{"id":"alj-H301278-2024-03-12","awcc_number":"H301278","decision_date":"2024-03-12","opinion_type":"alj","claimant_name":"Michelle Burnett","employer_name":"South Side Highschool","title":"BURNETT VS. SOUTH SIDE HIGHSCHOOL AWCC# H301278 & H303725 MARCH 12, 2024","outcome":"denied","outcome_keywords":["denied:3"],"injury_keywords":["back","knee","lumbar","cervical","shoulder","hip","neck","fracture"],"pdf_url":"https://labor.arkansas.gov/wp-content/uploads/BURNETT_MICHELLE_H301278H303725_20240312.pdf","source_index_url":"https://labor.arkansas.gov/workers-comp/awcc-opinions/administrative-law-judge-opinions/","filename":"BURNETT_MICHELLE_H301278H303725_20240312.pdf","text_length":30868,"full_text":"BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION \n \n WCC NO. H301278 & H303725 \n \nMICHELLE BURNETT, Employee CLAIMANT \n \nSOUTHSIDE HIGH SCHOOL, Employer RESPONDENT \n \nARKANSAS SCHOOL BOARDS ASSN., Carrier RESPONDENT \n \n \n OPINION FILED MARCH 12, 2024 \n \nHearing  before  ADMINISTRATIVE  LAW  JUDGE  ERIC  PAUL  WELLS  in  Fort  Smith, \nSebastian County, Arkansas. \n \nClaimant represented by EDDIE H. WALKER, Attorney at Law, Fort Smith, Arkansas. \n \nRespondents represented by GUY ALTON WADE, Attorney at Law, Little Rock, Arkansas. \n \n STATEMENT OF THE CASE \n \n On December 14, 2023, the above captioned claim came on for a hearing at Fort Smith, \nArkansas.      A  pre-hearing  conference  was  conducted  on August  21,  2023,  and  a  Pre-hearing \nOrder  was  filed  on August  22,  2023.      A  copy  of  the  Pre-hearing  Order  has  been  marked \nCommission's Exhibit No. 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 relationship of employee-employer-carrier existed between the parties on January \n18, 2023, and February 24, 2023. \n 3. The claimant sustained a compensable injury to her low back, right knee, and right arm \non or about January 18, 2023. \n\nBurnett – H301278 & H303725 \n \n-2- \n 4. The claimant was earning sufficient wages to entitle her to compensation at the weekly \nrates  of  $835.00  for  temporary  total  disability  benefits  and  $626.00  for  permanent  partial \ndisability benefits. \n By agreement of the parties the issues to litigate are limited to the following: \n 1.  Whether  Claimant  sustained  a  new  compensable  injury  to  her  low  back,  right  knee, \nright arm, and coccyx on or about February 24, 2023, or whether current need for treatment is a \ncontinuance of compensable injuries sustained on January 18, 2023. \n 2. Whether Claimant is entitled to medical treatment in the form of an MRI of the lumbar \nspine. \n 3. Whether Claimant sustained a compensable cervical spine injury on January 18, 2023, \nand/or February 24, 2023. \n 4. Whether Claimant is entitled to medical treatment for her cervical spine injury. \n The claimant's contentions are as follows: \n“a. The Claimant contends that she is in need of additional medical \ntreatment  either  due  to  the  continuing  effects  of  her  admittedly \ncompensation  injury  on January  18,  2023  or  the  effects  of  her  job \nrelated fall that occurred on February 24, 2023. \n \nb.  The  Claimant  contends  that  the  respondents  should  be  held \nliable  for  additional  medical  treatment  regarding  the  claimant’s \nback, including but not necessarily limited to an MRI. \n \nc.  The  Claimant  contends  that  his  attorney  is  entitled  to  an \nappropriate attorney’s fee.” \n \n The respondents’ contentions are as follows: \n“Respondents contend they accepted the January 18, 2023 event as \ncompensable  and  have  paid  the  reasonable,  necessary  and  related \nbenefits. The claimed February 24, 2023 event did not occur within \nthe course and scope of claimant’s employment or while claimant \nwas performing employment services.” \n\nBurnett – H301278 & H303725 \n \n-3- \n \n The claimant in this matter is a 52-year-old female who sustained compensable injuries to \nher low back, right knee, and right arm on January 18, 2023, while employed by the respondent. \nThe claimant additionally alleges to have suffered a compensable cervical spine injury during her \nJanuary 18, 2023, incident. On direct examination the claimant gave testimony about her January \n18, 2023, accident and her symptoms directly after as follows: \nQ Ms.  