{"id":"full_commission-H104308-2024-03-07","awcc_number":"H104308","decision_date":"2024-03-07","opinion_type":"full_commission","claimant_name":"Keith Smith","employer_name":"Rock Dental Arkansas, Pllc","title":"SMITH VS. ROCK DENTAL ARKANSAS, PLLC AWCC# H104308 MARCH 7, 2024","outcome":"denied","outcome_keywords":["affirmed:1","dismissed:1","granted:1","denied:3"],"injury_keywords":["back","neck","sprain","lumbar","fracture","hip","thoracic"],"pdf_url":"https://labor.arkansas.gov/wp-content/uploads/Smith_Keith_H104308_20240307.pdf","source_index_url":"https://labor.arkansas.gov/workers-comp/awcc-opinions/full-commission-opinions/","filename":"Smith_Keith_H104308_20240307.pdf","text_length":18605,"full_text":"BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION \n \n \nCLAIM NO.  H104308 \n \nKEITH W. SMITH, \nEMPLOYEE \n \nCLAIMANT \nROCK DENTAL ARKANSAS, PLLC,  \nEMPLOYER \n \nRESPONDENT \nCINCINNATI CASUALTY COMPANY, \nINSURANCE CARRIER/TPA \nRESPONDENT \n  \n      \nOPINION FILED MARCH 7, 2024 \n \nUpon review before the FULL COMMISSION in Little Rock, Pulaski County, \nArkansas. \n \nClaimant represented by the HONORABLE LAURA BETH YORK and B. \nTANNER THOMAS, Attorneys at Law, Little Rock, Arkansas. \n \nRespondents represented by the HONORABLE GUY ALTON WADE, \nAttorney at Law, Little Rock, Arkansas. \n \nDecision of Administrative Law Judge:  Affirmed. \n \n \n OPINION AND ORDER \nThe claimant appeals an administrative law judge’s opinion filed July \n27, 2023.  The administrative law judge found that the claimant failed to \nprove he sustained a compensable injury.  After reviewing the entire record \nde novo, the Full Commission finds that the claimant did not prove by a \npreponderance of the evidence that he sustained a compensable injury.     \nI.  HISTORY \n The testimony of Keith Wayne Smith, now age 68, indicated that he \nbecame a dentist in 1984.  Dr. Smith testified that he began working for the \nrespondent-employer, Rock Dental Arkansas, in October 2020.  The \n\nSMITH - H104308   2\n  \n \n \nclaimant testified that he commuted to the respondents’ office in Helena, \nArkansas.  The parties stipulated that the employee-employer relationship \nexisted on April 19, 2021.  The claimant testified on direct examination: \nQ.  Let’s focus in on April 19 of ’21.  Can you tell me what \nhappened that day? \nA.  Having a better memory sometimes than I can realize, one \nof the assistants had been on vacation and had come back \nfrom vacation on that date.  She’d been on a cruise of some \nsort and had returned to work on that Monday, the 19\nth\n.  And \nwe were looking at the schedule, people were being allocated \nto the chairs as usual, and I went to brew some tea.  I \napparently had put it into the microwave to brew, and then \nwhen I went back to retrieve it and make tea or whatever I \nwas going to do – I think I was using iced tea, because it was \nApril, getting warmer, and I stumbled and fell over some \nchairs.  They were kind of like conference chairs for a \nconference table.  And as I have stated prior, it was a very \nlarge table in a fairly constricted space, so the chairs were \nusually not in a neat fashion, they were kind of in a disarray, \nyou might say, and I had to go from the door, which is on one \nend of the room to the back of the room, which is past the \ntable, if you will, and I fell.  And I stumbled and it felt like - I \nmean, I've stumbled before for one reason or another, but it \nfelt different.  I was hurting.  I was able to pull myself up, get in \na chair, but apparently the others heard, you know, a \ncommotion of some nature and came to see what was going \non, and I was white.  I mean, I was in sort of a shock.  I don’t \nreally remember all the details of what was said around me \nand all such as that, but I did pull up in a chair.  If I was sitting \nupright in a chair I could make some sense.  Apparently I had \nstarted a procedure with one of the patients with anesthesia, \nand I did, was able to go back even after the injury and finish \nwhat I had started.... \nQ.  