{"id":"alj-G905912-2024-09-05","awcc_number":"G905912","decision_date":"2024-09-05","opinion_type":"alj","claimant_name":"Gregory Patterson","employer_name":"City Of Monette","title":"PATTERSON VS. CITY OF MONETTE AWCC# G905912 SEPTEMBER 5, 2024","outcome":"denied","outcome_keywords":["denied:1"],"injury_keywords":["neck","back","knee","cervical"],"pdf_url":"https://labor.arkansas.gov/wp-content/uploads/Patterson_Gregory_G905912_20240905.pdf","source_index_url":"https://labor.arkansas.gov/workers-comp/awcc-opinions/administrative-law-judge-opinions/","filename":"Patterson_Gregory_G905912_20240905.pdf","text_length":15293,"full_text":"BEFORE THE ARKANSAS WORKERS’ COMPENSATION COMMISSION \nWCC NO. G905912 \n \nGREGORY PATTERSON, EMPLOYEE CLAIMANT \n \nCITY OF MONETTE, EMPLOYER RESPONDENT \n \nMUNICIPAL LEAGUE WC PROGRAM, CARRIER/ \nARKANSAS MUNICIPAL LEAGUE, TPA                       RESPONDENT \n \n \nOPINION FILED SEPTEMBER 5, 2024 \n \nHearing before Administrative Law Judge Steven Porch on July 26, 2024, in Jonesboro, Arkansas. \n \nClaimant was represented by Mr. Matthew J. Ketcham, Attorney at Law, Fort Smith, Arkansas. \n \nRespondents were represented by Ms. Mary K. Edwards, Attorney at Law, Little Rock, Arkansas. \n \nSTATEMENT OF THE CASE \n \n A full hearing was held on this claim on July 26, 2024.  A prehearing telephone conference \ntook place on February 27, 2024. A prehearing order was filed on that date. However, an amended \nprehearing order was filed on February 28, 2024, amending the issue, and subsequently entered \ninto evidence as Commission Exhibit 1. The parties’ stipulations are set forth. \nSTIPULATIONS \n By agreement of the parties, the stipulations applicable to this claim are as follows: \n1. The Arkansas Workers’ Compensation Commission has jurisdiction of the \nwithin claim. \n \n2. An employer/employee/carrier relationship existed among the parties on or \nabout September 10, 2019. \n \n3. The Claimant sustained a compensable head injury. \n \n \n \n \n \n \n\nPATTERSON AWCC NO. G905912 \n \n2 \n \nISSUES \n The parties have identified the following issue to be adjudicated: \n1. Whether Claimant is entitled to additional reasonable and necessary medical treatment \nfor his compensable head injury, specifically headaches and seizures. \n \nAll other issues are reserved. \n \nCONTENTIONS \n \nClaimant Contentions. \nClaimant contends that he was injured on September 10, 2019, when he was a passenger \non an ATV in which the driver took a turn too fast causing the Claimant to be ejected from the \nvehicle which caused an injury to his head and brain. The Claimant was life-flighted to Regional \nOne Health Medical Center in Memphis, Tennessee for emergency treatment. He was hospitalized \nfor two days and was discharged with a head injury and intraparenchymal hemorrhage of the brain. \nThe Claimant followed-up with a neurosurgery within one month. The Claimant followed-up with \ntherapy including speech therapy within a month of the injury. On October 1, 2019, the Claimant \nwas seen by Dr. John Brophy for follow-up on the traumatic head injury. On December 19, 2019, \nthe Claimant was seen at St. Bernard’s Medical  Center  for  increased  headaches.  The  Claimant \ncontinued to follow-up with Dr. Brophy for continued increase in headaches and was released on \nJanuary  22,  2019.  The  Claimant  continued  regular  treatment  and  imaging  of  his  head  due  to \nongoing and continuous headaches. The Claimant began to have seizures along with numbness on \nthe left side of his body  and was seen at NEA Baptist Hospital wherein testing and evaluations \nhave been performed as well as continued follow-up with the Semmes-Murphy Clinic.  \nRespondent Contentions. \nRespondents contend that Claimant’s head injury was accepted as compensable, and he has \nreceived  all  reasonable  and  necessary  medical  treatment  and  indemnity  benefits.  