Burnett,  it  has  been  agreed  upon  that  you  had  an \naccident while working for the Fort Smith Public School system on \nJanuary 18, 2023. Will you explain how that accident happened. \n \nA Yes,  I  was – I  had  entered  the  stairwell,  south  hallway, \nFreshman  Center,  and  lost  my  footing  as  I  was  approaching  the \nsecond floor – second, third floor. When I fell, I hit my knees first \nand then fell backwards. \n \n I  called  for  some  assistance  and  no  one  responded,  so  I \nattempted to assist myself and slipped two more steps, two or three \nmore  steps,  and  then  I  used  my  cellular  device  to  call  Rachel \nFoster who eventually came to assist me. \n \nQ And  what  symptoms  did  you  have  after  that  accident \noccurred? \n \nA My knees were hurting. I had pain in my lower back and I \nhad some shoulder pain. \n \nQ What  would  you  consider  to  have  been  your  primary \nsymptoms at that time? What was hurting you worse? \n \nA My knees were, of course, because I had scraped them and \nthen my lower back was giving me – it was pretty intense. It hurt. \nIt was more of a throbbing sensation. And then my upper arm, my \narm  and  my  shoulder,  the  same  type  of  symptoms,  they  were \nthrobbing. \n \nQ Now,  you  say  your  arm  and  your  shoulder.  Tell  us  a  little \nbit  more  about  that.  What  do  you  mean  your  arm  and  your \nshoulder? \n \n\nBurnett – H301278 & H303725 \n \n-4- \nA Well, my shoulder was more of a sore sensation where my \narm  was  throbbing,  so  it  was  the  intensity  was  a little  bit  more  so \ndown my arm. \n \nQ And were you sent to the doctor the same day? \n \nA Yes, sir. \n \nQ And was that Dr. Ian Cheyne? \n \nA Yes, sir. \n \n The  claimant  was  seen  by  Dr.  Ian  Cheyne  at  Mercy  Occupational  Medicine  Clinic  on \nJanuary 18, 2023. Following is a portion of that medical record: \nCHIEF COMPLAINT \nRight side, left side, and back. \n \nPATIENT DESCRIPTION OF ACCIDENT \nMichelle  was  walking  up  steps  when  she  reached  the  railing  and \nlost  her  footing.  She  states  that  she  landed  on  her  knees  and  fell \nback onto the wall. She then tried to call for help and tried to stand \nup  but  ended  up  slipping  two  more  stairs  injuring  both  her  upper \narms. \n \nHISTORY OF PRESENT ILLNESS \nMichelle’s primary problem is pain located in the lower back. She \ndescribes   it   as   throbbing,   Tender.   The   problem   began   on \n1/18/2023.  Michelle  says  that  it  seems  to  be  constant.  She  has \nnoticed that it is made worse by bending, sitting. Her pain level is \n7. \nMichelle’s secondary problem is pain located in the left upper arm. \nShe  describes  it  as  aching.  The  problem  began on  1/18/2023. \nMichelle  says  that  it  seems  to  be  variable – depending  on  the \nactivity level, intermittent. She has noticed that it is made worse by \nlifting. Her pain level is 4. \nMichelle’s tertiary problem is pain located in the right upper arm. \nShe  describes  it  as  soreness,  Tender.  The  problem  began  on \n1/18/2023.  Michelle  says  it  seems  to  be  variable - depending  on \nactivity level, intermittent. She has noticed that it is made worse by \nlifting. Her pain level is 4. \nMichelle’s fourth problem is pain located in the right knee, left \nknee.  She  describes  it  as  pressure,  sharp,  throbbing.  The  problem \nbegan  on  1/18/2023.  Michelle  says  that  it  seems  to  be  variable – \n\nBurnett – H301278 & H303725 \n \n-5- \ndepending  on  the  activity  level.  She  has  noticed  that  it  is  made \nworse by standing. Her pain level is 6. \nMichelle’s  fifth  problem  is  pain  located  in  the  right  hip.  She \ndescribes  it  as  pressure,  sharp,  throbbing.  