Do you remember how your foot caught the chair? \nA.  No.   \nQ.  And do you remember how you fell? \nA.  Forward.   \n \n The respondents’ attorney cross-examined the claimant: \n\nSMITH - H104308   3\n  \n \n \nQ.  Now, at the time of this particular claim you were working \nfor Rock Dental at their clinic in Helena, correct? \nA.  Yes, sir.... \nQ.  You would arrive at the office at approximately 8 o’clock, \nand this happened some time, as you described, between \n8:00 and 8:30, is that right? \nA.  Yes.   \nQ.  Now, you have told me that you are actually making tea \nand had been brewing it in the microwave, is that right? \nA.  Correct.   \nQ.  Left it in the microwave, went to see a patient, and you \nwere on your way back to get the tea from the microwave? \nA.  Right.   \nQ.  Now the tea in this microwave is in your conference \nroom/breakroom, is that correct? \nA.  Yes.   \nQ.  And you did not actually physically make it to the \nmicrowave and fell on your way to the microwave, correct? \nA.  Yes.   \nQ.  Now, in the deposition I asked you if before the fall \nwhether you had become light-headed or dizzy, and you said \nnot whatsoever, do you remember that? \nA.  Yes, I do.   \nQ.  So you don’t recall actually becoming dizzy or light-\nheaded on the way to the microwave, is that right? \nA.  No.   \nQ.  Now, you also responded that you never reported to \nanyone that you had been light-headed or dizzy before the \nfall, is that correct? \nA.  Yes.   \nQ.  Now, there was nothing on the floor that caused you to \nfall? \nA.  Other than the chairs, no. \nQ.  There wasn’t any bananas or food or liquids or anything \nthat you noticed on the floor, correct? \nA.  No.   \nQ.  So you didn’t slip in anything?  Nobody had just waxed the \nfloor or put any type of objects or materials that would cause \nyou to slip, correct? \nA.  No.   \n\nSMITH - H104308   4\n  \n \n \nQ.  Now, after the fall there were people that came in the \nbreakroom and tried to figure out what the noise was, is that \nright? \nA.  Yes. \nQ.  Now, the office manager actually called an ambulance, \nwhich picked you up and took you to the Helena Regional \nMedical Center? \nA.  That’s correct.   \n \n The record contains a Patient Care Report from Pafford Medical \nServices – Helena dated April 19, 2021: \nD-DISPATCHED PRIORITY 1 CODE 3 TO THE FAMILY \nDENTISTRY OFFICE ON PLAZA FOR A FALL \nC-C/C IS A FALL WITH INJURY. \nH-THE PT HAS A HX OF HTN, OBESITY, DEPRESSION \nA-ASSESSMENT REVEALS A 65 YEAR OLD WHITE MALE, \nFOUND LAYING IN AN EXAM CHAIR IN ONE OF THE \nEXAM ROOMS WHEN WE ARRIVE.  THE PT STATES THAT \nHE FELL IN THE BREAK ROOM AROUND 0830, AND THAT \nHE NOW HAS PAIN IN HIS LOWER BACK.  HE DOES \nSTATES (sic) THAT JUST PRIOR TO FALLING HE FELT \nDIZZY AND LIGHTHEADED.  THE PT’S V/S ARE STABLE \nOTHER THAN HIS HEART RATE, WHICH IS NOTED TO BE \nBRADYCARDIC.... \nT-THE PT WAS TRANSPORTED ROUTINE STATUS TO \nHRMC ER.... \n \n Dr. Jeff Audibert treated the claimant at Helena Regional Medical \nCenter on April 19, 2021:  “This 65-year-old white male dentist stood up & \nfelt dizzy and lightheaded, then fell to the floor.  He does feel slight low back \npain.  No chest pain or shortness of breath.  No headache or neck pain.  He \ndoes not feel sick at this time.  His heart rate is 53.  He is on a beta-blocker.  \nNo other complaints at this time.”  Dr. Audibert diagnosed “Dizziness and \ngiddiness; Sprain of ligaments of lumbar spine.”   \n\nSMITH - H104308   5\n  \n \n \n An x-ray of the claimant’s lumbar spine was taken on April 19, 2021 \nwith the impression, “No significant findings in the LS spine.  Dilated loops \nof jejunum could be related to gastrostomy.”   \n Dr. Christopher R. Blackmon, D.C. examined the claimant on May 7, \n2021:  “Keith sought treatment today, complaining of intermittent sharp and \nthrobbing discomfort in the low back....Assessment:  Keith has a new \ncondition.”  