{"id":"alj-H305634-2024-10-28","awcc_number":"H305634","decision_date":"2024-10-28","opinion_type":"alj","claimant_name":"Steven Keeling","employer_name":"Foust Fabrication, Co","title":"KEELING VS. FOUST FABRICATION, CO. AWCC# H305634 October 28, 2024","outcome":"granted","outcome_keywords":["granted:4"],"injury_keywords":["back","lumbar","fracture","hip","ankle"],"pdf_url":"https://www.labor.arkansas.gov/wp-content/uploads/KEELING_STEVEN_H305634_20241028.pdf","source_index_url":"https://labor.arkansas.gov/workers-comp/awcc-opinions/administrative-law-judge-opinions/","filename":"KEELING_STEVEN_H305634_20241028.pdf","text_length":23549,"full_text":"BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION \n \n WCC NO. H305634 \n \nSTEVEN KEELING, Employee CLAIMANT \n \nFOUST FABRICATION, CO., Employer RESPONDENT \n \nAPPLIED UNDERWRITERS, Carrier RESPONDENT \n \n \n \n OPINION FILED OCTOBER 28, 2024 \n \nHearing   before   ADMINISTRATIVE   LAW   JUDGE   ERIC   PAUL   WELLS   in   Springdale, \nWashington County, Arkansas. \n \nClaimant represented by JASON M. HATFIELD, Attorney at Law, Fayetteville, Arkansas. \n \nRespondents represented by RANDY P. MURPHY, Attorney at Law, Little Rock, Arkansas. \n \n STATEMENT OF THE CASE \n \n On July  30,  2024,  the  above  captioned  claim  came  on  for  a  hearing  at  Springdale, \nArkansas.   A pre-hearing conference was conducted on May 13, 2024, and a Pre-hearing Order \nwas  filed  on May  14,  2024.      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 August \n23, 2023. \n 3. The claimant sustained a compensable injury to his back on or about August 23, 2023 \n By agreement of the parties the issue to be litigated is limited to the following: \n\nKeeling – H305634 \n \n-2- \n 1. Whether claimant is entitled to additional medical treatment for his compensable back \ninjury, in the form of a lumbar fusion as recommended by Dr. James Blankenship. \n The claimant's contentions are as follows: \n“Claimant   sustained   a   compensable   injury   while   working   for \nRespondent on or about 8/23/23. At that time, Claimant was in the \ncourse  and  scope  of  his  employment  with  Respondent  when  the \nscissor lift he was operating malfunctioned, causing it to fall while \nClaimant was still inside the machine. Claimant fell approximately \n20  feet  to  the  ground  below.  Claimant  was  rushed  to Mercy \nHospital by ambulance. \n \nImaging  revealed  multiple  fractures  along  Claimant’s  lumbar \nspine,  ribs  and  sternum.  A  CT  scan  of  his  abdomen  showed  a \ncompression fracture of  the L1 vertebrae  with approximately 20% \nheight  loss  in  that  joint.  He  was  instructed  to  follow  up  with  a \nneurosurgeon  and  return  to  the  hospital  in  2  weeks  for  repeat \nimaging. \n \nAt   a   follow   up   visit   on   10/9/23,   Dr.   Castellvi   at   Mercy \nrecommended   that   Claimant   participate   in   physical   therapy. \nClaimant  attended  the  recommended  physical  therapy  and  was \nreferred to Dr. Cannon for continued pain. Dr. Cannon scheduled a \nlumbar  epidural  steroid  injection  for  the  back  pain.  The  injection \ndid  not  provide  any  relief.  At  that  time,  Claimant  began  treating \nwith Dr. Blankenship. \n \nDr.   Blankenship   reviewed   the   imaging   and   determined   that \nClaimant    suffered    from    severe     foraminal    stenosis    with \nretrolisthesis,  significant  facet  arthropathy,  and  an  annular  fissure \non  the  midline.  Since  conservative  measures  have  failed,  Dr. \nBlankenship  has  recommended  a  Lumbar  Arthrodesis  surgery  on \nthe  L4-L5  and  L5-S1.  Respondents  have  denied  the  requested \nsurgery  and  the  recommendation  for  a  post  op  lumbar  brace  and \npost op bone stimulator. \n \nAdditionally,  the  Respondents  have  failed  to  pay  medical  bills \nfrom   Mercy   Hospital,   Bentonville   Ambulance,   Delta   Medical \nSupplies, Neurosurgery Spine Center and Siloam Springs Hospital. \nThese bills have been provided to the Respondents.” \n \n The respondents’ contentions are as follows: \n\nKeeling – H305634 \n \n-3- \n“Respondents contend that appropriate benefits have been paid as a \nresult  of  the  compensable  injury.  