{"id":"alj-H401902-2026-02-05","awcc_number":"H401902","decision_date":"2026-02-05","opinion_type":"alj","claimant_name":"Chad Hill","employer_name":"Washington County Judge","title":"HILL VS. WASHINGTON COUNTY JUDGE AWCC# H401902 February 05, 2026","outcome":"granted","outcome_keywords":["modified:2","granted:5","denied:3"],"injury_keywords":["back","hip","lumbar","herniated","repetitive"],"pdf_url":"https://www.labor.arkansas.gov/wp-content/uploads/HILL_CHAD_H401902_20260205.pdf","source_index_url":"https://labor.arkansas.gov/workers-comp/awcc-opinions/administrative-law-judge-opinions/","filename":"HILL_CHAD_H401902_20260205.pdf","text_length":50298,"full_text":"BEFORE THE ARKANSAS WORKERS’ COMPENSATION COMMISSION \n   \n CLAIM NO. H401902 \nCHAD HILL, EMPLOYEE CLAIMANT \n \nWASHINGTON COUNTY JUDGE, EMPLOYER RESPONDENT \n \nAAC RISK MANAGEMENT SERVICES, CARRIER/TPA RESPONDENT \n \n OPINION FILED FEBRUARY 5, 2026 \n \nHearing before ADMINISTRATIVE LAW JUDGE JOSEPH C. SELF in Springdale, Washington \nCounty, Arkansas. \n \nClaimant represented by EVELYN E. BROOKS, Attorney, Fayetteville, Arkansas. \n \nRespondents represented by JARROD PARRISH, Attorney, Little Rock, Arkansas. \n \n STATEMENT OF THE CASE \n  \n On  November 13,  2025,  the  above  captioned  claim  came  on  for  a  hearing  at  Springdale, \nArkansas. A pre-hearing conference was conducted on August 28, 2025, and a pre-hearing order was \nfiled on that same date.  A copy of the pre-hearing order has been marked as Commission’s Exhibit \n#1 and made a part of the record without objection. \n At the pre-hearing conference the parties agreed to the following stipulations: \n1.    The Arkansas Workers’ Compensation Commission has jurisdiction of this claim.  \n2 The employee/employer/carrier relationship existed on January 23, 2024. \n3 Claimant sustained a compensable injury on January 23, 2024.  \nBy agreement of the parties, the issues to be litigated and resolved at the forthcoming hearing \nwere limited to the following: \n            1.  Compensation rate. \n            2.  Whether claimant is entitled to temporary total disability benefits from June 9, 2025, to a  \n                 date yet to be determined. \n            3.  Whether claimant is entitled to medical benefits. \n\nHill-H401902 \n2 \n \n            4.  Attorney’s fee.  \n All other issues are reserved by the parties. \n The claimant contends that “He is entitled to medical treatment, including surgery by Dr. \nBlankenship. Claimant contends he is entitled to temporary total disability from June 9, 2025, to a date \nyet to be determined. Claimant reserves all other issues.” \n The respondents contend that “All appropriate benefits have been paid with regard to this \nmatter. It is respondents’ position that the surgical recommendation is not reasonable and necessary \nfor the claimant’s compensable injury and that respondents should not be liable for benefits associated \nwith the same.” \n           From a review of the entire record including medical reports, documents, and other matters \nproperly  before  the  Commission,  and  having  had  an  opportunity  to  hear  the  testimony  of  the \nwitnesses and to observe their demeanor, the following findings of fact and conclusions of law are \nmade in accordance with A.C.A. §11-9-704: \n \n  FINDINGS OF FACT & CONCLUSIONS OF LAW \n \n 1. The stipulations agreed to by the parties at a pre-hearing conference conducted on August \n28, 2025, and contained in a pre-hearing order filed on that same date are hereby accepted as fact. \n2. Claimant has met his burden of proof by a preponderance of the evidence that he is entitled \nto additional medical benefits as recommended by Dr. James Blankenship for his compensable back \ninjury. \n3. Claimant  has  failed  to  prove  by  a  preponderance  of  the  evidence  that  he  is  entitled  to \ntemporary total disability benefits from June 9, 2025, to a date yet to be determined. \n HEARING TESTIMONY \n \nClaimant testified on his own behalf. He is 41 years old and went to work for Washington \n\nHill-H401902 \n3 \n \nCounty in early 2019 as a heavy equipment operator. On January 23, 2024, claimant was taking snow \nchains off the back of his grader when he slipped on cold, wet surfaces. He said he yanked himself \nback up to avoid falling in the mud and instantly felt pain in his lower back, hip to hip area. The pain \nstarted going down his left leg and on the inside of his left groin. Claimant reported the injury to his \nsupervisor, Brian Shumake, within 10 to 15 minutes. Respondents accepted the injury and sent him \nfor treatment.  \nClaimant’s course of treatment began with conservative care, including physical therapy and \nepidural shots. About four months after the injury, Dr. James Calhoun performed a laminectomy and \ndiscectomy.  Following  surgery,  claimant  had  physical  therapy  and  consulted  with  Dr.  Calhoun \napproximately  three  times,  one  of  which  was  by  telephone.  Dr.  Calhoun  released  claimant  in \nSeptember 2024. According to claimant, his symptoms at the time he was released included extreme \nlower back pain, weakness and nerve pain going down his left leg and inside left groin, drop foot, and \ntingling and burning in his feet, leg, back and groin. Claimant did not believe the surgery improved his \ncondition at all. He explained these symptoms to Dr. Calhoun, who offered no additional treatment \nexcept physical therapy. \nClaimant testified that before his work accident, he had not had any problems with his back \nthat restricted his activities. When shown medical records from 2016 mentioning low back pain \npossibly from baling hay, claimant did not recall that visit. He stated that at some point before starting \nwork at Washington County, he began a regular exercise routine of free weights, jogging, walking on \ntreadmills, and stationary bike, Monday through Friday before work. Before the accident, claimant \nstated that he had no trouble doing his work or his workout, and his back caused him no problems. \nSince the accident, claimant testified that his symptoms have never gone away, but the drop \nfoot in his left foot began after the surgery. Claimant described the foot drop as not being able to feel \nhis foot when walking, causing him to trip because he cannot control it. He estimated he has fallen 30 \n\nHill-H401902 \n4 \n \nto 40 times since surgery, sometimes catching his foot on something, other times his legs just \ncollapsing when he tries to walk. \nAfter surgery, claimant returned to work at Washington County in light duty, initially in the \nsign shop and later at the front desk. Dr. Calhoun placed him on restrictions including no bending, \ntwisting, or lifting more than 15 pounds. Claimant testified the sign shop work was difficult because \nhe is tall and had to constantly bend over tables to make signs. He could not stand straight up for \nextended periods.  \nOn October 23, 2024, approximately five months after his back surgery, claimant's back flared \nup when he helped a co-worker move sign pedestals while cleaning up the shop. He told his supervisor \nDerek Morgan that he had hurt his back. Mr. Morgan did not offer to send him to a doctor. The next \nmorning, claimant called Bart Ledgerwood while driving to work, reporting that his back hurt and he \nhad not slept all night. He asked if he could take a vacation day, take a day without pay, or come in \nand try to work as long as he could. Bart told him he would put him down for a vacation day and to \ngo home. Neither Mr. Morgan nor Mr. Ledgerwood offered to send claimant to a doctor even though \nboth were aware claimant had a workers' compensation claim for his back. \nClaimant testified that later that afternoon, around 3:15 p.m., Mr. Morgan texted claimant \nsaying he needed a doctor's note for missing a day. Claimant panicked because he understood the \npolicy to require a note only for missing a day before or after a holiday, or for missing a third \nconsecutive day. He asked his wife, who works for Baptist Health, if she could get him a doctor's note. \nClaimant said when he returned to work, Mr. Morgan told him if he did not have a doctor's note, he \nwould be fired. Claimant did not use his personal health insurance because he understood using it for \nanything related to workers' compensation would be insurance fraud, and he did not have money to \npay for a doctor out of pocket.  \nClaimant received a written reprimand on October 29, 2024, for cursing at a fellow employee \n\nHill-H401902 \n5 \n \nand for excessive use of his personal phone. In the five years he worked for Washington County \nbefore his accident, claimant testified he had never received a write-up for misconduct. \nAfter Dr. Calhoun released him, claimant said he wanted a second opinion from another \ndoctor due to his continued symptoms but was denied by the carrier as being too soon after his release. \nHe finally saw Dr. James Blankenship who recommended additional surgery, which claimant is seeking \nin this hearing.  \nClaimant testified that he has been unable to work since he was terminated. He applied to a \nfew jobs, but he determined that he could not even work a part-time job. He said he does household \nchores and yard work—vacuuming, yard work, tilling his garden—by taking frequent breaks, but his \nback still hurts the next day.  \nOn cross-examination, claimant was confronted with his deposition testimony stating he never \nhad any prior injuries, problems, symptoms, or conditions involving his low back before January 23, \n2024. When shown the 2016 medical records documenting lower back pain, paravertebral spasms, \npositive straight leg raise on the left, and radiculopathy of the lumbosacral region, claimant stated he \ndid  not  remember  that  visit  until  his  attorney  told  him  about  it  before  the  hearing.  He  only \nremembered the 2016 visit was to check if he was diabetic and to get a prostate exam. \nClaimant confirmed that he had three MRIs: January 27, 2024 (pre-surgery), July 11, 2024 \n(post-surgery), and June 23, 2025 (for Dr. Blankenship). He underwent a functional capacity evaluation \nin October 2024 with a consistency score of 31 out of 49. When asked for an explanation, claimant \nsaid he did not know what it meant. \nClaimant agreed Washington County brought him back to work in modified duty both before \nhis surgery on May 28, 2024, and then again after surgery, working in the sign shop and office. \nClaimant worked for the County until his termination in November 2024. \nRegarding the note from Dr. Slabbert which took claimant off work on October 24, 2024, \n\nHill-H401902 \n6 \n \nclaimant admitted he had never been evaluated by Dr. Slabbert, never seen him, never been to his \noffice, never spoken to anyone in his office, and had never tried to make an appointment with him. \nClaimant admitted when he turned the note in, he knew it was not legitimate, knew he had no \naffiliation with that doctor, and knew it would be fraudulent. He conceded it was dishonest to present \nthat note to his employer. Claimant does not disagree with the decision to terminate his employment \nbecause of the fraudulent note he submitted to Washington County. \nAfter being terminated, claimant applied for unemployment benefits and listed the reason for \ntermination simply as \"Doctor note\" without disclosing he had falsified a medical record. Claimant \nwas denied unemployment benefits but testified he thought the denial was because he was receiving \npermanent partial disability payments. Since termination, claimant applied to Waste Management, \nCrawford County dump, CARDS trash service, AutoZone, and construction companies. In addition \nto the outdoor work mentioned earlier, claimant does laundry, dishes, and cooking in what he termed \n“small portions.”  \nClaimant was asked about cursing at the co-worker at the office. Claimant said sometimes you \njoke around with co-workers, and he did not think he was yelling at her. He termed it as expressing \nfrustration about not knowing how to use the phone. He conceded that he used profanity. \nOn redirect examination, claimant's actual deposition answer about prior back problems was \n\"No. Not that I can remember, no,\" not simply \"no.