CLAIM NO. E412411
JOSEPH REEVES, EMPLOYEE, CLAIMANT v. CAPCO PIPE COMPANY, EMPLOYER, RESPONDENT and CIGNA, INSURANCE CARRIER, RESPONDENT
Before the Arkansas Workers’ Compensation Commission
OPINION FILED MAY 19, 1997
Upon review before the FULL COMMISSION in Little Rock, Pulaski County, Arkansas.
Claimant represented by the HONORABLE WILLIAM KROPP, III, Attorney at Law, Fort Smith, Arkansas.
Respondents represented by the HONORABLE ROBERT HORNBERGER, Attorney at Law, Fort Smith, Arkansas.
Decision of Administrative Law Judge: Affirmed as modified.
[1] OPINION AND ORDER
[2] The respondents appeal and the claimant cross-appeals an opinion and order filed by the administrative law judge on June 21, 1996. In that opinion and order, the administrative law judge found that the claimant sustained a compensable psychological injury caused by a compensable physical injury that occurred on August 11, 1994. In addition, the administrative law judge found that all medical expenses for the claimant’s hand injury and the claimant’s psychological treatment had been paid by the respondents through the date of the hearing held on March 21, 1996. With regard to the claimant’s claim for additional indemnity benefits, the administrative law judge found that the respondents were responsible for an additional 26 weeks of disability benefits for the claimant’s compensable psychological injuries, and the administrative law judge found that the claimant is not entitled to a permanent partial disability rating for his psychological injuries. In addition, the administrative law judge found that the claimant has failed to prove by a preponderance of the evidence that he is permanently and totally disabled or that he is entitled to a greater permanent partial disability rating than the 43% which the respondents have accepted and paid for his left hand injury. The administrative law judge also found that the respondents are liable for the continuing cost of treatment for the claimant’s psychological injury.
[3] After conducting a de novo review of the entire record, we find that the claimant failed to prove by a preponderance of the evidence that he is permanently and totally disabled as a result of his left hand impairment. In addition, we find that the claimant failed to prove by a preponderance of the evidence that he sustained any permanent physical impairment to his left hand in excess of the 43% impairment rating accepted and paid by the respondents. We also find that the claimant proved by a preponderance of the evidence that he sustained a compensable exacerbation of a preexisting mental disorder (bipolar disorder) as a result of the compensable physical injury sustained on August 11, 1994. However, we also find that the temporary exacerbation of the claimant’s previously undiagnosed bipolar disorder resolved prior to the respondents’ termination of temporary total disability compensation in February of 1995. Consequently, we find that the claimant failed to prove by a preponderance of the evidence that he is entitled to additional medical benefits or additional indemnity compensation related to the compensable mental condition.
[4] The claimant sustained a “crush and burn” injury to the left hand (and a burn to the left forearm) on August 11, 1994, while employed by the respondent as a line operator in the manufacture of PVC pipe. The claimant was 56 years old at the time of the injury.
[5] Dr. Michael Moore performed surgery involving the left index, long and ring fingers on November 29, 1994, including an amputation at the interphalangeal joint of the left index finger. After various modalities of therapy, Dr. Moore opined on February 20, 1995, that the claimant had reached maximum medical improvement, and that the claimant had sustained a 43% impairment to his left hand as a result of the injury.
[6] The claimant returned to work performing his former duties for the respondent sometime in March of 1995. However, on April 18, 1995, the claimant presented to Dr. Claude Martimbeau, an orthopedist, with left shoulder problems. Dr. Martimbeau diagnosed capsulitis and a frozen shoulder, as well as a partial tear of the left bicep. Dr. Martimbeau prescribed medication and physical therapy, and assigned the claimant light-duty work with no work overhead, and with no pushing or pulling with the left arm (i.e., essentially one-handed work).
[7] The claimant subsequently left the respondents’ employ on May 11, 1995, approximately two months after his return to work. A functional capacity evaluation performed on May 19, 1995, at the request of Dr. Martimbeau indicates that the claimant demonstrated the ability to function in the heavy physical demand level during the assessment, but that the claimant has sustained significant functional and sensory deficits involving the left arm and hand which “may impact his return to work as a line operator.” After a June 8, 1995, follow-up, Dr. Martimbeau indicated that the claimant was experiencing only minimum soreness and stiffness in the left shoulder, with good range of motion. However, after reviewing the functional capacity evaluation results, Dr. Martimbeau recommended that the claimant be employed in a mostly one-handed job. With regard to use of the left hand, Dr. Martimbeau indicated that the claimant should not engage in any repetitive work with heavy manipulation, and that, because of sensory deprivations in the claimant’s left hand and fingers, the claimant should avoid working with sharp objects (machinery or tools) or in work that would expose the claimant’s left hand to intense heat or cold. Dr. Martimbeau has opined that it would not be safe for the claimant to return to work as a line operator.
