{"id":"alj-H208285-2024-10-02","awcc_number":"H208285","decision_date":"2024-10-02","opinion_type":"alj","claimant_name":"Teresa Wright","employer_name":"Lowes Home Centers LLC","title":"WRIGHT VS. LOWES HOME CENTERS LLC AWCC# H208285 October 02, 2024","outcome":"unknown","outcome_keywords":[],"injury_keywords":["shoulder","neck","back","cervical","strain","thoracic","sprain","fracture"],"pdf_url":"https://labor.arkansas.gov/wp-content/uploads/Wright_Teresa_H208285_20241002.pdf","source_index_url":"https://labor.arkansas.gov/workers-comp/awcc-opinions/administrative-law-judge-opinions/","filename":"Wright_Teresa_H208285_20241002.pdf","text_length":20256,"full_text":"BEFORE THE ARKANSAS WORKERS’ COMPENSATION COMMISSION \nWCC NO. H208285 \n \nTERESA A. WRIGHT, EMPLOYEE CLAIMANT \n \nLOWES HOME CENTERS LLC, \nSELF-INSURED EMPLOYER RESPONDENT \n \nSEDGWICK CLAIMS MANAGEMENT, \nTHIRD-PARTY ADMINISTRATOR RESPONDENT \n \nOPINION FILED OCTOBER 2, 2024 \n \nHearing  before  Administrative  Law  Judge,  Steven  Porch,  on August 27,  2024,  in  Little  Rock, \nArkansas. \n \nClaimant was represented by Mr. Mark Alan Peoples, Attorney at Law, Little Rock, Arkansas. \n \nRespondents were represented by Mr. Randy P. Murphy, Attorney at Law, Little Rock, Arkansas. \n \nSTATEMENT OF THE CASE \n \n A  full  hearing  was  held  on  this  claim  on August 27,  2024.    A  prehearing  telephone \nconference  took  place  on April  10,  2024.  A  prehearing  order  was  entered  on  that  date  and \nsubsequently  entered  into  evidence,  with  amendments  by  the  parties,  as Commission  Exhibit  1. \nThe parties’ stipulations are set forth. \nSTIPULATIONS \n By agreement of the parties, the stipulations applicable to this claim are as follows: \n1. The Arkansas Workers’ Compensation Commission has jurisdiction of the \nwithin claim. \n \n2. The employer/employee/carrier  relationship  existed  among  the  parties  on \nSeptember 20, 2022, when Claimant sustained compensable injuries to her \nright shoulder, arm, elbow, neck and back. \n \n \n \n \n \n \n\nWRIGHT H208285 \n \n \n2 \n \n \nISSUES \n The parties have identified the following issues to be adjudicated: \n1. Whether Claimant is entitled to additional reasonable and necessary medical treatment, \nspecifically a cervical anterior fusion for the C5-C6-C7.\n1\n \n \nAll other issues are reserved. \n \nCONTENTIONS \n \nClaimant’s Contentions:  The  Claimant  contends  that she sustained work  injuries to  her \nright shoulder, right arm, right elbow, neck, and back on September 20, 2022. That she is entitled \nto medical treatment, temporary partial disability benefits due to work hours being reduced, and a \ncontroverted attorney’s fee at maximum statutory rate.  \nRespondents’ Contentions: Respondents  contend that  Claimant  has  received  appropriate \nbenefits for the compensable injury.  \nFINDINGS OF FACT AND CONCLUSIONS OF LAW \n Therefore, after a thorough consideration of the facts, issues, the applicable law, and the \nevidentiary record, I hereby make the following Findings of Fact and Conclusions of Law in accordance \nwith Ark. Code Ann. § 11-9-704 (Repl. 2012):   \n1. The Arkansas Workers’ Compensation Commission has jurisdiction over this claim. \n \n2. The stipulations set forth above are reasonable and are hereby accepted. \n \n3. The Claimant has proven, and I find by the preponderance of the evidence that Claimant \nhas proven that a cervical anterior fusion for her C5-C6, not her C6-C7, is reasonable \nand necessary medical treatment for her compensable neck injury. \n \n \n \n \n1\n The issues of temporary total disability