{"id":"full_commission-H201972-2023-07-13","awcc_number":"H201972","decision_date":"2023-07-13","opinion_type":"full_commission","claimant_name":"James Beauchamp","employer_name":"Conagra Foods Packaged Foods, LLC","title":"BEAUCHAMP VS. CONAGRA FOODS PACKAGED FOODS, LLC AWCC# H201972 JULY 13, 2023","outcome":"affirmed","outcome_keywords":["affirmed:1"],"injury_keywords":["hip","knee","fracture","back","lumbar","strain","ankle"],"pdf_url":"https://labor.arkansas.gov/wp-content/uploads/Beauchamp_James_H201972_20230713.pdf","source_index_url":"https://labor.arkansas.gov/workers-comp/awcc-opinions/full-commission-opinions/","filename":"Beauchamp_James_H201972_20230713.pdf","text_length":46153,"full_text":"BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION \n \n \nCLAIM NO.  H201972 \n \nJAMES BEAUCHAMP, \nEMPLOYEE \n \nCLAIMANT \nCONAGRA FOODS PACKAGED FOODS, LLC,  \nEMPLOYER \n \nRESPONDENT \nBROADSPIRE SERVICES, INC., \nINSURANCE CARRIER/TPA \nRESPONDENT \n  \n      \nOPINION FILED JULY 13, 2023 \n \nUpon review before the FULL COMMISSION in Little Rock, Pulaski County, \nArkansas. \n \nClaimant represented by the HONORABLE EVELYN E. BROOKS, Attorney \nat Law, Fayetteville, Arkansas. \n \nRespondents represented by the HONORABLE JARROD S. PARRISH, \nAttorney at 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 \nJanuary 23, 2023.  The administrative law judge found that the claimant \nproved he sustained a compensable injury to his right hip and pelvis.  After \nreviewing the entire record de novo, the Full Commission finds that the \nclaimant’s right hip and pelvis injury was a natural consequence of the \ncompensable left hip injury.  We find that the claimant proved he was \nentitled to temporary total disability benefits beginning February 15, 2022 \nuntil a date yet to be determined.     \nI.  HISTORY \n\nBEAUCHAMP - H201972   2\n  \n \n \n The record indicates that James Alan Beauchamp, now age 62, \nbecame employed with the respondents, Conagra, in 1997.  Mr. \nBeauchamp testified that he was hired to be a “floater” for the respondents \nbut had been an “operator” for 15-20 years.  The claimant testified that the \n“operator” position entailed several work duties which included use of a \n“power jack.”         \nThe parties stipulated that the employee-employer-carrier \nrelationship existed on January 4, 2022.  The claimant testified on direct \nexamination: \n Q.  So what happened on January 4\nth\n of 2022? \nA.  I was taking the trash out and like I don’t want to get into \ntoo much detail, but like the watermelons that you see at \nSam’s Club, them boxes like that.  There is boxes like that \nand you know the straps around them, they had broke the box \ndown and one of the straps was hanging out and I tripped \nover one of them straps and fell down on my left hip and knee \nand my hard – I mean on concrete.   \n \n The respondents’ attorney cross-examined the claimant: \nQ.  Now, the mechanics of this fall at ConAgra, we understand \nyou tripped on one of the bands that goes on one of these big \nboxes? \nA.  Yes, sir. \nQ.  You fell to your left on your left hip.  Correct? \nA.  Yes, sir. \nQ.  Nothing hit your right hip.  Correct? \nA.  No.   \n \n According to the record, the claimant treated at Arkansas \nOccupational Medicine Services PA on January 4, 2022: \n\nBEAUCHAMP - H201972   3\n  \n \n \nJames Beauchamp is a 61 year-old male, and employee of \nConAgra/Pinnacle Foods.... \nEmployer states patient fell injuring his left hip.... \nPatient states that he was walking and tripped on a strap \ncausing him to fall, landing on his left knee and left hip.  \nPatient states that his left knee is scrapped (sic), but left hip is \nhurting.... \nJames’s primary problem is pain located in the left hip.  He \ndescribes it as throbbing, stiff, aching, sharp.  He considers it \nto be intense.  The problem began on 1/4/21....He was injured \ntoday while at work.... \nIMAGING STUDIES \nXRAY – Left Hip:  Normal.  Acute Findings – Absent.  No \nFracture Seen.   \n \n The diagnosis of J. Daniel Nicholas, PA-C on January 4, 2022 was \n“1.  Pain in left hip.”  J. Daniel Nicholas planned conservative treatment and \nstated, “James’s recommended Work Status is Restricted Duty....Allow \nsitting work as needed.” \n The claimant testified on direct examination: \n  Q.  Did you return to work that day? \nA.  I know I – I don’t know if I worked.  I think they probably \nsent me home because I was pretty hurt.   \nQ.  Okay. \nA.  And then I laid out the next day.   \nQ.  So what were your symptoms? \nA.  Basically, the bruise on my leg and my knee was scraped \nand basically that is the way it was.   \n \n The claimant signed a Form AR-N, EMPLOYEE’S NOTICE OF \nINJURY, on January 6, 2022.  The ACCIDENT INFORMATION section of \nthe Form AR-N indicated that the claimant injured his “Left knee and hip.”  It \nwas reported on the Form AR-N, “Employee was moving a pallet of \n\nBEAUCHAMP - H201972   4\n  \n \n \ncardboard boxes to the trash dock.  He stopped to adjust the boxes and \nupon returning to the jack controls, got his foot tangler (sic) in a piece of \nloose strapping causing him to fall.”     \n J. Daniel Nicholas’ diagnosis on January 11, 2022 was “1.  Pain in \nleft hip....James’s recommended work status is Restricted Duty.  Return to \nwork plan discussed with patient and communicated to the \nemployer....Avoid weightbearing left leg.”   \n J. Daniel Nicholas continued to follow up with the claimant for left hip \npain.   \n A “Left lower extremity venous duplex” was carried out on January \n24, 2022 with the impression, “Negative for left leg deep vein thrombosis.  \nSubcutaneous edema of the left lower leg.”   \n The respondents’ attorney cross-examined the claimant: \nQ.  