{"id":"full_commission-G904931-2024-09-19","awcc_number":"G904931","decision_date":"2024-09-19","opinion_type":"full_commission","claimant_name":"Porter Sims","employer_name":"Bryant School District","title":"SIMS VS. BRYANT SCHOOL DISTRICT AWCC# G904931 September 19, 2024","outcome":"denied","outcome_keywords":["denied:2"],"injury_keywords":["shoulder","rotator cuff","back"],"pdf_url":"https://labor.arkansas.gov/wp-content/uploads/Sims_Porter_G904931_20240919.pdf","source_index_url":"https://labor.arkansas.gov/workers-comp/awcc-opinions/full-commission-opinions/","filename":"Sims_Porter_G904931_20240919.pdf","text_length":39345,"full_text":"BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION \n \n \nCLAIM NO.  G904931 \n \nPORTER SIMS, \nEMPLOYEE \n \nCLAIMANT \nBRYANT SCHOOL DISTRICT,  \nEMPLOYER \n \nRESPONDENT \nARKANSAS SCHOOL BOARDS ASSOCIATION \nWCT, INSURANCE CARRIER/TPA \nRESPONDENT \n  \n      \nOPINION FILED SEPTEMBER 19, 2024 \n \nUpon review before the FULL COMMISSION in Little Rock, Pulaski County, \nArkansas. \n \nClaimant represented by the HONORABLE DANIEL E. WREN, Attorney at \nLaw, Little Rock, Arkansas. \n \nRespondents represented by the HONORABLE KAREN H. McKINNEY, \nAttorney at Law, Little Rock, Arkansas. \n \nDecision of Administrative Law Judge:  Affirmed in part, reversed in part. \n \n \n OPINION AND ORDER \nThe claimant appeals an administrative law judge’s opinion filed \nOctober 24, 2023.  The administrative law judge found that the claimant \nfailed to prove he was entitled to additional temporary total disability \nbenefits or additional medical treatment.  After reviewing the entire record \nde novo, the Full Commission finds that the claimant did not prove he was \nentitled to additional temporary total disability benefits.  We find that the \nclaimant proved additional medical treatment as recommended by Dr. \nSmith was reasonably necessary in accordance with Ark. Code Ann. §11-9-\n508(a)(Repl. 2012).     \n\nSIMS - G904931  2\n  \n \n \nI.  HISTORY \n Porter Sims, now age 69, testified that he became employed with the \nrespondents, Bryant School District, in about September 2005.  The \nrespondents’ attorney examined the claimant at a deposition of record: \nQ.  Describe for me the work that you were doing for the \nBryant School District.   \nA.  Installing and maintaining the HVAC equipment and other \njobs as needed. \n  Q.  What would “other jobs as needed” entail? \nA.  Moving furniture, digging ditches, building fence, \nremodeling rooms, painting.  Could be about anything you \ncould think of, really.   \n \n The parties stipulated that the employment relationship existed at all \npertinent times, including December 20, 2018.  The respondents’ attorney \nexamined the claimant: \n Q.  What happened in December 2018? \nA.  I tripped and fell in the hallway of Hurricane Creek \nElementary School.... \n Q.  And how did you land? \n A.  On my shoulder.     \n \nThe parties stipulated that the claimant “sustained an admittedly \ncompensable injury to his left shoulder” on December 20, 2018 “for which \nthe respondents paid medical and indemnity benefits.”  \n According to the record, Dr. P. Allan Smith performed surgery on \nJuly 24, 2019:  “1.  Left shoulder arthroscopy with rotator cuff repair.  2.  \nBiceps tenodesis with labral debridement.  3.  Subacromial \n\nSIMS - G904931  3\n  \n \n \ndecompression.”  The post-operative diagnosis was “1.  Left rotator cuff \ntear.  2.  Impingement.  3.  Biceps tendon and labral tear.”   \n Dr. Smith reported on February 19, 2020, “Porter Simms (sic) \nunderwent a left rotator cuff repair with biceps tenodesis on July 24, 2019.  \nThey reached MMI on January 28, 2020.  Based on the guides to the \nevaluation of permanent impairment, fourth edition, they sustained a 4% \nupper extremity impairment or a 2% whole person impairment[.]”  The \nclaimant testified that he eventually returned to full-duty work following \nsurgery performed by Dr. P. Allan Smith, but that he continued to suffer with \nleft shoulder pain.   \n Dr. Shahryar Ahmadi performed a second surgery on December 14, \n2020:  “Arthroscopy, left shoulder, surgical debridement, extensive.”  The \npre- and post-operative diagnosis was “1.  Left shoulder rotator cuff tear, \nlow-grade articular-sided tear of the supra and infraspinatus and \nsubscapularis.  2.  Internal derangement of the left shoulder.  3.  Left \nshoulder bursitis.”   \n Dr. Ahmadi noted on March 23, 2021: \n  Is status post left shoulder arthroscopy and debridement.... \nPorter Ray Sims is a 65 y.o.  Underwent above procedure on \nDecember 14, 2020.  Patient finished a course of physical \ntherapy.  Currently does not have any significant pain.... \nIn summary this is 65-year-old gentleman who is [more] than \n3 months out from left shoulder arthroscopy and debridement.  \nHe is doing very well and completely satisfied result of \noperation.  Impairment rating was done today.  At this point he \n\nSIMS - G904931  4\n  \n \n \ncan go back to normal activity without any restriction.  We are \ngoing to follow the patient as needed basis.   \n \n Dr. Ahmadi assigned the claimant a 4% whole-person impairment \nrating on March 23, 2021.  Dr. Ahmadi also stated on March 23, 2021, “It is \nmy medical opinion that Mr. Porter Sims may return to work without \nrestrictions.”  The claimant testified that “my arm seemed to feel pretty \ngood” following surgery by Dr. Ahmadi.  The claimant testified, however, \nthat he again began to feel pain in his left shoulder.   \n An MRI left shoulder arthrogram was taken on December 23, 2021 \nwith the following impression: \n  1.  Circumferential labral tearing. \n2.  Focal moderate grade partial-thickness articular sided tear \ninvolving the anterior fibers of the supraspinatus tendon which \nis in close proximity to the tendon anchor within the humeral \nhead.  This finding is suggestive for a residual versus \nrecurrent tendon tear.  Mild supraspinatus tendinopathy.   \n3.  Contrast is present within both the glenohumeral joint \ncapsule and the subacromial-subdeltoid bursa without a \ndistinguishable full thickness tendon defect.   \n4.  Moderate subscapularis tendinopathy. \n5.  Glenohumeral cartilage loss.   \n \n Dr. Joel N. Smith performed surgery on March 10, 2022:  “1.  Left \nshoulder arthroscopic repair involving the subscapularis.  2.  Left shoulder \nmini open biceps tenodesis.  3.  Left shoulder arthroscopy with \nchondroplasty of the humeral head, glenoid and labral debridement.”  The \npost-operative diagnosis was “Left shoulder pain with rotator cuff tear, \nbiceps tendinitis, chondromalacia.”   \n\nSIMS - G904931  5\n  \n \n \n The respondents’ attorney examined the claimant: \nQ.  And then Dr. Joel Smith did surgery and he kept you off \nwork? \n  A.  Yes, ma’am.   \nQ.  Did you receive disability checks, from Workers’ Comp, \nwhile you were off work?   \nA.  Yes, ma’am.  I received checks.   \nQ.  All right.  So, how was your shoulder after this third \nsurgery? \nA.  It hurt.  But they kept telling me that’s expected after \nsurgeries and I figured that, too.  That was my third one.   \nQ.  Where was the pain after this third surgery? \nA.  Same area.  On top of my left shoulder, like it is right now.   \n \n On March 15, 2022, Kelly Payer, LPN informed “Misty,” “Please \nexcuse Mr. Sims from work March 10, 2022 until his postoperative \nappointment March 22, 2022.  An updated work note will be given at that \ntime.”  The record indicates that Kelly Payer was corresponding with Misty \nThompson, a Claims Supervisor for the respondent-carrier. \n The claimant testified that he retired from employment with the \nBryant School District on or about June 30, 2022.     \n The record includes a series of Daily Notes from Athletico Physical \nTherapy beginning August 8, 2022.  It was assessed at Athletico Physical \nTherapy on August 8, 2022, “Held on functional IR stretch in attempts to \ndecrease the client’s increased c/o burning that follow.  The client continued \nto have some burning pain in the arm with table exercises.”   \n Dr. Smith’s impression on August 16, 2022 included “1.  Shoulder \nPain, Left.”  Dr. Smith signed a note indicating, “The patient was last \n\nSIMS - G904931  6\n  \n \n \nevaluated on 08/16/2022....Mr. Sims is to remain off work until seen back in \nclinic in 6 weeks.”   \n Kelly Payer sent the following communication on August 31, 2022: \n  RTW \n  To whom it may concern, \nMr. Sims may return to work at a sedentary position only with \nno use of the left \narm. \n \n The record indicates that Dr. Joel Smith’s signature was attached to \nKelly Payer’s August 31, 2022 communication.     \n Misty Thompson sent an e-mail to Leslie Nichols, a Bookkeeper with \nthe respondent-employer, on August 31, 2022:  “Attached is an updated \nwork release on Mr. Sims.  Light duty – sedentary position only with no use \nof the left arm.  If he remained employed by the District, would light duty be \navailable within these restrictions?\"  Terry Harper, the respondent-\nemployer’s Maintenance Director, informed Leslie Nichols on August 31, \n2022, “Yes if he would be allowed to be put in light duty.”  Leslie Nichols \nthen corresponded with Misty Thompson on August 31, 2022:  “Good \nafternoon, please see the response from Terry Harper regarding Porter \nSims.  Accommodations would be made for him to return to work if he was \nstill employed.”  Misty Thompson then wrote, “Got it!  I will issue his final \nTTD check tomorrow, $664.00 for the dates of 08/24-08/31/22.”  \n The respondents’ attorney examined the claimant: \n\nSIMS - G904931  7\n  \n \n \n  Q.  Did [Dr. Smith] ever send you back to work? \nA.  He – on August Misty called me and told me that Dr. Smith \nsaid I could go back to work on light duty, with no use of my \nleft arm.  But she didn’t add that.  That was – she just said I \ncould go back to work on light duty.  I found out the no use the \nleft arm was in there.  But she didn’t tell me that.   \nQ.  How’d you find that out? \nA.  From my doctor.   \nQ.  So what did you do when she told you that you were \nreleased to light duty, back in August? \nA.  I said that was fine.  I had no arguments.   \nQ.  Had you already retired, at that point? \nA.  Yes, ma’am.  