\" Regarding the functional capacity evaluation, \nclaimant testified the evaluator asked him to stand on his left leg and squat down. When claimant \nasked if the evaluator would catch him because he knew he would fall, the evaluator said no. Claimant \nrefused because he did not want to hurt himself. Claimant testified he gave good effort in the \nevaluation and tried to be cooperative, but he has not been able to squat on one leg since his surgery. \nRegarding the fraudulent note, claimant testified he had never done anything like that before. \nHe was trying to keep his job and panicked when told he would be fired if he did not have a doctor's \n\nHill-H401902 \n7 \n \nnote. He told both Mr. Morgan and Mr. Ledgerwood he had hurt his back moving signposts, but \nneither offered to send him to a doctor; both knew about his workers' compensation claim for a back \ninjury. He repeated that he offered to come into work, but Mr. Ledgerwood told him to take a vacation \nday and go home. \nClaimant testified he never had to explain why he wanted vacation days when he took accrued \nvacation. He had never had to bring a doctor's note for one day off work being sick. Requiring a \ndoctor's note was not within the policy as he understood it or as it had been practiced with him before. \nBefore the accident happened, claimant said he had never been reprimanded for using his personal \ncell phone. \nOn recross-examination, claimant admitted he was willing to lie to keep his job. He had no \nsick time left, which is why he asked for a vacation day or to take it without pay. Claimant understood \nthat vacation time requires two weeks' notice to a supervisor, but claimant maintained he was told he \ncould take a vacation day rather than coming into work. Claimant agreed that regardless of what the \npolicy is and whether he should or should not have been asked for a note, there was no justification \nfor producing a fraudulent note and representing that it was true and accurate. \nMr. William Bartley  Ledgerwood testified for respondents. He  is superintendent of the \nWashington County Road Department. He testified claimant did not fully cooperate with efforts to \nkeep him working. He believed claimant hated working the front desk and telephone and was usually \na no-show when assigned there. Claimant received a written reprimand on October 29, 2024, for \ncursing at a secretary at the front desk. The incident was significant enough to draw attention from \nother employees and supervisors. Claimant had received verbal reprimands about phone usage before \nreceiving a written reprimand for excessive personal cell phone use on the same date.  \nIn response to claimant’s testimony about working at a table too low for him in the sign shop, \nMr. Ledgerwood said claimant was provided with a table at the right height with a stool to avoid \n\nHill-H401902 \n8 \n \ndiscomfort to his back. \nRegarding the events October 23-24, 2024, Mr. Ledgerwood testified Superintendent Crowder \nfelt a doctor's note was relevant because of claimant's past history of not showing up and taking off \nfor jobs he did not want to do, indicating a pattern of claimant taking off whenever he wanted to. The \nnote was requested based on this pattern; claimant had depleted all his sick time. Mr. Ledgerwood \nexplained the vacation time policy requires two weeks' notice to structure who will be working. When \nsomebody calls in asking to take a vacation day, it has always been denied. However, Mr. Ledgerwood \ntold claimant he could take a vacation day because claimant had no other way to take time off—\nWashington County policy does not give unpaid days if vacation time is available. The superintendent \nasked Derek Morgan to request the note from claimant. \nMr. Ledgerwood stated the reason claimant was terminated was because he produced a forged \ndoctor's note; but for the fraudulent note, claimant would have continued working in modified duty \nas he had since January 2024. Mr. Ledgerwood stated claimant was one of the better grader operators \nthey had. As such, the intent was always for him to go back to operating the grader if he could. He \ndenied there was collusion to set up traps for write-ups or reprimands; the write-ups were all the result \nof claimant's behavior and conduct. \nOn cross-examination, Mr. Ledgerwood said he was field superintendent when claimant was \nfirst employed and was aware claimant had a back injury at work. He agreed when claimant called that \nmorning saying his back hurt, Mr. Ledgerwood told claimant to go home, and he would put it down \nas a vacation day. He explained this was not the first time claimant had been asked to bring a note \nwhen taking a vacation day as a sick day. Since claimant came back to work after surgery, he would \nschedule doctor visits and use vacation time because he had no more sick time. Mr. Ledgerwood \nallowed him to use vacation time as sick time; whether workers’ compensation should pay for those \nappointments was not his decision to make. He personally had observed the pattern of claimant calling \n\nHill-H401902 \n9 \n \nin when he was at the front desk. When asked why claimant was not fired for this pattern, Mr. \nLedgerwood could not answer.  \nMr. Ledgerwood admitted he brought no documents to support the pattern of calling in when \nclaimant was going to be on the front desk. The personnel file contained only two write-ups from \nOctober 29, 2024—nothing before that date. Mr. Ledgerwood conceded his knowledge about videos \nand TikToks on claimant's phone was secondhand. Mr. Ledgerwood could not answer how many \nvacation days claimant had, whether the pattern of calling in sick was documented in the personnel \nfile. When claimant was a grader operator, Mr. Ledgerwood would not have known about cell phone \nuse. It was only when claimant was at light duty in a public place could his phone use be observed. \nOn redirect examination, Mr. Ledgerwood confirmed he personally observed the pattern of \nclaimant calling in sick as he described. The County kept claimant working until the fake doctor's note. \nClaimant expressed often that he hated light-duty and did the work begrudgingly, but he eventually \ndid what was asked. If claimant had not been terminated for the false medical record, Mr. Ledgerwood \nstated that the County would have continued to accommodate him. \nOn recross-examination, the County would have continued to accommodate claimant even \nafter full release, keeping him in the sign shop or front desk as they do with other injured employees. \nThe County makes jobs for injured workers because they are \"more of a family than a business.\" Mr. \nLedgerwood agreed it is normal practice to send an employee to a doctor when they report being hurt \nat work. \nREVIEW OF THE EXHIBITS \n In addition to the prehearing order discussed above, the exhibits admitted into evidence in \nthis case were Claimant's Exhibit # 1, consisting of two index pages and 33 numbered pages of medical \nrecords thereafter; Respondent's Exhibit # 1, consisting of one index pages and 33 numbered pages \nof medical records; Respondent's Exhibit # 2 consisting of one index page and 31 pages of non-\n\nHill-H401902 \n10 \n \nmedical documents.   