{"id":"alj-H107721-2025-11-12","awcc_number":"H107721","decision_date":"2025-11-12","opinion_type":"alj","claimant_name":"Andrew Vanlente","employer_name":"City Of Ward","title":"VAN LENTE VS. CITY OF WARD AWCC# H107721 November 12, 2025","outcome":"granted","outcome_keywords":["granted:4"],"injury_keywords":["neck","shoulder","back","ankle","hip","fracture","knee","cervical"],"pdf_url":"https://www.labor.arkansas.gov/wp-content/uploads/VanLente_Andrew_H107721_20251112.pdf","source_index_url":"https://labor.arkansas.gov/workers-comp/awcc-opinions/administrative-law-judge-opinions/","filename":"VanLente_Andrew_H107721_20251112.pdf","text_length":97794,"full_text":"BEFORE THE ARKANSAS WORKERS’ COMPENSATION COMMISSION \nWCC NO. H107721 \n \n \nANDREW VAN LENTE, EMPLOYEE CLAIMANT \n \nCITY OF WARD, \n SELF-INSURED EMPLOYER RESPONDENT \n \nARK. MUNICIPAL LEAGUE, \n THIRD-PARTY ADM’R RESPONDENT \n \n \nOPINION FILED NOVEMBER 12, 2025 \n \nHearing before Administrative Law Judge O. Milton Fine II on August 14, 2025, in Little \nRock, Pulaski County, Arkansas. \n \nClaimant represented by Mr. Andy L. Caldwell, Attorney at Law, Little Rock, Arkansas. \n \nRespondents  represented  by  Ms. Karen  H.  McKinney,  Attorney  at  Law,  Little  Rock, \nArkansas. \n \n \nSTATEMENT OF THE CASE \n \n On August  14,  2025,  the  above-captioned  claim  was  heard  in  Little  Rock, \nArkansas.  A prehearing conference took place on June 2, 2025.  The Prehearing Order \nentered  on  that  date  pursuant  to  the  conference  was  admitted  without  objection  as \nCommission  Exhibit  1.    At  the  hearing,  the  parties  confirmed  that  the  stipulations, \nissues, and respective contentions, as amended, were properly set forth in the order. \nStipulations \n At  the  hearing,  the  parties  discussed  the  stipulations  set  forth  in  Commission \nExhibit  1.    After  amendments  thereof at  the  hearing,  they  are  the  following,  which  I \naccept: \n\nVAN LENTE – H107721 \n2 \n \n 1. The Arkansas Workers’ Compensation Commission has jurisdiction over \nthis claim. \n2. The  employee/self-insured  employer/third-party  administrator  relationship \nexisted   on   September   17,   2021,   when   Claimant   sustained   multiple \ncompensable  injuries,  both  of  a  scheduled  and  an  unscheduled  nature, \nwhen he was struck by a motor vehicle. \n3. Respondents have accepted this claim as compensable and paid medical \nand  indemnity  benefits  pursuant  thereto,  including  a  combined  values \nrating of nineteen percent (19%) to the body as a whole that was assigned \nby  Functional  Testing  Centers,  Inc.    Thereafter,  based  on  a  March  12, \n2025,   report   by   Dr.   Barry   Baskin,   Respondents  accepted  additional \nimpairment ratings equivalent to nine percent (9%) to the body as whole. \nIssues \n The  parties  discussed  the  issues set  forth  in  Commission  Exhibit  1.   After  an \namendment at the hearing, the following were litigated: \n1. Whether Claimant is entitled to higher impairment rating(s), and additional \npermanent  partial  disability  benefits  pursuant  thereto,  in  connection  with \nhis stipulated compensable injuries. \n2. Whether Claimant is permanently and totally disabled or, in the alternative, \nentitled  to  wage  loss  disability  benefits,  in  connection  with  his  stipulated \ncompensable injuries. \n3. What was Claimant’s average weekly wage? \n\nVAN LENTE – H107721 \n3 \n \n4. Whether Claimant is entitled to a controverted attorney’s fee. \nAll other issues have been reserved. \nContentions \n The  respective  contentions  of  the  parties,  following  amendment  at  the  hearing, \nread as follows: \n Claimant: \n1. Claimant  contends  that  he  sustained  injuries  to  his  head,  neck,\n1\n left  arm, \nleft  shoulder,  back,  bilateral  pelvis,  right  leg,  right  ankle,  and  right  foot  in \nthe  course  and  scope  of  his  employment  on  about  September  17,  2021.  \nHe was a pedestrian and was struck by a fast-moving vehicle on highway \n67/167,  resulting  in  numerous  injuries  all  over  his  body.  Respondents \nhave  accepted  the  claim and  paid  temporary  total  disability  benefits,  plus \nsome medical expenses. \n2. Respondents miscalculated  the  claimant’s  average  weekly  wage  and \ncompensation  rates,  resulting  in  an  underpayment  of  indemnity  benefits.  \nHe  was  earning  $17.00  per  hour  at  the  time  of  his  injury.   The  wage \nrecords  furnished  by  Respondents  show  that  he  worked  2,264.50  hours \nover  the  52  weeks  preceding  his  injury,  which  equal  to  184.5  hours  of \novertime.    Also  during  that  52-week  period,  he  received  two  bonuses \n \n \n1\nClaimant in his testimony denied that he suffered any head or neck injury.  See \ninfra. \n\nVAN LENTE – H107721 \n4 \n \ntotaling $500.00.  The calculation of ($17.00 x 2080) + $4,704.00 + $500 ÷ \n52 = $780.00.  This results in compensation rates of $514.00/$386.00. \n3. Claimant further contends  that he  is  entitled  to  the underpayment of \nindemnity  benefits  based  on  the  foregoing,  along  with  a  controverted \nattorney’s   fee   thereon.      He   was   given   a   nineteen   percent   (19%) \nimpairment rating  to  the  body  as  a  whole  for  the  combination  of  his \nimpairments  for  his  upper  body,  shoulder,  pelvis,  and  gait derangement, \nwhich Respondents accepted. \n4. Claimant   contends   that   he   is   entitled   to   additional   impairment   in \naccordance  with  the Fourth Edition  of  the AMA  Guides,  per  the  report  of \nDr. Barry Baskin. \n5. Also, Claimant contends that he is permanently and totally disabled or, in \nthe  alternative, entitled  to  wage  loss  disability  benefits.  His  attorney  is \nentitled to a controverted attorney’s fee thereon. \n6. All other issues have been reserved. \n Respondents: \n1. Respondents contend that they have accepted this claim as compensable \nand have not controverted his right to any benefits.  Claimant was found to \nbe  at  maximum  medical  improvement  on  November  8,  2023.  He  was \nassessed a 19% impairment rating to the body as a whole on February 5, \n2024.  This rating  has  been  accepted,  and  permanent  partial  disability \nbenefits are currently being paid therefor.  Claimant, through his attorney, \n\nVAN LENTE – H107721 \n5 \n \nrequested that Dr. Baskin evaluate him for a permanent impairment rating.  \nThe doctor issued a report on March 12, 2025, in which he opined that the \noriginal rating of nineteen percent (19%) included a fifteen percent (15%) \nrating  for  gait derangement.  In his  report,  Dr.  Baskin  stated  that  a  rating \nbased  on  gait derangement  is  only  to  be  used  when  there  is  no  other \nmeans  to  assess  an  impairment  rating.  He  reviewed  the  EMG/NCV \nstudies  done  in  2022,  and  concluded  that  they  provide  other  means  to \nassess Claimant’s impairment.  According to him, Claimant has a twenty-\nfour percent (24%) impairment  rating to  the  body as  a whole  for  his  left \nlower  extremity  injury.  The  doctor specifically stated in his report, “using \nthe  nerve  conduction  studies  and rating  Mr.  Van  Lente on  those  as \nopposed  to  using a gait derangement  abnormality  which  is  a  stand-alone \nrating does  provide [him] with  a  9%  whole  person  impairment  more  than \n[the] rating  on  the  gait derangement alone.”  Respondents previously \naccepted  and  paid  the nineteen  percent  (19%)  rating, which  was  for  the \nfifteen percent (15%) gait derangement, one percent (1%) to the shoulder, \nand  two  percent  (2%) for  the  pelvic  injury.  Respondents  accepted  and \nhave paid this additional nine percent (9%) impairment as assessed by Dr. \nBaskin.  Respondents  contained  that  they relied  upon  the  impairment \nrating as issued on February 5, 2024, and approved by Dr. Regis Renard \non March 6, 2024, in good faith. Claimant made a formal request for a new \nor  additional  evaluation  for  an  impairment rating.  Upon  being  presented \n\nVAN LENTE – H107721 \n6 \n \nwith  Dr. Baskin’s additional rating, Respondents  accepted  and  paid  the \nadditional nine percent (9%) as assessed by him. \n2. Claimant has also requested permanent and total disability benefits, or in \nthe  alternative,  wage  loss  disability  benefits.    While  his  physicians  have \nopined  that  he  may  not  be  able  to  return  to  work  as  a  police  officer,  no \nphysician  has  opined  that  he  is  permanently  and  totally  disabled.    The \nfunctional  capacity  evaluation  revealed  that he  is  capable of  working  in a \nmedium  duty  job  classification.    Respondents  obtained  a  vocational \nassessment  evaluation.    This  evaluation  revealed  that  he  has  many \ntransferable  skills,  and  identified  numerous  sedentary  and  light-duty  jobs \nfor  which  he  was  qualified.    Therefore,  Respondents  also  contend  that \nClaimant  is  not  permanently  and  totally  disabled,  nor  has  he  sustained \nsubstantial wage loss disability, if any. \n3. With respect to the average weekly wage issue, the Form AR-W prepared \nby  Respondents  has  one  typographical  error:    Line  19  should  read \n$1,609.50  instead  of  $1,509.50.    The  52  weeks  preceding  Claimant’s \ninjury are otherwise accurately reflected on that form.  Claimant received a \nraise  during  that  period.    Pursuant  to Lankford  v.  Crossland  Constr.  Co., \n2011  Ark.  App.  416, 2011  Ark.  App.  LEXIS 451, the  proper  method  to \naccount for this is to use all of the earnings and then divide by 52.  As for \nClaimant’s  bonuses,  they  were  excluded  from  the  calculation  because \nthey  were  considered  fringe  benefits  under Taylor  v.  Lubritech,  75  Ark. \n\nVAN LENTE – H107721 \n7 \n \nApp. 68, 54 S.W.3d 132 (2001).  Finally, Claimant only worked about 10.5 \nto 12 hours of overtime in the year preceding his injury.  Many of the hours \nthat he is terming “overtime” were not considered as such and were not \ncompensated as such.  Taking all of this into account, his average weekly \nwage was actually $701.48, yielding compensation rates of $468/$351.00. \nFINDINGS OF FACT AND CONCLUSIONS OF LAW \n After reviewing the record as a whole, including medical reports, documents, and \nother  matters  properly  before  the  Commission,  and  having  had  an  opportunity  to  hear \nthe testimony of the claimant and to observe his demeanor, I hereby make the following \nfindings  of  fact  and  conclusions  of  law  in  accordance  with  Ark.  Code  Ann.  §  11-9-704 \n(Repl. 2012): \n1. The Arkansas Workers’ Compensation Commission has jurisdiction over \nthis claim. \n2. The stipulations set forth above are reasonable and are hereby accepted. \n3. Claimant has failed to prove by a preponderance of the evidence that he is \nentitled  to  impairment  ratings in  addition  to  and/or higher  than  those  set \nforth in Stipulation No. 3, supra. \n4. Claimant has failed to prove by a preponderance of the evidence that he is \npermanently and totally disabled. \n5. Claimant  has  proven  by  a  preponderance  of  the  evidence  that  he  has \nsustained wage loss disability of fifteen percent (15%). \n\nVAN LENTE – H107721 \n8 \n \n6. The preponderance of the evidence establishes that Claimant’s average \nweekly   wage   was   $699.57,   entitling   him   to   compensation   rates   of \n$466.00/$350.00. \n7.  Claimant has not proven by a preponderance of the evidence that he has \nbeen  underpaid  indemnity  benefits  based  on  a  miscalculation  of  his \naverage weekly wage. \n8. Claimant  has  proven  by  a  preponderance  of  the  evidence  that  his \nattorney, the Hon. Andy L. Caldwell, is entitled to a controverted fee on the \nindemnity benefits awarded herein, pursuant to Ark. Code Ann. § 11-9-715 \n(Repl. 2012). \nCASE IN CHIEF \nSummary of Evidence \n Claimant was the sole witness. \n Along  with  the  Prehearing  Order  discussed  above,  the  exhibits  admitted  into \nevidence in this case were Claimant’s Exhibit 1, a compilation of his medical  records, \nconsisting  of three index  pages and 421 numbered  pages  thereafter; Claimant’s non-\nmedical  records,  consisting  of  one  index  page  and  32  numbered  pages  thereafter; \nClaimant's  Exhibit  3,  the  previous  Prehearing  Order  plus  the  prehearing  questionnaire \nresponses of the parties, consisting of 11 pages; Claimant’s Exhibit  4,  the  August  12, \n2025, email from Claimant’s counsel to Respondents’ counsel concerning the bases for \nthe former’s calculation of his client’s average weekly wage, consisting of one page; \nRespondents’ Exhibit 1, another compilation of Claimant’s medical records, consisting \n\nVAN LENTE – H107721 \n9 \n \nof two index  pages  and 101 numbered  pages  thereafter;  and  Respondents’ Exhibit  2, \nnon-medical records, consisting of one index page and 50 numbered pages thereafter. \nAdjudication \nA. Permanent Partial Disability Benefits \n Introduction.    