{"id":"alj-H400052-2024-09-03","awcc_number":"H400052","decision_date":"2024-09-03","opinion_type":"alj","claimant_name":"Jimmy Pruitt","employer_name":"Nidec Motor Corp","title":"PRUITT VS. NIDEC MOTOR CORP. AWCC# H400052 September 3, 2024","outcome":"unknown","outcome_keywords":[],"injury_keywords":["shoulder","back","strain","fracture","rotator cuff","repetitive"],"pdf_url":"https://labor.arkansas.gov/wp-content/uploads/PRUITT_JIMMY_H400052_20240903.pdf","source_index_url":"https://labor.arkansas.gov/workers-comp/awcc-opinions/administrative-law-judge-opinions/","filename":"PRUITT_JIMMY_H400052_20240903.pdf","text_length":21071,"full_text":"BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION \n \n WCC NO. H400052 \n \nJIMMY PRUITT, Employee CLAIMANT \n \nNIDEC MOTOR CORP., Employer RESPONDENT \n \nTRAVELERS INDEMNITY CO., Carrier RESPONDENT \n \n \n \n OPINION FILED SEPTEMBER 3, 2024 \n \nHearing  before  ADMINISTRATIVE  LAW  JUDGE  ERIC  PAUL  WELLS  in  Fort  Smith, \nSebastian County, Arkansas. \n \nClaimant represented by GREGORY R. GILES, Attorney at Law, Texarkana, Arkansas. \n \nRespondents represented by GUY ALTON WADE, Attorney at Law, Little Rock, Arkansas. \n \n STATEMENT OF THE CASE \n \n On June  6,  2024,  the  above  captioned  claim  came  on  for  a  hearing  at  Fort  Smith, \nArkansas.      A  pre-hearing  conference  was  conducted  on March  11,  2024,  and  a  Pre-hearing \nOrder  was  filed  on March  12,  2024.      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 July 15, \n2023. \n 3. The  claimant  sustained  a  compensable  injury  to  his  right  shoulder  on  or  about  July \n15, 2023. \n By agreement of the parties the issues to litigate are limited to the following: \n\nPruitt – H400052 \n \n-2- \n 1. Whether Claimant is  entitled to medical treatment for his compensable right shoulder \ninjury in the form of surgery as recommended by Dr. Justin Walden. \n The claimant's contentions are as follows: \n“a.  Claimant  contends  that  he  is  entitled  to  the  additional  medical \ntreatment being recommended by Dr. Justin Walden.” \n \n The respondents’ contentions are as follows: \n“Respondents  contend  that  comparison  of  the  two  MRIs  fail  to \nshow  a  need  for  surgery  related  to  the  work  injury.  Claimant’s \nsubsequent   findings   and   any   surgical   recommendation   is   not \nrelated  to  the  July  15,  2023  work  event and  therefore  is  not  the \nresponsibility of the respondents.” \n \n The  claimant  in  this  matter  is  a 50-year-old  male  who  sustained  a  compensable  right \nshoulder injury on or about July 15, 2023. At the hearing in this matter the claimant gave direct \nexamination testimony about how his right shoulder injury occurred as follows: \nQ And   on   July   the   15\nth\n of   2023,   describe   for   us   what \nhappened that you sustained your injury. \n \nA I had cranked the table down so I could sit down and when \nit  came  to  the  end  of  my  shift,  we  always  have  to  crank  the  table \nback up. And as I was cranking it up, it jammed. And when I was \ntrying to pull the bar to turn it, I felt a pop and pulling and burning \nsensation in my shoulder. (indicating). \n \nQ Which arm were you using to crank the crank? \n \nA The right shoulder, the right hand. \n \nQ I  guess  from  a  sitting  position  to  a  raised  position,  how \nmuch are you able to lower or raise the table? \n \nA It’s about two-foot to raise it all the way back up. \n \nQ And as you were trying to raise it back up, what happened \nwith the crank? \n \n\nPruitt – H400052 \n \n-3- \nA The  table  jammed  and  I  pulled  and  when  I  did,  I  felt  the \nhurt  in  my  shoulder,  the  pain,  the  pulling  sensation  (indicating), \nburning. \n \n The claimant reported his injury at that time. However, the claimant declined to go see a \ndoctor. The claimant continued to work in a light duty capacity for the respondent. The claimant \ntestified that his right shoulder symptoms became worse over the next weeks and was allowed to \nsee the company doctor after talking to his safety manager.  \n On August 14, 2023, the claimant was first seen for his compensable right shoulder injury \nby James McWilliams, ANP. Following is a portion of that medical report from JMAC Medical: \nHPI:  \nPt  sustained  what  was  thought  to  be  mild  right  shoulder  strain  at \nwork  on  7/15.  Since  then  he  has  been  taking  ibuprofen  but  the \nshoulder  has  not  improved.  He  has  pain  in  the  shoulder  when  he \nreaches  overhead  or  horizontal  with  outstretched  arms.  The  pain \ntends to throb at night. \n \n*** \nAssessment:  \nImpingement syndrome of shoulder region (disorder) \nM75.4/726.2)  Impingement  syndrome  of  right  shoulder  modified \n14 Aug. 2023. \n \nPlan:  \nImpingement syndrome of shoulder region (disorder) \n1. Right shoulder corticosteroid injection \n \nThe claimant was also given a right shoulder corticosteroid injection at that visit and given a full \nduty release.  \n On  August  19,  2023,  the  claimant  was  again  seen  by  ANP  McWilliams.  Following  is  a \nportion of that medical record: \nSubjective:  \nPt  sustained  what  was  thought  to  be  mild  right  shoulder  strain  at \nwork  on  7/15.  He  had  pain  in  the  shoulder  whenever  he  reaches \noverhead  or  horizontal  with  outstretched  arms.  The  pain  tends  to \n\nPruitt – H400052 \n \n-4- \nthrob at night. On 8/14 he was seen by this provider and was given \ncorticosteroid  injection  into  the  affected  shoulder.  However,  he \nsays  the  pain  never  resolved  and  may  be  somewhat  worse.  He  is \nalso having numbness in his right arm and hands. He says that this \nimproves somewhat by letting his arm dangle and shaking it. Also \nc/o pain in bilateral anterior thighs and loss of taste. \n \n*** \nPlan:  \nI  have  discussed  with  pt  that  arm  numbness,  thigh  pain,  &  taste \nsensation  are  all  under  3  different  locus  of  neurological  control. \nThe fact that he can achieve improved sensation in his right arm by \nletting  it  dangle  is  subjective  of  circulatory  etiology.  It  is  difficult \nto imagine his recent shoulder injection causing these problems. \n \nTaste sense altered (finding) \n1. Rapid COVID negative \n2. May need neuro consult if this persists \n \nThigh pain (finding) \n1. OTC ibuprofen \n \nNumbness and tingling sensation of skin (finding) \n1. Limit overhead reaching \n \nImpingement syndrome of shoulder region (disorder) \n1. Right shoulder MRI without contrast. \n \nThe claimant was also prescribed gabapentin 300 mg, one capsule two times per day.  \n On  September  13,  2023,  the  claimant  underwent  an  MRI  of  his  right  shoulder  at  Mena \nRegional  Health.  The  report  from  that  diagnostic  test  was  signed  by  Dr.  Jonathan  Welsh.  A \nportion of that report follows: \nFINDINGS:  Multiplanar  T1  and  T2  weighted  images  of  the  right \nshoulder were obtained. \n \nThe motor cuff muscles and tendons are intact. The biceps tendon \nis  within  the  bicipital  groove.  The  glenoid  labrum  is  normal  in \nappearance. There is moderate acromioclavicular joint \ndegenerative  joint  disease  with  subarticular  bone  marrow  edema \npresent in the distal clavicle and acromion. There is a small amount \n\nPruitt – H400052 \n \n-5- \nof   fluid   in   the   subacromial/subdeltoid   bursa   consistent   with \nbursitis. \n \nIMPRESSION: \n1. Acromioclavicular    joint    degenerative    joint    disease    with \ninflammatory changes including subarticular bone marrow edema. \n2. Evidence of bursitis. \n \n On September 15, 2023, ANP McWilliams placed a memo in the claimant’s medical \nrecord. The body of that memo follows: \nReceived the results of right shoulder MRI that was performed on \nSeptember  13\nth\n.  The  rotator  cuff  muscles  and  tendons  are  intact. \nThe  bicep  tendon  is  in  place  within  the  bicipital  groove.  The \nlabrum  is  normal  in  appearance.  There  is  moderate  AC  joint \ndegenerative  joint  disease  with  subarticular  bone  marrow  edema \npresent  in  the  distal  clavicle  and  the  acromion.  There  is  a  small \namount of fluid in the subacromial subdeltoid bursa consistent with \nbursitis.  Discussed  the  case  with  radiologist  about  possibility  of \nosteomyelitis.  