There were emails from the parties following the hearing, which are blue backed \nto this record.  \nReviewing the medical records in chronological order, the records that predate the January 23, \n2024, incident that gave rise to this claim were those from January 27, 2016, when Dr. Carolyn Dillard \nexamined claimant. One of the chief complaints was lower back pain on the left side that started two \nweeks prior with no injury and no fever. Physical examination showed paravertebral spasms on left \nparaspinal lumbar area with tenderness to palpation, full flexion, full extension, full lateral bending, \nfull rotation, and positive straight leg raise on the left. Claimant's diagnoses included radiculopathy of \nthe lumbosacral region. He was prescribed cyclobenzaprine as needed for muscle spasm and advised \nto use NSAIDs, stretching of low back, and to return in two weeks if no improvement. No records \nwere provided of a return visit.  \nOn January 27, 2024, claimant underwent an MRI of his lumbar spine at Northwest Medical \nCenter Bentonville. The MRI showed five non-rib-bearing lumbar vertebral bodies with normal \nvertebral body heights. There was T1 and T2 hyperintense signal with STIR hyperintense signal in the \ninferior endplate of L4, superior part of L5, inferior endplate of L5, and superior endplate of S1, likely \ndegenerative. Disc space narrowing and desiccation were noted at L4-L5 and L5-S1. At L4-L5, there \nwas a disc bulge with bilateral subarticular and foraminal components and central protrusion, mild \nbilateral facet osteoarthritis and ligamentum flavum thickening, mild spinal canal stenosis, effacement \nof bilateral traversing L5 nerve roots, and mild bilateral neural foraminal stenosis. At L5-S1, there was \na broad disc bulge, mild bilateral facet osteoarthritis and ligamentum flavum thickening, no spinal \ncanal stenosis, and mild bilateral neural foraminal stenosis greater on the left. The impression was \ndegenerative disc disease and facet osteoarthritis at L4-L5 with mild spinal canal stenosis and mild \nbilateral neural foraminal stenosis, with effacement of bilateral traversing L5 nerve roots requiring \n\nHill-H401902 \n11 \n \ncorrelation for radiculopathy. At L5-S1, mild degenerative disc disease and facet osteoarthritis with \nmild bilateral neural foraminal stenosis. \nClaimant first saw Dr. James Calhoun at Pain Treatment Centers of America on May 6, 2024. \nDr. Calhoun noted claimant was a new patient with uncontrolled lower back and leg pain not managed \nwith activity modification, home exercise, over-the-counter NSAIDs, and current pain medication. \nClaimant described constant pain with intermittent flare-ups, worsened by any physical activity and \nrelieved by rest and medications. Associated symptoms included restrictions in activities, mood \nchanges, and difficulty sleeping. Claimant had completed 12 sessions of physical therapy with no \nimprovement in left leg symptoms. He had returned to driving a grader and developed some right leg \nsymptoms, reporting continued weakness in the right foot. He had a central disc herniation at L4-5. \nDr. Calhoun discussed a left L4-5 microdiscectomy, including the risks and postoperative course. On \nMay 28, 2024, Dr. Calhoun performed a laminotomy including decompression of nerve root at one \ninterspace, lumbar, for herniated nucleus pulposus at L4-5 left. \nOn June 27, 2024, claimant saw Dr. Calhoun for a telemedicine follow-up, one-month post-\nsurgery. Claimant had done very poorly with continued low back and right leg pain worsened with any \nincrease in activity. He was using a cane. On the pain disability scale, claimant reported family/home \nresponsibilities 7/10, recreation 8/10, social life 8/10, work-related activities 8/10, sexual behavior \n8/10, self-care 6/10, and life support activities 3/10, for a Pain Disability Index score of 48. Dr. \nCalhoun's assessment was postoperative pain after spinal surgery. The plan was to try a Medrol dose \npack. Current restrictions were no lifting more than 20 pounds, no repetitive bending/twisting, no \nstanding or sitting more than 30 minutes, and no walking more than 15 minutes. Claimant was not at \nmaximum medical improvement. A telemedicine follow-up was scheduled in one month. \n\nHill-H401902 \n12 \n \nOn July 11, 2024, a postoperative MRI was performed at Fort Smith Hospital. The study \nshowed moderate loss of disc height and endplate edema and enhancement at L4-L5 suspected to be \ndegenerative Modic type 1 changes, with infection considered less likely. Left laminotomy changes \nwere noted with enhancing soft tissue in the laminotomy bed and left lateral recess; the radiologist \nrecommended  correlation  with  duration  since  surgery  as  findings  may  represent  postoperative \ngranulation tissue, with epidural fibrosis not excluded. There was persistent disc bulge asymmetric to \nthe left with stenosis of the left lateral recess and mass effect on the L5 nerve root. Moderate narrowing \nof the proximal right lateral recess with displacement of right L5 nerve root was noted. The canal was \npatent. There was moderate foraminal stenosis. At L3-L4, there was a left extraforaminal zone annular \nfissure with broad-based 4mm disc protrusion and moderate foraminal stenosis with displacement of \nexiting L3, with the canal narrow due to short pedicles. The impression noted primary canal stenosis \ndue to short pedicles and degenerative and postoperative changes at L4-L5 including left laminotomy \nand persistent lateral recess narrowing with probable mass effect on L5 nerve roots. Enhancement in \nthe left laminectomy bed and lateral recess was likely granulation tissue given recent surgery. No \npseudo meningocele or arachnoiditis was seen. Minimal edema in the disc and edema/enhancement \nin the endplates was likely degenerative, with infection considered less likely. \nOn July 17, 2024, claimant saw Dr. Calhoun for postoperative follow-up, two months post-\nsurgery. Claimant continued to complain of diffuse weakness and numbness in the left leg after the \nuncomplicated microdiscectomy. He reported the entire left leg felt numb and would give way, causing \nhim to fall. After riding a lawn mower, it affected his right leg as well for 24 hours. Dr. Calhoun \nreviewed the postoperative MRI and stated the radiologist reported some lateral recess stenosis, but \nDr. Calhoun disagreed. He found no significant neural compromise above that area to explain \nclaimant's entire left leg weakness. The physical examination showed give-way weakness in every \nmuscle tested on the left. Dr. Calhoun's assessment was postoperative pain after spinal surgery and \n\nHill-H401902 \n13 \n \npost-laminectomy syndrome of lumbar region. Dr. Calhoun had no explanation for the diffuse \ncomplaints in the lower left extremity. He started claimant on physical therapy, kept him on the same \nrestrictions plus allowed him to attend physical therapy, and scheduled telemedicine in one month. \nDr. Calhoun stated claimant's prognosis was poor. \nOn August 21, 2024, claimant had another telemedicine visit with Dr. Calhoun. Claimant had \nattended 7 of 8 physical therapy sessions with no improvement. He still fell when his left leg \"gave \nout.