{"id":"alj-H404754-2025-04-18","awcc_number":"H404754","decision_date":"2025-04-18","opinion_type":"alj","claimant_name":"Amanda Engleman","employer_name":"Washington Regional Medical Center","title":"ENGLEMAN VS. WASHINGTON REGIONAL MEDICAL CENTER AWCC# H404754 April 18, 2025","outcome":"granted","outcome_keywords":["granted:2"],"injury_keywords":["shoulder","back","rotator cuff","sprain","fracture"],"pdf_url":"https://www.labor.arkansas.gov/wp-content/uploads/ENGLEMAN_AMANDA_H404754_20250418.pdf","source_index_url":"https://labor.arkansas.gov/workers-comp/awcc-opinions/administrative-law-judge-opinions/","filename":"ENGLEMAN_AMANDA_H404754_20250418.pdf","text_length":35195,"full_text":"BEFORE THE ARKANSAS WORKERS’ COMPENSATION COMMISSION \n   \n CLAIM NO. H404754 \n \nAMANDA ENGLEMAN, EMPLOYEE CLAIMANT \n \nWASHINGTON REGIONAL MEDICAL CENTER, EMPLOYER RESPONDENT \n \nRISK MANAGEMENT RESOURCES, CARRIER/TPA RESPONDENT \n \n \n OPINION FILED APRIL 18, 2025 \n \n \nHearing  before  ADMINISTRATIVE  LAW  JUDGE JOSEPH  C.  SELF in Fort  Smith, Sebastian \nCounty, Arkansas. \n \nClaimant represented by EDDIE H. WALKER, JR., Attorney, Fort Smith, Arkansas. \n \nRespondents are represented by MELISSA WOOD, Attorney, Little Rock, Arkansas. \n \n \n STATEMENT OF THE CASE \n  \n On January 21, 2025, the above captioned claim came on for a hearing in Fort Smith, Arkansas. \nA pre-hearing conference was conducted on September 27, 2024, and a pre-hearing order was filed \non that same date. A copy of the pre-hearing order has been marked as Commission’s Exhibit #1 and \nmade 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 employee/employer/carrier relationship existed on June 2, 2023. \n3   The respondents have controverted the claim in its entirety. \n4.  The compensation rates are the maximum.  \nBy agreement of the parties, the issues to be litigated and resolved at the forthcoming hearing \nwere limited to the following: \n\nEngleman-H404754 \n2 \n \n \n1. Whether claimant sustained a compensable injury on June 2, 2023, specifically bilateral  \nshoulder injuries. \n 2. If  compensable,  whether  claimant  is  entitled  to  temporary  total  disability  benefits,  and      \nmedical benefits.  \n 3.  Attorney fees. \nAll other issues are reserved by the parties. \nThe claimant contends that “She is entitled to temporary total disability benefits from June 13, \n2024, to  a  date  yet  to  be  determined  and  reasonably  necessary  medical  treatment. The  claimant \ncontends that her attorney is entitled to an appropriate attorney’s fee.” \nThe respondents contend that “Claimant’s bilateral shoulder injuries were initially accepted as \na  medical  only  claim,  but  the  claim  has  now  been  denied  in  its  entirety  due  to  a  lack  of  objective \nfindings. Additionally,  respondents  contend  that  claimant  has  preexisting  issues  with  her  shoulders \nand possibly underwent new injuries after June 2, 2023.”   \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 \nSeptember 27, 2024, and contained in a pre-hearing order filed that same date are hereby accepted as \nfact. \n 2.    Claimant has met her burden of proving that she suffered a compensable bilateral shoulder \n\nEngleman-H404754 \n3 \n \n \ninjury on June 2, 2023, and is entitled to reasonable and necessary medical treatment for that injury as \nrecommended by Dr. Greg Jones. \n 3.    Claimant has met her burden of proving she is entitled to temporary total disability from \nJune 13, 2024, to a date to be determined.  \n 4.    Respondents are entitled to an offset for any short-term and long-term payments made \nto  claimant if  the  employer  paid  for  either short-term  disability  insurance,  long-term  disability \ninsurance, or both. \n \n FACTUAL BACKGROUND \n Prior to the hearing, the parties advised they were unable to depose Dr. Greg Jones until the \nday  after  the  scheduled  hearing. They  agreed  that  the  record  could  be  supplemented  with  that \ndeposition. However,  respondents subsequently determined to  forego that  deposition,  and  advised \nthe record could be closed based on the testimony and documents submitted at the hearing.  \n Before the testimony began, the parties announced that there were both short-term and long-\nterm disability policies  under  which  claimant  had  drawn  benefits. The  parties  agreed  that  if  the \nemployer paid for either or both, respondents are entitled to an appropriate offset.  \nHEARING TESTIMONY \n \n Claimant was the only witness to testify on her behalf. She stated that on June 2, 2023, she \ninjured  her  shoulders when  she  kept  a  patient  from  sliding  off  an  operating  room  table. Claimant \nreported that she had popped her left shoulder, and her right shoulder was hurting. She was sent to \nthe Employee Health nurse that same day. She stated that x-rays were done on the shoulders, and she \nwas referred to physical therapy before returning to see a physician’s assistant. The physical therapy \ndid not help claimant alleviate her symptoms and she saw the physician, Dr. Konstantin Berestnev, \non June 9, 2023. Her condition was unchanged after a week; she received a steroid injection, was told \n\nEngleman-H404754 \n4 \n \n \nto  continue  the  physical therapy  and  was  restricted  from  pushing,  pulling,  or  lifting  as  well  as  no \noverhead activity.  \n Claimant testified  she  continued with  physical  therapy  and  had  a  second  injection,  but  her \ncondition was getting worse. She said the doctor released her on the last visit despite her request for \nan MRI or a referral to an orthopedic doctor.  \n Claimant had an injury to her left shoulder for which she was treated on February 17, 2022. \nShe had injured her shoulder at home and when it was still hurting two weeks later, she decided to \nseek medical attention. There was no follow-up visit because claimant said the shoulder healed on its \nown. Claimant stated that she was able to perform her duties as a Covid ICU nurse following her fall \nat home.  \nClaimant took a position in the cardiac unit in a hospital in Columbus, Indiana in July 2022 \nand  had no  problems  with  either  shoulder  while  she  was  working  there. She  began  working  at \nWashington Regional on November 29, 2022; between that date and June 2, 2023, she did not have \nany issues with either shoulder that required her to receive medical treatment. However, after the June \n2, 2023, injury, she  testified her shoulders  never  completely  returned  to  the  condition  they  were  in \nbefore  the  incident  in  the  operating  room. She  did  not  return  to  Conservative  Care  Occupational \nHealth because when that doctor released her from his care, she believed that was all that would be \ndone  for  her. When  he  denied  her  request  for  an  MRI  and  a  referral  to  an  orthopedic  doctor,  she \nknew of no reason to go back to see Dr. Berestnev again.  \n In March 2024, claimant went to see Dr. J. Clayton because her shoulders had not healed. She \ngave Dr. Clayton a history regarding her shoulders which mentioned the previous injury she received \nfrom a fall, and also related a separate incident of hurting her shoulder while moving a dog. As a nurse, \nshe felt Dr. Clayton needed a complete history of any issues she had with her shoulder. She was then \n\nEngleman-H404754 \n5 \n \n \nreferred to Dr. Greg Jones, a shoulder specialist. Dr. Jones eventually performed surgery on claimant’s \nleft  shoulder, and  she reported  that while she  was  helped  by  that  surgery, a  second  surgery was \nscheduled for her left shoulder. Claimant said that surgery was also anticipated for her right shoulder. \nClaimant related that after the June 2, 2023, injury, she had a clicking or popping sound in her left \nshoulder because the bicep tendon had dislocated. Dr. Jones evaluated the right shoulder, and claimant \nbelieves her condition with it is the same as with her left shoulder. \n Because  she believed she  could not receive workers’ compensation benefits after she was \nreleased by Dr. Berestnev, claimant filed for short-term disability benefits and subsequently was placed \non  long-term  disability. She  did  so  because  she  believed  that  she  could not receive  workers’ \ncompensation benefits after she was released from care by Dr. Berestnev. Claimant had surgery on \nher left shoulder on June 13, 2024, and does not believe that she has been physically able to perform \nher job duties since that time. \n On cross-examination, claimant explained what her job duties as an operating room circulator \nwere at Washington Regional. These responsibilities included getting the rooms ready for an upcoming \nsurgery which required equipment to be pushed into the room, changing a bed, and removing patients \nfrom the pre-op area and onto the operating table. She was required to lift patient’s limbs, push heavy \ntables, and position people while they are under anesthesia.  \n Regarding the incident in question, claimant repeated that her left shoulder popped, and that \nher right shoulder also hurt while she was preventing the patient from falling, but she did not realize \nthe right shoulder was hurt until the surgery was over. As of the date of the hearing, claimant had not \nhad treatment on her right shoulder. Claimant explained on the fall around February 2022 occurred \nwhen  she  was  painting  and  fell  from  a  barstool  onto  her  left  elbow. She elaborated  about  what \nhappened when she lifted a fifty-pound dog from the driver’s side of her car into the passenger seat \n\nEngleman-H404754 \n6 \n \n \nin April 2023. \n Claimant recognized that she stated in her report to the Joint Chiropractic Clinic on February \n26, 2024, that her complaints began two years ago. She had identified that January 1, 2021, as a possible \ndate  the  symptoms  started. Claimant  said  she  had  been  a  nurse  for  twenty  years,  pushing,  pulling, \nlifting, and having back pain. The report from Dr. Clayton on April 16, 2024, mentioned the injury to \nher left shoulder from a fall, as well as the incident of repositioning the dog. \n Claimant had this exchange with respondent’s counsel (TR.30) \nQuestion. (By Ms. Wood) And then we have one from Dr. Zimmerman dated \nMay 17, 2024, showing that your left shoulder pain had been present for over \ntwo years and you associate it with falling off a barstool onto your left elbow; \nis that correct? \nAnswer.  (By  claimant) No. I  think  the  left  shoulder  was  from  the  injury  at \nwork. \n \nQ. Did you tell Dr. Zimmerman about the fall at home? \nA. He did know, yes, because it is part of Mercy’s records, and he has access \nto all the records. \n \nQ. So you did tell somebody about that. \nA. Yes. \n \nQ. You just didn’t tell Dr. Zimmerman that? \nA.  I told Dr. Zimmerman that I had been a nurse for a long time, and I was \ninjured at  work. I also  told  him about  the  fall  and  about  the  dog.  I  told \neverybody about everything that ever caused the shoulder pain.  \n \nQ. And you definitely told him about the incident at work? \nA. Yes. \n \nQ. All Right. But we have one from Dr. Jones dated May 29, 2024, showing \nyou told him you were pushing carts or lifting patients and that exacerbated \nyour left shoulder pain, is that correct? \nA. Yes. \n \nQ. You also told him your symptoms began two and a half years ago when \nyou  fell  off  a  ladder  while  painting  and  landed  directly  on  your  elbow. Did \nyou tell him that as well? \nA.  I  did  not  tell  him  that. I  told  him  I  did  fall  two  and  a  half  years  ago  or \nhowever long it was at that point, and I think about the dog and then about \n\nEngleman-H404754 \n7 \n \n \nwork. \n \nQ.  You  then  documented  that  there  were  two  episodes  when  a  dog  jerked \nyour shoulder. Did you tell him about that as well? \nA. I did not tell him the dog jerked my shoulder, no. \n \n On redirect examination, claimant testified that she answered the questions she was \nasked about other shoulder injuries that caused pain, but that neither the fall and the incident \nwith the dog required physical therapy nor an injection into her shoulder.  \n After  claimant rested,  respondents  called  Shelly  Crabtree, the  assistant  director  of \nsurgery at Washington Regional. The initial report of injury did not come to Ms. Crabtree; \nher testimony  was  primarily  about how  work-related  injuries  are  normally managed at \nrespondent  Washington  Regional.  She  testified  that  upon the report of  an  injury,  the \nemployee  is  sent  to  Employee Health  and  the  recommendations  from  Employee  Health \ngovern whether an employee can come back to work that day or if they need to be sent to \nthe workers’ compensation doctor. She stated that at no time did claimant ask her for any \nassistance with her job duties or complain about continuing problems with her shoulders. \nOn  cross-examination,  Ms.  Crabtree  explained  that  there  was  no  light  duty  in  her \ndepartment. She was unaware of the injections that claimant received at Conservative Care \nOccupational Health or the physical therapy that claimant had done before she was released. \nWhen a person gets a “full duty release,” Ms. Crabtree did not do any follow-up because she \nbelieves they are fit to return to duty if released without restrictions. \nRespondent called Heather Weathers, the occupational health nurse at Washington \nRegional, serving as the manager of that department. She was familiar with claimant’s case \nand  was  aware  of  the  incident  of  June  2,  2023.  