{"id":"alj-H302325-2023-12-05","awcc_number":"H302325","decision_date":"2023-12-05","opinion_type":"alj","claimant_name":"Alisha Berry","employer_name":"Home Helpers Of Nwa","title":"BERRY VS. HOME HELPERS OF NWA AWCC# H302325 DECEMBER 5, 2023","outcome":"granted","outcome_keywords":["granted:3"],"injury_keywords":["knee","sprain","back","lumbar","hip"],"pdf_url":"https://labor.arkansas.gov/wp-content/uploads/BERRY_ALISHA_H302325_20231205.pdf","source_index_url":"https://labor.arkansas.gov/workers-comp/awcc-opinions/administrative-law-judge-opinions/","filename":"BERRY_ALISHA_H302325_20231205.pdf","text_length":42005,"full_text":"BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION \n \n WCC NO. H302325 \n \nALISHA BERRY, Employee CLAIMANT \n \nHOME HELPERS OF NWA, Employer RESPONDENT \n \nAMTRUST NORTH AMERICA, Carrier RESPONDENT \n \n \n \n OPINION FILED DECEMBER 5, 2023 \n \nHearing  before  ADMINISTRATIVE  LAW  JUDGE  ERIC  PAUL  WELLS  in  Fort  Smith, \nSebastian County, Arkansas. \n \nClaimant represented by MICHAEL L. ELLIG, Attorney at Law, Fort Smith, Arkansas. \n \nRespondents   represented   by   WILLIAM   C.   FRYE,   Attorney   at   Law,   North   Little   Rock, \nArkansas. \n \n STATEMENT OF THE CASE \n \n On  September  7,  2023,  the  above  captioned  claim  came  on  for  a  hearing  at  Fort  Smith, \nArkansas.   A pre-hearing conference was conducted on June 19, 2023, and a Pre-hearing Order \nwas  filed  on  June  20,  2023.      A  copy  of  the  Pre-hearing  Order  has  been  marked  Commission's \nExhibit 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 March 7, \n2023. \n 3. The claimant sustained a compensable injury to her right knee on March 7, 2023. \n By agreement of the parties the issues to litigate are limited to the following: \n\nBerry – H302325 \n \n-2- \n 1.  Whether  Claimant  is  entitled  to  temporary  total  disability  benefits  from  March  10, \n2023, to June 4, 2023. \n 2.   Whether   Claimant   is   entitled   to   additional   medical   treatment   in   the   form   of \nprescription medication and physical therapy. \n 3. The Claimant’s weekly compensation rates. \n 4. Whether Claimant’s attorney is entitled to an attorney fee. \n Claimant’s contentions are: \n“The claimant contends that she is entitled to temporary partial disability benefits \nfrom  March  8,  2023  through  March  15,  2023  and  temporary  total  disability \nbenefits from March 16, 2023 through a date yet to be determined. The  claimant \nfurther contends that her attorney is entitled to the statutory fee for such benefits.” \n \n Respondents’ contentions are: \n \n“The  Respondents  contend  that  work  was  made  available  to  the  claimant  from \nMarch  8,  2023  to  June  5,  2023.  At  that  time  Dr.  Coker  took  the  claimant  off \npending an evaluation by Dr. Miedema.” \n \n The claimant in this matter is a 43-year-old female who was employed by the respondent \non  March  7,  2023,  as  a  home  health  or  help  aid  when  she  sustained  a  compensable  right  knee \ninjury. In direct examination testimony the claimant described her general job duties as follows: \nQ What  were  you  doing  for  Home  Helpers?  What  was  your \njob assignment? \n \nA I  went  into  clients’  homes  and  if  they  needed  a  bath,  I \nhelped them with a bath. If they needed help to the toilet, I helped \nthem to the toilet. I folded their clothes, swept their floors, mopped \ntheir floors. \n The  last  client  that  I  had,  I  was  walking  with  him  through \nhis  house  for  daily  exercise.  I  hooked  up  his  oxygen  machine.  I \nlaid out food. Well, he had a feeding tube, so we would put liquid, \nhis medicine into it, and I brought it to him and his wife fed that to \nhim. \n Changed their sheets, dishes. \n \n\nBerry – H302325 \n \n-3- \nQ All right. \n \nA I mean that is just some of the stuff. \n \n The claimant would go and work in different respondent-client’s homes over the time she \nworked for the respondent. The claimant described her job assignment on March 7, 2023, and her \ncompensable right knee injury on direct examination as follows: \nQ And what assignment did you have on March 7\nth\n of 2023? \n \nA I  went  into  a  client’s  home  who  had  a  feeding  tube,  a \ntrachea. He couldn’t walk other than with a walker and his body \nhad been really weak. He didn’t have much strength. I would help \ntake  all  of  his  food  over  to  where  he  sat  and  ate  at.  And  I  would \nbring all of the – I think there was like five different cups of water \nfor him to brush his teeth and put his dentures in and stuff to fix his \nhair or comb it or whatever. He had a lot of different things. They \nwere  very  particular  on  what  all  he  needed  and  in  order  and \neverything was done in a timeline. \n \nQ Did  you  also  do  things  around  the  house,  housekeeping \ntype things? \n \nA Yes. I folded the laundry, swept the floor, steamed the floor \nevery day as well. I filled up their humidifiers. I opened their mini \nblinds so they would have light in the house. I did their dishes. \n \nQ All  right.  