right nerve root.” A “very small soft tissue density . . . causing a slight defect on the left side of the thecal sac” was located at the C4-C5 level. The clinical significance of the latter abnormality could not be determined by the CT scan, and while “slight herniation” could not be ruled out, this was thought to be “less likely” than a disc protrusion. [11] Based on these findings, Dr. Giles performed an anterior cervical diskectomy and fusion at C4-5 and C5-6 on September 17, and discovered that claimant’s herniated disc was actually at the C4-5 level, with cervical spondylosis present at C5-6. Claimant’s initial recovery appears to have gone fairly well, as Dr. Giles’ letter of October 26, 1993, to Dr. Runyan indicates:He is no better from his physical therapy or steroids. He has continued to have chronic neck and interscapular pain as well as suboccipital headaches. All modalities of therapy have been unsuccessful. . . Because of the discomfort I am going to go ahead and proceed with a myelogram on him because of the MRI findings. We will schedule this for the later part of next week and be prepared to proceed with an anterior cervical fusion if necessary based on myelographic findings.
[12] By December 6, 1993, claimant’s fusion still appeared intact, however, his continued complaints of chronic pain prompted Dr. Giles to order a follow-up CT scan in search of pseudoarthrosis. Dr. Giles plainly stated that is this were located, claimant would “most likely . . . need further surgery.” [13] The CT scan was performed on December 9, and revealed left-side lucency at C4-5 which suggested “at least partial non fusion.” However, claimant appeared to have achieved fusion at C5-6. Based on these findings, Dr. Giles opined that additional surgery would not be necessary and, by December 22, 1993, began to contemplate the extent of claimant’s permanent impairment. [14] Unfortunately, claimant’s symptoms persisted, including a “pinching feeling in his interscapular region on the left side” and “chronic neck and shoulder discomfort” presented to Dr. Giles on January 6, 1994. These prompted Dr. Giles to order an additional limited CT scan, which was performed on January 13. Dr. William T. Henry noted the less than encouraging findings:Clifford Freeman was re-evaluated on October 25, 1993, and his x-rays reveal the grafts are incorporating. There is no evidence of pseudoarthrosis and I have told him to steadily increase his activity and have placed him on Williams neck exercises.
[15] (We consider the reference to L4-5, found above, to be a typographical error, since claimant’s lumbar spine is not relevant to this claim and all other references, including Dr. Giles’ review of Dr. Henry’s findings, speak only of the C4-5 and C5-6 levels.) [16] Dr. Henry went on to state that “my concern would be non-union of the attempted fusion, at this time.” Dr. Giles discussed these latest findings and their implications in a January 13, 1994, letter:I am concerned that there has been development of increased lucency in the intervertebral spaces at both levels. This is particularly noticeable at the L4-L5 level. On the sagittal reconstructions as we reconstruct from right to left there is more lucency seen in the intervertebral spaces than what was seen on the December 9 reconstructions. (Emphasis added).
[17] Dr. Giles reiterated his opinion in a subsequent letter of January 27:His CT scan today shows increasing lucency at the C4-5 level, compatible with a pseudoarthrosis. Because of her (sic) persistent neck and intrascapular pain, I feel we should go ahead and bring him back to the hospital and re-do the 4-5 level with Cloward 13mm graft. I will also look at the 5-6 level at that time. If there is any question of lack of fusion, I will also re-do that level at the same time. It appears on the scan that there is some lucency that is occurring even at the 5-6 level, but the 4-5 level shows a definite possible pseudoarthrosis.
[18] Respondents appear to have arranged for claimant to be examined by Dr. Thomas P. Rooney, an orthopedist, for a second opinion. Concerning additional surgery, Dr. Rooney summed up his evaluation as follows in a February 2, 1994, letter:It is my opinion that Mr. Freeman’s current problems are related to his surgical procedure which came as a result of his injury in that he has sustained a non-fusion at one of the graft levels. I feel that he should undergo a revision of this which would necessitate his being in the hospital approximately three days. It would be basically another anterior fusion surgery using the Cloward technique and drilling out the non-fused segment.
