{"id":"alj-H301493-2024-02-14","awcc_number":"H301493","decision_date":"2024-02-14","opinion_type":"alj","claimant_name":"Janice Casey","employer_name":"Conway Regional Medical Center","title":"CASEY VS. CONWAY REGIONAL MEDICAL CENTER AWCC# H301493 FEBRUARY 14, 2024","outcome":"denied","outcome_keywords":["dismissed:1","denied:2"],"injury_keywords":["fracture"],"pdf_url":"https://labor.arkansas.gov/wp-content/uploads/CASEY_JANICE_H301493_20240214.pdf","source_index_url":"https://labor.arkansas.gov/workers-comp/awcc-opinions/administrative-law-judge-opinions/","filename":"CASEY_JANICE_H301493_20240214.pdf","text_length":16833,"full_text":"BEFORE THE ARKANSAS WORKERS’ COMPENSATION COMMISSION \n   \n CLAIM NO. H301493 \n \nJANICE CASEY, Employee                                                                            CLAIMANT \n \nCONWAY REGIONAL MEDICAL CENTER, Employer                            RESPONDENT                         \n \nRISK MANAGEMENT RESOURCES, Carrier                                          RESPONDENT                        \n \n \n \n OPINION FILED FEBRUARY 14, 2024 \n \nHearing   before   ADMINISTRATIVE   LAW   JUDGE   GREGORY   K.   STEWART   in \nRussellville, Pope County, Arkansas. \n \nClaimant represented by EDDIE H. WALKER, JR., Attorney, Fort Smith, Arkansas. \n \nRespondents  represented  by  CAROL  LOCKARD  WORLEY,  Attorney,  Little  Rock, \nArkansas. \n \n \n STATEMENT OF THE CASE \n  \n On  January  18,  2024,  the  above  captioned  claim  came  on  for  hearing at \nRussellville, Arkansas.  A pre-hearing conference was conducted on October 25, 2023, \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 \nFebruary 21, 2023. \n 3.   The claimant was earning sufficient wages to entitle her to compensation at \n\nCasey – H301493 \n \n2 \n \nthe maximum rates. \n At the pre-hearing conference the parties agreed to litigate the following issues: \n1.   Compensability of injury to claimant’s head and brain on February 21, 2023. \n2.    Temporary total disability benefits from February 22, 2023 through a date yet \nto be determined. \n3.      Attorney’s fee. \nThe  claimant  contends  that as a  result of  her  fall  which occurred  while she  was \nperforming  employment  services  she  sustained  injury  to  her  head  and  brain.   The \nclaimant contends that since the cause of the fall is unexplained, the resulting injuries are \ncompensable.    The  claimant  contends  that  she  is  entitled  to  temporary  total  disability \nbenefits from February 22, 2023 to a date yet to be determined and reasonably necessary \nmedical treatment.  The claimant contends that her attorney is entitled to an appropriate \nattorney’s fee.   \nThe respondents contend that claimant’s injury was idiopathic in nature and, thus, \nnot compensable under the Arkansas Workers’ Compensation Act.  Respondents further \ncontend that in the event compensability is found, the medical documentation does not \nsupport entitlement to indemnity benefits associated with a compensable injury.  \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 \nfact and conclusions of law are made in accordance with A.C.A. §11-9-704: \n \n \n\nCasey – H301493 \n \n3 \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 October 25, 2023and contained in a pre-hearing order filed that same date are hereby \naccepted as fact. \n 2.   Claimant  has  failed  to  prove  by  a  preponderance  of  the  evidence  that  she \nsuffered a compensable injury to her head and brain on February 21, 2023. \n \n FACTUAL BACKGROUND \n The claimant worked for respondent in a lab area.  On February 21, 2023, she was \nat work when she had a syncopal episode and fell, injuring her head.  Claimant was taken \nto the emergency room at St. Mary’s in Russellville before being air flighted to Baptist \nHealth in Little Rock.  Claimant has been diagnosed with a skull fracture with hemorrhage. \n After  her  initial  treatment  and  hospitalization,  she  has  treated  with  neurology  at \nBaptist  and  with  her  primary  care  physician,  Jessica  McNeese.    Medical  records  from \nMcNeese  were  introduced  into  the  record,  but  not  the  medical  records  of  Baptist \nNeurology.  Claimant has not returned to work for respondent or for any other employer \nsince the accident.   \n Claimant has filed this claim contending that she suffered a compensable injury to \nher  head  and  brain  as  a  result  of  the  accident  on  February  21,  2023.   