{"id":"alj-H204710-2024-06-20","awcc_number":"H204710","decision_date":"2024-06-20","opinion_type":"alj","claimant_name":"Alice Lawrence","employer_name":null,"title":"LAWRENCE VS. SEARCY COUNTY JUDGEAWCC# H204710June 20, 2024","outcome":"granted","outcome_keywords":["granted:3"],"injury_keywords":["back","knee","hip","lumbar","ankle"],"pdf_url":"https://labor.arkansas.gov/wp-content/uploads/LAWRENCE_ALICE_H204710_20240620.pdf","source_index_url":"https://labor.arkansas.gov/workers-comp/awcc-opinions/administrative-law-judge-opinions/","filename":"LAWRENCE_ALICE_H204710_20240620.pdf","text_length":28139,"full_text":"BEFORE THE ARKANSAS WORKERS’ COMPENSATION COMMISSION \n   \n CLAIM NO. H204710 \n \nALICE E. LAWRENCE, Employee                                                     CLAIMANT \n \nSEARCY COUNTY JUDGE, Employer            RESPONDENT \n \nAAC RISK MANAGEMENT SERVICES, Carrier                                              RESPONDENT \n \n \n OPINION FILED JUNE 20, 2024 \n \nHearing before ADMINISTRATIVE LAW JUDGE JOSEPH C. SELF in Harrison, Boone County, \nArkansas. \n \nClaimant represented by NEAL L. HART, Attorney, Little Rock, Arkansas. \n \nRespondents represented by JASON M. RYBURN, Attorney, Little Rock, Arkansas. \n \n \n STATEMENT OF THE CASE \n  \n On October 26, 2023, the above captioned claim came on for a hearing in Harrison, Arkansas.  \nAn Order following that hearing was entered on November 30, 2023, in which respondents’ motion \nfor an independent medical examination (IME) was granted, and the remaining issues in this matter \nwere held in suspense pending the results of that examination.  Rather than continually referring to \nthe previous order, the pertinent parts of it are reproduced in this order, including the summary of the \ntestimony and the exhibits; any references to the request for an IME are deleted.  \n  A pre-hearing conference was conducted on August 3, 2023, and a pre-hearing order was filed \non that same date.  A copy of the pre-hearing order has been marked as Commission’s Exhibit #1 \nand 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 June 16, 2022. \n\nLawrence-H204710 \n2 \n \n            3.  The  compensation  rates  are  $413.00  for  temporary  total  disability  and  $310.00 for \npermanent partial disability.   \n Before testimony began at the hearing, the parties also announced two additional stipulations: \n 4.    An accident occurred on June 16, 2022, and respondents have accepted a left leg injury. \n 5.    Temporary total disability payments were paid through March 2, 2023, and there have \nbeen no temporary total disability payments since that date.  \n            At the pre-hearing conference the parties agreed to litigate the following issues: \n            1.  Compensability regarding claimant’s back injury. \n            2.  If compensable, whether claimant is entitled to medical treatment. \n            3.  Whether claimant is entitled to temporary total disability benefits. \n            4.  Attorney’s fees. \n The parties requested that the third issue be modified to read “whether claimant is entitled to \nadditional temporary total disability benefits for a back injury, a leg injury, or both.”   \n All other issues are reserved by the parties. \n The claimant contends that “She suffered a compensable injury to her left lower extremity, \nlow back, and other body parts after she was run over by a garbage truck at work. The low back was \nand  is,  at  the  very  least,  an  aggravation  of  a  preexisting  condition, and is, therefore, respondents’ \ncontinued responsibility, for medical care purposes, payment of indemnity benefits, and for any and \nall other benefits related thereto and allowed by the Act. The workers’ compensation doctor is Justin \nCutler,  D.O.,  a  Harrison orthopedic surgeon. While respondents continue to pay for Dr. Cutler’s \nmedical care, they have denied at least two of his treatment recommendations, namely a C-brace for \nclaimant’s leg and a referral to pain management for left lower extremity pain. This  constitutes \nreasonable,  necessary,  and  related  medical  care,  and  respondents  should  be  required  to  provide  it. \n\nLawrence-H204710 \n3 \n \nClaimant continues to treat with Dr. Cutler at respondent’s expense; she remains in a healing period \nand in an “off work” capacity secondary to her various injuries; at least one of her injuries is scheduled; \nand she has not returned to work. She is, therefore, entitled to an award of additional temporary total \ndisability  benefits  from  the  date  last  paid  (approximately  May  10,  2023)  through  a  date  to  be \ndetermined. Claimant’s counsel is entitled to payment of a statutory attorney’s fee on all controverted \nindemnity benefits. Claimant respectfully reserves the right to amend and/or otherwise alter the above \ncontentions as discovery progresses. All other potential issues are expressly reserved for litigation at a \nlater date including, but not necessarily limited to, anatomical impairment, permanent total disability, \nwage-loss disability, vocational rehabilitation, Section 11-9-505(a) benefits, and any other additional \nbenefit allowed by law. This is a claim for additional compensation, and claimant renews her request \nfor  an  award  of  any  and  all  benefits to which she may be entitled, under the Arkansas Workers’ \nCompensation Act.” \n The respondents contend that “The claimant’s left lower extremity was accepted, and all \nappropriate benefits have been paid. The claimant’s back condition is preexisting  and  there  is  no \nobjective evidence to support a compensable injury to the lower back. The treatment suggested by \nDr. Cutler is for the back and symptoms related to the back. The claimant’s period of disability, if \nthere is one, is related to her back which is not compensable.” \n From a review of the entire record, including medical reports, documents, and other matters \nproperly before the Commission, and having had an opportunity to hear the testimony of the claimant \nand  to  observe her demeanor,  the  following  findings  of  fact  and  conclusions  of  law  are  made  in \naccordance with A.C.A. §11-9-704: \n  FINDINGS OF FACT & CONCLUSIONS OF LAW \n \n 1.   The stipulations agreed to by the parties at a pre-hearing conference conducted on August \n\nLawrence-H204710 \n4 \n \n \n3, 2023, and contained in a pre-hearing order filed that same date are hereby accepted as fact, as are \nthe stipulations announced at the beginning of the hearing. \n 2. Claimant has met her burden of proving that she suffered a compensable injury to her left \nleg and back on June 16, 2022. \n 3. Respondent is liable for payment of all reasonable and necessary medical treatment provided \nin connection with claimant's compensable injuries. \n 4. Claimant is entitled to temporary total disability benefits beginning March 3, 2023 until a \ndate to be determined.  \n 5. Respondent has controverted claimant's entitlement to all unpaid indemnity benefits. \nFACTUAL BACKGROUND \n As set forth above, the hearing on the motion by respondents for an IME and the claimant's \ncase in chief were combined. The parties were advised that if I determined that an IME was reasonable \nand necessary, no decision would be rendered on the other issues presented. If I decided that the IME \nwas not reasonable and necessary, then a decision on those issues would be rendered.  Neither party \nobjected to this manner of handling this matter.  The Order granting the request for the IME was \nentered on November 30, 2023.  \n Following the receipt of the IME report, I sent an email inquiry to the parties and requested \nbriefs on their respective positions in light of what the IME revealed, as well as what it did not cover. \nThose briefs were excellent and very much appreciated.  That post-hearing exchange is blue backed \nto the record in this case.   \nHEARING TESTIMONY \n \n Claimant was the only witness at the hearing. She gave a detailed vocational history, including \ndescribing  the  physical  requirements  of  the  jobs  that  she  had  worked  following  her  high  school \n\nLawrence-H204710 \n5 \n \n \ngraduation in 1996. She also described the requirements of the job that she was doing with respondent, \nSearcy County, prior  to  her  accident  on  June  16,  2022.  