HODGE v. BENTON SERVICES CENTER, 1999 AWCC 167

CLAIM NOS. E600814, E603961 E616815

JAMES HODGE, EMPLOYEE, CLAIMANT v. BENTON SERVICES CENTER, EMPLOYER, RESPONDENT and PUBLIC EMPLOYEE CLAIMS DIVISION, INSURANCE CARRIER, RESPONDENT

Before the Arkansas Workers’ Compensation Commission
OPINION FILED JUNE 4, 1999

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

Claimant represented by GARY DAVIS, Attorney at Law, Little Rock, Arkansas.

Respondents represented by RICHARD SMITH, Attorney at Law, Little Rock, Arkansas.

Decision of Administrative Law Judge: Affirmed.

[1] OPINION AND ORDER
[2] This claim came before an Administrative Law Judge for a hearing on September 3, 1998. The issues were claimant’s entitlement to unpaid medical benefits for two MRIs performed in connection with his compensable injury of September 18, 1995 and the compensability of an injury sustained on November 6, 1996. The Administrative Law Judge found that the contested MRIs were the responsibility of the respondent, that the November 6, 1996 injury was an aggravation of his prior compensable injuries and that claimant was entitled to temporary total disability benefits from May 27, 1997, through December 10, 1997. Respondent has appealed from the order filed on October 5, 1998. [3] On appeal respondent argues that the MRIs were performed for the investigation of conditions which pre-existed claimant’s compensable injuries. Respondent also argues that claimant has failed to prove that there was any change in his condition as a result of his November 6, 1996 injury and that any resulting disability is attributable to degenerative disease in his cervical and lumbar spine. Claimant’s position is that the nature of his compensable injuries and the medical evidence establish that the contested MRIs were reasonable and necessary for the treatment of his compensable injuries. Claimant also argues that his November 6, 1996 injury constitutes an aggravation or recurrence of his previous injuries, either of which would be compensable. Based upon our de novo review of the record before us and without giving the benefit of the doubt to either party we affirm the Judge’s opinion in this case. [4] Claimant is a 58 year old man with an eighth grade education. Claimant has been employed by respondent for 17 years. On September 18, 1995 while operating a tractor claimant was struck in the head by a tree limb. As a result of that injury claimant suffered pain in his neck and back for which he continues to receive medical treatment. Claimant also reported low back and leg pain after this injury. Claimant missed a “couple of weeks from work” but was able to return to his previous duties. This injury has been accepted as compensable. [5] On April 8, 1996, claimant was cutting down storm damaged trees which fell on him and knocked him to the ground. This incident reinjured his neck and back and resulted in pain in his hips, left leg and left wrist as well. Claimant was off work for a period of time after this incident as a result of his injuries. Claimant returned to work and resumed his previous duties. This injury has been accepted as compensable. [6] On November 6, 1996, claimant suffered a recurrence of his injury when he lifted and carried a 32 gallon water cooler filled with ice and water. Claimant reported that when he lifted it he felt a sudden onset of pain in his neck. Claimant “rubbed the hide off” his neck and when he sought medical care the doctor told him he had a rash. Claimant’s condition continued to worsen after this incident. Once again he missed a couple of weeks of work then returned to work. [7] Claimant has been seen and treated for each injury by his family physician, Dr. Paul Hogue. In May of 1997, Dr. Hogue referred claimant to Dr. Richard Jordan, a neurosurgeon, who became claimant’s primary treating physician and performed surgery on claimant’s neck in May of 1997 and again in October of the same year. As a result of these surgeries claimant was temporarily totally disabled from May 27, 1997 through December 10, 1997. [8] The first question to resolve is the issue of the two contested MRIs, one taken of the head and neck on December 6, 1995, and another taken of the lumbar spine on December 26, 1995. The head and neck image was done on the order of Dr. Lon Burba, a neurologist, to whom claimant had been referred by an associate of Dr. Hogue. The purpose of the procedure was to “rule out nerve root avulsion and/or inflammation in the supporting soft tissues in the left neck, left arm and shoulder”. While it is true that Dr. Burba noted the presence of symptoms (i.e. hyperreflexia, headaches and double vision) which may have preexisted claimant’s first injury the MRI was ordered as a result of that injury. Dr. Burba clarified any possible confusion when in a letter dated February 20, 1996, he wrote;