She  requests \npayment  of  related  medical,  temporary  total  disability  benefits,  and  a  controverted \nattorney fee. \nADJUDICATION \n Claimant has the burden of proving that her injury was the result of an accident \n\nCasey – H301493 \n \n4 \n \nthat arose in the course of her employment, and that it grew out of, or resulted from the \nemployment.  Moore v. Darling Store Fixtures, 22 Ark. App. 21, 732 S.W. 2d 496 (1987).  \n“Arising out of the employment” refers to the origin or cause of the accident, while “in the \ncourse of the employment” refers to the time, place and circumstances under which the \ninjury occurred.  Little Rock Convention & Visitors Bureau v. Pack, 60 Ark. App. 82, 959 \nS.W. 2d 415 (1997).   \n Respondent contends that claimant’s syncopal episode was idiopathic and not \ncompensable.    Claimant  contends  that  the  syncopal  episode  was  unexplained  and \ncompensable.  An idiopathic injury is one whose cause is personal in nature or peculiar \nto the individual.  Crawford v. Single Source Transportation, 87 Ark. App. 216, 189 S.W. \n3d 507 (2004).  Injuries sustained due to an unexplained cause are different from injuries \nwhere the cause is idiopathic.  Id. at 220-21, 189 S.W. 3d at 510.  When a claimant suffers \nan unexplained injury at work, it is generally compensable.  Id.  at 221, 189 S.W. 3d at \n510.    Because  an  idiopathic  injury  is  not  related  to  employment,  it  is  generally not \ncompensable  unless  conditions  related  to  the  employment  contribute  to  the  risk.   Id.  \nEmployment  conditions  that  may  contribute  to  the  risk  or  aggravate  the  injury  include \nplacing the employee in a position that increases the dangerous effect of a fall, such as \na height, near machinery or sharp corners, or in a moving vehicle.  Id., 189 S.W. 3d at \n510.   \n In  this  case,  the  events  of  the  night  before  (2/20/23)  and  early  morning  hours \n(2/21/23) are relevant.  Testifying at the hearing was William Casey, claimant’s husband \nof five years.  He testified that around midnight he found claimant in the bathroom sitting \non the toilet.  Claimant informed him that she had been constipated but finally had a bowel \n\nCasey – H301493 \n \n5 \n \nmovement.  Claimant also indicated that she was nauseous due to the smell.  According \nto Casey, claimant did not have diarrhea and did not vomit that night.   \n Likewise,  claimant  testified  that  her  stomach  was  cramping  around  midnight  on \nFebruary  21,  2023,  and  that  she  was  constipated.    She  also  testified  that  she  was \nnauseous due to the smell but did not vomit or faint that night.  Claimant further testified \nthat she did not feel sick or ill when she went to work on February 21, 2023, and that she \ndid not vomit after she arrived at work that day.   \n The medical records contain a history significantly different from the testimony of \nclaimant and  her  husband.   The  initial  medical  record  from  the  emergency  room at  St. \nMary contains the following history: \n  Patient was and had episode of fall with hitting her head \n  patient having nausea and vomiting.  Patient complaining \n  of severe headache.  Patient has seizure-like activity after \n  she hit her head.  Husband states patient had episode of \n  nausea and vomiting which happened last night.  And this \n  morning at work patient had nausea vomiting and diarrhea \n  as well.  (Emphasis added.) \n \n \n After  her  initial  treatment  at  the  emergency  room,  claimant  was  air  flighted  to \nBaptist in Little Rock.  The Baptist emergency room record contains the following history: \n  Janice M. Casey is a 57 y.o. female that presents to the \n  ED via transfer from St. Mary’s for evaluation after a fall \n  this morning.  Per EMS and pt records, the patient was \n  at work when she had a syncopal episode.  She fell from \n  standing and hit her head on the hard tile floor with reported \n  seizure like activity after.  The patient was sick with nausea \n  and vomiting last night.  Patient is slightly confused but able \n  to answer questions.  (Emphasis added.) \n \n \n Also on February 21, 2023, claimant was evaluated by Dr. Timothy Burson for a \n\nCasey – H301493 \n \n6 \n \nneurosurgical consult.  His report contains the following history: \n  Pt by report fell at work and struck her head.  