As   reflected   in   Stipulation   No.   3,   Claimant   was   assigned \nimpairment  ratings  equal  to nineteen  percent  (19%)  to  the  body  as  a  whole  by \nFunctional Testing Centers, Inc. (“FTCI”), on February 5, 2024.  Thereafter, on March \n12,  2025,  Dr.  Barry  Baskin authored  a  report  in  which  he  assigned  permanent \nimpairment ratings equivalent to an additional nine percent (9%) to the body as whole.  \nRespondents have accepted the aforementioned ratings, which when combined amount \nto twenty-eight percent (28%) to the body as a whole; and have been paying Claimant \npermanent partial disability benefits pursuant to this. \n In this proceeding, Claimant is seeking to be awarded permanent ratings higher \nthan that accepted by Respondents, and permanent partial disability benefits thereto, in \nconnection   with   his stipulated compensable   injuries of September 17,   2021.  \nRespondents dispute that  Claimant is  entitled  to  any  ratings/benefits  over  and  above \nthat which they have already accepted. \n Standards.      Permanent   impairment,   generally   a   medical   condition,   is   any \npermanent  functional  or  anatomical  loss  remaining  after  the  healing  period  has  been \nreached.  Ouachita Marine v. Morrison, 246 Ark. 882, 440 S.W.2d 216 (1969).  Pursuant \nto Ark. Code Ann. § 11-9-522(g) (Repl. 2012), the Commission adopted the AMERICAN \nMEDICAL ASSOCIATION,  GUIDES TO THE EVALUATION OF PERMANENT IMPAIRMENT (4th \n\nVAN LENTE – H107721 \n10 \n \ned. 1993) (hereinafter “AMA Guides”) as  an  impairment  rating  guide.   See AWCC  R. \n099.34.    A  determination  of  the  existence  or  extent  of  physical  impairment  must  be \nsupported by objective and measurable physical or mental findings.  Ark. Code Ann. § \n11-9-704(c)(1)(B)  (Repl.  2012).   “Objective findings” are “those findings which cannot \ncome under the voluntary control of the patient.”  Id.  §  11-9-102(16)(A)(i).    Permanent \nbenefits are to be awarded only following a determination that the compensable injury is \nthe  major  cause  of  the  disability  or  impairment.   Id.  §  11-9-102(4)(F)(ii)(a).    “Major \ncause” is defined as “more than fifty percent (50%) of the cause,” and a finding of major \ncause  must  be  established  by  a  preponderance  of  the  evidence.   Id.  §  11-9-102(14).  \nThis standard means the evidence having greater weight or convincing force.  Barre v. \nHoffman,  2009  Ark.  373,  326  S.W.3d  415; Smith  v.  Magnet  Cove  Barium  Corp.,  212 \nArk. 491, 206 S.W.2d 442 (1947). \n Any  medical  opinion concerning  impairment must be  stated  within a  reasonable \ndegree of medical certainty.  Ark. Code Ann. § 11-9-102(16)(B) (Repl. 2012).  It should \nbe  noted,  however,  that  in  interpreting  this  provision,  the  Arkansas  Supreme  Court  in \nFreeman v. Con-Agra Frozen Foods, 344 Ark. 296, 40 S.W.3d 760 (2001) stated:  “This \ncourt  has  never  required  .  .  .  that  the  magic  words  ‘within  a  reasonable  degree  of \nmedical certainty’ even be used by the doctor.” \n A claimant’s testimony is never considered uncontroverted.  Nix v. Wilson World \nHotel,  46  Ark.  App.  303,  879  S.W.2d  457  (1994).    The  determination  of  a  witness’ \ncredibility and how much weight to accord to that person’s testimony are solely up to the \nCommission.  White v. Gregg Agricultural Ent., 72 Ark. App. 309, 37 S.W.3d 649 (2001).  \n\nVAN LENTE – H107721 \n11 \n \nThe  Commission  must  sort  through  conflicting  evidence  and  determine  the  true  facts.  \nId.  In so doing, the Commission is not required to believe the testimony of the claimant \nor  any  other  witness,  but  may  accept  and  translate  into  findings  of  fact  only  those \nportions of the testimony that it deems worthy of belief.  Id. \n Evidence\n2\n.   Claimant  testified  that  at  the  time  of  his  September  17,  2021, \naccident that is the subject of this litigation, he had been employed as a police officer for \nRespondent  City  of  Ward  for approximately  six years.   Asked  how  he  got  hurt,  he \nrelated: \nI  was  coming  back  from  Cabot on 67/167 North . . . around 6:00 o’clock, \n7:00 o’clock [p.m.], I believe  I was just coming back from lunch.  I had just \nspoken with the night shift officer.  He said he was going to go grab lunch.  \nI was like, “Yeah, go ahead.  I’m on my way back now.”  I drove up on a \nState Police vehicle on the left side of the road along with—I don’t recall if \nit was two or three other vehicles around Mile Marker 21, and I stopped to \nassist  him  if  he  needed  assistance,  try  to  manage  traffic  a  little  bit.   I \nstopped on the right side, and I remember backing up quite a ways to try \nto  slow  traffic—slow  traffic  down  before  they  got  there.    The  last  thing  I \nremember was exiting the car, and the next thing I remember was feeling \nuncomfortable  and  couldn’t  really  see  or  hear,  and  I  knew  something \nhappened, something was wrong, but I didn’t know what.  I had no idea \nwhat had happened. \n \nLater, Claimant learned that he had been struck by an automobile. \n He  was  taken  by  air  ambulance  to  the  University  of  Arkansas  for  Medical \nSciences (“UAMS”), where he stayed for five or six days.  Asked to list the parts of his \nbody that were injured, Claimant related that his pelvis, right leg and ankle, left arm, left \n \n \n2\nThe  evidence  discussed  in  the  context  of  this  issue  also  has  bearing  on  the \nissue of whether Claimant is permanently and totally disabled, or entitled to wage loss \ndisability benefits.  See infra. \n \n\nVAN LENTE – H107721 \n12 \n \nshoulder, and  left hip had  been  hurt.   Following  his  hospitalization,  Claimant  went  to  a \nrehabilitation center for a month. \n It  was  Claimant's  testimony  that  he  was  non-weight-bearing  for  five  to  six \nmonths.  He developed a pressure sore on the back of his right heel because his cast \nwas too tight.  Due to disuse, his right foot turned inward. \n On  cross-examination,  Claimant stated  that  his  most  recent  surgery,  to  correct \nhis foot inversion, did not help.  He is still suffering from pain in that extremity.  His foot \ndrop is due to nerve damage that he suffered when he sustained a fracture just below \nthe knee when he was struck by the vehicle. \n Claimant in his testimony recounted that the multiple injuries that he sustained in \nthe  accident  at  bar  included  a  fracture  of  the  left  humeral  head,  a  fracture  of  the \nposterior iliac of the sacroiliac joint, a fracture of the right pubic bone, three fractures of \nthe right lower extremity, multiple fractures of his right foot.  While initially hospitalized, \nClaimant underwent three separate surgeries to stabilize his hip/pelvis, to stabilize and \nfix  his  right  lower  extremity  and  foot,  and  to  place  a  pin  in  his  arm.    Claimant \nacknowledged  that  he  was  “very  fortunate”  that  the  above  were  his  only  injuries, \nconsidering that he was struck by a vehicle moving at high speed.  His neck, back, and \ninternal organs were not harmed, nor did he suffer any amputations or paralysis.  When \nhe left the hospital, it was on a stretcher because he had to be non-weight-bearing due \nto his pelvic injuries.  Later, he remained non-weight-bearing on his right leg.  While his \nmedical records reflect that his foot drop condition has improved slightly, Claimant took \nissue with this. \n\nVAN LENTE – H107721 \n13 \n \n The  medical  records  in  evidence  show  that  Claimant  presented  on  September \n17, 2021, to UAMS as a Level 1 Trauma patient after being struck by a motor vehicle at \nhighway  speed.   Examination  showed  him  to  have,  inter  alia,  compression  of  the  iliac \ncrests  and  symphysis  pubis,  along  with  “significant  deformity”  of  the  right  lower \nextremity.  A tourniquet had been applied to the right leg prior to Claimant’s arrival at the \nhospital.   After  being  given  Ketamine  for  pain,  he  became  disoriented  and  combative.  \nAs  a  result,  he  had  to  be  intubated  so  that  his  scans  could  be  completed.   He  was \nassessed as having the following: \n-Comminuted left humeral head fracture \n-Left posterior iliac fracture extending into the sacroiliac joint with possible \nsubtle buckle fracture of the left sacral ala [sic] \n-Right ischia ramus buckle fracture \n-Right pubic body fracture without pubic diastasis \n-Comminuted and distracted right tibia and fibular fractures \n-Comminuted smashed right midfoot and forefoot fractures \n-Minimal  asymmetric  facet  widenting  [sic]  right  C5-6  likely  degenerative \ngiven facet and uncal [sic] hypertrophy resulting in severe right NF \nstenosis \n-Possible injury of right popliteal artery vs. basal spasm\n3\n \n \nThe  CT  scan  of  Claimant’s  left  upper  extremity  showed  a  “[c]omminuted  mildly \ndisplaced  and  impacted  humeral  neck  fracture  with  comminution  involving  the  lesser \nand greater tuberosities.”  The more extensive findings of the scan of his right lower \nextremity were the following: \nFindings    consistent    with    Lisfranc    injury    with    multiple    displaced \ncomminuted    fractures    of    the   tarsals    and   metatarsals   along    the \n \n \n3\nAnother  record  from  UAMS  references  Claimant  having  a  fracture  of  the right \nfemur.    However,  the  balance  of  the  records  is  silent  about  this,  and  Claimant  did  not \nreference this in his hearing testimony. \n\nVAN LENTE – H107721 \n14 \n \ntarsometatarsal  articulations.    Associated  subluxation  and  dislocation \ninvolving all tarsometatarsal articulations as described above. \n \nAdditional fractures of distal 3\nrd\n and 5\nth\n metatarsals. \n \nDistal tibial fracture with stabilizing intramedullary nail partly visualized. \n \nAn x-ray of that lower extremity revealed: \nAgain noted is mildly comminuted and displaced fracture of the head and \nneck region of the right fibula.  There is comminuted fracture of the distal \nshaft of the tibia with butterfly fragment posteriorly.  There is also impacted \nand displaced fracture of the junction of the proximal and mid shaft of the \ntibia. \n \nX-ray of the pelvis reflected a fracture of the pubic bone on the right side of the junction \nwith  the  superior  pubic  ramus.  A  CT  scan  of  Claimant’s  cervical  spine  showed \ndegenerative changes at multiple levels, including moderate severe left neural foraminal \nnarrowing  at  C4-5,  severe  right  neural  foraminal  narrowing  at  C5-6,  and  moderate left \nC6-7 neural foraminal narrowing. \n Claimant was given units of blood.  An intramedullary rod with proximal and distal \ninterlocking screws were surgically installed in Claimant’s right fibula on September 19, \n2021.  As part of that surgery, a wound on his calf was irrigated and debrided.  Claimant \nalso underwent an open reduction/internal fixation of his proximal humerus fracture, and \na pelvic percutaneous fixation, on September 20, 2021.  Later, on September 23, 2021, \nClaimant  underwent  a  right  mid-foot  fusion.\n4\n  Dr.  Renard  performed  all  of  these \nsurgeries. \n \n \n4\nOne of the pre-and post-operation diagnoses listed in the report on the mid-foot \nfusion  is  “acute  kidney  injury.”   There  are  references  to  it  elsewhere  in  Claimant’s \nrecords that are in evidence.  But he did not mention it in his testimony; to the contrary, \n\nVAN LENTE – H107721 \n15 \n \n A  note  by  LMSW  Carmen  Coody at  UAMS reflects  that  Claimant  “state[d]  he \nstruggles  with  anxiety,  depression  and  PTSD since  childhood  and  is  receive[n]g \nmedication  management  and  therapy.”  His  patient  history  includes  the  following \nreference:  “PSH of lumbar fusion.” \n On  September 27,  2021,  Claimant  was  discharged  from  UAMS and  transported \nby ambulance to Lonoke Heath and Rehabilitation, a skilled nursing facility.  