Respondents  contend  that  the \nproposed   surgery   by   Dr.   Blankenship   is   not   related   to   the \ncompensable injury.” \n \n The claimant in this matter is a 34-year-old male who sustained a compensable injury to \nhis low back on or about August 23, 2023, when a scissor-lift he was on tipped over and fell to \nthe ground. The claimant was at  a height of about 20-feet  when the scissor-lift fell over and he \nfell  hitting  the  concrete  beneath  him,  tail  end  first.  The  claimant  testified  that  his  pain  was  so \ngreat  that  he  laid  on  the  ground  until  an  ambulance  arrived  to  take  him  to  Mercy  Hospital  in \nRogers, Arkansas. \n The  claimant  was  admitted  to  the  hospital  that  day  and  spent  the  night  before  being \nreleased the following day. Following is a portion of the claimant’s hospital records from that \ntime: \nFollow-up   &   Outstanding   Issues/Tests:   Follow-up   with   Dr. \nGammer’s  (orthopedics)  office  in  2  weeks  for  repeat  imaging. \nFollow-up with Dr. Castellvi’s (neurosurgery) in 4 weeks. \n \nHospital  Course:  Steven  Keeling  is  a  32  y.o.  male  who  was \nadmitted to Mercy Hospital NWA on 8/23/2023 and found to have \na principle diagnosis of a compression fracture of the L1 vertebra, \nclosed  nondisplaced  zone  III  fracture  of  the  sacrum,  contusion  of \nthe left arm and rhabdomyolysis after a fall from a scissor lift. His \ncreatinine improved with IV hydration. \n \nHe was seen by orthopedics regarding closed nondisplaced zone III \nfracture  of  the  sacrum.  They  recommended  WBAT  with  walker \nand to follow-up in 2 weeks for repeat imaging. \n \nNeurosurgery  was  consulted  regarding  L1  compression  fracture \nand  recommended  TLSO  brace  when  out  of  bed  and  okay  to \nremove  when  laying  down  and  bathing.  He  is  to  follow-up  in  4 \nweeks for repeat imaging. \n \nPatient was seen by PT and fitted for TLSO and he was discharged \nhome in stable condition. \n\nKeeling – H305634 \n \n-4- \n \n The claimant was seen by Dr. Alex Castellvi on October 9, 2023. Following is a portion \nof that medical report: \nASSESSMENT AND PLAN: \nIs  a  32-year-old  gentleman  who  had  an  L1  compression  fracture. \nX-rays  of  the  lumbar  spine  shows  a  compression  fracture  with \napproximately 10 to 20% loss of height. At this time the patient is \ncomplaining   of   radicular   complaints   down   the   right   lower \nextremity with numbness in the S1 distribution on the right side. I \nwould like to obtain an MRI of the lumbar spine without contrast. I \nwould also like the patient to attempt physical therapy and consider \nhaving  a  right-sided  epidural  steroid  injection  at  L5-S1.  Also \nobtain flexion-extension films of the lumbar spine to assess for any \nlumbar  instability  at  L5-S1.  I  would  the  patient  like  the  patient  to \nfollow-up in the neurosurgery clinic in approximately 3 months for \nfurther   evaluation.   Please   feel   free   to   contact   me   with   any \nquestions or concerns. \n \n On  October  25,  2023,  the  claimant  underwent  an  MRI  of  his  lumbar  spine  without \ncontrast at Siloam Springs Regional Hospital. The report from that diagnostic testing is found at \nClaimant’s Exhibit 2, pages 1- 2, and is signed by Dr. Micah Fritsche. Following is a portion of \nthat diagnostic report: \nIMPRESSION: \n1. No acute abnormality in the lumbar spine. \n2.   Mild-to-moderate   multilevel   degenerative   disc   disease.   No \nsignificant central canal or neuroforaminal stenoses. \n3. Posterior central annular fissuring at L4-L5. \n \n The  claimant  was  seen  by  Dr.  Robert  Cannon  of The  Neurosurgery  Spine  and  Pain \nManagement Center on December 21, 2023. Following is a portion of that medical record:  \nHPI: \nMr.  