So the issue that is presented today has been framed as \nwhether you suffered a compensable right hip injury on \nJanuary 4, 2022.  Do you understand that? \nA.  Yes. \nQ.  You agree you did not experience any right hip pain or \nright hip discomfort for nearly three weeks after January 4, \n2022? \nA.  After the bruising had gone away from my left hip is when I \nstarted feeling pain all the way across. \nQ.  And that was approximately three weeks after January \n4\nth\n? \nA.  I would say.   \n \n The claimant began treatment appointments at ApexNetwork \nPhysical Therapy on January 27, 2022.  A physical therapist diagnosed “1.  \n\nBEAUCHAMP - H201972   5\n  \n \n \nContusion of right hip, initial encounter.  2.  Right Hip Pain.”  It was \nreported, “James states that his feet became caught in some pallet \nstrapping causing him to fall, hitting his left knee and left hip on the \nfloor....Mr. Beauchamp demonstrates signs consistent with a hip contusion \nand trochanteric bursitis which impairs his gait, mobility and ability to work \nand sleep.”   \n A physical therapist’s diagnosis on February 1, 2022 was “1.  \nContusion of right hip, initial encounter.  2.  Right Hip Pain.  3.  Low back \npain.”  It was noted, “James states that he was really sore on Sunday and \n[it’s] the right hip hurting today, along with the middle of the low back.  He \ntells me that the left hip is doing ‘fine.’”   \n The claimant followed up with J. Daniel Nicholas on February 8, \n2022:  “Patient states his left hip is doing a little better, but he has been \nhaving severe pain in his right hip....James’s primary problem is pain \nlocated in the left hip....James’s secondary problem is pain located in the \nright hip....The problem began on 1/4/2022....James has significant \nimprovement in his left hip.  He has developed severe right hip pain with no \nspecific injury.”   \n J. Daniel Nicholas’ diagnosis on February 8, 2022 was “1.  Pain in \nleft hip.  2.  Right Hip Pain....The cause of his right hip pain is unclear.  The \nonly way it could be related to his original injury is if it was caused by \n\nBEAUCHAMP - H201972   6\n  \n \n \novercompensation when using crutches for his left leg.”  Mr. Nicholas \nrecommended a Work Status of “Restricted Duty.  Return to work plan \ndiscussed with patient and communicated to the employer....No \nweightbearing with right leg.” \n The claimant treated at MANA Family Medicine on February 9, 2022:  \n“1.  Pain in pelvis ... Acute, Fell on his L at work and was doing well until he \nstarted PT.  Now with severe pain in the R pelvis possibly at the sacrial (sic) \niliac joint.  Patient really needs a pelvic xray.”  Dr. Joseph O’Connell \nreported, “Fell at work and bruised the left hip, now right hip also hurts \nreally bad.  Can walk on left hip, but not right.  Walking is almost non-\nexistent and extremely painful for patient.  The pain is worse instead of \ngetting better – in even more pain after completing PT exercises.  Getting \nTENS unit in the back.” \n The respondents’ attorney cross-examined the claimant: \nQ.  So as far as return-to-work efforts, you told me in your \ndepo you worked up through February 12\nth\n.  Is that right? \nA.  That sounds right.   \nQ.  And then that is when you went back to a doctor and said \nyou were taken off work.  Correct? \nA.  They told me not to come back.   \n \n Dr. Mark Allard examined the claimant on or about February 15, \n2022: \nPt here today WC injury (fall) on 01/04/2022.  Pt was taking \nout some boxes to the trash, and tripped over a plastic strip.  \nPt fell directly on his left side.  Pt was seen @ the \n\nBEAUCHAMP - H201972   7\n  \n \n \noccupational clinic, and x-rays were taken, and they were \nnegative for a fx.  Pt was put on crutches, and sent to physical \ntherapy.   \nPt reports within a couple of wks he was feeling much better, \nand was down to only using 1 crutch.  However, he had a visit \nto therapy on the 22\nnd\n, and was given a HEP, and completed \nall the exercises, went shopping with his wife and 3 yr old \ngrandson, and by the next day was unable to walk, and had \npain on the right side.  Pt c/o today of right buttock/lower \nlumbar pain.  Pt describes the pain as a sharp stabbing \npain.... \n61-year-old man injured his left hip and thigh about 6 weeks \nago at work.  He tripped over something and landed hard on \nhis left side.  He saw the providers at the occupational \nmedicine clinic [and] got some physical therapy and was \nmaking progress.  Bruising and swelling were resolving and \nhe was getting around better.  They gave him some home \nexercises to do 2 weeks ago.  Apparently there was a whole \nbunch of exercises and he did all of them that day.  Then he \nwent to the mall and went shopping with his wife and his \ngrandson and that evening he was miserable and has stayed \nmiserable.  This pain is different though.  The pain is over in \nhis right sacroiliac area.  He does have some low back pain.  \nHe does not have any left hip or thigh pain.  This pain goes \ndown into his buttock but does not radiate down his thigh or \nhis leg.  No numbness or tingling.  No history of back \nproblems.  He is profoundly disabled by this pain however and \nis just barely able to get around with crutches and is having a \ntough time getting in and out of work due to his sitdown duty. \n \n Dr. Allard arranged x-rays on or about February 15, 2022: \nLumbar Spine:  Radiographic Findings:  evidence of \nosteoarticular abnormality: He has got some anterolisthesis \nat L3/4 and retrolisthesis at L4/5.  Mild degenerative scoliosis \nin his lumbar spine.  No evidence of fracture of the lumbar \nspine or the pelvis.  