{"id":"full_commission-H104834-2025-04-22","awcc_number":"H104834","decision_date":"2025-04-22","opinion_type":"full_commission","claimant_name":"Kelli Hellums","employer_name":"Area Agency On Aging Western Arkansas","title":"HELLUMS VS. AREA AGENCY ON AGING WESTERN ARKANSAS AWCC# H104834 April 22, 2025","outcome":"dismissed","outcome_keywords":["dismissed:2","granted:1","denied:1"],"injury_keywords":["back","lumbar","fracture","thoracic","strain"],"pdf_url":"https://www.labor.arkansas.gov/wp-content/uploads/Hellums_Kelli_H104834_20250422.pdf","source_index_url":"https://labor.arkansas.gov/workers-comp/awcc-opinions/full-commission-opinions/","filename":"Hellums_Kelli_H104834_20250422.pdf","text_length":23137,"full_text":"BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION \n \n \nCLAIM NO.  H104834 \n \nKELLI S. HELLUMS, \nEMPLOYEE \n \nCLAIMANT \nAREA AGENCY ON AGING WESTERN \nARKANSAS, EMPLOYER \n \nRESPONDENT \nRISK MANAGEMENT RESOURCES, \nINSURANCE CARRIER/TPA \nRESPONDENT \n  \n      \nOPINION FILED APRIL 22, 2025 \n \nUpon review before the FULL COMMISSION in Little Rock, Pulaski County, \nArkansas. \n \nClaimant represented by the HONORABLE MATTHEW J. KETCHAM, \nAttorney at Law, Fort Smith, Arkansas. \n \nRespondents represented by the HONORABLE MELISSA WOOD, Attorney \nat Law, Little Rock, Arkansas. \n \nDecision of Administrative Law Judge:  Affirmed as Modified. \n \n \n OPINION AND ORDER \nThe respondents appeal an administrative law judge’s opinion filed \nNovember 21, 2024.  The administrative law judge found that the claimant \nproved she was entitled to additional medical treatment.  After reviewing the \nentire record de novo, the Full Commission finds that the claimant proved \nadditional medical treatment provided by Dr. Roman was reasonably \nnecessary in accordance with Ark. Code Ann. §11-9-508(a)(Supp. 2024).   \nI. HISTORY \n Kelli Hellums, now age 63, testified that she was employed with the \nrespondents, Area Agency on Aging, on August 6, 2020.  The parties \n\nHELLUMS - H104834  2\n  \n \n \nstipulated that the employment relationship existed on August 6, 2020, on \nwhich date the claimant “sustained a compensable injury to her lower back.”  \nThe claimant testified on direct examination: \n  Q.  And what was your job with Area Agency? \n  A.  I was an in-home aide.... \n  Q.  Were you assigned to one particular patient? \n  A.  Yes, sir.... \n  Q.  What happened [on August 6, 2020]? \nA.  We got her a shower and she sits in her chair.  And I \nusually like kneel down, you know, to put her shoes and socks \nand stuff on.  And when I kneeled to put her shoe on, it just \nfelt like something on my left side just completely separated \nand I went straight down and was just stuck in a fetal \nposition.... \n \n The claimant received emergency treatment on August 6, 2020: \nPatient presents with complaint of low back pain and transient \nnumbness to her right leg.  She reports that she was bending \nover putting on her patient shoes when she felt something pop \nin her back and she felt like something was separating....She \ninitially had some numbness in her right leg but it has since \nresolved. \n \n A CT of the claimant’s lumbar spine was taken on August 6, 2020 \nwith the impression, “1.  No acute fracture or traumatic malalignment.  \nModerate degenerative change as described above.”  The claimant was \nprescribed medication and it was noted, “She will follow up with \nNeurosurgery next week.” \n The record indicates that the claimant began treating at Mercy Clinic \nOccupational Medicine-Fort Smith on August 10, 2020.  Dr. Ian T. Cheyne \nreported at that time:   \n\nHELLUMS - H104834  3\n  \n \n \nKelli’s primary problem is pain located in the lower thoracic \nregion.  She describes it as pressure, burning.  The problem \nbegan on 8/6/2020.  Kelli says that it seems to be constant.  \nShe has noticed that it is made worse by moving it.  Her pain \nlevel is 7.  Pain is in the left low back....She went to the ED on \n8/6.  CT showed degenerative changes.  