Dr. Carlos \nRoman evaluated him on October 4, 2021.  His report reads in pertinent part: \nThe  patient  is  a  46-year-old  gentleman.  He  is  a  police  officer.  He  was \nworking  the  scene  of  an  accident  when  a  truck  hit  him  directly.  He  was \nthe  pedestrian  in  a  motor  vehicle  accident.  He  had  multi-orthopedic \ntrauma to include severe right humerus fracture, closed crush injury to his \nright  foot, closed  pelvic  fracture,  and  right  proximal  severe  open  tibia \nfracture.  He  was  taken  to  UAMS Orthopedic Trauma.  He  was  seen  by \nDr. Renard.  He initially underwent surgery on the pelvis with placement of \na  pin.  He  underwent  iliac  sacral  screw  placement  and  reduction  and \ninternal  fixation  of  the  left  humerus  by  way  of  a  Delta  pectoral  incision.  \nThey used to [sic] fibular straight autograft. \n \nOn   September   19,   2021,   his   right tibia fracture   was   treated   with \nintramedullary  rod  placement.  He  also  underwent  I&D [irrigation  and \ndebridement] of a wound from a posterior calf soft tissue trauma. \n \nHe also had Lisfranc fracture of the mid foot on the right with crush injury \nof the first through third metatarsal.  He underwent reduction and internal \nfixation of the foot on September 23, 2021. \n \nHe  suffered  an  acute  kidney  injury  and  kidney  contusion.  There  was  no \nother visceral trauma. \n \nHe  is  currently  in  a  rehab  facility.  He  remains  non-weight-bearing.  He  is \non  a  stretcher.  He  can  sit  up  for  just  a few minutes  at  a  time  due  to  the \npain  in  his  pelvis.  He  is  completely  non-weight-bearing  on  the  right  leg.  \n \nhe stated that he suffered no damage to any of his internal organs as a result of being \nstruck  by  the  automobile.    Regardless,  he  was  not  assigned  a  permanent  impairment \nrating in connection with it, and has not requested that the Commission do so. \n\nVAN LENTE – H107721 \n16 \n \nThe  left  leg  had  an  ankle  sprain,  but  was  spared  any  major  trauma.  His \nleft arm is in a sling. \n \nPrior  to  the  injury,  he  had  previous  lumbar  fusion  and  decompressive \nsurgery.  He  was a  legacy opiate patient.  He  was  on  oxycodone,  10 mg \ntablets,   four   times   a   day   prior   to   the   injury.  He   was   also   on \nantidepressants  prior  to  the  injury.  He  had  some  pre-existing  opiate \ntolerance that obviously poses some challenges as far as making sure he \ngets appropriate pain control, and making sure he gets a great rehab and \ngets the best possible outcome from this injury. \n \nDr. Roman adjusted Claimant’s medications and assessed him as having: \n1.  Multi-orthopedic trauma \n2.  Pelvic fracture \n3.  Right tibia fracture \n4.  Crush injury to right foot \n5.  Left humerus fracture \n6.  Legacy opiate patient \n7.  Opiate dependency \n \n On  September  28,  2021,  Claimant  returned  to  UAMS  for  evaluation  by  Dr. \nRenard’s office.  The report reads in pertinent part: \n1) Closed  segmental  right  tibia and  fibula fractures  complicated  from  foot \ndrop likely from proximal fibular neck fracture with displacement at time of \ninjury.  He has healed his road rash and surgical wounds.  His sutures can \nbe  removed.  It  is  too  soon  to  begin  weight bearing  on  the  right  lower \nextremity for about 8 weeks.  We will monitor his foot drop, however, it is \npossible  that  he  will  require  perm[anent] foot bracing  with  ambulation. \nFollowup in 4 weeks with repeat radiographs of the right tibia and fibula. \n \n2) Crush injury about the right foot s/p Lisfranc arthrodesis and pinning of \nthe lateral TMT joints.  Sutures can be removed.  He will be placed into a \nshort  leg  cast  for  the  next  few  weeks.  It  is  too  soon  to  begin  weight \nbearing on the right lower extremity.  Likely about 8 weeks until advancing \nweight bearing. Follow up in 4 weeks with radiographs of the right foot out \nof  the  cast  and  likely  removal  of  the  right  foot  pin.  I  anticipate  that  the \npatient  will  have  some  perm[anent] degree  of  dysfunction  about  the  right \nfoot given the amount of crush injury and fractures about his foot once he \nobtains maximal medical improvement. \n \n\nVAN LENTE – H107721 \n17 \n \n3) Pelvic  ring  injury s/p percutaneous  fixation.  I  will  allow  the  patient  to \npost and pivot with full weight on the left lower extremity at this time.  He is \nnot  allowed  to  try  to  formally  ambulate  on  the  left  lower  extremity  as  he \ncannot  bear  any  weight  on  the  right  lower  extremity  at  this  time  and  I  do \nnot  want  him  to  accidentally  hop  on  the  LLE.  Follow  up  in 4 weeks  with \nradiographs AP, Inlet, Outlet   views   of   the   pelvis,   and   probably \nadvancement to full weight bearing on the left lower extremity. \n \n4) Left  proximal  humerus  fracture:  encourage  ROM  of  the  left  shoulder.  \nActive  motion  for  ADL’s  of  the  left  elbow,  wrist  and  hand.  Followup  in 4 \nweeks with repeat radiographs of the left shoulder and likely advancement \nto  5  pounds  weight bearing  on  the  left  upper  extremity  and  increase  in \nactive shoulder motion and strengthening with therapy.  I anticipate that he \nwill  have  a  certain  degree  of  left  shoulder  stiffness  after  the  injury  and \nsurgery,  however  with  aggressive  therapy  I  hope  we  can  minimize  his \nfuture shoulder dysfunction. \n \n- Overall  he  is  unable  to  resume  any  work  at  this  time  secondary  to  his \nmultiple injuries.  Until he has better function of his LUE would I consider \nallowing desk duty. \n \n- Pain as per pain provider is recommended.  I can provide temporary pain \nmedication if needed. \n \n On October 13, 2021, Renard wrote that he was keeping Claimant off work until \nhis November 10, 2021, reevaluation.  Dr. Roman saw Claimant again on November 1, \n2021, and noted that because Claimant was already a patient at his clinic and had been \ntaking opiates before the accident, he would have drug tolerance and a need for more \nopiates than a typical patient.  Per his visit to Dr. Renard’s office on November 2, 2021, \nClaimant  developed  a  decubitus  ulcer  on  his  injured  foot  and  discoloration  of  the  toes \non  that  same  foot.  He  developed  MRSA  (methicillin-resistant  staph  aureus)  in  that \nlower  extremity  and  was  treated  with  antibiotics.   On  November  10,  2021,  Renard \nincreased Claimant’s weight restrictions to 10 pounds on his left upper extremity,  but \nkept him non-weight-bearing on his right lower extremity.  His left shoulder was injected.  \n\nVAN LENTE – H107721 \n18 \n \nThe  doctor  kept  him  off  work  an  additional  four  weeks.    Dr.  Roman  on  November  23, \n2021, noted that  Claimant  has  fibular nerve  palsy along  with  numbness  and  tingling  in \nhis feet.  Per wound care notes on November 24, 2021, his ulcer and toe discoloration \nimproved. \n On December 8, 2021, Dr. Renard wrote that Claimant could return to light duty \nimmediately with the following restrictions:  “desk duty only, no lifting over 25 lbs., left \nupper  extremity,  non-weight  bearing  right  lower  extremity.    Please  allow  for  assistive \ndevices, i.e., wheelchair.”  He saw Renard for a 14-week follow-up on January 5, 2022.  \nThe  doctor  noted  that  he  had  removed  the  percutaneous  pins  from  Claimant’s  foot \nduring  his  last  visit.   Claimant  requested  another  shoulder  injection.    Renard  allowed \nhim  to  be  full  weight-bearing  with  his  left  upper  extremity.    However,  Claimant  was  to \nremain  non-weight-bearing  on  his  right  lower  extremity.    He  was  prescribed  a  PRAFO \n(pressure relieving ankle foot orthosis) to address his foot drop.  The doctor stated that \nClaimant could perform desk duty if available and perform “[e]ssentially computer work \nonly and answering phones/emails, etc.”  Dr.  Roman  saw  Claimant  again  on  January \n19, 2022, and noted that his right lower extremity showed “significant edema” along with \n“some calf atrophy.” \n Dr. Renard revisited Claimant’s restrictions on February 9, 2022, giving him a 25-\npound lifting  restriction  for  his  left  upper  extremity  and  “desk  duty  only.”   During \nClaimant’s five-month  follow-up  appointment  on  February  23,  2022,  Renard  found  him \nto be doing “fairly well,” and stated that “[h]e can advance his weight-bearing  continue \nwith therapy.  The report continues in pertinent part: \n\nVAN LENTE – H107721 \n19 \n \n5  months  s/p  right  Midfoot  arthrodesis  and  pinning.    Debridement  and \nintramedullary fixation of complex segmental right tibia fracture.  This point \ndoes   appear   this   is   associated   with   a   posterolateral   corner   injury.  \nAdditionally he has a decubitus ulcer on his heel with some backup.  We \nwill  get  a[n]  order  for  a  KAFO  with  an  open  [sic]  he  will  see  if  this  helps.  \nHe can weightbear in this brace.  So [sic] get a bone stimulator to see with \nthe  most  distal  aspect  of  his  tibial  fracture  to  heal  without  surgical \nintervention. \n \n. . . \n \nThe patient will likely be a maximal medical improvement (MMI) in about 4 \nmonths[’] time (assuming he heals his tibia fracture, however if he requires \nsurgical  revision  of  his  right  tibia  for  nonunion  MMI  will  be  about  9-12 \nmonths from  surgical  revision) ultimately  MMI  is  going  to  depend on  how \nhis healing of his right foot drop proceeds. \n \n Dr.  Baskin  conducted  a  second  opinion  evaluation  of  Claimant  on March  16, \n2022.  His report reads in pertinent part: \nIMPRESSION: \nMr.  Van  Lente is  a  nice  gentleman  referred  for  evaluation  of  polytrauma \ndating  back  to  September  17,  2021,  from  a  pedestrian  versus  motor \nvehicle accident.  He has had neuropsychological evaluation, and I do not \nhave  that  report.  He  has  had  previous  head  trauma  as  a  child.  He  has \nhad  previous  poly  trauma  otherwise.  From  the  accident  September  17, \n2021, he has had a fracture of the left proximal humerus that is status post \nORIF.  He  has  had  pelvic  fractures status  post  pinning,  and  an  SI  joint \nscrew,  it  appears.  He  has  had  segmental  fractures  of  the  right  tibia  and \nfibula  status  post  repair.  He  has  had  a  peroneal  nerve  palsy.  He  has  a \nprevious   history   of   back   pain,   neck,   pain,   and   some   headaches. \nNeuropsychological test results are not available. \n \nPLAN:   I  am  hopeful  he  will  get  some  return  of  his  peroneal  palsy, \nalthough  this  was  a  fracture  dislocation  of  the  proximal  fibula,  and  the \nnerve  could have  been  stretched  significantly.  Reportedly,  the  surgeon \nsaid  it  was not  severed.  We  will  eventually get  nerve  conduction studies \ndone.  He is going to get a KAFO to help with his ambulation on the right \nlower  extremity.  This  will  be  a  double  metal  upright  that  will  spare \npressure  to  his  heel.  He  does  have  a  pressure  sore  that  was  nearly \nhealed,  but  now  has  come  back.  He  sees Wound Care,  and  his  wife  is \nhelping manage the wound. \n\nVAN LENTE – H107721 \n20 \n \n \n. . . \n \nWe  will  get  him  set  up  for  EMG  and  nerve  conduction  studies  down  the \nroad a ways.  For  now,  I  think  just  clinical  observation  will  be  most \nappropriate.  He will continue his counseling with Mr. Knott in Conway.  I \nwould  like  to  look  at  his  neuropsychological  evaluation.  Cognitively  he \nseems  to  be  pretty  much  intact  at  this  point.  CT  of  his  head  and  neck \nwere  negative  for  acute  findings.  He  did  have  some  moderate  severe \nneural  foraminal  narrowing  in  the  cervical  spine.  I  will  see  him back  and \nfollow up in about a month or so.  I will follow him along.  At some point, \nhe will need an impairment rating.  I do not think he is ready to go back to \nwork just yet.  Dr. Renard has released him to 50 percent weightbearing to \nthe right lower extremity.  He is complaining of feeling unstable in the right \nknee.  I  did  not  do  a  detailed  knee  evaluation  today.  He  is  still  under \nfollow up with Dr. Renard and the orthopedic group.  The knee will have to \nbe addressed.  