{"id":"alj-H110044-2023-07-18","awcc_number":"H110044","decision_date":"2023-07-18","opinion_type":"alj","claimant_name":"Scott Metzger","employer_name":"Winsupply, Inc","title":"METZGER VS. WINSUPPLY, INC. AWCC# H110044 JULY 18, 2023","outcome":"unknown","outcome_keywords":[],"injury_keywords":["neck","back","cervical","lumbar","carpal tunnel","thoracic","shoulder","fracture"],"pdf_url":"https://labor.arkansas.gov/wp-content/uploads/METZGER_SCOTT_H110044_20230718.pdf","source_index_url":"https://labor.arkansas.gov/workers-comp/awcc-opinions/administrative-law-judge-opinions/","filename":"METZGER_SCOTT_H110044_20230718.pdf","text_length":23603,"full_text":"BEFORE THE ARKANSAS WORKERS’ COMPENSATION COMMISSION \nCLAIM NO.  H110044 \n \nSCOTT METZGER, EMPLOYEE         CLAIMANT \n \nv. \n \nWINSUPPLY, INC. EMPLOYER              RESPONDENT \n \nSENTRY CASUALTY INSURANCE COMPANY, \nINSURANCE CARRIER                 RESPONDENT \n \nOPINION FILED JULY 18, 2023 \n \nHearing before Administrative Law Judge, James D. Kennedy, on the 23\nrd\n day of May, \n2023, in Little Rock, Pulaski County, Arkansas. \n \nClaimant is represented by Mr. Gary Davis, Attorney-at-Law, Little Rock, Arkansas. \n \nRespondents  are  represented  by  Mr.  Jarrod  S.  Parrish,  Attorney-at-Law,  Little  Rock, \nArkansas. \n \nSTATEMENT OF THE CASE \n  \n A hearing was conducted on the 23\nrd\n day of May, 2023, to determine the sole issue \nof additional medical treatment as recommended by Doctor Gary Frankowski.  A copy of \nthe  Prehearing  Order  dated  March 21,  2023, was  marked  “Commission  Exhibit  1” and \nmade part of the record without objection.  The Order provided the parties stipulated that \nthe  Arkansas  Workers’   Compensation had   jurisdiction  of  the   claim   and   that  an \nemployer/employee relationship existed on November 4, 2020, at which time the claimant \nsustained  compensable  injuries,  including  but  not  limited  to  his  neck  and  back.  The \nclaimant’s  average  weekly  wage  was  $1080.00  which  entitled  him  to  temporary  total \ndisability   and   permanent   partial   disability   in   the   amount   of   $711.00   /   $533.00, \nrespectively.  \n\nMETZGER – H110044 \n \n2 \n \n The  claimant’s  and  respondent’s  contentions were  set  out  in  their  respective \nresponses to the prehearing questionnaire and made part of the record without objection.  \nThe sole witness to testify was the claimant, Scott Metzger.  The claimant submitted one \nexhibit  without  objection,  which  consisted  of  one  hundred  thirty-four  (134)  pages  of \nmedical.  The   respondents   submitted   two   (2)   exhibits   without   objection,   with \n“Respondent’s Exhibit One” consisting of medical reports of Dr. Frankowski, consisting of \nfive  (5)  pages,  and “Respondent’s  Exhibit  Two”  consisting  of  three  (3)  pages  which \nincluded  a  Form  AR-2  and  correspondence  from  Sentry  Insurance  addressed  to  Dr. \nFrankowski.  From a review of the record as a whole, to include medical reports and other \nmatters properly before the Commission, and having had an opportunity to observe the \ntestimony and demeanor of the witness, the following findings of fact and conclusions of \nlaw are made in accordance with Ark. Code Ann. §11-9-704. \nFINDINGS OF FACT AND CONCLUSSIONS OF LAW \n \n1. The Arkansas Workers’ Compensation Commission has jurisdiction over this \nclaim. \n \n2.  That  an  employer/employee  relationship  existed  on  November  4,  2020,  the \ndate that the claimant suffered a compensable injury, including but not limited \nto his neck and back. \n   \n3.  That the claimant’s average weekly wage was $1080.00, which entitled him to \ntemporary  total  disability  and  permanent  partial  disability  in  the  amount  of \n$711.00 / $533.00, respectively. \n \n4.  That  the  claimant  has  failed  to  satisfy  the  required  burden  of  proof, by  a \npreponderance of  the credible  evidence,  to prove  that  the medical  treatment \nrecommended  by  Dr.  Frankowski is  causally  related  to  and  reasonably \nnecessary for his work-related injuries. \n    \n5.  