Claimant  completed  the  paperwork  and \npresented her complaint of shoulder pain on that date. Ms. Weathers said that the restrictions \n\nEngleman-H404754 \n8 \n \n \nof “no push/pull/lift more than five pounds with the left arm. No work above chest level \nwith the left arm” were such that claimant could be accommodated in her department and \nonce she was released to full duty in August, she went back to her regular job. \nOn  cross-examination,  Ms.  Weathers  stated  that  when  an  employee  reported  an \ninjury,  she would  do  what  was  best  for  the  employee  at  the  beginning  and  then  the  claim \nwould be turned over to the workers’ compensation adjuster. She did not know why the claim \nwas  initially  accepted  as job-related  and  then  changed,  as  she  was  not  involved  in  that \ndetermination. Ms. Weathers did not know of any new injuries that claimant sustained after \nAugust 8, 2023.  \nHaving  seen  the  witnesses  testify  and  then  reviewed  the  documentary  evidence  in \nview of that testimony, I have no reason to believe that any of the witnesses were less than \ntruthful. I found claimant’s testimony on her purpose for mentioning other injuries to her \nshoulders  to  various  medical  providers  to  be  credible. I  also  believe  that  she  did  not \nunderstand she could continue with a workers’ compensation claim after she was released \nfrom  conservative  care.\n1\n  The witnesses  for  respondents did  not  agree  on  the  existence  of \nlight  duty,  as  Ms.  Weathers  said  claimant  worked under  restrictions after being  limited in \nweight and height use of her left arm. I do not believe Ms. Crabtree was trying to deceive \nwhen  she  said  no  light  duty  was  available in  her  department, but simply testified as  she \nremembered the events.  \n \n \n \n1\n This lack of understanding was not due to respondent’s failure, as claimant was promptly given the Form N on \nJune 2, 2023. (R. NMX.2). A petition to change physicians was not submitted until after she retained counsel, as it \nwas filed by her attorney on July 29, 2024 (R. NMX. 7-8). \n\nEngleman-H404754 \n9 \n \n \nREVIEW OF THE EXHIBITS \n \n Claimant  submitted  seventy  pages  of  medical  records  in  support  of  her  claim, while \nrespondent submitted fifty-two pages of medical records, many of which were duplicative of those \nrecords submitted by claimant. \nClaimant’s records begin with the medical reports from February 2022 when claimant  fell \nwhile  painting.  As  she  testified,  there  was  only  one  visit  and  after  a negative  left  shoulder  x-ray, \nclaimant was referred to her family practice for any follow-up care that she might need. \nThe  records  from  June  2, 2023, from  Conservative  Care  Occupational  Health contain  the \npatient’s description of the accident the day it occurred. These notes are consistent with her testimony \nthat she stated that she was repositioning a patient on the surgical table when she felt a pop and sharp \npain  in  her  left  shoulder. She mentioned that  her right  shoulder  was  hurting  as  well.  X-rays  were \nnegative for any acute abnormalities, and she received conservative care before returning for a follow \nup visit on June 9, 2023. At that visit, claimant related that her primary problem was the pain in her \nleft shoulder which ranged from moderate to severe depending on her activity; she thought she was \nimproving slightly. Dr. Berestnev referred her to physical therapy and restricted her activity to no work \nabove the shoulders. \nClaimant began physical therapy at Total Spine at Washington Regional on June 14, 2023, and \ncontinued through July 18, 2023. At the final visit, the assessment was that claimant still had acute \npain in the left and right shoulder, but she reported feeling better overall with increased function at \nwork and decreased pain. She returned to Conservative Care on July 21, 2023, where she was seen by \nPhysician’s Assistant Ceth Dawson, who recommended that she return to regular duty with no activity \nrestrictions. She returned to conservative care on August 8, 2023, when Dr. Berestnev found that she \nwas getting better, and he released her from care with no restrictions. \n\nEngleman-H404754 \n10 \n \n \nClaimant next saw Dr. J. Clayton on March 26, 2024, with her chief complaint regarding her \nleft shoulder. This report relates the incident of moving the dog in her vehicle and did not specifically \nmention  the  incident  in  the  operating room  where  she  was  repositioning  a  patient.  