benefits and controverted attorney’s fee has \nbeen reserved by the Claimant during the hearing. The Claimant also specified what medical \ntreatment is being sought, a cervical anterior fusion for the C5-C6-C7. \n\nWRIGHT H208285 \n \n \n3 \n \n \nCASE IN CHIEF \nSummary of Evidence \n The record is made up of Claimant’s Exhibit 1, Medical Records, that consists of 51 pages, \nRespondents’ Exhibit 1, medical  records,  that  consist  of 1383 pages\n2\n, Respondents’ Exhibit 2, \nvideo of Claimant, and Commission Exhibit 1, Pre-Hearing Order, that consists of 5 pages. Forms \nAR-C and AR-1 blue-backed and made a part of this record. The Claimant was the only witness \ntestifying in the full hearing.  \nClaimant  was employed  as a Merchandiser/Stocker for  the  Respondent/Employer. On \nSeptember 20, 2022, Claimant was moving a metal beam that supports top stock items from one \narea to another with a co-worker. While ascending a ladder, approximately 15 feet high, to hang a \nsupport  beam  with  the  co-worker,  the  co-worker,  unbeknownst  to  Claimant, dropped  the  beam \ncausing the full weight of the 75-to-100-pound metal beam to pull down, in a jerking manner, on \nthe right arm, shoulder, and neck of the Claimant. Due to the tearing in Claimant’s right arm and \nshoulder, her fingers would not let go of the beam causing continuous strain on her arm, shoulder, \nand neck. The Claimant needed assistance to release her fingers from the metal beam. Trans. p. \n18,  lines  7-25,  to  page  19,  lines  1-5. The  Claimant  went  to  the  emergency  room  at  the  Baptist \nHospital  in  North  Little  Rock  on  September  20,  2022.  During  the  physical  examination  it  was \n \n2\n The Respondents submitted a 1,383-page medical record which was largely irrelevant to \nthe issue concerning the cervical spine and was also in violation of my order. The Respondents \nblatantly ignored the portion of my order that reads “Any medical exhibit exceeding fifty (50) \npages must be abstracted.” The voluminous 1,383-page record was not abstracted. Moreover, the \nmedical records were to be “indexed by medical provider” and be “chronologically arranged” not \n“grouped” by medical provider with no specific identifiable page index for each treatment date. \nRespondents are put on notice, as a courtesy, that if this occurs again, I will not admit his client’s \nexhibit into evidence. \n\nWRIGHT H208285 \n \n \n4 \n \n \nnoted that her cervical back had a normal range of motion and that her neck was supple, meaning \nno limitation of motion. Resp. Ex. 1, p. 35.  \nClaimant on October 19, 2022, during a follow-up visit with Ortho Arkansas did complain \nabout pain radiating from her shoulder into her neck. Resp. Ex. 1, pp. 539-541. During the physical \nexam, no  neck  findings  were  recorded. Id. However,  on  January  30,  2023,  an  MRI  scan  was \nperformed on Claimant that revealed a small disc protrusion with mild spinal canal stenosis. Cl. \nEx. 1, pp. 10-11. There was also a mild uncovertebral hypertrophy and facet arthropathy with mild \nneural foramen stenosis. Id. The MRI report further revealed a central disc protrusion at the C4-\nC5 with mild spinal canal stenosis. Id. There was also a mild facet arthropathy, asymmetric to the \nleft,  but  no  significant  neural  foramen  stenosis. Id. There  was  also  a  broad-based  posterior  disc \nprotrusion  at  C5-C6  along  with  a  mild  ligamentum  flavum  thickening. Id. There  was  a \ncircumferential  disc  bulge  at  the  C6-C7  with  mild  spinal  canal  stenosis  and  effacement  of  CSF \nventral to the cord. Id. There was also an uncovertebral hypertrophy facet arthropathy, worse on \nthe left. Id. There was a moderate right and severe left neural foramen stenosis. Id. Based on this \nMRI  scan  the  Claimant  was  refereed  to  Dr.  