Said she \n  had a “stomach virus” the night before with a lot of \n  vomiting.  Felt faint and passed out.  Remembers \n  falling then people standing over her.  Complains \n  of a headache.  Pain at site where she hit her head. \n \n     *** \n  57-year-old female was at work feeling fine stood up \n  had some groin pain nonspecific abdominal pain fell \n  and struck her head.  Transferred from St. Mary’s \n  Hospital after a ground-level fall.  The patient was at \n  work she had a syncopal episode and fell from stand- \n  ing, hit her head on a hard floor.  There was apparently \n  seizure activity afterwards.  Patient slightly confused \n  but able to answer questions.  (Emphasis added.) \n \n \n Both   William   Casey   and   claimant   have   attempted   to   explain   away   these \ninconsistencies.  William Casey testified that claimant’s sister was present when he \narrived at the hospital and he informed her that claimant was constipated the night before.  \nCasey  also testified that he doesn’t recall having any conversations with the medical \nproviders  at  the  hospital,  but  indicated  that  he  never  told  anyone  that  claimant  was \nvomiting.  With respect to the references in the medical records regarding nausea and \nvomiting prior to the fall, he stated: \n  Q Okay.  You realize in the medical records there  \n  is multiple references to claimant being nauseous and \n  vomiting prior to her fall.  Are you aware of that? \n \n  A Somebody assumed that their own self.   \n \n \n However, as previously noted, the initial emergency room report specifically states: \n  Husband states patient had episode of nausea and \n  vomiting which happened last night.  (Emphasis \n  added.) \n\nCasey – H301493 \n \n7 \n \n Claimant  testified  that  she  does  not  remember  anything  that  happened  at  the \nhospital and does not remember talking to the doctors or the nurses.  She did not know \nwhere the information in the medical history came from. \n After having the opportunity to observe the witnesses and consider their testimony, \nI  do  not  find  the  testimony  persuasive  with  regard  to  the  medical  history.    The  initial \nmedical history clearly states that William Casey stated that claimant had an episode of \nnausea and vomiting the night before.  It also indicates that claimant had nausea, vomiting \nand  diarrhea  that  morning at  work.    Likewise,  the emergency  room  report  from Baptist \nindicates that claimant had been sick with nausea and vomiting the night before.  Finally, \nthe report of Dr. Burson who performed a neurosurgical consult specifically stated in his \nhistory: \n  Said she had a “stomach virus” the night before with a lot \n  of vomiting.  Felt faint and passed out. \n \n \n Given the specificity of the reports indicating that William Casey gave a history of \nnausea and vomiting the night before and that claimant gave the history of a “stomach \nvirus” the night before with “a lot of vomiting”, I do not find that these statements are the \nresult of medical providers assuming histories that they were not given or that they were \nsomehow based on misinterpretations.  In short, I see no reason not to give credence to \nthe histories contained in the medical records. \n That history indicates that claimant was suffering from nausea with vomiting and \ndiarrhea the night before February 21, 2023.  It also indicates that claimant had diarrhea \nand vomiting at work that morning.   \n Based  upon  the  evidence  presented,  particularly  the  histories  contained in  the \n\nCasey – H301493 \n \n8 \n \nmedical records, I find that claimant’s syncopal episode was idiopathic in nature and not \nthe  result  of  her  employment  with  respondent.    Claimant  specifically  testified  that  she \nwalked over to her desk to input information into a computer when she simply passed out: \n  Q And then you passed out? \n \n  A Yes. \n \n Claimant  admitted  that  she  did  not  trip  over  anything;  did  not  inhale  or  ingest \nanything that would have made her pass out or faint; and that there was no work-related \ncause that she could identify that made her lose consciousness.  Instead, her testimony \nindicates that something in her body caused her to pass out. \n  Q Something went wrong with your body and it shut \n  down.  