[19] Despite Dr. Rooney’s final comments, respondents deemed claimant’s healing period to be at end as of February 2, 1994, and discontinued temporary total disability benefits thereafter. [20] Respondents point out in their brief that Dr. Giles, “as a result of Dr. Rooney’s opinion . . . refused to further treat the Claimant, and he tendered the treatment of the Claimant to Dr. Rooney on February 28, 1994.” We note that Dr. Giles’ explanation for transferring claimant’s care, set forth in a letter to Dr. Izard on May 25, 1994, amounts to far less than the arbitrary refusal respondents imply:In summary, this man has had a two level anterior cervical diskectomy with two small fragments having been found at C4-5 on the left, and an unsuccessful fusion at both of these levels. It has now been approximately 4 1/2 months since surgery, and again he exhibits no radicular symptoms.
Normally, one would expect to see evidence of definite bony union after five to six months at the latest, if it’s going to occur, and he is approaching that time zone. He doesn’t have any peripheral neurological findings. The amount of relief he experienced immediately following the surgery was much less than one would hope for, and I’m afraid with any future surgery, it would more than likely produce a similar response. Of course, some attention will need to be directed towards the dependence he’s developed on pain medications if surgery is not undertaken.
However, if the patient is comfortable with Dr. Giles and Dr. Giles recommendations, and understands the expectations, then I see no reason not to proceed with the surgery, since objectively, he does appear to be developing pseudoarthroses at both levels. (Emphasis added.)
[21] On March 30, 1994, Dr. Rooney opined that claimant “has reached his maximum healing barring further surgery.” However, Dr. Giles informed claimant’s attorney in a letter of June 1, 1994, that claimant “continues to be in his healing period and he certainly is incapable of work at this time.” Dr. Rooney penned yet another letter on July 19, 1994, to a representative of respondents, and explained his thoughts on continued diagnostics and claimant’s future management:It has been my recommendation in the past because of the pseudoarthrosis as described by Dr. Bill Henry that we consider revision of his graft site, but this was denied based on his second opinion obtained through Dr. Rooney. It was therefore my recommendation that Dr. Rooney oversee his treatment, as it was apparently based on Dr. Rooney’s decision and consultation that his treatment from our standpoint was denied.
Since I am not being allowed to treat the patient in the form that I feel is acceptable based on his persistent pain and x-ray findings, I have taken the position that he be returned to the care of Dr. Rooney, who rendered the opinion or another physician of choice of the workmens’ compensation carrier.
[22] Another physician entered the picture on August 24, 1994, when Dr. Jim J. Moore, a neurosurgeon, performed an independent medical examination. Dr. Moore noted that:I don’t think it would be unreasonable to proceed with another CT, to see whether or not the occurrence of pseudoarthrosis can be established with anymore (sic) certitude. . . I have no desire to continue with the future care of Mr. Freeman. Dr. Giles is perfectly competent to continue with the treatment that he has already started, and I certainly have no criticism of his treatment thus far.
[23] Dr. Moore went on to discuss his opinion of claimant’s current status and the need for additional surgery:Apparently, initially, the patient did well. Certainly he had relief of his left shoulder pain, although he has persisted in having neck pain and headache, or tightness in the back of the head. Initial followup (sic) studies suggested developing good solidity; however, unfortunately, followup (sic) failed to reveal such to be case at C4-5 level especially, with the description of a pseudoarthrosis developing. According to a report dated 1/13/94, Dr. Giles felt that additional surgery was indicated to attempt to refuse the 4-5 level and inspect the C5-6 level to make sure there is adequate fusion going on.
[24] Dr. Rooney ordered further radiographic studies in late September and early October, 1994. Dr. David L. Harshfield performed these studies, and reported on October 3 that “the examination reveals stable fusion site at C4-5 and C5-6 levels.” Dr. Rooney also reviewed the results, and stated in an October 12 letter that “I think there is a definite fusion of the C5-6 level. I still cannot be absolutely sure about the fusion at the C4-5 level.” Dr. Moore examined Dr. Harshfield’s findings as well, and reported his opinion to claimant’s attorney on October 21, 1994:It is my feeling that this patient has not yet reached the end of a healing period and will not until the pseudoarthrosis has resolved, either spontaneously or by additional surgery. There certainly are areas of support for either approach, but additional surgery would not be contraindicated. I do feel this patient requires medical care and it is felt that the most appropriate individual to provide this, either surgically or nonsurgically, would be the operating surgeon, in this instance, Dr. Giles.