Dr.  Clayton \nbelieved that claimant had a rotator cuff impingement and gave her an injection of 1cc of Kenalog 40 \nand 2cc of 1% Lidocaine. When claimant returned to Dr. Clayton on April 16, 2024, claimant related \nthat she had an injury to her left shoulder which was from a fall and clarified that the incident involved \nrepositioning a dog was not the actual inciting event. The result of the examination was “Left shoulder \nhas positive impingement signs. She localizes the pain to the interior lateral aspect of her shoulder but \nsays that it is really deeper than that site. She is grossly neurovascularly intact.” Dr. Clayton believed \nthat  an  MRI  was  appropriate  to  evaluate  her  rotator  cuff pathology  or some other  pathology  that \nmight be causing her significant pain. \nFollowing  the  MRI,  claimant  returned  to  see  Dr.  Clayton  on  May  14,  2024. The  MRI  was \nlargely  unremarkable  although  it  did note  some  degenerative  changes at the  AC  joint.  Dr.  Clayton \nbelieved that claimant needed to see his partner, Dr. Greg Jones. Before she was able to see Dr. Jones, \nshe was treated by Dr. T. Zimmerman on May 17, 2024. Dr. Zimmerman performed an ultrasound \nguided corticosteroid injection into the long head of the bicep tendon sheath of her left shoulder and \nan ultrasound guided corticosteroid injection into the acromioclavicular joint of the left shoulder. Dr. \nZimmerman recorded this history of present illness:  \n“Forty-three-year-old female who presents for evaluation of left shoulder pain. \nShe reports interior left shoulder pain which will radiate to her upper arm and \nsometimes posterior shoulder pain as well. This has been present for over two \nyears and she associates it with starting after falling off a barstool onto her left \nelbow. She reports associated clicking and difficulty with motion. She has pain \nwith reaching over her head or posteriorly.” \n \nDr.  Zimmerman  noted  that  the  MRI  of the  right  shoulder  demonstrated tendinosis  of  the \nsupraspinatus  tendon,  degenerative  of  the  AC  joint,  and  a  buildup of  fluid  in  the  long  head  of  the \n\nEngleman-H404754 \n11 \n \n \nbicep tendon sheath. However, the entire visit related to treatment of her left shoulder; the narrative \nends with the caveat that dictation software was used, and I suspect this was an error in dictation.\n2\n   \nClaimant first saw Dr. Greg Jones on May 29, 2024. Dr. Jones again recounted claimant’s fall \nfrom a step ladder while painting and the episode where a dog jerked her shoulder, but did not mention \nthe incident in the operating room which occurred on June 2, 2023. He reviewed the four views of \nthe shoulder x-ray series from March 26, 2024, and found: \n“She has a flat acromion, non-pointed sealed coracold and normal anatomy of \nthe glenohumeral joint. No evidence of arthritis. She has had an impingement \nchange  in  the  greater tuberosity  and  chronic  AC  arthropathy  changes  with \novert spur  formation,  but  definitely  sclerosis  and  cystic  changes  on the \nclavicular in the AC joint site.” \n \nDr. Jones also reviewed the MRI and found “There is no evidence of full fitness cuff tear, and \nthe bicep tendon has minimal fluid on the Sheath. She has some evidence of subacromial bursitis to \nmy evaluation and exam. There is no full thickness rotator cuff tear.” He recommended a left shoulder \narthroscopic  AC  resection  and subacromial  bursectomy  as  the  appropriate  next  steps  in  treating \nclaimant’s symptoms. Surgery was performed on June 13, 2024. The post-operative diagnosis was:  \n1. Subluxation of the bicep tendon with longitudinal split and hyper vascular tenosynovitis. \n2. AC meniscus arthropathy with torn AC meniscus elements. \n3. Moderately severe subacromial bursitis rotator cuff fully intact. \n \nClaimant returned to Dr. Jones on July 17, 2024. In his history in that clinic note, Dr. Jones \nmentioned the episode that was documented which involved a pop in her shoulder and which resulted \nin her being sent to physical therapy. He further stated: \n“I  am  a  little  bit  confused  in  that  appears  to  have clearly  had a work \ncomponent. A diagnosis was made at work that prompted the use of physical \ntherapy   for   that   purpose. I   think confirming   this   was: 1.Reported 2. \nRecognized  3.  