{"id":"full_commission-H108811-2024-12-16","awcc_number":"H108811","decision_date":"2024-12-16","opinion_type":"full_commission","claimant_name":"Julie Revels","employer_name":"Magnet Cove Elementary School","title":"REVELS VS. MAGNET COVE ELEMENTARY SCHOOL AWCC# H108811 December 16, 2024","outcome":"unknown","outcome_keywords":[],"injury_keywords":["shoulder","fracture","rotator cuff","wrist","back"],"pdf_url":"https://www.labor.arkansas.gov/wp-content/uploads/Revels_Julie_H108811_20241216.pdf","source_index_url":"https://labor.arkansas.gov/workers-comp/awcc-opinions/full-commission-opinions/","filename":"Revels_Julie_H108811_20241216.pdf","text_length":34585,"full_text":"BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION \n \n \nCLAIM NO.  H108811 \n \nJULIE REVELS, \nEMPLOYEE \n \nCLAIMANT \nMAGNET COVE ELEMENTARY SCHOOL,  \nEMPLOYER \n \nRESPONDENT \nARKANSAS SCHOOL BOARDS ASSOCIATION \nWORKERS’ COMPENSATION TRUST, \nINSURANCE CARRIER/TPA \nRESPONDENT \n  \n      \nOPINION FILED DECEMBER 16, 2024  \n \nUpon review before the FULL COMMISSION in Little Rock, Pulaski County, \nArkansas. \n \nClaimant represented by the HONORABLE GARY DAVIS, Attorney at Law, \nLittle Rock, Arkansas. \n \nRespondents represented by the HONORABLE MELISSA WOOD, Attorney \nat Law, Little Rock, Arkansas. \n \nDecision of Administrative Law Judge:  Affirmed. \n \n \n OPINION AND ORDER \nThe respondents appeal an administrative law judge’s opinion filed \nJuly 16, 2024.  The administrative law judge found that the claimant proved \nshe sustained an 11% permanent anatomical impairment rating.  After \nreviewing the entire record de novo, the Full Commission finds that the \nclaimant proved she sustained permanent anatomical impairment in the \namount of 11%.   \nI. HISTORY \n Julie Ann Revels, now age 58, testified that she had been employed \nwith the respondents, Magnet Cove School District, for 21 years.  The \n\nREVELS - H108811  2\n  \n \n \nparties stipulated that the employment relationship existed at all pertinent \ntimes, including September 21, 2021.  The claimant testified that she \nslipped in a “water bottle spill” and that she “fell completely on my \nshoulder.”  The parties stipulated that the claimant “sustained an admittedly \ncompensable injury to her right shoulder” on September 21, 2021. \n An MRI of the claimant’s right shoulder was taken on September 23, \n2021 with the following impression: \n1. Large full-thickness tears of the supra and infraspinatus as \ndetailed above.   \n2. There is tendinosis and tenosynovitis of the long head \nbiceps tendon with intact anchor.   \n3. There is no grossly detached labral tear on this \nconventional exam. \n4. Focal bone bruise/contusion involving the greater tubercle \nwithout acute displaced fracture or cortical depression.  \nHumeral head remains well aligned across the glenoid \nfossa. \n5. There is mild active osteoarthritis across the AC joint \nwithout diastases.   \n \n Dr. Christopher M. Young noted on October 7, 2021:  “Julie Revels is \nhere for complaints of right 8/10 shoulder pain that has been going on since \n09/21/2021.  This is a work comp injury that happened while walking into \nthe classroom and slipping and falling landing on her right arm....MRI done \nprior to appointment shows right full thickness rotator cuff tear....After \ndiscussion, due to her increasing pain and weakness, we plan to proceed \nwith right shoulder open rotator cuff repair.  With this being [an] acute injury \n\nREVELS - H108811  3\n  \n \n \nand having a full thickness rotator cuff tear it is best to get this fixed in a \ntimely manner.” \n Dr. Young performed surgery on October 29, 2021:  “Diagnostic right \nshoulder arthroscopy with open Right rotator cuff repair.”  The pre- and \npost-operative diagnosis was “Rotator cuff tear right shoulder, documented \nwith MRI and unresponsive to conservative care.”   \n The claimant was provided treatment at Malvern Physical Therapy \nfollowing surgery, and she was discharged from Malvern Physical Therapy \non October 25, 2022.   \n The claimant participated in a Functional Capacity Evaluation on \nDecember 21, 2022:  “The results of this evaluation indicate that a reliable \neffort was put forth, with 50 of 50 consistency measures within expected \nlimits....Ms. Revels completed functional testing on this date with reliable \nresults.  Overall, Ms. Revels demonstrated the ability to perform work in the \nLIGHT classification of work[.]”   \n Casey Garretson, Occupational Therapist, Functional Testing \nCenters, Inc., provided an “IMPAIRMENT EVALUATION SUMMARY – \nUpper Extremity” on December 21, 2022: \nMs. Revels reports injury at work when she slipped and fell on \nwet floor, and she landed on her right shoulder resulting in the \nimmediate onset of right shoulder pain.... \nThere is no noted atrophy of the Right shoulder girdle.  There \nis no popeye deformity or other abnormalities in the muscle \nbulk or any asymmetrical bony defects observed of the Right \n\nREVELS - H108811  4\n  \n \n \nbicep or shoulder region.  Sensation was intact and normal \nthroughout the Right upper extremity.  The Contralateral UE \nhad full motion.  Right elbow and wrist PROM was within \nnormal limits.  Passive ROM values did mildly exceed AROM \nmeasurement values.  The patients’ pain was not taken into \naccount to determine this Impairment Rating.  No other \nratable finding was found related to the Right UE.   \n \n Casey Garretson assigned the rating, “Right Upper Extremity:  9% \nUpper Extremity Impairment 5% Whole Person Impairment (Table 3).”      \n Dr. Young noted on March 2, 2023: \nThe patient is here for evaluation of right shoulder.  She \nunderwent FCE for evaluation after her injury to determine \nwhat she was capable of doing and what her disability rating \nwas.  I calculated all of her FCE numbers with the occasional \nbimanual lifting up to 30 pounds, the unilateral lifting \nmaximum right upper extremity of 10 pounds.  She also had \ndemonstrated functional limited reaching of 5 pounds.  She \ncan only occasionally lift at the level of normal work day.  She \nwas unable to reach overhead.  Based on these figures, I was \nable to come up with an 18% upper extremity disability rating \nand an 11% whole person disability rating based on the \nguides to evaluation of permanent impairment of volume 4\nth\n \naddition (sic). \n \n The parties stipulated that “the claimant’s authorized physician \nassigned her a permanent anatomical impairment rating of 11% to the body \nas a whole.” \n Dr. Young reported on May 30, 2023: \nJulie A. Revels is here for a postoperative visit about 18 \nmonths out from a right rotator cuff repair.  Patient still has \nsome pain in her right shoulder.  Her ROM is still limited and \nstill cannot lift anything over her head.  She is limited with how \nmuch weight she can pick up with this arm, and there are \n\nREVELS - H108811  5\n  \n \n \nsome struggles she has at work being able to do her job \nproperly.... \nPatient is at MMI.  She underwent FCE for evaluation after her \ninjury to determine what she was capable of doing and what \nher disability rating was.  I calculated all of her FCE numbers \nwith the occasional bimanual lifting up to 30 pounds, the \nunilateral lifting maximum right upper extremity of 10 pounds.  \nShe also had demonstrated functional limited reaching of 5 \npounds.  She can only occasionally lift at the level of normal \nwork day.  She was unable to reach overhead.  Based on \nthese figures, I was able to come up with an 18% upper \nextremity disability rating and an 11% whole person disability \nrating based on the guides to evaluation of permanent \nimpairment 4\nth\n addition (sic).  At this time I will discharge her \nfrom my care.  She will follow up as needed.   \n \n Dr. Young noted in part on September 5, 2023: \nThe patient is here for followup from the functional testing \ncenter from Mountain Home, Arkansas for impairment rating \non her right shoulder.  They ended up with a different rating \n[than] I ended up with as a final impairment rating for the \nwhole body.  The patient reports that they didn’t measure \nanything or do any exercises pertaining to reaching overhead \nwhich is where her problem lies.... \nI do not have any reason to change my 11% whole person \nimpairment rating.  I am not going to go back and recalculate \nmy number because I standby (sic) the first number that I did.  \nI am not sure how they ended up at 5%.  I however ended up \nat 11% and I still support that.   \nIMPRESSION:  Right rotator cuff tear with now permanent \ndisability.  I calculated her permanent whole body disability \n11% according to the guides to partial permanent impairment, \nfourth edition.   \n \n Rick Byrd, “Certified Senior Disability Analyst” with Functional \nTesting Centers, Inc., provided an Impairment Rating Review on September \n14, 2023 and stated in part: \n\nREVELS - H108811  6\n  \n \n \nOn 05-30-2023, Dr. Young assigned Ms. Revels an 18% right \nUpper Extremity Impairment which is a (sic) 11% Whole \nPerson Impairment based on, “I calculated all of her FCE \nnumbers with the Occasional bimanual lifting up to 30 pounds, \nthe unilateral lifting maximum right upper extremity of 10 \npounds.  