{"id":"alj-H206753-2023-03-13","awcc_number":"H206753","decision_date":"2023-03-13","opinion_type":"alj","claimant_name":"Daniela Grana","employer_name":"Rockline Industries, Inc","title":"GRANA VS. ROCKLINE INDUSTRIES, INC. AWCC# H206753 MARCH 13, 2023","outcome":"denied","outcome_keywords":["dismissed:1","denied:3"],"injury_keywords":["wrist","shoulder","repetitive","carpal tunnel"],"pdf_url":"https://labor.arkansas.gov/wp-content/uploads/GRANA_DANIELA_H206753_20230313.pdf","source_index_url":"https://labor.arkansas.gov/workers-comp/awcc-opinions/administrative-law-judge-opinions/","filename":"GRANA_DANIELA_H206753_20230313.pdf","text_length":18561,"full_text":"BEFORE THE ARKANSAS WORKERS’ COMPENSATION COMMISSION \n   \n CLAIM NO.  H206753 \n \nDANIELA GRANA, Employee                                                                         CLAIMANT \n \nROCKLINE INDUSTRIES, INC., Employer                                              RESPONDENT                          \n \nCNA INSURANCE COMPANY, Carrier                                                    RESPONDENT                        \n \n \n OPINION FILED MARCH 13, 2023 \n \nHearing before ADMINISTRATIVE LAW JUDGE GREGORY K. STEWART in Springdale, \nWashington County, Arkansas. \n \nClaimant represented by EVELYN E. BROOKS, Attorney, Fayetteville, Arkansas. \n \nRespondents represented by KAREN H. MCKINNEY, Attorney, Little Rock, Arkansas. \n \n \n STATEMENT OF THE CASE \n  \n On  February  15,  2023,  the  above  captioned  claim  came  on  for  hearing  at \nSpringdale, Arkansas.  A pre-hearing conference was conducted on November 2, 2022 \nand a pre-hearing order was filed on that same date.  A copy of the pre-hearing order has \nbeen marked as Commission’s Exhibit #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 the \nwithin claim. \n 2.   The employee/employer/carrier relationship existed among the parties on April \n6, 2022. \n At the time of the hearing the parties  agreed to stipulate that claimant earned an \naverage weekly wage of $529.94 which would entitle her to compensation at the weekly \n\nGrana – H206753 \n \n2 \n \nrates of $353.00 for total disability benefits and $265.00 for permanent partial disability \nbenefits. \n At the pre-hearing conference the parties agreed to litigate the following issues: \n1.    Compensability of bilateral injuries to hands and wrists. \n2.     Medical. \n3.     Temporary total disability benefits from May 26, 2022 through a date yet to  \nbe determined. \n4.      Attorney fee. \nAt  the time of the hearing the claimant clarified that she is  requesting temporary  \ntotal  disability  benefits  from  May  26,  2022  through  the  date  she  returned to  work  for \nrespondent. \n The claimant contends she sustained a compensable injury to her bilateral hands \nand  wrists.    She  contends  she  is  entitled  to  medical  treatment  and  temporary  total \ndisability  benefits  from  May  26,  2022  through  the  date  she  returned  to  work.  Claimant \nreserves all other issues. \n The respondents contend that the claimant did not sustain a compensable injury.  \nAfter  seeking  treatment  for  bilateral  wrist  pain  and  undergoing  conservative  treatment, \nDr. Berestnev opined in his May 27, 2022 report that the claimant has elevated ESR and \nanti-ANA  titer  suggestive  of  Lupus  and  that  her  current  wrist  complaints  are  not  work \nrelated but the result of her underlying pre-existing condition. \n From a review of the record as a whole, to include medical reports, documents, \nand other matters properly before the Commission, and having had an opportunity to hear \nthe testimony of the witnesses and to observe their demeanor, the following findings of \n\nGrana – H206753 \n \n3 \n \nfact and conclusions of law are made in accordance with A.C.A. §11-9-704: \n \n  FINDINGS OF FACT & CONCLUSIONS OF LAW \n \n 1.   