On  September \n\nPATTERSON AWCC NO. G905912 \n \n3 \n \n10, 2019, Claimant jumped out of a mule and hit his head. He was med-flighted to the Regional \nOne Health Medical Center in Memphis. Claimant saw Dr. Brophy, who released him to full duty, \nplacing him at maximum medical improvement and no improvement rating on January 22, 2020. \nClaimant saw a neuropsychologist, Dr. Zolten on December 9, 2021. Dr. Zolten noted his memory \nwas  normal  and  did  not  recommend  further  treatment  for  the  compensable  injury.  Dr.  Brophy \nconfirmed that Dr. Zolten’s neuropsychologist report was normal and released him from his care \non  January  25,  2022.  Respondents  are  not  aware  of  any  further  medical  treatment  or  treatment \nrecommendations.    \nFINDINGS OF FACT AND CONCLUSIONS OF LAW \n After reviewing the record as a whole, including medical reports, non-medical documents, \nand other matters properly before the Commission, I hereby make the following findings of fact \nand conclusions of law in accordance with Ark. Code Ann. § 11-9-704 (Repl. 2012): \n1.  The Arkansas Workers’ Compensation Commission has jurisdiction over this claim. \n \n2.  The stipulations set forth above are reasonable and are hereby accepted.  \n3.  The  Claimant  has  proven  by  the  preponderance  of  the  evidence  that  he is  entitled  to \nreasonable and necessary medical treatment for his headaches and seizures.    \n \n \nCASE IN CHIEF \nSummary of Evidence \n The record consisted of Claimant’s Exhibit 1, Medical Records, that consists of 109 pages, \nRespondent Exhibit 1, medical records, consisting of 84 pages, Respondents Exhibit 2, medical \nand  Indemnity  logs,  consisting  of  4  pages,  and Commission  Exhibit  1,  Pre-Hearing  Order,  that \nconsists of 5 pages. I have also blue-backed Claimant’s and Respondents’ post-hearing briefs.  I \n\nPATTERSON AWCC NO. G905912 \n \n4 \n \nalso had the opportunity to hear the testimony and observe the demeanor of the Claimant, who was \nthe only witness in the full hearing.  \nThe Claimant worked in road construction for Respondent/Employer. Claimant suffered a \ncompensable head injury on September 10, 2019, when he was thrown from an ATV injuring his \nhead. This resulted in a closed head injury with intracranial hemorrhage. Resp. Ex. 1, page 18. The \nRespondents accepted the injury as compensable and paid temporary total disability and medical \nbenefits  for  Claimant.  Though  Claimant,  through  direct  testimony,  agreed  he  has  completed \noccupational  therapy  that  improved  his  speech  and  standing,  he  continues  to  receive  medical \ntreatment for headaches. See Resp. Ex. 1, pages 14 – 16. Respondents sent Claimant to Dr. John \nBrophy at the Semmes-Murphy Clinic in Memphis on October 1, 2019. Resp. Ex. 1, pages 18 – \n22. Dr. Brophy cleared Claimant to return to school, as he was a high school student, and return to \nwork with restrictions. The Claimant received a CT scan of his head on December 19, 2019, that \nfound no evidence of acute intracranial hemorrhage. Resp. Ex. 1, page 36. This time Dr. Brophy \nreleased Claimant to return to work full duty without restrictions on January 22, 2020. Resp. Ex. \n1, pages 37 - 42. Dr. Brophy also found that he did not sustain any permanent impairment and that \nhe has reached maximum medical improvement or the end of his healing period on January 22, \n2020. Id. \nOn  August  22,  2020,  the  Claimant  was  involved  in  a  motor  vehicle  accident  where  he \ninjured his neck, upper to mid back, right forearm, and right knee. Resp. Ex. 1, pages 43 – 47. A \nC-collar was placed on Claimant while in triage to limit the movement of his neck. A CT scan of \nClaimant’s cervical spine was normal. Resp. Ex. 1, page 46. The Claimant saw Dr. John Brophy \nagain on September 28, 2021, one year and nine months from his last visit, and was recommended \nfor a neuropsych evaluation on December 9, 2021; Dr. A.J. Zolten, Clinical Neuropsychologist, \n\nPATTERSON AWCC NO. G905912 \n \n5 \n \nperformed  the  evaluation.  Resp.  Ex.  1,  page  57 - 60.  