Would  you  briefly  describe  the  accident  that \noccurred on March 7\nth\n of 2023. \n \nA I was walking and slid on a mat. My right leg went forward \nand turned to the left and my left leg went up underneath me. \n \nQ What physical difficulties did you experience at that time? \n \nA It hurt and it was painful. \n \nQ What hurt? \n \nA I am sorry. My right knee. Sorry. \n \n\nBerry – H302325 \n \n-4- \n The  claimant  reported  her  injury  on  March  11,  2023,  and  was  seen  at  Baptist  Health \nWalk-In Clinic that same day. Following is a portion of that medical record: \nReason for Visit: \nKnee Pain (right) \nPatient’s had right knee pain worsening as the week goes on. She \nslipped and clients house a few days ago and fell in the kitchen. Its \nbeen getting worse in the mornings and much worse this morning. \nHurts to walk. Hurts to bend it. Feels swollen. She works in home \nhealth. \n \n*** \nAssessment/Plan \n1. Internal derangement of right knee (Primary) \n-   MRI   Knee   Right   WO   Contrast;   Future;   Expected   date: \n03/18/2023 \n- Ambulatory referral to Orthopedic Surgery \n \n2. Acute pain of right knee \n- XR Knee 3 Vw Right \n \n3. Effusion of bursa of right knee \n \n4. Fall on same level, initial encounter \n \nI  read  x-ray  and  discussed  with  patient.  I  am  concerned  about \ninternal  derangement  of  the  meniscus  and  the  medial  collateral \nligament   especially.   She   is   having   quite   a   bit   of   pain   with \nextension and flexion and walking. We will place her on crutches. \nDiscussed use. Do not want to immobilize in a has that will make it \nmore  stiff  and  swollen.  However  she  needs  to  avoid  bearing \nweight.  Needs  an  MRI  and  orthopedic  Surgeon.  She  will  inform \nher work. \n \n One March 22, 2023, the claimant underwent an MRI of her right knee at Baptist Health. \nFollowing is a portion of that diagnostic report signed by Dr. Jennifer Wood. \n1. Partial ACL tear or high-grade sprain \n2. Horizontal tearing of the posterior horn of the medial meniscus \n3.   Abnormal   appearance   of   the   posterior   horn   of   the   lateral \nmeniscus extending to the inferior articular cartilage (best seen on \nimage 21 of series 4) is also concerning for a tear. \n \n\nBerry – H302325 \n \n-5- \n On  March  28,  2023,  the  claimant  was  seen  at  Baptist  Health  by  orthopedic  surgeon  Dr. \nJeffrey Evans. Following is a portion of that medical record: \nChief Complaint \n- Knee Pain (Right Knee Pain) \n \n*** \nAssessment and Plan: \n1. Acute pain of right knee (Primary) \n- XR Knee 1 Vw Right \n \n2.   Sprain   of   anterior   cruciate   ligament   of   right   knee,   initial \nencounter \nAssessment & Plan \nMy  personal  reading  of  X-rays  of  right  knee  are  normal  and  MRI \nright  knee  shows  an  anterior  cruciate  ligament  tear  and  posterior \nhorn medical meniscus rear. \nContinue NWB on right leg with crutches. \nShe will file work comp claim. \nShe will need right knee arthroscopy for anterior cruciate ligament \nreconstruction and partial meniscectomy soon. \n \n3. Complex tear of medial meniscus of right knee as current injury, \ninitial encounter \nAssessment & Plan \nSee above. \n \n On  April  30,  2023,  the  claimant  went  to  the  emergency  department  at  Mercy  Hospital \nwhere the claimant continued to complain of pain and difficulties with her right knee. A portion \nof that emergency department record follows: \nMedical Decision Making \nDifferential   diagnosis   includes:   Cellulitis,   contact   dermatitis, \nhematoma, effusion, DVT, other \n \nThe  patient  is  a  42-year-old  female  with  history  of  recent  right \nknee  injury  resulting  in  a  medial  meniscus  tear  and  ACL  tear  that \npresents to the  emergency department  for evaluation of right knee \npain with overlying skin color changes. The patient’s examination \ndemonstrates  patient  has  rash  that  is  consistent  with  cellulitis \noverlying  the  right  knee  with  a  prepatellar  effusion,  no  additional \nacute significant abnormalities. Laboratory evaluation \n\nBerry – H302325 \n \n-6- \ndemonstrates  benign  laboratory  evaluation.  Imaging  studies  show \nknee  x-ray  shows  some  mild  soft  tissue  swelling  without  acute \nadditional   abnormal   findings   per   my   interpretation.   Doppler \nultrasound    right    lower    extremity    demonstrates    no    acute \nabnormality.    EKG    shows    not    performed.    Interventions    in \nemergency  department  included  patient  received  Toradol  for  pain \ncontrol  with  no  relief.  She  received  Dilaudid  and  Benadryl.  The \npatient  had  mild  improvement.  She  received  her  first  dose  of \nantibiotic  in  the  emergency  department.  Patient  was  discharged \nwith  oral  pain  pill  tablets  and  next  dose  of  Bactrim  as  she  cannot \nget her medications until the afternoon. The patient was prescribed \ncourse of Bactrim and additional pain medication. She was referred \nback  to  our  orthopedic  surgery  group  as  she  is  having  some \ndifficulty navigating the Workmen’s Comp follow-up  instructions \ndue  to  miscommunication.  The  patient  understands  close  return \nprecautions and is agreeable with outpatient management. \n \n The  claimant  then  began  to  treat  with  Dr.  Tom  Coker  at  Ozark  Orthopedics  on  May  5, \n2023. On May 5, 2023, Dr. Coker  examined the  claimant and reviewed her previous diagnostic \nresults regarding her right knee. \nHPI \n42-year-old  white  female  who  got  hurt  at  work  on  March  7  she \nslipped. She has a job that does not have sitdown duty apparently. \nShe  went  to  a  med  a  quick  type  facility  had  x-rays  which  I \nreviewed  look  normal  the  reports  normal.  