This letter is in support of the MRI scan of the neck performed on Mr. James Hodge. As you know, this gentleman was doing well until he sustained an accident driving a tractor with a canopy over it. A limb got caught under the canopy, struck him in the side of the head, violently pushed his head to one side and since then he has had needle sticking sensation in the left shoulder and arm. He has considerable degenerative changes in the cervical spine and bulging discs at multiple levels with an EMG that shows evidence of radiculitis at C5-6 and C7-8. He had no problems prior to the accident and, therefore, I would feel comfortable stating that these complaints are related to the accident and the MRI scan should be related to this workman’s compensation injury.
At the request of Dr. Burba, Mr. Hodge was seen by Dr. Scott Schlesinger, a neurosurgeon, on December 18, 1995 for an evaluation. After reviewing the tests which had previously been performed Dr. Schlesinger requested the contested MRI of the lumbar spine. This scan was performed to allow Dr. Schlesinger to look for a possible cause of the leg and back pain which arose after his compensable injury. Based on this study, Dr. Schlesinger was able to conclude that at that time claimant was not a candidate for surgical intervention of his compensable injury.

[9] Based upon the medical records we find that the head and neck MRI done on December 6, 1995, and the lumbar spine MRI done on December 26, 1995 constituted reasonable and necessary treatment for claimant’s compensable injury. Accordingly, these expenses should be borne by the respondent. [10] The remaining issue to be resolved is the compensability of claimant’s November 6, 1996, lifting injury and his subsequent period of temporary total disability. On November 7th, 1996 claimant was seen by Dr. Kirk Watson. Dr. Watson noted that claimant had hurt his neck again the previous day resulting in quite a bit of restriction of motion and rather intense pain posteriorly. Dr. Watson diagnosed claimant with acute cervical neck strain with chronic neck pain. This reappearance of the symptoms of claimant’s previous compensable injuries is a recurrence of those injuries and therefore compensable. SeeMedlock v. Colson Caster Co., Full Commission Opinion filed June 29, 1998, (E400991) wherein we defined recurrence to mean that symptoms of a preexisting condition had once again manifested themselves. [11] Dr. Jordan performed a three level discectomy and a three level spinal fusion during which an internal immobilizer was installed on May 27, 1997. Claimant initially enjoyed significant benefit from this procedure until he began suffering a return and progressive worsening of his pre-surgery symptoms. Upon examination it was determined that the two upper screws attaching the instrumentation to his spine had begun to back out. A revision of the cervical fusion was performed on October 29th, 1997 during which the failing screws were replaced with larger ones. As a result of these two procedures, and on order of Dr. Jordan, claimant was unable to work from May 27, 1997, through December 10, 1997, when he was released to return to light duty work. Dr. Jordan testified that within a reasonable degree of medical certainty the major cause of the need for these surgeries was the work related injuries suffered by claimant. Accordingly these surgeries were reasonable and necessary for the treatment of claimant’s compensable injury and are the responsibility of the respondent. [12] Based upon the preceding considerations we affirm the opinion of the Administrative Law Judge in this matter. Respondent is directed to comply with the award set forth in the opinion of the Administrative Law Judge. 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 opinion of the Administrative Law Judge. For prevailing on this appeal before the Commission, claimant’s attorney is hereby awarded an additional attorney’s fee in the amount of $250.00. [13] IT IS SO ORDERED. [14] ____________________________
ELDON F. COFFMAN, Chairman ____________________________ PAT WEST HUMPHREY, Commissioner [15] Commissioner Wilson dissents.