Keeling  sustained  a  20  foot  fall  at  work  when  he  fell  of  a \nscissorlift  onto  concrete  on  August  23,  2023.  He  had  a  closed \npelvis  fracture  and  since  that  time  has  had  some  significant  low \nback  pain.  He  now  describes  pain  in  his  lower  back  going  down \nthe right leg down to the level of the calf and occasionally into the \nfoot  and  toes.  He  has  some  numbness  as  well  as  tingling.  He \n\nKeeling – H305634 \n \n-5- \ndescribes a pain typically as burning in nature and rates it 8 out of \n10 at the most severe and a 3 out of 10 at the least severe. He did \nnot  have  any  pain  prior  to  his  fall  and  it  started  after  the  fall.  The \npain  is  worsened  by  walking,  standing,  sitting,  and  changes  in \nweather. Excessive bending or twisting also increases his pain. \n \nHe has currently been to physical therapy with some improvement. \nHe  has  done  a  home  exercise  program  as  well  as  stretching  with \nsome  mild  improvement.  He  has  tried  a  TENS  unit  which  helps \noccasionally and has tried topical agents such as anti-inflammatory \ncreams  and  heat  and  ice.  He  has  not  had  any  type  of  injections \npreviously. \n \n*** \nDiagnosis: \nM51.16  Intervertebral  disc  disorders  with  radiculopathy,  lumbar \nregion \nM54.15 Radiculopathy, lumbar region \nM47.897 Other spondylosis, lumbosacral region \nM46.1 Sacroiliitis, not elsewhere classified \n \nRecommendations: \n1. Lumbar epidural steroid injection to be done under fluoroscopy. \nWe will get his MRI scans that were not available at today’s visit. \nHe  goes  a  history  of  some  disc  herniations/bulging  at  the  L4-L5 \ndisc    and    he    has    symptoms    to    match    an    L4-L5,    L5-S1 \nradiculopathy. We will get those scans for review and then proceed \nforward  with  the  injection  as  soon  as  possible.  I  did  not  address \nany work status as I will defer to his primary treatment physicians \nwho  have  him  on  or  off  work  at  this  time.  I  also  discussed  the \npossibility  of  a  right  S1  joint  injection  but  his  pain  seems  to  be \nmore  radicular  in  nature  and  then  we  will  review  the  MRI  for \nfurther options. \n \n2.  Lastly  if  interventional  options  do  not  help,  then  consideration \nof surgical alternatives would be the next step. \n \n A  follow-up note is found at Claimant’s Exhibit 1, page 89, regarding the claimant’s \nlumbar epidural injections with Dr. Cannon dated January 31, 2024. In that note it indicates the \nclaimant had no complications but received only 30% relief on a scale of 0% being no relief and \n\nKeeling – H305634 \n \n-6- \n100% being total relief. It was also noted that the claimant did not experience “a long duration of \npain relief.” \n The  respondent  sent  the  claimant  to  see  Dr.  James  Blankenship  at  The  Neurosurgery \nSpine and Pain Management Center.  The  claimant did so on  February 12, 2024.  Following is a \nportion of that medical record: \nHPI: \nThe patient is in today for evaluation. The patient was seen by Dr. \nCannon  and  referred  in  to  see  us.  He  did  have  an  LESI  with  Dr. \nCannon that gave him very minimal, very temporary relief. He tells \nus  that  on  August  23,  2023,  he  fell  20  feet  and  landed  on  his \ntailbone.  Prior  to  that  he  had  no  history  of  back  and  leg  pain.  His \ngreatest pain complaint is right-sided low back pain to the right hip \nand  right  buttock  and  goes  down  the  posterior  aspect  of  his  right \nlower  extremity  to  his  foot.  He  has  numbness  and  tingling  in  the \nright  lateral  foot  and  third  and  fourth  digits.  He  denies  any \nweakness. Sitting aggravates his pain. He did 20 visits of physical \ntherapy with no relief. He has not worked since his injury. \n \n*** \nImpression: \nDr.  Cannon  saw  this  gentleman  in  late  December.  