She is currently on \nsteroid pack and muscle relaxer.... \nDue to the significant pain and need for walker to help with \nambulation, will set up for an MRI of the lumbar spine.  \nComplete steroid pack and switch to ibuprofen/tylenol \nafterwards.  Hot showers twice daily.   \n \n Dr. Cheyne diagnosed “1.  Strain of muscle, fascia and tendon of \nlower back[.]”       \n An MRI of the claimant’s lumbar spine was taken on August 19, 2020 \nwith the following impression: \nFacet hypertrophy L5-S1 with far right-sided disc protrusion \nbut no significant stenosis.   \nPosterior element hypertrophy L4-5 with spondylosis and \nposterior lateral small protrusions with mild canal and lateral \nrecess stenosis. \nPosterior element hypertrophy L3-4 with disc bulge versus \nprotrusion and mild canal and lateral recess narrowing. \nAnd central disc protrusion at L2-3 with mild left lateral recess \nnarrowing.  Other findings as noted.   \n \n The claimant followed up with Dr. Cheyne on August 24, 2020:  “Kelli \nwas assisting a client with putting on their shoes when she felt a pain in her \nlower back....Kelli’s primary problem is pain located in the lower thoracic \nregion.”  Dr. Cheyne diagnosed “1.  Strain of muscle, fascia and tendon of \nlower back[.]...Will refer to PT.” \n\nHELLUMS - H104834  4\n  \n \n \n The claimant testified that she underwent physical therapy for six \nweeks.  The claimant testified that physical therapy “didn’t help anything.  It \nmade it worse.”     \n Dr. Eugene Becker performed a Lumbar Epidural Steroid Injection on \nOctober 20, 2020.  The claimant testified that she benefitted from the \ninjection provided by Dr. Becker.     \n The claimant followed up with Dr. Cheyne on November 5, 2020:  \n“Kelli’s primary problem is pain located in the lower thoracic region....Kelli \nsays that it seems to be variable – depending on the activity level.  She \nfeels it is almost entirely resolved.  Her pain level is 3.  Additional History:  \npatient is s/p LESI x 1 and has had significant improvement in pain.  She \nstill notices some pain with certain movements but overall much \nimproved....Will place on regular duty but recommend she follow up with \npain management for another injection.”   \n Dr. Becker performed Lumbar Epidural Steroid Injections on \nNovember 17, 2020 and December 15, 2020.  The claimant testified that \nshe benefitted from Dr. Becker’s treatment.     \n The record indicates that the claimant was seen at OrthoArkansas \non February 8, 2021.  Payton Ransom, PA reported at that time:   \nMs. Hellums is a 59-year-old female presenting to clinic for \nWorker’s Comp. evaluation.  Her date of injury was August 6, \n2020.  She was bending down to put a shoe on an elderly \npatient that she takes care of when she noticed a sharp \n\nHELLUMS - H104834  5\n  \n \n \nstabbing/pulling sensation in her left lumbar spine.  This pain \ninitially was severe.  It localizes to the left lower lumbar \nspine....States that her daily pain scale is a 3-4 out of 10.   \nShe has undergone 3 epidural steroid injections by Dr. \nBecker.  She reports minimal relief with these.  Additionally \nshe has undergone physical therapy which exacerbated her \nsymptoms.  She also tried trials of muscle relaxers, anti-\ninflammatories, and steroid Dosepaks with minimal relief.  She \nis currently on light duty at work, working at a desk.... \nAP and lateral x-ray of the lumbar spine ordered, obtained, \nand interpreted today reveals Mild grade 1 anterolisthesis of \nL3-4.  Mild to moderate degenerative disc disease L3-4, L4-5, \nL5-S1.  Slight scoliotic curvature to the right of the lumbar \nspine.   \nCT lumbar spine reviewed from August 6, 2020 reveals facet \nhypertrophy at L5-S1, L4-5, and L3-4.  Mild grade 1 \nanterolisthesis of L3-4.   \nMRI lumbar spine reviewed from 8/19/2020 on disc today \nreveals Diffuse central posterior disc bulge at L2-3 with mild \ncentral stenosis.  Diffuse posterior disc bulge at L3-4 with mild \nto moderate central canal stenosis With facet hypertrophy.  \nDisc bulge and facet hypertrophy at L3-4 creating moderate \nbilateral subarticular recess stenosis, worse on the right.  Mild \nleft foraminal stenosis L5-S1 with bilateral facet \nhypertrophy.... \nI reviewed x-ray, MRI and CT with patient and Case manager \nin clinic today.  We discussed the multiple levels of \ndegeneration in the lumbar spine, particularly at L3-4.  Patient \ndoes have chronic, degenerative processes in the lumbar \nspine.  Additionally, patient’s pain is primarily axial, worse on \nthe left.  She does have multiple levels of facet hypertrophy.  \nShe has failed other conservative treatment such as physical \ntherapy and epidural steroid injections as well as muscle \nrelaxers.  I recommend a trial of facet injections/rhizotomies in \nhopes of alleviating symptoms.  At this point I do not \nrecommend surgical intervention.   \nThe patient’s MRI does not show fracture.  There are signs of \nspondylolisthesis At L3-4 which is pre-existing.  There are no \nobjective findings of acute injury.  However, the patient’s \nsymptoms began on and after the work injury.  The patient \nhas no history of pain in the low back or down the leg prior to \nthe work injury.  Therefore it is within a certain degree of \n\nHELLUMS - H104834  6\n  \n \n \nmedical certainty that at least 51% of the patient’s current \nsymptoms are directly related to their work injury.  Injury was \n[an] acute exacerbation of a chronic, degenerative process.   \nI am placing the patient on work restrictions of no bending, \ntwisting or lifting over 20 pounds.   \n \n Payton Ransom assessed “Degenerative disc disease, lumbar spine, \nwith facet hypertrophy, with axial back pain, worse on the left.  Mild grade 1 \ndegenerative spondylolisthesis, L3-4.  Muscle strain, lumbar spine.” \n Dr. Carlos Roman performed a procedure on February 12, 2021:  \n“Lumbar facet injections done, L3-L4, L4-L5, L5-S1 with medial branch \nblock.”  The pre-and post-operative diagnosis was “1.  Lumbar spondylosis.  \n2.  Severe low back pain.  3.  Lumbar degenerative disc disease.  4.  \nLumbar listhesis, L3-L4.”  Dr. Roman advised the claimant, “Followup in two \nto three weeks for medial branch blocks for possible rhizotomy if the pain in \nher back persists.” \n Dr. Roman performed a procedure on February 26, 2021:  “Left-\nsided medial branch blocks at lumbar facets at L3-L4, L4-L5, and L5-\nS1....Follow up in two weeks for rhizotomy.”   \n Dr. Roman performed a procedure on March 19, 2021:  “Rhizotomy \nof lumbar facet joints left side at L3-L4, L4-L5, and L5-S1.”   \n The claimant testified that she did not benefit from treatment \nprovided by Dr. Roman.   \n Payton Ransom noted on April 21, 2021: \n\nHELLUMS - H104834  7\n  \n \n \nMs. Hellums is a 59-year-old female presenting to clinic for \nWorker’s Comp. evaluation....Her date of injury was August 6, \n2020.  She was bending down to put a shoe on an elderly \npatient that she takes care of when she noticed a sharp \nstabbing/pulling sensation in her left lumbar spine.... \nShe has undergone 3 epidural steroid injections by Dr. \nBecker.  She reports minimal relief with these.  Additionally \nshe has undergone physical therapy which exacerbated her \nsymptoms.  She also tried trials of muscle relaxers, anti-\ninflammatories, and steroid Dosepaks with minimal relief.  She \nis currently on light duty, working at a desk. \nShe is here today for follow-up after L3 S1 rhizotomies by Dr. \nRoman.  She states that her pain was good with both the facet \nblocks but she has had some increased pain after the actual \nrhizotomy.  Still complaining of the same pain.... \nThe patient states they are unable to return back to work due \nto their pain.  My recommendation is for a functional capacity \nexam.  If the patient has a valid functional capacity exam, then \nthey may return back to work per the defined restrictions of \nthat the valid functional capacity exam.  If the functional \ncapacity exam is invalid, the patient may return back to work \nfull duty without restrictions.... \nThere is no need for the patient to follow up after this \nfunctional capacity exam.... \nThe patient is at maximum medical improvement.   \nThe patient’s work restrictions are to return back to work full \nduty without restrictions.   \nThe patient’s impairment rating will be a 0% as taken out of \npage 113 of the “Guides to the Evaluation of Permanent \nImpairment, Fourth Edition.”  This is for a grade 1 \ndegenerative spondylolisthesis, not operated on.   \nI am releasing the patient from my medical care. \nI will see the patient back only as needed.   \n \n Payton Ransom’s assessment on April 21, 2021 was “Mild grade 1 \ndegenerative spondylolisthesis, L3-4, with mild central stenosis and facet \nhypertrophy, with axial back pain, worse on the left.  Muscle strain, lumbar \nspine.  Degenerative disc disease, lumbar spine.”    \n\nHELLUMS - H104834  8\n  \n \n \n The claimant participated in a Functional Capacity Evaluation on \nMay 10, 2021:  “The results of this evaluation indicate that a reliable effort \nwas put forth, with 50 of 50 consistency measures within expected \nlimits....Ms. Hellums completed functional testing on this date with reliable \nresults.  Overall, Ms. Hellums demonstrated the ability to perform work in \nthe LIGHT classification of work[.]”          \n The claimant testified that the respondents terminated her \nemployment following the Functional Capacity Evaluation.   \n A pre-hearing order was filed on August 22, 2024.  According to the \ntext of the pre-hearing order, the claimant contended, “She received a \ncompensable injury to her low back on August 6, 2020 when she was \nhelping a patient get dressed and felt a sharp shooting pain in her low back.  \nThe claimant followed up with Dr. Ian Cheyne at Mercy Clinic Occupational \nMedicine for continued low back pain.  The claimant was referred for pain \nmanagement and lumbar injections.  On August 19, 2020 the claimant \nreceived an MRI of her lumbar spine and referred for additional pain \nmanagement.  The claimant was treated and evaluated at Ortho Arkansas \nfor her continued low back pain.”   \n The respondents contended, “All appropriate benefits were paid with \nregard to claimant’s injury sustained on August 6, 2020.  She was found to \nbe at maximum medical improvement with a 0% rating assigned on April \n\nHELLUMS - H104834  9\n  \n \n \n21, 2021.  The medical records do not support entitlement to indemnity \nbenefits, and additional medical treatment is not reasonable and \nnecessary.”   \n The parties agreed to litigate the following issue:  “1.  Whether \nclaimant is entitled to additional medical benefits.  All other issues are \nreserved by the parties.”   \n A hearing was held on October 14, 2024.  The claimant testified that \nshe had received injections from Dr. Roman the previous Friday.  The \nclaimant testified that she felt “better than I have in two years.”     \n An administrative law judge filed an opinion on November 21, 2024.  \nThe administrative law judge found, “2.  Claimant has met her burden of \nproving that she is entitled to additional medical treatment for her \ncompensable back injury of August 20, 2020.”  The respondents appeal to \nthe Full Commission.   \nII.  ADJUDICATION \n The 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)(Supp. \n2024).  The 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 (2005).  Preponderance \n\nHELLUMS - H104834  10\n  \n \n \nof the evidence means the evidence having greater weight or convincing \nforce.  Metropolitan Nat’l Bank v. La Sher Oil Co., 81 Ark. App. 269, 101 \nS.W.3d 252 (2003).  What constitutes reasonably necessary medical \ntreatment is a question of fact for the Commission.  Wright Contracting Co. \nv. Randall, 12 Ark. App. 358, 676 S.W.2d 70 (1984).  \n An administrative law judge found in the present matter, “2.  \nClaimant has met her burden of proving that she is entitled to additional \nmedical treatment for her compensable back injury of August 20, 2020.”  \nThe Full Commission finds that the claimant proved additional treatment \nwith Dr. Roman was reasonably necessary in connection with her \ncompensable injury. \nThe parties stipulated that the claimant sustained a compensable \ninjury on August 6, 2020.  The claimant testified that she felt a “separation” \nin her back while bending over to assist a home health patient.  Dr. Cheyne \nsubsequently diagnosed a “strain of muscle” in the claimant’s lower back.  A \nCT and MRI showed degenerative abnormalities in the claimant’s lumbar \nspine, but no physician of record has recommended surgical treatment.  \nThe claimant did not benefit from physical therapy after lumbar epidural \nsteroid injections performed by Dr. Becker.   \nPayton Ransom, PA examined the claimant at OrthoArkansas on \nFebruary 8, 2021 and assessed the following:  “Degenerative disc disease, \n\nHELLUMS - H104834  11\n  \n \n \nlumbar spine, with facet hypertrophy, with axial back pain, worse on the left.  \nMild grade 1 degenerative spondylolisthesis, L3-4.  Muscle strain, lumbar \nspine.”  Dr. Roman initiated a series of branch blocks and eventually a \nrhizotomy, but the claimant testified that she initially received no \nimprovement following Dr. Roman’s treatment.     \n Payton Ransom opined on April 21, 2021 that the claimant had \nreached Maximum Medical Improvement.  Payton Ransom noted, “I am \nreleasing the patient from my medical care.  I will see the patient back only \nas needed.”  The claimant put forth a valid effort during a Functional \nCapacity Evaluation performed on May 21, 2021.   \nThe probative evidence before the Full Commission demonstrates \nthat the claimant reached Maximum Medical Improvement no later than \nApril 21, 2021, the date Maximum Medical Improvement was assessed by \nPayton Ransom.  We find that Payton Ransom’s assessment of Maximum \nMedical Improvement was corroborated by the record and was entitled to \nsignificant evidentiary weight.  See Minnesota Mining & Mfg. v. Baker, 337 \nArk. 94, 989 S.W.2d 151 (1999).  However, it is well-settled that a claimant \nmay be entitled to ongoing medical treatment after the healing period has \nended, if the medical treatment is geared toward management of the \nclaimant’s injury.  Patchell v. Wal-Mart Stores, Inc., 86 Ark. App. 230, 184 \nS.W.3d 31 (2004).  As we have discussed, the claimant testified that she \n\nHELLUMS - H104834  12\n  \n \n \nreceived an injection from Dr. Roman on or about October 11, 2024.  The \nclaimant testified that afterward she felt “better than I have in two years.”  \nThe Full Commission finds that the claimant proved that additional \nconservative treatment provided by Dr. Roman was reasonably necessary \nin connection with the compensable injury sustained by the claimant on \nAugust 6, 2020. \nAfter a de novo review of the entire record currently before us, the \nFull Commission finds that the claimant proved she was entitled to \nadditional medical treatment as recommended by Dr. Roman.  The claimant \nproved that said treatment was reasonably necessary in accordance with \nArk. Code Ann. §11-9-508(a)(Supp. 2024).  For prevailing on appeal to the \nFull Commission, the claimant’s attorney is entitled to a fee of five hundred \ndollars ($500), pursuant to Ark. Code Ann. §11-9-715(b)(Supp. 2024). \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 \n \n \n \n \n \n\nHELLUMS - H104834  13\n  \n \n \nDISSENTING OPINION \n \n I must respectfully dissent from the majority’s opinion finding the \nclaimant met her burden of proving she is entitled to additional medical \ntreatment. \nThe claimant sustained an injury to her lower back while working for \nthe respondent employer on August 6, 2020.  After eight months of \nconservative treatment, the claimant was released at maximum medical \nimprovement with no permanent impairment.  \nOver four years later, after the accident in question, the claimant \nsought additional treatment in the form of injections recommended by Dr. \nCarlos Roman.  