His  impression  was  while  certainly  it  is  possible  it \nwould not be his first suspicion as the bone marrow edema would \nbe  consistent  with  the  AC  joint  DJD  which  often  affects  the \nacromion  as  well.  Septic  arthritis  and  other  inflammatory  process \nare within DDx. Will check CBC and CRP. \n \n ANP McWilliams had the claimant’s blood drawn and tested to rule out an infection in \nhis  right  shoulder  on  September  19,  2023.  An  addendum  was  done  after  the  results  of  the \nclaimant’s blood test as follows: \nReceived  results  of  CBC  &  CRP.  WCBs  are  normal  (7.7)  which \nsuggest  no  infection.  The  CRP  is  also  normal  suggestive  of  low \namount of inflammation consistent with the bursitis seen on recent \nMRI.    Recommend    continuation    of    anti-inflammatories    and \nparticipation in PT. \n \n On September 27, 2023, the claimant was again seen by ANP McWilliams. Following is \na portion of that medical report: \nSubjective:  \nPt continues to have right shoulder pain with numbness in his right \narm.  He  stated  that  he  injured  the  arm  at  work  on  7/15  and  was \n\nPruitt – H400052 \n \n-6- \nseen  by  me  on  8/14  after  it  failed  to  improve.  At  that  time \nexamination indicated right shoulder impingement as he could not \nabduct the arm without significant pain. Apley Scratch and Empty-\nCan tests were positive for impingement. At that time he was given \ncorticosteroid  injection  in  the  shoulder.  However,  5  days  later  he \nreported that the pain never resolved and was somewhat worse. He \nalso reported onset of numbness in right arm and hands and pain in \nbilateral  anterior  thigs  and  loss  of  taste.  In  was  explained  to  him \nthen  that  this  collection  symptoms  could  not  all  be  caused  by  the \nsame  anatomical  injury.  MRI  of  the  right  shoulder  was  obtained \nand  demonstrated  AC  joint  djd  with  inflammatory  changes  and \nsubarticular   bone   marrow   edema   in   the   distal   clavicle   and \nacromion.  There  was  also  a  small  fluid  accumulation  in  the \nsubdeltoid  bursa  consistent  with  shoulder  bursitis.  Discussed  the \nMRI  with  radiologist  and  he  thought  it  was  probably  not  likely  to \nbe   osteomyelitis   but   CBC   and   CR-P   were   done   to   rule   out \ninfection  and  both  of  these  were  negative.  Pt  states  to  me  today \nthat  he  had  prior  injury  to  the  shoulder  which  also  caused  pain  in \nhis right shoulder and this was reported to safety officer at the time \nover a year ago. However, it resolved spontaneously and didn’t \ngive him any trouble until recent reinjury. \n \n*** \nPlan:  \nImpingement syndrome of shoulder region (disorder)  \nI  have  discussed  with  him  that  his  MRI  findings  explain  shoulder \npain  but  his  arm  &  hand  numbness  are  more  suggestive  of  cspine \nor  carpal  tunnel  etiology.  As  his  original  injury  was  specified  as \nonly  shoulder  pain  I  explained  to  him  that  I,  or  another  provider, \ncould  work  up  that  problem  on  his  private  medical  insurance  but \nworkman’s comp restricts me to the injury he first presented with. \nThe  logical  next  step  would  be  to  send  him  for  specialty  care, \neither Orthopedics, Physiatry, or PT for the shoulder impingement. \nHe will continue to be restricted from reaching away from his body \nor overhead with extended arms. \n \n1. Physical Therapy Eval and Treat right shoulder pain \n \n The  claimant  began  to  see  Dr.  Justin  Walden  at  Chi  St.  Vincent  in  Hot  Springs  on \nNovember  13,  2023,  for  his  right  shoulder  complaints.  Following  is  a  portion  of  that  medical \nreport: \n\nPruitt – H400052 \n \n-7- \nSUBJECTIVE: Jimmy Pruitt is here for complaints of pain in right \nshoulder.  He  reports  pain  began  7-15-2023.  He  was  at  work  and \nwas  cranking  a  table  and  the  gears  stuck  and  he  felt  a  pulling \nsensation  associated  with  pain  in  his  right  shoulder.  He  reports  he \nhad  occasional  soreness  in  his  shoulder  prior  to  this  episode  but \nnever  pain  this  severe.  He  is  right-hand  dominant.  