{"id":"full_commission-H101899-2024-01-10","awcc_number":"H101899","decision_date":"2024-01-10","opinion_type":"full_commission","claimant_name":"Felicia Parker","employer_name":"Uams","title":"PARKER VS. UAMS AWCC# H101899 JANUARY 10, 2024","outcome":"granted","outcome_keywords":["reversed:1","dismissed:1","granted:4","denied:2"],"injury_keywords":["neck","back","cervical","strain","lumbar","fracture","knee","thoracic"],"pdf_url":"https://labor.arkansas.gov/wp-content/uploads/Parker_Felicia_H101899_20240110.pdf","source_index_url":"https://labor.arkansas.gov/workers-comp/awcc-opinions/full-commission-opinions/","filename":"Parker_Felicia_H101899_20240110.pdf","text_length":42391,"full_text":"BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION \n \n \nCLAIM NO.  H101899  \n \nFELICIA PARKER, \nEMPLOYEE \n \nCLAIMANT \nUAMS,  \nEMPLOYER \n \nRESPONDENT \nPUBLIC EMPLOYEE CLAIMS DIVISION, \nINSURANCE CARRIER/TPA \nRESPONDENT \n  \n      \nOPINION FILED JANUARY 10, 2024 \n \nUpon review before the FULL COMMISSION in Little Rock, Pulaski County, \nArkansas. \n \nClaimant represented by the HONORABLE SHEILA F. CAMPBELL, \nAttorney at Law, North Little Rock, Arkansas. \n \nRespondents represented by the HONORABLE CHARLES H. McLEMORE, \nJR., Attorney at Law, Little Rock, Arkansas. \n \nDecision of Administrative Law Judge:  Reversed. \n \n OPINION AND ORDER \nThe respondents appeal an administrative law judge’s opinion filed \nJuly 19, 2023.  The administrative law judge found that the claimant proved \nshe was entitled to additional medical treatment and additional temporary \ntotal disability benefits.  After reviewing the entire record de novo, the Full \nCommission reverses the administrative law judge’s opinion.  The Full \nCommission finds that the claimant did not prove she was entitled to \nadditional temporary total disability benefits or medical treatment.     \nI.  HISTORY \n\nPARKER - H101899  2\n  \n \n \n The testimony of Felicia Parker, now age 53, indicated that she \nbecame employed as a Certified Nursing Assistant with the respondents, \nUniversity of Arkansas for Medical Sciences, in about 2021.  The claimant \ntestified that she performed “house calls” for the respondent-employer.  The \nclaimant testified that this employment position required her to carry \nmedical equipment, occasionally climb stairs, and clean motor vehicles.     \nThe parties stipulated that the employee-employer-carrier \nrelationship existed at all pertinent times, including February 4, 2021.  The \nclaimant testified on direct examination: \n Q.  And what was the date of the injury? \n A.  February the 4, 2021, if I’m not mistaken. \n Q.  And can you tell us how the accident happened? \nA.  I was leaving one client’s house and I was on my way to \nthe next client, and I was sitting at a stoplight at, I guess, \nthat’s Percy Machin and Pershing.  I was sitting there – there \nwas a North Little Rock Police officer in front of me and as the \nlight began to change while we were sitting there, I heard a \nscreeching and when I looked to my left, you know, and I – \nand by the time I could look up in the mirror, the young lady \nhad plowed into me while we were sitting still....When she \nplowed into me, it pushed me hard, so my knees hit the – the \npanel of the car and instantly I had a headache and the – my \nneck was hurting.   \n \n The parties stipulated that the claimant “sustained compensable \ninjuries to her head, neck, and back” as a result of the February 4, 2021 \nmotor vehicle accident.  According to the record, the claimant received \nemergency medical treatment on February 4, 2021:  “Patient presents with \n • Motor Vehicle Crash....Injury location:  Head/neck and torso.”   \n\nPARKER - H101899  3\n  \n \n \n An ED Provider noted the following on February 4, 2021: \n50 y/o F with hx of DM, HTN, CKD who presented after a \nMVC with lateral neck and diffuse lower back pain.  Was the \nrestrained driver at a stop when she was rear ended.  Was \nambulatory since accident.  Was well appearing in no acute \ndistress.  Head AT, NC.  Normal phonation.  No obvious neck \ndeformity, swelling or injury.  Normal WOB.  A&O.  Normal \nspeech.  No acute findings on xrays.  Supportive treatment \nwith PCP follow up.   \nImpression: \n1.  MVC (motor vehicle collision), initial encounter Acute. \n2.  Cervical strain, acute, initial encounter Acute. \n3.  Low back strain, initial encounter Acute.   \n \nAn x-ray of the claimant’s lumbar spine on February 4, 2021 showed \n“No acute fracture.  Scoliosis and multilevel degenerative disc disease and \npredominantly lumbar facet arthropathy.”    \n The claimant signed a Form AR-N, EMPLOYEE’S NOTICE OF \nINJURY, on February 5, 2021.  The ACCIDENT INFORMATION section of \nthe Form AR-N averred that the claimant injured her “Back/neck/R. Knee” in \nan accident occurring February 4, 2021.   \n The respondents contended that they paid temporary total disability \nbenefits beginning February 5, 2021.  A physical therapist noted on \nFebruary 9, 2021, “Per verbal authorization from Tiphanie Nelson, WC \nAdjuster, patient is allowed 6 Physical Therapy visits; additional visits will \nrequire prior authorization.”   \n The claimant saw Dr. William E. Ackerman, III on February 22, 2021:  \n“Pain in the lumbar spine and multiple joints.  She was involved in an MVA \n\nPARKER - H101899  4\n  \n \n \ntwo days ago.  She reports that her vehicle was stopped when another \nvehicle struck her from behind, and she now has pain in the cervical spine.  \nShe is now under the care of an orthopedic surgeon at UAMS....She has \nhad the onset of increased neck and back pain since her MVA and last \nvisit....It is my opinion that the patient has sufficient pathology to warrant \ncontinuation of pharmacologic management....I will refill the patient’s \nhydrocodone as previously prescribed.”   \n Dr. Michael D. Cassat attested on February 23, 2021, “We will get an \nMRI of her thoracic and lumbar spine prior to any additional physical \ntherapy, follow up with me after.  Her work restrictions will be no lifting, \npushing, pulling greater than 10 lb, no flexion/extension.” \n The record indicates that an MRI of the claimant’s thoracic and \nlumbar spine was taken on or about February 24, 2021 with the following \nimpression: \n1.  Multilevel degenerative disc disease throughout the \nthoracic spine with disc protrusion superimposed at T9-10 \nand to a lesser degree T8-9. \n2.  Inferiorly directed left paracentral disc protrusion at L1-2 \nwith abnormal soft tissue in the ventral epidural space with \nsome compression of the left L2 nerve root within the \nlateral recess. \n3.  Advanced disc degeneration changes at L4-5 and L5-S1 \nwith facet arthropathy.  Asymmetric left-sided foraminal \nstenosis at L5-S1.   \n4.  No intrinsic cord abnormality.   \n5.  Incidental hemangioma at T6 vertebra.   \n \n The claimant followed up with Dr. Cassat on March 1, 2021: \n\nPARKER - H101899  5\n  \n \n \nShe returns today to discuss her thoracic and lumbar MRI.  \n[She] continues to have significant cervical spine pain, low \nback pain, some radicular leg pain.  We reviewed her images \nwhich show multilevel degenerative change with multiple \nherniations, areas of central and foraminal stenosis, areas of \nfacet hypertrophy.  We discussed that the acuity of several of \nthese discs is unknown, we will ask Radiology to compare to \nprevious CT.  Certainly she reports a significant symptom free \nperiod since her last period of low back pain.  Her symptoms \nstarted shortly after her motor vehicle accident, from a \ncausation standpoint this is greater than 51% likely to be \ndirectly related.  We will plan on starting physical therapy, we \ndiscussed her existing pathology and different treatment \noptions.  She will follow up with me in 6 weeks, sooner if \nneeded.... \nHer work restrictions will be no lifting, pushing, pulling greater \nthan 10 lb.  She can change positions from seated to standing \nas needed.   \n \n Dr. Cassat assessed “Lumbar strain, initial encounter” and “Cervical \nstrain, acute, initial encounter.”  Dr. Cassat ordered “Ambulatory Referral to \nPhysical Therapy.”   \n The record indicates that the claimant received a series of physical \ntherapy visits beginning March 8, 2021.  The claimant followed up with Dr. \nCassat on March 15, 2021: \nShe returns today to discuss her ongoing neck and back pain.  \nShe has only attended 2 physical therapy visits as of yet.  She \ncontinues to have significant pain in both areas.  She reports \nsignificant limitations in ability to perform activities secondary \nto pain.... \nWe had a long discussion today regarding her pathology and \nreturn to activity.  We discussed that her work restrictions will \nremain the same.  I asked that she increase her physical \ntherapy to 3 times per week.  Try and increase her activity at \nhome as well.  We discussed that if physical therapy fails to \nimprove her symptoms then we will likely arrange for epidural \n\nPARKER - H101899  6\n  \n \n \nsteroid injections and if that fails she may need surgical \nconsultation.  Follow up with me after physical therapy.   \n \n Dr. Cassat reported on March 15, 2021: \nIt is my medical opinion that Ms. Felicia Parker may return to \nwork, light duty with the following restrictions, no lifting, \npushing, pulling greater than 10 lb, no flexion/extension of \nback.  Please allow her to change positions from seated to \nstanding, as needed.   \n \n Tiphanie Nelson, WC Claims Specialist, e-mailed Nancy Hall on \nMarch 16, 2021: \nCan these restrictions be accommodated?  Please send me a \ncopy of her job description so I can send to Dr. Cassat, there’s \nbeen some confusion of her returning to work and I spoke with \nDr. Cassat and he said that Ms. Parker can not go back in the \nfield right now and that if these restrictions can not be \naccommodated, she must remain off work.  Thank you.   \n \n Tiphanie Nelson e-mailed Donna S. Curtis, a case manager for the \nrespondents, on March 22, 2021: \n  Hey Donna –  \nI’m having issues with this.  Usually if the doctor gives the \nclaimant restrictions and they can not be accommodated then \nthe claimant is to remain off work.  Apparently they are telling \nher that after her FMLA is up end of today she has to return \nback to work tomorrow.  I asked if they can accommodate \nthese restrictions and I haven’t received an answer from Mrs. \nDaily.  I spoke with Nancy and she said that they need further \ndetailed restrictions saying what she can and can not do.  Dr. \nCassat called me himself and stated that the (sic) never really \ntakes the patient’s off work they always give them restrictions \nbut there’s no way that she can return to work going out in the \nfield lifting patients and he’s never had to give any further \ndetailed restrictions.  He said that if they can not \naccommodate these restrictions that she’s on that she can not \ndo her regular job.  