SI joints look normal.... \nHip:  Radiographic Findings:  evidence of osteoarticular \nabnormality:  He has got some early osteoarthritis of the right \nhip with some joint space narrowing and osteophyte \nformation.  None on the left side.  No evidence of fracture.   \n \n\nBEAUCHAMP - H201972   8\n  \n \n \n Dr. Allard assessed “1.  Low back pain – Lumbar back strain.  \nSymptoms are on the right side.  He does not sound like he has a lot of \nradicular pain, but the amount of pain he has is remarkable and he [is] just \nbarely able to even walk.  It is my medical opinion that this is likely due to \noveruse 2 weeks ago and is not directly related to his work-related injury \nfrom 6 weeks ago....James will need to be off work for approximately the \nnext 2 weeks.” \n The claimant followed up with Dr. O’Connell on February 23, 2022:  \n“His pain seems to be related to overcompensating with the R hip while \nusing crutches.”   \n The claimant signed a Form AR-C, CLAIM FOR COMPENSATION, \non March 7, 2022.  The ACCIDENT INFORMATION section of the Form \nAR-C indicated that the Date of Accident was January 4, 2022.  The \nclaimant wrote on the Form AR-C, “I fell on my left hip while working, \ninjuring both hips in the impact.” \n An MRI of the claimant’s left hip was taken on April 12, 2022 with the \nfollowing impression: \n1.  Mildly displaced, acute or subacute fractures of the left \nsuperior and left inferior pubic rami. \n2.  Nondisplaced, acute or subacute fracture of the right \nsacral ala. \n3.  No fracture of either proximal femora.   \n \n\nBEAUCHAMP - H201972   9\n  \n \n \nAn MRI of the claimant’s right hip was taken on April 13, 2022, with \nthe following impression: \n1.  Acute or subacute, mildly displaced fractures of the left \nsuperior and left inferior pubic rami. \n2.  Nondisplaced, acute or subacute fracture of the right \nsacral ala. \n3.  No fracture of either proximal femora. \n4.  Findings of femoroacetabular impingement of each hip, a \nchronic finding.  On this MRI of the right hip, abnormal \nsignal in the superior aspect of the right acetabular labrum \nis consistent with chronic degeneration of the labrum \nrelated to the femoroacetabular impingement.   \n \n Dr. O’Connell signed a note on April 26, 2022 which indicated, \n“JAMES BEAUCHAMP is currently under my medical care.  At this time it is \nmy recommendation that he only use a walker and not crutches due to his \npelvic fractures.”   \nDr. Matthew Coker examined the claimant on May 1, 2022: \nPatient presents for evaluation of his bilateral hips.  He is a \n61-year-old gentleman who injured his hip on the left side \nback in January with a fall at work.  He states that at first he \ndid not think it was much better continue to bother him had it \nworked up and was recently found to have some ramus \nfractures on the left side.  He was also subsequently found to \nhave a right sacral alae fracture.  He did develop some right \nhip pain but this was not associated with the fall on the left \nside.  This started to bother him a few weeks later.  The left \nside is a work-related injury but the right side is not \nconsidered a work-related injury.  Patient is on Percocet at \nthis time for the pain.  States as the right side is bothering him \nthe most at this time.... \nOn physical exam he is a well-developed well-nourished 61-\nyear-old male in no acute distress.  Examination of the \nbilateral lower extremity shows light touch sensation intact to \nthe L4-S1 distribution.  He can flex and extend the hip, knee \n\nBEAUCHAMP - H201972   10\n  \n \n \nand ankle.  He has motion of the hip that is uncomfortable but \nhe is he does have good motion both left and right.  Straight \nleg raise a little uncomfortable but not exquisitely painful.  \nMRIs were reviewed showing a left sided superior and inferior \nramus fracture and on the right and the sacrum, on the \nsuperior and lateral aspect he has a increased uptake \nconsistent with [an] acute versus subacute fracture of the right \nsacral alae.   \n \n Dr. Coker assessed and planned the following:  “Impression is ramus \nfractures on the left after a fall at work and a right sacral fracture.  Plan will \nbe to continue to keep him off work for now because he is just not able to \nget around safely.  He is not able to do his normal duties at work.  He will \nfollow-up with me in 6 weeks for repeat evaluation with [an] AP of the \npelvis.  My hopes is at that time we can increase his activities at work.”   \n Dr. Christopher P. Dougherty reported on June 22, 2022, “He was \nseen today for bilateral hip pain from a fall at work that occurred January \n4\nth\n, 2022.  The MRI and x-rays taken 4/15/22 and 1/4/22 showed a left \ninferior and superior pubic ramus fracture, non displaced sacral ala, and a \npossible nonunion fracture.  New x-rays today were taken of the pelvis and \nthey showed early osteoarthritis of the right hip.”  Dr. Dougherty assessed \n“1.  Closed fracture pelvis, multiple pubic rami – stable.”   \n A CT of the claimant’s pelvis was taken on August 2, 2022 with the \nimpression, “1.  Fractures involving the left superior/inferior pubic rami and \nright aspect of the sacrum as described above.\"   \n The claimant followed up with Dr. Dougherty on August 3, 2022: \n\nBEAUCHAMP - H201972   11\n  \n \n \nHe was seen today to discuss his CT results for the pelvis.  \nThe Ct showed a left superior/inferior pubic ramus fracture \nand a right fracture of the aspect sacrum.  AL (sic) of these \nfractures are directly related to his fall at work and he remains \noff work at thist (sic) time due to these fractures.  He cannot \ndo sedentary work due to his fractures.  His vitamin D levels \nwere discussed and noted at the level of 20.  He will need to \ntake part in 50,000 units for 8 weeks before other planning.  \nHe will need to get lab redrawn in 8 weeks and follow up to \nassess new vitamin lab reports.   \n \n Dr. Dougherty assessed “1.  Fracture of superior pubic ramus....  2.  \nVitamin D deficiency.”             \n Dr. Dougherty signed a Return to Work/School note on August 8, \n2022 which indicated that the claimant “Was Seen in my office on:  \n8/03/22....Work limitations:  No work at this time.”   \n A pre-hearing order was filed on September 15, 2022.  According to \nthe text of the pre-hearing order, the claimant contended that he was \n“entitled to medical treatment for his right hip, and pelvic fractures in \naddition to treatment respondents are providing for his left hip.  Claimant \ncontends he is entitled to temporary total disability benefits from the date \nlast worked to a date yet to be determined.  The claimant reserves all other \nissues.”   \n The parties stipulated that the respondents “have controverted the \nclaim regarding claimant’s right hip and pelvis.”  The respondents \ncontended that the claimant “did not suffer a right hip injury on or about \nJanuary 4, 2022.  Respondents further contend that in the event \n\nBEAUCHAMP - H201972   12\n  \n \n \ncompensability is found, the medical records do not support entitlement to \nmedical treatment or indemnity benefits for the right hip.”   \n The parties agreed to litigate the following issues: \n1.  Whether claimant sustained a compensable injury on \nJanuary 4, 2022, regarding his right hip and pelvis. \n2.  If compensable, whether claimant is entitled to temporary \ntotal disability benefits, and medical benefits. \n3.  Compensation rate. \n4.  Attorney fees.   \n \nAt the referral of Dr. Dougherty, the claimant began physical therapy \nvisits at Trinity Rehabilitation, Inc. on September 16, 2022.   \nDr. O’Connell signed the following statement on November 2, 2022:  \n“Mr. James Beauchamp, (DOB 12/23/60) has been my patient for over 10 \nyears.  He has never had issues with his hips or pelvis.  His fracture of \npelvis was a result of a fall at work in early 2022.”   \nAfter a hearing, an administrative law judge filed an opinion on \nJanuary 23, 2023.  The administrative law judge found that the claimant \nproved he “suffered a compensable injury to his right hip and pelvis on \nJanuary 5, 2022.”  The administrative law judge awarded reasonably \nnecessary medical treatment and temporary total disability benefits.  The \nrespondents appeal to the Full Commission.   \nII.  ADJUDICATION \nA.   Compensability \n\nBEAUCHAMP - H201972   13\n  \n \n \nAct 796 of 1993, as codified at Ark. Code Ann. §11-9-102(4)(Repl. \n2012), provides, in pertinent part: \n(A)  “Compensable injury” means: \n(i)  An accidental injury causing internal or external \nphysical harm to the body ... arising out of and in \nthe course of employment and which requires \nmedical services or results in disability or death.  An \ninjury is “accidental” only if it is caused by a specific \nincident and is identifiable by time and place of \noccurrence[.]   \n \nAn injury must also be established by medical evidence supported by \nobjective findings. Ark. Code Ann. §11-9-102(4)(D)(Repl. 2012).  “Objective \nfindings” are those findings which cannot come under the voluntary control \nof the patient.  Ark. Code Ann. §11-9-102(16)(A)(i)(Repl. 2012).   \nThe 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).   \nAn administrative law judge found in the present matter, “2.  \nClaimant has met his burden of proving that he suffered a compensable \ninjury to his right hip and pelvis on January 5, 2022.”  The administrative \nlaw judge inexplicably failed to cite any portion of the pertinent controlling \nstatute, Ark. Code Ann. §11-9-102(4)(Repl. 2012), supra.  Nevertheless, it \n\nBEAUCHAMP - H201972   14\n  \n \n \nis the duty of the Full Commission to enter findings in accordance with the \npreponderance of the evidence and not on whether there is substantial \nevidence to support the administrative law judge’s findings.  Roberts v. Leo \nLevi Hospital, 8 Ark. App. 184, 649 S.W.2d 402 (1983).  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 \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).   \nThe Full Commission finds in the present matter that the claimant did \nnot prove by a preponderance of the evidence that he sustained a \ncompensable injury to his right hip or pelvis on January 4, 2022.  The \nclaimant testified that he tripped and fell on his left hip and knee while \nperforming employment services for the respondents on January 4, 2022.  \nThere was no stipulation of record regarding compensability of the \naccidental injury which occurred on January 4, 2022.  In their brief on \nappeal to the Full Commission, the respondents expressly state that the \nclaimant sustained a “compensable injury to his left hip.”   \nThe claimant testified on cross-examination that he fell on his left hip \nas a result of the January 4, 2022 specific incident.  The claimant agreed \n\nBEAUCHAMP - H201972   15\n  \n \n \nthat he did not injure his right hip on January 4, 2022.  J. Daniel Nicholas, \nP.A. reported on January 4, 2022 that the claimant fell and injured his “left \nhip.”  Mr. Nicholas did not report that the claimant also injured his right hip \nor pelvis.  The claimant signed a Form AR-N, EMPLOYEE’S NOTICE OF \nINJURY, on January 6, 2022.  It was reported on the Form AR-N that the \nclaimant injured his “Left knee and hip.”  There was no indication that the \nclaimant also injured his right hip or pelvis.  J. Daniel Nicholas continued to \nfollow up with the claimant for complaints of “Pain in left hip.”  A physical \ntherapist noted on January 27, 2022 that the claimant injured his “left knee \nand hip” as a result of the accidental injury.  