In  my opinion,  greater  to  fifty  percent  contribution  to  the \n \n2\n If it is not an error, then this finding should be included in my analysis regarding the objective findings for the right \nshoulder injury.  \n\nEngleman-H404754 \n12 \n \n \nproblems that exist. I think she needs to pursue this in an appropriate fashion, \nand I have recommended same.” \n \nDr. Jones said she was not ready to return to “full unrestricted lifting activity” and he did not \nrelease her to return to work. \nClaimant began physical therapy at Mercy Occupational Therapy Treatment. The record from \nthe ninth visit on August 19, 2024, showed that physical therapy was causing pain to the claimant’s \nleft shoulder. When Dr. Jones next saw claimant on August 28, 2024, he believed she was so anxious \nto  get  back  to  work  that she  has  been  pressuring  her shoulders  in  terms  of  her  range  of  motion \nrecovery; her shoulder was very inflamed with bursitis at that visit. He gave her a subacromial bursitis \ninjection of 8mL. of 0.25% Marcaine, 2 mL. of Decadron, and prescribed Hydrocodone for two to \nthree  weeks at night to  help  claimant  sleep;  he also  prescribed Diclofenac.  Dr.  Jones  stopped  her \nphysical therapy and scheduled claimant to come back in four weeks. \nClaimant’s next visit was October 2, 2024. Claimant reported she was dramatically better after \nthe  previous  injection  for  about  ten  days,  and  while  her shoulder  remained  weak,  she  had  a  near \nresolution of the pain in her left shoulder. At this visit, she mentioned the continuing problem with \nthe right shoulder, but Dr. Jones thought that dealing with her left shoulder was more pressing and \ndecided not to pursue anything with the right shoulder at that time. Dr. Jones concluded his notes \nwith the following: \n“We are going to continue the physical therapy, hold off any consideration that \na FCI or impairment assessment related to the surgery done on June 13, 2024. \nWill see her back in two months to evaluate her progress and hopefully the job \nand work-related caliber and the work comp setting can be identified that she \ncan  perform  in  the  interim.  This  case  has gotten  confusing  because  of  the \nrefusal  to  consider  an  injury that  was  reported  at  work  and  is  yet  to  be \ndetermined as to that situation.” \n \nClaimant  sent  a  letter  to Dr.  Jones  on  October  14,  2024,  asking  for his  opinion regarding \n\nEngleman-H404754 \n13 \n \n \ncausation (respondent’s non-medical exhibit, page 10-11). Dr. Jones was asked when considering other \nincidents claimant had with her shoulder if “within a reasonable degree of medical certainty that the \nJune 2, 2023, incident is more than 50% the cause of her need for surgery.”  Dr. Jones responded on \nOctober 24,  2024 and clarified that he understood claimant’s history with her left shoulder before \nJune 2, 2023, mentioning both the fall with the contusion and moving a dog, but stated that nothing \nabout those instances arose to the level of the nature of the symptomology which she presented to \nhim. Dr. Jones noted that claimant:   \n“had   received optimum   opportunity   for   conservative   care   including \nextending  physical  therapy with  a  conservative  care, occupational  health \ndepartment or physicians and as detailed notes revealed that it was considered \na work-related injury and persistent in its character. Although it did not rise \nto the level of ‘needing surgery’ had remained the principal diagnosis when \nshe completed care under their auspices.” \n \nDr. Jones stated that claimant’s symptoms continued to worsen and became life-limiting when \nshe came to see him: \n“It is my opinion that the nature of the injury sustained in the work-related \nincident described in detail historically both by her and in the medical records \npreviously making it clear to me that within a reasonable degree of certainty \nthat the June 2, 2023 incident is more that fifty percent the cause of the injury, \nsubsequent symptomology and findings that led me to recommend the surgery \nprocedure undertaken on June 13, 2024.” \n \nDr. Jones saw claimant on December 4, 2024, he recommended a second surgery, an “open \ndeltotrapezial fascial repair.” In this record, the right shoulder is mentioned again: \n“If and when we get to the point of taking care of the right shoulder, I would \njust do it as an open AC resection given the display that she has made with \nreturns to the bilateral stretching injury and catching the patient is likely to \nhave the same sort of AC sprain on the right as we have seen on the left.” \n \nBilateral shoulder x-rays were made during this visit and demonstrated: \n“Suttle superior displacement of the right distal clavicle compared to the \n\nEngleman-H404754 \n14 \n \n \nacromion.  