The  patient  did \nnot have any significant prior history of back pain or leg pain until \nhe  fell  about  20  feet  and  landed  on  his  tailbone  on  August  23  of \nlast  year.  Dr.  Cannon  performed  an  LESI  with  very  minimal  and \ntransient  relief.  The  patient  has  done  a  significant  amount  of \nphysical  therapy  with  no  significant  relief.  The  patient’s  chief \ncomplaint  is  right  buttock  and  posterolateral  leg  pain  to  his  foot. \nHe  has  paresthesias  in  the  third  and  fourth  digits  of  his  right  foot \nwith  no  weakness.  The  patient  4/5  strength  in  his  right  EHL \nindicative  of  an  L5  radiculopathy  on  the  right-hand  side.  He  does \nhave significant malalignment. His MRI demonstrates severe facet \narthropathy.  At  the  L4-L5  level  he  has  a  gross  annular  fissure  in \nthe  midline.  At  L3-L4  he  has  significant  facet  arthropathy.  His \npiriformis  examination  today  is  markedly  positive.  His  MRI  does \nnot   show   any   significant   foraminal   stenosis   but   his   plain \nradiographs  have  severe  foraminal  stenosis  with  retrolisthesis  at \nthe L5-S1 level. Steve visited with him about his previous therapy \nand it does appear that he had good treatment for his piriformis but \nit  just  did  not  afford  him  any  relief.  His  S1  joint  examination  is \nonly positive for Faber’s. I think we have a combination of an L5 \n\nKeeling – H305634 \n \n-7- \nradiculopathy   from   foraminal   stenosis.   Once   again   his   MRI \ndemonstrates    some    posterior    disc    bulging    at    this    level. \nInterestingly when he lies down on the MRI table he does not have \nanywhere  near  the  significant  retrolisthesis.  I  think  when  he  is \nstanding he has retrolisthesis because of the instability at the L5-S1 \ndisc  space  and  that  creates  the  neural  foraminal  narrowing.  If  he \nhad  not  had  appropriate  significant  conservative  treatment  on  his \npiriformis, I would say we need to do that but he has. He also has a \ngross  annular  fissure  at  L4-L5.  The  pain  he  is  having  may  very \nwell  also  be  referred  from  that  level  from  the  annular  fibers  and \nwhere the L5 nerve root goes back in the spinal cord. \n \nRecommendations: \nI   told   him   he   has   failed   all   routine   and   usual   conservative \nmeasures. I have told him that surgical intervention would need to \ninclude  an  L4-L5  and  L5-S1  arthrodesis.  The  L4-L5  level  would \nbe done via a lateral approach on L4-L5. He would then undergo a \nposterior   decompression   and   foraminal   decompression   on   the \nright-hand  side  with  a  TLIF  implantation  and  right  side  unilateral \ncortical screws L4 to S1. \n \nI  have  offered  him  a  lumbar  arthrodesis  at  L4-L5  and  L5-S1.  The \nrationale  for  the  L4-L5  level  has  to  do  with  the  fact  that  he  has  a \ngross  annular  fissure  at  this  level  which  could  give  him  referred \npain  down  the  right  leg  and  also  contribute  to  his  piriformis \nsyndrome.  The  gentleman  also  has  anterior  splaying  at  this  level \nthat markedly reduces in flexion but at his age would be indicative \nof annular dysfunction and instability. The rationale for the L5-S1 \nlevel   is   that   he   has   severe   foraminal   stenosis   on   his   plain \nradiographs with marked retrolisthesis. This is not present when he \nis  recumbent  on  the  MRI  table  which  is  just  an  indication  that  he \nhas  gross  segmental  instability.  He  would  then  undergo  posterior \ndecompression with facetectomy decompressing the L5 nerve root \nall  the  way  out  into  the  neural  exit  foramen  at  L5-S1  with  TLIF \nimplantation.  He  would  then  undergo  unilateral  cortical  screw \nplacement  on  the  right-hand  side.  The  gentleman  understands  the \nrisks  and  benefits  of  surgery.  