He had a lot of bone trauma and soft tissue injury that are \ncertainly  still  in  the  works.  I  will  look  forward  to  seeing  him  back  and \nfollow-up in about a month or so. \n \n Dr.  Renard  on  April  20,  2022,  again  wrote  that  Claimant  could  return  to  desk \nduty.    Twelve  days  later,  on  May  2,  2022,  he  again  operated  on  Claimant,  performing \nthe following procedures: \n1.  Removal  of  deep  hardware  from  the  right  tibia  for  the  purpose  for \ndynamization of the nonunion \n2.  Right fibula osteotomy \n3.  Bone marrow aspiration with injection to the right tibia nonunion \n4.  Partial  excision  of  right  hallux  toenail  for  treatment  of  infected \ningrown toenail \n \n Claimant underwent a  nerve  conduction  study  on  May  18,  2022.   The  report by \nDr. Michael Chesser reads: \nSevere  combined  right  common  peroneal  and  posterior  tibial  traumatic \nneuropathies.    There  was  no  residual  innervation  detected  in  the  right \nperoneus  longus,  and ˂ 25% estimated residual innervation in the tibialis \nanterior.      There   was - 25   to   50% residual   innervation   in   the \ngastrocnemius.    The  emg  needle  exam  of  the  right vastus lateralis  and \nbiceps femora was normal. \n\nVAN LENTE – H107721 \n21 \n \n \n Dr. Renard saw Claimant on May 18, 2022, and again wrote that he could return \nto desk duty.  The next day, May 19, 2022, Claimant again saw Dr. Baskin and reported \nthat  his  ankle  dorsiflexion  was  improving.   The  doctor wrote that Claimant “is making \nprogress but is still not ready to go back to work yet.”  He recommended that Claimant \nundergo an MRI of his right knee.  That MRI, which took place on June 2, 2022, showed \nno evidence of a meniscal tear or ligament injury, but did reveal degenerative findings.  \nBaskin’s June 23, 2022, report includes the following statement:  “He is interested in \ngoing  back  to  work,  and  I  think  we  are  about  there.”   Claimant  continued  in  pain \nmanagement and in physical therapy.  Dr. Roman wrote on July 27, 2022: \nHe  is  a  legacy  opiate  patient.    He  was  on  Percocet,  10mg  tablets  four \ntimes a day prior to the injury and we have brought that back down to his \nbaseline.    I  would  prefer  to  challenge  that  ever  lower  but  that  was  pre-\nexisting.    Whether  that  continues  to  be  covered  by  Workers’ \nCompensation or not, we will see.  Opiate counseling was done.  I would \nlove  to  see  him  at  a  lower  dose  for  just  general  health  reasons and  to \nmaintain effectiveness of the opiate. \n \n Dr. Baskin on August 8, 2022, wrote:  “Mr. Van Lente has completed his driving \nevaluation  and  passed.    It  is  okay  for  him  to  return  to  work  at  his  recommended \nrestrictions, and it is okay for him to drive.”  Renard concurred on August 24, 2022, \nstating  that  Claimant  “should  continue  work  with  current  restrictions.”   In   a \ncontemporaneous  document,  the  doctor  clarified  that  Claimant  should  be  working  no \nmore than four hours a day, and added:  “He is ambulating better with the AFO [ankle \nfoot  orthosis] and  modified  shoe  wear.    His  main  issue  is  residual  swelling.    He  may \nbenefit   from   lymphedema   clinic   evaluation   and   treatment   so   I   will   order   the \n\nVAN LENTE – H107721 \n22 \n \nconsultation.”  Dr. Baskin followed up on this on October 13, 2022, ordering Lympha \nPress garments for Claimant. \n Claimant returned to Renard’s office on November 23, 2022.  The note of that \nvisit reads in pertinent part:  “Will give patient updated PT order to transition to work \nhard therapy program.  Will update work note to light duty with 6 hour limit.”  Baskin \nreported on December 21, 2022, that Claimant was “doing some work hardening with \nFunctional Testing Centers” and was “making steady progress.”  After  seeing  him  on \nJanuary 9, 2023, Dr. Roman wrote: \nHe has returned to work.  He has a six-hour work limit.  He is on a more of \na light-duty with his foot and ankle, mostly doing paperwork there.  I think \nfor him it has been improvement for him mentally.  He has a strong desire \nto get back in the work force.  He is still struggling with the footdrop. \n \n On March 1, 2023, Claimant returned to Dr. Renard and reported that he had not \nonly  been  driving  but  had  been  working  desk duty for  four  hours  a  day.    The  report \ncontinues in pertinent part: \nIMAGING AND DIAGNOSTIC RESULTS  My interpretation of outside and \nour  radiographs  today  demonstrate  some  interval  healing  of  the  distal \nsegment of the right tibia fracture with stable hardware, no gap about this \nsite  after  dynamization  with  some  evidence  of  healing  of  the  fibular \nosteotomy  and  potential  bony  changes  where  the  tibia  is  now  loading  at \nprevious  gap  site.    Healed  right  midfoot  fusion.    Healed  left  proximal \nhumerus   fracture   with   area   of   some   impaction   about   the   greater \ntuberosity.  Healed pelvic ring. \n \nASSESSMENT    Mr.  Van  Lente  is  here  today  for  routine  re-evaluation  10 \nmonths  after  most  recent  surgery  for  his  left  [sic]  tibia  nonunion  with \ndynamization,  bone  marrow  aspiration  and  injection  to  the  nonunion  site \nand right fibular osteotomy and months after index surgery.  He has some \nimpingement/rotator  cuff  symptoms  about  the  left  shoulder  and  I  offered \nan injection to the left shoulder.  He can work some more with therapy for \nrotator  cuff  strengthening  in  the  future  if  he  has  issues  and  is  to  be \n\nVAN LENTE – H107721 \n23 \n \nconsidered  for  arthroscopy  or  other  procedures  about  the  left  shoulder  I \nwould recommend Dr. Justin Rabinowitz, our shoulder specialist as this is \na more complex issue than I think a sports surgeon could completely treat. \n \nHe  continues  to  ambulate  reasonably  with  the  AFO  and  modified  shoe \nwear.  His residual swelling seems to be controlled with compression sock \nand  therapy.   I think  the dynamization  is  healing  with  smoothening  of  the \nfracture lines and healing of fibula osteotomy site.  He can continue desk \nduty   work   if   available   working   no   more   than   4   hour   shifts   with \naccommodations for his crutches/walker. \n \nAs  he  had  done  previously,  Renard  upon  request  administered  an  injection  into \nClaimant’s injured shoulder to address pain issues that the doctor ascribed to “post-\ntraumatic arthritis.” \n When  Claimant  saw  Dr.  Baskin  on  April  4,  2023,  he  reported  that  he  was  now \nworking at desk duty for up to six hours a day.  He noted that Claimant’s use of the \nLympha Press could impact the number of hours he could be at work, and added:  “Dr. \nRenard has released him to full weightbearing and has allowed him to walk some out of \nthe AFO, but he has not done much of that yet.  I am pleased with his progress and he \nis as well.”  Renard on May 3, 2023, officially increased Claimant’s work restrictions to \nup to six hours per day.  The doctor added that Claimant “[m]ay stand, and walk as \ntolerated for tasks.” \n Dr. Baskin as part of a follow-up visit with Claimant on July 25, 2023, wrote: \nPLAN: \nI recommend that Mr. Van Lente increase his work to 7 hours a day, up to \n35 hours a week.  I do not believe he is ready to go on patrol at this point \ndue  to  potential  risk  to  himself  and  others  if  he  does.   He  is  a  veteran \npolice officer.  I believe he should continue to go to the gym and work on \nhis lower extremity strengthening.  I think his AFO currently is appropriate \nfor him.  I am not sure he will ever be able to return to patrol duty at this \npoint. \n\nVAN LENTE – H107721 \n24 \n \n \n On August 9, 2023, Dr. Renard stated that Claimant “is essentially at MMI at this \ntime,” but added that he could nonetheless require additional bracing, injections and \nother procedures in the future.  The report contains an addendum that reads:  “The \npatient  requests  Bridle  tendon  transfer  surgery  after  he  tried  AFO  modifications  and  it \nfailed  to  produce  the  results  that  he  had  hoped  it  would  achieve.    Will  find  a  date  to \nschedule.”  The doctor also authored a note that states: \nIt  is  my  medical  opinion  that  Mr.  Andrew  Van  Lente  is  cleared  to  work  7 \nhours  per  shift.    He  may  increase  his  hours  by  one  hour  per  shift as \ntolerated up to 12 hours per shift.  He may revert his work hours to the 7 \nhour minimum if working more than 7 hours per shift is not well-tolerated.  \nThe  length  of  his  shifts  may  vary  day-to-day  as  determined  by  Mr.  Van \nLente’s perception of his ability to tolerate work that day, but each shift \nshould be a minimum of 7 hours. \n \n On  October  2,  2023,  Dr.  Renard  again  operated  on  Claimant,  performing  the \nfollowing procedures: \n1.  Right posterior tibial tendon transfer to dorsal midfoot \n2.  Tenodesis of the right peroneus longus to brevis \n3.  Transfer of the right peroneus longus to the dorsal midfoot \n4.  Removal of deep hardware from the right midfoot cuneiforms \n \nSeeing him on October 11, 2023, Renard wrote that Claimant had been taken off work \nfrom the date of surgery until the date of the appointment; and that he was restricted to \ndesk duty “until cleared.”  On  November  8,  2023,  this  restriction  was  continued,  along \nwith  the  notation  that  Claimant  was  not  allowed  to  drive  until  he  could  be  tested  for \ndriver safety.  He was sent back to physical therapy. \n\nVAN LENTE – H107721 \n25 \n \n Casey  Garretson,  Occupational  Therapist,  evaluated  Claimant  on  February  5, \n2024,  for  the  purpose  of  assigning  him  a  permanent  impairment  rating.    His  report \nsummarizes: \n[Claimant]  has  sustained  2%  UEI  [upper  extremity  impairment],  1%  WPI \n[whole-person  impairment]  for  his  left  shoulder  injury,  a  15%  WPI  for  his \nright lower leg injuries and a 2% WPI for his pelvic injury. \n \nAccording to the [American Medical Association] Guides [to the Evaluation \nof  Permanent  Impairment,  Fourth  Edition]  these  are  combined  using  the \ncombined  values  chart  on  page  322,  resulting  in  a  19%  Whole  Person \nImpairment as a result of his work injury that occurred on 09-17-2021. \n \n On March 8, 2024, Dr. Renard opined that Claimant reached maximum medical \nimprovement as of November 8, 2023.  Claimant told Renard on July 24, 2024, that “he \nmay work as an instructor for EMS.”  That record continues:  “He can perform as much \nduties  with  his  right  lower  extremity  as  possible  with  AFO.”  Renard  warned  that \nClaimant \nmay   require   additional   procedures,   injections or   simply   therapy   for \nexacerbations.    He  may  require  new  braces  in  the  future  or  even \nadditional  fusion  procedures  about  there  [sic]  right  foot/ankle  over  time.  \nHe  ultimately  may  need  to  consider  changing  occupation  based  on  the \nfinal limitations. \n \nDr.  Renard  on  September  18,  2024,  wrote  that  Claimant  was  directed  to  use  the \nLympha Press on a “PRN basis as need during non work hours.” \n In the most recent report by Dr. Roman that is in evidence, dated December 11, \n2024, he wrote in pertinent part: \n\nVAN LENTE – H107721 \n26 \n \nHISTORY OF PRESENT ILLNESS: \n \n. . . \n \nHe  developed  a  chronic  foot  drop.  They  did  a  tendon  transfer  by  Dr. \nRenard  last  year,  which  did  help  with  the  dorsiflexion.  He  has  got  some \nbetter use of the foot, but it is still unstable with lateral motion, so a lot of \npain   in   the   joint,   itself.   At   this   point,   he   is   at   maximum   medical \nimprovement.  He  does  not  need  any  further  surgeries  and  none  are \nscheduled.  He does use an AFO device on the right foot at times, but the \ntendon transfer I think was of benefit.  It did not help the pain as much as I \nthink he wanted, but the function is definitively there.  He does not have to \nuse  an  AFO  device  as  much.  The  pain  level  right  now,  is  about  a  5/10.  \nOverall,  I  think  he  is  doing  well.  No  skin  breakdown  issues.  He  had  a \nheel ulcer there  for  a  while  and  that  has  healed  up.  He  has  got  a  lot  of \nscarring areas, and we make sure he does hygiene checks. \n \nMEDICATIONS:  He gets Percocet 10 mg tablets, dispense 90 per month, \nclonazepam  1 mg  tablets,  dispense 60 per month, and  lidocaine patches \n5%.  