I retired in June, she called me in August.   \n \n The claimant’s attorney examined Terry Harper: \nQ.  Mr. Harper, what is your job title within the Bryant School \nDistrict? \n  A.  I’m our Facilities Maintenance Director. \nQ.  All right.  And as the Maintenance Director were you the \nsupervisor of Mr. Sims?   \nA.  No, sir....I didn’t take the job until July 1\nst\n of last year....I \nnever supervised Buddy.   \nQ.  Okay.  So you don’t know Mr. Sims? \nA.  I know him.  \nQ.  Okay.  How do you know him? \nA.  Just because we’re in the same building.  I was in \ntransportation at the time.  I was one of our administrators of \ntransportation.... \nQ.  Was he employed by the District on August 31\nst\n of 2022? \nA.  That would be an HR question.  I’m not sure at that point \nand time.... \nQ.  Did you answer the question? \nA.  From Leslie Nichols, I did. \nQ.  And what was your answer? \nA.  I said [as read], “Yes, if he would be allowed to be put on \nlight duty.”   \nQ.  Was there a specific job mentioned? \nA.  That was it.... \nQ.  Any details at all about a job that may or may not have \nbeen communicated to my client? \n\nSIMS - G904931  8\n  \n \n \nA.  Nope, not – not by me.  Our practice is I have several on \nlight duty now that are sedentary from six to eight hours a day, \nbut I bring them back in just so they don’t have to burn their \nvacation time or their sick time.  So I accommodate – I’ve \nnever said no to anyone.   \nQ.  Are those people employed by the Bryant School District? \nA.  Yes.   \n \n The respondents’ attorney cross-examined Terry Harper: \nQ.  Do you know of any reason why Porter Sims would not \nhave been allowed to return to work? \nA.  Not to my knowledge, no. \nQ.  And the testimony is going to come, according to Mr. \nSims’ attorney, that Mr. Sims had retired.  Do you know of any \nreason why he would not have been rehired on light duty \nrestrictions? \nA.  Not to my knowledge, no.   \n \n The claimant followed up for treatment at Athletico Physical Therapy \nbeginning September 7, 2022.  It was noted at Athletico on September 15, \n2022, “The client reports that he rolled over in bed 3 days ago when he felt \na pop in his shoulder, resulting in increased pain.  The client notes that his \npain eventually dissipated and now he feels his normal shoulder burn.”   \n Dr. Joel N. Smith reported on September 27, 2022: \nThis is a 67 year old male who is being seen for a chief \ncomplaint of follow up shoulder pain, involving the left \nshoulder.  This occurred in the context of an injury at work and \nhas been treated with activity modification and physical \ntherapy.  The left shoulder pain occurs when sleeping on \nshoulder, occurs at night, constantly occurs, and occurs with \nactivity and associated with still complaints of pain.  Has pain \nwith PT, pain with sleeping, and was helping his son change a \ncarburetor on Saturday, holding a wrench, and felt a pop – \npain has increased since then.  The left shoulder pain 4 out of \n10 currently.  He has the following pertinent history:  prior \n\nSIMS - G904931  9\n  \n \n \nrotator cuff repair.  He reports intermittent functional \nlimitations and difficulty lifting objects/weight.  Since the last \nvisit, his condition is stable.... \n \n Dr. Smith’s impression included “1.  Shoulder Pain, left....Plan:  \nOrder MRI – shoulder.”  Dr. Smith stated, “Mr. Sims is to remain off work \nuntil seen back in clinic for MRI result follow up.”   \n Misty Thompson informed a Workers’ Compensation Paralegal on \nOctober 17, 2022 that the respondent-carrier would not authorize the MRI \nrecommended by Dr. Smith on September 27, 2022.   \n An MRI left shoulder arthrogram was taken on November 23, 2022 \nand was compared to the MRI taken December 23, 2021, with the following \nimpression: \n1.  Prior rotator cuff repair with near full-thickness \nmidsubstance subscapularis tear and deep articular sided and \ninterstitial tearing superiorly and inferiorly at the subscapularis \ntendon.  There are intact bursal sided fibers at the anchor \nsuperiorly at the lesser tuberosity.   \n2.  Anchor superiorly in the humeral head with fibers of the \nsupraspinatus tendon maintaining continuity to the anchor.  \nThere is, however, mild articular sided fraying/thinning of the \nsupraspinatus tendon with articular sided/interstitial tearing \npropagating across the conjoined portion/anterior \ninfraspinatus tendon just proximal to the footplate tear.  No \nfull-thickness supraspinatus or infraspinatus tear.   \n3.  Circumferential labral tearing/detachment. \n4.  Prior biceps tenodesis. \n5.  Defect in the joint capsule at the superior margin of the \nsubscapularis tendon with gadolinium extending from the joint \nspace into the subacromial/subdeltoid bursa. \n6.  Moderate acromioclavicular joint arthritis.  Mild \nglenohumeral arthritis.   \n \n\nSIMS - G904931  10\n  \n \n \n Dr. Theodore Hronas corresponded with the respondents’ attorney \non March 15, 2023: \n  At your request, the following films and reports were reviewed: \n  MRI arthrogram of the left shoulder, 12/23/2021. \n  Operative note, 03/10/22.  