Do you agree with that? \n \n  A Correct. \n \n      *** \n  Q So did you experience some odd sensation or \n  feeling coming over your body before you went out? \n \n  A I did. \n \n \n This is also noted in the history contained in Dr. Burson’s neurological consultation \nreport which states: \n  57-year-old female was at work feeling fine stood up had \n  some groin pain nonspecific abdominal pain fell and struck \n  her head. \n \n \n Finally, I note that on March 5, 2023, claimant completed Form AR-N.  When asked \nto briefly discuss the cause of injury  claimant indicated: \n  I had just drew blood from a patient went to my desk, had \n  tinkling feeling from feet to chest and then next thing I \n\nCasey – H301493 \n \n9 \n \n  remember is hearing Cindy and Dr. Walker and in \n  terrible pain from my head where I made contact \n  with the floor.  (Emphasis added.) \n \n \n Based on the totality of the evidence, I find that claimant’s syncopal episode was \nidiopathic in nature.  The medical records indicate a history of diarrhea and vomiting the \nnight before and the morning of the syncopal episode.  Claimant’s testimony indicates \nthat immediately prior to this episode she felt an odd sensation or feeling.  Dr. Burson’s \nmedical report indicates “some groin pain nonspecific abdominal pain”.  And in her Form \nAR-N, claimant described a “tinkling feeling from feet to chest”.  Notably,  there  is  no \nevidence linking the syncopal episode to her job activities with respondent as opposed to \nan idiopathic incident. \n Even  if  a  claimant  suffers  an  idiopathic  injury  it  may  still  be  compensable  if \nemployment  conditions  contribute  to  the  risk  or  aggravate  the  injury  by  placing  the \nemployee in a position that increases the dangerous effect of a fall, such as a height, near \nmachinery  or  sharp  corners,  or  in  a  moving  vehicle.   Crawford  v.  Single  Source \nTransportation, 87 Ark. App. 216, 189 S.W. 3d 507 (2004).   \n Claimant testified that in her addition to her desk, there is a filing cabinet, a chair, \nanother desk, and a refrigerator.  Although there was some question regarding what she \nmay have struck when she fell, claimant admitted that she did not know what happened \nand does not know if she hit her head on anything.   \n  Q Since you are familiar with the lab and the configura- \ntion of the lab and the objects in the lab, have you reached  \na conclusion in regard to what you believe happened? \n \nA No, sir.  I just don’t know what happened to me. \n \n\nCasey – H301493 \n \n10 \n \n    *** \nQ And you told me under oath you could not testify  \nthat you hit your head on anything? \n \nA I don’t recall hitting my head because I was  \npassed out. \n \n \n Accordingly, it would require speculation and conjecture to find that claimant struck \nher  head  against  her  desk  or  any  other  piece  of  furniture  that  day.    Speculation  and \nconjecture  are  not  to  be  substituted  for  credible  evidence  by  the  Commission.   Dena \nConstruction Co. v. Herndon, 264 Ark. 791, 796, 575 S.W.2d 155 (1979).  Therefore, I do \nnot find that claimant’s employment conditions contributed to the risk or aggravated her \ninjury by placing her in a position that increased the effects of a fall. \n \nORDER \n Claimant has failed to prove by a preponderance of the evidence that she suffered \na compensable injury to her head or brain while employed by respondent on February 21, \n2023.  Therefore, her claim for compensation benefits is hereby denied and dismissed. \n Respondents  are  responsible  for  payment  of  the  court  reporter’s  charges  for \npreparation of the hearing transcript in the amount of $611.65. \n IT IS SO ORDERED. \n \n      _____________________________________ \n       GREGORY K. STEWART \n       ADMINISTRATIVE LAW JUDGE","preview":"BEFORE THE ARKANSAS WORKERS’ COMPENSATION COMMISSION CLAIM NO. H301493 JANICE CASEY, Employee CLAIMANT CONWAY REGIONAL MEDICAL CENTER, Employer RESPONDENT RISK MANAGEMENT RESOURCES, Carrier RESPONDENT OPINION FILED FEBRUARY 14, 2024 Hearing before ADMINISTRATIVE LAW JUDGE GREGORY K. STEWART in Russellville, Pope County...","fetched_at":"2026-05-19T22:57:29.030Z","links":{"html":"/opinions/alj-H301493-2024-02-14","pdf":"https://labor.arkansas.gov/wp-content/uploads/CASEY_JANICE_H301493_20240214.pdf","source_publisher":"https://labor.arkansas.gov/workers-comp/awcc-opinions/administrative-law-judge-opinions/"}}