Has  not  worked  since \nthat incident maybe about a week later she was sent elsewhere had \nother  x-rays  again.  I  have  some  x-rays  dated  that  look  like  what \nshe is talking about and they look normal and she has crutches she \nhas  been  almost  nonweightbearing  since  this  happened  because  it \nhurts is her pain is mostly medial with the initial  injury she is not \nreal  sure  the  mechanism  of  injury  but  could  have  been  a  twist  it \nwas  not  a  direct  blow  she  is  not  sure  but  did  not  hear  a  pop \nswelling  occurred  but  not  immediately  but  there  is  pain  with \nweightbearing pain with motion and now the pain is more diffuse. \nShe  had  an  MRI  done  which  I  reviewed  the  initial  report  says \nnormal MRI and there is an addendum to it where they state there \nmay be a torn lateral meniscus and a partial tear of the ACL. I have \nreviewed the MRI in my opinion the MRI is normal or  correct on \nthe first viewing but not the second. Her menisci do not have tears \nI believe they have some intrameniscal signal. The ACL is intact it \ncould  have  been  sprained  but  I  do  not  see  a  surgical  torn  ACL  in \nher. She is now 6 or 7 weeks out from her injury and is still unable \n\nBerry – H302325 \n \n-7- \nto  bear  weight  as  she  was  placed  in  a  knee  immobilizer  after  the \nMRI  I  believe  she  saw  an  orthopedic  surgeon  and  discussed  ACL \nreconstruction etc. After being placed in her knee immobilizer she \ndeveloped  a  cellulitis  when  to  the  ER  this  past  Sunday  and  was \nplaced  on  antibiotics  she  had  redness  swelling  medially  and  she \npartially  blames  it  on  that  knee  immobilizer  rubbing  it  I  am  not \nsure  but  it  does  not  sound  like  there  is  a  hematoma  from  the  first \ninjury  that  got  infected  and  it  may  have  just  been  a  superficial \ncellulitis.  She  has  not  been  treated  with  antibiotics  for  for  5  days \nand is resolving. \n \n The  claimant  underwent  a  second  MRI  of  the  right  knee  at  the  recommendation  of  Dr. \nCoker on May 22, 2023. The impression section states, “There is a bone contusion in the anterior \nmedial femoral condyle.” \n Dr. Coker again saw the claimant on June 5, 2023, with the benefit of having been able to \nreview her second right knee MRI. Following is a portion of his report: \nHPI \n42  Y  female  here  for  MRI  results  MRI  shows  normal  menisci \nnormal  ligaments  a  bone  contusion  medial  femoral  condyle.  She \nworks in healthcare take care of people she fell 3 months ago down \nin  Fort  Smith  she  was  seen  by  Fort  Smith  Dr.  And  a  second \nopinion  was  wanted  because  he  was  discussing  surgery  for  torn \nACL torn meniscus.  I  reviewed her old MRI did  not see that kind \nof  pathology  and  we  have  repeated  her  MRI  to  confirm  that  her \nmenisci are fine her ACL is intact she does not need surgery. What \nshe  has  now  are  mottled  skin  and  shiny  skin  hypersensitivity  to \ntough  numbness  to  the  toes  but  good  capillary  refill  and  signs \nconsistent  with  reflex  sympathetic  dystrophy.  We  discussed  the \nfact  that  she  has  no  surgical  problems  with  her  knee  but  her \ncontusion at work is because this RSD type of picture. Therefore I \nam going to recommend that she see a physical medicine and rehab \nphysician  we  have  1  or  2  in  our  group  with  Dr. Miedema  and  Dr. \nBJ Diana. He could all but so she could be followed up by whoever \nWorker’s Comp. wants her to see if there have a PMNR doctor in \nmind or a neurologist. This point was already started PT Sorg and \ncontinue  PT  until  they  can  be  further  evaluated  we  discussed  the \nfact  I  want  full  range  of  motion  full  weightbearing  and  offered \ncrutches.  Discussed  the  fact  that  this  is  RSD  the  treatment  is  a \nphysical therapy to regain mobility and then beyond that there may \nbe other treatments that  a physical medicine rehab her neurologist \n\nBerry – H302325 \n \n-8- \nmight  recommend.  This  is  not  an  orthopedic  surgical  problem  at \nthis  point  if  this  was  a  simple  fall  and  contusion  she  would  have \nalready  returned  to  work  but  we  have  this  other  diagnosis  that  I \nbelieve  is  work-related.  So  we  will  continue.  So  we  will  continue \nPT  until  she  has  had  a  change  to  make  arrangements  to  see  other \nmedical specialist thank you. \n \n*** \nAssessment/Plan \nAssessment  of  her  diagnosis  of  contusion  right  knee  she  may  be \nfull weightbearing full range of motion \n \n1. Body mass index 25-29 – overweight \nZ68.25; Body mass index (BMI) 25.0-25.9, adult \nBODY MASS INDEX: CARE INSTRUCTIONS \n \n2. Contusion of right knee \nS80.01XA: Contusion of right knee, initial encounter \nPHYSICAL    THERAPIST    REFERRAL –    Schedule    Within: \nprovider’s discretion. Note to Provider: Contusion w/RSD on right \nknee, full ROM, full strengthening, full weightbearing \n \n3. Complex regional pain syndrome type 1 \nReflex sympathetic dystrophy of right knee \nG90.521: Complex regional pain syndrome 1 of right lower limb \n \n On  the  recommendation  of  Dr.  Coker,  the  claimant  was  seen  by  Dr.  Mark  Miedema  at \nOzark  Orthopedics  on  June  14,  2023.  