He  is  going  to  go  home  at  my \nsuggestion  and  talk  to  his  family  and  then  get  back  with  us  about \nwhat he wants to do. \n \n The  claimant  has  asked  the  Commission  to  determine  if  he  is  entitled  to  additional \nmedical  treatment  for  his  compensable  back  injury  in  the  form  of  surgical  intervention  as \nrecommended by Dr. Blankenship. \n\nKeeling – H305634 \n \n-8- \nEmployers  must  promptly  provide  medical  services  which  are  reasonably  necessary  in \nconnection  with  the  compensable  injuries,  Ark.  Code  Ann.  §11-9-508(a).    However,  injured \nemployees have the burden of proving by a preponderance of the evidence that medical treatment \nis  reasonably  necessary.   Patchell  v.  Wal-Mart  Stores,  Inc.,  86  Ark.  App.  230,  184  S.W.3d  31 \n(2004).    What  constitutes  reasonable  and  necessary  medical  treatment  is  a  fact  question  for  the \nCommission,  and  the  resolution  of  this  issue  depends  upon  the  sufficiency  of  the  evidence.  \nGansky v. Hi-Tech Engineering, 325 Ark. 163, 924 S.W.2d 790 (1996). \n The respondent in this matter requested a peer review be performed by Care Review out \nof Arlington, Texas. That review was done on April 16, 2024, at the expense and request of the \nrespondent.  It  was  performed  by  Dr.  E.  Thomas Chappell,  a  board-certified  neurological \nsurgeon. Records and evidence regarding that peer review can be found at Claimant’s Exhibit 1, \npages  96-103.  It  is  clear  from  those  records  that  Dr. Chappell agreed  with  the  surgical \nintervention recommended by Dr. Blankenship. Following is a portion of those records: \nRecommendation and Clinical Rationale: \n \n1. (Appeal)  Lumbar  arthrodesis  L4-L5  &  L5-S1.  CPT  codes \n22558, 22224, 22633, 63056, 63047, 22840, 22845, 22853 X2. \nODG  by  MCG,  Evidence-Based  Medical  Treatment  Guidelines, \nLumbar Fusion (Updated Mar 29, 2024) states, “Lumbar fusion \nmay   be   indicated   for   1   or   more   of   the   following:   Lumbar \nspondylolisthesis  (and  presence  of  1  or  more  of  the  following: \nSymptoms  requiring  treatment,  as  indicated  by  the  presence  of \nALL  of  the  following:  Patient  has  persistent  disabling  symptoms, \nincluding 1 or more of the following: Low back  pain: Neurogenic \nclaudication: Radicular pain).” \n \nWithin  the  medical  information  available  for  review,  there  is \ndocumentation  of  low  back  pain  radiating  to  the  right  lower \nextremity  to  the  foot  with  positive  SLR  on  the  right,  decreased \nsensation in the right L5 dermatome, diminished ankle jerk on the \nright,   and   marked   right   EHL   weakness   that   persists   despite \nmedication, ESI, physical therapy, home exercise, and TENS. MRI \n\nKeeling – H305634 \n \n-9- \nrevealed mild to moderate multilevel degenerative disc disease, no \nsignificant   central   canal   or   neuroforaminal   stenoses,   posterior \ncentral  annular  fissuring  at  L4-L5.  Radiographs  revealed  severe \ndisc   space   settling   at  the   lumbosacral   with   retrolisthesis   that \nexacerbated  the  extension  and  slightly  reduces  in  flexion  and \nmarked  disc  space  settling  and  anterior  splaying  at  L45  that  does \nexacerbate   in   extension   and   significantly   reduces   in   flexion. \nTherefore,  I  recommend  certification  of  the  requested  lumbar \narthrodesis  L4-L5  &  L5-S1,  CPT  codes  22558,  22224,  22633, \n63056, 63047, 22840, 22845, 22853 X2. \n \n The respondent requested another review of the claimant’s condition from Dr. Owen \nKelly,  a  board-certified  orthopedic  surgeon.  On  March  22,  2024,  Dr.  Kelly  issued  that  report. \nFollowing is the summary found at the end of that report: \nSUMMARY: \nMr.  Keeling  sustained  and  L1  Burst  fracture  with  a  fall  from  a \nheight of around 20 feet. The imaging and exam revealed a loss of \nvertebral  height  of  20-25%,  an  intact  posterior  ligament  complex \nand  an  initial  intact  neurological  status.  He   also  sustained  a \nquestionable   sacral   injury.   