I will increase that to 60.  He puts them on that ankle inside of his hip \nand  does  get  good  relief  with  them.  He  does  have  a  lymphedema \nmachine  at  home  to  help  keep  the  lymphedema  in  the  right  lower \nextremity down.  I do recommend that he could use that three times a day \nversus twice a day.  He does one hour sessions with that, but it does keep \nthe posttraumatic lymphedema down.  So, we discussed that as well. \n \nREVIEW OF SYSTEMS:  There is no major change in his medical health \nsystems.      He   does   struggle   with   depression.      He   has   got   some \nposttraumatic  stress  disorder  from  the  injury  as  well.    He  did  apply  for \nSocial  Security  Disability,  which  he  was  definitely  a  legitimate  applicant \nand did get approved, which I think is definitely the right thing.  He had a \nlife-changing injury. \n \nPHYSICAL  EXAM:   He  is  alert,  oriented,  well  developed,  well  nourished, \ngentleman.  Height  6 feet 2 inches,  weight  260  pounds,  O2  saturation \n97%,  heart  rate  82,  respiratory  rate  14.  Cranial  nerves II through XII \ngrossly  intact.  Ambulating  today  without  an  assistive  device.  The  right \nfoot,  he  deals  with  some  chronic  lymphedema  there,  decreased  range  of \nmotion  of  the  ankle  on  extension  and  flexion.  But  he  does  have  better \ndorsiflexion  of  the  foot  since  the  tendon  transfer.  The  bone  alignment \nlooks  fairly  well.  He  has  got  significant  scarring  areas  over  the  foot.  He \nhas  got  a  slight  varus  deformity  with  ambulation.  No  skin  breakdown \nissues.  The  pain  in  the  left  hip  and  pelvic  area.  Incision  over  the \n\nVAN LENTE – H107721 \n27 \n \ndeltopectoral  groove  from  the  humerus  fracture  over  the  right  shoulder.  \nNo skin breakdown issues.  Peripheral pulses are palpable. \n \nDIAGNOS[E]S: \n1. Multi-orthopedic trauma \n2. Long-term opiate use \n3. Opiate use by way of oxycodone \n4. Footdrop, right side \n5. Chronic pelvic pain \n6. Left-sided pelvic fracture \n7. Chronic posttraumatic lymphedema, right lower extremity \n8. Crush injury, right foot \n \n Likewise, Dr. Baskin’s most recent report, dated March 12, 2025, bears quoting \nat length (with emphasis added): \nSUBJECTIVE:  Mr. Van Lente is back in for follow up.  He has had a right \nankle tendon surgery by Dr. Renard in October of 2023 to help him better \nstabilize the ankle and also to help him try to evert the ankle a bit better.  \nHe  was  rolling  his  ankle  over  laterally  due  to  weakness  in  his  ankle \neverters.  He  had  a  right  great  toenail  removal  at  the  same  time  and  the \nnail  has  grown  back.  He  did  not  go  back  to  work  after  his  surgery.  He \nstates that the employer said that they had him on a temporary job and the \njob  was  essentially  eliminated per  his  he [sic] and his wife’s description \ntoday. He said they had nothing for him to do and he is not able to go out \non  patrol.  He  has  had Functional Capacity Evaluation  with Functional \nTesting Centers   on   2/5/2024   with   Casey   Garretson, Occupational \nTherapist.  I  noted  that  he  was  referred  for  an  impairment rating.  The \ninjuries  included  right  open  proximal tibia fracture  with  comminuted  tibial \nshaft  fracture  with  residual  foot  drop  with  peroneal  nerve  palsy  from \nproximal neck fracture/displacement. \n \nInjury #1 was intermedullary fixation of right tibial fracture, sharp excision \ndebridement  of  skin  and  subcutaneous  tissues  of  the  right  posterior calf \nwound by Dr. Renard 9/19/2021. \n \nInjury #2 was  a  closed  crush  injury  with  several  metatarsal  and  tarsal \nfractures  on  the  right  foot.  Procedure  was  open  treatment  of  right 1st \nthrough 3rd  tarsometatarsal  joint  injuries  with  a  Lisfranc  arthrodesis \nprocedure  and  also  percutaneous  treatment  of  the  right 4th  and 5th \ntarsometatarsal  joint  fracture/dislocations.  Nonoperative  treatment  of  the \n\nVAN LENTE – H107721 \n28 \n \nright  lesser  metatarsal  neck  fractures 2nd, 3rd, 4th  and 5th  toes  with  Dr. \nRenard 9/23/2023. \n \nInjury #3 he  had  removal  of  deep  hardware from  the  right  tibia  for  the \npurpose of dynamization of the nonunion.  He had right fibular osteotomy, \nbone  marrow  aspiration  with  injection  of  the  right  tibia  nonunion,  partial \nexcision of the right hallux toenail for treatment of infected ingrown toenail \nby  Dr.  Renard  on  5/2/2022.  He  had  wide  posterior tendon  tibial  tendon \ntransfer  to  the  mid foot  with tendonesis  of  the  right peroneus  longus and \nbrevis tendon, transfer of the right peroneus longus to the dorsal midfoot, \nremoval of deep hardware of the right midfoot.  This was the most recent \nprocedure  done  on  10/2/2023  with  Dr. Renard.  The  other  injury  was  a \nclosed  pelvic  disruption.  He  had  percutaneous  fixation  of  posterior  pelvic \nfracture,  open  treatment  with  plate  and screw fixation of  left  proximal \nhumerus fracture 9/20/2021 with Dr. Renard. \n \nInjury #4 was  a  closed  left  commuted  proximal  humerus  fracture  and  he \nunderwent  reduction  internal  fixation  of  left  proximal  humerus  by  Dr. \nRenard.  He   was   noted   on   the Impairment Evaluation   with   Casey \nGarretson to have continued functional difficulty with walking and reaching \noverhead with his left upper extremity. \n \nAndy continues  to  complain  of  swelling  in  the  right  lower  extremity and \nfoot.  This  is  primarily  from  the  knee  down.  He  still  wears Lymphapress \ngarments.  He  states  he  is  using  the Lymphapress  garment  three \ntimes a day.  We discussed whether three times a day was absolutely \nan indication or not and I do not really see a huge advantage to using \nthe Lymphapress  three  times  a  day.  That  would  potentially  knock \nAndy  out  of  going  back  to  work  unless  he  was  able  to  use  the \nLymphapress on  the  job.  Again,  he  has  not  worked  since  his  most \nrecent  surgery.  His Impairment Rating  from  Casey  Garretson  was  2% \nupper  extremity impairment equal  to  a 1% whole  person  impairment  for \nthe  left  shoulder  injury,  15%  whole  person  impairment  for  his  right  lower \nleg injuries, and a 2% whole person impairment for his pelvic injury. \n \nMr.  Garretson  used  gait derangement  noted  in  his  report  that  Mr.  Van \nLente had a 15% whole person impairment writing due to his antalgic gait \nand  the  fact  that  he  has  to  wear  an  ankle  foot  orthosis.  He  noted  in  his \nreport  that  Mr.  Van  Lente  did  have  objective  physical  findings  that  are \nconsistent with his AFO use requirement.  He noted that Mr. Van Lente did \nhave  a  documented  peroneal nerve  injury  stemming  from  his  tib/fib \ndislocation  and  fracture,  but  he  noted  that  in  his  opinion,  this  was  not \n\nVAN LENTE – H107721 \n29 \n \nrateable  using  the  guides  in  an  objective manner  as  manual  muscle \ntesting is subjective. \n \nI  went  back  and  looked  at  the  EMG  and  nerve  conduction  studies  that  I \nordered and had done with Dr. Mike Chesser, Little Rock Neurologist, on \nMay  16,  2022.  Andy  did  not  have  any  recordable  latency  of  the  right \nperoneal  nerve  at  the  ankle,  fibular  head  or  popliteal fossa  and  no \nrecordable right tibial motor nerve at the ankle or popliteal fossa.  He had \nno  recordable  sural  nerve  potentials at  the  right  ankle.  He  had  3+ \ndenervation potential positive sharp waves in the right tibialis interior, 4+ in \nthe  right  peroneus  longus.  This  was  felt  to  be  confirming  of  a  peroneal \nnerve  palsy  and  a  posterior  tibial  nerve  palsy.  Dr.  Chesser’s impression \nwas severe combined right common peroneal and posterior tibial dramatic \nneuropathies.  There  was  no  residual  innervation  detected  in  the  right \nperoneus longus and less than 25% estimated residual innervation in the \ntibialis anterior.  There  was  approximately  25-50%  residual  innervation  in \nthe  gastrocnemius.  EMG  of  the  right  vastus lateralis  and  biceps  femoris \nabove the knee were normal.  This indicates that the injury was related to \nthe tib/fib fractures and not higher up than the sciatic nerve.  The findings \non Dr. Chesser‘s EMG Nerve Conduction Studies are objective.  Mr. Van \nLente may have gotten a little bit more return of the posterior tibial nerve \nwith  plantar  flexion  but  his  dorsiflexion  is  still  minimal.  He  had  to  have \ntendon  transfers  to  help  him  with eversion  due  to  no  significant  peroneal \nmuscle function. \n \nWe went over his findings on the Impairment Rating, and the fact that he \nhas  never  gone  back  to  work.  He  will  be  50  next  month.  He  is  a  fairly \nlarge  man,  tall  statured,  and  I  do  not  see  him  going  back  to  work  as  a \npolice  officer  on  patrol  with  the  nerve  injuries  that  he  sustained.  He  has \ncontinued  to  have  weakness  in  the dorsiflexion  of  the  right  ankle  and \nsome weakness in the plantar flexion and eversion of the right ankle.  He \nhas  sensory  deficits  in  the  peroneal  and  posterior  tibial  distribution \nincluding the medial and lateral planter branches by my exam today.  \nThis  is  consistent  with  the  recordings  done  by  Dr.  Chesser  on  my \nreferral.  He  does  have  objective findings  that  can  be  rated  using \nTable  68  impairments  from  nerve  deficits  on  page  89  of  the Fourth \nEdition Guides.  Based  on  his  common  peroneal  nerve  injury,  he \nwould   have   a   15%   whole   person   impairment   equal   to   42% \nimpairment  for  the  lower extremity  based on  peroneal  nerve  deficits \nfor  motor  loss.  He  would  have  an  additional  8%  whole  person \nimpairment equal to 5% lower extremity impairment for his persistent \nsensory  loss.  He  has  had  trouble  with  getting  blisters  on  his  foot \nand  has  had  persistent  edema  likely  related  to  the  nerve  injury  and \n\nVAN LENTE – H107721 \n30 \n \nresultant venous stasis disease.  He would also have 4% impairment \ndue to his tibial motor nerve in the form of 2% to the medial plantar \nbranch and 2% to the lateral plantar branch both the terminal nerves \nfor the tibial  motor  nerve  in  the  leg.  He  would  have  sensory  loss \nfrom both of those nerve[s] as well [as] 2% to the whole person, 5% \nto  the  lower  extremity,  total[ing] 4%  for  sensory  loss.  If  he  is  rated \non  objective  findings  and  the  results  of  his  EMG  nerve  conduction \nstudies by a Board Certified Neurologist Dr. Chesser, he would have \n17% whole person impairment based on his common peroneal nerve \ninjury  that  is  combined  with  8%  of  the  tibial  motor  nerve  including \nthe  medial  and  lateral  plantar  nerves,  which  are  the  terminal  nerves \nin the foot.  17% combined with 8% using the combined values chart \non  page  322  would yield  a  24%  impairment  to  the  whole  person \nbased   on   Mr.   Van   Lente‘s  right  lower  extremity  fractures  and \nresultant  nerve  injury.  Using  the  nerve  conduction  studies  and \nrating Mr.   Van Lente   on   those   as   opposed   to   using   a   gait \nderangement  abnormality,  which  is  a  stand  alon[e] rating  does \nprovide Mr. Van Lente with a 9% whole person impairment more than \nrating  on  the  gait derangement alone.  In  my  opinion,  this  is a  more \naccurate rating.  The gait derangement is again only used when there \nare no other means to objectively rate these injuries. \n \nMr. Valente and I discussed him returning to work as a police officer and I \nthink  that  is  unlikely  unless  he  has  some  sort  of  modified  duties  such  as \ncriminal  investigation  or  administrative-type  role.  I  do  not  believe  he  is \never  going  to  be  able  to  go  back  on  patrol.  He  is  still  requiring \nLymphapress for post traumatic venous stasis issues in the right leg.  This \ndiagnosis has not been confirmed with Doppler exam or objective findings \nbut  clearly he  has  had  swelling  as  his  injury has not  rated him on  that.  I \nthink  the  neurologic  rating  on  the  posterior  tibial  nerve  and  its  terminal \nbranches  as  well  as  the  common  peroneal  nerve  injury  are  accurate  and \nreliable.  