\" Dr. Calhoun's assessment remained post-laminectomy syndrome of lumbar region. He talked \nwith claimant's case manager and offered more physical therapy. A return visit was scheduled in \nSeptember, and Dr. Calhoun stated claimant would most likely be declared at maximum medical \nimprovement. \nOn September 18, 2024, Dr. Calhoun saw claimant for follow-up. Claimant reported he was \nunchanged  with  severe  burning  pain  across  his  lower  back  with  radiations  superiorly  and \nhypersensitive skin. He reported continued weakness in his left leg despite more physical therapy. Dr. \nCalhoun noted there was no good explanation for this on the postoperative MRI. Physical examination \nshowed 4/5 strength in left iliopsoas, quadriceps, hamstrings, and gastrocnemius/soleus, 3/5 strength \nin left tibialis anterior, and give-way weakness in every muscle tested on the left. Dr. Calhoun's \nassessment was postoperative pain after spinal surgery. His plan stated no further treatment would be \nof benefit. Claimant was at maximum medical improvement with 10% impairment of the whole \nperson according to the fourth edition of the AMA Guidelines to Permanent Impairment. Claimant \nwas kept on the same restrictions. Dr. Calhoun suggested claimant undergo a functional capacity \nevaluation to determine permanent restrictions. \nOn October 3, 2024, claimant underwent a functional capacity evaluation. In an addendum \ndated October 7, 2024, Dr. Calhoun noted claimant gave an unreliable effort, making the results \n\nHill-H401902 \n14 \n \ninvalid. Claimant remained at maximum medical improvement. Because claimant gave an unreliable \neffort, Dr. Calhoun released him to work full time with no restrictions. \nOn October 15, 2024, claimant was examined at Conservative Care Occupational Health \nSpringdale. The work note stated claimant could not perform essential job functions as a heavy \nequipment operator. The examination noted claimant required a cane for walking, had left foot drop \nand left leg radiculopathy, and decreased range of motion in low back to 60 degrees with positive \nstraight leg raising test on the left. The examining physician stated claimant had failed back surgery \nwith multiple pain medications and muscle relaxants providing no relief. \nOn October 24, 2024, claimant submitted a purported off-work slip from Dr. Slabbert to his \nemployer. On October 29, 2024, Baptist Health Family Clinic sent a letter stating the patient had no \nvisit history of being seen in their clinic on October 24, 2024, and that Dr. Slabbert was out of town \non that date. \nOn November 20, 2024, Dr. Calhoun sent a letter to Ms. Brooks stating claimant should return to his \nprimary care physician for further prescriptions of gabapentin or muscle relaxants. \nOn June 9, 2025, claimant saw Dr. James Blankenship at The Neurosurgery Spine & Pain \nManagement Center. Chief complaint was lower back pain and bilateral hip and buttock pain, left \ngreater than right. Claimant also complained of left testicular pain and bilateral lower extremity \nsymptoms down to his toes on the right and to the popliteal fossa on the left. He described decreased \nstrength in both lower extremities, left greater than right. He denied incontinence but had urinary \nurgency. Claimant reported his May 2024 laminectomy did not significantly help and if anything \nincreased his pain. He did three months of physical therapy postoperatively, with the last therapy in \nAugust. He was originally injured in January 2024 pulling a chain off a grader when he slipped and \nfell. He worked postoperatively at light duty until November 2024. Since then, he had been off work. \n\nHill-H401902 \n15 \n \nConservative treatment included physical therapy, NSAIDs, heat/ice, and epidural steroid \ninjection  in  April  2025.  On  examination,  claimant  had  4/5  extensor  hallucis  longus  and  foot \ndorsiflexors weakness on the left. He had an L5 radiculopathy on examination with sensory deficits in \nthe L5 dermatome and straight leg raising positive at 10 degrees. His gait was ataxic and assisted by \ncane with foot drop. Lumbar radiographs showed severe disc space settling at L4-L5 and L5-S1 with \nsevere foraminal stenosis. Examination of the spine showed range of motion restricted with flexion \nand extension limited due to pain. Straight leg raising test was positive on the left side. \nDr. Blankenship stated claimant's neurologic examination revealed an L5 radiculopathy with \nsensory deficits in the L5 dermatome, 4/5 strength in extensor hallucis longus and foot dorsiflexors \non the left, and straight leg raising positive at 10 degrees. Dr. Blankenship reviewed claimant's \nfunctional capacity evaluation and was concerned that some of the inconsistencies had more to do \nwith pure avoidance of falling due to weakness and the fact that claimant had been falling. Dr. \nBlankenship stated he would not weigh those findings given the condition claimant was in when he \ngot the test and what was going on, to preclude further intervention based on what he saw on the \nMRI. \nDr. Blankenship noted claimant had a fairly large recurrent disc herniation in the midline, \neccentric off to the left, with severe foraminal stenosis and marked endplate changes resulting in \nbilateral lateral recess stenosis, left much more significant than right. The L3-L4 level showed marked \nfacet arthropathy but no significant neural impingement. The lumbosacral level also had significant \ndegenerative changes with foraminal narrowing. Dr. Blankenship stated claimant had certainly failed \nroutine and usual conservative measures and had an early disc recurrence at L4-L5. Both findings were \nconsistent  with  claimant's  current  pain  complaints  and  physical  examination  findings.  