The  problem  began  on \n1/18/2023.  Michelle  says  that  it  seems  to  be  variable – depending \non  the  activity  level.  She  has  noticed  that  it  is  made  worse  by \nstanding.  Her  pain  level  is  4.  Additional  History:  patient  sore  in \nseveral  areas as above from fall. Most painful areas seem to be in \nthe knees, right hip and low back. She has noticed an abrasion right \nknee and bruising b/l upper extremities. \n \n*** \nDIAGNOSIS \n1. Fall   (on)   (from)   other   stairs   and   steps,   initial   encounter \n(W10.8XXA). \n2. Contusion of right upper arm, initial encounter (S40.021A). \n3. Contusion of left upper arm, initial encounter (S40.022A). \n4. Contusion of right knee, initial encounter (S80.01XA). \n5. Contusion of left knee, initial encounter (S80.02XA). \n6. Contusion of right hip, initial encounter (S70.01XA). \n7.   Contusion   of   lower   back   and   pelvis,   initial   encounter \n(S30.0XXA). \n \nThe claimant was placed on work restrictions of alternate sit/stand/walk as tolerated, prescribed \npain medication, and told to ice and heat areas of most discomfort. \n The claimant returned to see Dr. Ian Cheyne on January 25, 2023. The History of Present \nIllness portion of that medical report does indicate a lessening of pain in various body parts. The \nreport  also  indicates  soreness  in  her  left  neck  during  a  portion discussing  her  left  upper  arm  as \nfollows: \nMichelle’s secondary problem is pain located in the left upper arm. \nShe  describes  it  as  soreness.  The  problem  began  on  1/18/2023. \nMichelle says that it seems to be not present now. She has noticed \nthat it is made worse by lifting. She feels it is improving. Her pain \nlevel is 0. Patient states she has some soreness on her left neck. \n \n That  same  report  from  January  25,  2023,  includes  an  Examination  section,  which  states \nthe following regarding the claimant’s cervical spine examination: \n\nBurnett – H301278 & H303725 \n \n-6- \nCervical Spine: An abrasion is not present. Bruising is not present. \nErythema  is  not  present.  An  open  wound  is  not  present.  Pain  on \nmotion is not present. Pain to palpation is not present. Swelling is \nnot present. Range of motion is normal. \n \nI note that no diagnosis was included in that medical report referencing the claimant’s neck or \ncervical spine. The claimant was given home exercises and told to follow up in one week. \n The claimant returned to see Dr. Ian Cheyne on February 9, 2023. The History of Present \nIllness section of that report states: \nAdditional History: Patient mainly have right low back pain at this \npoint. Everything else seems to have resolved. She states that there \nare times she has to lean against a wall while she is walking to get \nsome relief. Potential pain radiating right groin. \n \nThe  claimant  was  then  referred  to  physical  therapy  three  times  per  week  for  two  weeks.  It \nappears the claimant was scheduled to begin physical therapy on February 22, 2023, but missed \nher appointment.  \n On February 24, 2023, the claimant alleges to have had a second fall while at work again \ninjuring her low back, right knee, and right arm. She also alleges additional injury to her coccyx \nand cervical spine during the second incident/fall. On direct examination the claimant described \nher second incident as follows: \nQ Now,  tell  us  about  your  second  incident  in  February  of \n2023, on February 24\nth\n. What happened? \n \nA We were asked to arrive early for supervision purposes, so \nI went to my office, gathered my items. My daughter was going to \nbring breakfast because I didn’t have time to eat, especially with \nmedication. \n \n So  she  texted  me  and  she  said  she  was  outside.  I  already \nchecked  in.  I  walked  outside  to  retrieve  the  items  and  speaking \nwith  her  about  the  upcoming  Black  History Month  at  Northside.  