If  not  already  paid,  the  respondents  are  ordered  to  pay  for  the  cost  of the \ntranscript forthwith. \n \n \n\nMETZGER – H110044 \n \n3 \n \n \nREVIEW OF TESTIMONY AND EVIDENCE \n \n The claimant, Scott Metzger, testified that he was fifty-nine (59) years old at the \ntime of the hearing; was born on April 30, 1964; and graduated the 12\nth\n grade.  He was \nworking for the respondent when he was involved in a motor vehicle accident and   was \nstill with the company.  The accident occurred when another vehicle hit a concrete barrier \non the interstate and lost its load which consisted of a large pallet of energy drinks that \nthen  skidded  across  the  highway.    The  claimant  was  unable  to  avoid  the  pallet.  The \naccident totaled the truck the claimant was driving, and he ultimately was treated by Dr. \nPaulus, who provided medications, with the claimant receiving injections to his neck and \nback.  The claimant received surgery to his neck on December 17, 2021. His treatment \nwas provided by the workers’ compensation insurance carrier.  He suffered pain in his \nlower  and  middle  back, and  his  neck.    He  also  stated  he  suffered  from  shooting  pain \nthrough  his  arms  and  down  his  back,  and  was  still  suffering  from, “shooting  pains \nconstantly, the sciatic is going down my legs every day, even with the medications.”  The \nclaimant stated that he had difficulty turning his head from side to side and from looking \nup,  with  pain  radiating  down  both  arms.  (Tr.  pp.  5-8)   The  claimant  was  still  taking \nmedications for his back at the time of the hearing. (Tr. p. 9)   After surgery, the claimant \ntestified that his neck was better with no more numbness and, “no more really hurting.”  \nIn regard to his back, he still had, “sharp, sharp pain still today.”  He went on to state that \nhe suffered sciatica every day which is sometimes left and sometimes right and is, “very, \nvery painful, sharp, sharp.”  (Tr. p. 10)  The claimant had received injections in his back \nfrom February 12, 2021, up until October or November when he became aware that the \n“insurance people” were not going to pay for them anymore.  Dr. Frankowsi was trying to \n\nMETZGER – H110044 \n \n4 \n \nschedule a nerve blocking test at the time and it was denied.  He then used his health \ninsurance for the test, and a nerve abrasion was then set up for June 16\nth\n, for cauterizing \nthe nerves. (Tr. p.11)  This had been previously performed on the middle of his back by \nDr. Paulus.  He denied any other accidents but did admit that he had tripped and “chipped \nthe eyeball.” (Tr. p.12)  The claimant stated his current symptoms consisted of lower back \npain and that he takes hydrocodone twice a day, which doesn’t stop the pain, but does \nknock the sharpness off.  He also takes gabapentin twice a day, plus tizanidine, a muscle \nrelaxer, once a day.  These medications were prescribed by Dr. Frankowski. (Tr. p.16)  \nThe claimant had a medical appointment on June 16\nth \nand he last saw Dr. Frankowski on \nApril 21\nst\n, he thought, when he received the nerve block. (Tr. p.17) \n Under cross-examination, the claimant admitted that he currently was working from \n7:00  a.m.  to  4:00  p.m.  for  the  respondent  at  the  same  pay  that  he  made  prior  to  the \naccident, and that as far as he knew he would be able to continue long-term.  He also \nadmitted  to  performing  basic  household  chores,  which  included  cutting  the  grass  and \nmaintaining his yard.  He admitted hunting with a crossbow on a stand which was how he \ninjured his orbital when he fell out of the stand onto the ground.  He admitted that while \nhunting  from a  deer  stand,  he  had  to  climb up  a  ladder  and  also admitted  fishing.   He \nadmitted to receiving three (3) branch block injections, and that the last two (2) only gave \nhim six (6) to seven (7) hours of relief before he was back to his baseline, but the relief \nhe received was  tremendous. (Tr. pp.18-20)  The claimant was specifically questioned \nabout page 105 of his medical exhibit packet and which provided that he had received an \nablation at L4-5 and he denied receiving the ablation of the lower back. (Tr. p. 21)  He \n\nMETZGER – H110044 \n \n5 \n \nwent  on  to  state  that  if  Dr.  