[25] In the meantime, claimant continued to seek medical care and consulted Dr. Scott Carle at a walk-in clinic in Little Rock on October 14, 1994. Dr. Carle appears to have been supplied with Dr. Harshfield’s radiographic studies, but otherwise seems to have had no familiarity with claimant’s history. Nevertheless, “in light of a stable fusion,” Dr. Carle recommended use of a “TENS unit, elavil at night, and a non-narcotic analgesic for daytime pain.” He further stated that: “Although he should not drive a truck, I did release him for modified duty as he could certainly perform desk work.” [26] Dr. Rooney subsequently opined on November 10, 1994, that: “I think Mr. Freeman did reach his maximum healing period as described previously in March of 1994, and he should be able to perform essential functions in over the road truck driving.” Dr. Moore issued an additional opinion as well on November 22, 1994:I have received and reviewed the radiographs that you submitted and I disagree with Dr. Harshfield’s interpretation of these radiographs. There is, in my opinion, definite motion at the C4-5 level. If you look carefully at the spinous processes, there is a very definite increase in the separation between these on flexion as opposed to neutral and hyperextension. This would suggest a pseudoarthrosis at the C4-5 level which had been noted and observed previously on other diagnostic studies.
[27] Dr. Moore went on to suggest that continued management by claimant’s operating neurosurgeon would be appropriate so long as he remained symptomatic, and had no “major objections” to claimant’s return to light duty work. [28] Dr. Giles opined on claimant’s situation once more in a December 7, 1994, letter sent in response to previous correspondence from claimant’s attorney:I believe this patient has a pseudoarthrosis at C4-5. I felt this way initially and still feel this way. Whether or not this patient is a candidate for additional surgery, there are points in both arenas and both points offer some degree of merit. As far as the end of a healing period, the patient still has a pseudoarthrosis and is still symptomatic. Admittedly, objectively, he checks out really pretty well. On the basis of a plateauing of the situation, I feel that he would, in view of the fact that he does have a pseudoarthrosis, warrant a rating of 25% permanent partial to the body as a whole as far as the C4-5 level, and 15% PPD so far as the fused C5-6 level.
[29] Claimant’s compensable injury occurred prior to July 1, 1993, and the provisions of Act 796 of 1993 are thus inapplicable to the resolution of this matter. [30] We are persuaded by our review of the record that claimant is entitled to continued medical care from Dr. Giles for the management of his compensable injury, including additional surgery, and that the same is reasonable and necessary for the treatment of his compensable injury. We note, of course, that there have been a multitude of medical opinions set forth in this case, and that some of them are to an extent conflicting. However, when medical opinions conflict, the Commission may resolve the conflict in the light of the record as a whole, and, in that light, reach the result that accords with reason, justice, and common sense. Barksdale Lumber Co. v.McAnally, 262 Ark. 379, 557 S.W.2d 868 (1977). [31] The available medical evidence indicates that claimant suffers from a persistent pseudoarthrosis at least at the C4-5 level, and has most likely not achieved fusion at that site. The medical evidence also suggests that claimant may have similar problems at C5-6. Dr. Henry’s post-operative CT scan revealed the possibility of nonfusion as early as January 13, 1994 and, based on that study, Dr. Giles suspected the presence of pseudoarthrosis at that time as well. Since then, Dr. Giles, whose opinions are entitled to considerable weight due to his status as claimant’s primary treating and operating physician, has at no time retreated from his opinion of January 13, 1994, to the effect that additional surgery was warranted by the “increased lucency” at both the C4-5 and C5-6 levels (which he regarded as compatible with pseudoarthrosis). [32] We note also that Dr. Giles is not alone in his opinion that claimant has failed to achieve fusion and suffers from the development of pseudoarthrosis. Dr. Moore’s opinions, recited above, have consistently indicated that pseudoarthrosis