Dr.  Miedema  examined  the  claimant  and  provided  an \nassessment and plan as follows: \nAssessment/Plan \nODI 37 Completely disabled \n \n1. Pain of right knee joint \nMs.  Berry  presents  for  evaluation  of  About  3  months  right  knee \npain.  She  had  an  injury  at  work  in  March  which  precipitated  her \nsymptoms. She had a fall while at  work. She was not having pain \nprior to this injury. She saw Dr. Coker. She had a recent MRI. She \nhas been having to use crutches to get around. She has been going \nto PT. \n \n\nBerry – H302325 \n \n-9- \nShe  had  an  MRI  of  the  right  knee  at  Ozark  on  5/22/2023  which \nshowed a contusion of the anterior medial tibial condyle. M25.561: \nPain in right knee. \n \n2. Complex regional pain syndrome type 1 \nRight  lower  extremity  CRPS  type  1  after  a  fall  and  subsequent \nbony  contusion.  This  patient  qualifies  for  diagnosis  of  Complex \nRegional  Pain  Syndrome  (CRPS)  Type  1  based  on  the  Budapest \ncriteria  presenting  symptoms  of  allodynia  &  hyperalgesia,  with \nassociated  vasomotor/sudomotor  changes.  She  saw  Dr.  Coker  and \nthere is no surgical indication at this time. She has been doing PT \nwith   significant   ongoing   pain   and   functional   limitations.   She \ncannot bear weight on her right leg and has been ambulating using \ncrutches. \n \nI    would    like    her    to    continue    with    physical    therapy    for \ndesensitization,  strengthening  and  range  of  motion.  I  would  like \nher to stop gabapentin and I would recommend starting Lyrica for \nneuropathic  pain  50  mg  twice  a  day.  Would  also  recommend  she \nstart  Celebrex  200  mg  twice  a  day.  Vitamin  C  supplementation \ncould also be helpful. \n \nGiven the severity of the patient’s pain and functional limitation \nand no relief or inability to tolerate conservative measures, we will \nproceed  with  right  lumbar  sympathetic  block  for  diagnostic  and \ntherapeutic purposes. \n \nI  do  not  think  she  has  reached  maximum  medical  improvement.  I \ndo not think she can return to work at this time. \n \n The claimant was seen by PA Wesley McGehee on July 26, 2023, at Ozark Orthopedics. \nFollowing is a portion of that medical report: \nAssessment/Plan \nODI 37 Completely disabled \n \n1. Pain of right knee joint \nMrs.  Berry  presents  for  follow  up  evaluation  of  about  a  4  month \nhistory  of  right  knee  pain.  She  had  an  injury  at  work  in  March  of \n2023  which  precipitated  her  symptoms.  She  had  a  fall  while  at \nwork.  She  was  not  having  pain  prior  to  this  injury.  She  saw  Dr. \nCoker. She had a recent MRI. She has been having to use crutches \nto get around. Since her last visit with Dr. Miedema on 6/14/2023 \nshe has been taking the prescribed gabapentin pregabalin, Celebrex \n\nBerry – H302325 \n \n-10- \nand baclofen. She has also continued with the physical therapy for \ndesensitizing   techniques   and   attempts   of   improving   range   of \nmotion. She presents today to review her progress from her recent \nprocedure. \n \nShe  had  an  MRI  of  the  right  knee  at  Ozark  on  5/22/2023  which \nshowed a contusion of the anterior medial tibial condyle. \n \nOn my review of her 4 view lumbar radiographs taken at Ozark on \n7/26/2023   this   reveals   evidence   of   5   nonrib-bearing   lumbar \nvertebral  bodies.  Normal  osseous  alignment  is  noted.  There  is \nminimal evidence of degenerative disc height loss at L5-S1 slightly \nmore  progressed  at  L5-S1  comparatively.  No  listhesis  identified. \nNo acute fractures noted. M25.561: Pain in right knee. \n \n2. Complex regional pain syndrome type 1 \nRight  lower  extremity  CRPS  type  1  after  a  fall  and  subsequent \nbony  contusion.  This  patient  qualifies  for  diagnosis  of  Complex \nRegional  Pain  Syndrome  (CRPS)  Type  1  based  on  the  Budapest \ncriteria  presenting  symptoms  of  allodynia  &  hyperalgesia,  with \nassociated  vasomotor/sudomotor  changes.  She  saw  Dr.  Coker  and \nthere is no surgical indication at this time. She has been doing PT \nwith   significant   ongoing   pain   and   functional   limitations.   She \ncannot bear weight on her right leg and has been ambulating using \ncrutches. \n \nShe is s/p lumbar sympathetic nerve block on 7/3/23 with roughly \n40%  pain  relief  and  functional  improvement  But  for  only  a  short \ntime after this injection. \n \nShe  does  state  the  mottling  associated/skin  color  changes  in  her \nright  leg  did  improve  after  this  injection.  However,  she  still \ncontinues  with  significant  pain  and  functional  limitations.  Despite \nthe   continued   efforts   with   physical   therapy   and   taking   the \npregabalin  now  up  to  100  mg  twice  per  day.  Celebrex  200  mg \ntwice per day and baclofen 10 mg 3 times per day a needed. \n \nI  would  like  for  her  to  continue  this  medication  regimen  for  now. \nShe    should    also    continue    with    the    physical    therapy    for \ndesensitizing  techniques.  And  attempting  to  improve  her  rage  of \nmotion as much as tolerated. \n \nConsidering  she  did  have  some  improvement  especially  with  the \nskin changes in her right leg after the previous lumbar sympathetic \n\nBerry – H302325 \n \n-11- \nnerve  block  my  recommendation  is  that  we  proceed  to  repeat  this \nin hopes of more sustained relief. \n \nI  do  not  think  she  has  reached  maximum  medical  improvement.  