I \nwas walking backwards, you know, to hurry up and get back inside \nto help with supervision and fell over the curb. \n\nBurnett – H301278 & H303725 \n \n-7- \n \n*** \nQ Okay. So let’s go back to the fall that occurred on February \n24. \n \nA Uh-huh. \n \nQ Do you feel like you sustained any injury in that fall? \n \nA Yes, I do. \n \nQ And what injury or injuries do you believe you sustained? \n \nA Back  injuries,  lower  back  injuries,  especially.  The  January \none was more of my right side, the leg, the arm, and my shoulder \nwas sore. This area was sore (indicating). \n \nQ And  in  the  February  fall,  did  you  fall  from  a  standing \nposition? \n \nA Yes. \n \nQ And what kind of surface did you land on? \n \nA The asphalt and the concrete and the curb that was there. \n \nQ Had you been released from active treatment regarding the \nJanuary injury when the February injury occurred? \n \nA No, sir. \n \n On  February  24,  2023,  the  claimant  was  seen  at  Mercy  Emergency  Department. \nFollowing is an emergency department note from that visit: \nPt reports that she comes to the ed today for a fall that occurred at \nwork. \n \nPt reports that she was walking backwards towards a curb and she \ntripped on the curb causing her to fall backwards and onto her right \nside hitting her right head and the back of her head on the concrete. \nNo visual abnormalities noted to these areas. Pt reports that she is \nhaving pain of constant all over generalized 9/10. \n \n\nBurnett – H301278 & H303725 \n \n-8- \nPt  is  an  a/ox4  with  breathing  even  and  unlabored.  Call  light  in \nplace. Pt denies any needs at this time. Family at bedside. \n \nThe  claimant  was  instructed  to  take  over-the-counter  Tylenol  and  ibuprofen  for  pain  and  to  ice \nand heat alternating every 20 minutes. \n On March 2, 2023, the claimant was again seen by Dr. Ian Cheyne. The record from that \nvisit, in part, states: \nAdditional History: Patient pain now only in the low back. She had \nanother fall on 2/24 at school. She went to the ED, XR coccyx was \nnegative. She has not started PT yet. \n \n On  March  2,  2023,  the  claimant  also  saw  Dr.  Thomas  Cheyne.  I  note  that  Dr.  Thomas \nCheyne  is  a  different  doctor  than  Dr.  Ian  T.  Cheyne.  Following  is  a  portion  of  Dr.  Thomas \nCheyne’s clinic note: \nSubjective: This patient is a 51-year-old who presents with coccyx \npain as well as mild right lateral hip pain. She is an employee with \nFort Smith public school system and had a fall on 2/24/2023. This \nwas in a parking lot and she fell backward over a curb and landed \non her buttocks on the curb. She had had another fall several weeks \nprior to that and is being treated for low back pain and is going to \nbe  starting  physical  therapy  in  the  near  future.  With  regard  to  the \nfirst  fall  she  has  been  having  radiation  of  pain  from  the  right  hip \ninto  the  anterior  medial  aspect  of  the  right  proximal  thigh  which \nmay well be sciatic in nature. She had x-rays after the more recent \nfall of the lumbar spine and pelvis with no fracture being noted. \n \nObjective:  She  is  quite  tender  over  the  coccyx.  She  is  able  to \nslowly bend to touch her lower legs. She walks on her toes and her \nheels with assistance. She has mild decreased sensation in the right \nanterior  medial  thigh  as  compared  to  the  left.  She  has  good \nstrength  and  muscle  tone  in  her  legs  and  her  DTRs  are  1+  and \nequal  bilaterally.  Straight  leg  raise  is  negative  bilaterally.  She  has \nmild  tenderness  over  the  greater  trochanter  of  the  right  femur  but \nhas good range of motion of her hip. \n \nI  have  received  her  lumbar  spine  and  pelvic  films  and  agree  that \nthere is no definite fracture. \n \n\nBurnett – H301278 & H303725 \n \n-9- \nImpression: Coccydynia. \n \nPlan:  She  will  temporarily  stop  her  diclofenac,  we  will  give  her  a \nMedrol Dosepak and then have her resume the diclofenac. She will \nstay  at  light  activity,  we  will  give  her  some  restrictions  to  be \nallowed  to  sit  or  stand  as  needed  and  to  limit  the  amount  of \nwalking  she  does.  