The claimant seems to think that they can \n\nPARKER - H101899  7\n  \n \n \nfire her if she does not return to work and you know that would \nnot be good if they did that.  That will open up some legal \nproblems.  Can you help me with this.   \n \n Donna S. Curtis corresponded with Tiphanie Nelson and several \nother individuals on March 22, 2021: \n  Hello Everyone, \nI just got off the phone with Melinda regarding Ms. Parker.  \nMelinda is calling Ms. Parker now to tell her that she can \nreturn to work tomorrow at her usual time and in her “home \ndepartment.”  Melinda and I also discussed that, if there is not \nenough for her to do in her deskwork on her home unit that we \ncan share her time with her home department and another \ndepartment, such as the POEM clinic.  (Melissa Vandiver is \noff today so I cannot discuss the possibility of sharing or \nmoving her to POEM during her time of restrictions but I will \ndo that tomorrow when Melissa returns.)   \nSo as of now, Ms. Parker will return to work with her \nrestrictions tomorrow.  I will also call Ms. Parker shortly just to \nreassure her that we will work with her as she works with her \nrestrictions.   \nThanks to everyone for helping out with assisting Ms. Parker \nand Melinda in bringing her back to work.   \n \n The claimant corresponded with her supervisor, Melinda A. Daily, \nand several other individuals on March 22, 2021: \nHello everyone!  Its obvious that a lot of conversations have \nbeen going, but I just want to be open and frank about my \ncurrent situation.  I’m in constant pain everyday on a scale of \n8 out of 10.  I continue to have back pain and spasms, neck \npain, numbness and tingles in my hands, fingers and down \nmy legs.  My anxiety is at an all time high and I’m very \nfrustrated about the whole situation and process... \n \nMelinda, \nI’m fully aware that my FMLA periods end today, but I have \ndecided not to return to work on tomorrow.  There’s no way \nthat I can return tomorrow taking my current meds for pain \n\nPARKER - H101899  8\n  \n \n \nand muscle spasms.  I have reached out to FMLA/Standard \nfor an extension or help with this matter since all my time has \nbeen exhausted.  I apologize for any inconvenience, but my \nfirst priority at this time it to take care of myself with the help of \nPT and medication to control my pain.  Its evident that team \nUAMS is working on its behalf, with no regards to my pain or \nmobility but only the push for me to return to work ASAP.  \nPlease let me know if there’s anything you need from me at \nthis time.   \nI’m not really sure what my options are at this point, but I have \nspoken briefly with Ms Curtis and still awaiting for Ms Hall call \nback. \nHopefully, I will be able to return here in the near future! \n \nDr. Cassat, \nHR stated that they have received everything from you that \nwas needed, but according to your nurse she stated that she \nstill has the paperwork.  She also stated that since I’m on a \npain contract with Dr. William Ackerman he may need to fill \nout the paperwork that Standard will be reaching out to you for \nthe claim I submitted today.  Thanks! \n \nMs Nelson, \nStandard will be reaching out to you as well.  I don’t know how \nWorkmans Comp and Standard works but hopefully you guys \nwill help me with the do’s and dont’s to help advocate on my \nbehalf.  Thanks in advance for your assistance.   \n \n Tiphanie Nelson informed the claimant on March 22, 2021: \nOn the workers comp injury – We have to go by what Dr. \nCassat says.  He has you on restrictions that UAMS are \nwilling to accommodate.  The medication that Dr. Ackerman \nhas you on is not related to the Workers Comp injury and you \nwere obviously on before your work injury.  We can not \ncontinue to pay TTD based on his prescriptions.   \n \n The respondents contended that they paid temporary total disability \nbenefits until March 22, 2021, “when she was released to work with \n\nPARKER - H101899  9\n  \n \n \nrestrictions by her treating physician, which her employer could \naccommodate and the claimant in fact returned to work for her employer.” \n Donna S. Curtis e-mailed the claimant and several other individuals \non March 23, 2021: \n  Good morning everyone, \nI got a call from Melissa yesterday evening, even though she \nwas off for the day.  She did confirm that we are happy to \nhave you, Felicia, work in our POEM clinic while you have \nyour restrictions.  So when things are worked out just let me \nknow and Melissa will be working with us all. \nThank you all,  \nDonna \n \n Deborah Davis, PT noted on March 23, 2021, “lifting restrictions \nincluding no lifting over 10lbs....Hard time the last couple of days.  Back to \nwork light duty this week.  Can’t tell I am making any progress....Advised \nshe try water therapy at our Spine Center to see if buoyancy of water will \nassist her mobility.” \n The claimant testified on direct examination: \n  Q.  And so when did you go back to work? \nA.  It was in April, I believe.  I don’t remember the exact date, \nbut I was in house calls.  I was on light duty.  I couldn’t do \nanything that I normally would do, so it kind of put a strain on \nour department.  So my supervisor talked with Ms. Hutts, and \nthey came up with the position in the Thomas and Lyon \nLongevity Clinic for me to become a phone MA where I would \nsit and do the phone calls – phone calls, refills and \nmedications.  Well, refills – just answer the phones and do the \nrefills – fax refills and everything.  