The gait derangement rating is not needed or valid given the \nprevious nerve conduction studies by Dr. Chesser.  I did not see any \nother  changes  that  would  be  recommended  in  the  impairment rating  that \nwas  given  by Functional Testing Centers.  I  think  it  is  unlikely  that \nFunctional Testing Centers had the  EMG  nerve  conduction  studies  that \nwere ordered by me in May of 2022. \n \nWith  regards  to  the Lymphapress,  schedule  two  times  a  day  versus \nthree  times a  day,  I do  not  feel  it  is absolutely indicated  that he  use \nthe Lymphapress three times a day.  That might free him up to take a \njob   that   otherwise   would   not   be   available   to   him   just   for   the \nLymphapress application one more time daily. \n\nVAN LENTE – H107721 \n31 \n \n \n Discussion.  The Commission may determine its own impairment rating under the \nAMA  Guides,  rather  than  simply  assessing  the  validity  of  the  ratings  that  have  been \nassigned.  Avaya v. Bryant, 82 Ark. App. 273, 105 S.W.3d 811 (2003).  However, after \nclosely reviewing  the  evidentiary  record in  light  of  the  AMA  Guides,  I  am  unable  to \npinpoint  a  single  instance  where  Claimant’s  compensable  injuries  were  unrated  or \nunderrated.  The Commission is authorized to accept or reject a medical opinion and is \nauthorized  to  determine  its  medical  soundness  and  probative  value.   Poulan  Weed \nEater  v.  Marshall,  79  Ark.  App.  129,  84  S.W.3d  878  (2002); Green  Bay  Packing  v. \nBartlett,  67  Ark.  App.  332,  999  S.W.2d  692  (1999).    I  credit  the  opinion  of  Garretson \nregarding his rating of Claimant’s shoulder and hip/pelvic injuries; and I credit Dr. Baskin \nregarding his rating of Claimant’s right lower extremity injuries. \n In sum, Claimant has failed to prove by a preponderance of the evidence that he \nis  entitled  to  impairment  ratings  in  addition  to  and/or  higher  than  those  set  forth  in \nStipulation No. 3, supra. \nB. Permanent and Total Disability/Wage Loss Disability \n Introduction.    Claimant  has  contended  that  as  a  result  of  his compensable \ninjuries, he is permanently and totally disabled.  In the alternative, he has asserted that \nhe  is  entitled  to  wage  loss  disability  benefits  over  and  above  his impairment  ratings \ndiscussed above.  Respondents have argued otherwise. \n Standards.   As  the  parties  have  stipulated,  the  September  17,  2021,  accident \ncaused  Claimant  to  suffer  multiple  compensable  injuries.    Some  of these  injuries—\n\nVAN LENTE – H107721 \n32 \n \nnamely, the ones to his right lower extremity and foot—were scheduled.  See Ark. Code \nAnn.  §  11-9-521(a)(4),  (11) (Repl.  2012).    The  others—specifically,  those  involving  his \nleft  shoulder  and  his  hip/pelvis,  were unscheduled.   Cf. id.  §  11-9-521.    The  term \n“permanent  total  disability”  is  defined  in  the  statute  as  “inability,  because  of \ncompensable injury or occupational disease, to earn any meaningful wages in the same \nor other employment.”  Id. § 11-9-519(e)(1) (Repl. 2012). \n Claimant’s entitlement to wage loss disability benefits is controlled by Ark. Code \nAnn. § 11-9-522(b)(1) (Repl. 2012), which states: \nIn considering claims for permanent partial disability benefits in excess of \nthe  employee’s  percentage  of  permanent  physical  impairment,  the \nWorkers’ Compensation Commission may take into account, in addition to \nthe  percentage  of  permanent  physical  impairment,  such  factors  as  the \nemployee’s  age,  education,  work  experience,  and  other  matters \nreasonably expected to affect his or her future earning capacity. \n \nSee  Curry  v.  Franklin  Elec., 32 Ark. App. 168, 798 S.W.2d 130 (1990).  Such “other \nmatters” include motivation, post-injury income, credibility, demeanor, and a multitude of \nother  factors.   Id.; Glass  v.  Edens,  233  Ark.  786,  346  S.W.2d  685  (1961).    As  the \nArkansas  Court  of  Appeals  noted  in Hixon  v.  Baptist  Health,  2010  Ark.  App.  413,  375 \nS.W.3d 690, “there is no exact formula for determining wage loss . . . .”  Under § 11-9-\n522(b)(1),  when  a  claimant  has  been  assigned  an  impairment  rating  to  the  body  as  a \nwhole, the Commission possesses the authority to increase the rating, and it can find a \nclaimant  totally  and  permanently  disabled  based  upon  wage-loss  factors.   Cross  v. \nCrawford County Memorial Hosp., 54 Ark. App. 130, 923 S.W.2d 886 (1996). \n\nVAN LENTE – H107721 \n33 \n \n To  be  entitled  to  any wage-loss disability  in excess of  an  impairment  rating,  the \nclaimant must prove by a preponderance of the evidence that he sustained permanent \nphysical  impairment  as  a  result  of  a  compensable  injury.   Wal-Mart  Stores,  Inc.  v. \nConnell,  340  Ark.  475,  10  S.W.3d  727  (2000).    The  wage  loss  factor  is  the  extent  to \nwhich  a  compensable  injury  has  affected  the  claimant’s  ability  to  earn  a  livelihood.  \nEmerson  Elec.  v.  Gaston,  75  Ark.  App.  232,  58  S.W.3d  848  (2001).    In  considering \nfactors that may impact a claimant’s future earning capacity, the Commission considers \nhis motivation  to  return  to  work,  because  a  lack  of  interest  or  a  negative  attitude \nimpedes the assessment of his loss of earning capacity.  Id.  The Commission may use \nits  own  superior  knowledge  of  industrial  demands,  limitations,  and  requirements  in \nconjunction  with  the  evidence  to  determine  wage-loss  disability.   Oller  v.  Champion \nParts  Rebuilders,  5 Ark.  App.  307,  635 S.W.2d  276  (1982).    Finally,  Ark.  Code  Ann.  § \n11-9-102(4)(F)(ii) (Repl. 2012) provides: \n(a) Permanent  benefits  shall  be  awarded  only  upon  a  determination \nthat the compensable injury was the major cause of the disability or \nimpairment. \n \n(b) If  any  compensable  injury  combines  with  a  preexisting  disease  or \ncondition  or  the  natural  process  of  aging  to  cause  or  prolong \ndisability  or  a  need  for  treatment,  permanent  benefits  shall  be \npayable for the resultant condition only if the compensable injury is \nthe major cause of the permanent disability or need for treatment. \n \n“Major cause” is more than fifty percent (50%) of the cause, and has to be established \nby  a  preponderance of the  evidence.    Ark.  Code  Ann.  §  11-9-102(14)  (Repl.  2012).  \n“Disability” is the “incapacity because of compensable injury to earn, in the same or any \n\nVAN LENTE – H107721 \n34 \n \nother  employment,  the  wages  which  the  employee  was  receiving  at  the  time  of  the \ncompensable injury.”  Id. § 11-9-102(8). \n Evidence.  The testimony of Claimant was that prior to his going to work for the \nCity of Ward, he was employed for 11 years as a part-time police officer for the City of \nAustin.  Prior to this, he worked as an auxiliary policeman for another municipality.  He \nalso held a full-time and a part-time job as a paramedic for a number of years.  Claimant \nhas taken and completed courses to be a paramedic/EMT, as well as in the areas of law \nenforcement  and  respiratory  therapy.    He  is  certified  as  a  paramedic  as  well  as  a \nrespiratory therapist. \n Because  of  the  condition  of  his  right  ankle,  he  has  to  wear  a  brace.    It,  in  turn, \nhooks  into  a  special  shoe  that  he  must  wear  because  of  ever-present  swelling  in  his \nright foot and his difficulty in controlling the toes of that foot.  Claimant elevates his right \nlower extremity because failure to do so causes swelling and discoloration in that foot.  \nThe swelling presses on the joints and nerves in that extremity. \n In  dealing  with  the  swelling  of  his  right  leg  due  to  the  accident,  he  treats  with  a \nLympha  Press.    This  device  is  a  sleeve  that  goes  over  his  leg  and  alternates  creating \nand releasing pressure on that extremity for an hour.  He uses the press three times a \nday—once each in the morning, afternoon, and evening.  In an effort to help him obtain \na job by minimizing the time conflict, he has attempted to reduce his use of the device to \ntwice a day.  However, this has been unsuccessful; when he has tried this, his swelling \nand pain have increased.  He has daily pain in his right ankle and foot.  Despite use of \n\nVAN LENTE – H107721 \n35 \n \nthe special shoe and brace, his gait is unsteady and has been altered.  Climbing stairs \nis difficult, as is squatting and kneeling. \n Currently,  Claimant  also  uses  a  TENS  unit.    It  helps  him  to  flex  his  right  foot \nupward by aiding with muscle stimulation.  The purpose of this is to treat his foot drop. \n Claimant now  returns to  his  orthopedist,  Dr.  Renard,  once  a  year.   He  sees  Dr. \nRoman  every  three  months  for  pain  management.   His  medications  include  Zoloft, \nWellbutrin, Mirtazapine, Tizanidine, Percocet, Clonazepam and Lidocaine patches. \n According to Claimant, he returned to work at light duty in August or September \nof  2022.   His  hours  were  gradually  increased  by  Dr.  Baskin.   The  City  of  Ward \naccommodated his restrictions and allowed him to go home to use the Lympha Press.  \nIncluding the drive time to and from his home and changing clothing to use the device, \nthis treatment would take 105 minutes.  The light-duty work that Claimant was assigned \nconsisted  of  scanning  old  case  files—which  he  completed  in  approximately  one  year, \nand  then  conducting  background  checks  and  scanning  in  contact  cards,  which  took \nabout a month.  Thereafter, Claimant underwent corrective surgery on his right foot.  But \nonce he was ready to return to work after this procedure, the city had no more light duty \navailable to him.  Thus, he has not gone back to work. \n Asked  if  he  agrees  with  the  opinion  of  the  vocational  expert,  Dr.  Melissa  Jones \nWilkins, that he cannot do his past work, Claimant responded: \nYes . . . I’m not able to—I’m not able to run, I’m not able to do what they \ncall explosive movement as far as go from a run to a walk, to a dead stop, \nmove side to side.  I guess it’s called a juke.  I’m not able to do any of that.  \nLifting would be an issue because of—you know, a lot of lifting you do with \nyour legs. \n\nVAN LENTE – H107721 \n36 \n \n \n It is his belief that he would need accommodations at any place of employment.  \nHe  would  need  to  be  able  to  elevate  his  right  foot  and  use  the Lympha Press.    His \nemployer would have to allow him to use Percocet—a narcotic pain medication that he \ntakes three times a day. \n Claimant  related  that he  tries  to  perform  at  least  one  task  per  day  around  the \nhouse—be that dusting, loading the dishwasher, or performing laundry.  Because of the \ncondition  of  his  right  leg,  he  can  only  be  on  his  feet  doing  chores  for  10  minutes  at  a \ntime  before  the  pain  necessitates  that  he  sit  down.    After  30  to  40  minutes  of \nrecuperation, he is ready to resume activities.  As a result, the length of time it takes him \nto perform a given task has increased significantly. \n On cross-examination, Claimant acknowledged that he was already on Percocet \nfor  chronic  pain  and  on  anti-depression  medication,  including  Zoloft, prior  to  the \naccident.   He  was  also  being  medicated  for post-traumatic stress  disorder and \nunderwent  a  microdiscectomy before  sustaining  his  compensable  injuries.  Claimant \nuses  the  Lympha Press  three  times per day:    once  in  the  morning,  once mid-day,  and \nonce  in  the  evening.    He  explained  that he  is  able  to  tolerate  the  12-hour  stretch \nbetween  his  evening treatment and his  first  one  the  next  day because  he elevates  his \nleg at night.  He was prescribed a Lympha Press because his physicians decided that it \nwas  more  efficient  for  him  to  undergo  treatment  of  his  lymphedema  at  home.   The \nLympha Press motor is 12 by 14 inches.  The device is portable. \n\nVAN LENTE – H107721 \n37 \n \n Claimant agreed that before his most recent surgery interrupted it, he was being \ntrained by  the  City  of  Ward  to  be  a  dispatcher.    While  he  described  the  process  as \n“difficult,”  he  agreed  that  he  was  able  to  perform  as  a  Level  1  dispatcher.    