Pauls’  records  provided  he  had  received  an  ablation  of  the \nlower back, “I have to disagree with it.” \n “Claimant’s Exhibit   One”,   included  a   report   from   Ortho   Arkansas   and   Dr. \nOnyekwelu, dated March 16, 2023,  which provided that the claimant had reached MMI \nwith a ten percent (10%) impairment rating, with no restrictions for work with respect to \nthe cervical spine. (Cl. Ex. 1, PP. 1-2)  A second document from Ortho Arkansas dated \nOctober 28, 2022, provided that Dr. Frankowski had been asked to give an opinion on \nhow the  claimant’s  injuries  could  or  could  not  relate  to  an  injury  that  he  sustained  in \nNovember of 2020.  Dr. Frankowski opined as follows: \n“And I  was  asked  to  give  his  statement  whether  this  was  felt  to be  linked to  the \ninjury  from  the  accident  based  upon  patient’s  MRI  findings.    I  cannot  with \nreasonable medical certainty state that this is a causation and related to the injury \nresulting in the patient’s back pain.  This could represent a condition resulting from \ndegenerative changes but with an acute worsening after the accident but it is very \ndifficult  to  delineate  based  on  MRI  findings.    And  again  the  patient  initially \npresented to January 2021 and my first visit in regards to the patient’s back pain \nand discussion of his back pain took place on 9/1/2022.” (Cl. Ex. 1, P. 3) \n \nOn  October  7,  2022,  the  procedure  note  provided  the  claimant  had  received a \nbilateral  L4-L5  diagnostic  medial  branch  block.    The  claimant  had  presented with \nsymptomatic  lumbar  spondylosis.  (Cl.Ex.1,  PP.  4-7)  The  claimant  had  previously \npresented  to  Dr.  Frankowski  on  October  4,  2022,  and  also  September  1, 2022.    The \nOctober visit referred to lumbar facet arthropathy  with a right L4-5 level facet cyst and \nthat  the  claimant  had  received  radiofrequency  neurotomy  for  the  innervation  of  the \nbilateral L4-5 facets. The claimant was also diagnosed with lumbar spondylosis.  (Cl. Ex. \n1, PP. 8-14)  The procedure note by Dr. Frankowski dated July 29, 2022,  provided for \nsymptomatic lumbar spondylosis and the claimant was offered a facet rhizotomy. (Cl. Ex \n1, PP. 15-16)  The claimant earlier presented to Dr. Frankowski on July 11, 2022.  This \n\nMETZGER – H110044 \n \n6 \n \nreport also referred to lumbar spondylosis with facet arthropathy at L4-L5.   (Cl. Ex. 1, \nPP. 17-25) \nThe claimant had previously presented to Dr. Cayne of Ortho Arkansas on June \n14, 2022, with low back and neck pain. The report provided he was following-up due to \nthe diagnostic medial branch blocks for the innervation of the bilateral L4-L5 and L5-S1.  \nThe records stated the patient had lumbar radiculopathy and received epidural steroid \ninjections  and  a  diagnostic  medial  branch  block.  (Cl.Ex.1,  PP. 26-34)  A  cervical  MRI \ndated June 14, 2022, provided for mild to moderate spinal canal stenosis at C5-C6 and \nC6-C7.  The report also provided for moderate to severe foraminal stenosis bilaterally at \nC5-C6, severe right at C6-C7, moderate severe left at C6-C7, and mild to moderate right \nat  T2-T3.    The  report  also  provided  there  was a  possible  degenerative  signal  versus \npost-op  change,  or  low-grade  bony  stress  at  the  C6-C7  pedicles  bilaterally.    (Cl.Ex.1, \nPP.  35)  Dr.  Cayne  had  previously  performed  an  electrodiagnostic  study  on  June  14, \n2022, which provided there was electrodiagnostic evidence of a carpal tunnel syndrome \nand  ulnar  neuropathy,  generalized  neuropathy,  focal  nerve  entrapment,  or  cervical \nradiculopathy in the bilateral upper limbs. (Cl.Ex.1, PP. 36-37) \nThe claimant was seen by Dr. Frankowski on May 17, 2022.  The report provided \nthe  claimant  had  been  undergoing  bilateral  L4-5  transforaminal  epidural  steroid \ninjections and  also provided  that the claimant had  lumbar radiculopathy. (Cl.Ex.1, PP. \n44-48)  The claimant had previously presented to Dr. Onyekwelu on May 10, 2022, who \nprovided  that  there  was  a  concern  for  a  cubital  tunnel  syndrome  versus  an  acute \nradiculopathy  at  C8.  (Cl.Ex.1,  PP.  38-43)    The  claimant  had  earlier  been  seen  by  Dr. \nFrankowski on April 18, 2022, for an epidural steroid injection. (Cl.Ex.1, P. 49)  On April \n\nMETZGER – H110044 \n \n7 \n \n1, 2022, the claimant was seen by Dr. Frankowski, who provided a lumbar radiculopathy. \n(Cl.Ex.1,  PP.  50-54)    Dr.  Frankowski  had  treated  the  claimant  with  a  bilateral \ntransforaminal epidural steroid injection at the L5-S1 on March 11, 2022. (Cl.Ex.1, P. 55) \nThe  claimant  was  seen  by  Dr.  Onyekwelu  on  February  22,  2022.    The  report \nprovided that the claimant had presented due to low-back pain. Spinal stenosis of the \nlumbar region was noted.  The report also provided for a history of a cervical spine fusion. \n(Cl.Ex.1, PP. 56-60)  An MRI of February 17, 2022, provided for severe facet arthropathy \nat L4-L5 with bilateral facet diffusions and subchondral marrow edema, likely reflecting \nacute  reactive/degenerative  changes.  (Cl.Ex.1,  P.  61)      Prior  to  the  MRI,  the  claimant \nhad been seen by Dr. Onyekwelu on February 1, 2022.  The report provided the claimant \nwanted to discuss his low-back and neck pain.  It also provided that they had recently \nperformed  an  anterior  cervical  decompression  fusion  surgery  at  the  C5-C6  and \nthe C6-C7 with interval improvement with radicular arm pain. (Cl.Ex.1, PP. 62-67)  The \nclaimant had been seen by Dr. Onyekwelu on January 4, 2022, following the surgery.  \nThe  report  provided  there  was  full  range  of  motion  of  the  cervical  spine  with  no \ntenderness,  and  there  was  also  full  range  of  motion  of  the  lumbar  and  thoracic  spine \nwithout pain and tenderness.  The shoulders also had a full range of motion. (Cl.Ex.1, \nPP. 68-72)  Surgery had been performed on December 17, 2022, by Dr. Onyekwelu, for \ncervical  stenosis  at  the  C5-6  and  C6-7,  with  C6-C7  left  radiculopathy.    An  anterior \ncervical   decompression,   discectomy,   and   fusion   at   the   C5-C6   and   C6-C7   was \nperformed. (Cl.Ex.1, PP. 73-76)  The records provided the claimant first presented to Dr. \nOnyekwelu on August 31, 2021, with a complaint of neck pain which radiated down the \nleft side of his neck into his shoulder and left arm. (Cl.Ex.1, PP. 77-81)      \n\nMETZGER – H110044 \n \n8 \n \n  The records also provided the claimant initially presented to Stephen Paulus on \nJanuary 8, 2021, suffering from neck pain with degeneration of the cervical intervertebral \ndiscs  at  C5-C6  and  C6-C7,  and  also  with  low  back  pain.    (Cl.Ex.1,  PP.  128-132)    The \ninitial MRI of record dated January 26, 2021, provided the claimant suffered moderate to \nadvanced L4-L5 facet arthropathy with subtle degenerative anterolisthesis of the L4 and \nL5, along with L3-L4 and L4-L5 shallow disc bulges, without significant canal stenosis or \nno significant neural foraminal narrowing, and no focal disc protrusion or extrusion and \nno acute fracture. (Cl.Ex.1, PP. 126-127)  The claimant continued to present to Dr. Paulus \nfrom January 26, 2021, through August 27, 2021.  Dr. Paulus provided for degeneration \nof  the  cervical  intervertebral  disc  with  spinal  stenosis  of  the  cervical  region  and  also \nlumbosacral  spondylosis  without  myelopathy.    The  report  also  provided  for  a  possible \nreferral to Dr. Frankowski for an evaluation. (Cl.Ex.1, PP. 82-125)  Although much of the \ntreatment  by  Dr.  Paulus  related  to  the  cervical  spine,  on  May  21,  2021,  Dr.  Paulus \nperformed   a    bilateral    medial    branch  radio  frequency  neurotomy  at  L3  and  L4. \n(Cl.Ex.1,PP. 104-106) \nThe  documents  of “Respondents  Exhibit  One”  were  reviewed  as  part  of  the \nclaimant’s  documents.    “Respondents  Exhibit Two”  consisted  of an  AR–2  Form  and  a \nletter from the workers’ compensation carrier dated October 14, 2022, and addressed to \nDr.  Frank  Frankowski,  requesting  that  he  offer his  opinion  in  regard  to  the  claimant’s \ninjuries. (Resp.Ex.2, P.2) \n      DISCUSSION AND ADJUDICATION OF ISSUES \n \nIn the present matter, the parties stipulated the claimant sustained compensable \ninjuries including but not limited to his neck and back, on November 4, 2020.  