On  June  16,  2022, she  was  performing her \nnormal job of picking up trash. She had gotten out of the F-350 truck to shut the back doors of the \ncage that is built onto the truck. While she was out of the vehicle, another truck pulled behind the one \nthat  she  had  exited  and  honked  its  horn.  The  driver  of  the  vehicle  in  which  she  was  riding  pulled \nforward, hitting her and knocking her in front of the back tire. The wheel of the tire went up on her \nleft foot. Claimant tried to roll away from the vehicle. Claimant testified that she screamed, causing \nthe driver of the vehicle to stop. At that time, the wheel was on her lower back and then the driver \nbacked down her leg again. Because she was afraid that the driver might roll over her again, she got \nout of way of the wheels of the truck. Claimant said she could not put weight on her leg. Because of \nwhere the accident took place, claimant got into the truck and returned to the main road where a call \nwas made to 911 and an ambulance came to her location and aid was administered. Claimant was then \nflown to Springfield, Missouri where she was treated and released to see her family doctor; there were \nno broken bones in her leg.  \n After seeing her family physician, Dr. Jose Abiseid, she was referred to Dr. Justin Cutler, an \northopedist in Harrison, Arkansas. Claimant’s main issue at that point was still with her leg, and she \nwas treated conservatively with medication and physical therapy. Because it is thirty-six miles from \nher  home  to  the  physical  therapist,  claimant  has  not  been  receiving  physical  therapy,  but  has  been \ndoing her exercises at home. Dr. Cutler administered an injection to her back which helped with the \npain. Dr. Cutler also sent claimant for an MRI on her back. Claimant testified that Dr. Cutler wanted \nher to be seen by a pain management specialist and to have a C-brace to improve her walking; these \nhave been denied by the respondent. Dr. Cutler had not released claimant to return to work as of the \ndate of the hearing.  \n\nLawrence-H204710 \n6 \n \n \n Claimant saw Dr. Edward Saer after having been referred by Dr. Cutler. Dr. Saer has treated \nclaimant for her back injuries in the past. Claimant believed that he was not interested in seeing her \nfor her 2022 injury. \n When asked to describe her current symptoms, claimant said she still has swelling. She cannot \nfeel her leg from her knee down and has no control over it. She stated she has numbness up to her \nhip. She has shooting pains and muscle spasms in her back, but a large part of her leg is numb and \nwithout sensation. She uses her walker constantly. She believes her symptoms are getting worse over \ntime. Claimant said she gets relief when she lies down and doesn’t do much to aggravate her condition. \nThe problem with her leg gives her problems sleeping. Claimant admitted that she had had problems \nwith her left leg associated with her prior back problems, but the surgeries alleviated the leg problems. \nShe said the problems with her leg are different now because of the numbness. \n On  cross-examination,  claimant  admitted  that  she  had  degenerative  conditions in her  back \nwhich were diagnosed as early as 2007. Claimant stated that she had been fused on her pelvis up to \nL1 (but later corrected herself to say L-4 was the top of the fusion). \n When asked to relate the events of the injury, claimant said that the bed of the truck struck \nher and pushed her off balance, causing her to fall on her right side. Her left leg was closer to the tire, \nbut she testified that her body was facing the front of the truck, directly in front of the tires, and then \nclarified that it was a dual tire truck. In order to get away from the tires, she tried to roll under the \ntruck but was pinned and could not get away from it. Claimant testified that she had tire tread marks \non  her  back  where  the  driver  stopped.  Claimant  admitted  that  she  had  no  damage  to  her  organs, \nnothing was broken and had no ligament tear. \n While in Springfield, claimant said the emergency room personnel did not focus on her back \nbecause  she  told  them  her  problems  were  with  her  left  leg.  