Had  he \nfinished  his  training,  however,  he  would  not  have  been  able  to  do  this  job  for  the  city \nbecause dispatching services were going to be reassigned to a statewide call center. \n At  present,  Claimant  is  still  employed  with  the  City  of  Ward.    The  police  chief \ninformed  him  that  while  he  is  not  working, he  is  being  “kept on  the  books”  until  the \ncurrent litigation is at an end.  Claimant agreed that Respondents do not have a job that \nfits  his  accommodations  because  the  city  is  limited  by  its  budget  and  the  number  of \nemployees  it  can  have.    The  testimony  of  Claimant  is  that  he  has  been  approved  to \nreceive Social Security Disability benefits.  He has informed the city of that, and of his \nintention to continue on disability and not come back to work. \n However, Claimant acknowledged that he has “never passed up an opportunity” \nto  attend  school.    While  he  is  not  currently  certified  to  be  a  respiratory  therapist,  this \ncould be rectified with additional schooling.  But he expressed doubts about his ability to \nbe in this line of work because it would require a lot of walking.  Apart from the walking \nissue,  which  he  conceded  that  an  employer  could  conceivably  accommodate  with \nalternate transportation, Claimant was asked if he could physically perform the job of a \nrespiratory therapist in a patient’s room.  He responded: \nI’d say most of it.  Some of it would require me standing for a long period \nof  time,  like  if  the  patient’s  been  ventilated  or  if  I’m  doing  a—an \nassessment  on  them.    Some  patients  need  a  little  bit  more  time  than \nothers.  Some it’s educational, so there would be a lot of standing and a \nlot of walking. \n\nVAN LENTE – H107721 \n38 \n \n \nLater in his cross-examination, the following exchange occurred: \nQ. But   you   would   agree   with   me   that   if   the   walking   were \naccommodated, you can do certain jobs, right? \n \nA. Correct. \n \n He  confirmed  that  when  Dr.  Baskin  first  released  him  to  return  to  work,  he  was \nrestricted to working four hours a day.  But this was increased to the point that he was \nworking  eight  hours  a  day,  and  being  accommodated  with  his  need  to  travel  home \nduring  the middle of  the  day to  have a  Lympha  Press treatment.  While  the ankle  foot \northosis device  that  he  wears  helps  some  with  this,  he  is  still  limited  somewhat  in  his \nability to walk. \n Claimant  does  not  think  that  he  will  have  to  undergo  any  additional  surgical \nprocedures; nor does he think that he will need any more MRIs, despite the fact that his \nMSA  report  in  evidence  envisions  both  of  these  possibilities.   While  he  still  sees  Dr. \nRoman every three months, he has not returned to Dr. Baskin since March 2025. \n Claimant performs household chores “[i]n small intervals.”  These tasks include \nlaundry,  vacuuming,  and  carrying  in  groceries.   He  conceded  that while  he has  no \nproblems  sitting  for  extended  periods  of  time,  he  has  not  applied  for  any  jobs.  His \nexplanation was, “I haven’t really known of anything that’s come open.”  According to \nClaimant, he was not provided a copy of his vocational evaluation.  He was unaware of \nthe  jobs  that  the  evaluator  identified  in  the  report  as  ones  that  he  potentially  would  be \nqualified  to  have.    Shown  that  there  were  jobs  on  the  report  that  paid  from  $16.00  to \n$20.00 per hour, Claimant confirmed that that range included what he had been making \n\nVAN LENTE – H107721 \n39 \n \nfor the City of Ward.  He agreed that with respect to those jobs that required that he talk \non  the  telephone and  review  reports,  he  is  capable  of  doing  these  things.   While \nClaimant testified that he would love to teach paramedics, he added that such positions \nare very rare. \n It  was  Claimant's  testimony  that  he  has  not  seen  the  report  of  his  functional \ncapacity evaluation.  He was not aware that he demonstrated the ability to perform work \nin the Medium category.  Claimant is still being paid permanent partial disability benefits \nin accordance with the ratings he was assigned out of that evaluation. \n Under  redirect-examination,  Claimant  stated  that  while  he  took  medication  for \nchronic pain prior to suffering his compensable injuries, the dosages have increased as \na  result.    Now,  they  cause  him  to  have  dizziness  and  difficulty  concentrating.   With \nrespect to the potential jobs for him listed in Wilkins’s report, Claimant insisted that he \ncould not possibly take any of them without two accommodations:  that he could elevate \nhis right leg and be able to use the Lympha Press in the middle of the day.  He added \nthat, regardless, he had not been offered any of those jobs.  However, Claimant agreed \nwith the vocational evaluator’s opinion that his need for use of the Lympha Press in the \nmiddle of the day is a “complicating factor” and a “barrier” to his resuming work outside \nthe  home.    Claimant  offered  that  his  use  of  narcotic  pain  medication  would  also  be  a \n“complicating factor.” \n The following exchange took place during the recross-examination of Claimant: \nQ. You have multiple certifications proving your ability to learn new job \ntasks, requirements, correct? \n \n\nVAN LENTE – H107721 \n40 \n \nA. Correct.  I rarely passed on an opportunity. \n \n In  addition  to  the  medical  records  discussed  above,  the  other  documents  in \nevidence  that  bear  on  this  issue  include  the  functional  capacity  evaluation  of  Claimant \nthat  was  conducted  on  February  5,  2024.    As  a  result,  Claimant gave  a  reliable  effort, \nwith 51/51 consistency measures within expected limits, and demonstrated the ability to \nperform work in the Medium category. \n Melissa Jones Wilkins, Ph.D., conducted a vocational evaluation of Claimant.  In \nher  report  thereon,  dated  May  30,  2024,  she  wrote  the  following  summary  of  her \nfindings: \nMr. Van Lente’s previous positions have consisted of MEDIUM and VERY \nHEAVY labor.  At  this  time,  Mr.  Van  Lente  has  demonstrated  capacities \nafter  his  2021  injury.  As  a  result,  he  is  limited  to  primarily  medium  level \nwork  with  limited  use  of  his  left  shoulder  and  right  ankle.  With  these \nrestrictions,  he  will  be  unable  to  return  to  previously  held  occupations.  \nBased  only  on  the  work-related  capacities,  as  measured  solely  by  the \nFCE, if he is able to perform work outside of his home, at the sedentary to \nlight  level  his  annual  earnings  capacity  is  estimated  in  the  range  of \n$16.37-$20.70 (median  $18.57) per  hour  per  OES  data  and  $13.14-\n$23.00 (median $16.90) per hour per labor market research. \n \nIn vocational  rehabilitation,  counselors  need  to  rehabilitate  the  “whole \nperson,” which  involves  looking  at  the  physical,  psychological,  and  social \neffects of the disability (Browden et al., 2002; Hartley & Tarvydas, 2022).  \nOne important need for Mr. Van Lente is the ability to return to his home in \nthe middle  of  the  day to  do  his  lymphedema  treatment.  This  need  is  not \nfactored in if one relies solely on the FCE for limitations for Mr. Van Lente.  \nThis is a complicating factor in barrier to Mr. Van Lente working outside of \nthe  home.  In  this  vocational  scenario,  Mr. Van  Lente would  need  the \naccommodation  of  leaving  work  in  the  middle  of  the  day  to  complete  his \nlymphedema  treatment  in  a  timeframe  that  would  go  beyond  the  typical \nlunch  hour.  This  treatment,  according  to  Eric  Jones,  RN,  CCM,  was \nordered by Dr. Baskin on October 13, 2022.  Remote work, or work from \nhome,  maybe  his  best  option  in  this  scenario.    Through a  labor  market \nsurvey, jobs were located that paid $16-$27.27 per hour (median $23 per \n\nVAN LENTE – H107721 \n41 \n \nhour).  If  Mr. Van  Lente is  able  to  work  full-time,  his  earnings  capacity \nwould  be  $47,840  annually  and  if  he  is  able  to  work  part  time  due  to \nlymphedema treatment, his earnings capacity is estimated at $23,920 per \nyear. \n \n Discussion.   The evidence  reflects  that  Claimant is a  high  school graduate.    He \nworked for a number of years as a police officer.  In addition, he has been employed as \na  paramedic.    Claimant  has  taken  and  completed  courses  to  be  a  paramedic/EMT,  as \nwell  as  in  the  areas  of  law  enforcement  and  respiratory  therapy.    He  has  held \ncertifications to be a paramedic and a respiratory therapist. \n On September 17, 2021, he was struck by a vehicle traveling at highway speed.  \nThis  resulted  in  his  being  airlifted  to  UAMS,  where  he  underwent  surgeries  on  his  left \nshoulder, pelvis, and right lower extremity as detailed above.  Thereafter, he underwent \nphysical therapy. \n With  respect  to  his  aforementioned  unscheduled  injuries,  Claimant  reached  the \nend  of  his  healing  period  and  was  assigned  permanent  impairment  ratings  on  this  by \nGarretson:  one percent (1%) to the body as a whole for his left shoulder injury, and two \npercent (2%) to the body as a whole regarding his pelvic injury.  Following his shoulder \nsurgery,  Claimant  was  treated  with  injections  to  address  his  pain  on  more  than  one \noccasion. \n To put it mildly, Claimant’s right lower extremity condition has been addressed \nless  successfully.    The  specifics  of  that  treatment,  which  has  included  three  surgeries, \nhave been explained.   Despite  multiple operations  conducted by  Dr.  Renard,  Claimant \nhas been left with a right leg beset by, inter alia, nerve damage and lymphedema.  The \n\nVAN LENTE – H107721 \n42 \n \nresulting  pain   is   addressed   with   opiates, while   the   lymphedema   is   treated   with \napplications  of  the  Lympha  Press  three  times  a  day.  He  wears  an  orthotic  device.  \nDespite  this,  he  is  still  able  to  engage  in  household  activities  such  as  laundry  and \nvacuuming—albeit it at a slower pace. \n Claimant’s medical history reveals that he was already using Percocet (Roman in \nhis notes refers to him as a “legacy opiate patient”) for chronic pain before the accident \nin question.  Moreover, he already had anxiety, depression, and PTSD.  Despite these \nthings, until he was struck by the vehicle, he had been able to function in the workforce, \nincluding as a law enforcement officer and as an EMT. \n Eventually,  while  Claimant  was  still  undergoing  treatment  of  his  compensable \ninjuries, he was released to light duty.  His restrictions were gradually lessened.  While \nstill  working  for  the  City  of  Ward,  he  was  able  to  function  successfully  in  a  desk  job, \ndoing  such  tasks  as  digitizing  records.    His  success  in  this  endeavor  resulted  in  his \nrunning  out  of  tasks  that  comported  with his restrictions.    He  was also  training  to  be  a \ndispatcher before a change in programs kept this from proceeding further. \n An issue cited by both Claimant in his testimony and Dr. Wilkins in her vocational \nevaluation as  a  barrier  to  his  obtaining  full-time  employment  is  his  use of  the  Lympha \nPress  during  the  middle  of  the  day.    While  Claimant  was  still  working  for  the  City  of \nWard,  he  would  travel  home  at  mid-day  to  use  the  device.    In  so  doing,  he  would \nchange his clothing and use the device before heading back to the office.  I am aware \nthat Claimant testified that he needs this third treatment to help with pain and swelling.  \nDr. Roman echoed this, writing:  “I do  recommend  that  he  could use  that  [the  Lympha \n\nVAN LENTE – H107721 \n43 \n \nPress] three times a day versus twice a day.”  However, Dr. Baskin was of a different \nopinion: \nWith regards to the Lymphapress, schedule two times a day versus three \ntimes  a  day,  I  do  not  feel  it  is  absolutely  indicated  that  he  use  the \nLymphapress three times a day.  That might free him up to take a job that \notherwise   would   not   be   available   to   him   just   for   the   Lymphapress \napplication one more time daily. \n \nAfter due consideration, I credit Dr. Baskin’s opinion on this.  