[8] An award for a scheduled injury is limited to the benefits provided in the statute for that scheduled injury, absent a finding of permanent and total disability. See,e.g., Anchor Construction Co. v. Rice,
252 Ark. 460,
479 S.W.2d 573 (1972); Springdale Farms v. McGarrah,
260 Ark. 483,
541 S.W.2d 928 (1976); Moyers Brothers v. Poe,
249 Ark. 984,
462 S.W.2d 862 (1971); Taylor v. Pfeiffer PlumbingHeating,
8 Ark. App. 144,
648 S.W.2d 526 (1983); Rash v.Goodyear Tire and Rubber Co.,
18 Ark. App. 248,
715 S.W.2d 449 (1986); Haygood v. Belcher,
5 Ark. App. 127,
633 S.W.2d 391 (1982). In addition, an injury scheduled under Ark. Code Ann. §
11-9-521 is payable without regard to subsequent earning capacity. Consequently, an award for a scheduled injury cannot be increased by considering wage loss factors, unless the claimant proves that he is permanently and totally disabled. See, e.g., Rice, supra; McGarrah, supra;Taylor, supra; Rash, supra; Haygood, supra
[9] In the present case, we find that the claimant failed to prove by a preponderance of the evidence that he is permanently and totally disabled as a result of the crush and burn injury sustained to his left hand on August 11, 1994. In this regard, the medical evidence indicates that the claimant has experienced some degree of sensory and functional loss in several fingers of the left hand as a result of his work-related injury and subsequent surgery. These deficits may limit the claimant’s ability to perform repetitive left hand functions, and the deficits prevent the claimant from working with sharp objects or in an environment exposing the claimant’s left hand to hazardous heat or cold. However, the claimant’s functional capacity evaluation indicates that the claimant is otherwise capable of functioning at a heavy physical demand level, and we note that the claimant returned to work performing the greater portion of his regular work duties for the respondents for a period between March and May of 1995. Moreover, we find that the claimant’s left hand restrictions do not represent a significant impediment to the claimant’s return to most areas of the job market, although safety concerns apparently prevent his return to work as a line operator for the respondents. Consequently, since we find that the claimant failed to prove that he is permanently and totally disabled, we find that the claimant’s permanent disability compensation for his scheduled hand injury is limited to the 43% permanent anatomical impairment established by the medical evidence.
[10] In addition to sustaining the left hand injuries discussed above, the claimant also became hospitalized (through the emergency room of St. Edwards Hospital in Ft. Smith) at the Harbor View psychiatric facility on December 27, 1994, under the care of Dr. Richard Mauroner. Dr. Mauroner initially diagnosed the claimant with “atypical bipolar disorder, currently manic, with psychosis” for which Dr. Mauroner prescribed lithium and inpatient psychiatric care. Additional progress notes indicate that the claimant’s manic presentation at the time of inpatient admission substantially subsided during inpatient care, and the claimant was discharged to outpatient care on January 6, 1995. Dr. Mauroner’s records indicate that the claimant subsequently experienced some degree of depression during the period that the claimant returned to work for the respondent.
[11] In addition, a letter from Dr. Mauroner to the claimant’s attorney dated October 5, 1995, states that Dr. Mauroner felt that the claimant had reached the maximum medical improvement possible regarding his work-related injuries. Dr. Mauroner testified that the claimant will likely require life-long medication to control his bipolar disorder. Dr. Mauroner testified that the claimant’s mental illness requires that the claimant obtain employment in a low stress environment. In addition, Dr. Mauroner testified that the claimant’s mental illness has an adverse effect on the claimant’s power of concentration. Dr. Mauroner testified that he believes that the claimant experiences a 30% impairment rated to the body as a whole as a result of his bipolar disorder.