The stipulations agreed to by the parties at a pre-hearing conference conducted \non November  2,  2022  and  contained  in  a  pre-hearing  order  filed  that  same  date  are \nhereby accepted as fact. \n 2.    Claimant has failed to meet her burden of proving by a preponderance of the \nevidence that she suffered a compensable injury to her bilateral hands and wrists. \n \n FACTUAL BACKGROUND \n Claimant is a 27-year-old woman who began working for respondent in 2019 as \nan auxiliary machine operator.  Claimant testified that her job required her to rotate her \njob activities every 30 minutes.  She described those various activities as follows: \n  Q And you have been instructed if someone’s not - - \n  if you need to move and there is no one else to come and \n  get you, you have been instructed you are not supposed to \n  work more than 30 minutes doing this job; right? \n \n  A Right. \n \n  Q So part of the job you said - - are these baby wipes? \n \n  A Facial. \n \n  Q Facial wipes? \n \n  A Facial wipes. \n \n  Q Okay.  And they come down in little five by five \n  packets individually and they come down.  You get two \n  of them.  Then you have to move them over to another \n  line to get labeled. \n \n  A Yes. \n\nGrana – H206753 \n \n4 \n \n \n  Q And you do that for 30 minutes; right? \n \n  A Yes. \n \n  Q And then you move on to the next place where \n  you take the facial wipe packets and you put them in a \n  box; right? \n \n  A Right. \n \n  Q And that is more shoulder movement; isn’t it? \n \n  A That is the shoulder, but before you get to the \n  shoulder part, you have to set two of them side by side \n  and the next person grabs them and flips both of the \n  packages together.  And then the third person basically \n  like - - I want to say fixes them so they won’t fall off the \n  line and then  you go put them in the box. \n \n  Q Okay.  So there is three people that are handling \n  the packs; right? \n \n  A Yes. \n \n  Q And you only can do that, what you are doing, for \n  30 minutes at a time; right? \n \n  A Right. \n \n  Q And the only job that you are indicating that you \n  are really - - you are putting them together, so that seems \n  like arm movement; right?  A full arm movement and not  \n  a wrist movement? \n \n  A It would be a wrist movement because you have to \n  set them together. \n \n  Q Okay.  So you are setting them together? \n \n  A Because it comes flat out and you have to set them \n  up straight. \n \n  Q Then someone else has to take them and turn them \n  over? \n\nGrana – H206753 \n \n5 \n \n \n  A Right. \n \n  Q Again, only 30 minutes; correct? \n \n  A Correct. \n \n  Q And then someone else moves them into the box? \n \n  A Correct. \n \n  Q That is arm movement; right? \n \n  A  Right. \n \n  Q And then you have to palletize them? \n \n  A Right. \n \n  Q And once they are in the box, you have to get them \n  to the pallet? \n \nA Right.  Yes. \n \n \n Claimant  also  testified  that  if  the  machine  gets  jammed  they  must  open  the \nmachine and remove the jam to get the machine working again.  Claimant testified that \nbeginning in April 2022 she developed pain, numbness, and loss of strength in her wrist.  \nShe stated that she reported these symptoms to her supervisor but he dismissed them. \n Medical records indicate that on April 11, 2022 claimant sought medical treatment \nat respondent’s first aid station where she was treated with ice.  The records indicate that \nclaimant  received  treatment  in  the  form  of  ice  on  several  occasions  from  the  first  aid \nstation.  According to claimant’s testimony, the first medical treatment she received for \nher wrist was from a chiropractor who “popped” her wrists.  Those medical records were \nnot submitted into evidence. \n\nGrana – H206753 \n \n6 \n \n When  claimant’s  complaints  continued,  respondent  referred  claimant  to  Dr. \nBerestnev for an evaluation.  His initial evaluation was on April 20, 2022, at which time \nhe noted that claimant had been having pain in her right wrist since April 6, but did not \nreport it until April 11 and that she had been seeing a chiropractor for those complaints.  \nHe noted that claimant attributed her complaints to turning over packages and gradually \ndeveloping pain in her right wrist.   Dr. Berestnev diagnosed claimant’s condition as right \nwrist extensor tendinitis; repetitive use disorder.  He recommended that claimant’s work \nplace  be  modified  and  prescribed  a  lace-up  wrist  support.    He  also  indicated  that  her \nproblems appeared to be related to her work activities.   \n Claimant  returned  to  Dr.  Berestnev  on  April  27,  at  which  time  he  noted  that \nclaimant’s right wrist was about the same and that her left wrist was starting to hurt due \nto overcompensating.  He referred claimant to physical therapy and she apparently had \nsix sessions of physical therapy before returning to Dr. Berestnev on May 18.  At that visit \nDr. Berestnev noted that claimant had signs of medial neuropathy and ordered an NCV \nand CT panel.  \n Claimant’s last visit with Dr. Berestnev occurred on May 18, 2022.  At that time he \nindicated that claimant’s lab work showed elevated ESR and anti-ANA titer suggestive of \nlupus.    Dr.  Berestnev  stated  that  claimant  should  see  her  primary  care  physician  and \nindicated that the cause of claimant’s complaints did not appear to be related to her work \nactivities. \n On May 31, claimant was seen by Rachel Hudman, APN, who noted:  “She reports \nhistory of bilateral wrist pain for the past 1 year.”   Hudman diagnosed claimant with \nbilateral wrist pain; gave her trial steroid for pain; and took her off work until claimant could \n\nGrana – H206753 \n \n7 \n \nbe seen by her primary care physician.  Hudman also referred claimant to rheumatology \nfor a further evaluation. \n On  June  13,  2022,  claimant  was  evaluated  by  her  primary  care  physician,  Dr. \nHurtado.  He noted that claimant’s anti-nuclear  factor  was  positive,  but  that  she  had  a \nnegative  CRP  and  CCP.    He  also  noted  that  claimant  had  a  pending  rheumatology \nappointment.  With regard to her bilateral wrists, Dr. Hurtado referred claimant for a nerve \nconduction study/EMG. \n Claimant underwent NCV/EMG testing from Dr. Miles Johnson on June 23, 2022, \nwhich   he   interpreted   as   showing   mild   bilateral   carpal   tunnel   syndrome   with   no \nelectrodiagnostic   evidence   of   radiculopathy,   plexopathy,   generalized   peripheral \nneuropathy  or  other  peripheral  nerve  entrapment  syndromes.    Following  this  testing, \nclaimant  returned  to  Dr.  Hurtado  on  June  24,  who  referred  her  to  Dr.  Mark  Allard, \northopedic surgeon, for treatment. \n Claimant was evaluated by Dr. Allard on July 7, 2022, and he diagnosed claimant \nwith bilateral carpal tunnel syndrome, prescribed therapy, and the use of a splint.  When \nclaimant’s condition did not improve he gave her an injection in the wrist on August 11 \nand on August 24, 2022 performed a right hand carpal tunnel release procedure. \n Prior to the surgery by Dr. Allard,  claimant was evaluated by Dr. Song who in a \nreport  dated  August  16,  2022  assessed  her  as  ANA  positive  but  noted  that  she  was \nclinically not typical for lupus. \n Following her surgery, claimant was released to return to work by Dr. Allard without \nrestrictions on September 21, 2022.  Claimant did return to work for respondent and had \nincreased pain.  Thereafter, Dr. Allard ordered twelve visits of occupational therapy before \n\nGrana – H206753 \n \n8 \n \nreleasing claimant with no restrictions as of November 17, 2022. \n Claimant has filed this claim contending that she suffered a compensable injury to \nher  bilateral  hands  and  wrists  as  a  result  of  her  employment  with  respondent.    She \nrequests   payment   of   medical   benefits,   temporary   total   disability   benefits,   and   a \ncontroverted attorney fee. \n \nADJUDICATION \n Claimant  contends  that  she  has  suffered  a  compensable  injury  to  her  bilateral \nhands and wrists in the form of carpal tunnel syndrome.   