Joel N. Smith, M.D. \n  MRI arthrogram of the left shoulder, 11/23/2022. \n \nThe clinical history is of a work-related accidental injury \ndescribed as a fall injury resulting in a torn left rotator cuff.  \nRotator cuff repair was performed in 2019, 2020, and 2022.  \nOn September 24, 2022, his left shoulder popped while \nchanging a carburetor.  Two MRI arthrograms of the left \nshoulder are presented for review.  The studies are of good \nquality and sufficient for diagnostic purposes.  I am a board-\ncertified radiologist with additional training in body and \nmusculoskeletal MRI and therefore my primary focus will be \non the study provided. \n \nThe MRI arthrogram of the left shoulder, 12/23/2021, shows \nsusceptibility artifact within the humeral head related to \nmetallic bone anchors secondary to prior rotator cuff tear.  \nThere is a small 2 mm region of contrast signal involving the \nundersurface of the supraspinatus tendon characteristic of a \ngrade II articular surface tear.  The infraspinatus and teres \nminor muscles and tendons are normal.  There is abnormal \ncontrast traversing the superior margin of the subscapularis \ncharacteristic of a full thickness tear creating a defect within \nthe adjacent rotator cuff interval, with contrast from the joint \nspace communicating directly with the subacromial/subdeltoid \nbursa.  There is glenohumeral joint arthritis.  The long head of \nthe biceps tendon is not seen within the bicipital groove. \n \nFollowing the MRI arthrogram, further surgery was performed, \n03/10/2022, which included arthroscopic repair of the \nsubscapularis, mini open biceps tenodesis, and humeral head \nchondroplasty with glenoid and labral debridement.   \n \nAn MRI arthrogram of the left shoulder, 12/23/2022, was \nperformed approximately nine months after the prior surgical \nintervention and three months after the injury that occurred on \n\nSIMS - G904931  11\n  \n \n \n09/24/2022.  The exam shows susceptibility artifact related to \nbone anchors used in repair of the supraspinatus and \nsubscapularis tendons.  A previously seen small articular \nsurface tear of the supraspinatus has resolved.  There is an \nextensive high grade partial articular surface tear of the \nmidsubstance of the subscapularis tendon with abnormal \ncontrast occupying the rotator interval characteristic of \ncomplete tear of the superior glenohumeral ligament and \nrotator interval capsule.  The coracohumeral ligament is intact.  \nThe infraspinatus and teres minor muscles and tendons are \nnormal.  The long head of the biceps tendon is not visualized \nconsistent with tenodesis.  There is again circumferential \nlabral tearing and detachment.   \n \nIn summary, there are findings of a successful repair of a \nsupraspinatus tendon.  The most recent MRI arthrogram \nshows a progressive high grade articular surface tear of the \nsubscapularis tendon with a complete tear of the adjacent \nrotator interval capsule and likely the superior glenohumeral \nligament.  There is unchanged circumferential \ntearing/detachment of the labral and stable mild glenohumeral \nosteoarthritis.   \n \nMy findings herein are stated within a reasonable degree of \nmedical certainty.   \n \n A pre-hearing order was filed on June 1, 2023.  According to the pre-\nhearing order, the claimant contended, “The claimant contends he is \nentitled to TTD benefits from August 31, 2022, to a date yet to be \ndetermined.  The claimant contends that on or about December 20, 2018, \nhe sustained an admittedly compensable injury to his left shoulder when he \ntripped and fell while working on air conditioning (AC) units.  The claimant \nhas undergone three (3) surgeries between July 24, 2019, through March \n10, 2022, and has attended multiple visits for conservative treatment.  The \n\nSIMS - G904931  12\n  \n \n \nclaimant contends that on August 16, 2022, he saw Dr. Smith, who \ncontinued his off-work status until September 27, 2022.  The claimant \ncontends that on August 31, 2022, without a physician visit/examination, \nand without any consultation from the claimant, he received a random \nelectrically signed note from a licensed practical nurse (LPN) purporting to \nchange his work status to sedentary with no use of his left arm.  At this \npoint, the adjuster for the Arkansas School Board Association Workers’ \nCompensation Trust, Ms. Misty Thompson, discontinued PPD benefits to \nthe claimant.  Thereafter, on September 27, 2022, the claimant returned for \nhis scheduled visit with Dr. Smith.  The claimant contends he informed Dr. \nSmith he had felt a ‘pop’ in his left shoulder while holding a wrench which \ncaused an increase in his left shoulder pain.  The claimant contends that \nDr. Smith, without any reference to the aforementioned LPN’s August 31, \n2022, note, continued to keep the claimant on off-work status until he \nreturned to Dr. Smith for review of an MRI Dr. Smith ordered at the \nSeptember 27, 2022, visit.  The claimant contends the respondents have \nfailed and/or refused to pay for any medical treatment past September 27, \n2022, and have failed to pay him any additional TTD benefits since they \nterminated them on August 31, 2022.  