I \ndo not think she can return to work at this time. We will extend her \nwork  excuse  out  until  she  follows  up  with  us  after  this  repeat \nlumbar sympathetic nerve block. \n \nWe  also  discussed  today  that  neuromodulation  could  be  a  good \ntreatment modality for her in the future. \n \nAdditionally,  I  did  obtain  lumbar  radiographs  today  to  assess  for \nany  significant  evidence  of  lumbar  spondylosis.  We  may  obtain  a \nlumbar MRI in the future depending on her response to the lumbar \nsympathetic nerve block. \n \nI  will  plan  to  follow-up  with  the  patient  after  this  procedure  to \nreassess their progress.  \nG90.521: Complex regional pain syndrome 1 of right lower limb. \nNERVE BLOCK, LUMBAR SYMPATHETIC (PROC) – Note to \nProvider: Right lumbar sympathetic nerve block 64520 \n \n3. Low back pain \nM54.50: Low back pain, unspecified \nL-SPINE 4 OR 5 VIEWS \n \n The final medical record introduced into evidence in this matter is a report by PA Wesley \nMcGehee from the claimant’s August 17, 2023, visit. A portion follows: \nAssessment/Plan \n1. Pain of right knee joint \nMrs.  Berry  presents  for  follow-up  evaluation  of  about  a  5  month \nhistory  of  right  knee  pain.  She  had  an  injury  at  work  in  March  of \n2023  which  precipitated  her  symptoms.  She  had  a  fall  while  at \nwork.  She  was  not  having  pain  prior  to  this  injury.  She  saw  Dr. \nCoker.  She  had  a  recent  MRI  of  the  right  knee.  She  has  been \nhaving  to  use  crutches  to  get  around.  Since  her  last  visit  with  Dr. \nMiedema   on   6/14/2023   she   has   been   taking   the   prescribed \npregabalin, Celebrex and baclofen. She has also continued with the \nphysical  therapy  for  desensitizing  techniques  and  attempts  of \nimproving  range  of  motion  as  well  as  exercises  for  her  lumbar \nspine.  She  presents  today  to  review  her  progress  from  her  recent \nprocedure and to discuss additional treatment options. \n \n\nBerry – H302325 \n \n-12- \nShe  had  an  MRI  of  the  right  knee  at  Ozark  on  5/22/2023  which \nshowed a contusion of the anterior medial tibial condyle. \n \nOn my review of her 4 view lumbar radiographs taken at Ozark on \n7/26/2023   this   reveals   evidence   of   5   nonrib-bearing   lumbar \nvertebral  bodies.  Normal  osseous  alignment  is  noted.  There  is \nminimal   evidence   of   degenerative   disc   height   loss   at   L5-S1 \notherwise  disc  space  heights  are  relatively  well-maintained.  Mild \nevidence  of  facet  arthropathy  noted  at  L4-5  and  L5-S1,  M25.561: \nPain in right knee. \n \n2. Complex regional pain syndrome type 1 \nRight lower extremity CRPS type 1 after fall and subsequent bony \ncontusion.   This   patient   qualifies   for   diagnosis   of   Complex \nRegional  Pain  Syndrome  (CRPS)  Type  1  based  on  the  Budapest \ncriteria  presenting  symptoms  of  allodynia  &  hyperalgesia,  with \nassociated  vasomotor/sudomotor  changes.  She  saw  Dr.  Coker  and \nthere is no surgical indication at this time. She has been doing PT \nwith   significant   ongoing   pain   and   functional   limitations.   She \ncannot bear weight on her right leg and has been ambulating using \ncrutches. \n \nShe is s/p lumbar sympathetic nerve block on 7/3/23 with roughly \n40% pain relief  and functional improvement but  only a short time \nafter this injection. \n \nShe  reported  during  her  follow  up  appointment  on  7/26/2023  that \nher skin mottling associated/skin color changes in her right leg did \nimprove after the initial injection. \n \nWe  therefore  proceeded  to  repeat  the  left  lumbar  sympathetic \nnerve block which was done on 8/3/2023 with a report of 40% pain \nrelief  but  for  only  4  days  after  the  injection.  She  states  the  repeat \ninjection  did  cause  numbness  surrounding  the  area  of  her  right \nknee. However, she states the injection did cause a flare in pain in \nher right hip progressing across her pelvis to her left side. \n \nShe  has  continued  working  with  physical  therapy  for  improving \nrange of motion and desensitization techniques. She also has been \nincorporating   exercises   for   her   lumbar   spine   as   previously \ninstructed. \n \nShe continues to utilize pregabalin 100 mg twice per day, Celebrex \n200  mg  once  per  day,  and  baclofen  10  mg  3  times  per  day  as \n\nBerry – H302325 \n \n-13- \nneeded.  She  request  refills  of  these  medications  which  I  will \nprovide. \n \nAt this point, I would recommend electrodiagnostic examination of \nthe   right   lower   extremity   to   further   elucidate   pathology   and \nevaluate  for  a  radiculopathy  verses  peripheral  nerve  entrapment \nversus peripheral neuropathy. \n \nShe is to continue to contemplate the option of neuromodulation. \n \nI do not yet think she has reached maximal medical improvement. I \ndo not think she can return to work at this time. We will extend her \nwork excuse out until she follows up with us to review the results \nof her electrodiagnostic study and the MRI of the lumbar spine.  \nG90.521: Complex regional pain syndrome 1 of right lower limb. \nELECTROMYOGRAM   +   NERVE   CONDUCTION   STUDY. \nNote  to  Imaging  Facility:  EMG/NCS  right  lower  extremity,  eval \nfor  peripheral  neuropathy,  peripheral  nerve  entrapment  vs.  lumbar \nradiculopathy. \nPregabalin  100  mg  capsule –  Take  1  capsule(s)  every  day  by  oral \nroute for 30 days. Qty: (30) capsule. Refill: 2. \nCelcoxib  200  mg  capsule –  Take  1  capsule(s)  every  day  by  oral \nroute for 30 days. Qty: (30) capsule. Refill: 2. \nBaclofen  10  mg  tablet –  Take  1  tablet(s)  3  times  a  day  by  oral \nroute as needed for 30 days. Qty: (90) tablet. Refill: 2. \nPharmacy: Hudson Pharmacy \n \n3. Lumbosacral radiculopathy \nWe  reviewed  the  minimal  to  mild  evidence  of  Mild  evidence  of \ndegenerative  disc  change  and  facet  arthropathy  identified  on  her \nlumbar radiographs obtained during her last visit. \n \nShe  has  been  working  with  physical  therapy.  She  has  significant \npain   and   functional   limitations.   She   has   not   improved   with \nconservative treatment measures thus far. \n \nIn  an  effort  to  rule  out  the  presence  of  any  significant  amount  of \ncentral  canal  stenosis  or  neuroforaminal  narrowing  I  do  think  it  is \nappropriate to proceed with obtaining an MRI of the lumbar spine. \nThe  results  of  this  advanced  imaging  could  help  further  tailor  our \ntreatment plan depending on what pathology this may reveal. \n \nI  will  plan  to  see  the  patient  back  to  review  the  results  of  the \nlumbar  MRI  and  her  electrodiagnostic  study  once  they  have  been \nperformed. \n\nBerry – H302325 \n \n-14- \nM54.17: Radiculopathy, lumbosacral region \nRADIOLOGIST  REFERRAL.  Schedule  Within:  provider’s \ndiscretion.   Note   to   Provider:   MRI   of   lumbar   spine   without \ncontrast. \n \n The claimant has asked the Commission to determine whether she is entitled to additional \nmedical treatment in the form of prescription medications and physical therapy. In review of the \nmedical  evidence  submitted  at  the  hearing  and  provided  to  the  claimant  by  multiple  physicians \nand  a  physician’s  assistant,  I  find  that  all  of  the  medical  treatment  regarding  prescription \nmedications  and  physical  therapy  for  the  claimant’s  compensable  right  knee  injury  to  be \nreasonable, necessary treatment for her compensable right knee injury. \n The  claimant  has  asked  the  Commission  to  determine  whether  she  is  entitled  to \ntemporary  total  disability  benefits  from  March  10,  2023,  to  June  4,  2023.  It  is  clear  from  the \nmedical records that the claimant was placed on crutches and to avoid bearing weight on March \n11, 2023, at her initial visit to Baptist Health Walk-In Clinic. The same restrictions continued on \nthe  claimant  through  different  medical  providers  well  past  the  claimant’s  June  4,  2023, \ntemporary total disability requested  end date. During the timeframe of March 10, 2023, to June \n4,  2023,  the  claimant  was  within  her  healing  period  and  placed  on  restrictions  of  no  weight \nbearing and was required to use crutches. \n The  respondent  called  Kimberly  Coffey  as  a  witness  in  this  matter.  Ms. Coffey  recently \nchanged her last name from Davison to Coffey due to marriage. Ms. Coffey is a hiring manager \nfor  the  respondent  and  managed  the  claimant’s  assignments  for  the  respondent.  It  is  the \nrespondent’s contention that the claimant had work made available to her for March 10, 2023, to \nJune 4, 2023, within her restrictions. Following is a portion of Ms. Coffey’s direct examination \ntestimony: \n\nBerry – H302325 \n \n-15- \nQ Okay.  Now,  after  she  was  hurt  and  you  all  got  the  light-\nduty slip, did you visit with her about coming back to work? \n \nA Yes, sir. \n \nQ Would you tell Judge Wells about that. \n \nA I  asked  her  if  she  could  come  back  to  work  on  a  limited \nbasis. \n \n*** \n THE WITNESS: Yes. She was asked to do some light duty, \nwhether or not she could go in and do the peri-care. She was asked \nif  she  could  take  him  his  toothbrush,  his  stuff  to  clean  up  with  in \nthe morning, to shave, to fix his hair, brush his teeth. Just general \nhygiene stuff. \n \nQ [BY  MR.  FRYE]  Okay.  Now,  she  had  a  sit-down.  Were \nthese things that she could do sitting down? \n \nA Yes, sir. She could sit down and do those. \n \nQ Okay. Now, let’s be clear. There were other people in the \nhouse, were there not, that could help with any other patient care? \n \nA Uh-huh. \n \nQ And who were those people? \n \nA It was Mr. Nguyen’s wife, which she did a lot of the care \nfor him, like his feeding tubes and everything. And Mr. Nguyen’s \ndaughter, who worked from home. I asked – \n \nQ Go ahead. \n \nA I did ask Ms. Berry if she would be able to do it just sitting \nin  a  chair  beside  his  bed  encouraging  him  to  do  his  exercise.  She \nsaid  that  she  was  unable.  I  asked  her –  because  she  said  she \ncouldn’t carry a cup, so I asked her, “Well, maybe Ms. Nguyen can \ncarry the cups for you or you could carry one cup at a time and set \nwith him while he does his morning routine.” \n \nQ Okay. \n \nA And she said that she was not able to do it. \n\nBerry – H302325 \n \n-16- \n \nQ All right. About how many – I know this started in March. \nAbout  how  many  times  did  you  contact  her  about  maybe  coming \nback to work? \n \nA I contacted her several times. \n \nQ And then after the deposition, did you also again reach out \nto her? \n \nA I did. \n \nQ Tell me about that situation. \n \nA We  had  a  client  that  he  was  a  younger  man,  all  he  wanted \nto  do  was  sit  at  his  table  and  play  games,  talk  to  someone,  just \nwanted  companionship.  