Edward  Saer,  a  spine  surgeon  specialist, at  Ortho \nArkansas. Dr.  Saer  noted  in  his  assessment/plan  that  Claimant  has  undergone  some  physical \ntherapy  for  her shoulder,  and  she  claims that treatment  has made her  neck  pain  worse  and \nheadaches worse. Claimant Ex. 1, p. 14. Dr. Saer further noted that her neck is not “really tender \nto palpation except in the midline in the cervical thoracic area.” Id. Dr. Saer noted the January 30, \n2023, MRI and recognized the central disc bulge at C5-C6 that abuts but does not compress the \ncord. Id. He further noted the foraminal narrowing at C6-C7 on the left. Id. Otherwise, Claimant \nhas mild degenerative changes that are relatively normal. Id. Dr. Saer diagnosed her with cervical \nstrain/sprain and referred her for physical therapy. Id.  \n\nWRIGHT H208285 \n \n \n5 \n \n \nOn March 28, 2023, the Claimant had a follow-up visit with Dr. Saer, after her physical \ntherapy treatment, to discuss her neck pain. Claimant’s Ex. 1, p. 16. The Claimant believed that \nthe physical therapy helped but she is still having pain. Id.  Dr. Saer reviewed her imaging with \nher  and  explained  that  the  problem  is  not  with  the  bulging  disc  in  her  neck,  rather  she  has  soft \ntissue strain or sprain that is causing her pain. Id. Dr. Saer ordered her more physical therapy for \nher neck. Id. On April 29, 2023, the Claimant had another follow-up with Dr. Saer where she states \nshe  was  improving  while  undergoing  physical  therapy  on  her  cervical  spine  and  right  shoulder \nuntil the therapy stopped. Claimant’s Ex. 1, p. 21. Claimant stated that she feels like her shoulder \nis tightening up again and she is having more pain in her neck and headaches again. Id. Dr. Saer \nshowed her how to do cervical isometrics, but Claimant feels that she is not able to do them one \nhanded. Id. Dr. Saer stated in his note that there is not much else that he can do for her neck. Id.  \nOn  June  27,  2023,  Claimant  had  another  follow-up  with  Dr.  Saer  where  she  expressed \ncontinued discomfort with her neck. Claimant’s Ex. 1, p. 26. Claimant states that some of her pain \nradiates  over  the  right  scapular  area. Id. The  Claimant  was  in  a  sling  for  a  while  following  her \nsurgery, but claims wearing the sling aggravated her cervical complaints. Id. Dr. Saer noted that \ncervical  motion  was  good  in  all  directions  although  she  has  some  pain  and  there  were  no  acute \nspasms. Id. Dr.  Saer  again  referred  Claimant  to  cervical  physical  therapy  to  try  and  strengthen \nsome of her cervical muscles. Id.   \nOn September 7, 2023, Claimant had another follow-up with Dr. Saer where she claims to \nstill have pain in her neck that goes up to her head, with constant headaches. Resp. Ex. 1, p. 640. \nDuring this visit Dr. Saer noted that the Claimant is literally in tears because she is in so much pain \nand cannot sleep at night. Id. Dr. Saer ordered another MRI but noted that he does not believe the \npain  is  likely  related  to  a  nonstructural  problem. Id.  Dr.  Saer  wants  the  Claimant  to  continue \n\nWRIGHT H208285 \n \n \n6 \n \n \nworking  on  strengthening  her  upper  extremity. Id.    