An administrative law judge ruled the claimant met her \nburden of proving she is entitled to additional medical treatment, and the \nrespondents appeal. \nArk. Code Ann. § 11-9-508(a) requires an employer to provide an \nemployee with medical and surgical treatment \"as may be reasonably \nnecessary in connection with the injury received by the employee.\"  The \nclaimant has the burden of proving by a preponderance of the evidence the \nadditional treatment is reasonable and necessary.  Nichols v. Omaha Sch. \nDist., 2010 Ark. App. 194, 374 S.W.3d 148 (2010). \nWhat constitutes reasonably necessary treatment is a question of \nfact for the Commission.  Gant v. First Step, Inc., 2023 Ark. App. 393, 675 \n\nHELLUMS - H104834  14\n  \n \n \nS.W.3d 445 (2023).  In assessing whether a given medical procedure is \nreasonably necessary for treatment of the compensable injury, the \nCommission analyzes both the proposed procedure and the condition it \nsought to remedy.  Walker v. United Cerebral Palsy of Ark., 2013 Ark. App. \n153, 426 S.W.3d 539 (2013).  \nIn workers’ compensation cases, a decision often rests solely on the \ncredibility of the claimant as a witness.  A determination of the weight and \ncredibility of a witness' testimony is exclusively within the province of the \nCommission.  Wade v. Mr. C. Cavenaugh's, 298 Ark. 363, 768 S.W.2d 521 \n(1989).  \nThe Commission has the right to believe or disbelieve the testimony \nof any witness, and the Commission's decision is entitled to the weight we \ngive a jury verdict.  Tyson Foods, Inc. v. Disheroon, 26 Ark. App. 145, 761 \nS.W.2d 617 (1988). \nAfter her injury on August 6, 2020, Dr. Ian Cheyne prescribed \nphysical therapy and muscle relaxers.  The claimant was ultimately referred \nto Dr. Eugene Becker who performed three lumbar epidural steroid \ninjections. The claimant reported on November 5, 2020, that her pain had \nalmost entirely resolved.  \nWhen the claimant reported ongoing pain on January 20, 2021, Dr. \nCheyne referred the claimant for facet injections, which were performed by \n\nHELLUMS - H104834  15\n  \n \n \nDr. Carlos Roman on February 12, 2021.  Ultimately, Dr. Roman performed \na rhizotomy in February of 2021, which the claimant testified did not work at \nall.   \nThe claimant was released at maximum medical improvement (MMI) \nwith no impairment rating on April 21, 2021.  At that time, PA Payton \nRansom opined: \nPatient does have chronic, degenerative \nprocesses in the lumbar spine.  Additionally, \npatient’s pain is primarily axial, worse on the \nleft.  She does have multiple levels of facet \nhypertrophy. She has failed all other \nconservative treatment such as physical \ntherapy and epidural steroid injections.  She \nrecently failed rhizotomies. \n \n The claimant was released at maximum medical improvement with \nno impairment rating and waited three and a half years until after a motion \nto dismiss was filed by the respondents to seek additional medical \ntreatment.  \nThe additional treatment recommended by Dr. Roman has failed to \naddress the claimant’s ongoing complaints during her initial treatment, and \nthere is no evidence that it would be any different today, nor has the \nclaimant diligently sought this treatment prior to a motion to dismiss being \nfiled. \n\nHELLUMS - H104834  16\n  \n \n \n The claimant has wholly failed to meet her burden of proving that the \ntreatment she seeks is necessary, reasonable, or causally related to her \nwork-related injury. \nAccordingly, for the reasons set forth above, I must dissent. \n \n    ___________________________________ \n    MICHAEL R. MAYTON, Commissioner","preview":"BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION CLAIM NO. H104834 KELLI S. HELLUMS, EMPLOYEE CLAIMANT AREA AGENCY ON AGING WESTERN ARKANSAS, EMPLOYER RESPONDENT RISK MANAGEMENT RESOURCES, INSURANCE CARRIER/TPA RESPONDENT OPINION FILED APRIL 22, 2025","fetched_at":"2026-05-19T22:29:44.436Z","links":{"html":"/opinions/full_commission-H104834-2025-04-22","pdf":"https://www.labor.arkansas.gov/wp-content/uploads/Hellums_Kelli_H104834_20250422.pdf","source_publisher":"https://labor.arkansas.gov/workers-comp/awcc-opinions/full-commission-opinions/"}}