She also had demonstrated functional limited \nreaching of 5 pounds.  She can only occasionally lift at the \nlevel of normal workday.  She was unable to reach overhead.  \nBased on these figures, I was able to come up with an 18% \nupper Extremity disability rating and an 11% whole person \ndisability rating based on the guides to the evaluation of \npermanent impairment of volume 4\nth\n addition”. \n \nWith the above impairment, there is nothing in the 4\nth\n Edition \nGuides that allows for impairment based on pounds lifted or \nlimitations with functionally reaching overhead or with weight.  \nI can find not correlate (sic) the above rating with any table of \nthe Guides and obviously no table was listed to support Dr. \nYoung’s impairment rating of Ms. Revels.   \n \nAn Impairment rating was completed by Functional Testing \nCenters on 12-21-2022 using objectively measured PROM \nthat is outside the control of the patient with a finding of:  9% \nRight Upper Extremity Impairment, which is a 5% Whole \nPerson Impairment.  I do believe that this rating is the most \naccurate and objective rating as it is based off the 4\nth\n Edition \nGuides.   \n \n The parties stipulated that “the respondents have accepted and paid, \nor are in the process of paying, a permanent anatomical impairment rating \nof 5%.” \n The respondents’ attorney examined Rick Byrd at hearing: \nQ.  What did you do in order to evaluate the two different \nratings that are involved in this case?  We’ve got a 5% and an \n11%.   \nA.  So I went to the guides – 4\nth\n Edition Guides, and Dr. \nYoung had – and I quoted him in this letter where he said he’d \ncalculated it all from FCE numbers with occasional lifting of 30 \n\nREVELS - H108811  7\n  \n \n \npounds and 10 pounds with the right hand.  And then he said \n[as read], “Based on these figures, I calculated an 18% upper \nextremity impairment and an 11% whole person disability \nrating.”  And then he said, “... based on the guides.”  And I am \nvery familiar with the guides and there is nowhere in the \nguides where it allows for lifting to correlate with an \nimpairment.... \nQ.  So the 12-21 evaluation that was done, you reviewed in \ndetail the measurements and all of the activities that Mr. \nGarretson had Ms. Revels perform? \nA.  I did.  I went back and just made sure that the guides – \nthat the ratings, the individual numbers that were assessed \nwere the appropriate numbers for, like, flexion loss, extension \nloss, abduction loss, and it – and it did indeed add up to 9% of \nthe right upper extremity, which then using Table 3 is a 5% \nimpairment.... \n \n The claimant’s attorney cross-examined Rick Byrd: \n  Q.  Rick, you’re not a medical doctor. \n  A.  No, sir.... \n  Q.  Casey’s not a medical doctor. \n  A.  No, sir.   \nQ.  So we’re talking about the difference of opinion between \nthe orthopedic surgeon and your company, right? \nA.  I think we’re talking about the difference in the guides – in \ninterpretation of the guides and actually utilizing the guides, as \nopposed to a medical and a non-medical situation. \nQ.  And its interpretation of the guides, as you say, because \nDr. [Young] did, in fact, indicate that he relied upon the 4\nth\n \nEdition of the guides, right? \nA.  He did.   \n \n A pre-hearing order was filed on March 7, 2024.  According to the \ntext of the pre-hearing order, the claimant contended, “The claimant \ncontends she sustained admittedly compensable injuries to her right \nshoulder.  She contends her authorized, principal treating physician \nassigned her a permanent anatomical impairment rating of 11% BAW, and \n\nREVELS - H108811  8\n  \n \n \nshe is entitled to PPD benefits based on this 11% BAW rating.  She \ncontends the respondents have accepted and will pay only a 5% BAW \npermanent anatomical impairment rating.  The claimant contends the \nrespondents have controverted payment of PPD benefits commensurate \nwith the difference between the 11% BAW rating and the 5% BAW rating, \nwhich is 6% BAW and, therefore, her attorney is entitled to a controverted \nfee based on this amount (6% BAW).  