The  left  shoulder  has  a  wide  AC  resection,  flat acromion.  No \nglenohum arthritis or evidence of fracture or destructive lesion with respect to \nthe  left,  fore  view  series.  The right  four view  series demonstrate light  to \nmoderate AC arthropathy with slight dorsal displacement. No glenohumeral \nfracture  displacement and  no  calcification  of  the  rotator  cuff insertion  on \neither shoulder.” \n \nThe second surgery on claimant’s left shoulder was scheduled for January 31, 2025, ten days \nafter the hearing in this case took place. No additional records regarding that surgery were submitted. \nIn  addition  to  the  medical  records, claimant  submitted  a  copy  of  the  AR-N form  that  was \ncompleted on June 2, 2023, in which claimant maintained that she was injured on both shoulders while \n“holding heavy weight of patient to prevent injury”. \nRespondents’ medical  exhibits which did  not duplicate  the  records submitted  by  claimant \nincluded records from Mercy Hospital Occupational Therapy on August 26, 2024, which added little \nto what Dr. Jones explained in his records. Respondents’ non-medical records numbered were seven \npages,  including the  Form  N  given  to  claimant  on  June  2,  2023, claimant’s petition to change \nphysicians, and the letter from claimant’s attorney to Dr. Jones seeking clarification of his records and \nasking his opinion as to causation. \nADJUDICATION \n \n As  this  claim  was  controverted  in  its  entirety, claimant  has  the  burden  of  proving by  a \npreponderance of the evidence that (1) an injury occurred that arose out of and in the course of her \nemployment; (2) the injury caused internal or external harm to the body that required medical services \nor  resulted  in  disability  or  death;  (3)  the  injury  is  established  by  medical  evidence  supported  by \nobjective findings, which are those findings which cannot come under the voluntary control of the \npatient; and (4) the injury was caused by a specific incident and is identifiable by time and place of \noccurrence. Mikel v. Engineered Specialty Plastics, 56 Ark. App. 126, 938 S.W.2d 876 (1997). Respondents \nopposed this claim because they believed there was a lack of objective findings as to the alleged injury \n\nEngleman-H404754 \n15 \n \n \nof June 2, 2023, and because claimant had preexisting issues with her shoulders.\n3\n  \nThe proof on the first and fourth elements were well established; claimant promptly reported \nthe injury on June 2, 2023, and was sent by her employer for medical treatment the same day. There \nis also objective medical evidence of an injury to both shoulders. Dr. Jones was able to see the left \nshoulder injury during surgery, recording the post operative diagnosis of a subluxation of the bicep \ntendon with longitudinal split and hyper vascular tenosynovitis, AC meniscus arthropathy with torn \nAC meniscus elements, and moderately severe subacromial bursitis rotator cuff fully intact. Because \nthe  left  shoulder  has  been  the  main  emphasis  of  her  course  of  treatment,  there  are  fewer medical \nrecords for the right shoulder injury. However, Dr. Jones mentioned in his December 04, 2024, chart \nnote that  x-rays of the right shoulder “demonstrates mild-to-moderate  AC  arthropathy  with  slight \ndorsal displacement.”  That suffices for an objective finding of an injury to the right shoulder.  \n That then leaves the question whether claimant showed by a preponderance of the evidence \nthat the incident of June 2, 2023, caused the harm for which claimant seeks treatment. The evidence \non this point was somewhat muddied by the inquiry claimant made of Dr. Jones regarding causation. \nHe was asked if the June 2, 2023, incident was more than 50% the cause of claimant’s need for surgery, \nand answered that he believed the “June 2, 2023, incident is more than 50% the cause of the injury.” \nThat,  however, would  only  be  relevant  if one  of  the  issues  in this  case  called  for  a \"major  cause\" \nanalysis,  which  applies to  injuries  that  are  not  identifiable  by  time  and  place  pursuant  to  Arkansas \nCode  Annotated  §  11-9-102(4)(E)(ii)), or claims  where  a  claimant  is  seeking  permanent  disability \nbenefits pursuant to Arkansas Code Annotated section 11-9-102(4)(F)(ii).  