She said that it was a \nposition that I would – that I would go to to help some other \nyoung ladies to work.  But when I got there, they moved \n\nPARKER - H101899  10\n  \n \n \neveryone else out and I was the only one there doing all the \nwork.   \nQ.  And so did that job require you to do a significant amount \nof walking? \nA.  No.  I was stable, but the work was overwhelming, and I \nwas in a lot of pain.... \n \n The respondents’ attorney cross-examined the claimant: \n  Q.  I heard you testify about going back to work.   \n  A.  Yes. \nQ.  You understood that you had been getting some \nrestrictions and your employer was ready to accommodate \nyou.  Was that your understanding? \nA.  Yes.   \nQ.  Okay.  And you did actually go back to work? \nA.  I did.   \n \n The claimant followed up with Dr. Cassat on April 12, 2021: \nShe returns today for recheck.  She reports overall \nimprovement in her neck and low back pain but there is still \npersistent.  She reports that she is able to do more but is not \nable to return to her baseline activities without discomfort.  \nShe reports that physical therapy has been helping but she \nfeels that she has recently plateaued and is willing to \ninvestigate additional treatment options....at this point we \ndiscussed continuing her work restrictions as they have been, \nobtaining a cervical and lumbar spine MRI for possible \nintervention.  She can continue with her physical therapy until \nthat time.  Follow up with me after imaging. \n \n Dr. Cassat diagnosed “Cervical strain, acute, initial encounter” and \n“Lumbar strain, initial encounter.”     \n Amelia R. Ray, APRN and Dr. Samuel Clay Overly saw the claimant \nat UAMS Orthopedic Spine Clinic on July 2, 2021: \nThe patient is a 50 y.o. female who presents to the clinic \ntoday as a new patient for evaluation of neck pain and back \n\nPARKER - H101899  11\n  \n \n \npain.  Her back pain bothers her worse.  This started February \n2021 after she was involved in a motor vehicle accident.  She \nreports that she has low back pain especially with bending, \nwalking or doing dishes....She previously has tried physical \ntherapy and aqua therapy which did help a lot with her \npain....Her neck pain was worse at the time of the accident \nbut has since improved significantly.... \nImaging:  I reviewed all imaging studies myself. \nCervical and lumbar MRI \nIMPRESSION:   \n1.  Degenerative disc disease with spondylosis at C5-6.  Right \nparacentral disc osteophyte is present.  No central canal \nstenosis. \n2.  Multilevel advanced disc degeneration throughout the \nlumbar spine without stenosis.  Neural foraminal stenosis \nleft greater than right at L5-S1. \n3.  No acute fractures demonstrated.   \n \nAssessment/Plan: \n50-year-old female with a BMI of 65 presenting to the clinic for \nchronic low back pain in absence of radiculopathy as well as \ncervical neck pain in absence of radiculopathy or myelopathy.  \nThe patient was involved in a motor vehicle accident February \n21.  The time of that accident, she was having neck pain \nassociated with bilateral shoulder pain.  This was likely due to \nthe disc herniation seen at C5-6.  However, the pain has \ncompletely resolved.  Her main issue is low back pain which is \nlikely mechanical axial low back pain secondary to the \nmultilevel degenerative disc disease seen throughout the \nlumbar spine as well as her weight.  At this point in time, she \nis not a surgical candidate for this reason.  There is no canal \nstenosis seen in the lumbar spine.  There is some foraminal \nstenosis on the left at L5-S1 however she is not presenting \nwith true radicular type symptoms in his leg.  For treatment, \nwe have offered her a radiofrequency ablation of L4-5 were \n(sic) she has quite a bit of joint arthritis.  This will likely help \nwith a lot of her back pain especially when she is bending \nover.  We have recommended physical therapy targeting the \ncervical and lumbar spine.  We will write for naproxen for pain \nrelief.  She will follow up via telemedicine with me in 6 weeks \nto see how the RFA went and how physical therapy is going.  \nThe patient is on board with this plan.   \n\nPARKER - H101899  12\n  \n \n \n \n Dr. Gregory L. Smith performed bilateral lumbar medial nerve branch \nblocks on August 2, 2021 and September 8, 2021.  The claimant testified \nregarding Dr. Smith’s treatment, “I – it wasn’t hurting as bad as it was.  I \nhad a temporary relief – some relief.  But then after a while, it wore off.”   \n The claimant testified on direct examination: \nQ.  When did you stop actually working this phone job as an \nMA? \nA.  That was April the 7\nth\n – no February 7, 2022.  February 7, \n2022.   \nQ.  And what precipitated you leave an employment on \nFebruary 7, 2022.   \nA.  Because I was in a lot of pain, and I just couldn’t – I \ncouldn’t do that job anymore....I was just in a lot of pain.  And \nso that’s the reason why I stopped working and I was off to \nget ready to have my surgery.   \n \n The claimant testified that she underwent bariatric weight-loss \nsurgery on April 1, 2022.     \n The claimant began treating with Dr. Ahmed Ghaleb on April 19, \n2022:  “Pleasant patient presents for the evaluation and management of \nchronic pain.”  Dr. Ghaleb’s assessment included “Lumbosacral spondylosis \nwithout myelopathy” and “Cervical spondylosis without myelopathy.”  Dr. \nGhaleb prescribed Nortriptyline, Tizanidine, and Hydrocodone.   \n Dr. Ghaleb performed “ESC Lumbar Medial Branch Nerves \nNeurotomy” on May 5, 2022.   \n\nPARKER - H101899  13\n  \n \n \n The record contains a Change of Physician Order dated June 11, \n2022:  “A change of physician is hereby approved by the Arkansas \nWorkers’ Compensation Commission for Felicia Parker to change from Dr. \nMichael Cassat to Dr. Ahmed Ghaleb[.]  \n The claimant returned to Dr. Ghaleb on July 19, 2022: \nThe patient complains of pain in the BACK, NECK, KNEES.  \nThe patient has been experiencing this pain for the last \nseveral years.  She reports onset of pain gradually over time.  \nThe patient describes her pain as constant with intermittent \nflare ups.  The pain is cramping, numbing, pressure like, \nsharp and shooting.  The pain radiates to the bilateral lower \nextremity....Pain medication improves quality of life.... \nPatient was advised to maintain normal activities and advised \nto avoid prolonged bed rest and focus on improving the \nactivity of daily living.... \n \n Dr. Ghaleb prescribed Nortriptyline, Methocarbamol, and \nHydrocodone, and instructed the claimant to follow up in one month. \n The claimant’s testimony indicated that the respondent-carrier paid \nfor the claimant’s visit with Dr. Ghaleb occurring July 19, 2022, but that the \nrespondents would not authorize additional visits with Dr. Ghaleb.        \n A pre-hearing order was filed on October 6, 2022.  The claimant \ncontended, “Claimant contends that she sustained a compensable injury to \nher lumbar spine, cervical spine and thoracic spine and knees in the course \nand scope of her employment.  She is entitled to additional TTD from \n3/20/21 through a date yet to be determined.  Claimant further contends \nthat she is entitled to additional medical treatment, a change of physician \n\nPARKER - H101899  14\n  \n \n \nrehabilitation, medical expenses, medical mileage, and attorney’s fees in \nthis claim.”   \n The parties stipulated that the respondents “have controverted the \nadditional benefits sought herein, inclusive of the Claimant’s alleged \nbilateral knee injuries of February 4, 2021.”  The respondents contended, \n“The Respondent contends that the claimant reported having an injury to \nher back neck and right knee occurring February 4, 2021 in a motor vehicle \naccident.  Respondent accepted the head neck and back symptoms as an \naggravation of the claimant’s preexisting condition, and provided benefits to \nthe claimant for this aggravation.” \n The respondents contended, “Respondent has provided medical \ntreatment reasonable and necessary for the compensable injury, including \nconservative treatment with Dr. Michael Cassat.  Dr. Cassat ordered MRI \nstudies of the cervical and lumbar, and referred the claimant for a surgical \nevaluation by Dr. Samuel Overly, who saw her July 2, 2021 noted her \ncervical pain resolved, and did not recommend surgery on her low back.  \nThe claimant was provided bilateral L3 to L5 medial nerve branch blocks to \nL4/L5, L5/S1 facets on August 2, 2021 and September 8, 2021 by Dr. \nGregory Smith.  The claimant used her one time Change of Physician to \nsee Dr. Ghaleb July 19, 2022.  Respondent paid for the visit, and the \nclaimant cannot be entitled to another Change of Physician.  The claimant \n\nPARKER - H101899  15\n  \n \n \nseeks pain management with Dr. Ghaleb, but she was already under a pain \nmanagement contract with Dr. Ackerman at the time of injury for her chronic \nand preexisting conditions.  Respondent contends that the claimant has \npreexisting condition to her spine and knees for which she was receiving \ntreatment including chronic pain management with Dr. Ackerman, and \npreparing for bariatric surgery.  The Respondent contends that the claimant \ncannot establish her need for pain management is reasonable and \nnecessary for or causally related to a work injury occurring February 4, \n2022.  Respondent contends that the claimant cannot establish that her \nneed for treatment of her knee(s) is reasonable and necessary for or \ncausally related to a work injury occurring February 4, 2022.”   \n The respondents contended, “Respondent paid TTD benefits to the \nclaimant while she was in a healing period and unable to work, from \nFebruary 5, 2021 until March 22, 2021 when she was released to work with \nrestrictions by her treating physician, which her employer could \naccommodate and the claimant in fact returned to work for her employer.” \n The respondents contended, “Respondent contends that the \nclaimant has been provided medical treatment reasonable and necessary \nfor and causally related to the work injury, and has been paid the disability \nbenefits she is owed to date.  The Respondents reserve the right to raise \n\nPARKER - H101899  16\n  \n \n \nadditional contentions, or to modify those stated herein, pending the \ncompletion of discovery.” \n The parties agreed to litigate the following issues: \n1.  Whether the Claimant is entitled to additional reasonably \nnecessary medical care in relation to her compensable \nhead, neck, and back injuries of February 4, 2021; \n2.  Whether the Claimant sustained compensable bilateral \nknee injuries on February 4, 2021, and is entitled to \nappropriate benefits associated therewith; \n3.  Whether the Claimant is entitled to additional temporary \ntotal disability benefits from March 23, 2021 through a date \nyet to be determined, in relation to her compensable head, \nneck, and back injuries of February 4, 2021; \n4.  