Treatment   consisted   of   bracing, \nphysical  therapy  and  an  injection.  He  continues  to  heal  and  has \nsome sensation loss documented at L5. Progression to full healing \nmay  take  up  a  full  year.  The  initial  treating  neurosurgeon  has \nindicated  that  surgical  intervention  was  not  necessary  and  this \nassessment  is  correct.  The  pathology  noted  at  the  lower  lumbar \nlevels appears to be non-traumatic. \n \nI  note  that  both  Dr.  Kelly  and  Dr. Chappell only  performed  medical  record  reviews  and  never \nsaw the claimant or provided medical treatment to the claimant. \n Dr.  Cannon  in  his  December  21,  2023,  medical  report  regarding  the  claimant  stated, \n“Lastly if interventional options do not help, then consideration of surgical alternatives would be \nthe  next  step.”  The  medical  records  and  the  claimant’s  testimony  are  in  agreement  that \nconservative care  received  by  the  claimant  has  not  improved  his  condition  including  physical \ntherapy  and  epidural  steroid  injections.  Both  Dr.  Blankenship  and  the  respondent-hired  peer \nreview  doctor,  Dr. Chappell,  agree  that  the  surgical  recommendations  of  Dr.  Blankenship  are \n\nKeeling – H305634 \n \n-10- \nappropriate.  Only  Dr.  Kelly,  a  board-certified  orthopedic  surgeon, finds  Dr.  Blankenship’s \nsurgical  recommendations  inappropriate  care.  In  Dr.  Kelly’s  report,  he  states,  “The  initial \ntreating  neurosurgeon  has  indicated  that  surgical  intervention  was  not  necessary,  and  this \nassessment is correct.” After thorough review of the medical records submitted into evidence in \nthis matter, I find no doctor or medical provider who “indicated that surgical intervention was \nnot necessary.” While Dr. Castellvi provided conservative treatment for the claimant, he never \nopined  on  surgical  intervention.  The  greater  weight  of  the  evidence  in  this  matter  supports  that \nby  a  preponderance  of  the  evidence  the  additional  medical  treatment  recommended  by  Dr. \nBlankenship  in  the  form  of  surgical  intervention  is  reasonable  and  necessary  medical  treatment \nfor the claimant’s compensable back injury. \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 his 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 \nMay 13, 2024, and contained in a Pre-hearing Order filed May 14, 2024, are hereby accepted as \nfact. \n 2. The  claimant  has  proven  by  a  preponderance  of  the  evidence  that  he  is  entitled  to \nadditional  medical  treatment  for  his  compensable  back  injury  in  the  form  of  lumbar  fusion \nsurgery as recommended by Dr. James Blankenship and its aftercare. \n \n \n\nKeeling – H305634 \n \n-11- \n ORDER \nThe  respondents  shall  be  responsible  for  payment  of  the  additional  medical  treatment \nrecommended by Dr. Blankenship in the form of surgical intervention and its aftercare. \nPursuant  to  A.C.A.  §11-9-715(a)(1)(B)(ii),  attorney  fees  are  awarded  “only  on  the \namount of compensation for indemnity benefits controverted and awarded.” Here, no indemnity \nbenefits  were  controverted  and  awarded;  therefore,  no  attorney  fee  has  been  awarded. Instead, \nclaimant’s attorney is free to voluntarily contract with the medical providers pursuant to A.C.A. \n§11-9-715(a)(4). \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. H305634 STEVEN KEELING, Employee CLAIMANT FOUST FABRICATION, CO., Employer RESPONDENT APPLIED UNDERWRITERS, Carrier RESPONDENT OPINION FILED OCTOBER 28, 2024 Hearing before ADMINISTRATIVE LAW JUDGE ERIC PAUL WELLS in Springdale, Washington County, Arkansas. C...","fetched_at":"2026-05-19T22:48:06.694Z","links":{"html":"/opinions/alj-H305634-2024-10-28","pdf":"https://www.labor.arkansas.gov/wp-content/uploads/KEELING_STEVEN_H305634_20241028.pdf","source_publisher":"https://labor.arkansas.gov/workers-comp/awcc-opinions/administrative-law-judge-opinions/"}}