Therefore, the claimant contends he \nis entitled to payment of the subject and ongoing medical care, as well as \n\nSIMS - G904931  13\n  \n \n \nTTD benefits from the date the respondents terminated them on August 31, \n2022, through a date yet to be determined.”   \n The parties stipulated that the respondents “controvert the payment \nof any additional medical or indemnity benefits other than those they have \nalready paid to date....The respondents contend the claimant has received \nall benefits to which he is entitled.  The claimant was released to sedentary \nduty as of August 31, 2022, which the respondent-employer, the Bryant \nSchool District (the school district) offered and made readily available to the \nclaimant; however, the claimant refused this offer of light duty employment \nand failed and/or refused to even attempt to return to work.  Consequently, \nthe respondents contend the claimant is not entitled to any additional TTD \nbenefits since the employer has work that comports with the claimant’s \nphysical limitations and restrictions, they offered this work and made it \navailable to him, but he failed and/or refused to accept this offer and did not \neven attempt to perform the light duty job.  In addition, the respondents \ncontend that any additional medical treatment the claimant may require \nafter August 31, 2022, is not causally related to his compensable injury, but \nis the result of a new injury and/or independent intervening cause that \noccurred as the result of the claimant working at home and lifting the \nwrench.” \n The parties agreed to litigate the following issues: \n\nSIMS - G904931  14\n  \n \n \n1.  Whether the claimant is entitled to additional medical and \nTTD benefits. \n2.  Whether the claimant’s attorney is entitled to a \ncontroverted fee on these facts. \n3.  The parties specifically reserve any and all other issues for \nfuture litigation and/or determination.   \n \n After a hearing, an administrative law judge filed an opinion on \nOctober 24, 2023.  The administrative law judge found, among other things, \nthat the claimant failed to prove he was entitled to additional temporary total \ndisability benefits after August 31, 2022.  The administrative law judge \nfound that the claimant sustained a “new injury or aggravation” in \nSeptember 2022 and was therefore not entitled to additional medical \ntreatment.  The administrative law judge therefore denied and dismissed \nthe claim.  The claimant appeals to the Full Commission.   \nII.  ADJUDICATION \n A.  Temporary Disability \n Temporary total disability is that period within the healing period in \nwhich the employee suffers a total incapacity to earn wages.  Ark. State \nHwy. Dept. v. Breshears, 272 Ark. 244, 613 S.W.2d 392 (1981).  “Healing \nperiod” means “that period for healing of an injury resulting from an \naccident.”  Ark. Code Ann. §11-9-102(12)(Repl. 2012).  The healing period \nis that period for healing of an injury which continues until the claimant is as \nfar restored as the permanent character of his injury will permit.  Roberson \nv. Waste Mgmt., 58 Ark. App. 11, 944 S.W.2d 858 (1997).  The \n\nSIMS - G904931  15\n  \n \n \ndetermination of when the healing period has ended is a question of fact for \nthe Commission.  Mad Butcher, Inc. v. Parker, 4 Ark. App. 124, 628 S.W.2d \n582 (1982).   \n An administrative law judge found in the present matter, “2.  The \nclaimant has failed to meet his burden of proof in demonstrating he is \nentitled to additional TTD benefits after August 31, 2022[.]”  The Full \nCommission finds that the claimant did not prove he was entitled to \nadditional temporary total disability benefits.  The claimant testified that he \nbecame employed with the respondents, Bryant School District, in about \nSeptember 2005.  The claimant testified that he installed and maintained \nHVAC equipment for the claimant, and that he also performed other duties \nwhich occasionally required manual labor.  The parties stipulated that the \nclaimant sustained a compensable injury to his left shoulder on December \n20, 2018.  The claimant testified that the injury occurred after he tripped and \nfell. \n The claimant thereafter underwent three left shoulder surgeries \nperformed by Dr. P. Allan Smith, Dr. Ahmadi, and Dr. Joel N. Smith.  The \nclaimant’s testimony indicated that he received temporary total disability \nbenefits for times he was off work following surgery.  As we have noted, the \nclaimant’s testimony indicated that he retired from employment with the \nBryant School District on or about June 30, 2022.  The claimant continued \n\nSIMS - G904931  16\n  \n \n \nto receive follow-up treatment related to his left shoulder injury.  In a note \ndated August 31, 2022, Dr. Smith appeared to agree that the claimant could \n“return to work at a sedentary position only with no use of the left arm.”  The \nclaimant testified that he was not expressly informed that he could return to \nwork “with no use of the left arm.”  Nevertheless, the claimant also testified \nthat he had “no arguments” that he had been released to light duty.  