Dr. Allard reported on February \n15, 2022 that the claimant “landed hard on his left side” when the claimant \nfell on January 4, 2022.  The evidence does not demonstrate that the \nclaimant injured his right hip or pelvis as a result of the January 4, 2022 \naccidental injury. \nThe Full Commission finds that the claimant did not prove by a \npreponderance of the evidence that he sustained a “compensable injury” to \nhis right hip or pelvis.  The claimant did not prove that he sustained an \naccidental injury causing internal or external physical harm to his right hip or \npelvis.  The claimant did not prove that he sustained an injury to his right \nhip or pelvis which arose out of and in the course of employment, required \nmedical services, or resulted in disability.  The claimant did not prove that \n\nBEAUCHAMP - H201972   16\n  \n \n \nhe sustained an injury to his right hip or pelvis which was caused by a \nspecific incident or was identifiable by time and place of occurrence on or \nabout January 4, 2022.  The Full Commission accordingly does not affirm \nthe administrative law judge’s finding that the claimant proved he “suffered \na compensable injury to his right hip and pelvis on January 5, 2022.”  \nB.   Natural Consequence \nThe Full Commission has determined supra that the claimant did not \nprove he sustained a compensable injury to his right hip or pelvis on \nJanuary 4, 2022.  The respondents argue on appeal that the claimant “did \nnot establish a causal link between his alleged right hip injury and the \ncompensable injury to his left hip.”  When the primary injury is shown to \nhave arisen out of and in the course of employment, the employer is \nresponsible for any natural consequence that flows from that injury.  Nichols \nv. Omaha Sch. Dist., 2010 Ark. App. 194, 374 S.W.3d 148.  The basic test \nis whether there is a causal connection between the injury and the \nconsequences of such.  Id.  The burden is on the employee to establish the \nnecessary causal connection.  Id.  Whether there is a causal connection is \na question of fact for the Commission.  Jeter v. B.R. McGinty Mechanical, \n62 Ark. App. 53, 968 S.W.2d 645 (1998).   \nIn the present matter, the parties implicitly stipulated that the \nclaimant proved he sustained a compensable injury to his left hip on \n\nBEAUCHAMP - H201972   17\n  \n \n \nJanuary 4, 2022.  The Full Commission finds that the claimant proved his \nsubsequent right hip difficulties were a natural consequence flowing from \nthe compensable left hip injury.  The claimant agreed on cross-examination \nthat he began suffering from right hip pain approximately three weeks after \nthe compensable left hip injury.  The determination of the credibility and \nweight to be given a witness’s testimony is within the sole province of the \nCommission.  Murphy v. Forsgren, Inc., 99 Ark. App. 223, 258 S.W.3d 794 \n(2007).  The Full Commission finds in the present matter that the claimant \nwas a credible witness.  The claimant informed a physical therapist no later \nthan February 1, 2022 that his right hip was hurting.  J. Daniel Nicholas \nnoted on February 8, 2022 that the claimant “has been having severe pain \nin his right hip....He has developed severe right hip pain with no specific \ninjury.”  Mr. Nicholas opined on February 8, 2022, “The cause of his right \nhip pain is unclear.  The only way it could be related to his original injury is if \nit was caused by overcompensation when using crutches for his left leg.”  \nSuch a notation by a treating health provider is evidence demonstrating that \nthe claimant’s right hip complaints were a natural consequence of the \ncompensable left hip injury. \nDr. Allard reported on February 15, 2022 with regard to the \nclaimant’s right hip symptoms, “It is my medical opinion that this is likely \ndue to overuse 2 weeks ago [emphasis supplied] and is not directly related \n\nBEAUCHAMP - H201972   18\n  \n \n \nto his work-related injury from 6 weeks ago.”  Dr. O’Connell stated on \nFebruary 23, 2022, “His pain seems to be related to overcompensating with \nthe R hip while using crutches.”  An MRI of the claimant’s right hip on April \n13, 2022 showed several abnormalities including a “fracture of the right \nsacral ala.”  These diagnostic abnormalities where not shown to be present \nbefore the January 4, 2022 compensable injury to the claimant’s left hip.  \nWe find that these abnormalities were additional evidence demonstrating \nthat the claimant’s right hip difficulties were a natural consequence of the \ncompensable injury occurring January 4, 2022.  Dr. Coker reported on May \n1, 2022, “Impression is ramus fractures on the left after a fall at work and a \nright sacral fracture.”  Dr. Dougherty opined on August 3, 2022, “He was \nseen today to discuss his CT results for the pelvis.  The Ct showed a left \nsuperior/inferior pubic ramus fracture and a right fracture of the aspect \nsacrum.  AL (sic) of these fractures are directly related to his fall at work \n[emphasis supplied].”   \nBased on the probative evidence of record, the Full Commission \nfinds that the claimant proved his right hip and pelvis difficulties were a \nnatural consequence of the January 4, 2022 compensable injury to the \nclaimant’s left hip.  Nichols, supra. \nC.   Temporary Disability \n\nBEAUCHAMP - H201972   19\n  \n \n \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 determination of when the \nhealing period has ended is a question of fact for the Commission.  Carroll \nGen. Hosp. v. Green, 54 Ark. App. 102, 923 S.W.2d 878 (1996).   \nThe Full Commission finds in the present matter that the claimant \nproved he was entitled to temporary total disability benefits beginning \nFebruary 15, 2022 and continuing until a date yet to be determined.  