The  neuropsychological  testing  revealed \nsubtle to mild residual auditory/verbal weaknesses including modestly lower-than-expected core \nauditory cognitive skills, paraphasia noted during confrontational naming, and low average FAS \nverbal fluency. Id. All these findings are mildly weaker than expected. Id. Dr. Zoltan made clear \nin his report that since Claimant is two years post injury, these problems are likely to be chronic, \nbut  he  doubts  that  these  problems  will  interfere  with  overall  functioning  when  considering \nactivities for daily living or his work. Id. Dr. Zolten concludes his report by stating memory, motor, \nvisual perceptual, and executive skills were all entirely within the normal limits. Id. Dr. Brophy \nopined,  during  a  January  25,  2022,  follow-up visit to review Dr. Zolten’s evaluation, that no \nsignificant cognitive problems are noted based on the neuropsychological evaluation that was two \nyears post closed head injury. Resp. Ex. 1, pages 61 -64. Claimant was cleared to remain at work \non full duty without restrictions. Id. Dr. Brophy also opined that “no further treatment is indicated \nat this time.”  Id.  \nClaimant  next  visited  the  Buffalo  Island  Medical  Clinic  on  July  25,  2022,  complaining \nabout episodes of “passing out”. Claimant’s Ex. 1, pages 1 – 4. The Claimant testified that these \nepisodes of ‘passing out’ were contributed to seizures. The Claimant received an MRI of his head \nin an effort to discover the source of these fainting spells or syncope on August 8, 2022. The MRI \nreport stated that “No abnormal areas of enhancement are noted within the brain.” Claimant’s Ex. \n1,  pages  14 – 15.  The  final  impression of the report was a “negative MRI of the brain with \ncontrast.” Despite the Claimant’s MRI noting a normal brain, the Claimant was prescribed Keppra, \na seizure medication, and continued to be treated for seizures. The Respondents, at this time, were \nnot paying for treatment of the headaches nor the seizures. Respondents stopped paying benefits \nto Claimant on January 25, 2022. \n\nPATTERSON AWCC NO. G905912 \n \n6 \n \nAdjudication \nA. Whether Claimant is entitled to additional reasonable and necessary medical \ntreatment for his compensable head injury, specifically for headaches and \nseizures. \n \n Arkansas Code Annotated Section 11-9-508(a) (Repl. 2012) states that an employer shall \nprovide for an injured employee such medical treatment as may be necessary in connection with \nthe  injury  received  by  the  employee.   Wal-Mart  Stores,  Inc.  v.  Brown,  82  Ark.  App.  600,  120 \nS.W.3d 153 (2003).  But employers are liable only for such treatment and services as are deemed \nnecessary for the treatment of the claimant’s injuries.  DeBoard v. Colson Co., 20 Ark. App. 166, \n725 S.W.2d 857 (1987).  The claimant must prove by a preponderance of the evidence that medical \ntreatment is reasonable and necessary for the treatment of a compensable injury.  Brown, supra; \nGeo  Specialty  Chem.  v.  Clingan,  69  Ark.  App.  369,  13  S.W.3d  218  (2000).    What  constitutes \nreasonable  and  necessary  medical  treatment  is  a  question  of  fact  for  the  Commission.   White \nConsolidated Indus. v. Galloway, 74 Ark. App. 13, 45 S.W.3d 396 (2001); Wackenhut Corp. v. \nJones, 73 Ark. App. 158, 40 S.W.3d 333 (2001). \n As  the  Arkansas  Court  of  Appeals  has  held,  a  claimant  may  be  entitled  to  additional \ntreatment even after the healing period has ended, if said treatment is geared toward management \nof the injury.  See  Patchell v. Wal-Mart Stores, Inc., 86 Ark. App. 230, 184 S.W.3d 31 (2004); \nArtex Hydrophonics, Inc. v. Pippin, 8 Ark. App. 200, 649 S.W.2d 845 (1983).  Such services can \ninclude  those  for  the  purpose  of  diagnosing  the  nature  and  extent  of  the  compensable  injury; \nreducing or alleviating symptoms resulting from the compensable injury; maintaining the level of \nhealing achieved; or preventing further deterioration of the damage produced by the compensable \ninjury.  Jordan v. Tyson Foods, Inc., 51 Ark. App. 100, 911 S.W.2d 593 (1995); Artex, supra.  A \n\nPATTERSON AWCC NO. G905912 \n \n7 \n \nclaimant is not required to furnish objective medical evidence of his continued need for medical \ntreatment.  Castleberry v. Elite Lamp Co., 69 Ark. App. 359, 13 S.W.3d 211 (2000). \n But to prove his entitlement to the treatment at issue, Claimant must also prove that it is \ncausally  related  to  his  compensable  injury  of September 10,  2019.   