Dr. Blackmon diagnosed “Wedge compression fracture of T11-\nT12 vertebra[.]”   \n Jim Cavanaugh, a claims adjuster with the respondent-carrier, \ntestified that he interviewed the claimant by telephone on May 11, 2021.  \nThe respondents’ attorney examined Mr. Cavanaugh at hearing: \nQ.  Now when you talked to Dr. Smith, did you ask him how \nhe fell or what led to his fall? \nA.  Yes.   \nQ.  What was his response?  What did he tell you? \nA.  He indicated that, you know, he went to the breakroom to \nobtain a drink I think perhaps from the microwave when he \nfainted or lost consciousness in the breakroom.   \nQ.  So he indicated to you that he had actually fainted or \npassed out, which caused the fall? \nA.  Yes.  Based on our conversation, that’s what it was \nindicating, what he was indicating, you know, given any other \nexplanation at that time.... \nQ.  Did you ask him if he tripped or slipped or fell over \nanything? \nA.  I did.  I did. \nQ.  And what was his response? \nA.  He did not think that that was an aspect related to his fall.   \nQ.  That he didn’t trip over a chair or a table or any other \nobject that was in the floor? \nA.  Correct. \n\nSMITH - H104308   6\n  \n \n \n \n An MRI of the claimant’s lumbar spine was taken on May 20, 2021 \nwith the following impression: \n1.  Acute to subacute superior endplate compression fracture \nof T12 with vertebral body height loss of up to 25%. \n2.  Advanced facet arthropathy at L4-5 and L5-S1 with \nmoderate to severe narrowing of the left neural foramen at L4-\n5.   \n \n The claimant testified that the respondents terminated his \nemployment on May 22, 2021.   \nThe claimant underwent “Uncomplicated T11, and T12 \nvertebroplasty procedures” on June 1, 2021.     \n Dr. Blackmon corresponded with the claimant’s attorney on February \n8, 2023: \nPlease allow me to summarize my treatment of Dr. Keith \nSmith. \nDr. Smith presented himself to this office on 5/7/2021 with the \nchief complaint of right upper low back pain, hip pain, and leg \npain.  He stated that he had suffered a back injury at his work \nlocation in Helena, Arkansas on 4/19/2021.  He was initially \ntaken to the emergency room at Helena Regional Medical \nCenter.  He was told that he didn’t have any fractures.  \nHowever, his pain continued with little to no improvement so \nhe sought care at this office. \nOn his initial visit, x-rays were taken and revealed 2 spinal \ncompression fractures in the lower thoracic spine.  He was \nreferred to his primary care physician for treatment of the \nfractures.  An MRI was performed and confirmed the spinal \nfractures.  He was then referred for kyphoplasty to repair the 2 \ncompression fractures.   \nPost surgically, I saw Dr. Smith on 06/10/21 and 6/25/2021.  \nHe explained that he had been convalescing and allowing \nsome down time for healing.  Unfortunately, he stated that he \n\nSMITH - H104308   7\n  \n \n \nneeded to return to work which prevented him from continuing \non the treatment plan. \nRecently, beginning in November of 2022, I have seen Dr. \nSmith for follow up treatment secondary to the \naforementioned kyphoplasty.  He reports protracted soreness, \nand tightness in the affected thoracic region.  He has been \nunder regular chiropractic care from 11/11/2022 to present.  \nAt the 11/11/2022 appointment, secondary x-rays were taken \nand these images revealed the surgical repair (kyphoplasty) of \nthe thoracic vertebrae.  Some residual scar tissue is also \npresent.  The ongoing maintenance therapy is to maintain \ncomfort, especially in light of the patient’s occupation, and \nalso, to keep range of motion at a maximum.  Lastly, this will \nensure long range patient comfort. \nPlease let me know if I can be of further assistance to you or \nyour office.   \n \n A hearing was held on March 8, 2023, at which time an \nadministrative law judge announced the parties’ contentions.  The claimant \ncontended, among other things, that he fell and injured his back in the \ncourse and scope of employment on April 19, 2021, and that he sustained a \ncompensable injury.  