In Kildow v.  Baldwin Piano & \nOrgan, 333 Ark. 335, 969 S.W. 2d 190 (1998), the Supreme Court recognized that carpal \ntunnel syndrome constitutes a gradual onset injury.  Therefore, claimant is not required \nto prove that her injury was caused by rapid repetitive motion.  However, claimant must \nstill prove (1) that her bilateral carpal tunnel syndrome arose out of and in the course of \nher employment; (2) her injury caused internal or external physical harm to her body that \nrequired medical services or resulted in disability; and (3) the injury was the major cause \nof  the  disability  or  need  for  treatment.    A.C.A.  §11-9-102(4)(A)(ii)(E)(ii).   In  addition, \nclaimant  must  offer  medical  evidence  supported  by  objective  findings  establishing her \ninjury.  A.C.A. §11-9-102(4)(D).   \n After reviewing the evidence in this case impartially, without giving the benefit of \nthe doubt to either party, I find that claimant has failed to meet her burden of proving by \na preponderance of the evidence that her bilateral carpal tunnel syndrome arose  out of \nand in the course of her employment with the respondent. \n There is no question that in April 2022 claimant reported complaints of right hand \n\nGrana – H206753 \n \n9 \n \nand wrist pain to the respondent and that she sought medical treatment at the first aid \nstation.    In  addition,  claimant  was  seen  by  Dr.  Berestnev  who  initially  indicated  that \nclaimant’s symptoms were related to her employment activities before indicating that her \nsymptoms  were  not  related  to  her  work  activities  following  additional  testing.    Notably, \nRachel Hudman, APN, indicated that claimant had a history of bilateral wrist pain “for the \npast 1 year.”  Finally, Dr. Allard in his initial report of July 7, 2022 indicated: \n  26-year-old right-hand-dominant young lady works at \n  a repetitive manufacturing job comes in with a three- \n  month history of bilateral radial hand numbness and \n  pain. \n \n \n All of the foregoing evidence would indicate that claimant suffered a compensable \ninjury as a result of her job activities with respondent.  However, the reality is that at the \nsame time claimant was working at respondent she was also working for other employers.  \nAt the time her complaints began she was not only working for another employer but had \nalso started a business of her own as well. \n Claimant began working for respondent in 2019 as an auxiliary machine operator \nand she has performed this job since that time.  Claimant testified that for respondent she \nworked three days one week and then four the next.  Her shift was for 12 hours with three \nbreaks.  Claimant’s job required her to rotate among various job activities as an auxiliary \nmachine operator every  30  minutes.    Claimant  performed  that  job  for  the  remainder  of \n2019; 2020; 2021; and the first three months of 2022 without any carpal tunnel symptoms.  \nHer problems did not begin until April 2022. \n At the same time claimant was working for respondent she was also performing \nwork for other employers which required the use of her hands.  These jobs included office \n\nGrana – H206753 \n \n10 \n \nwork at Lindsey Management; C & W Properties; and Staffmark.  In the performance of \nthis office work she operated a computer and performed 10-key input.  In addition, she \nalso  worked  for  Tyson  as  a  machine  operator  and  at  Walmart  Optical  monitoring \nmachinery.   \n Notably,  in  December  2021,  just  five  months  before  April  2022,  claimant  began \nworking for Famous Footwear as a manager.  Claimant testified that as a manager she \nwas  responsible  for  running  the  cash  register,  operating  a  computer,  counting  money, \nand monitoring other employees.  Claimant performed this work for 20 hours per week \nand was performing this work in April 2022 at the same time her hand complaints began.  \nClaimant continued performing this work at Famous Footwear until May 2022, after she \nsought medical treatment for her hand and wrist complaints.   \n In  addition  to  her  jobs  at  respondent  and  as  a  manager  for  Famous  Footwear, \nclaimant also started her own business, MB Creations.  MB Creations was crafting type \nwork  in  which  claimant  would  personalize  items  such  as  t-shirts  and  cups.    Claimant \nbegan this business in early 2022, shortly before her complaints began.  Claimant testified \nthat she would spend one to two hours per week performing this work.   \n Thus,  while  claimant  did  have  a  job  at  respondent  that  required  the  use of  her \nhands, she had been performing that job for more than two years without any complaints \nof hand or wrist pain.  When her complaints began she was also performing work involving \nthe use of her hands as a manager at Famous Footwear (beginning in December 2021) \nand in her own crafting business (beginning in early 2022).  Given this evidence, I do not \nfind that claimant has met her burden of proving by a preponderance of the evidence that \nher  carpal  tunnel  syndrome  arose  out  of  and  in  the  course  of  her  employment  with \n\nGrana – H206753 \n \n11 \n \nrespondent  as  opposed  to  her  employment  at  Famous  Footwear  or  the  work  she  was \nperforming for her own business, MB Creations.  To the extent that her treating physicians \nrelate her carpal tunnel complaints to her job activities with respondent, I note that there \nis no indication that any of those physicians were aware of the other jobs claimant was \nalso performing involving the use of her hands while she was working for respondent. \n In  summary,  claimant  has  the  burden  of  proving  by  a  preponderance  of  the \nevidence that her bilateral carpal tunnel syndrome arose out of and in the course of her \nemployment with respondent.  While claimant’s job with the respondent did require the \nuse of her hands, at the same time claimant was working for the respondent she was also \nemployed  by  other  employers  performing  jobs  which  required  the  use  of her  hands.  \nClaimant performed her work for respondent for more than two years without any carpal \ntunnel complaints.  When claimant’s problems began in April 2022 she was also working \n20  hours  per  week  as  the  manager  of  Famous  Footwear  and  was  performing  crafting \nwork for her own business which she had begun in early 2022.  For these reasons, I find \nthat claimant has failed to meet her burden of proving by a preponderance of the evidence \nthat her bilateral carpal tunnel syndrome arose out of and in the course of her employment \nwith respondent. \n \nORDER \n Claimant has failed to prove by a preponderance of the evidence that she suffered \na compensable injury in the form of bilateral carpal tunnel syndrome while employed by \nrespondent.    Therefore,  her  claim  for  compensation  benefits  is  hereby  denied  and \ndismissed. \n\nGrana – H206753 \n \n12 \n \n Respondents are liable for payment of the court reporter’s charges for preparation \nof the hearing transcript in the amount of $579.95. \n IT IS SO ORDERED. \n \n     _______________________________________ \n      GREGORY K. STEWART \n      ADMINISTRATIVE LAW JUDGE","preview":"BEFORE THE ARKANSAS WORKERS’ COMPENSATION COMMISSION CLAIM NO. H206753 DANIELA GRANA, Employee CLAIMANT ROCKLINE INDUSTRIES, INC., Employer RESPONDENT CNA INSURANCE COMPANY, Carrier RESPONDENT OPINION FILED MARCH 13, 2023 Hearing before ADMINISTRATIVE LAW JUDGE GREGORY K. STEWART in Springdale, Washington County, Arkan...","fetched_at":"2026-05-19T23:09:21.636Z","links":{"html":"/opinions/alj-H206753-2023-03-13","pdf":"https://labor.arkansas.gov/wp-content/uploads/GRANA_DANIELA_H206753_20230313.pdf","source_publisher":"https://labor.arkansas.gov/workers-comp/awcc-opinions/administrative-law-judge-opinions/"}}