is present, and have encouraged the return of claimant’s care to Dr. Giles. Even Dr. Rooney, whose opinion respondents relied upon to terminate temporary total disability benefits in the first place, acknowledged after his initial evaluation of claimant that “he does appear to be developing pseudoarthrosis at both levels.” In addition, Dr. Runyan has stated that, while there is “possibly” a fusion at C5-6, “there does not seem to be a fusion at the C4-5 level.” Dr. Runyan also noted that, with regard to additional surgery, “I feel as Dr. Giles.” [33] Ranged against the foregoing are the opinions of Drs. Harshfield and Carle. The former opined on October 3, 1994, that claimant’s fusion site was “stable” at both levels and the latter essentially agreed with and adopted those findings on October 18, 1994. However, Dr. Moore has specifically disagreed with Dr. Harshfield’s interpretation of the radiographic studies the latter performed in early October, and Dr. Rooney himself could not be “absolutely sure” that Dr. Harshfield’s studies revealed that all was well at C4-5. We are accordingly persuaded that Dr. Carle’s opinion is entitled to little weight due to his reliance on Dr. Harshfield’s disputed findings (e.g., from Dr. Carle’s letter of October 18, 1994: “His most recent radiographic studies reveal stable fusion sites at C4/5 and C5/6 levels). [34] Concerning the specific matter of additional surgery, we note that claimant’s primary treating physician, Dr. Giles, has consistently recommended such treatment ever since the detection of pseudoarthrosis in early 1994. Dr. Moore has not indicated that surgery is ill-advised, and even Dr. Rooney stated that he saw “no reason not to proceed with the surgery, since objectively, he does appear to be developing pseudoarthrosis.” Finally, Dr. Runyan has expressly stated that he shares Dr. Giles’ opinion on additional surgery. We also note that claimant has testified that he wishes to remain under Dr. Giles’ care, and that Drs. Moore and Rooney have opined that claimant’s care should be returned to Dr. Giles. [35] Finally, Dr. Giles, in his letter of January 27, 1994, clearly related claimant’s ongoing difficulties to his first attempted fusion, “which came as a result of his injury.” [36] From the medical evidence discussed above, we specifically find that claimant has proven, by a preponderance of the credible evidence, that he remains in need of continued medical care for his compensable injury of June 2, 1993, including additional surgery, that the same is reasonable and necessary for the treatment of his compensable injury, and that said care should be provided by Dr. Wilbur M. Giles, claimant’s primary treating and operating physician. [37] We further find that claimant is entitled to continued temporary total disability benefits from February 3, 1994, to a date yet to be determined. [38] Temporary total disability is that period within the healing period in which the employee suffers a total incapacity to earn wages. Arkansas State Highway andTransp. Dep’t. v. Breshears, 272 Ark. 244, 613 S.W.2d 392I am still not convinced that this gentleman has a solid fusion at either 4-5 or 5-6 and if he is continuing to have an intractable pain problem with evidence of pseudoarthrosis then I am still of the opinion, as I was in January of this year, that he needs to have another operative procedure with conversion of the grafts to a 13mm Cloward by way of another anterior fusion. I do not feel that his healing period has ended and with or without the surgical procedure Mr. Freeman will probably be restricted in some form as concerns overhead work or push-pull type maneuvers, but that would be basically answered as a result of his second surgical procedure, if, indeed, he proceeded to do that. I feel at this point in time that he should return to our office if it is agreeable with the other people involved and have another CT and flexion, extension x-rays of the 4-5 and 5-6 level done to see if, indeed, he does have a pseudoarthrosis. If this is interpreted as a persistent pseudoarthrosis then it would be my recommendation that he proceed with the surgical procedure as originally outlined.
Even if Mr. Freeman is allowed to return to some type of light duty I think he will continue to complain of persistent pain and will be in need of narcotic medications which in and of themselves would lead to a long-term problem.