She  will  use  heat  therapy  and  avoid  direct \npressure  on  the  coccyx  as  much  as  possible.  If  this  does  not \nimprove within the next 2 to 3 weeks we may consider getting her \ninto the pain clinic for a coccyx injection. \n \n The claimant again failed to go to her physical therapy appointment that was ordered by \nDr. Ian Cheyne on March 6, 2023. However, the claimant did begin physical therapy on March \n15,  2023,  having  had  two  physical  therapy  sessions  before  again  seeing  Dr.  Ian  Cheyne  on \nMarch 16, 2023. The medical report states, “She feels like it is improving slowly.” \n On  April  4,  2023,  the  claimant  was  again  seen  by  Dr.  Thomas  Cheyne.  Following  is  a \nportion of that clinic note: \nThis  patient  returns  for  follow-up  of  her  coccydynia  as  well  as \nright-sided  sciatica.  She  has been taking  her  diclofenac,  going  to \nphysical  therapy  and  using  her  heat  therapy.  She  has  had  a  little \nimprovement   but   continues   to   be   symptomatic.   She   is   not \ninterested  in  having  injections  in  the  coccyx  at  this  point.  I  would \nrecommend  getting  an  MRI  scan  of  the  lumbar  spine  and  we  will \nsee  her  back  after  the  scan.  She  will  otherwise  continue  her \nconservative treatment for now. \n \n The  claimant  continued  with  the  physical  therapy  ordered  by  Dr.  Ian  Cheyne  after  her \nJanuary 18, 2023, fall. The claimant again saw Dr. Ian Cheyne on April 13, 2023. In that medical \nreport  he  stated,  “Patient  is  continuing  to  show  slow  improvement.”  Dr.  Ian  Cheyne  also \nacknowledged  the  claimant  had  been  seeing  Dr.  Thomas  Cheyne  in  orthopedics,  who  had \nordered  a  lumbar  MRI.  I  note  that  the  claimant  has  not  been  provided  an  MRI  of  her  lumbar \nspine by the respondents at the time of the hearing in this matter. \n\nBurnett – H301278 & H303725 \n \n-10- \n On June 2, 2023, the claimant is seen by her primary care physician, Dr. Jeffrey Hamby. \nThe  claimant  was  assessed  by  Dr.  Hamby  for  a  variety  of  reasons  including  cervicalgia.  A \nportion of the History of Present Illness section of that medical report follows: \nPatient states she is having chronic cervical pain with no injury or \ntrauma  and  started  taking  Tylenol  8 hour,  using  Diclofenac  and \nsome Tramadol she has had on hand to help with the pain. Patient \nis  also  using  a Tens  unit  30  minutes a  day  and  seeing  her \nChiropractor  for  this  as  well.  Most  recent  echo cardiogram  was \nreviewed with the patient: no signs of heart failure. Need more of a \nreport on the echo that was performed so will request more records \non  this.  PT  needs  an  MRI  C-Spine  for  chronic  cervical  pain  with \nbilateral radiculopathy down to her shoulders. Explained to patient \nthat  she  does  not  need  want  her  to  go  to  the  chiropractor  until  the \nMRI is back. Recommended patient go to Fort Smith Wellness for \nmassage therapy. Return in 3 weeks. \n \n On June 6, 2023, the claimant underwent an MRI of the cervical spine at Prime Medical \nImaging. Following is a portion of that diagnostic report: \nNo acute abnormality evident at the craniovertebral junction. \n \nMuch  of  the  bony  spinal  canal  in  the  cervical  spine  is  relatively \nnarrow on a developmental basis. \n \nAt the C2-3 level, no significant disc abnormality or canal stenosis. \n \nAt C3-4, there is mild retrolisthesis by 2 or 3 mm. There is central \ndisc  herniation,  moderately  severe  canal  stenosis,  there  may  be \nmild cord compression. Additionally, moderate bilateral foraminal \nspurring/exit foramina stenosis at this level. \n \nAt the C4-5 level, there is mild broad disc bulging. There is a left \nforaminal  disc  herniation  producing  moderately  severe  stenosis  of \nthe  left  exit  foramen.  Mild  narrowing  right  exit  foramen.  