Terry \nHarper, the respondent-employer’s Facilities Maintenance Director, credibly \ntestified that the claimant would have been allowed to return to light-duty \nwork.  The claimant did not express an interest in ending his retirement and \nreturning to sedentary or light-duty work for the respondents.  Whether or \nnot the claimant remained within a healing period, the Full Commission \nfinds that the claimant was not totally incapacitated from earning wages on \nor after August 31, 2022.  Therefore, the claimant did not prove he was \nentitled to additional temporary total disability benefits.  See Breshears, \nsupra.   \n B.  Reasonably Necessary Medical Treatment \n Ark. Code Ann. §11-9-102(4)(Repl. 2012) provides, in pertinent part: \n  (F)  BENEFITS. \n(i)  When an employee is determined to have a compensable \ninjury, the employee is entitled to medical and temporary \ndisability as provided in this chapter.... \n(iii)  Under this subdivision (4)(F), benefits shall not be \npayable for a condition which results from a nonwork-related \nindependent intervening cause following a compensable injury \nwhich causes or prolongs disability or a need for treatment.  A \n\nSIMS - G904931  17\n  \n \n \nnonwork-related independent intervening cause does not \nrequire negligence or recklessness on the part of a claimant.   \n \n An administrative law judge found in the present matter, “3.  The \npreponderance of the evidence demonstrates the claimant sustained a new \ninjury or aggravation supported by new and objective medical findings in \nSeptember 2022; therefore, he has failed to meet his burden of proof in \ndemonstrating he is entitled to additional medical treatment at the \nrespondents’ expense after the date they last paid his medical expenses in \nlate September 2022.”  The Full Commission does not affirm this finding. \n The parties stipulated that the claimant sustained a compensable \ninjury to his left shoulder on December 20, 2018.  Dr. Smith performed a left \nshoulder arthroscopy and rotator cuff repair on July 24, 2019.  Dr. Ahmadi \nperformed a left shoulder arthroscopy on December 14, 2020.  An MRI left \nshoulder arthrogram on December 23, 2021 showed, among other things, \n“1.  Circumferential labral tearing.”  Dr. Joel Smith performed a left shoulder \narthroscopic repair on March 10, 2022.  A physical therapist reported on \nSeptember 15, 2022 that the claimant felt a “pop” in his left shoulder while \nsimply rolling over in bed.  The claimant also testified that his left shoulder \nwould occasionally “pop” during aggressive physical therapy treatment.   \n Dr. Smith reported on September 27, 2022, “Has pain with PT, pain \nwith sleeping, and was helping his son change a carburetor on Saturday, \nholding a wrench, and felt a pop – pain has increased since then.”  It is \n\nSIMS - G904931  18\n  \n \n \nwithin the province of the Workers’ Compensation Commission to reconcile \nconflicting evidence and to determine the true facts.  Georgia-Pacific v. \nCarter, 62 Ark. App. 162, 969 S.W.2d 677 (1998), citing Arkansas Dep’t of \nHealth v. Williams, 43 Ark. App. 169, 863 S.W.2d 583 (1993).  The \nevidence does not demonstrate in the present matter that the so-called \n“wrench incident” in September 2022 was an independent intervening \ncause which caused or prolonged disability or a need for medical treatment.  \nThe question is whether there is a causal connection between the primary \ninjury and subsequent disability.  Guidry v. J&R Eads. Const. Co., 11 Ark. \nApp. 219, 669 S.W.2d 483 (1984).  If there is such a connection, there is no \nindependent intervening cause unless the subsequent disability is triggered \nby activity on the part of the claimant which is unreasonable under the \ncircumstances.  Id.  \n  In the present matter, the Full Commission finds that treatment \nrecommended by Dr. Smith on and after September 27, 2022 was \nreasonably necessary in accordance with Ark. Code Ann. §11-9-\n508(a)(Repl. 2012).  The evidence does not demonstrate that the claimant’s \nact of simply handing a wrench to his son on or about September 24, 2022 \nresulted in an “independent intervening cause” which absolved the \nrespondents of liability for providing reasonably necessary medical \ntreatment.  Nor is there any probative evidence demonstrating that the \n\nSIMS - G904931  19\n  \n \n \nclaimant sustained a “new injury or aggravation” on or about September 24, \n2022.  In addition, there is no portion of Dr. Hronas’ March 15, 2023 report \nwhich can be construed as evidence for a finding that there was an \nindependent intervening cause on or about September 24, 2022.  There is \nno probative evidence demonstrating that the abnormalities shown on the \nNovember 23, 2022 MRI were the result of an “independent intervening \ncause” involving a wrench.  Nor was the claimant acting “unreasonably” on \nor about September 24, 2022. \n After reviewing the entire record de novo, the Full Commission finds \nthat the claimant did not prove he was entitled to additional temporary total \ndisability benefits.  