I also note that the device \nin question is portable; although a large amount of the time spent on his use of it during \nthe middle of the day is travel to and from his home, the evidence does not support the \nfinding that he must undergo this treatment at home as opposed to suitable site in the \nworkplace. \n With respect to Claimant’s vocational evaluation, I note that he testified that he \nwas never informed of the substance of Wilkins’s report.  She noted that his “previous \npositions have consisted of MEDIUM and VERY HEAVY labor.”  His functional capacity \nevaluation, as detailed above, showed that he demonstrated the ability to perform work \nin  the  Medium  category.   Dr. Wilkins  agreed  with  Baskin  that  Claimant  could  never \nreturn  to  being  an  officer  on  patrol.    But  she  did  identify  work  that  he  could  perform \nwithin the results of his FCE, and concluded:  “If [Claimant] is able to work full-time, his \nearnings capacity would be $47,840 annually and if he is able to work part time due to \nlymphedema treatment, his earnings capacity is estimated at $23,920 per year.” \n As  Claimant  readily  conceded  in  his  testimony,  he  has  “never  passed on an \nopportunity” to further his education.  While he felt that he could obtain the training to be \ngainfully employed as a respiratory therapist, his difficulties walking and standing would \n\nVAN LENTE – H107721 \n44 \n \npose formidable obstacles to his being able to navigate a healthcare center and attend \nto patients properly.  Despite this, he acknowledged that any walking requirements were \naccommodated, he could do certain jobs. \n Claimant has been approved to receive Social Security Disability benefits.  After \nconsideration  of  the  evidence, particularly  his  testimony, I do  not find  that  he  is \nmotivated to return to the workforce.  The evidence at bar compels a finding that he has \nnot proven that he is permanently and totally disabled. \n The  question  remains,  however,  whether  he  is  entitled  to  wage  loss  disability \nbenefits.    In  analyzing  this  sub-issue,  I  cannot  take  into  consideration  any  scheduled \ninjuries.  For that reason, I must confine my analysis to his unscheduled injuries.  Taking \nthem   into   account   in   light   of   the   above   legal   standards   and   evidence, the \npreponderance  of  the  evidence  establishes  that  he  has  sustained  wage  loss  in  the \namount  of  fifteen  percent  (15%).   Moreover, his  compensable unscheduled shoulder \nand hip/pelvic injuries are the major cause of this disability. \nC. Average Weekly Wage \n In  determining  the  average  weekly  wage  of  a  claimant,  Ark.  Code  Ann.  §  11-9-\n518 (Repl. 2012) gives the following guidance: \n(a)(1) Compensation  shall  be  computed  on  the  average  weekly  wage \nearned  by  the  employee  under  the  contract  of  hire  in  force  at  the \ntime  of  accident  and  in  no  case  shall  be  computed  on  less  than  a \nfull-time workweek in the employment. \n \n(2) Where  the  injured  employee  was  working  on  a  piece  basis,  the \naverage weekly wage shall be determined by dividing the earnings \nof the employee by the number of hours required to earn the wages \nduring  the  period  not  to  exceed  fifty-two  (52)  weeks  preceding  the \n\nVAN LENTE – H107721 \n45 \n \nweek in which the accident occurred and by multiplying this hourly \nwage  by  the  number  of  hours  in  a  full-time  workweek  in  the \nemployment. \n \n(b) Overtime  earnings  are  to  be  added  to  the  regular  weekly  wages \nand  shall  be  computed  by  dividing  the  overtime  earnings  by  the \nnumber of weeks worked by the employee in the same employment \nunder the contract of hire in force at the time of the accident, not to \nexceed a period of fifty-two (52) weeks preceding the accident. \n \n(c) If, because of exceptional circumstances, the average weekly wage \ncannot  be  fairly  and  justly  determined  by  the  above  formulas,  the \ncommission may determine the average weekly wage by a method \nthat is just and fair to all parties concerned. \n \nThe term “wages” is defined in Ark. Code Ann. § 11-9-102(19) (Repl. 2012) in pertinent \npart as follows: \n“Wages”  means  the  money  rate  at  which  the  services  rendered  is \nrecompensed  under  the  contract  of  hiring in  force  at  the  time  of  the \naccident  including  the  reasonable  value  of  board,  rent,  housing,  lodging, \nor similar advantage received from the employer . . . . \n \n Evidence.  Claimant testified that at the time he was injured, his job title with the \nCity  of  Ward  was  Senior  Patrolman.    He  was  a  shift  supervisor  with  patrol  duties.   He \nworked  12-hour  shifts  there.    This  consisted  of  three  12-hour  shifts  and  four  12-hour \nshifts  every  two  weeks,  or  84  hours  during  that  period.    His  testimony  was  that  he \nworked overtime: \nThere would be times I’d have to work late.  I’d usually turn my radio on \nabout an hour before I’d go in while I was getting ready.  That dictated \nhow quick I needed to get ready.  Depending on what was going on, I may \nhave to go in early. \n \nOn  April  21,  2021,  he  received  a  pay  raise;  his  hourly  rate  was  raised  from  $14.99  to \n$17.00.  Overtime was paid at 1.5 times the hourly rate. \n\nVAN LENTE – H107721 \n46 \n \n However, on cross-examination, Claimant acknowledged that the payroll records \nin evidence reflect that in the year prior to his injury, his hourly rate actually was $14.38 \nuntil it became $14.99 in January 2021.  The following exchange took place: \nQ. And because you worked less than 40 [hours] one week and more \nthan  40  the  next  week,  that  was  considered  regular  time  if  you \nworked 36/48, correct? \n \nA. I’m  under  the  impression  that  we—the  eight  hours  was  built-in \novertime since it was on a different week. \n \nWhen  shown  his  payroll  records,  however,  he  agreed  that  his  compensation  was  as \noutlined  in  the  above question;  because he was  paid every two  weeks,  with one  week \nunder 40 hours and the second above 40, he was not paid overtime for an excess the \nsecond  week  provided  that  the  total  for  the  two-week  period  did  not  exceed  80  hours.  \nHe conceded that he never took issue with the amount that the was paid. \n Under further examination by his attorney, Claimant acknowledged that while he \nworked overtime, he was not paid accordingly. \n The records in evidence show that in the year preceding the injury, in addition to \nhis straight pay and overtime, he was paid $250.00 in “Longevity Pay” and $250.00 as a \n“Year-End Bonus.” \n Discussion.  Claimant’s Form AR-W  that  is  in  evidence  is  not  broken  down  into \n52  weeks.   Instead,  as  discussed  at  the hearing,  it  is  broken down  into  the  26 2-week \npay periods that comprised the year preceding his injury.  Even a casual glance at the \ndata presented on the form shows two anomalies.  First, in contrast to his testimony on \ncross-examination, his hourly rate was not as stable as presented.  Per the Form AR-W, \n\nVAN LENTE – H107721 \n47 \n \nhis  rate for  the  first  seven  pay  periods was  $14.38  before  it  dropped to  $13.88  for  the \neighth  and  then  rose  to  $15.17  for the  ninth.    Thereafter,  it  held at  $14.99  for  the  next \nthree  pay  periods  before  returning  to  the  $15.17  figure  for—again—just  one  period.  \nThereafter,  it  held  steady  at  $17.00  per  hour  for  nine  pay  periods  before  increasing  to \n$18.59 for the final one.  Second—and more troubling—is the fact that the payment of \novertime  to  him  was  not  at  all  consistent.    Claimant worked  in  excess  of  80  hours  in \neach of the 26 2-week periods in question.  Per Claimant’s testimony elicited on cross-\nexamination, he should have been paid overtime during each of these periods because \nhe would have worked in excess of 40 hours a week.  But per the Form AR-W, in only \nfive periods was he paid overtime.  The most amazing instance comes at Line 19 of the \nform.  This line reflects that during the two-week period in question, he worked 108.75 \nhours—and yet was paid no overtime.  Based on the evidence adduced at the hearing, I \ncredit the Form AR-W as correctly reflecting what Claimant was paid during the period \nat issue. \n That said, the issue of whether Respondent City of Ward may have broken state \nand/or federal law by not paying Claimant overtime when it perhaps should have is not \nbefore  the  Commission.    The  instant  analysis  is  undertaken strictly to  determine  what \nClaimant  was  paid  during  the  year  before  he  was  hurt—not what  he  perhaps  should \nhave been paid.  Only the former question is relevant in determining the amount of his \naverage weekly wage under the Arkansas Workers' Compensation Act. \n\nVAN LENTE – H107721 \n48 \n \n As for Claimant’s two bonuses, they have been held to be fringe benefits that are \nnot to be included in the average weekly wage calculation.  See Taylor v. Lubritech, 75 \nArk. App. 68, 54 S.W.3d 132 (2001). \n Employing the analysis set out in § 11-9-518 (see Lankford v. Crossland Constr. \nCo.,  2011  Ark.  App.  416,  2011  Ark.  App.  LEXIS 451) shows  that  during  the  one-year \nperiod  in  question,  Claimant  earned  regular  pay  totaling  $35,729.84.    This  amount, \ndivided  by  52,  equals  $687.11.    This  amount in  turn—when  added  to  the  amount  of \novertime  he  earned  over  the  same  period,  $647.90,  divided  by  52  to  equal  $12.46—\nresults  in a  sum  of  $35,729.84.    The evidence preponderates  that  this  is  Claimant’s \naverage weekly wage, yielding compensation rates of $466.00/$350.00. \n The  payout  history  that  is  in  evidence  reflects  that  Respondents  have  been \npaying  Claimant  indemnity  benefits  at  the  rates  set  out  above.    For  that  reason, \nClaimant  has  not  proven  by  a  preponderance  of  the  evidence  that  he  has  been \nunderpaid benefits of this type. \nD. Controversion \n Introduction.    Claimant  has  asserted  that  he  is  entitled  to  a  controverted \nattorney’s fee in this matter. \n Standard.    One  of  the  purposes  of  the  attorney's  fee  statute  is  to  put  the \neconomic  burden  of  litigation  on  the  party  who  makes  litigation  necessary.   Brass  v. \nWeller,  23  Ark.  App.  193,  745  S.W.2d  647  (1998).    In  this  case,  the  fee  would  be \ntwenty-five percent  (25%)  of  any  indemnity benefits  awarded  herein,  one-half  of  which \nwould be paid by Claimant and one-half to be paid by Respondents in accordance with \n\nVAN LENTE – H107721 \n49 \n \nSee Ark. Code Ann. § 11-9-715 (Repl. 2012).  See Death & Permanent Total Disability \nTrust Fund v. Brewer, 76 Ark. App. 348, 65 S.W.3d 463 (2002). \n Discussion.    The  evidence  before  me  clearly  shows  that  Respondents have \ncontroverted Claimant’s entitlement to the additional indemnity benefits awarded herein.  \nThus,  the  evidence  preponderates  that  his counsel,  the  Hon. Andy  L.  Caldwell,  is \nentitled to the fee as set out above. \nCONCLUSION AND AWARD \n Respondents are directed to furnish/pay benefits in accordance with the findings \nof fact and conclusions of law set forth above.  All accrued sums shall be paid in a lump \nsum  without  discount,  and  this  award  shall  earn  interest  at  the  legal  rate  until  paid, \npursuant to Ark. Code Ann. § 11-9-809 (Repl. 2012).  See Couch v. First State Bank of \nNewport, 49 Ark. App. 102, 898 S.W.2d 57 (1995). \n Claimant’s  attorney  is  entitled  to  a twenty-five percent  (25%)  attorney’s  fee \nawarded herein, one-half of which is to be paid by Claimant and one-half to be paid by \nRespondents in accordance with Ark. Code Ann. § 11-9-715 (Repl. 2012). \n IT IS SO ORDERED. \n       ________________________________ \n       Hon. O. Milton Fine II \n       Chief Administrative Law Judge","preview":"BEFORE THE ARKANSAS WORKERS’ COMPENSATION COMMISSION WCC NO. H107721 ANDREW VAN LENTE, EMPLOYEE CLAIMANT CITY OF WARD, SELF-INSURED EMPLOYER RESPONDENT ARK. MUNICIPAL LEAGUE, THIRD-PARTY ADM’R RESPONDENT OPINION FILED NOVEMBER 12, 2025 Hearing before Administrative Law Judge O. Milton Fine II on August 14, 2025, in Lit...","fetched_at":"2026-05-19T22:34:27.147Z","links":{"html":"/opinions/alj-H107721-2025-11-12","pdf":"https://www.labor.arkansas.gov/wp-content/uploads/VanLente_Andrew_H107721_20251112.pdf","source_publisher":"https://labor.arkansas.gov/workers-comp/awcc-opinions/administrative-law-judge-opinions/"}}