Whether the Claimant provided sufficient notice of her \nalleged left knee injury of February 4, 2021, in accordance \nwith Ark. Code Ann. §11-9-701; and, \n5. Attorney’s fees with respect to controverted indemnity \nbenefits.   \n \nAfter a hearing, an administrative law judge filed an opinion on July \n19, 2023.  The administrative law judge found, among other things, that the \nclaimant “did not sustain a compensable bilateral knee injury on February 4, \n2021.”  The claimant does not appeal that finding.  The administrative law \njudge found that the claimant was “entitled to additional medical treatment \nfor her head, neck, and back injuries of February 4, 2021.”  The \nadministrative law judge also found that the claimant proved she was \nentitled to temporary total disability benefits “from March 23, 2021, through \na date to be determined.”  The respondents appeal those findings to the \nFull Commission.    \n\nPARKER - H101899  17\n  \n \n \nII.  ADJUDICATION \nA.  Temporary Total Disability \nTemporary 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 \ncontinues until the employee is as far restored as the permanent character \nof the injury will permit, and if the underlying condition causing the disability \nhas become stable and nothing further in the way of treatment will improve \nthat condition, the healing period has ended.  Harvest Foods v. Washam, \n52 Ark. App. 72, 914 S.W.2d 776 (1996).  The claimant has the burden of \nproving, by a preponderance of the evidence, that she remains within a \nhealing period.  Hickman v. Kellogg, Brown & Root, 372 Ark. 501, 277 \nS.W.3d 591 (2008).  Preponderance of the evidence means the evidence \nhaving greater weight or convincing force.  Metropolitan Nat’l Bank v. La \nSher Oil Co., 81 Ark. App. 269, 101 S.W.3d 252 (2003).  The determination \nof when the healing period has ended is a question of fact for the \nCommission.  Carroll Gen. Hosp. v. Green, 54 Ark. App. 102, 923 S.W.2d \n878 (1996). \n\nPARKER - H101899  18\n  \n \n \nIn workers’ compensation cases, the Commission functions as the \ntrier of fact.  Blevins v. Safeway Stores, 25 Ark. App. 297, 757 S.W.2d 569 \n(1988).  The determination of the credibility and weight to be given a \nwitness’s testimony is within the sole province of the Commission.  Murphy \nv. Forsgren, Inc., 99 Ark. App. 223, 258 S.W.3d 794 (2007).  The \nCommission is not required to believe the testimony of the claimant or any \nother witness but may accept and translate into findings of fact only those \nportions of the testimony it deems worthy of belief.  Farmers Co-op v. Biles, \n77 Ark. App. 1, 69 S.W.3d 899 (2002).  An administrative law judge’s \nfindings with regard to credibility are not binding on the Full Commission.  \nRoberts v. Leo Levi Hospital, 8 Ark. App. 184, 649 S.W.2d 402 (1983).  The \nFull Commission has the duty to decide the case de novo and we are not \nbound by the characterization of evidence adopted by an administrative law \njudge.  Tyson Foods, Inc. v. Watkins, 37 Ark. App. 230, 792 S.W.2d 348 \n(1990). \nAn administrative law judge found in the present matter, “4.  The \nClaimant is entitled to additional temporary total disability benefits from \nMarch 23, 2021, through a date to be determined.”  The Full Commission \ndoes not affirm this finding.  The parties stipulated that the claimant \n“sustained compensable injuries to her head, neck, and back” as the result \nof a motor vehicle accident occurring February 4, 2021.  An emergency \n\nPARKER - H101899  19\n  \n \n \nphysician’s impression on February 4, 2021 included “Cervical strain” and \n“Low back strain.”  An x-ray on February 4, 2021 showed that the claimant \nsuffered from degenerative disc disease in her lumbar spine.  The \nrespondents paid temporary total disability benefits beginning February 5, \n2021.  The claimant was treated conservatively and was provided physical \ntherapy.  Dr. Cassat assigned work restrictions beginning February 23, \n2021.  An MRI on February 24, 2021 showed degenerative disc disease in \nthe claimant’s thoracic and lumbar spine.     \nDr. Cassat assessed “Lumbar strain” and “Cervical strain” on March \n1, 2021.  As the Full Commission has noted supra, Dr. Cassat reported on \nMarch 15, 2021, “It is my medical opinion that Ms. Felicia Parker may return \nto work, light duty with the following restrictions, no lifting, pushing, pulling \ngreater than 10 lb, no flexion/extension of back.  Please allow her to change \npositions from seated to standing, as needed.”  The subsequent \ncorrespondence of record indicates that the respondent-employer in good \nfaith accommodated the work restrictions assigned by Dr. Cassat.  The \nrespondents allowed the claimant to return to restricted work in compliance \nwith Dr. Cassat’s restrictions.  The respondent-carrier paid temporary total \ndisability benefits until March 22, 2021.  In order to prove that she was \nentitled to additional temporary total disability benefits, the claimant was \nrequired to prove that she was totally incapacitated from earning wages, \n\nPARKER - H101899  20\n  \n \n \nwhile she remained within a healing period.  See Breshears, supra.  The \nevidence of record in the present matter does not demonstrate that the \nclaimant was totally incapacitated from earning wages at any time after \nMarch 22, 2021, following Dr. Cassat’s release to restricted work duty on \nMarch 15, 2021.  