We find that additional medical treatment recommended \nby Dr. Smith on September 27, 2022, including  diagnostic testing, was \nreasonably necessary in accordance with Ark. Code Ann. §11-9-\n508(a)(Repl. 2012).  There are currently no other recommendations for \nadditional medical treatment.  The respondents did not prove that there was \nan “independent intervening cause” in accordance with Ark. Code Ann. §11-\n9-102(4)(F)(iii)(Repl. 2012).  For prevailing in part on appeal, the claimant’s \nattorney is entitled to a fee of five hundred dollars ($500), pursuant to Ark. \nCode Ann. §11-9-715(b)(Repl. 2012).   \n \n \n\nSIMS - G904931  20\n  \n \n \n IT IS SO ORDERED.  \n    \n    ___________________________________ \n    SCOTTY DALE DOUTHIT, Chairman \n \n    ___________________________________ \n    M. SCOTT WILLHITE, Commissioner \n \n \n \nCommissioner Mayton dissents. \n \nDISSENTING OPINION \n I must respectfully dissent from the Majority’s finding that the \nclaimant proved additional medical treatment as recommended by Dr. \nSmith was reasonably necessary in accordance with Ark. Code Ann. § 11-\n9-508(a)(Repl. 2012). \n Ark. Code Ann. § 11-9-508(a) (Repl. 2012) requires an employer to \nprovide an employee with medical and surgical treatment \"as may be \nreasonably necessary in connection with the injury received by the \nemployee.\" In addition, the claimant must prove a causal connection \nbetween the work-related accident and his alleged disability.  Bates v. Frost \nLogging Co., 38 Ark. App. 36, 827 S.W.2d 664 (1992).  Plainly stated, the \nclaimant must demonstrate by a preponderance of the evidence there \nexists a causal relationship between his current condition and his \n\nSIMS - G904931  21\n  \n \n \nemployment.  Harris Cattle Co. v. Parker, 256 Ark. 166, 506 S.W.2d 118 \n(1974).  \nIt is well settled that there is no causal connection when an alleged \ninjury is the result of an independent intervening cause since:  \n“benefits shall not be payable for a \ncondition which results from a \nnonwork-related independent \nintervening cause following a \ncompensable injury which causes \nor prolongs disability or a need for \ntreatment.  A nonwork-related \nindependent intervening cause \ndoes not require negligence or \nrecklessness on the part of a \nclaimant.”  \n \nArk. Code Ann. § 11-9-102(4)(F)(iii). \nAn aggravation is a new injury resulting from an independent \nincident.  Farmland Ins. Co. v. DuBois, 54 Ark. App. 141, 923 S.W.2d 883 \n(1996).  Our appellate courts have consistently held that since an \naggravation is a new injury, it must be proved by new objective medical \nfindings of a new injury to a preexisting condition.  See Vaughn v. Midland \nSchool Dist., 2012 Ark. App. 344 (2012).  \nA recurrence is not a new injury but simply another period of \nincapacitation resulting from a previous injury. Atkins Nursing Home v. \nGray, 54 Ark. App. 125, 923 S.W.2d 897 (1996).  A recurrence exists when \nthe second complication is a natural and probable consequence of a prior \n\nSIMS - G904931  22\n  \n \n \ninjury.  Weldon v. Pierce Bros. Constr., 54 Ark. App. 344, 925 S.W.2d 179 \n(1996).   \nIt is within the Commission's province to weigh all the medical \nevidence, to determine what is most credible, and determine its medical \nsoundness and probative force.  Sheridan Sch. Dist. v. Wise, 2021 Ark. \nApp. 459, 637 S.W.3d 280 (2021).  \nIn weighing the evidence, the Commission may not arbitrarily \ndisregard medical evidence or the testimony of any witness.  Id.  However, \nthe Commission has the authority to accept or reject medical opinions. \nWilliams v. Ark Dept. of Community Corrections, 2016 Ark. App. 427, 502 \nS.W. 3d 530 (2016).  Furthermore, it is the Commission's duty to use its \nexperience and expertise in translating the testimony of medical experts \ninto findings of fact and to draw inferences when testimony is open to more \nthan a single interpretation. \nHere, the claimant must prove a causal relationship exists between \nhis employment, his 2018 compensable injury, and his condition after the \nSeptember 2022 carburetor incident.  Wal-Mart Stores, Inc. v. Westbrook, \n77 Ark. App. 167, 72 S.W.3d 889 (2002).  \nOn August 31, 2022, Dr. Smith released the claimant with light duty \nrestrictions at that time, stating that the claimant “may return to work at a \nsedentary position only with no use of his left arm.” \n\nSIMS - G904931  23\n  \n \n \n Despite these clear restrictions, the claimant advised Dr. Joel Smith \non September 27, 2022, he “was helping his son change a carburetor on \nSaturday [September 24, 2022], holding a wrench, and felt a pop – pain has \nincreased since then.”  \n Throughout his treatment, the claimant underwent two MRIs, one \nprior to the claimant’s 2022 surgery and one in November of 2022, after the \ncarburetor incident.  Dr. Theodore Hronas, a board-certified radiologist, \nreviewed these MRIs and opined that the first MRI conducted on December \n23, 2021 revealed: \n...susceptibility artifact within the \nhumeral head related to metallic \nbone anchors secondary to prior \nrotator cuff tear.  