The claimant \n\nMETZGER – H110044 \n \n9 \n \nis therefore not required to establish “objective medical findings” in order to prove that he \nis entitled to additional benefits. Chamber Door Indus., Inc. v. Graham, 59 Ark. App. 224, \n956 S.W.2d 196 (1997) \nHowever, when assessing whether medical treatment is reasonably necessary for \nthe treatment of a compensable injury, we must analyze the proposed procedure and the \ncondition  that  it  is  sought  to  remedy.   Deborah  Jones  v.  Seba,  Inc., Full  Workers’ \nCompensation filed December 13, 1989. (Claim No. D512553).  The respondent is only \nresponsible  for  medical  services  which  are  causally  related  to  the  compensable  injury.  \nTreatments  to  reduce  or  alleviate  symptoms  resulting  from  a  compensable  injury,  to \nmaintain the level of healing achieved, or to prevent further deterioration of the damage \nproduced by the compensable injury are considered reasonable medical services. Foster \nv. Kann Enterprises, 2009 Ark. App. 746, 350 S.W.2d 796 (2009).  Liability for additional \nmedical  treatment  may  extend  beyond  the  treatment  healing  period as  long  as  the \ntreatment is geared toward management of the compensable injury. Patchell v. Wal-Mart \nStores, Inc., 86 Ark. App. 230, 180 S.W.3d 31 (2004). \nThe claimant bears the burden of proof in establishing entitlement to benefits under \nthe   Arkansas   Workers’   Compensation   Act   and   must   sustain   that   burden   by   a \npreponderance of the evidence. Dalton v. Allen Engineering Co., 66 Ark. App 260, 635 \nS.W.2d 543.  Injured employees have the burden of proving, by a preponderance of the \nevidence,  that  the  medical  treatment  is  reasonably  necessary  for  the  treatment  of the \ncompensable injury. Owens Plating Co. v. Graham, 102 Ark. App 299, 284 S.W. 3d 537 \n(2008).  What constitutes reasonable and necessary treatment is a question of fact for \n\nMETZGER – H110044 \n \n10 \n \nthe  Commission.   Anaya v. Newberry’s 3N Mill,  102  Ark.  App.  119,  282  S.W.3d  269 \n(2008).  \nThe claimant was involved in a motor vehicle accident on November 4, 2020, when \na vehicle hit a concrete barrier on the interstate and a large pallet of energy drinks broke \nloose, came across the interstate, and the claimant hit the pallet with the vehicle he was \ndriving,  totaling  his  vehicle.  The  claimant  testified  that  following  the  accident,  he  was \nsuffering from lower and middle back pain, with pain shooting down his arms and legs.  \nThe claim was accepted as compensable and the claimant was treated by Dr. Paulus with \nthe  original  treatment  of  record  being  January  8,  2021.    The  report  provided  that  the \nclaimant  was  suffering  from  neck  pain  with  degeneration  of  the  cervical  intervertebral \ndiscs at C5-C6 and C6-C7 along with low back pain.  The MRI dated January 26, 2021, \nprovided that the claimant suffered from moderate to advanced L4-L5 facet arthropathy \nwith  subtle  degenerative  anterolisthesis  of  the  L4  and  L5,  along  with  L3-L4 and  L4-L5 \nshallow  disc  bulges  without  significant  canal  stenosis  and  with  no  significant  neural \nforaminal  narrowing and  with  no  focal  disc protrusion  and no acute  fracture.   Although \nmuch of the treatment of Dr. Paulus involved the cervical spine, he performed a bilateral \nmedial branch radio frequency neurotomy at L3 and L4 on May 21, 2021.  The claimant \nappeared to treat with Dr. Paulus up until August 27, 2021, with that report providing for \ndegeneration of the cervical intervertebral disc with spinal stenosis of the cervical region \nand lumbosacral spondylosis without myelopathy.  The report also provided for a possible \nreferral to Dr. Frankowski for an evaluation.   \nThe claimant received an anterior cervical decompression, diskectomy, and fusion \nat  C5-C6  and  C6-C7  by  Dr.  Onyekvwelu  on  December  18,  2021,  which  apparently \n\nMETZGER – H110044 \n \n11 \n \nresolved  the  issues  involving  the  claimant’s  cervical  spine.   