He  denies  any \nnumbness  or  tingling  to  his  right  upper  extremity.  He  works  at \nNidec  motors.  He  has  had  previous  physical  therapy  which  made \nhis pain worse. He has had previous corticosteroid injection which \nhe had an allergic reaction with loss of taste and tingling sensation \nthrough his right side. He has been taking oral anti-inflammatories \nwith  no  improvement.  He  is  unable  to  sleep  on  his  right  side.  He \nhas  been  working  light  duty.  He  has  not  had  previous  surgery  to \nhis right shoulder. \n \n*** \nIMAGING STUDIES: Grashey AP and axial lateral views of right \nshoulder  in  office  today  which  show  moderate  acromioclavicular \njoint space narrowing. No glenohumeral joint space narrowing. No \nacute  fracture.  Humeral  head  centered  on  glenoid.  No  hardware \npresent. \n \nMRI  images  unavailable  for  review  but  report  shows  subacromial \nbursitis with AC arthritis and bony edema. \n \nASSESSMENT: Right shoulder AC arthritis, biceps tendinitis, and \nsubacromial bursitis. \n \nTREATMENT  AND  PLAN:  Patient  is  shoulder  is  related  to \naggravation   of   pre-existing   arthritis.   Diagnosis   and   treatment \noptions discussed with patient recommended shoulder arthroscopy \nwith biceps tenotomy, subacromial decompression, and open distal \nclavicle excision. Details of surgery as well as anticipated recovery \nwere  discussed  with  patient  as  well  as  need  for  postoperative \ntherapy and  activity restrictions. Potential complications including \ninfections,  arthrofibrosis,  chronic  pain,  neurovascular  injury,  and \nanesthetic related complications. All questions were answered. \n \nMy   future   plan   of   care   may   include   medications,   injections, \nradiographs,   physical   therapy,   occupational   therapy,   advanced \nimaging,  splint  application,  cast  application,  bracing  and  surgical \nintervention  as  indicated.  Future  follow  up  visits  may  be  with \nNeysa Ellis, PA-C, Jared Wilson, PA-C, or Mallory Melby, PA-C. \n \n\nPruitt – H400052 \n \n-8- \n On  January  19,  2024,  Dr.  Walden  authored  an  addendum  to  his  November  13,  2023, \nmedical  report  regarding  the  claimant.  As  Dr.  Walden  noted,  he  was  unable  to  view  the  actual \nMRI images during the claimant’s November 13, 2023, visit as they were unavailable to him. \nHowever, apparently, Dr. Walden received the MRI images and made the following addendum: \nAddendum 1-19-2024: MRI images of right shoulder received and \nwere  reviewed  which  showed  right  shoulder  AC  arthritis  with \nedema  indicating  acute  inflammation.  There  is  effusion  of  AC \njoint.  Near  complete  detachment  of  superior  labrum  and  biceps \ninsertion. Partial thickness tear of supraspinatus with no atrophy or \nretraction. Recommend shoulder arthroscopy and  biceps tenotomy \nand mini open distal clavicle excision. \n \n The claimant has asked the Commission to determine whether he is entitled to additional \nmedical  treatment  for  his  compensable  right  shoulder  injury  in  the  form  of  the  surgical \nprocedures recommended by Dr. Walden in his January 19, 2024, addendum. \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 On  February  7,  2024,  Dr.  John  Jaksha  with  Mena  Regional  Health  System  authored  a \n“Preliminary Report”  regarding  the  claimant’s  September 13,  2023,  right  shoulder  MRI. \nFollowing a portion of that “Preliminary Report:” \nClinical  History:  Second  opinion,  muscular/skeletal,  radiologist  if \npossible, HX of traumatic injury, patient for surgical consult (Hx). \n \n\nPruitt – H400052 \n \n-9- \n*** \nFindings: \nNo rotator cuff tear is identified. \nMinimal edema of the distal supraspinatus and mild peritendinous \nedema could represent a mild tendon strain or tendinopathy. \nMinimal  edema  along  the  superficial  margin  of  the  infraspinatus \ncould represent a mild muscle strain. \n \nBiceps tendons intact. \nNo definite labral tear is seen. \nModerate  acromioclavicular  degenerative  changes  with  narrowing \nof the shoulder outlet. \nModerate  marrow  edema  in  the  distal  clavicle  is  indeterminate. \nDifferential  diagnosis  includes  sequoia  of  degenerative  changes, \nrecent or repetitive trauma. \n \nImpression: \nMinimal edema distal supraspinatus tendon. \nMinimal  edema  along  the  superficial  margins  of  the  infraspinatus \nmuscle. \nAcromioclavicular  degenerative  changes  with  marrow  edema  in \nthe distal clavicle, see above. \n \n On February 28, 2024, Dr. Bryan Frentz authored a report regarding the claimant’s right \nshoulder  and  answered  questions  at  the  conclusion  of  the  report.  