Finally, the claimant’s attorney \nrespectfully requests the Commission order the respondents to deduct any \nattorney’s fees the claimant owes based on controverted benefits she may \nreceive by award or otherwise, and to pay his attorney’s fees by separate \ncheck payable directly to him.” \n The parties stipulated, “The respondents controvert only the \ndifference between the 11% BAW and five 5% BAW impairment ratings, \nwhich totals six percent 6% BAW.”  The respondents contended, “The \nrespondents contend they have accepted and paid all appropriate benefits \nrelated to the claimant’s September 21, 2021, compensable shoulder injury.  \nThe respondents contend they have accepted a 5% BAW permanent \nanatomical impairment rating, and that this 5% BAW rating is supported by \nthe AMA Guides, while the 11% rating is not supported by the AMA Guides.  \nThe respondents reserve the right to supplement their contentions and to \nassert any and all other applicable defenses and arguments upon the \n\nREVELS - H108811  9\n  \n \n \ncompletion of necessary investigation and discovery.  The respondents \nreserve any and all other issues for future determination and/or litigation.”   \n The parties agreed to litigate the following issues: \n1. Whether the claimant is entitled to PPD benefits \ncommensurate with the eleven percent 11% BAW, or the \nfive percent 5% BAW permanent anatomical impairment \nrating pursuant to the applicable American Medical \nAssociation Guides to the Evaluation of Permanent \nImpairment (AMA, 4\nth\n Edition 1993 (the AMA Guides). \n2. Whether and to what extent the claimant’s attorney is \nentitled to a controverted fee on these facts. \n3. The parties specifically reserve any and all other issues for \nfuture determination and/or litigation.   \n \n  A hearing was held on April 17, 2024.  The respondents’ attorney \nexamined Casey Garretson: \nQ.  It looks like you evaluated [the claimant] on December 21\nst\n \nof ’22.  Does that sound correct? \nA.  It sounds correct.... \nQ.  What measurements are done for a shoulder rating? \nA.  For an impairment rating? \nQ.  For an impairment rating, yes.   \nA.  We would take passive range of motion measurements.  \nSo the book has the guides on which measurements to do, so \neven in our report – in our impairment rating report we even \nhave pictures of exactly how we would take those \nmeasurements, so we’d have the person do forward flexion of \ntheir shoulder, and then we’d have them do extension, we’d  \nhave them do abduction, adduction, internal rotation, and \nexternal rotation.... \nQ.  When you say the book, just to clarify that is the AMA \nGuides 4\nth\n Edition? \nA.  Correct.  Yes.... \nQ.  Did you need to have her lift anything overhead to affect \nher rating in any way? \nA.  No.... \nQ.  You rely completely on passive measurements? \n\nREVELS - H108811  10\n  \n \n \nA.  Correct.  In her case there was no other ratable findings \nother than the passive range of motion.... \nQ.  You have issued a 5% rating associated with her shoulder \ninjury.  Is that right? \nA.  Correct.   \nQ.  Tell the judge, if you will, why you think that is the accurate \nrating. \nA.  I think you can look off kinda Rick’s response and, you \nknow, I would’ve said the exact same thing.  I would’ve said, \nyou know, we did that rating, the only objective measurements \nthat we were able to find were those passive range of motion \nmeasurements.... \nQ.  In your review of the records and the measurements \ntaken, is there anything that you have seen to support 11% \nbeing associated with this injury? \nA.  No.   \n \n The claimant’s attorney cross-examined Casey Garretson: \nQ.  You don’t have any information to the effect that Dr. \nYoung used active range of motion in order to determine his \nimpairment, correct? \nA.  Correct.   \n \n An administrative law judge filed an opinion on July 16, 2024.  The \nadministrative law judge found, among other things, that the claimant \nproved she was entitled to 11% permanent anatomical impairment.  The \nrespondents appeal to the Full Commission. \nII.  ADJUDICATION \n Permanent impairment is any functional or anatomical loss remaining \nafter the healing period has been reached.  Johnson v. Gen. Dynamics, 46 \nArk. App. 188, 878 S.W.2d 411 (1994).  The Commission has adopted the \nAmerican Medical Association Guides to the Evaluation of Permanent \n\nREVELS - H108811  11\n  \n \n \nImpairment (4\nth\n ed. 1993) to be used in assessing anatomical impairment.  \nSee Commission Rule 34; Ark. Code Ann. §11-9-522(g)(Repl. 2012).  It is \nthe Commission’s duty, using the Guides, to determine whether the \nclaimant has proved she is entitled to a permanent anatomical impairment.  \nPolk County v. Jones, 74 Ark. App. 159, 47 S.W.3d 904 (2001).   \n Any determination of the existence or extent of physical impairment \nshall be supported by objective and measurable physical findings.  Ark. \nCode Ann. §11-9-704(c)(1)(B)(Repl. 2012).  Objective findings are those \nfindings which cannot come under the voluntary control of the patient.  Ark. \nCode Ann. §11-9-102(16)(A)(i)(Repl. 2012).  Although it is true that the \nlegislature has required medical evidence supported by objective findings to \nestablish a compensable injury, it does not follow that such evidence is \nrequired to establish each and every element of compensability.  Stephens \nTruck Lines v. Millican, 58 Ark. App. 275, 950 S.W.2d 472 (1997).  All that \nis required is that the medical evidence be supported by objective findings.  \nSingleton v. City of Pine Bluff, 97 Ark. App. 59, 244 S.W.3d 709 (2006).  \nMedical opinions addressing impairment must be stated within a reasonable \ndegree of medical certainty.  Ark. Code Ann. §11-9-102(16)(B)(Repl. 2012).   \n Permanent benefits shall be awarded only upon a determination that \nthe compensable injury was the major cause of the disability or impairment.  \nArk. Code Ann. §11-9-102(F)(ii)(a)(Repl. 2012).  “Major cause” means \n\nREVELS - H108811  12\n  \n \n \n“more than fifty percent (50%) of the cause,” and a finding of major cause \nshall be established according to the preponderance of the evidence.  Ark. \nCode Ann. §11-9-102(14)(Repl. 2012).  Preponderance of the evidence \nmeans the evidence having greater weight or convincing force.  \nMetropolitan Nat’l Bank v. La Sher Oil Co., 81 Ark. App.269, 101 S.W.3d \n252 (2003).   \n An administrative law judge found in the present matter, “2.  The \nclaimant has met her burden of proof in demonstrating she is entitled to an \nimpairment rating of 11% BAW – i.e., to additional PPD benefits based on \nthe 6% BAW difference in the two (2) subject ratings.”  The Full \nCommission finds that the claimant proved she sustained permanent \nanatomical impairment in the amount of 11%.   \n The parties stipulated that the claimant sustained a compensable \ninjury to her right shoulder on September 21, 2021.  An MRI of the \nclaimant’s right shoulder taken September 23, 2021 showed, among other \nthings, “large full-thickness tears of the supra and infraspinatus as detailed \nabove.”  Dr. Young began treating the claimant after the compensable injury \nand noted that she had sustained a “right full thickness rotator cuff tear.”  \nOn October 29, 2021, Dr. Young performed a “Diagnostic right shoulder \narthroscopy with open Right rotator cuff repair.”  The pre- and post-\n\nREVELS - H108811  13\n  \n \n \noperative diagnosis was “Rotator cuff tear right shoulder, documented with \nMRI and unresponsive to conservative care.”   \n Casey Garretson, an occupational therapist and part owner of \nFunctional Testing Centers, Inc., opined on December 21, 2022 that the \nclaimant had sustained a 5% whole-person impairment rating.  Mr. \nGarretson asserted that the 5% rating was based on “passive range of \nmotion” and the 4\nth\n Edition of the Guides to the Evaluation of Permanent \nImpairment.  However, Dr. Young opined on March 2, 2023 that the \nclaimant had sustained “an 11% whole person disability rating” in \naccordance with the 4\nth\n Edition of the Guides.  Dr. Young reiterated his \nexpert opinion on May 30, 2023 and September 5, 2023.   \n The respondents argue on appeal that the proper anatomical \nimpairment rating is 5% based on the calculations of Casey Garretson and \nRick Byrd with Functional Testing Centers, Inc.  The respondents contend \nthat Dr. Young did not properly reference the 4\nth\n Edition of the Guides in \nassessing 11% permanent anatomical impairment.  The Full Commission \nnotes that the Guides are “just that:  mere guides to aid the Commission in \nassessing the degree of a claimant’s disability as defined by statute and \ninterpreted by the courts.”  See Singleton v. City of Pine Bluff, 102 Ark. App. \n305, 285 S.W.3d 253 (2008).       \n\nREVELS - H108811  14\n  \n \n \n It is the Commission’s duty to translate the evidence of record into \nfindings of fact.  Gencorp Polymer Prods. v. Landers, 36 Ark. App. 190, 820 \nS.W.2d 475 (1991).  It is within the Commission’s province to weigh all of \nthe medical evidence and to determine what is most credible.  Minnesota \nMining & Mfg. v. Baker, 337 Ark. App. 94, 989 S.W.2d 151 (1999).  