The  Claimant  received  another  MRI  on \nSeptember 26, 2023, from Chenal MRI. Claimant’s Ex. 1, pp. 38-39. The  MRI  revealed  the \nfollowing impression: \n1. Multilevel degenerative disease. \n2. Severe left foraminal stenosis at C6-7. \n3. Moderate foraminal stenoses on the left at C3-4 and on the right at C6-7. \n4. Mild foraminal stenoses at C3-4, C4-5, C5-6, and C6-7. \n5. Broad central protrusion type disc herniation at C3-4, with contact of the left ventral \ncord. \n6. No evidence of cord contusion, epidural hematoma, compression fracture, or ligament \ndisruption.  \nId. \nOn October 2, 2023, Claimant again followed-up with Dr. Saer to report that since her last \nvisit  she  has  been  feeling  the  same.  Claimant’s Ex. 1, p. 43. Claimant requested  a  change  of \nphysician on November 29, 2023, and it was approved on January 9, 2024, for Claimant to start \nseeing Dr. Reza Shahim. The Claimant saw Dr. Reza Shahim on January 4, 2024. Claimant’s Ex. \n1, pp. 45-49. Dr. Shahim reviewed the previous MRI cervical spine that shows cervical spondylosis \nwith stenosis at the C5-6 and C6-7. Id. Dr. Shahim noted that the Claimant does have a cervical \ndisc  injury  at  C5-6  and  some  degrees  of  C6-7. Id.  Dr.  Shahim  recommends  that  Claimant  go \nthrough  a  series  of  cervical  injections  in  preparation  for  possible  surgical  intervention. Id.  Dr. \nShahim recommended a treatment option of anterior cervical fusion with potential complications \nexplained. Id. The Claimant wants a C5-6 anterior fusion and if necessary, a possible C6-7 anterior \nfusion.  \nThe  Respondents  deny  this  treatment  as  unnecessary and unreasonable. To  bolster  its \nclaim, the Respondents retained two consulting experts, Dr. Owen Kelly and Dr. Shane McAlister, \nto review the Claimant’s medical records and provide an opinion regarding the causation of the \nproposed  surgery  to  the work-related injury.  Dr.  Shane  McAlister,  a  board-certified  radiologist, \n\nWRIGHT H208285 \n \n \n7 \n \n \nreviewed Claimant’s medical records and diagnostic imaging. Resp. Ex. 1, pp. 749-756. Dr. Kelly \nconcluded in his opinion that an “anterior cervical fusion has been suggested by a subsequent \ntreating  physician.  This  physician  indicated  that  the  injury  was  the  reason  for  the  surgery.  This \ndirectly contradicts the opinion of the initial treating spine specialist.” Id. at 755-756. Dr. Kelly \nopined that the initial treating spine specialist documented clearly and precisely the reasoning why \nsurgery  would  not  be related. Id. Dr.  Kelly  further  concluded  that  this  initial  opinion  appears \ncorrect, objectively based, and is supported by the medical records. Id. Dr. Kelly concluded that \nthe anterior cervical fusion procedure would not be related to the one-time isolated incident. Id.  \nDr.  Shane  McAlister,  Radiologist,  opined  that  the  records  and  diagnostic  imaging \nsubmitted do not document any traumatic injury to the cervical spine from the work incident that \noccurred on September 20, 2022. Respondents Ex. 1, p. 528. He further opined that there was no \naxial loading on the spine as a mechanism for injury to the disc or vertebral bodies, and the MRI \nscanning is the most sensitive imaging available  for evaluating acute bony or soft tissue injury, \nand  none  was  found. Id. Dr.  McAlister  concluded  that  any  further  treatment  of  the  cervical \nsymptoms would be related to the underlying degenerative process or other etiology. Id.  \nAdjudication \nA. Whether Claimant is entitled to additional reasonable and necessary medical \ntreatment, specifically a cervical anterior fusion for the C5-C6-C7. \nArkansas Code Annotated Section 11-9-508(a) (Repl. 2012) states that an employer shall \nprovide for an injured employee such medical treatment as may be necessary in connection with \nthe  injury  received  by  the  employee.   