{"id":"alj-H203241-2023-03-02","awcc_number":"H203241","decision_date":"2023-03-02","opinion_type":"alj","claimant_name":"Sarahl Hooten","employer_name":"Central Arkansas Nursing Centers Inc","title":"HOOTEN VS. CENTRAL ARKANSAS NURSING CENTERS INC. AWCC# H203241 MARCH 2, 2023","outcome":"denied","outcome_keywords":["affirmed:1","modified:1","dismissed:1","denied:3"],"injury_keywords":["knee","shoulder","hip","back","sprain"],"pdf_url":"https://labor.arkansas.gov/wp-content/uploads/HOOTEN_SARAHL_H203241_20230302.pdf","source_index_url":"https://labor.arkansas.gov/workers-comp/awcc-opinions/administrative-law-judge-opinions/","filename":"HOOTEN_SARAHL_H203241_20230302.pdf","text_length":31690,"full_text":"BEFORE THE ARKANSAS WORKERS’ COMPENSATION COMMISSION \nCLAIM NO. H203241 \n \nSARAH L. HOOTEN, Employee                                                                           CLAIMANT \nCENTRAL ARKANSAS NURSING CENTERS INC., Employer                  RESPONDENT \nESIS INC., Carrier                                                                                           RESPONDENT \n OPINION FILED MARCH 2, 2023 \nHearing before ADMINISTRATIVE LAW JUDGE JOSEPH C. SELF in Fort Smith, Sebastian \nCounty, Arkansas. \nClaimant represented by EDDIE H. WALKER JR., Attorney, Fort Smith, Arkansas. \nRespondents represented by ERIC NEWKIRK, Attorney, Little Rock, Arkansas. \n \n STATEMENT OF THE CASE \n On December 9, 2022, the above captioned claim came on for  hearing at Fort Smith, \nArkansas.  A pre-hearing conference was conducted on August 25, 2022 and a pre-hearing order was \nfiled on that same date.  A copy of the pre-hearing order has been marked as Commission’s Exhibit \n#1 and made a part of the record without objection. \n At the pre-hearing conference the parties agreed to the following stipulations: \n 1.    The Arkansas Workers’ Compensation Commission has jurisdiction of this claim.  \n 2.   The employee/employer/carrier relationship existed on December 22, 2021. \n  3. The respondents have controverted the claim regarding claimant’s left knee.    \n4. The compensation rates are $402.00 for temporary total disability and $302.00 for \npermanent partial disability.  \n At the pre-hearing conference the parties agreed to litigate the following issues: \n1. Whether claimant sustained a compensable injury regarding her left knee. \n\nHooten-H203241 \n2 \n \n2. If compensable, is claimant entitled to a total knee replacement and indemnity benefits \nassociated therewith. \nAll other issues are reserved by the parties. \nThe claimant contends that: \n“a. That as the result of her admittedly compensable injury to her knee she is entitled to a \ntotal knee replacement and indemnity benefits associated with that knee replacement. \nb. The claimant further contends that the knee replacement has been controverted and \ntherefore, for any indemnity benefits associated with that knee replacement have been controverted \nand an award of such benefits will entitle her to an appropriate attorney’s fee.”  \nThe respondents contend that: \n“1. That the claimant did not sustain a compensable left knee injury as a result of a \npurported work incident on December 22, 2021. The respondents contend that there are no objective \nmedical findings of a related left knee injury on December 22, 2021, and the claimant made no \ncomplaints pertaining to her left knee on or about December 22, 2021. \n2. Alternatively, to the extent the claimant has any objective medical findings in existence \npertaining to her left knee, those findings would be traceable to the claimant’s preexisting left knee \nabnormalities and treatment she had already been receiving in connection with her left knee. Thus, \nany objective medical findings, to the extent they exist, would not be causally connected to the work \nincident/event. \n3. By way of further alternative defense, the respondents contend that even if objective \nfindings are somehow determined to exist which are traceable to a work incident/event on December \n22, 2021, those findings would be minimal in nature and a minor temporary aggravation of claimant’s \npreexisting left knee condition. Any needed medical treatment to restore the claimant to her baseline \ncondition as it related to the temporary aggravation would be minimal in nature and certainly not an \n\nHooten-H203241 \n3 \n \ninvasive,  extensive  procedure  such  as  a  total  knee  replacement. Respondents  contend  that  the \nclaimant’s need for a total knee replacement is causally connected to her preexisting left knee \nabnormalities and not traceable, in whole or in part, to the underlying alleged December 22, 2021 \nwork incident/event. \n4. By way of final alternative defense, the respondents assert an offset for any group \ninsurance benefits paid in any form or nature to or on behalf of the claimant, as well as an offset for \nany unemployment benefits paid to the claimant, to the extent allowed under Arkansas law.    \nFrom a review of the record as a whole, to include medical reports, documents, and other \nmatters properly before the Commission, and having had an opportunity to hear the testimony of the \nwitnesses and to observe their demeanor, the following findings of fact and conclusions of law are \nmade in accordance with A.C.A. §11-9-704: \n  FINDINGS OF FACT & CONCLUSIONS OF LAW \n 1.   The stipulations agreed to by the parties at a pre-hearing conference conducted on August \n25, 2022, and contained in a pre-hearing order filed that same date, are hereby accepted as fact. \n 2. Claimant has failed to prove by a preponderance of the evidence that she suffered a \ncompensable injury to her left knee on December 22, 2021. \n FACTUAL BACKGROUND \n Following the hearing, the parties were asked if they wanted to each submit a brief in support \nof their position. Both declined, but subsequently, claimant requested that the parties submit post-trial \nbriefs.  That request was granted. The email exchange after the hearing and the brief filed by claimant \nare blue backed to the record; respondent did not submit a post-hearing brief.  \nHEARING TESTIMONY \n The claimant called two witnesses before she testified. Jordan Gump stated she was working \nwith claimant on December 22, 2021, when she heard a resident calling out for help. She and claimant \n\nHooten-H203241 \n4 \n \nbegan running and claimant fell in front of Ms. Gump, hitting her entire left side on the floor, including \nher shoulder, hip, knee, and foot.  She helped claimant get back to her feet but did not recall claimant \nvoicing a complaint about any part of her body being injured at that time.  A day later, Ms. Gump was \nworking with claimant and noticed that she was limping and heard her complain about her knee hurting.  \n On cross-examination, Ms. Gump said that she did not see claimant limping before December \n22, 2021. She had noticed that when walking, claimant “waddles in general” but she noticed a \ndifference in how she was walking after she fell. Ms. Gump did not recall claimant complaining about \nher knee hurting before December 22 or having her job modified because of her left knee.  \n Susan Willhite was called by claimant.  She said that she was working in the area where claimant \nfell to the floor and saw claimant when she returned from the doctor. Ms. Willhite testified claimant \nsaid her knee was hurting and Ms. Willhite noticed that claimant was limping. Ms. Willhite had seen \nher limp like that before some months earlier. Ms. Willhite said that she had talked to claimant before \nthe accident happened in the restroom or break room and was aware that claimant had knee problems. \nWhen shown her deposition testimony where she was asked if claimant was complaining of pain, Ms. \nWillhite read where she stated, “just her knee”, but when asked at the hearing: \n Question (by Mr. Walker) So was it clear to you that she was complaining about \n having injured  her knee when she fell? \n A. I don’t know. I am confused here. \n           Q. Well it’s a pretty straight forward question, ma’am. I asked you about the   \n           accident and you said – I asked you “did you see her actually fall?” You said “yes.”  \n           I said, “do you recall what part or parts of her body actually hit the floor?”       \n A. “Her knee.” \n Q. Then I asked –  \n A. I think the whole body. \n Q. Then I asked you “Do you recall her complaining of any pain or complaining \n that  she  thought  she  was  injured  in  anyway?”  Now  I  would  have  been \n referring to the incident; wouldn’t I? \n A. Uh-huh. \n\nHooten-H203241 \n5 \n \n Q. And your answer was, “Just the knee”. \n A. Uh-huh. \n Ms. Willhite then said that she didn’t know if claimant was complaining about knee pain when \nshe returned from the doctor on the night of the accident because she just briefly passed her when \nshe got back. She said she didn’t talk to claimant when claimant returned from the doctor. At that \npoint, Ms. Willhite’s deposition was proffered as an exhibit and the testimony in the deposition will \nbe summarized below.  \n On cross-examination, Ms. Willhite admitted that she was a little foggy on when claimant \nstarted complaining about her knee. Ms. Willhite thought it might have been in January, then at one \npoint said December, but admitted that she didn’t really know. She knew claimant had gone on \nChristmas vacation in South Carolina. Ms. Willhite was aware that claimant had prior knee problems \nbut was not aware of a July 14, 2020, work incident. She had noticed claimant was limping when she \ncame back from the doctor on December 22, 2021, but that was not anything different, because she \nhad seen claimant limping all the time.  \n On redirect-examination, Ms. Willhite said that she had seen claimant limping for quite some \ntime but had never discussed it with claimant. \n Ms. Willhite’s deposition was taken four days before the hearing. She said she had known \nclaimant for eight years and recalled the accident of December 22, 2021. She said claimant tripped on \nher own feet because there was nothing there. She saw claimant fall but did not remember what parts \nof her body hit the floor. She recalled claimant complaining of pain in her knee but did not remember \nwhich knee. She didn’t recall anything else being said about the knee because claimant was sent to the \ndoctor after it happened. She didn’t know if anyone else was around to see the fall, including Jordan \nGump. Ms. Willhite said she was the one that helped claimant up from the floor. Ms. Willhite said she \nwas passing out linen and just happened to be there at the time of the fall. Ms. Willhite thought \n\nHooten-H203241 \n6 \n \nclaimant didn’t act like she was really hurt, but more embarrassed. After she returned from the doctor, \nshe said her knee was hurting. She didn’t know anything about claimant’s medical condition before \nthe fall.  \n On cross-examination in the deposition, Ms. Willhite said she didn’t know for sure if claimant \ntold her something about the knee on December 22 or if it was a different day. She did see claimant \nwearing a knee brace but didn’t know if that was in January when she started doing that. There was \nthen this exchange with respondent’s counsel: \n Question (by Mr. Newkirk) I need to know can you testify under oath that she  \n            told you her knee was hurting that day at the time of that incident. \n  A. She did tell me; yes, when she got back; yes. \n \n Q. You say, “when she got back.” That’s what I am saying. \n A. Yeah. \n Q. When you helped her up, did she say anything about it? \n A. No. \n Q. And when she got back – do you know if you saw her in December or  \n in January when she got back? \n             A. See I don’t know. I don’t know when it was. \n Q. You just know at some point you saw her again –  \n A. Right. \n \n Q. – after the incident, she mentioned her knee was hurting? \n A.  (No response) \n Q. Is that right? \n A. Right. \n Q. It could have been in December; it could have been in January? \n A. Right. \n On redirect examination, Ms. Willhite clarified that she saw claimant fall and knew that she \nwent to the doctor on that same day. She knew that claimant came back to the nursing home that \n\nHooten-H203241 \n7 \n \nsame day and said that her knee got messed up. Ms. Willhite said that she had seen claimant when she \ngot back on the same day.   \nOn  recross  examination,  the  following  exchange  took  place  between  Ms.  Willhite  and \nrespondent’s counsel: \n Question (by Mr. Newkirk) Well, what you are telling us is one thing to  \n            Mr. Walker and you are telling me two different things. You are telling Mr. \nWalker that on that day – she came back in there that day on December 22 \nand she complained to you about her knee and she was limping and wearing \na thing? \n            A. Uh-huh. \n Q. – and you know it was that day, but yet you tell me – \n A. It was that day she did come back because she had to give the nurse the \nslip for going; yeah. \n \n Q. So it wasn’t in January? \n A. No, no it was right after it happened. \n Claimant testified that on December 22, 2021 she fell at work when she was going to look for \nsomeone that was yelling for help. She went to the doctor and returned to work because the doctor \ndid not take her off duty. She said she first realized her knee was injured on the same night when she \nwas walking to give a person a shower but did not report it that night. She believed she first mentioned \nthat her knee was hurting on the third or fourth day after the fall. Claimant had time off work during \nthe Christmas vacation and then returned after her trip. She said when she returned to work, her knee \nwas swollen and “hurting like crazy”. She went to see the doctor at Arkansas Occupational Health, \nthe facility where she was sent by the HR director. Claimant did not recall if she said at the time that \nthe knee was hurting because of the fall. \n Claimant stated when she was at the emergency room the night of the fall, the emergency \nroom doctor did not x-ray her knee because he did not have an order to do that. She understood that \nthe incident report that she filled out listed problems with her left shoulder and left hip but