The claimant contended that he was entitled to \nmedical treatment, temporary total disability benefits, and fees for legal \nservices.   \n The parties stipulated that the respondents \"have controverted the \nclaim in its entirety.\"  The respondents contended that the claimant did not \nsustain a compensable injury.  The respondents’ attorney stated that there \nwere two defenses to the claim:  “One is course and scope, the other is \nidiopathic, in neither case which would mean it was compensable.” \n\nSMITH - H104308   8\n  \n \n \n An administrative law judge filed an opinion on July 27, 2023.  The \nadministrative law judge found that the claimant did not prove he sustained \na compensable injury.  The administrative law judge therefore denied and \ndismissed the claim.  The claimant appeals to the Full Commission.  \nII.  ADJUDICATION \n Ark. Code Ann. §11-9-102(4)(Repl. 2012) provides, in pertinent part: \n  (A)  “Compensable injury” means: \n(i)  An accidental injury causing internal or external physical \nharm to the body ... \narising out of and in the course of employment and which \nrequires medical services or results in disability or death.  An \ninjury is “accidental” only if it is caused by a specific incident \nand is identifiable by time and place of occurrence[.] \n \n A compensable injury must also be established by medical evidence \nsupported by objective findings.  Ark. Code Ann. §11-9-102(4)(D)(Repl. \n2012).   \n The employee has the burden of proving by a preponderance of the \nevidence that he sustained a compensable injury.  Ark. Code Ann. §11-9-\n102(4)(E)(i)(Repl. 2012).  Preponderance of the evidence means the \nevidence having greater weight or convincing force.  Metropolitan Nat’l \nBank v. La Sher Oil Co., 81 Ark. App. 269, 101 S.W.3d 252 (2003).   \n An idiopathic injury is one whose cause is personal in nature, or \npeculiar to the individual.  Crawford v. Single Source Transp., 87 Ark. App. \n216, 189 S.W.3d 507 (2004), citing Kuhn v. Majestic Hotel, 324 Ark. 21, 918 \n\nSMITH - H104308   9\n  \n \n \nS.W.2d 158 (1996).  Injuries sustained due to an unexplained cause are \ndifferent from injuries where the cause is idiopathic.  ERC Contractor Yard \n& Sales v. Robertson, 335 Ark. 63, 977 S.W.2d 212 (1998).  Where a \nclaimant suffers an unexplained injury at work, it is generally compensable.  \nLittle Rock Convention & Visitors Bur. v. Pack, 60 Ark. App. 82, 959 S.W.2d \n415 (1997).  Because an idiopathic injury is not related to employment, it is \ngenerally not compensable unless conditions related to the employment \ncontribute to the risk.  Id.  Employment conditions can contribute to the risk \nor aggravate the injury by, for example, placing the employee in a position \nwhich increases the dangerous effect of the fall, such as on a height, near \nmachinery or sharp corners, or in a moving vehicle.  Id.  See also \nDelaplaine Farm Center v. Crafton, 2011 Ark. App. 202, 382 S.W.2d 689.   \n In 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 Commission is not required to believe the testimony of the \nclaimant or any other witness but may accept and translate into findings of \nfact only those portions of the testimony it deems worthy of belief.  Farmers \nCo-op v. Biles, 77 Ark. App. 1, 69 S.W.3d 899 (2002).  The Full \nCommission reviews an administrative law judge’s opinion de novo, and it is \nthe duty of the Full Commission to conduct its own fact-finding independent \nof that done by an administrative law judge.  Crawford v. Pace Indus., 55 \n\nSMITH - H104308   10\n  \n \n \nArk. App. 60, 929 S.W.2d 727 (1996).  The Full Commission enters its own \nfindings in accordance with the preponderance of the evidence.  Tyson \nFoods, Inc. v. Watkins, 31 Ark. App. 230, 792 S.W.2d 348 (1990).         \n An administrative law judge found in the present matter, “3.  The \nclaimant failed to prove, by a preponderance of the evidence, that he \nsuffered a work-related injury by specific incident.”  