(1981). The healing period itself continues until the injured employee is as far restored as the permanent character of the injury will permit, and will end once the underlying condition has become stable and nothing further in the way of treatment will improve that condition. MadButcher, Inc. v. Parker, 4 Ark. App. 124, 628 S.W.2d 582
(1982). The persistence of pain may not of itself prevent a finding that the healing period is over, provided that the underlying condition has stabilized. Id. Finally, the question of when the healing period has ended is a factual determination that is to be made by the Commission. [39] We find first of all that claimant remained in his healing period beyond February 2, 1994 — the date on which respondents contend it ceased. Dr. Giles expressly stated on June 1, 1994, that claimant “continues to be in his healing period and he certainly is incapable of work at this time,” and Dr. Moore made it equally clear that claimant remained in his healing period as of August 24, 1994. [40] It is true that Dr. Rooney declared claimant’s healing period to be at an end on March 30, 1994. However, Dr. Rooney’s opinion was contingent upon claimant not having the additional surgery recommended by Dr. Giles — the performance of which Dr. Rooney had voiced no strong objection to (indeed, he saw no reason “not to proceed” as of February 2, 1994). And while Dr. Moore eventually issued an impairment rating on November 22, 1994, he noted at the same time that claimant “still has a pseudoarthrosis and is still symptomatic . . . continued follow is appropriate.” Also, Dr. Giles himself stated again on December 7, 1994 (subsequent to Dr. Moore’s issuance of an impairment rating), that he did not feel that claimant’s healing period had ended. [41] Finally, we note claimant’s credible testimony that he continues to experience a “sharp, piercing pain” in the back of his neck, and that he is unable to be up and around more than four or five hours without having to lie down. [42] Based on Dr. Giles’ assessments of June 1, 1994, and December 7, 1994, and on claimant’s own credible testimony, we specifically find that claimant’s healing period extended beyond February 2, 1994, to a date yet to be determined. [43] We also find that claimant remained totally incapacitated to earn wages beyond February 2, 1994, and has yet to be given permission to return to work by his primary treating physician, Dr. Giles. Concerning this issue, we note that Dr. Giles initially believed claimant should be able to return to work on January 1, 1994, and that he might even be able to attempt light duty a month earlier, as indicated by his letter of November 10, 1993:
[44] However, the foregoing statements were rendered before the performance of additional diagnostic studies in December, 1993, and January, 1994, which indicated nonfusion and the presence of pseudoarthrosis at least at the C4-5 level. Thereafter, Dr. Giles’ opinion changed considerably, as he recommended additional surgery as early as January 13, 1994, and pronounced claimant incapable of work as late as June 1, 1994. On December 7, 1994, Dr. Giles further opined that even if claimant were allowed to return to light duty, he would continue to experience pain to a degree requiring the further administration of narcotic medications. We do not find that this amounted to a release of claimant to light duty work. [45] It is true that some of the other physicians with whom claimant has consulted have indicated that he could return to light, or possibly full, duty. These include Dr. Carle on October 18, 1994 (“Although he should not drive a truck . . . he could certainly perform desk work.”), Dr. Moore on October 31, 1994, and November 22, 1994 (Dr. Moore allowed for a return to full duty on a trial basis on October 31, but then suggested light duty as “first step” on November 22), and Dr. Rooney on November 10, 1994 (“he should be able to perform essential functions in over the road truck driving”). [46] We do not consider any of the foregoing physicians to be in as good a position as Dr. Giles, claimant’s primary treating and operating physician, to render an opinion on his ability to return to work. Dr. Giles’ letter of December 7, 1994, was written after Drs. Carle, Moore, and Rooney had issued their opinions on claimant’s return to work, and its content indicates that he was aware of this issue (e.g., “even if Mr. Freeman is allowed to return to some type of light duty”). Again, we are not persuaded that Dr. Giles himself has at any point released claimant to return to work, or has acquiesced to the same by way of his December 7, 1994, letter. Indeed, this last letter from Dr. Giles expressly indicates that a return to even light duty is not in claimant’s best interests. [47] While we thus find Dr. Giles’ opinion to be sufficient on the issue of claimant’s return to work, we still note that he is not alone in his overall view of claimant’s situation. This is made apparent by Dr. Runyan’s letter of April 4, 1995, to claimant’s attorney, in which he explains that Dr. Giles’ letter of December 7, 1994, “is the document that you need to go by and I agree with Dr. Giles . . . since he is the surgeon who performed the surgery and is familiar with that type of surgery.” [48] Because we consider Dr. Giles, as the primary treating physician, to be best-suited in this case to render an opinion concerning claimant’s ability to return to work, and since he has yet to release claimant to return to work, we specifically find that claimant has proven, by a preponderance of the credible evidence, that he remained totally incapacitated to earn wages well beyond February 2, 1994. [49] While we regard our findings above as dispositive of the issue of temporary total disability, we are not unaware of respondents assertion that claimant was offered a light duty position in February, 1995, that he did not accept. Although claimant did make inquiry regarding light duty following his visit with Dr. Carle, he contends that no specific light duty program was ever offered and that he would have been unable to accept in any event due to his impending relocation to Louisiana. [50] Even if we were to find that claimant was available for a return to light duty, which we do not, we are not persuaded that he refused an offer of such work. [51] The documentary evidence concerning this issue is limited to a letter of February 8, 1995, sent by respondents’ attorney to claimant’s attorney (which claimant admitted receiving):At that point in time I informed you by way of my secretary and by the previous letter that I had sent to you that I did not want Mr. Freeman returning to a work status until January 1, 1994. . . Should he voice to me that he is willing to try your light duty program then I would be willing for him to try to do that as of December 1, 1993.