said \nnothing about her left knee. Claimant said that at the time that she filled out the form, her hip and \n\nHooten-H203241 \n8 \n \nshoulder were really bothering her, but her knee didn’t start hurting until three days afterwards. When \nasked why she testified in a deposition that her knee was bothering her when she went to the \nemergency room, she said it was possible that she got that incident mixed up with a previous fall that \nshe had. She said she was very nervous during the deposition and nervous while she was testifying, \nwhich causes her to become forgetful. It was established that the previous fall she referred to was in \nJuly   2020. Claimant said that her knee hurt worse after the December 22, 2021 accident Claimant \nstated that she was not wearing a brace on her knee at the time of the December 22, 2021 accident, \nbut was given one following that fall. Claimant said that she continued to work at the nursing home \nafter the July 2020 accident and was released from active treatment. She did not return to the doctor \nfor any additional treatment on her knee prior to December 22, 2021, because she believed there was \nnothing else that could be done for her. \n On cross-examination, claimant agreed that some of the testimony she gave in her deposition \nwas wrong because she was nervous. Claimant said the doctor that was treating her would not send \nher to an orthopedic doctor because the bone chips under her kneecap were nothing that could be \nhelped with surgery. She said that her knee problems continued to worsen, and she now was seeking \na total knee replacement. When shown the records from 2015 when she had a venous Dopplar study \nof her left leg, claimant did not remember that taking place. She did recall having an MRI for low back \nissues but did not recall completing a form in July 2020 in which she said that she “had water under \nmy kneecap” before the July 2020 fall. When asked if she told anyone following the December 22, \n2021, fall that her left leg had just buckled and gave out as she was walking, claimant maintained that \nshe did not remember saying that to anyone.  \n The following exchange took place in claimant’s deposition: \n Question (by Mr. Newkirk) What about your left knee? \n A. Well that’s – it popped. \n\nHooten-H203241 \n9 \n \n Q. So it didn’t feel like it was bruised. It felt worse? \n A. Yes. \n Q. So you knew instantly that something was wrong with your left knee worse \n            than just a bruise? \n A. Yes sir. \n Q. Like within three minutes? \n A. Yes sir. \n Claimant denied that was accurate, and said it was three days afterwards when she started \nhaving problems with her knee, but then said it might have been even later. Claimant was adamant \nthat she did not have any knee problems while she was on vacation, maintaining it was after she \nreturned.   \n The following testimony took place: \n Question (by Mr. Newkirk) OK. So actually, it was January, then, when you started  \n            developing your problems after you got back from your trip? \n A. I don’t remember exactly. \n Q. Well you got back about January 3. I think that’s what you testified to. Does that \n            sound about right? \n A. That sounds about right. \n Q. You were out there for a week? \n A. Yes. \n Q. Then when you came back to Arkansas you started having problems? \n A. After I started working. \n Q. OK. After you started working? \n A. Yes. \n Q. So you started doing your shift and started having problems and went to see \n            if they would let you go get some treatment for the knee? \n A. Yes.  \n Q. OK. So that is even different than what you told me earlier because it wasn’t \n            within three of four days, it was more like twelve to fourteen days, right? \n A. I think so. \n Q. So in your deposition when you told me it happened immediately, within seconds \n\nHooten-H203241 \n10 \n \n            and you knew, that is wrong; right? \n A. Yes. I got nervous. \n When shown the ARN form that claimant filled out on December 22, 2021, she conceded \nthere was nothing on it about her knee because that didn’t happen until sometime in January.  \n When asked about her statement in the deposition that her knee complaint was not treated in \nthe emergency room, claimant said that she asked why they weren’t checking her knee.  \n And then the following exchange took place: \n Question (by Mr. Newkirk) So you felt like – again there wouldn’t have been  \n            a need to check it, right, because you didn’t have knee problems from December \n            22, until January; right? \n A. Well I asked because I think since they were checking my shoulder and hip, they \n            should check my knee too, just to make sure it was alright, that’s why I was asking. \n Q. OK and again, you didn’t have additional knee problems until January? \n A. Right. \n On redirect-examination, claimant said she didn’t do anything during her trip to see her \ngrandchildren to injure her knee.  \n On questioning from the court, the following exchange took place: \n Question (by the Court) Ms. Gump testified she saw you limping either that night or  \n within the next couple of days. Do you remember hearing her say that? \n A. Yes sir. \n Q. But you just told us you didn’t have any trouble with the knee until January, \n             is that right? \n A. Yes sir. \n Following that exchange with me, the claimant said she had been limping “ever since I fell the \nfirst go around.” \n Then there was this exchange with her attorney: \n Question (by Mr. Walker) How soon after you fell did it get worse? \n A. About three days later.  \n Q. You understand that when you are answering my questions you are telling us \n             it got worse within days and when you are answering Mr. Newkirk’s questions, \n\nHooten-H203241 \n11 \n \n             you are saying it got worse in January. \n A. It kept on getting worse from the third day and it didn’t get any better. \n Respondent called Amanda Burton, the director of nursing at Alma Nursing and Rehab, who \nis claimant’s direct supervisor. She was not present on December 22, 2021, when claimant fell but did \nreceive a call from the charge nurse that evening, alerting her of the fall. She saw claimant on a day-\nto-day basis and prior to December 22, 2021, she had noticed that claimant had a limp regarding her \nleft leg and had also complained about claimant’s left knee. Ms. Burton said that claimant’s job had \nbeen modified because “she wasn’t able to keep up with call lights and stuff, so we had made it where \nshe did a lot of the vitals, pass the ice. Did a lot of the other things that the aides – so the aides could \ndo most of the care.” She next saw claimant on January 5, 2022, when claimant returned from vacation. \nWhen claimant was asked about what had happened, claimant said she was going to do something \nand while going down the hall her knee gave out. \n On cross-examination, Ms. Burton said she had not reviewed the paperwork that had been \ncompleted the night of the incident but had just asked claimant how she was doing because claimant \nwas limping. She believed this limp was worse than it had been before the incident on December 22, \n2021. Ms. Burton did not inquire as to whether claimant had done anything during her vacation to \nhurt her knee, she had simply noticed that claimant’s gait was worse, and she asked how she was doing. \nWhen claimant said her knee was hurting, Ms. Burton sent her to see the human resources director to \nmake an appointment with a doctor about her knee. \n On redirect-examination, Ms. Burton said that because the knee injury seemed to be work \nrelated, she sent her to human resources. She didn’t know if a knee buckling or giving out was \ncompensable and that was not for her to decide. \n Respondents then called Kristina Martens, the lead CNA at Alma Nursing. She had known \nclaimant for six years and worked alongside her. Ms. Martens believed that she was claimant’s direct \n\nHooten-H203241 \n12 \n \nsupervisor, as claimant was to bring any problems to her and then to Amanda Burton if necessary. \nMs. Martens described the way claimant walked as “she hobbles” because of her knee, and had done \nso prior to December 22, 2021. She knew that claimant had accommodations at work of a light duty \nnature, which had begun before December 22, 2021. Ms. Martens was not present when the accident \ntook place and did not see claimant again until after claimant returned from vacation. At that time, \nclaimant told Ms. Martens that “she was walking down the hallway and her knee buckled and she fell.”  \n On cross-examination, Ms. Martens said she had not seen the incident report and did not \nknow what claimant had said about how the accident had taken place. She said that she had seen \nclaimant wearing a brace on her knee after the fall in December 2021. \nREVIEW OF THE EXHIBITS \n \n The medical records revealed little that was not previously discussed during the testimony. \nClaimant went to the emergency room on December 22, 2021, where she was examined for shoulder \nand hip injuries. Consistent with claimant’s testimony, there was no record of her knee  being \nexamined.  \n Claimant next was seen by Cynthia Johnson, APRN, at Arkansas Occupational Medicine \nServices on January 11, 2022. This is consistent with her testimony that when she returned from her \nvacation, she reported that her knee was hurting, and an appointment was scheduled for her at that \nfacility. X-rays were ordered and there were no acute findings or obvious fractures, but additional \nimaging was ordered due to claimant’s presentation.  \n The diagnosis was: \n 1. Sprain of unspecified site of left knee, initial encounter. \n 2. Fall on same level from slipping, tripping, and stumbling with subsequent striking  \n            against unspecified object, initial encounter. \n\nHooten-H203241 \n13 \n \n At that visit, claimant reported that her left knee began hurting and swelling a few days after \nher injury. She was put on restrictive duty which included no lifting, pushing, pulling in excess of ten \npounds and she was to stand, sit, and walk as tolerated.   \nAn MRI was performed on February 8, 2022, and the impression was: \n 1. Moderate medial joint space degenerative change with cartilage loss and marginal \n osteophytes and marrow edema-type changes femur greater than tibia and with medial \n meniscus tear. \n 2. Joint effusion. \n 3. Small central anterior horn lateral meniscus tear. \n Following the MRI claimant was referred to Mercy Clinic River Valley Muscular Skeletal \nCenter. She was scheduled for a knee arthroplasty total replacement on May 3, 2022, but that surgery \ndid not occur.  There were no office notes or other information from the surgeon that was going to \nperform the operation, Dr. Timothy Garlow, regarding his examination of claimant.    \n Respondent introduced several records that predated the fall of December 22, 2021.  The most \napplicable one was the MRI of claimant’s left knee from July 24, 2020.  The impression at that time \nwas:  \n1. Findings suggestive of microfractures and bony contusion of the inferior patella. \n2. Moderate suprapatellar joint effusion \n3. Tricompartmental osteoarthritis, most pronounced at the medial compartment. \n No definite tear of the menisci or cruciate ligaments.  \n \nADJUDICATION \n In order for claimant to prevail in this matter, she was required to show: (1) that she suffered \nan injury arising out of and in the course of her employment; (2) that the injury was caused by a specific \nincident; (3) that the injury caused internal or external physical harm to her body; (4) that the injury is \nsupported by objective findings; (5) that the injury was the major cause of the disability or need for \nmedical treatment. Ark. Code Ann. § 11-9-102.   I find claimant failed on her burden of proof on the \nfirst and fifth factor listed.  \n\nHooten-H203241 \n14 \n \n In reviewing the testimony provided by those witnesses other than claimant, I found Jordan \nGump to be credible; however, the portion of Ms. Gump’s recollection which was most beneficial to \nclaimant—that she was limping and complaining of pain in her knee the next day-- was directly \ncontradicted by claimant later in the hearing. (TR. 69).   \nAmanda Burton and Kristina Martens did not see claimant after the fall until she returned \nfrom vacation. However, both talked to claimant when she returned to work on January 5, 2022, and \ntestified that claimant attributed the fall to her knee “giving out” (Burton) or “buckling” (Martens).  \nGiven the various accounts claimant gave about her knee injury, which will be detailed below, their \nrecollections as to what claimant said on or about January 5, 2022, were both credible.  \n On the other hand, Susan Willhite was not a credible witness.  In reviewing her testimony at \nthe hearing and at the deposition a few days before the hearing, there are parts of her testimony that \ncannot be harmonized or attributed to misunderstanding the question.  I do not care to speculate on \nwhy her testimony was so varied regarding what happened on December 22, 2021, but I note that, as \nwith Ms. Gump’s testimony,  the portions that would have been most beneficial to claimant were \nrefuted by her. \n I turn now to the task of trying to reconcile claimant’s testimony.  At various times, she said: \n1. Her knee hurt immediately (R.X #3, page 34); but   \n2. On the AR-N form, she omitted a mention of the knee injury (R.X #2, page 2); then \n3. Went to the ER where the knee was both hurting (R.X. #3, page 4); and  \n4. Not hurting (TR.65); but \n5. She wanted it checked anyway before returning to work (TR. 63); where   \n6. She noticed it was hurting the same day when giving someone a shower (TR.36) and told \nMs. Gump and Ms. Willhite she hurt it in the fall; but \n7. It didn’t start hurting until three days later (TR. 39) ; however,  \n8. It may have been longer than three days, but definitely not while on vacation (TR. 58-59); \nalthough \n9. It wasn’t healed when she got back from the trip, because it had swollen like a basketball \n(TR.   39); but  \n10. It was more like 12 days after the fall when it started hurting. (TR. 59-60) \n\nHooten-H203241 \n15 \n \n I can understand how someone that is not accustomed to legal proceedings and dealing with \nattorneys could be nervous; the unknown does that to us all.  