There is a small 2 \nmm region of contrast signal \ninvolving the undersurface of the \nsupraspinatus tendon \ncharacteristic of a grade II articular \nsurface tear.  The infraspinatus \nand teres minor muscles and \ntendons are normal.  There is \nabnormal contrast traversing the \nsuperior margin of the \nsubscapularis characteristic of a \nfull thickness tear creating a defect \nwithin the adjacent rotator cuff \ninterval, with contrast from the joint \nspace communicating directly with \nthe subacromial/subdeltoid bursa. \nThere is glenohumeral joint \narthritis.  The long head of the \nbiceps tendon is not seen within \nthe bicipital groove.    \n \n\nSIMS - G904931  24\n  \n \n \nDr. Hronas further noted the claimant later underwent an \narthroscopic repair of the subscapularis, a mini open biceps tenodesis, and \na humeral head chondroplasty with glenoid and labral debridement on \nMarch 10, 2022.  \n The MRI conducted on November 23, 2022, approximately three \nmonths after the carburetor incident, showed: \n...susceptibility artifact related to \nbone anchors used in repair to the \nsupraspinatus and subscapularis \ntendons.  A previously seen small \narticular surface tear of the \nsupraspinatus has resolved.  \nThere is extensive high grade \npartial articular surface tear of the \nmidsubstance of the subscapularis \ntendon with abnormal contrast \noccupying the rotator interval \ncharacteristic of complete tear of \nthe superior glenohumeral \nligament and rotator interval \ncapsule.  The coracohumeral \nligament is intact.  The \ninfraspinatus and teres minor \nmuscles and tendons are normal. \nThe long head of the biceps \ntendon is not visualized consistent \nwith tenodesis.  There is again \ncircumferential labral tearing and \ndetachment. (Emphasis added). \n \nDr. Hronas opined that the November 2022 MRI shows “findings of a \nsuccessful repair of a supraspinatus tendon,” but that it also shows “a \nprogressive high grade articular surface tear of the subscapularis tendon \n\nSIMS - G904931  25\n  \n \n \nwith a complete tear of the adjacent rotator interval capsule and likely the \nsuperior glenohumeral ligament.” These findings were not present on the \nDecember 23, 2021 MRI. \nThe weight of the credible evidence is clear:  There were new \nobjective medical findings resulting from the carburetor-repair incident in \nSeptember 2022 after the claimant had been released with light duty \nrestrictions. \nAlthough, the claimant tries to downplay this incident by claiming he \ndid not do anything but hold a wrench, it is well settled that a claimant’s \ntestimony is considered disputed as a matter of law.  Uncorroborated \ntestimony of an interested party is always considered to be controverted. \nNix v. Wilson World Hotel, 46 Ark. App. 303, 879 S.W.2d 457 (1994).  It is \npatently clear that while the claimant denied performing any work which \nmight injury or harm his shoulder, his statements are directly contradicted \nby the weight of the evidence.  \nThere is simply no credible evidence to support the claimant’s own \nself-serving testimony that he did not sustain a new injury or aggravation \nwhile using a wrench to help his son change the carburetor when he felt a \npop and pain in his shoulder in September 2022.  \nAfter this incident, an MRI revealed “a progressive high grade \narticular surface tear of the subscapularis tendon with a complete tear of \n\nSIMS - G904931  26\n  \n \n \nthe adjacent rotator interval capsule and likely the superior glenohumeral \nligament,” which was not present in any records or on any test results prior \nto the September 2022 injury.  There is, in fact, no evidence showing that \nthese new findings are the natural and probable result of the compensable \ninjury.  These new objective findings provide clear objective medical \nevidence that this new injury is unrelated to the claimant’s 2019 on-the-job \ninjury.  \nThe weight of the credible evidence shows that the claimant \nsustained a new injury or aggravation resulting from an independent \nintervening event in September 2022 that is not causally related to his 2018 \nleft shoulder injury.  To find otherwise, in light of the clear MRI findings, \nwould require speculation and conjecture, which cannot substitute for \ncredible evidence to support a claim for benefits pursuant our Rules.  \nSmith-Blair, Inc. v. Jones, 77 Ark. App. 273, 72 S.W.3d 560 (2002). \nAccordingly, for the reasons set forth above, I respectfully dissent.  \n \n            \n                                           __________________________________ \n              MICHAEL R. MAYTON, Commissioner","preview":"BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION CLAIM NO. G904931 PORTER SIMS, EMPLOYEE CLAIMANT BRYANT SCHOOL DISTRICT, EMPLOYER RESPONDENT ARKANSAS SCHOOL BOARDS ASSOCIATION WCT, INSURANCE CARRIER/TPA RESPONDENT OPINION FILED SEPTEMBER 19, 2024","fetched_at":"2026-05-19T22:29:45.004Z","links":{"html":"/opinions/full_commission-G904931-2024-09-19","pdf":"https://labor.arkansas.gov/wp-content/uploads/Sims_Porter_G904931_20240919.pdf","source_publisher":"https://labor.arkansas.gov/workers-comp/awcc-opinions/full-commission-opinions/"}}