[12] A preexisting disease or infirmity does not disqualify a claim if the employment aggravated, accelerated, or combined with the disease or infirmity to produce the disability for which compensation is sought. NashvilleLivestock Commission v. Cox,
302 Ark. 69,
787 S.W.2d 664
(1990); Minor v. Poinsett Lumber Mfg. Co.,
235 Ark. 195,
357 S.W.2d 504 (1962); Conway Convalescent Center v.Murphree,
266 Ark. 985,
588 S.W.2d 462 (Ark.App. 1979). As is commonly stated, the employer takes the employee as he finds him. Murphree, supra. In such cases, the test is not whether the injury causes the condition, but rather the test is whether the injury aggravates, accelerates, or combines with the condition. However, although a disabling symptom of a preexisting condition may be compensable if it is brought on by an incident arising out of and in the course of employment, the employee’s entitlement to compensation ends when his condition is restored to the condition that existed before the injury unless the injury contributes to the condition by accelerating or combining with the preexisting condition. See, Arkansas Power and Light Co. v.Scroggins,
230 Ark. 936,
328 S.W.2d 97 (1959).
[13] In the present case, we find that the greater weight of the evidence establishes that the claimant’s work-related injury triggered a “manic” episode associated with the claimant’s underlying bipolar disorder. In this regard, Dr. Mauroner, a licensed psychiatrist, diagnosed the claimant with bipolar disorder when the claimant presented on December 27, 1994. Moreover, Dr. Mauroner’s testimony indicates that the claimant presented in a “manic” state at that time, that Dr. Mauroner’s diagnosis of a manic episode associated with bipolar disorder is consistent with criteria established in the Diagnostic and Statistical Manual ofMental Disorders, and that Dr. Mauroner believes the claimant’s work-related injury to the hand “triggered” the manic episode identified on December 27, 1994. Consequently, based on the evidence presented in the record, we find that the claimant established each of the requirements necessary to establish a compensable manic episode pursuant to Ark. Code Ann. §
11-9-113 (Repl. 1996).
[14] However, we also find that the claimant failed to prove by a preponderance of the evidence that he is entitled to additional medical benefits or indemnity compensation related to the manic episode triggered by his work-related injury. In this regard, both Dr. Mauroner’s testimony and the claimant’s psychiatric records from Harbor View indicate that the claimant’s manic episode essentially resolved during the course of hospitalization and medication between December 27, 1994, and January 6, 1995. Likewise, Dr. Mauroner’s testimony indicates that the claimant has not experienced any additional manic episodes since initiating lithium treatment for his underlying bipolar disorder. Consequently, we find that the preponderance of the evidence establishes that the manic episode triggered by the claimant’s work-related injury resolved prior to the respondent’s termination of temporary disability compensation in February of 1995.
[15] Likewise, the record indicates that the respondents continued to pay for the claimant’s psychiatric care into 1996 — long after the claimant’s compensable manic episode resolved. Consequently, we find that the claimant failed to prove by a preponderance of the evidence that he is entitled to additional medical treatment for his compensable manic episode, in addition to the medical treatment already accepted and paid by the respondents.
[16] Because we find that the claimant failed to prove by a preponderance of the evidence that he is entitled to any disability compensation in excess of the disability compensation already accepted and paid by the respondents, we find that the claimant’s constitutional challenge to the 26 week limitation for mental injuries pursuant to Ark. Code Ann. §
11-9-113 (Repl. 1996) is moot.
[17] Therefore, after conducting a 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 he is permanently and totally disabled as a result of his left hand impairment. In addition, we find that the claimant failed to prove by a preponderance of the evidence that he sustained any permanent physical impairment to his left hand in excess of the 43% impairment rating accepted and paid by the respondents. We also find that the claimant proved by a preponderance of the evidence that he sustained a compensable exacerbation of a preexisting mental disorder (bipolar disorder) as a result of the compensable physical injury sustained on August 11, 1994. However, we also find that the temporary exacerbation of the claimant’s previously undiagnosed bipolar disorder resolved prior to the respondents’ termination of temporary total disability compensation in February of 1995. Consequently, we find that the claimant failed to prove by a preponderance of the evidence that he is entitled to additional medical benefits or additional indemnity compensation related to the compensable mental condition.
[18] IT IS SO ORDERED.
ELDON F. COFFMAN, Chairman MIKE WILSON, Commissioner
[19] Commissioner Humphrey dissents.