A  follow-up  by  Dr. \nOnyekvwelu on January 4, 2022, provided there was a full range of motion of the cervical \nspine  without  pain  or  tenderness.    The  report  also  provided  there  was  a  full  range  of \nmotion of the lumbar thoracic spine without pain and tenderness.  The claimant was then \ntreated by Dr. Frankowski for lumbar facet arthropathy along with a L4-5 level cyst and \nDr. Frankowski offered a facet rhisotomy. \nThe insurance carrier contacted Dr. Frankowski by a letter dated October 14, 2022, \nrequesting that he opine in regard to the claimant’s condition involving his lower back.  He \nresponded two (2) weeks later with a letter that provided he could not with a reasonable \ndegree of medical certainty determine that the motor vehicle accident was the cause of \nthe  claimant’s  resulting  back  pain.    “This  could  represent  a  condition  resulting  from \ndegenerative changes but with an acute worsening after the accident, but it is very difficult \nto delineate based on MRI findings.”              \nQuestions  concerning  the  credibility  of  witnesses  and  the  weight  to  be  given  to \ntheir testimony are within the exclusive province of the Commission.  Powers v. City of \nFayetteville, 97 Ark. App. 251, 248 S.W.3d 516 (2007).  Where there are contradictions \nin the evidence, it is within the Commission’s province to reconcile conflicting evidence \nand to determine the true facts.  Cedar Chem. Co. v. Knight, 99 Ark. App. 162, 258 S.W.3d \n394 (2007).  The Commission has authority to accept or reject medical opinions and to \ndetermine its medical soundness and probative force.  Oak Grove Lumber Co. v. Highfill, \n62 Ark. App. 42, 968 S.W.2d 637 (1998).  However, the Commission may not arbitrarily \ndisregard the testimony of any witness.  Patchell v. Wal-Mart Stores, Inc., 86 Ark. App. \n230, 184 S.W.3d 31 (2004). \n\nMETZGER – H110044 \n \n12 \n \nIt  is  also  noted  that  in  workers’  compensation  law,  the  employer  takes  the \nemployee  as  he  finds  him  and  employment  circumstances  that  aggravate  pre-existing \nconditions are compensable. Heritage Baptist Temple v. Robinson, 82 Ark. App. 460, 120 \nS.W. 3d 150 (2003).  The parties agreed that the claimant suffered a compensable injury \nto his back and neck from a work-related injury on November 4, 2020.  Various imaging \nmodalities provided the claimant suffered from arthritic issues as do most people who are \napproximately sixty (60) years of age.  The testimony of the claimant does not resolve the \nissue of the additional treatment recommended by Dr. Frankowski, nor does the opinion \nissued  by  Dr.  Frankowski,  the  treating  physician,  in  regard  to  the  additional  treatment \nwhich he proposed being work-related.  Speculation and conjecture cannot substitute for \ncredible evidence.  Liaromatis v. Baxter county Regional Hospital, 95 Ark App. 296, 236 \nS.W.3d. 52 (2006).  \nAfter reviewing all of the evidence, without giving the benefit of the doubt to either \nparty, there is no alternative but to find that the claimant has failed to satisfy the required \nburden of proof to prove, by a preponderance of the credible evidence, that the medical \ntreatment  he  requested,  specifically  additional  treatment  by  Dr.  Frankowski is  causally \nrelated  and  reasonably  necessary  for  the  treatment  of  the  compensable  work-related \nback and neck injury.  \n IT IS SO ORDERED. \n  \n    \n      ___________________________ \n      JAMES D. KENNEDY \n      Administrative Law Judge","preview":"BEFORE THE ARKANSAS WORKERS’ COMPENSATION COMMISSION CLAIM NO. H110044 SCOTT METZGER, EMPLOYEE CLAIMANT v. WINSUPPLY, INC. EMPLOYER RESPONDENT SENTRY CASUALTY INSURANCE COMPANY, INSURANCE CARRIER RESPONDENT OPINION FILED JULY 18, 2023 Hearing before Administrative Law Judge, James D. Kennedy, on the 23 rd day of May, 2...","fetched_at":"2026-05-19T23:05:22.906Z","links":{"html":"/opinions/alj-H110044-2023-07-18","pdf":"https://labor.arkansas.gov/wp-content/uploads/METZGER_SCOTT_H110044_20230718.pdf","source_publisher":"https://labor.arkansas.gov/workers-comp/awcc-opinions/administrative-law-judge-opinions/"}}