The \nclaimant sustained a compensable injury to his left hip on January 4, 2022.  \nJ. Daniel Nicholas stated on January 4, 2022, “James’s recommended \nWork Status is Restricted Duty....Allow sitting work as needed.”  The \nclaimant’s testimony indicated that he returned to at least restricted work \nduties for the respondents.  The claimant eventually began suffering from \n\nBEAUCHAMP - H201972   20\n  \n \n \npain in his right hip, which condition the Full Commission has found to be a \nnatural consequence of the compensable left hip injury.   \nThe claimant agreed on cross-examination that he worked for the \nrespondents through February 12, 2022.  Dr. Allard took the claimant off \nwork on February 15, 2022.  The evidence demonstrates that the claimant \nremained within a healing period and was totally incapacitated from earning \nwages beginning February 15, 2022.  Dr. O’Connell recommended on April \n26, 2022 that the claimant “only use a walker and not crutches due to his \npelvic fractures.”  Dr. Coker kept the claimant off work beginning May 1, \n2022.  Dr. Dougherty stated on August 8, 2022, “No work at this time.”      \nThe evidence demonstrates that the claimant remained within a \nhealing period and was totally incapacitated from earning wages beginning \nFebruary 15, 2022.  No treating physician has yet opined that the claimant \nreached the end of his healing period for the compensable left hip injury or \nnatural consequences thereof.  The Full Commission therefore finds that \nthe claimant proved he was entitled to temporary total disability benefits \nbeginning February 15, 2022 and continuing until a date yet to be \ndetermined.  Breshears, supra. \nAfter reviewing the entire record de novo, the Full Commission finds \nthat the claimant proved his right hip and pelvis condition was a natural \nconsequence of the compensable left hip injury which the claimant \n\nBEAUCHAMP - H201972   21\n  \n \n \nsustained on January 4, 2022.  The claimant proved that the treatment of \nrecord was reasonably necessary in accordance with Ark. Code Ann. §11-\n9-508(a)(Repl. 2012).  The claimant proved that he was entitled to \ntemporary total disability benefits beginning February 15, 2022 until a date \nyet to be determined.  The respondents are entitled to an appropriate offset \nin accordance with Ark. Code Ann. §11-9-411(Repl. 2012).  The claimant’s \nattorney is entitled to fees for legal services in accordance with Ark. Code \nAnn. §11-9-715(a)(Repl. 2012).  For prevailing on appeal, the claimant’s \nattorney is entitled to an additional fee of five hundred dollars ($500), \npursuant to Ark. Code Ann. §11-9-715(b)(Repl. 2012).   \nIT 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 must respectfully dissent from the Majority’s determination that the \nclaimant has met his burden of proving that he suffered a compensable \ninjury to his right hip and pelvis on January 5, 2022.  (The Full Commission \n\nBEAUCHAMP - H201972   22\n  \n \n \nhas recognized that the date of the claimant’s date of accident is incorrectly \ndocumented as January 5, 2022.  The correct date is January 4, 2022).   \n In order to prove a compensable injury as a result of a specific \nincident that is identifiable by time and place of occurrence, a claimant must \nestablish the following by a preponderance of the evidence:  (1) an injury \narising out of and in the course of employment; (2) that the injury caused \ninternal or external harm to the body which required medical services or \nresulted in disability or death; (3) medical evidence supported by objective \nfindings, as defined in Ark. Code Ann. § 11-9-102(16), establishing the \ninjury; and (4) that the injury was caused by a specific incident identifiable \nby time and place of occurrence.  Odd Jobs & More v. Reid, 2011 Ark. App. \n450, 384 S.W.3d 630 (2011).  \nMore relevant here is the question of whether the claimant’s right hip \ninjury is a natural consequence of his January 4, 2022 injury.  Arkansas \nCode Annotated section 11-9-508(a) requires an employer to provide an \ninjured employee such medical services as may be reasonably necessary \nin connection with the injury received by the employee.  When the primary \ninjury is shown to have arisen out of and in the course of employment, the \nemployer is responsible for any natural consequence that flows from that \ninjury.  Nichols v. Omaha Sch. Dist., 2010 Ark. App. 194, 374 S.W.3d 148 \n(2010).  However, for this rule to apply, the basic test is whether there is a \n\nBEAUCHAMP - H201972   23\n  \n \n \ncausal connection between the injury and its alleged \nconsequences. Id.  The burden is on the employee to establish the \nnecessary causal connection. Id.  Whether a causal connection exists \nbetween two episodes is a question of fact for the Commission.  Jeter v. \nB.R. McGinty Mech., 62 Ark. App. 53, 968 S.W.2d 645 (1998). \nThe claimant has been unable to indicate any record or recollection \nthat would prove that his right hip injury is related to his January 2022 fall. \nIn fact, the great majority of the evidence reflects that there is no causal \nlinks between the two injuries.  \nOn January 4, 2022, the claimant was seen at Arkansas \nOccupational Medicine Services with a history of falling and injuring his left \nhip with no mention of all of any type injury to his right hip.  (Resp. Ex. 1 Pp. \n36-37).  The claimant was seen again at Arkansas Occupational Medicine \nServices on February 8, 2022, complaining of pain in his left and right hips, \nstating that he had “developed severe right hip pain with no specific injury.” \n(Resp. Ex. 1, P. 51).  