In the \npresent matter, the Full Commission finds that Dr. Young’s assessment of \n11% permanent anatomical impairment is supported by the evidence of \nrecord and is more credible than the 5% rating suggested by the evaluators \nat Functional Testing Centers, Inc.  We reiterate that all that is required for \na valid impairment rating is that the medical evidence be supported by \nobjective findings.  See Stephens Truck Lines, supra.  There are supporting \nobjective medical findings of permanent impairment in the present matter, \nto include a documented full-thickness rotator cuff tear in the claimant’s \nright shoulder as a result of the compensable injury.  Dr. Young, the treating \nsurgeon, on three occasions assessed an 11% permanent anatomical \nimpairment rating.  Moreover, Dr. Young’s calculation of 18% upper \nextremity impairment, 11% whole person impairment is plainly supported by \nthe 4\nth\n Edition of the Guides at page 3/20, “Table 3.  Relationship of \nImpairment of the Upper Extremity to Impairment of the Whole Person.” \n After reviewing the entire record de novo, the Full Commission finds \nthat the claimant proved by a preponderance of the evidence that she \n\nREVELS - H108811  15\n  \n \n \nsustained permanent anatomical impairment in the amount of 11%.  The \nclaimant proved that the 11% rating assessed by Dr. Young was wholly \naccurate and was consistent with the American Medical Association Guides \nto the Evaluation of Permanent Impairment (4\nth\n ed. 1993).  The 11% rating \nwas supported by objective and measurable physical findings, to include a \nfull-thickness rotator cuff tear documented following the compensable \ninjury.  We find that Dr. Young’s conclusion that the claimant sustained 11% \npermanent anatomical impairment was stated within a reasonable degree of \nmedical certainty.  The claimant also proved that the September 21, 2021 \ncompensable injury was the major cause of the assessment of 11% \npermanent physical impairment.   \n The claimant’s attorney is entitled to fees for legal services in \naccordance with Ark. Code Ann. §11-9-715(a)(Repl. 2012).  The claimant is \nentitled to a fee based on the amount of permanent anatomical impairment \ncontroverted by the respondents, 6%.  For prevailing on appeal to the Full \nCommission, the claimant’s attorney is entitled to an additional fee of five \nhundred dollars ($500), pursuant to Ark. Code Ann. §11-9-715(b)(Repl. \n2012). \n \n \n \n\nREVELS - H108811  16\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 \n I respectfully dissent from the majority opinion finding the claimant \nhas met her burden of proof in demonstrating she is entitled to an \nimpairment rating of eleven percent (11%) body as a whole.  \nThe claimant suffered an admittedly compensable injury when she \nslipped and fell, tearing her rotator cuff, on September 21, 2021.  In the \ncourse of her treatment, the claimant received two whole-body impairment \nratings – five percent (5%) provided by Functional Testing Centers, Inc., \nand eleven percent (11%) from her treating physician, Christopher Young. \n An administrative law judge was tasked with determining whether the \nclaimant was entitled to an eleven percent (11%) whole-person rating, or \nwhether she was limited to a five percent (5%) rating.  After a hearing, the \nALJ opined the claimant was entitled to the eleven percent (11%) rating \nassigned by Dr. Young. \n\nREVELS - H108811  17\n  \n \n \n \"Permanent impairment\" has been defined as \"any permanent \nfunctional or anatomical loss remaining after the healing period has ended.\" \nMain v. McGehee Metals, 2010 Ark. App. 585, 377 S.W.3d 506 (2010).  \nAny determination of the existence or extent of physical impairment must be \nsupported by objective and measurable findings.  Wayne Smith Trucking, \nInc. v. McWilliams, 2011 Ark. App. 414, 384 S.W.3d 561 (2011).  \"Objective \nfindings\" are those that cannot come under the voluntary control of the \npatient, and specifically exclude pain, straight-leg-raising tests, and range-\nof-motion tests.  Ark. Code Ann. § 11-9-102(16)(A); Vangilder v. Anchor \nPackaging, Inc., 2011 Ark. App. 240 (2011). \nAn injured employee is entitled to the payment of compensation for \nthe permanent functional or anatomical loss of use of the body as a whole \nwhether his earning capacity is diminished or not.  Johnson v. General \nDynamics, 46 Ark. App. 188, 878 S.W.2d 411 (1994).  \nPursuant to Ark. Code Ann. § 11-9-522(g)(1)(A), the Commission \nhas adopted the American Medical Association Guides to the Evaluation of \nPermanent Impairment (4th ed. 1993) (AMA Guides), to be used in the \nassessment of permanent anatomical impairment.  Greene v. Cockram \nConcrete Co., 2012 Ark. App. 691 (2012).  The Commission is authorized to \ndecide which portions of the medical evidence to credit and to translate this \nmedical evidence into a finding of permanent impairment using the AMA \n\nREVELS - H108811  18\n  \n \n \nGuides.  Id. \n In the present case, Claimant slipped and fell, injuring her right \nshoulder.  The claimant underwent a right shoulder arthroscopy and rotator \ncuff repair on October 29, 2021.  Claimant’s surgeon, Dr. Christopher \nYoung, ultimately assigned a whole-body impairment rating of eleven \npercent (11%) on May 30, 2023.  Dr. Young does not detail how he arrived \nat an eleven percent (11%) rating, but rather states his findings were \n“based on the guides.” \nIn contrast, Casey Garretson has a doctoral degree in occupational \ntherapy and is a co-owner of Functional Testing Centers, Inc.  He \ndetermined the claimant sustained a five percent (5%) permanent \nimpairment. This rating was supported by six pages of notes, references to \nthe Guides, and direct evaluation of the claimant.  Id.  Mr. Garretson is \ncertified to do ratings pursuant to the 4\nth\n, 5\nth\n and 6\nth\n editions of the AMA \nGuides.  \nAt the hearing, Mr. Garretson testified he met with the claimant on \nDecember 21, 2022, to conduct a Functional Capacity Evaluation and \nrating.  He did the rating portion of the testing at the beginning of the \nmeeting.  \nDuring testing, Mr. Garretson took active and passive measurements \nof the claimant’s abduction, adduction, internal rotation and external \n\nREVELS - H108811  19\n  \n \n \nrotation.  He took each of these measurements three times and used the \nhighest result of the three in his findings, because “our goal is to give the \npatient the greatest impairment that we can.”  The claimant gave very \nconsistent effort, which he testified resulted in 50 out of 50 measurements. \nMr. Garretson assigned a five percent (5%) rating and could not find any \nbasis in the Guides to arrive at the eleven percent (11%) rating assigned by \nDr. Young.  \nRick Byrd, co-owner of Functional Testing Centers, also testified at \nthe hearing.  He explained he is also certified to do ratings pursuant to the \n4\nth\n, 5\nth\n and 6\nth\n editions of the AMA Guides.  \nAt the hearing, Mr. Byrd went into detail as to why a five percent (5%) \nrating is supported by the AMA Guides: \nQ: What did you do in order to evaluate \nthe two different ratings that are \ninvolved in this case?  We’ve got a 5% \nand an 11%.  \n  \nA: So I went to the guides -- 4th Edition \nGuides, and Dr. Young had -- and I \nquoted him in this letter where he said \nhe’d calculated it all from FCE numbers \nwith occasional lifting of 30 pounds and \n10 pounds with the right hand. And \nthen he said [as read], “Based on these \nfigures, I calculated an 18% upper \nextremity impairment and an 11% \nwhole person disability rating.” And \nthen he said “...based on the guides.” \nAnd I am very familiar with the guides \nand there is nowhere in the guides \nwhere it allows for lifting to correlate \nwith an impairment.  \n  \n\nREVELS - H108811  20\n  \n \n \nThere is in the guides an allowment \n(sic) for muscle strength, but muscle \nstrength is also a subject of (sic) \nmeasure. Lots of times we do reviews \nand they’ve tested a person’s muscle -- \nand so you push – the therapist or \nevaluator will push on them and then \ngrade their muscle tone -- grade their \nmuscle strength, and so that’s \nsubjective; it’s under the control of the \npatient.  \n  \nSo even with the lifting, that’s \nsubjective. So even if it was in the \nguides, it would be -- it would still be a \nsubjective measure because Miss \nRevels was in control of how much she \nwas lifting, and so whether that’s 5 \npounds or 50 pounds -- but there’s \nnothing -- nowhere in the guides is it \nallowed that you just look up lifting or \ndo any calculations or anything like \nthat.  So there was no table of the \nguides of the 4th Edition that would \nallow that.  \n  \nAnd then we had done, we being \nCasey, -- Functional Testing Centers \nhad done an impairment on her after \nDr. Young had declared her M.M.I. and \nwe had done it using passive range of \nmotion of the shoulder, which is an \nobjective measurement.  \n  \nWe had also -- and I’ve reviewed that \nwhere we look all the different aspects \nof how you could possibly get a rating, \n‘cause there’s more than just range of \nmotion.  Some doctors get caught up \nand just always do the same rating on \ntheir -- you know, if they don’t have that \nrating, they don’t get a rating, and lots \nof times that’s wrong, ‘cause they \nmight have crepitation or they might \nhave a chronic instability of the \nshoulder or they might have swelling \nand there’s other ways to rate, and so \nwe would look at all those, of which \nCasey did in his report and determined \n\nREVELS - H108811  21\n  \n \n \nthat the way that gives her the highest \nrating would be passive range of \nmotion loss.  \n \nMr. Byrd went on to explain: \n \nQ: So the 12-21 evaluation that was done, \nyou reviewed in detail the \nmeasurements and all of the activities \nthat Mr. Garretson had Miss Revels \nperform?  \n  \nA: I did. I went back and just made sure \nthat the guides -- that the ratings, the \nindividual numbers that were assessed \nwere the appropriate numbers for, like, \nflexion loss, extension loss, abduction \nloss, and it -- and it did indeed add up to \n9% of the right upper extremity, which \nthen using Table 3 is a 5% impairment.  \n  \nI went back and tried to make sense out \nof Dr. Young’s and thought maybe he \nused active range of motion, and so we \nused our active range of motion \nnumbers and that -- that did increase \nher impairment, as it should, but it only \nincreased it to 11% of the upper \nextremity, so it didn’t get to the 18%.   \n  \nQ: Is active range of motion able to be \nconsidered under the AMA Guides 4th \nEdition for permanency?  \n  \nA: It is in the guides, but not according to \nArkansas law stating it needs to be \nobjective finding, so the guides \ndefinitely allow (sic) for it but not under \nArkansas’s objectivity indicator.  \n  \nFinally,  Mr.  Byrd  explained  why  the  December  21,  2022 \nimpairment rating was more accurate than Dr. Young’s May 2023 \nrating, stating the Functional Testing Center’s evaluation was: \ndefinitely out of the guides, and we’ve stated \nthat  tables  and  the  methodology  is  exactly  as \n\nREVELS - H108811  22\n  \n \n \nthe   guides   would   indicate.   Our   report   has \npictures  of  how  we  measured  and -- ‘cause \nthere are different ways you can measure and \nget  different  results,  and  so  we  used  the  way \nthe guides indicate to measure and we believe \nthey are accurate.  \n   \nThe record is clear.  Two highly qualified professionals were unable \nto reproduce Dr. Young’s findings of an eleven percent (11%) whole-body \nimpairment.  Mr. Byrd and Mr. Garretson performed extensive testing and \nresearch to assign the claimant a five percent (5%) rating and testified to \ntheir reasoning.  These same efforts are not found in Dr. Young’s records. \nDr. Young provided no indication of why or how he came to his conclusion \nbased on the Guides, and taking all records into account, his findings are \nunreliable.  For these reasons, we should rely on the assessment by Mr. \nByrd and Mr. Garretson and limit the claimant to a five percent (5%) \npermanent impairment rating.  \nThere is no proof in the record of the method used by Dr. Young to \ncalculate his rating other than his self-serving statement that he relied on \nthe Guides.  This is no proof he calculated the ratings correctly.  Without \nproof of how he calculated his rating it would be speculation for the \nCommission to accept it, just because he was the treating physician.  The \nonly proof in the record of a rating that was correctly and carefully \ncalculated was the five percent (5%) rating assessed by Functional Testing \nCenters, Inc.  The only reliable rating is the five percent (5%) rating.   \n\nREVELS - H108811  23\n  \n \n \nAccordingly, for the reasons set forth above, I must dissent. \n \n     \n                                                _______________________________ \n    MICHAEL R. MAYTON, Commissioner","preview":"BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION CLAIM NO. H108811 JULIE REVELS, EMPLOYEE CLAIMANT MAGNET COVE ELEMENTARY SCHOOL, EMPLOYER RESPONDENT ARKANSAS SCHOOL BOARDS ASSOCIATION WORKERS’ COMPENSATION TRUST, INSURANCE CARRIER/TPA RESPONDENT","fetched_at":"2026-05-19T22:29:44.751Z","links":{"html":"/opinions/full_commission-H108811-2024-12-16","pdf":"https://www.labor.arkansas.gov/wp-content/uploads/Revels_Julie_H108811_20241216.pdf","source_publisher":"https://labor.arkansas.gov/workers-comp/awcc-opinions/full-commission-opinions/"}}