Mild \ncentral canal stenosis. \n \nAt  C5-6  level,  there  is  a  moderately  large  right  paracentral  disc \nherniation impressing upon the cord, producing moderately severe \ncanal stenosis. \n \n\nBurnett – H301278 & H303725 \n \n-11- \nAt  C6-7  level,  there  is  a  small  to  moderate  central  disc  herniation \nproducing at least mild canal stenosis. \n \nFacet arthrosis is present, most severe on the left at C4-5 level. \n \nIMPRESSION: \nMul  multilevel  disc  degenerative  disease  as  outlined  in  greater \ndetail  above.  Moderately  severe  canal  stenosis  results  at  both  the \nC3-4  and  C5-6  levels.  Significant  findings  at  additional  levels  as \ndescribed. \n \n On  August  15,  2023,  the  claimant  is  seen  at  WR  Family  Clinic  Fayetteville  as  a  new \npatient. The record is unclear as to whom the medical provider for the claimant’s visit is at that \ntime. Following is a portion of that record: \nHistory of Present Illness \nPt  referred  by  PCP  for  cervical  spine  evaluation.  She  reports \nprogressive  neck  pain  after  a  fall  at  work  in  January  of  this  year. \nShe describes pain through the right side her neck which extends to \nthe  right  shoulder  but  does  not  typically  radiate  down  the  arms. \nShe  does  note  bilateral  hand  numbness  which  is  intermittent.  She \nalso  reports  worsening  balance  in  the  past  year.  She  has  tried \ntreatment with PT but denies any relief with this. \n \n*** \nAssessment \nAssessed \n1. Cervical spondylosis with myelopathy (721.1) (M47.12) \n2. Cervical stenosis of spine (723.0) (M48.02) \n3. Cervical spinal cord compression (336.9) (G95.20) \n \n*** \nDiscussion/Summary \nPt  with  R>L  neck  pain  associated  with  worsening  balance  in  the \npast  year  as  described  above.  MRI  shows  severe  canal  stenosis  at \nC3-4 d/t large disc-osteophyte complex. This narrows the AP canal \ndiameter  to  6mm  with  compression  and  deformation  of  the  spinal \ncord. There is also at least moderate to severe canal stenosis at C5-\n6 and C6-7. Exam reveals BUE hyperreflexia concerning for early \nmyelopathy.   I   explained   the   findings   and   treatment   options, \ndiscussed that surgery is indicated to decompress the spinal cord as \nthis  degree  of  stenosis  carries  an  increased  risk  of  spinal  cord \n\nBurnett – H301278 & H303725 \n \n-12- \ninjury  if  left  untreated.  Will  arrange  for  follow  up  in  clinic  with \nsurgeon as soon as possible. Pt agrees with plan. \n \n The claimant sustained admittedly compensable injuries to her low back, right knee, and \nright  arm  when  she  fell  on  January  18,  2023.  The  claimant  also  alleges  a  compensable  cervical \nspine  injury  in  that  same  January  18,  2023,  fall.  The  claimant  again  fell  on  February  24,  2023, \nand  alleges  compensable  injuries  to  her  low  back,  right  knee,  right  arm,  coccyx,  and  cervical \nspine from that second fall. The claimant’s allegations of a compensable cervical spine injury \nthat  she  alleges  to  have  occurred  on  January  18,  2023,  and/or  February  24,  2023,  will  be \nconsidered following consideration of her allegations of compensable low back, right knee, right \narm,  and  coccyx  injuries  on  February  24,  2023.  At  the  time  the  claimant  alleges  those  injuries \nshe was backing up and fell, apparently striking the back right side of her body. The emergency \ndepartment record from February 24, 2023, states, “...fall backwards and onto her right side, \nhitting  her  right  head  and  the  back  of  her  head  on  concrete.  No  visual  abnormalities  noted  to \nthese areas. Pt reports that she is having pain of constant all over generalized 9/10.” A coccyx x-\nray  was  done  by  Dr.  Ian  Cheyne  on  March  2,  2023,  which  was  negative.  That  same  day,  the \nclaimant  is  also  seen  by  Dr.  Thomas  Cheyne,  who  reports  tenderness  over  the  coccyx,  but  also \nreviews lumbar spine and pelvic x-rays and agrees that there is no definite fracture.  \nThe claimant has the burden of proving her allegations of compensable injuries to her low \nback, right knee, right arm and coccyx from her February 24, 2023, fall. The claimant’s situation \nis somewhat unusual in that she was still treating for her admittedly compensable low back, right \nknee,  and  right  shoulder  injuries  from  her  first  fall  on  January  18,  2023.  However,  I  find  no \nobjective medical evidence of a new or different injury to her low back, right knee, or right arm \nafter  her  February  24,  2023,  fall.  Nor  do  I  find  any  objective  findings  of  injury  to  her  coccyx. \n\nBurnett – H301278 & H303725 \n \n-13- \nThere  was  tenderness  reported  but  no  bruising  was  reported,  or  derangement  from  x-ray.  The \nclaimant is unable to prove by a preponderance of the evidence that she sustained compensable \ninjuries to her low back, right knee, right arm, or coccyx in her fall on February 24, 2023. \n The claimant did sustain admittedly compensable injuries to her low back, right knee, and \nright arm on January 18, 2023. Dr. Thomas Cheyne has recommended an MRI of the claimant’s \nlumbar spine. In review of the claimant’s medical records including that of Dr. Ian Cheyne and \nDr.  Thomas  Cheyne,  I  do  believe  the  recommended  MRI  to  be  reasonable,  necessary  medical \ntreatment for the claimant’s January 18, 2023, compensable back injury,  as  the  claimant  had \nresponded to conservative treatment in an inordinately slow fashion.  \n The  claimant  also  claims  compensable  cervical  spine  injury  or  injuries  on  January  18, \n2023,  and/or  February  24,  2023. I  have  previously  included portions  of  an  MRI  report of  the \nclaimant’s cervical spine performed on June 6, 2023, after both of her January and February of \n2023  falls.  The  claimant  admits  to  having preexisting  cervical  spine  difficulties  and  underwent \nan  MRI  of  the  cervical  spine on September  9,  2022.  Following  is  a  portion  of  that  diagnostic \nreport: \nFINDINGS: \nThe  cervical  tonsils  in  appropriate  location  cervical  cord  grossly \nnormal signal. \n \nC2-C3: No significant disc bulge. \n \nC3-4:   Broad-based   central   disc   bulge   and   moderate   spurring \nindenting subarachnoid space to 8.3 mm. \n \nC4-5: No significant disc bulge. Facet arthropathy left greater than \nright. Minimal foraminal spurring. \n \nC5-6:  Central,  slightly  right  paracentral  disc  protrusion  indenting \nsubarachnoid space and cord. Narrowing of subarachnoid space to \n7 mm. Mild foraminal spurring. \n\nBurnett – H301278 & H303725 \n \n-14- \n \nC6-7:    Broad-based     central    disc    bulge     mildly    indenting \nsubarachnoid space and cord. Narrowing of subarachnoid space 7.2 \nmm. \n \nC7-T1: No significant disk bulge. \n \nT2-T3: Small central protrusion. \n \nIMPRESSION: \n1. C5-C6   central   right   paracentral   disc   protrusion   indenting \nsubarachnoid space and cord. \nCausing central canal stenosis. \n2.  Broad-based  central  disc  bulge  spurring  C3-4  with  mild  canal \nstenosis.  Prominent  foraminal  spurs.  Three  broad-based  central \ndisc bulge C6-C7: Canal stenosis. \n4. T2-T3 small central disc protrusion. \n \n Medical  records  introduced  into  evidence  clearly  show  significant  pain  and  problems \nrelated to claimant’s cervical spine prior to either of her 2023 falls. The claimant does not \nmention cervical or neck difficulties in her form AR-N signed by her on January 18, 2023. Nor \ndoes  the  claimant  mention  cervical  or  neck  difficulties  in  an  AR-C  signed  by  the  claimant  on \nJune 8, 2023, regarding her second fall. I will note that the claimant’s attorney does assert a \nclaim for cervical injury in a letter dated August 30, 2023. The claimant’s medical records after \nher January  18,  2023, fall  do  begin  on  January  25,  2023,  in  a  record  from  Dr.  