Surgical \nconsideration was warranted. Unfortunately, due to significant changes at the lumbosacral level, this \n\nHill-H401902 \n16 \n \nlevel would have to be incorporated into an arthrodesis, with the main focus of surgical intervention \nat L4-L5. \nDr. Blankenship recommended claimant undergo anterior lumbar interbody arthrodesis at L5-\nS1, lateral approach at L4-L5, and posterior decompression and pedicle screw fixation. After a lengthy \ndiscussion, claimant wanted to proceed with revision surgery. The rationale for offering surgery was \nthe obvious recurrent disc herniation with severe left and moderate right lateral recess and foraminal \nstenosis at L4-L5. The reasons for suggesting arthrodesis were twofold: first, a very early recurrence, \nwhich is always an indication of segmental instability; second, claimant would need a significant \namount of his facet joint taken off to safely and adequately decompress both the L4 and L5 nerves on \nthe left, which would further destabilize his spine. Lastly, he had severe foraminal collapse at both L4-\nL5 and L5-S1 requiring elevation of the disc space with implants. Dr. Blankenship told claimant it was \nunlikely he would get any foot strength back after a year, but it was possible. Claimant would need a \nnew MRI as a preoperative tool, as Dr. Blankenship would not operate based on a near year-old MRI. \nOn June 23, 2025, an MRI was performed at MANA MRI and read by Dr. Shawn Barnhill. \nThe study showed postoperative changes at L4-L5 with marked endplate changes both at L4-L5 and \nL5-S1,  more  significant at L4-L5. Mild disc  space  desiccation was noted at L3-L4. The conus \nmedullaris sat appropriately at the thoracolumbar junction with no distal conus medullaris pathology \nor pathology at the cauda equina appreciated. No pathologic enhancement was noted. At L4-L5, there \nwas a post-hemilaminectomy on the left with recurrent disc herniation with bilateral foraminal stenosis \nsecondary to broad-space disc protrusion, left much greater than right, resulting in bilateral lateral \nrecess stenosis, left greater than right. At L5-S1, there was midline disc protrusion without significant \nneural impingement. The impression was L4-L5 recurrent disc herniation on the left with extension \n\nHill-H401902 \n17 \n \nto the neural exit foramen with L4 neural compression and milder right-side lateral recess stenosis and \nforaminal stenosis. \nOn July 7, 2025, Dr. Blankenship issued a work note stating claimant should be excused from \nwork obligations until after he had surgery. \nDr. Ryan Fitzgerald, a board-certified diagnostic radiologist, was retained by respondents to \nprovide a radiology review opinion dated November 5, 2025. Dr. Fitzgerald personally reviewed the \nactual MRI images from January 27, 2024, July 11, 2024, and June 23, 2025. \nDr. Fitzgerald's review of the January 27, 2024, MRI revealed moderate disc space narrowing \nand mild endplate osteophytes at L4-5 and L5-S1, hallmarks of chronic degenerative disease. Mixed \nModic type I and II signal at L4-5 and L5-S1 represented active degenerative endplate inflammation \nsuperimposed upon background chronic degenerative marrow signal alteration. A minimal disc bulge \nat L3-4 was accompanied by an annular fissure across the left foraminal/extra-foraminal zones with \nmild/moderate left neural foraminal stenosis. A small central disc protrusion superimposed upon a \ndiffuse disc bulge at L4-5 contributed to mild spinal canal stenosis and mild/moderate bilateral \nsubarticular recess narrowing with crowding of the intracanalicular L5 nerve roots. Neural foraminal \nstenosis was moderate on the right at L4-5. \nOn the July 11, 2024, postoperative MRI, Dr. Fitzgerald found Modic type I signal on both \nsides of the L4-5 interspace (active degenerative endplate inflammation) was more widespread than \non the comparison exam. Enhancement indicative of granulation tissue was demonstrated within the \nsurgical bed. Ill-defined STIR hyperintense signal had developed within the paraspinous musculature \non the left from L4 through S1. A residual disc protrusion in the central zone at L4-5 superimposed \nupon a mild disc bulge was no larger than on the comparison study. Persistent spinal canal stenosis at \n\nHill-H401902 \n18 \n \nL4-5 was mild and the left subarticular recess was moderately stenotic. Crowding versus impingement \nof the left L5 nerve root was evident. \nDr. Fitzgerald's review of the June 23, 2025, MRI showed no evidence of acute traumatic injury. Mild \nill-defined STIR signal on both sides of the L4-5 and L5-S1 interspaces was again consistent with \ndegenerative Modic type I signal. Residual enhancing scar in the surgical bed at L4-5 was much less \npronounced than on the comparison exam. A minimal disc bulge and endplate osteophytes at L3-4 \ndid not compromise the spinal canal and were unchanged. A mild disc bulge persisted at L4-5; \nhowever, the previously demonstrated central disc protrusion had regressed relative to the July 2024 \nexam. No residual or new disc herniation was evident. Mild spinal canal stenosis and moderate left-\nsided subarticular recess narrowing at L4-5 were unchanged. Dr. Fitzgerald concluded claimant's June \n23, 2025, MRI revealed no evidence of acute traumatic injury. At L4-5, chronic degenerative disease \nand a residual disc bulge were present as on prior imaging, but no herniation or other new disc \nabnormality was found. \nADJUDICATION \nThere are two distinct parts to claimant's request for relief. He seeks additional medical care as \nrecommended by Dr. Blankenship and temporary total disability benefits from June 9, 2025, until a \ndate to be determined.  \nIS CLAIMANT ENTITLED TO ADDITIONAL MEDICAL TREATMENT \nIt was stipulated that claimant sustained a compensable injury on January 23, 2024. Claimant \nhas the burden of proving by a preponderance of the evidence that medical treatment is reasonable \nand necessary. Goyne v. Crabtree Contracting Company, 2009 Ark. App. 200, 301 S.W.3d 16. Once \ncompensability is established, claimant need not offer objective medical evidence to prove entitlement \nto additional benefits. Ark. Health Ctr. v. Burnett, 2018 Ark. App. 427, 558 S.W.3d 408.  \n\nHill-H401902 \n19 \n \n However, because of claimant's willingness to submit a fabricated note from a physician he \nhad never seen and because he suffered a very convenient memory lapse in his deposition about \nprevious issues with his back, I am examining this portion of the case to see if the evidence \nindependent of his testimony supports the need for the surgery Dr. Blankenship has recommended. \nTo that end, the medical records summary above is more detailed than what I normally feel is necessary \nto render an opinion.  \n             Looking first at Dr. Calhoun's records, I find significant inconsistencies therein. Post surgery, \nhe documented objective findings including weakness on examination, opined that claimant had done \n\"very poorly\" after surgery, stated claimant's prognosis was \"poor,\" found \"no explanation\" for \nclaimant's symptoms on the MRI, diagnosed post-laminectomy syndrome, and assigned permanent \nrestrictions and a permanent impairment rating. Despite those findings, he declared claimant at \nmaximum medical improvement with no further treatment of benefit, then released claimant to full \nduty with no restrictions based solely on an unreliable functional capacity evaluation. Dr. Calhoun's \nrelease of claimant to full duty work based on the FCE results is puzzling. The functional capacity \nevaluation measured claimant's effort and consistency during testing for a part of a day; it did not cure \nclaimant's  underlying  spinal  pathology  or  eliminate  the  objective  findings  Dr.  Calhoun  had \ndocumented on examination. Dr. Calhoun did not explain how a patient can simultaneously have a \npermanent anatomical impairment warranting restrictions and also be able to work full duty with no \nrestrictions. His statement that \"no further treatment would be of benefit\" appears to be his way of \nushering claimant out of his office. Dr. Calhoun did not suggest claimant see a neurosurgeon to \naddress the issues he had documented but left untreated.  \n I found the testimony of Mr. Ledgerwood insightful on this issue. He established claimant's \nreports to Dr. Calhoun took place before claimant had any incentive to exaggerate his post-surgery \n\nHill-H401902 \n20 \n \nsymptoms. Just the contrary; claimant hated working in the shop or office and was very eager to return \nto operating the grader. Having unnecessary treatment would only delay claimant's desired outcome. \nAs such, his complaints to Dr. Calhoun following surgery are believable in light of Mr. Ledgerwood's \nobservations. The Commission has the authority to accept or reject medical opinion and to determine \nits medical soundness and probative force. LVL, Inc. v. Ragsdale, 2011 Ark. App. 144, 381 S.W.3d 869. \nIn light of all the evidence, I reject Dr. Calhoun's finding that claimant reached maximum medical \nimprovement with no further treatment of benefit. \n Dr. Blankenship documented clinical findings consistent with those of Dr. Calhoun, including \nweakness in the left lower extremity, sensory deficits in the L5 dermatome, positive straight leg raising, \nand L5 radiculopathy on examination. Dr. Blankenship also observed that claimant's gait was ataxic \nwith foot drop and that claimant required a cane for ambulation. He ordered a new MRI which was \nperformed on June 23, 2025. Dr. Barnhill reported \"recurrent disc herniation\" with bilateral foraminal \nstenosis and lateral recess stenosis at L4-L5. Based on his clinical examination and the MRI, Dr. \nBlankenship recommended anterior lumbar interbody arthrodesis at L5-S1, lateral approach at L4-L5, \nand posterior decompression and pedicle screw fixation. \n Respondents retained Dr. Ryan Fitzgerald, a board-certified diagnostic radiologist, to provide \nan independent review. Unlike Dr. Barnhill, Dr. Fitzgerald personally reviewed and compared all three \nMRI studies that had been done in this matter. On the June 23, 2025, MRI, Dr. Fitzgerald found the \ndisc protrusion had regressed relative to the July 2024 study and stated \"no residual or new disc \nherniation was evident.\" However, Dr. Fitzgerald also found moderate left-sided subarticular recess \nnarrowing at L4-5 that was unchanged from prior studies, along with mild spinal canal stenosis and \nchronic degenerative disease with endplate changes. \n\nHill-H401902 \n21 \n \n Dr. Fitzgerald's interpretation conflicts with Dr. Barnhill's characterization of \"recurrent \nherniation.\" I find no fault with Dr. Fitzgerald's interpretations of the studies he reviewed; however, \nDr. Fitzgerald's findings do not resolve the question before me. Dr. Fitzgerald is a radiologist who \ninterprets imaging; he did not examine claimant. He did not opine on whether the pathology he \ndocumented—the unchanged moderate stenosis, the degenerative disease, the endplate changes—\nexplains  claimant's  clinical symptoms  or  warrants  surgical  intervention.  Those  are  clinical \ndeterminations outside the scope of a radiologist's expertise. \n Both Dr. Calhoun and Dr. Blankenship documented claimant's neurological deficits. Dr. \nCalhoun found weakness and stated he had \"no explanation\" for claimant's symptoms based on the \nimaging. Dr. Blankenship found similar weakness, along with radiculopathy, sensory deficits, and foot \ndrop requiring use of a cane. Both radiologists who reviewed the June 2025 MRI documented \npathology.  Dr.  Barnhill  characterized  it  as  \"recurrent  herniation\"  with  stenosis.  Dr.  Fitzgerald \ncharacterized it as regressed disc protrusion with unchanged moderate stenosis and degenerative \ndisease. They appear to be describing the same pathology using different terminology. \nDr. Fitzgerald's finding that there is \"no evidence of acute traumatic injury\" on the June 2025 \nMRI does not undermine Dr. Blankenship's recommendation. Dr. Blankenship, as a neurosurgeon \nwith specialized expertise in spinal surgery, correlated the clinical findings recorded by both examining \nphysicians with the imaging pathology documented by both radiologists and determined that surgical \nintervention is warranted. After carefully weighing all the medical evidence, I find claimant has proven \nby a preponderance of the evidence that the surgery recommended by Dr. Blankenship is reasonable \nand necessary. \nIS  CLAIMANT  ENTITLED  TO  TEMPORARY  TOTAL  DISABILITY  BENEFITS?  \n             Claimant seeks temporary total disability benefits from June 9, 2025, the date he first saw Dr. \n\nHill-H401902 \n22 \n \nBlankenship, to a date yet to be determined. For an injured employee to be entitled to temporary total \ndisability compensation, he must prove that he remains within his healing period and that he suffers \na total incapacity to earn wages. Ark. State Hwy. & Transp. Dept. v. Breshears, 272 Ark. 244, 613 S.W.2d \n392 (1981). The healing period ends when the underlying condition stabilizes such that further \ntreatment will not improve the condition. Nix v. Wilson World Hotel, 46 Ark. App. 303, 879 S.W.2d 457 \n(1994). \nBecause  I  have  found  that Dr Calhoun’s  release  of  claimant  at  maximum  medical \nimprovement was not supported by the evidence in this case, and that the surgery recommended by \nDr. Blankenship is reasonable and necessary, it follows that claimant remains within his healing period. \nHowever, claimant has failed to prove he suffered a total incapacity to earn wages from June 9, 2025, \nforward. \nDr. Blankenship's July 7, 2025, letter regarding work—issued after reviewing the June 23, 2025, \nMRI—stated claimant \"should be excused from work obligations until after he has surgery.\" While \nthis reflects Dr. Blankenship's legitimate medical judgment, it does not constitute proof of total \nincapacity to earn wages. The note is a general work excuse, but does not take into account claimant's \nproven capacity to perform the specific light duty he successfully performed at Washington County. \nA physician's statement that a patient should not work differs from medical proof that the patient is \ntotally incapacitated from earning wages in suitable employment. Ark. Code Ann. § 11-9-102(8). \nDr. Blankenship documented 4/5 strength in the left lower extremity, L5 radiculopathy, \nsensory deficits, and foot drop requiring use of a cane—findings substantially similar to those \ndocumented by Dr. Calhoun in July through September 2024 while claimant was working light duty. \nDr. Calhoun found give-way weakness in every muscle tested on the left, 4/5 strength in multiple \nmuscle groups, 3/5 strength in left tibialis anterior, left leg giving out causing falls, and post-\n\nHill-H401902 \n23 \n \nlaminectomy syndrome. The physicians differed not in their clinical findings regarding claimant's \ncondition, but in their treatment approach. Dr. Calhoun declared claimant at maximum medical \nimprovement despite objective neurological deficits he acknowledged having \"no explanation\" for on \nimaging. Dr. Blankenship, as a neurosurgeon, determined surgical intervention was warranted to \naddress the documented pathology. \nClaimant successfully performed light duty work at Washington County from July through \nNovember 2024 despite these physical deficits. He worked in the sign shop and at the front desk \nperforming sedentary and light tasks within his restrictions. If claimant could perform this work from \nJuly through November 2024 with the clinical condition that warranted surgical intervention, nothing \nin Dr. Blankenship's June 2025 findings demonstrated he had become totally incapacitated from \ncontinuing that same work. \nFurthermore, the objective imaging demonstrated no worsening of claimant's condition. Dr. \nFitzgerald's review of the June 23, 2025, MRI revealed the disc protrusion had regressed relative to \nthe July 2024 postoperative study, with no residual or new disc herniation evident. The moderate left-\nsided subarticular recess narrowing and mild spinal canal stenosis documented on the June 2025 MRI \nwere  unchanged  from  prior  studies. Claimant  performed light  duty  work  with  Dr.  Calhoun's \ndocumented  deficits  and the  findings on  the  post-surgery MRI.  Nothing  in  Dr.  Blankenship's \nexamination or in the June 2025 MRI demonstrates total incapacity from continuing that work. \nClaimant's counsel argues in her post-hearing email that the termination was unreasonable due \nto short notice for the work note requirement. Tyson Poultry v. Narvaiz, 2012 Ark. 36, 386 S.W.3d 1, \nholds that a termination for misconduct does not forfeit temporary total disability benefits but \nclaimant must still prove both healing period and total incapacity to earn wages. Even assuming \narguendo the termination was unreasonable, claimant fails the incapacity requirement—he successfully \n\nHill-H401902 \n24 \n \nperformed light duty despite the same clinical deficits Dr. Blankenship documented. Washington \nCounty provided modified duty work to claimant from January 2024 through his November 2024 \ntermination. Mr. Ledgerwood credibly testified that Washington County would have continued \nproviding modified duty consistent with claimant's restrictions absent the fraudulent note, and that \nfraud was the sole reason for termination. \nFor these reasons, I find claimant has failed to prove by a preponderance of the evidence that \nhe suffered a total incapacity to earn wages from June 9, 2025, forward, and he is therefore not entitled \nto temporary total disability benefits. \nORDER \n Claimant has met his burden of proving by a preponderance of the evidence that he is entitled \nto additional medical treatment as recommended by Dr. Blankenship for his compensable back injury. \nClaimant has failed to prove by a preponderance of the evidence that he is entitled to \ntemporary total disability benefits from June 9, 2025, to the date of the hearing. Pursuant to A.C.A. § \n11-9-715(a)(1)(B)(ii), attorney fees are awarded \"only on the amount of compensation for indemnity \nbenefits controverted and awarded.\" Here, no indemnity benefits were awarded; therefore, no attorney \nfee has been awarded. Instead, claimant's attorney is free to voluntarily contract with the medical \nproviders pursuant to A.C.A. § 11-9-715(a)(4). \nRespondent is responsible for paying the court reporter's charges for preparation of the \nhearing transcript. \n IT IS SO ORDERED.                                                                                    \n        _______     \n JOSEPH C. SELF \nADMINISTRATIVE LAW JUDGE","preview":"BEFORE THE ARKANSAS WORKERS’ COMPENSATION COMMISSION CLAIM NO. H401902 CHAD HILL, EMPLOYEE CLAIMANT WASHINGTON COUNTY JUDGE, EMPLOYER RESPONDENT AAC RISK MANAGEMENT SERVICES, CARRIER/TPA RESPONDENT OPINION FILED FEBRUARY 5, 2026 Hearing before ADMINISTRATIVE LAW JUDGE JOSEPH C. SELF in Springdale, Washington County, Ar...","fetched_at":"2026-05-19T22:31:47.821Z","links":{"html":"/opinions/alj-H401902-2026-02-05","pdf":"https://www.labor.arkansas.gov/wp-content/uploads/HILL_CHAD_H401902_20260205.pdf","source_publisher":"https://labor.arkansas.gov/workers-comp/awcc-opinions/administrative-law-judge-opinions/"}}