But I cannot just pick one of her accounts \nwithout engaging in speculation about why she said the others; maintaining “I was nervous” doesn’t \nexplain these various accounts of when her knee started hurting, all of which cannot be right. There \nis also the entry on the February 11, 2022, record from Arkansas Occupational Medicine Services \nwhere there is a mention of a “subsequent striking against unspecified object,” which could have only \ncome from claimant.   In her brief, claimant correctly pointed out that there is no evidence that she \ninjured her leg while on vacation, but then again, the only testimony on that point was from a most \nunreliable witness, the claimant herself.  It isn’t unreasonable to hear the part of her testimony where \nshe said it was swollen when she got back from the trip, or when she said it was hurting when she \nreturned, but not before, and conclude that something could have happened to her knee while she \nwas off work.   \n Even if I could settle on one of claimant’s many versions as the accurate account of when she \nnoticed her knee was injured, she still failed to prove that the fall on December 22, 2021, caused an \ninjury that necessitated a knee replacement surgery.  In Jackson v. O'Reilly Auto. Inc., 2013 Ark. App. \n755, the Court of Appeals affirmed a decision by the Commission that Jackson had not proven a \ncausal connection between his compensable injury and the need for a knee replacement.   In the case \nat bar, claimant’s proof that she suffered a compensable injury was insufficient due to her erratic \ntestimony, but nonexistent on the connection between the fall and the need for a knee arthroplasty.  \nSaid another way, even if I believed claimant tore her medial meniscus when she fell to the floor on \nDecember  22,  2021,  I  have  nothing  before  me  to  demonstrate  that  injury  required  the  knee \nreplacement surgery.  Claimant had problems with her knee before December 22, 2021.  Before the \nfall, Ms. Gump said she had always waddled when she walked (although it was more pronounced after \nthe fall); Ms. Willhite had seen her limping; Ms. Burton testified that her job had been modified due \n\nHooten-H203241 \n16 \n \nto her knee issues; and Ms. Martens described claimant’s ambulation as hobbling.  The MRI of July \n24, 2020, showed “tricompartmental osteoarthritis” in her left knee, which could explain why four \nwitnesses said claimant limped, hobbled, or waddled when she walked before the fall.  Without \nsomething from Dr. Garlow (or another medical professional) opining that the fall was at least a factor \nin the need for a knee replacement, claimant lacked the necessary proof that it was connected to her \nneed for that surgery.\n1\n            \nORDER \n \nClaimant has failed to meet her burden of proving by a preponderance of the evidence that \nshe suffered a compensable injury to her left knee on or about December 22, 2021. Therefore, her \nclaim for compensation benefits is hereby denied and dismissed. \nRespondents are responsible for paying the court reporter her charges for preparation of the \nhearing transcript in the amount of $ 846.95. \n IT IS SO ORDERED. \n \n \n                                                                                           \n_______     \n JOSEPH C. SELF \nADMINISTRATIVE LAW JUDGE \n \n \n \n \n \n1\n The burden of proof would have been less than the “major cause” standard: “An employee is not required to prove \nthat his compensable injury is the major cause for the need for treatment unless he is seeking permanent benefits; \nwhen the employee has suffered a specific injury and is only seeking medical benefits and temporary total disability, \nthe major-cause analysis is not applicable and the employee need only show that the compensable injury was a \nfactor in the need for additional medical treatment.” Williams v. L & W Janitorial, Inc., 85 Ark. App. 1, 145 S.W.3d 383 \n(2004).","preview":"BEFORE THE ARKANSAS WORKERS’ COMPENSATION COMMISSION CLAIM NO. H203241 SARAH L. HOOTEN, Employee CLAIMANT CENTRAL ARKANSAS NURSING CENTERS INC., Employer RESPONDENT ESIS INC., Carrier RESPONDENT OPINION FILED MARCH 2, 2023 Hearing before ADMINISTRATIVE LAW JUDGE JOSEPH C. SELF in Fort Smith, Sebastian County, Arkansas....","fetched_at":"2026-05-19T23:09:06.693Z","links":{"html":"/opinions/alj-H203241-2023-03-02","pdf":"https://labor.arkansas.gov/wp-content/uploads/HOOTEN_SARAHL_H203241_20230302.pdf","source_publisher":"https://labor.arkansas.gov/workers-comp/awcc-opinions/administrative-law-judge-opinions/"}}