That analysis is unnecessary \nsince claimant sufficiently identified the time and place of an injury, and she is not seeking permanent \n \n3\n Respondent  also  contended  that claimant “possibly underwent new injuries after June 2, 2023” but there was no \nevidence presented at the hearing to support a contention of a new injury.  \n\nEngleman-H404754 \n16 \n \n \ndisability at this time. An employer takes the employee as he finds him, and employment circumstances \nwhich  aggravate  pre-existing  conditions  are  compensable. Heritage  Baptist  Temple  v.  Robison,  82  Ark. \nApp.  460,  464,  120  S.W.3d  150,  152  (2003).  An  aggravation  of  a  preexisting,  non-compensable \ncondition by a compensable injury is, itself, compensable. Williams v. L&W Janitorial, Inc., 85 Ark. App. \n1, 145 S.W.3d 383 (2004).\n4\n \nBased on the foregoing analysis, I find claimant has met her burden of proof that she sustained \na compensable bilateral  shoulder  injury  on  June  2,  2023. Because  claimant’s shoulder injuries are \nunscheduled injuries, she must prove by a preponderance of the evidence that she remains within her \nhealing period and suffers a total incapacity to earn wages in order to receive temporary total disability \nbenefits, Allen Canning Co. v. Woodruff, 92 Ark. App. 237, 212 S.W.3d 25 (2005).  From the evidence \nbefore  me, claimant  has proven  that  she  remains  in her  healing  period and is  entitled  to additional \nmedical treatment. I also find she is totally incapacitated from earning wages. Dr. Jones restricted her \nfrom work following surgery for two months on July 17, 2024. He noted she had functional limitations \nthat rendered her not ready for work on October 2, 2024, and scheduled her for a reevaluation in two \nmonths. At the December 4, 2024, examination, it was determined that a second left shoulder surgery \nwould  be  necessary,  and  as  mentioned  above,  claimant  was  scheduled  for  that  procedure  after  the \nhearing in this case. In Farmers Coop. v. Biles, 77 Ark. App. 1, 69 S.W.3d 899 (2002), the Arkansas Court \nof Appeals held: \"If, during the period while the body is healing, the employee is unable to perform \nremunerative  labor  with  reasonable  consistency  and  without  pain  and  discomfort,  his  temporary \ndisability is deemed total.\" Based on my finding that additional medical treatment is appropriate for \nclaimant's injury, and that I found her to be a credible witness as to the pain she suffers on a near-\n \n4\n Because  the  issues  in  this  matter  were  limited  to  whether  this  was  a  compensable  injury  and  if  so, claimant’s \nentitlement to medical and temporary total disability benefits, it was not necessary for me to decide if claimant was \nsuffering from a pre-existing condition on June 2, 2023, and I offer no opinion on that question.  \n\nEngleman-H404754 \n17 \n \n \nconstant basis, I find she qualifies for temporary total disability from June 13, 2024 until a date to be \ndetermined. \nORDER \n \nRespondents  are directed  to  pay  benefits  in  accordance  with  the  findings  of  fact  set  forth \nherein this Opinion. \nAll accrued sums shall be paid in lump sum without discount, and this award shall earn interest \nat the legal rate until paid, pursuant to Ark. Code Ann. § 11-9-809. \nPursuant to Ark. Code Ann. § 11-9-715, the claimant's attorney is entitled to a 25% attorney's \nfee on the indemnity benefits awarded herein. This fee is to be paid one half by the carrier and one \nhalf by the claimant. \nThe respondent shall pay the court reporter’s fee in the amount of $585.45. \nAll issues not addressed herein are expressly reserved under the Act. \n \n IT IS SO ORDERED. \n                                                                                              \n_______     \n JOSEPH C. SELF \nADMINISTRATIVE LAW JUDGE","preview":"BEFORE THE ARKANSAS WORKERS’ COMPENSATION COMMISSION CLAIM NO. H404754 AMANDA ENGLEMAN, EMPLOYEE CLAIMANT WASHINGTON REGIONAL MEDICAL CENTER, EMPLOYER RESPONDENT RISK MANAGEMENT RESOURCES, CARRIER/TPA RESPONDENT OPINION FILED APRIL 18, 2025 Hearing before ADMINISTRATIVE LAW JUDGE JOSEPH C. SELF in Fort Smith, Sebastian...","fetched_at":"2026-05-19T22:41:51.197Z","links":{"html":"/opinions/alj-H404754-2025-04-18","pdf":"https://www.labor.arkansas.gov/wp-content/uploads/ENGLEMAN_AMANDA_H404754_20250418.pdf","source_publisher":"https://labor.arkansas.gov/workers-comp/awcc-opinions/administrative-law-judge-opinions/"}}