The  parties  agreed  that  this \nreport, which is found at Respondents’ Exhibit 1, pages 20-23,  was  generated  through  a  record \nreview and that review did not include viewing the MRI images of the claimant’s right shoulder. \nInstead,  medical  reports  about  the  MRI  results  were  used.  I  also  note  that  the  claimant  was  not \nexamined  by  Dr.  Frentz. On  page  22  of  Respondents’  Exhibit  1,  Dr.  Frentz  answered  the \nfollowing question, “Do the surgery requests make sense with the MRI report?” Dr. Frentz \nanswered, “No. There is essentially no significant pathology noted on the right shoulder MRI \nreport that would justify any type of surgical intervention.” \n This  matter  really  comes  down  to  a  question  of  what  do  the  September  13,  2023,  MRI \nimages of the claimant’s right shoulder actually show. Dr. Welsh, a staff radiologist at Mena \n\nPruitt – H400052 \n \n-10- \nRegional  Health,  and  Dr.  Jaksha,  who  signs  his  name  with  “Diplomat,  American  Board  of \nRadiology,” both have very similar findings after reviewing the MRI images. Neither saw the \ntype  of  derangement  Dr.  Walden,  who  is  an  orthopedic  surgeon,  saw  when  he  viewed  the  MRI \nimages  and  made  a  January  19,  2024,  addendum  about  his  findings.  At  that  time  Dr.  Walden \nstated:  \n... showed right shoulder AC arthritis with edema indicating acute \ninflammation.   There   is effusion   of   AC   joint.   Near   complete \ndetachment  of  the  superior  labrum  and  biceps  insertion.  Partial \nthickness tear of supraspinatus with no atrophy or retraction. \n \nI also note Dr. Walden had the opportunity to physically examine the claimant on November 13, \n2023, during the claimant’s office visit with him.  \nIn review of the medical evidence, I find that more weight should be given to Dr. Walden \nwho was not only able to review the MRI images of the claimant’s right shoulder but had the \nopportunity  to  physically  examine  the  claimant.  Both  Dr.  Jaksha  and  Dr.  Welsh  only  examined \nthe MRI images. Given Dr. Walden’s opinion, I find his proposed surgical intervention of the \nclaimant’s right shoulder to be reasonable and necessary medical treatment for his compensable \nright shoulder 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 \n \n \n\nPruitt – H400052 \n \n-11- \n FINDINGS OF FACT & CONCLUSIONS OF LAW \n 1.  The  stipulations  agreed  to  by  the  parties  at  the  pre-hearing  conference  conducted  on \nMarch 11, 2024, and contained in a Pre-hearing Order filed March 12, 2024, are hereby accepted \nas fact. \n 2. The  claimant  has  proven  by  a  preponderance  of  the  evidence  that  he  is  entitled  to \nmedical treatment for his compensable right shoulder injury in the form of surgical intervention \nas recommended by Dr. Justin Walden. \n ORDER \nThe  respondent  shall  pay  for  the  reasonable  and  necessary  medical  treatment  associated \nwith the claimant’s compensable right shoulder injury in the form of surgical intervention and its \naftercare.  \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. H400052 JIMMY PRUITT, Employee CLAIMANT NIDEC MOTOR CORP., Employer RESPONDENT TRAVELERS INDEMNITY CO., Carrier RESPONDENT OPINION FILED SEPTEMBER 3, 2024 Hearing before ADMINISTRATIVE LAW JUDGE ERIC PAUL WELLS in Fort Smith, Sebastian County, Arkansas. Claim...","fetched_at":"2026-05-19T22:48:27.749Z","links":{"html":"/opinions/alj-H400052-2024-09-03","pdf":"https://labor.arkansas.gov/wp-content/uploads/PRUITT_JIMMY_H400052_20240903.pdf","source_publisher":"https://labor.arkansas.gov/workers-comp/awcc-opinions/administrative-law-judge-opinions/"}}