[52] The foregoing communication between the parties’ attorneys utterly fails to identify what claimant’s duties would have been, or whether such duties had been considered and approved by any of his physicians — particularly Dr. Giles. [53] The testimony of Ms. Jami Snider, respondent employer’s risk manager, established that claimant’s duties would have consisted of “helping the recruiting department, which would be doing mail-outs to prospective students and drivers, calling on applications, filing, that type of clerical, basically, clerical type filing work.” However, neither Ms. Snider’s testimony nor claimant’s establishes that these duties were identified to claimant or discussed with his physicians before he received the above-quoted letter. [54] Finally, although claimant and Ms. Snider apparently discussed in October or November of 1994 an “idea” for him to work in a program keeping track of tires, there is no suggestion that such a program ever came to fruition insofar as claimant was concerned or that an offer of such work was actually made. [55] We thus do not find respondents’ bare declaration that light duty was available to be sufficient evidence of an offer of light duty work within claimant’s limitations, and accordingly do not find that claimant turned down an offer of light duty work. [56] Because we find that claimant has proven that he remained in his healing period and was totally incapacitated to earn wages subsequent to February 2, 1994, we further find that claimant has proven, by a preponderance of the credible evidence, that he is entitled to continued temporary total disability benefits from February 3, 1994, to a date yet to be determined. [57] Based on our de novo review of the entire record, and for the reasons discussed herein, we specifically find that claimant has proven, by a preponderance of the credible evidence, that he is entitled to continued medical treatment from Dr. Giles for his compensable injury of June 2, 1993, including additional surgery, that the same is reasonable and necessary for the treatment of his compensable injury, and that he is further entitled to additional temporary total disability benefits from February 2, 1994, until a date yet to be determined. The decision of the Administrative Law Judge must therefore be, and hereby is, affirmed. [58] 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 opinion in accordance with Ark. Code Ann. § 11-9-809 (Repl. 1996). [59] For prevailing on this appeal before the Full Commission, claimant’s attorney is hereby awarded an additional attorney’s fee in the amount of $250.00 as provided by Ark. Code Ann. § 11-9-715 (b) (Repl. 1996). [60] IT IS SO ORDERED.The claimant has been released to return to light duty, and there is even a suggestion that he has been released to return to full duty. We are continuing to pay permanent partial benefits, and there are still several months remaining on the rating that was assessed. Dr. Carle at Medistat has agreed to continue the treatment on the claimant for his work-related injury. If the claimant needs treatment, we are in hopes that he will go see Dr. Carle and that can be done with a minimum of wear and tear on the part of anyone.
We have made arrangements for the claimant to work at light duty for us for a half-day each day beginning on Monday, February 20, 1995. The claimant should report to Jami Snider by 8:00 a.m. on that date, and she will advise him of his duties. If that part-time employment is successful, we anticipate increasing the number of hours up to the point where he is working a full day at his old job.
JAMES W. DANIEL, Chairman PAT WEST HUMPHREY, Commissioner
[61] Commissioner Holcomb dissents.