See  Pulaski  Cty.  Spec.  Sch. \nDist. v. Tenner, 2013 Ark. App. 569 (2013) \nI  find  by  the  preponderance  of  the  evidence  that  Claimant  has  proven  he  is  entitled  to \nadditional  medical  treatment  for  his  headaches  and  treatment  for  seizures. Though  I  make  this \nfinding,  I  do  acknowledge  Respondents’  arguments to  the  counter.  For  example, Claimant \nmentioned to Dr. Brophy on October 22, 2019, that he was having increased headaches when using \nhis  computer  at  school.  Dr.  Brophy,  during  a  clinic  visit  on  January  21,  2022,  opined  that \nClaimant’s headaches have improved. Resp. Ex. 1, pages 37 – 39. Claimant’s next follow up visit \nwith Dr. Brophy occurred on September 28, 2021, over a year and a half since his last visit, and \nClaimant did not report a headache. Resp. Ex. 1, pages 52 – 55. The next clinic visit was on January \n25, 2022, there Dr. Brophy noted that Claimant had fatigue “without headaches”. It would appear \nthat  Claimant’s headaches had resolved but being  symptom  free  for  a  period of  time does  not \nequate to the complete resolution of the symptom. Which is evident in this case that the headaches \nhave returned, and the evidentiary record does not provide any other explanation for the headaches \nother than the compensable closed head injury. This is the same for the seizures.  \nClaimant  in  an  August  2,  2022,  medical  report  by  Neurology  Associates  of  Northeast \nArkansas PA, written approximately three years after the work-related injury, stated he has been \nexperiencing  severe  headaches  and  passing  out  episodes  for  at  least  the  last two  months. \nClaimant’s  Ex.  1,  pages  5 – 13.  Dr.  Ronald  South  prescribed  Claimant  Keppra,  a  seizure \nmedication. Id. Dr. South did not state in his report that the seizures were related to the Claimant’s \n\nPATTERSON AWCC NO. G905912 \n \n8 \n \ncompensable   work-related   head   injury.   Moreover,   when   Claimant   visited   the Neurology \nAssociates of Northeast Arkansas on April 5, 2023, he was experiencing left side numbness, left \nside facial numbness, and blurry vision for a week that resulted in a trip to the emergency room at \nNEA. Claimant’s Ex. 1, pages 53 – 57.  The ER doctors concluded that it was a pinched nerve and \ngave him a Toradol shot. Id. The treatment of the pinched nerve was successful in dealing with \nClaimant’s symptoms, except for the headaches. Id. I do not find that Claimant’s numbness was \nthe result of a seizure, rather a pinched nerve. However, Claimant is suffering from seizures and \nthere are no other explanations for them from the evidentiary record other than the work-related \ncompensable head injury. Claimant’s Ex. 1, pages 71-80. Therefore, I find that the Claimant has \nproven by the preponderance of the evidence a causal connection between Claimant’s headaches \nand  seizures and  his compensable work-related  injury.  Thus,  Claimant  is  entitled  to  additional \nmedical treatment for his headaches and seizures.  \nCONCLUSION \n In  accordance  with  the  Findings  of  Fact  and  Conclusions  of  Law  set  forth  above, \nClaimant’s requests for additional medical treatment for headaches and seizures are denied and all \nparties shall act consistent with this opinion.  \n IT IS SO ORDERED. \n \n       ________________________________ \n       Hon. Steven Porch \n                                                                                    Administrative Law Judge","preview":"BEFORE THE ARKANSAS WORKERS’ COMPENSATION COMMISSION WCC NO. G905912 GREGORY PATTERSON, EMPLOYEE CLAIMANT CITY OF MONETTE, EMPLOYER RESPONDENT MUNICIPAL LEAGUE WC PROGRAM, CARRIER/ ARKANSAS MUNICIPAL LEAGUE, TPA RESPONDENT OPINION FILED SEPTEMBER 5, 2024 Hearing before Administrative Law Judge Steven Porch on July 26, ...","fetched_at":"2026-05-19T22:48:31.903Z","links":{"html":"/opinions/alj-G905912-2024-09-05","pdf":"https://labor.arkansas.gov/wp-content/uploads/Patterson_Gregory_G905912_20240905.pdf","source_publisher":"https://labor.arkansas.gov/workers-comp/awcc-opinions/administrative-law-judge-opinions/"}}