Ian  Cheyne to \nconsistently state, “Patient states she has some soreness on her left neck.” However, that appears \nto  be  the  extent  of  her  cervical  or  neck  complaints  until  she  sees  Dr.  Hamby  on  June  2,  2023, \nwhen his report states, “Patient states she is having chronic cervical pain but no injury or trauma \nand started taking Tylenol 8 hour, using Diclofenac and some Tramadol she has had on hand to \nhelp with pain. Patient is also using a Tens unit 30 minutes a day and seeing her Chiropractor for \nthis as well.... Pt needs an MRI C-Spine  for  chronic  cervical  pain  with  bilateral  radiculopathy \ndown  to  her shoulders.”  Dr.  Hamby  does  at  that  time  order  an  MRI  of the  cervical  spine. \n\nBurnett – H301278 & H303725 \n \n-15- \nHowever,  prior  to  that  visit  with  Dr.  Hamby  it  appears  most  of  the  claimant’s  difficulties \nprimarily were located in her lower back.  \n In review of the claimant’s September 9, 2022, cervical spine MRI prior to her two falls \nand  the  June  6,  2023,  cervical  spine  MRI,  they  appear  to  be  essentially  the  same.  The \nImpressions section of the June 6, 2023, MRI states, “Mul multilevel disc degenerative disease \nas outlined in greater detail above.” Any change that might exist appears to be from progression \nof the disc degenerative disease and not from either of the claimant’s falls. The claimant is \nunable  to  prove  that  she  sustained  a  compensable  cervical  spine  injury  from  either  of  her  two \nfalls. Therefore, the claimant is also unable to prove her entitlement to medical treatment for her \ncervical spine. \n From 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 \nthe witness and to observe her demeanor, the following findings of fact  and conclusions of law \nare made 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  the  pre-hearing  conference  conducted  on \nAugust  21,  2023,  and  contained  in  a  Pre-hearing  Order  filed August  22,  2023,  are  hereby \naccepted as fact. \n 2. The claimant has failed to prove by a preponderance of the evidence that she sustained \ncompensable injuries to her low back, right knee, right arm, and coccyx on or about February 24, \n2023. \n\nBurnett – H301278 & H303725 \n \n-16- \n3. The  claimant  has  proven  by  a  preponderance  of  the  evidence  that  she  is  entitled  to \nmedical  treatment  for  her  compensable  low  back  injury  of  January  18,  2023,  in  the  form  of  an \nMRI of the lumbar spine. \n 4. The claimant has failed to prove by a preponderance of the evidence that she sustained \na compensable cervical spine injury on January 18, 2023, and/or February 24, 2023. \n 5. The claimant has failed to prove by a preponderance of the evidence that she is entitled \nto medical treatment for her cervical spine. \n ORDER \nThe  respondents  shall  pay  the  costs  associated  with  reasonable,  necessary  medical \ntreatment for the claimant’s compensable low back injury including an MRI of her lumbar spine \nas ordered by Dr. Thomas Cheyne. \nIf  they  have  not  already  done  so,  the  respondents  are  directed  to  pay  the  court  reporter, \nVeronica Lane, fees and expenses within thirty (30) days of receipt of the invoice. \n IT IS SO ORDERED.   \n \n                                ____________________________                                               \n       HONORABLE ERIC PAUL WELLS \n       ADMINISTRATIVE LAW JUDGE","preview":"BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION WCC NO. H301278 & H303725 MICHELLE BURNETT, Employee CLAIMANT SOUTHSIDE HIGH SCHOOL, Employer RESPONDENT ARKANSAS SCHOOL BOARDS ASSN., Carrier RESPONDENT OPINION FILED MARCH 12, 2024 Hearing before ADMINISTRATIVE LAW JUDGE ERIC PAUL WELLS in Fort Smith, Sebastian Cou...","fetched_at":"2026-05-19T22:56:09.797Z","links":{"html":"/opinions/alj-H301278-2024-03-12","pdf":"https://labor.arkansas.gov/wp-content/uploads/BURNETT_MICHELLE_H301278H303725_20240312.pdf","source_publisher":"https://labor.arkansas.gov/workers-comp/awcc-opinions/administrative-law-judge-opinions/"}}