At that time, Physician Assistant J. Daniel Nicholas \nopined that “[t]he cause of his right hip pain is unclear.  \nThe claimant later reported that to Dr. Mark Allard on February 15, \n2022, “he was feeling much better, and was down to only using 1 crutch” a \ncouple of weeks after his injury.  (Resp. Ex. 1, P. 57). He also told Dr. Allard \nit was not until the day after he did home exercises and went shopping with \n\nBEAUCHAMP - H201972   24\n  \n \n \nhis wife and 3-year-old grandson that his right hip began hurting and he \nwas unable to walk.  He also told Dr. Allard that his right hip pain was \ndifferent from his original injury.  (Resp. Ex. 1, Pp. 57-58).  A lumbar spine \nx-ray taken on February 15, 2022, showed “early osteoarthritis of the right \nhip with some joint space narrowing and osteophyte formation.  None on \nthe left side.  No evidence of fracture.” Id. The x-ray also showed \ndegenerative scoliosis in the lumbar spine. Id.  \nA CT scan of the claimant’s pelvis on August 2, 2022, showed “a \ncomminuted, mildly distracted fracture involving the left aspect of the \nsacrum” and “mild joint space narrowing involving both hips.” (Cl. Ex. 1, P. \n115).  “No acute fracture involving either hip [was] present.” Id.  Dr. Allard \nwent on to state that it was his medical opinion that the claimant’s pain in \nhis right hip is likely due to overuse two weeks ago and is not directly \nrelated to his work-related injury from six weeks ago.  (Resp. Ex. 1 P. 60).   \nUltimately, the claimant presented to Dr. Matthew Coker on April 28, \n2022, who reported that the claimant “did develop some right hip pain but \nthis was not related with the fall on the left side.  This started to bother him \na few weeks later.  The left side is a work-related injury but the right side is \nnot considered a work-related injury.”  (Resp. Ex. 1, P. 86).  \nOf the numerous professionals treating the claimant for his bilateral \nhip concerns, Dr. Christopher Dougherty, the claimant’s personal \n\nBEAUCHAMP - H201972   25\n  \n \n \npractitioner, is the only one who related the claimant’s right hip injury to his \nwork-related fall.  (Clt. Ex. 1, Pp. 119-120). \nThree different providers, two of which are specialists, have opined that the \nclaimant’s right hip problems are not related to his work injury.  \nTo determine if a claimant has sustained a compensable injury, it is \nimportant to review the reports of the initial medical treatment received by \nthe claimant.  When the claimant was treated on the date of the accident, \nJanuary 4, 2022, he gave no history of any type injury to his right side and \ndid not complain of any pain in that area.  When he returned to his original \nmedical provider on February 8, 2022, the PA, J. Daniel Nicholas, noted Mr. \nBeauchamp had developed right hip pain with no specific injury and the \ncause of his right hip pain was unclear.  Dr. Allard noted that the claimant’s \nright hip pain did not begin until a month after the January 4, 2022 accident \nand it was not until the day after the claimant had gone shopping with his \nwife and grandson that his right hip became painful and he could not walk. \nIn addition, the claimant told Dr. Allard the pain was different than the \noriginal injury.  After examining the claimant and receiving the history from \nthe claimant, it was Dr. Allard’s medical opinion that the claimant’s \ncomplaints of an injury to his right hip were not related to his work injury six \nweeks prior.  Finally, Dr. Coker opined after examining the claimant and \ntaking the history from him that the claimant developed some right hip pain, \n\nBEAUCHAMP - H201972   26\n  \n \n \nbut this did not develop until a few weeks later and is not associated with \nthe fall on the left side.  It should also be pointed out that by the time the \nclaimant was treated by Dr. Coker on April 28, 2022, nearly four months \nafter the accident on January 4, 2022, there were no objective medical \nfindings of a right hip injury by any of the medical providers who had treated \nthe claimant.  In addition, the opinion of the PA-C and the opinions of Dr. \nAllard and Dr. Coker were unequivocal that the right hip problems were not \nrelated to the January 2022 fall. \n         The claimant’s testimony as to when his right hip pain started and the \ncause of his right hip pain was not only “somewhat confusing” as stated by \nthe ALJ, but it was also all over the map and consisted of many different \nversions of when the pain started and the cause of the pain.  As a result, \nthe histories given by the claimant to PA Nicholas, Dr. Allard and Dr. Coker \nis of the utmost importance and confirms that his right hip issues are not \nrelated to the fall on January 4, 2022. \nIn his January 23, 2023 Opinion and Order, the ALJ concluded that \n“[r]elating a fracture on the right side of claimant’s hip from a violent fall on \nhis left side does not require speculation or guesswork.”  (P. 12).  However, \nwhile the weight and interpretation of the medical evidence are matters for \nthe Commission, it is within the Commission's province to reconcile \nconflicting evidence, including the medical evidence, and to determine the \n\nBEAUCHAMP - H201972   27\n  \n \n \ntrue facts.  Hernandez v. Wal-Mart Assocs., 2009 Ark. App. 531, 337 \nS.W.3d 531 (2009); Pyle v. Woodfield, Inc., 2009 Ark. App. 251, 306 \nS.W.3d 455 (2009).  The Commission is entitled to review the basis for \nmedical opinions in deciding the weight and credibility of the opinion and \nmedical evidence, but the Commission may not arbitrarily disregard medical \nevidence or the testimony of any witness.  