It  was  more  of  a  respite  type  situation  so \nthat  his  mother  would  have  a  little  bit  of  time  to  herself  to  do \nwhatever she needed to do. \n It wasn’t my knowledge, but when I called her and asked \nthe  mother  if  it  was  okay,  that  she  come  out,  the  mother  told  me \nthat he had just had surgery on his arm and that he could be a fall \nrisk  and  that  she  would  prefer  someone  who  was  more  stable  on \ntheir feet. \n \nQ Okay. Did you make an offer of another job at that time? \n \nA I  asked  her  if  she  would  like  to  go  back  to  Mr. Nguyen  or \nsomeone  else  where  she  was  basically  sitting  down,  where  there \nwere other people in the house, and she did decline. \n \n Ms.  Coffey  was  cross  examined  by  the  claimant’s  attorney  about  the  offers  of  light  or \nrestricted duty work the respondent alleges they made to the claimant as follows: \nQ Okay.  Now,  this  job  that  you  could  do  just  sitting  down, \nwould  that  entail  or  having  her  to  get  in  the  car  and  drive  to  the \nplace? \n \nA Yes, sir. \n \nQ And would it require to walk from the car to the place? \n \nA Yes, sir. \n \n\nBerry – H302325 \n \n-17- \nQ And would it require her to walk in the house? \n \nA Yes, sir. \n \nQ So  she  wasn’t  just  sitting  there.  She  wouldn’t  just  be \nautomatically sitting there at a table and giving him a cup. There is \nother  things  that  would  involve  moving  around  and  movement \ninvolved; is that correct? \n \nA Once  she  got  to  the  house,  her  limitation  would  be –  her \nmovement would be very limited. \n \nQ Well,   it   might   be   limited,   but   there   would   be   some \nmovement? \n \nA Of course. \n \nQ The  fact  that  she  is  using  crutches  to  move  around,  would \nthat interfere with doing some of this stuff? \n \nA Not in my opinion. I have been on crutches several times. I \ntore my knees before so I have been on crutches and I know what it \nfeels like and I know what I did. I know what I was able to do. \n \nQ So you are just saying just gut it out and do what you’ve \ngot to do? \n \nA Well, if you are on crutches, you are not putting any weight \non your knee. \n \nQ But you are just saying do what you’ve go to do? \n \nA If you are wanting a paycheck, you have to do some – \n \nQ If the doctor says you need to just do certain things, not do \ncertain things, you have got to decide whether you want to get paid \nor whether you want to not do those things; is that right? \n \nA Of course. But just like  you would be  at home,  you would \nbe getting up, going to the restroom, getting yourself something to \ndrink. \n \nQ Sure.  Well,  you  might  be.  You  might  be  lucky  enough  to \nhave someone at least bring you something to drink. \n \n\nBerry – H302325 \n \n-18- \nA If you are very lucky, yes. \n \nQ Okay.  Now,  this  other  job  that  you  offered  her  or  these \nfrequent jobs that you offered her, she just flat turned them down? \n \nA Yes, sir. \n \nQ And you thought they were within her limitations? \n \nA Yes, sir. \n \nQ Did she tell you she turned them down because she didn’t \nthink they were? \n \nA She did. \n \n On direct examination, the claimant testified about an offer of light duty  work extended \nto her by the respondent as follows: \nQ Now, during your period of treatment, did the Respondents \never offer to return you to light duty? \n \nA Can you repeat the question? \n \nQ Did  they  ever  offer  to  provide  you  a  job  within  your \nmedical restrictions? \n \nA Has work offered to do that? \n \nQ Yes. \n \nA The only time work offered to do that was the day after the \ndeposition, I got a call. \n \nQ All right. And did you – what happened with that? \n \nA So I got a call and I think I was told – I don’t know if it was \nfour  or  four  and  a  half  hours,  three  days  a  week  for  a  gentleman \nand all I would have to do is board games and puzzles because his \nmom takes care of everything else. \n  \n Within that same hour, I got a call back from Ms. Kim over \nhere  telling  me  that  he  had  to  have  arm  surgery  and  he  needed \nmore assistance like using the bathroom and taking a shower. And \n\nBerry – H302325 \n \n-19- \nI asked her how  I was supposed to do that when I am on crutches \nand it says light duty and she goes, “I don’t know. You can’t.” \nThat is what happened. \n \nQ Did  they  offer  you  another  job  after  that,  something  after \nthat? \n \nA No.  I  have  never  heard  back  from  them  about  doing  any \nother job. But then after that, I was taken completely off of work at \nsome point. \n \nQ Okay.  During  this  period  of  time,  how  has  your  condition \nchanged  or  been?  Has  it  gotten  any  better,  gotten  any  worse  or \nstayed the same? \n \nA My condition has gotten worse. \n \n Here,  the  respondent  witness,  Ms.  Coffey,  in  her  direct  examination  testimony  states, \n“She was asked if she could take him his toothbrush, his stuff to clean up with in the morning, to \nshave,  to  fix  his  hair,  brush  his  teeth.  