The Full Commission therefore finds that the claimant did \nnot prove she was entitled to temporary total disability benefits after March \n22, 2021. \nIn addition, the Full Commission finds that the claimant did not \nremain within a healing period for her compensable cervical strain or lumbar \nstrain beyond July 2, 2021.  Amelia Ray, APRN and Dr. Overly noted on \nJuly 2, 2021 that the claimant suffered with degenerative disc disease in her \ncervical and lumbar spine.  Dr. Overly reported, however, that the \nclaimant’s cervical pain “has completely resolved.”  The record therefore \nshows that the claimant reached the end of the healing period for her \ncervical strain no later than July 2, 2021.  Dr. Overly reported with regard to \nthe claimant’s low back or lumbar spine, “Her main issue is low back pain \nwhich is likely mechanical axial low back pain secondary to the multilevel \ndegenerative disc disease seen throughout the lumbar spine as well as her \nweight.”  Dr. Overly did not opine that the claimant continued to suffer from \nthe effects of a lumbar strain. \n\nPARKER - H101899  21\n  \n \n \nThe evidence demonstrates that the claimant sustained a \ncompensable cervical and lumbar strain resulting from the work-related \nmotor vehicle accident which occurred on February 4, 2021.  The Full \nCommission finds that the claimant reached the end of the healing period \nfor her compensable cervical and lumbar strain no later than July 2, 2021.  \nTemporary total disability benefits cannot be awarded after the healing \nperiod has ended.  Elk Roofing Co. v. Pinson, 22 Ark. App. 191, 737 \nS.W.2d 661 (1987).  Persistent pain does not extend an employee’s healing \nperiod, provided that the underlying condition has stabilized.  Mad Butcher, \nInc. v. Parker, 4 Ark. App. 124, 628 S.W.2d 582 (1982).  The record does \nnot show that the claimant reentered a healing period at any time after July \n2, 2021.  The claimant did not prove that she was entitled to additional \ntemporary total disability benefits after March 22, 2021, because she was \nno longer totally incapacitated from earning wages after that date.   \nB.   Medical Treatment \nThe employer shall promptly provide for an injured employee such \nmedical treatment as may be reasonably necessary in connection with the \ninjury received by the employee.  Ark. Code Ann. §11-9-508(a)(Repl. 2012).  \nThe employee has the burden of proving by a preponderance of the \nevidence that medical treatment is reasonably necessary.  Stone v. Dollar \nGeneral Stores, 91 Ark. App. 260, 209 S.W.3d 445 (2002).  It is the \n\nPARKER - H101899  22\n  \n \n \nCommission’s duty to translate the evidence of record into findings of fact.  \nGencorp Polymer Prods. v. Landers, 36 Ark. App. 190, 820 S.W.2d 475 \n(1991).  It is also within the Commission’s province to weigh all of the \nmedical evidence and to determine what is most credible.  Minnesota \nMining & Mfg. v. Baker, 337 Ark. 94, 989 S.W.2d 151 (1999).  What \nconstitutes reasonably necessary medical treatment is a question of fact for \nthe Commission.  Wright Contracting Co. v. Randall, 12 Ark. App. 358, 676 \nS.W.2d 750 (1984). \nAn administrative law judge found in the present matter, “3.  The \nclaimant is entitled to additional medical treatment for her head, neck, and \nback injuries of February 4, 2021.”  The Full Commission does not affirm \nthis finding.  As we have discussed at length, the parties stipulated that the \nclaimant “sustained compensable injuries to her head, neck, and back” as \nthe result of a work-related motor vehicle accident occurring February 4, \n2021.  The evidence of record actually does not demonstrate that the \nclaimant sustained a compensable injury to her head, and there are no \ntreatment recommendations of record related to the claimant’s head. \nHowever, the claimant sustained a compensable cervical strain and \nlower back strain as a result of the accidental injury occurring February 4, \n2021.  The claimant was treated conservatively, which treatment included \nphysical therapy and injections.  There are no credible recommendations of \n\nPARKER - H101899  23\n  \n \n \nrecord indicating that the claimant is a candidate for surgery as a result of \nthe February 4, 2021 compensable injury.  The Full Commission has \ndetermined supra that the claimant reached the end of the healing period \nfor her compensable injuries no later than July 2, 2021.  We recognize that \na claimant may be entitled to ongoing medical treatment after the healing \nperiod has ended, if the medical treatment is geared toward management of \nthe claimant’s injury.  Patchell v. Wal-Mart Stores, Inc., 86 Ark. App. 230, \n184 S.W.3d 31 (2004).  Such services can include diagnosing the nature \nand extent of the compensable injury, reducing or alleviating symptoms \nresulting from the compensable injury, maintaining the level of healing \nachieved, or preventing further deterioration of the damage produced by the \ncompensable injury.  Jordan v. Tyson Foods, Inc., 51 Ark. App. 100, 911 \nS.W.2d 593 (1995).  A claimant is not required to furnish objective medical \nevidence of her continued need for medical treatment.  Castleberry v. Elite \nLamp Co., 69 Ark. App. 359, 13 S.W.3d 211 (2000). \nIn the present matter, however, the evidence does not demonstrate \nthat treatment provided after July 2, 2021 was reasonably necessary in \nconnection with the compensable injury occurring February 4, 2021.  \nInstead, the record shows that such treatment was related to the claimant’s \npre-existing degenerative condition rather than a cervical or lumbar strain.  \nOn June 11, 2022, the claimant received a Change of Physician Order from \n\nPARKER - H101899  24\n  \n \n \nDr. Cassat to Dr. Ghaleb.  When an employee has exercised her absolute, \nstatutory right to a one-time change of physician, the respondents must pay \nfor the initial visit to the new physician in order to fulfill their obligation to \nprovide reasonably necessary medical treatment.  Wal-Mart Stores, Inc. v. \nBrown, 82 Ark. App. 600, 120 S.W.3d 153 (2003).  The record indicates that \nthe respondent-carrier, in accordance with Wal-Mart Stores, Inc. v. Brown, \nin fact paid for the claimant’s visit with Dr. Ghaleb which took place on July \n19, 2022 following the Change of Physician Order.   \nThe employee has the burden of proving by a preponderance of the \nevidence that additional medical treatment is reasonably necessary.  Stone, \nsupra.  In the present matter, the Full Commission finds that the claimant \ndid not prove additional medical treatment was reasonably necessary in \nconnection with the compensable injury.  The evidence demonstrates that \nthe claimant suffered from pre-existing degenerative disc disease in her \ncervical and lumbar spine.  The claimant sustained a work-related motor \nvehicle accident on February 4, 2021 which resulted in a cervical strain and \nlumbar strain.  The claimant received physical therapy and injections, and \nshe reached the end of the healing period for her compensable cervical and \nlumbar strain no later than July 2, 2021.  There is no credible medical report \nof record indicating that the claimant is a candidate for surgery as a result of \nthe injury occurring February 4, 2021.  Following the statutory change of \n\nPARKER - H101899  25\n  \n \n \nphysician to Dr. Ghaleb, the respondents fulfilled their obligation in \naccordance with Wal-Mart Stores, Inc., supra.  The evidence does not \ndemonstrate that any additional treatment with Dr. Ghaleb after July 19, \n2022, including his prescriptions of Nortriptyline, Methocarbamol, or \nHydrocodone, are reasonably necessary in connection with the February 4, \n2021 compensable injury.  \nAfter reviewing the entire record de novo, the Full Commission finds \nthat the claimant did not prove by a preponderance of the evidence that she \nwas entitled to additional temporary total disability benefits or additional \nmedical treatment.  The Full Commission therefore reverses the \nadministrative law judge’s opinion, and this claim is respectfully denied and \ndismissed.   \nIT IS SO ORDERED. \n       \n    ___________________________________ \n    SCOTTY DALE DOUTHIT, Chairman \n \n    ___________________________________ \n    MICHAEL R. MAYTON, Commissioner \n \n \nCommissioner Willhite dissents. \n \nDISSENTING OPINION \nAfter conducting a de novo review of this claim, I dissent in part and \nconcur in part with the majority.  I dissent as to the finding that Claimant failed \n\nPARKER - H101899  26\n  \n \n \nto prove by a preponderance of the evidence that she is entitled to additional \nmedical treatment for her lower back, but I concur as to the finding that the \nClaimant did not meet her burden of proof that she was entitled to additional \ntemporary total disability and other medical treatment. \nTo  show  entitlement  to  additional  medical  treatment,  Claimant  must \nprove  that  the  treatment  is  reasonably  necessary  in  connection  with  her \ncompensable  injury.  Ark.  Code  Ann.  §11-9-508(a)(1).  What  constitutes \nreasonable and necessary treatment under this section is a question of fact \nfor  the  commission.   Wright  Contracting  Co.  v.  Randall,  12  Ark.  App.  358, \n676 S.W.2d 750. \nThe  parties  stipulated  that  the  Claimant  sustained  a  compensable \ninjury to her head, neck and back as a result of the work-related motor vehicle \naccident that occurred on February 4, 2021.  Approximately six months prior \nto  the  accident,  Claimant  underwent  a  CT  that  showed  “multilevel  facet \narthrosis between L2 and S1 bilaterally.”   After the motor vehicle accident, \nClaimant underwent an MRI at L2-S1 region which showed a “left paracentral \ndisc protrusion” and compression of the nerve root.    This  is  an  identifiable \nchange in Claimant’s condition.    Dr.  Ghaleb  has  recommended  Claimant \nundergo a repeat lumbar radiofrequency ablation as a result of the Claimant’s \ncompensable   injury.  Therefore,   I   find   that   the   recommended  medical \nprocedure of lumbar radiofrequency ablation to be reasonable and necessary \n\nPARKER - H101899  27\n  \n \n \nand  that  Claimant  has  proved  by  a  preponderance  of  the  evidence  to  be \nentitled to additional medical treatment in that form. \nFor the foregoing reasons, I dissent from the majority opinion.  \n \n \n \n    ___________________________________ \n    M. SCOTT WILLHITE, Commissioner","preview":"BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION CLAIM NO. H101899 FELICIA PARKER, EMPLOYEE CLAIMANT UAMS, EMPLOYER RESPONDENT PUBLIC EMPLOYEE CLAIMS DIVISION, INSURANCE CARRIER/TPA RESPONDENT OPINION FILED JANUARY 10, 2024","fetched_at":"2026-05-19T22:29:46.071Z","links":{"html":"/opinions/full_commission-H101899-2024-01-10","pdf":"https://labor.arkansas.gov/wp-content/uploads/Parker_Felicia_H101899_20240110.pdf","source_publisher":"https://labor.arkansas.gov/workers-comp/awcc-opinions/full-commission-opinions/"}}