The Full Commission \nfinds that the claimant sustained an idiopathic injury which was not related \nto the claimant’s employment and was not compensable. \n The claimant, a dentist by profession, testified that he became \nemployed with the respondents in October 2020.  The parties stipulated that \nthe employee-employer relationship existed on April 19, 2021.  The \nclaimant testified that he “fell and stumbled over some chairs” that day while \nwalking to a microwave in the respondent-employer’s breakroom.  The \nclaimant testified that he pulled himself up, sat in a chair, and eventually \nreturned to work.  The claimant testified on cross-examination that he had \nnot felt “lightheaded or dizzy” before falling in the breakroom.  The Full \nCommission finds that the claimant was not a credible witness.  Farmers \nCo-op, supra.  The Patient Care Report from Pafford Medical Services, \ndated April 19, 2021, indicated that the claimant indeed “felt dizzy and \nlightheaded” before falling in the breakroom that morning.  Dr. Audibert, an \nexamining physician, corroborated the report from Pafford Medical \n\nSMITH - H104308   11\n  \n \n \nServices.  Dr. Audibert reported on April 19, 2021 that the claimant “stood \nup & felt dizzy and lightheaded, then fell to the floor.”  An x-ray on April 19, \n2021 showed “no significant findings” in the claimant’s lumbar spine.   \n The record shows that the claimant sustained an idiopathic injury on \nApril 19, 2021 which was not related to the claimant’s employment and was \nnot compensable.  The probative medical evidence demonstrates that the \nclaimant became “dizzy and lightheaded,” a personal condition which led to \nthe claimant’s fall in the respondents’ breakroom.  The Full Commission \nfinds that Jim Cavanaugh, a claims adjuster with the respondent-carrier, \nwas a credible witness whose testimony was corroborated by the record.  \nJim Cavanaugh testified that the claimant informed him “he fainted or lost \nconsciousness in the breakroom.”  Mr. Cavanaugh agreed that the claimant \ndid not report a “trip over a chair or a table or any other object” in the \nbreakroom.  There is no probative evidence demonstrating that any \nconditions related to the claimant’s employment contributed to the risk of \nfalling, which fall was caused by an idiopathic event.  The record does not \ncorroborate the claimant’s testimony that he tripped over a chair, and the \nrecord does not show that the claimant was working on a height, near \nmachinery or sharp corners, or in a moving vehicle.  Pack, supra. \n After reviewing the entire record de novo, the Full Commission \naffirms the administrative law judge’s finding that the claimant did not prove \n\nSMITH - H104308   12\n  \n \n \nby a preponderance of the evidence that he sustained a compensable \ninjury.  The evidence demonstrates that the claimant sustained an \nidiopathic injury on April 19, 2021 which was not related to the claimant’s \nemployment and was not compensable.  The claimant did not prove that he \nwas entitled to any medical treatment of record or temporary total disability \nbenefits.  This claim is respectfully denied and dismissed. \n IT IS SO ORDERED. \n \n    ___________________________________ \n    SCOTTY DALE DOUTHIT, Chairman \n \n    ___________________________________ \n    M. SCOTT WILLHITE, Commissioner \n \n    ___________________________________ \n    MICHAEL R. MAYTON, Commissioner","preview":"BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION CLAIM NO. H104308 KEITH W. SMITH, EMPLOYEE CLAIMANT ROCK DENTAL ARKANSAS, PLLC, EMPLOYER RESPONDENT CINCINNATI CASUALTY COMPANY, INSURANCE CARRIER/TPA RESPONDENT OPINION FILED MARCH 7, 2024","fetched_at":"2026-05-19T22:29:45.869Z","links":{"html":"/opinions/full_commission-H104308-2024-03-07","pdf":"https://labor.arkansas.gov/wp-content/uploads/Smith_Keith_H104308_20240307.pdf","source_publisher":"https://labor.arkansas.gov/workers-comp/awcc-opinions/full-commission-opinions/"}}