Just  general  hygiene  stuff.”  Ms.  Coffey  testified  that  she \ncould  perform  these  duties  sitting  down.  However,  I  find  it  unreasonable  to  say  a  job  could  be \ndone in a seated position when you are taking hygiene products to someone. Ms. Coffey further \ntestified that other people were in the home and could help with other patient care. This included \nthe  client’s  wife  and  daughter,  whom  to  my  knowledge  are  not  employees  of  the  respondent. I \nfind it unreasonable to expect the claimant to perform job duties in a physically restricted manner \nby  relying  upon  the  charity  of  others  who  are  not  employed  by  the  respondent.  The  respondent \ndid not provide work within the claimant’s restrictions during the period of time from March 10, \n2023, to June 4, 2023. \n The  claimant’s  restrictions  were  placed  upon  her  on  March  11,  2023,  regarding  her \ncompensable  right  knee  injury  and  she  continued  in  her  healing  period  beyond  June  4,  2023. \nDuring  that  period  work  within  her  restrictions  was  not  made  available  to  her.  As  such,  she  is \n\nBerry – H302325 \n \n-20- \nentitled  to  temporary  total  disability  benefits  from  March  11,  2023,  until  June  4,  2023,  for  her \ncompensable right knee injury. \n The parties were unable to agree on the claimant’s compensation rates and have asked the \nCommission  to  determine  those  rates  for  them.  Respondent  Exhibit  1  is  a  collection  of  payroll \nrecords  beginning  March  5,  2022,  and  going  to  March  3,  2023;  from  and  including  Saturday \nMarch  5,  2022,  to  and  including  Friday  March  3,  2023,  there  are  364  days  or  52  weeks.  Each \npayroll record indicates gross earnings for that given period. As such, all gross earnings for that \ntime  period  were  added  together  for  a  total  of  $22,476.61.  That  number  was  divided  by  52 \nweeks,  making  an  average  weekly  wage  of  $432.24.  As  to  the  claimant’s  temporary  total \ndisability  rate,  it  is  set  at  $288.00  as  $288.15  is  66-2/3%  of  $432.24,  the  claimant’s  average \nweekly wage. As to the claimant’s permanent and partial disability rate, it is set at $216.00, as it \nis 75% of the claimant’s $288.00 temporary total disability rate. \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  witnesses  and  to  observe  their  demeanor,  the  following  findings  of  fact  and  conclusions  of \nlaw are 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 \nJune 19, 2023, and contained in a Pre-hearing Order filed June 20, 2023, are hereby accepted as \nfact. \n 2.  The  claimant  has  proven  by  a  preponderance  of  the  evidence  that  she  is  entitled  to \ntemporary total disability benefits from March 11, 2023, to June 4, 2023.  \n\nBerry – H302325 \n \n-21- \n3.  The  claimant  has  proven  by  a  preponderance  of  the  evidence  that  she  is  entitled  to \nadditional medical treatment in the form of prescription medications and physical therapy for her \ncompensable right knee  injury ordered by medical providers contained in the records submitted \ninto evidence in this matter.  \n4. The claimant has proven by a preponderance of the evidence that her average weekly \nwage  is  $432.24,  her  temporary total  disability  rate  is  $288.00,  and  her  permanent  partial \ndisability rate is $216.00. \n5.  The  claimant  has  proven  by  a  preponderance  of  the  evidence  that  her  attorney  is \nentitled to an attorney’s fee in this matter.  \n ORDER \nThe  respondents  shall  pay  for  medical  treatment  regarding  prescription  medications  and \nphysical therapy for the  claimant’s compensable  right knee injury, including reimbursement  for \nany out-of-pocket expenses.  \nThe  respondents  shall  pay  the  claimant  temporary  total  disability  from  March  11,  2023, \nto June 4, 2023, at the temporary total disability rate of $288.00.  \nThe respondents shall pay to the claimant's attorney the maximum statutory attorney's fee \non the benefits awarded herein, with one half of said attorney's fee to be paid by the respondents \nin addition to such benefits and one half of said attorney's fee to be withheld by the respondents \nfrom such benefits pursuant to Ark. Code Ann. §11-9-715. \n All  benefits  herein  awarded  which  have  heretofore  accrued  are  payable  in  a  lump  sum \nwithout discount. \n This award shall bear the maximum legal rate of interest until paid. \n\nBerry – H302325 \n \n-22- \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 \n                                ____________________________                                              \n       HONORABLE ERIC PAUL WELLS \n       ADMINISTRATIVE LAW JUDGE","preview":"BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION WCC NO. H302325 ALISHA BERRY, Employee CLAIMANT HOME HELPERS OF NWA, Employer RESPONDENT AMTRUST NORTH AMERICA, Carrier RESPONDENT OPINION FILED DECEMBER 5, 2023 Hearing before ADMINISTRATIVE LAW JUDGE ERIC PAUL WELLS in Fort Smith, Sebastian County, Arkansas. Claima...","fetched_at":"2026-05-19T22:59:03.278Z","links":{"html":"/opinions/alj-H302325-2023-12-05","pdf":"https://labor.arkansas.gov/wp-content/uploads/BERRY_ALISHA_H302325_20231205.pdf","source_publisher":"https://labor.arkansas.gov/workers-comp/awcc-opinions/administrative-law-judge-opinions/"}}