Wal-Mart  Stores,  Inc.  v.  Brown,  82  Ark.  App.  600,  120 \nS.W.3d 153 (2003).  But employers are liable only for such treatment and services as are deemed \nnecessary for the treatment of the claimant’s injuries.  DeBoard v. Colson Co., 20 Ark. App. 166, \n725 S.W.2d 857 (1987).  The claimant must prove by a preponderance of the evidence that medical \n\nWRIGHT H208285 \n \n \n8 \n \n \ntreatment is reasonable and necessary for the treatment of a compensable injury.  Brown, supra; \nGeo  Specialty  Chem.  v.  Clingan,  69  Ark.  App.  369,  13  S.W.3d  218  (2000).    What  constitutes \nreasonable  and  necessary  medical  treatment  is  a  question  of  fact  for  the  Commission.   White \nConsolidated Indus. v. Galloway, 74 Ark. App. 13, 45 S.W.3d 396 (2001); Wackenhut Corp. v. \nJones, 73 Ark. App. 158, 40 S.W.3d 333 (2001). \n As  the  Arkansas  Court  of  Appeals  has  held,  a  claimant  may  be  entitled  to  additional \ntreatment even after the healing period has ended, if said treatment is geared toward management \nof the injury.  See  Patchell v. Wal-Mart Stores, Inc., 86 Ark. App. 230, 184 S.W.3d 31 (2004); \nArtex Hydrophonics, Inc. v. Pippin, 8 Ark. App. 200, 649 S.W.2d 845 (1983).  Such services can \ninclude  those  for  the  purpose  of  diagnosing  the  nature  and  extent  of  the  compensable  injury; \nreducing or alleviating symptoms resulting from the compensable injury; maintaining the level of \nhealing achieved; or preventing further deterioration of the damage produced by the compensable \ninjury.  Jordan v. Tyson Foods, Inc., 51 Ark. App. 100, 911 S.W.2d 593 (1995); Artex, supra.  A \nclaimant is not required to furnish objective medical evidence of his continued need for medical \ntreatment.  Castleberry v. Elite Lamp Co., 69 Ark. App. 359, 13 S.W.3d 211 (2000). \n But to prove his entitlement to the treatment at issue, Claimant must also prove that it is \ncausally  related  to  his  compensable  injury  of September  20,  2022.   See  Pulaski  Cty.  Spec.  Sch. \nDist. v. Tenner, 2013 Ark. App. 569 (2013) \nDr. Reza Shahim, in review of Claimant’s MRI cervical spine, noted cervical spondylosis \nwith stenosis at C5-6-7 central disc herniation with thecal sac compression at C5-6 and foraminal \nstenosis at C6-7. Claimant’s Ex. 1, p. 48. I credit Dr. Reza Shahim’s report and recommendations \nfor treatment. The Claimant has not had any serious issues with her neck prior to her September \n20, 2022, work related injury. Claimant, at the time of her injury, was moving a 75-to-100-pound \n\nWRIGHT H208285 \n \n \n9 \n \n \nmetal beam, that supports top stock items, from one area to another with a co-worker. Transcript \np. 18, lines 2 – 24. While Claimant and co-worker were both ascending ladders to hang the support \nbeam, the co-worker let go of the beam causing the full weight of the metal beam to pull down, in \na  jerk  manner, on  the  right  arm,  shoulder,  and the neck  of  the  Claimant.  Due  to  the immediate \ntearing of muscle in Claimant’s right arm and shoulder, her fingers would not let go of the beam \ncausing continuous strain on her arm, shoulder, and neck while she was still on the ladder holding \nthe metal beam. In fact, the Claimant needed help getting her fingers loose from the metal beam.  \nSince this incident, the Claimant has experienced continuous pain from her neck. The MRIs \nshow, according to some of the Claimant’s providers and reviewers, only degenerative conditions. \nAssuming  that  was  true, the  Claimant  was  asymptomatic prior  to her work-related  incident. \nHowever, after the work-related incident, I find that is not the case now. Simply stated, there is no \nreasonable  explanation  for Claimant’s injuries, considering Dr. Shahim’s opinion, and her pain \nother than the September 20, 2022, work-related injury. Therefore, I find by the preponderance of \nthe evidence that Claimant has proven her cervical injuries are causally related to her September \n20, 2022, work injury.  \nThe Claimant is now seeking a cervical anterior fusion of the C5-C6 and potentially the \nC6-C7.  I  find  by  the  preponderance  of  the  evidence  that Claimant  has  proven  that a  cervical \nanterior fusion of the C5-C6, recommended by Dr. Shahim, is reasonable and necessary medical \ntreatment  for  her cervical  injuries  and  pain. I  do  not  find  that the  Claimant  has  proven  by  the \npreponderance  of  the  evidence  that  a cervical  anterior  fusion  for  the  C6-C7  is  reasonable  and \nnecessary medical  treatment  based  on  Dr.  Shahim’s report stating  that  a  C6-C7  fusion  is  a \n“possible” need versus an actual need. Claimant’s Ex. 1, p. 49. Nevertheless, such treatment for a \nC5-C6 anterior fusion is legally allowable for 1.) reducing or alleviating symptoms resulting from \n\nWRIGHT H208285 \n \n \n10 \n \n \nthe  compensable  injury; 2.) maintaining  the  level  of  healing  achieved;  or 3.) preventing  further \ndeterioration of the damage produced by the compensable injury.  Jordan v. Tyson Foods, Inc., 51 \nArk. App. 100, 911 S.W.2d 593 (1995); Artex, supra.   \nThe  Claimant  has  received  physical  therapy  and neck injections  all  to  no  avail. The \nClaimant has also received cervical exercises from Dr. Saer that have not given the Claimant any \nneck pain relief. These conventional methods of treating Claimant’s neck injury have been tried, \nleaving surgical intervention. I do recognize that the Respondents have solicited the professional \nopinions of two radiologist, Dr. Owen Kelly and Dr. Shane McAlister. However, these doctors are \nradiologist,  not  spine  specialist, and have  not  physically  examined  the  Claimant. Dr.  Shahim’s \nmore  invasive  recommendation, given Claimant’s circumstances, is  reasonable  and  necessary \ntreatment solution. Moreover, Dr. Shahim, Spine Specialist, has evaluated her and her MRIs and \nhave recommended options that could relieve Claimant’s suffering. And as previously stated, I \nfind that a cervical anterior fusion of the C5-C6, recommended by Dr. Shahim, is reasonable and \nnecessary and connected to the work-related injury.  \nCONCLUSION \n In accordance with the Findings of Fact and Conclusions of Law set forth above, the parties \nshall act consistent with this opinion.  \n IT IS SO ORDERED. \n \n       ________________________________ \n       Hon. Steven Porch \n                                                                                    Administrative Law Judge","preview":"BEFORE THE ARKANSAS WORKERS’ COMPENSATION COMMISSION WCC NO. H208285 TERESA A. WRIGHT, EMPLOYEE CLAIMANT LOWES HOME CENTERS LLC, SELF-INSURED EMPLOYER RESPONDENT SEDGWICK CLAIMS MANAGEMENT, THIRD-PARTY ADMINISTRATOR RESPONDENT OPINION FILED OCTOBER 2, 2024 Hearing before Administrative Law Judge, Steven Porch, on Augus...","fetched_at":"2026-05-19T22:47:12.017Z","links":{"html":"/opinions/alj-H208285-2024-10-02","pdf":"https://labor.arkansas.gov/wp-content/uploads/Wright_Teresa_H208285_20241002.pdf","source_publisher":"https://labor.arkansas.gov/workers-comp/awcc-opinions/administrative-law-judge-opinions/"}}