She recognized the  diagram  of  her \n\nLawrence-H204710 \n7 \n \n \ncomplaints and agreed that she told the trauma team “Patient reports her left leg was run over by a \ndump truck. Patient denies any other injury. Isolated left leg injury.” \n Claimant stated when she began seeing Dr. Cutler, he was treating her specifically for her left \nleg issues and believed that the problem with her left leg now is related to her back. The walker she \nwas using on the day of the hearing had been prescribed to her from her surgery in 2016 or 2017. \nWhen asked about Dr. Cutler’s narrative in which he reported that she “reports accident occurring on \nJune 16, where she ended up underneath a garbage truck. Truck ran up her left leg all the way up to \nher thigh. Backed off of it.” She said that narrative was wrong. She did not know why Dr. Cutler did \nnot note that she was using a walker on July 26, 2022, because she was. \n Claimant repeated that she did not like how Dr. Saer was acting during her visits with him but \nknew of no reason why he would not want to help her or had any animosity toward her. She disagreed \nwith Dr. Saer’s opinion that her continued symptoms did not relate to her back injury. Because Dr. \nCutler did not agree with Dr. Saer’s opinion, a third opinion regarding claimant’s back was requested \nby Dr. Cutler. \n On redirect-examination, claimant clarified that she had a fusion from S1-L4, not L1. She was \naware  that  Dr.  Cutler  reviewed  the  MRI  of  her  spine  and  believed  there  was  a  large  lateral  disc \nherniation at L5-S1.  \nREVIEW OF THE EXHIBITS \n \n Claimant submitted  medical  records  of her treatment after  the  June 16, 2022, injury, while \nrespondent submitted records that predated that injury, except for an MRI performed on July 7, 2022, \nand the emergency room records from Cox Health dated June 16, 2022.   \n Claimant began with conservative care for her leg injury with Dr. Cutler on July 19, 2022. She \ndid mention in that initial visit that she was having numbness and tingling with some sharp shooting \n\nLawrence-H204710 \n8 \n \n \npains in her left thigh and left lower extremity.  The emphasis on claimant’s treatment remained with \nher left leg until after Dr. Cutler ordered an MRI and an EMG, which were performed on September \n8, 2022.  Upon seeing the results, Dr. Cutler requested an MRI on her lumbar spine.   \n On October 3, 2022, an MRI was performed at North Arkansas Regional Medical Center.  \nThe impression was:  \n1. Indeterminate intermediate intensity signal material within the left lateral recess \nat  L5/S1  contacting  and  possibly  encasing  the  traversing  left  S1  nerve  root. \nUnable to exclude scar tissue given the prior surgery. Correlate with any left S1 \nradicular symptoms. \n2. Prior  decompression  and  interbody/posterior  fusions  at  L4/L5  and  an  L5/S1. \nMild  adjacent  segment  disease  at  L3/L4  with  grade  1  retrolisthesis  and  mild \nbulging of the disk.  No narrowing at L3/L4.  \n \n Because she had been previously treated by Dr. Saer for back issues—including performing \ntwo spinal surgeries—Dr. Cutler referred claimant to see him again.  She was examined by Dr. Saer \non October 25, 2022, who recorded in his assessment:  \n“She does not have a definite bony injury in her lumbar spine and there is no \ndefinite  nerve  root  compression.  She  certainly  could  have  an  injury  to  the \nperoneal  nerve  or  a  neuropraxia  to  the  femoral  nerve  or  perhaps  even  the \nlumbar  plexus.    I  do  not  see  anything  in  her  spine  now  that  looks  like  she \nneeds further treatment. Continuing therapy is probably her best bet.” \n \n Claimant returned to Dr. Cutler on November 9, 2022, and expressed her dissatisfaction with \nDr. Saer, reporting that Dr. Saer asked her repeatedly about an EMG when she had already told him \nthat she had one.  Dr. Cutler still believed that the EMG and MRI of the lumbar spine are consistent \nwith  new  herniations  from  her  injury.      He  suggested  a  second  spine evaluation  and  performed  an \ninjection into claimant’s left LI joint.   \n Instead of seeing a different neurosurgeon, the next record was another EMG ordered by Dr. \nSaer, this time performed at Ortho Arkansas in Little Rock on December 15, 2022.  The impressions \nfrom this test were:  \n\nLawrence-H204710 \n9 \n \n \n            1.    Abnormal electrodiagnostic study. \n2.  There is electrodiagnostic evidence suggestive of a non-localizable left peroneal \nneuropathy  with  no  focal  slowing  seen  at  the  fibular  head  and  no  active \ndenervation in any peroneal and elevated muscles tested.  In addition, there were \ninconsistencies  seen  between  functional  and  volitional  activity  throughout  the \nstudy  as  patient  seen  doing  activities  such  as  ambulating,  able  to  get  onto  exam \ntable on own accord, rotate on table, extend and flex legs, but volitional activity \nwas minimally seen.  \n3. There  is  no  electrodiagnostic  evidence  of  any  other  focal  nerve  entrapment, \ngeneralized peripheral neuropathy or left lumbar radiculopathy. \n4. Of  note,  EMG  is  not  a  completely  sensitive  study,  and  does  not  evaluate  small \nsensory  pain  fibers.  Thus,  lack  of  active  denervation  on  today's  study  does  not \nexclude  an  active  radiculopathy.  Clinical  correlation  is  needed  to  determine  the \nsignificance of today's electrodiagnostic examination findings. \n \n Dr. Saer reviewed the results of the EMG on December 16, 2022, and again reassured claimant \nthat he saw nothing for which she needed surgery. \n Claimant returned to Dr. Cutler on December 28, 2022; his notes from that date through his \nAugust 16, 2023, office visit repeatedly included a recommendation that claimant be seen by another \nspecialist.  That final visit concluded with the following impression/plan:  \n“Patient is status post being run over by a dump truck with complete loss of \nfunction in the left lower extremity. Is being reported from workers comp that \nshe  had  a  previous  low  back  injury  with  a  nerve  root  impingement.  This  is \nnothing like that type of injury. This is a completely additional ordeal. Patient \nhas no functional use of her left lower extremity. Patient requires substantial \namount  of  assistance  and  cannot  drive  or  even  ambulate  without significant \nhelp.  Patient  would  greatly  benefit  from  a  C brace  to  help  control  her  hip, \nknee, and ankle motions. This will allow her to have more independence with \nactivities of daily living. Even where patient did have a documented previous \nback injury for many years ago, this is an injury that has more than aggravated \nthose problems. In reality, this is a completely new injury causing severe nerve \nfunction dysfunction to her entire left lower extremity.” \n \n An independent medical examination was conducted on December 28, 2023, by Dr. Chelsea \nMatthews, an orthopedic surgeon at UAMS Health Orthopedic and Spine Clinic in North Little \nRock Arkansas.  Dr. Matthews recorded the following under the physical exam section of the report: \n \n\nLawrence-H204710 \n10 \n \n \nMusculoskeletal inspection: examination   of   the   left   lower   extremity \ndemonstrates some atrophy of the subcutaneous fat on the medial aspect of \nthe calf. There is no evidence of this laterally. When resting she maintains the \nfoot in an equinovarus position. There does appear to be some spasm in the \ntibialis anterior. I made a  full to passively reduce to neutral. She exhibits no \nvoluntary motor function in eversion or dorsiflexion.  2/5 in plantar flexion. \nShe  reports  diminished  sensation  throughout  the  entirety  of  the  lower \nextremity.  Does  not  follow  a  distinct  anatomic  distribution. When standing, \nher  foot  naturally  rests on  the  lateral  aspect  of  the  mid  and  forefoot.  When \nambulating this foot drags. The tibialis anterior tendon does appear to be firing \nwhen performing this. She is able to passively correct the foot and maintained \nits position on the ground, however when she lifts the foot it begins to drag \nunderneath her again. Regards to more proximal exam, she is able to perform \nquad extension 2+ out of 5.  \n \n Dr. Matthews ordered an MR enterography “in order to better assess the level of nerve \ninjury and determine if there is still pathology in this area. After the MR enterography I feel we will \nhave the best answer as to whether her foot drop and symptoms are related to the crush injury or to \nher spine pathology.”  \n Dr. Matthews saw claimant again on January 25, 2024 and reviewed the MR enterography of \nclaimant’s left lower extremity.   After reviewing this information with claimant, Dr. Matthews \nrecorded this plan:  \nThere is no radiographic evidence of damage to the nerve at the area of her \nleg crush injury. She does report to me today the vehicle ran over her leg as \nhigh  up  as  her thigh which was  unclear  to  me  prior  to  date  today's  visit. \nNonetheless,  I  do  not  see  any  evidence  of  peroneal  nerve  damage  or \ncompartment damage to the leg to explain her foot contracture and spasticity. \nThis  may  be  explained  by  a  double  hit  phenomenon  to  the  nerve  war \napproximately. This is outside my realm of expertise as a foot ankle orthopedic \nsurgeon.  If  she  would  like  a  more  clear  answer,  she  may  seek  independent \nexamination by someone who specializes in spine and hip pathology.  \nBased on her clinical examination, I do not feel she is capable of carrying out \nwork duties including working a truck. She would be unable to ambulate any \nlong distance over 10 feet. She will be unable to climb ladders, stairs, squat or \ncarry any weighted objects.  \n \n \n \n \n\nLawrence-H204710 \n11 \n \n \nADJUDICATION \n \nBoiled down to its simplest elements, the issue to be decided in this case is whether claimant \ncan prove by a preponderance of the evidence that her foot drop is a result of injuries received when \na truck ran over her left leg on June 16, 2022, during the course of her employment.  In order to prove \na  compensable  injury  as  the  result  of    a  specific  incident  that  is  identifiable  by  time  and  place  of \noccurrence, a claimant must establish by a preponderance of the evidence (1) an injury arising out of \nand in the course of employment; (2) the injury caused internal or external harm to the body which \nrequired medical services or resulted in disability or death; (3) medical evidence supported by objective \nfindings establishing an injury; and (4) the injury was caused by a specific incident identifiable by time \nand  place  of  occurrence. Odd  Jobs  and  More  v.  Reid,  2011  Ark.  App.  450,  384  S.W.  3d  630.  The \n\"preponderance of the evidence\" standard means the evidence having greater weight or convincing \nforce. Barre v. Hoffman, 2009 Ark. 373, 326 S.W.3d 415.  \nThe parties stipulated that claimant met the criteria for a compensable injury as far as it related \nto the left leg injury. Thus, it was established there was a specific injury arising out of and in the course \nof  employment  which  caused  physical  harm  that  required  medical  services  and was  supported  by \nmedical  evidence,  and  respondents  accepted  the  claim  for  the  injury  to  the  left  leg.  However, \nrespondents deny that there is objective evidence of a back injury as a result of this incident, and thus \nhave controverted this claim as it relates to a back injury.  \nIn its posttrial brief, respondents took the position that “footdrop is not an objective finding \nbecause it can be controlled by the claimant.”  The Commission has cited reports from physicians that \nsuch a diagnosis is an objective finding (for example, see Copeland v. Ark. Dept. of Corrections  2019 AR \nWrk.  Comp.  LEXIS  33, White  v.  Lonnie  Crowell  Masonry,  Inc.  2017  AR  Wrk. Comp.  LEXIS  617  and \nWebber v. Scott Equipment, 2018 AR Wrk. Comp. LEXIS 54).  Further, while a perfectly healthy person \n\nLawrence-H204710 \n12 \n \n \nmight be able replicate some of the conditions observed by all the physicians that have seen her, Dr. \nCutler and Dr. Matthews noted objective findings following their examinations of claimant.  None of \nthese skilled physicians have suggested that claimant does not have an actual foot drop.  I am therefore \nsatisfied that the diagnosis of foot drop is an objective finding in this matter.  \nThe testimony  in  this  case  was  solely  that  of claimant,  and  I  found  her  to  be  credible. “A \nclaimant's  testimony  is  never  viewed  as  uncontroverted,  but  the  Commission  need  not  reject  the \nclaimant's testimony if it finds that testimony worthy of belief. Ringier America v. Combs, 41 Ark. App. \n47,  849  S.W.2d  1  (1993).  Respondents  pointed  out  that  claimant has  changed  her account  of  the \nevents during the injury, first saying to her physicians that the truck only ran over her calf or thigh, \nbut testified in deposition and at the hearing that it came up as high as her lower back.  While curious,  \nI do not find that to be as significant as respondents urge; whether the wheel that ran over her stopped \nat her calf, thigh or low back is of no significance to me in deciding this matter.    \nWhat  is  significant  is  that  claimant  was  working  without  restrictions  on  June  16,  2022,  and \nsince  she  was struck  by  the  truck,  has  not  been  able  to  work  since  that  date.    Dr.  Cutler  and  Dr. \nMatthews agree on that point; Dr. Saer did not offer an opinion as to her ability to work.\n1\n Further, \nwhile the IME by Dr. Matthews did not directly answer the question regarding a back injury presented \nin this case, she told us that claimant’s problem was either related to the crush injury or to her spine \npathology\n2\n--  then ruled out the leg injury as the source of claimant’s foot drop.  Eliminating the one \nnecessarily includes the other.  This is consistent with what Dr. Cutler has said—claimant’s foot drop \nis caused by an injury to her spine that was not present before the accident.  Therefore, I find claimant \n \n1\n While Dr. Saer did not specifically opine as to claimant’s ability to return to work, his report of December 15, 2022 \nincluded an “Oswestry Disability Index” score of 70, which indicates complete disability. It is not clear if this is based \non  objective  findings  or  subjective  reports  from  claimant. (This  was  not  included  in  my  opinion  of  November  30, \n2023, and is noted here rather than inserted into the previous review of the medical records.)  \n2\n See https://www.mayoclinic.org/diseases-conditions/foot-drop/symptoms-causes/syc-20372628, where there are \nthree groups of causes for foot drop, but only the first of these is relevant to claimant’s condition. \n\nLawrence-H204710 \n13 \n \n \nhas met her burden of proof that her current condition was caused by a back injury she suffered as \nthe result  of  a  specific injury  on  June  16,  2022.  As  such,  I  find  she  is  entitled  to  temporary  total \ndisability payments from March 3, 2023 to a date to be determined.  Claimant is entitled to medical \ncare as directed by Dr. Cutler, including referrals to specialists as he deems necessary to treat claimant’s \ncompensable back injury.  \nORDER \nRespondents  are  directed  to  pay  benefits  in  accordance  with  the  findings  of  fact  set  forth \nherein this Opinion. \nAll accrued sums shall be paid in lump sum without discount, and this award shall earn interest \nat the legal rate until paid, pursuant to Ark. Code Ann. § 11-9-809. \nPursuant to Ark. Code Ann. § 11-9-715, the claimant's attorney is entitled to a 25% attorney's \nfee on the indemnity benefits awarded herein. This fee is to be paid one-half by the carrier and one-\nhalf by the claimant. \nAll issues not addressed herein are expressly reserved under the Act. \n IT IS SO ORDERED. \n                                                                                            \n_______     \n JOSEPH C. SELF \nADMINISTRATIVE LAW JUDGE","preview":"BEFORE THE ARKANSAS WORKERS’ COMPENSATION COMMISSION CLAIM NO. H204710 ALICE E. LAWRENCE, Employee CLAIMANT SEARCY COUNTY JUDGE, Employer RESPONDENT AAC RISK MANAGEMENT SERVICES, Carrier RESPONDENT OPINION FILED JUNE 20, 2024 Hearing before ADMINISTRATIVE LAW JUDGE JOSEPH C. SELF in Harrison, Boone County, Arkansas. Cl...","fetched_at":"2026-05-19T22:53:03.039Z","links":{"html":"/opinions/alj-H204710-2024-06-20","pdf":"https://labor.arkansas.gov/wp-content/uploads/LAWRENCE_ALICE_H204710_20240620.pdf","source_publisher":"https://labor.arkansas.gov/workers-comp/awcc-opinions/administrative-law-judge-opinions/"}}