Aegon Ins. United States v. \nDurham-Gilpatrick, 2010 Ark. App. 827, 378 S.W.3d 773, 777 (2010). \nIn this case, while purporting to use “common sense-observation and \ndeduction” as required by our rules, the ALJ outright disregards the weight \nof the credible evidence.  Wal-Mart Stores v. VanWagner, 337 Ark. 443, \n990 S.W.2d 522 (1999).  Three medical providers state unequivocally that \nthe claimant’s right hip issues were not work related.  While the ALJ \ncontends that PA Nicholas, Dr. Allard, and Dr. Coker were all equivocal \nabout the source of the claimant’s right hip injury in their records, they each \nstate with no hesitation and without question that the claimant’s right hip \ninjury was not work related.  The ALJ’s reliance on the report of Dr. \nDougherty as the only unequivocal medical opinion is unfounded and not \nsupported by a reading of the medical records.  There is no evidence to \nsuggest that the opinions of PA Nicholas and Drs. Allard and Coker were \nequivocal in anyway and it is stretch by the ALJ to state that the report by \n\nBEAUCHAMP - H201972   28\n  \n \n \nDr. Coker is equivocal when he opined:  “The left side is a work-related \ninjury, but the right side is not considered a work-related injury.”   \n Dr. Dougherty was the first medical provider to state the claimant’s \nright hip issues were related to the January 4, 2022 fall.  Dr. Dougherty did \nnot see the Claimant until June 22, 2022, nearly six months after the \naccident in question and did not find the right hip issues to be related to the \nJanuary 4, 2022 fall until August 3, 2022, nearly seven months after the \naccident and his opinion was completely different from the three medical \nproviders that treated the claimant immediately after the accident in \nquestion.  (Clt. Ex. 1, Pp. 111,120).  It is clear the three medical providers \nwho treated the claimant immediately after the accident were in a much \nbetter position to determine if the claimant’s right hip issues were related to \nthe fall in January 2022 than Dr. Dougherty who did not relate the right hip \nissues to the original fall until seven months after the accident.  The opinion \nof one doctor who did not see the claimant until nearly six months after the \naccident should not carry the same weight as the three medical providers \nwho treated the claimant beginning the day of the accident and all share the \nsame medical opinion that the right hip problems were not related to the fall \nin January 2022. \nThe basis for the ALJ’s opinion appears to be that a series of \nmistakes were made on the part of the medical practitioners. The ALJ first \n\nBEAUCHAMP - H201972   29\n  \n \n \ndoes this when disregarding records from NWA Physical Abilities Testing \nCenter on January 27 and February 1, 2022, finding, without any proof, that \nthe code reflecting that the claimant presented with a right hip contusion \nwas simply entered incorrectly.  (P. 11).  There was absolutely no proof \npresented on this issue and nothing in the record to support this finding \nother than the conjecture and speculation of the ALJ which does not \nconstitute proof and should not be considered.  \n This line of reasoning appears again when the ALJ states in his \nopinion:  “It is unclear if the right hip issues were not considered a work-\nrelated injury by Dr. Coker, or not considered to be such by the workers’ \ncompensation carrier.  It is evident Dr. Coker’s staff had been contacted by \nthe adjuster for the carrier prior to examining the claimant on April 28, 2022, \nbecause the contact information for that adjuster is provided under the \nheading “Patient’s Care Team.”  From this wording, I cannot tell if Dr. Coker \nmade an independent evaluation on whether the right hip injury was related \nto the fall or recited what he had been told by the carrier about a right hip \nclaim.” (P. 12).  These statements and findings by the ALJ are disturbing \nand should not be condoned by the Commission.  These findings by the \nALJ are nothing more than pure conjecture and speculation on the part of \nthe ALJ with absolutely no testimony or proof of any kind to support his \naccusations.  To affirm the ALJ’s opinion based on his own conjecture and \n\nBEAUCHAMP - H201972   30\n  \n \n \nspeculation rather than the proof would condone these actions.  While the \nadjuster and respondent carrier’s contact information appears under the \n“Care Team” section of Dr. Coker’s report (Resp. Ex. 1, P. 84), there is no \nevidence or proof in the record to show that the adjuster or anyone from the \ncarrier ever spoke with Dr. Coker or his team.  The ALJ has pointed to no \nproof to support his accusations.  \nSimply put, “[s]peculation and conjecture cannot substitute for \ncredible evidence.” Smith-Blair, Inc. v. Jones, 77 Ark. App. 273, 72 S.W.3d \n560 (2002) (citing Dena Constr. Co. v. Herndon, 264 Ark. 791, 575 S.W.2d \n155 (1980)). The basis of the ALJ’s opinion in this matter is his own \nspeculation and conjecture.  Rather than review and rely on the evidence \nand proof presented at the hearing, the ALJ relies on proof that he supplied \nsua sponte and the claimant’s own self-serving testimony, which the ALJ \nadmitted was confusing.  The entirety of the reliable evidence in this matter \nproves that the claimant’s right hip injury was unrelated to his January 2022 \nfall. To find otherwise would allow an opinion to be based on the \nspeculation and conjecture of the ALJ rather than the proof submitted at the \nhearing.  \nFor the reasons stated above, I respectfully dissent. \n                                                                      \n \n    ___________________________________ \n    MICHAEL R. MAYTON, Commissioner","preview":"BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION CLAIM NO. H201972 JAMES BEAUCHAMP, EMPLOYEE CLAIMANT CONAGRA FOODS PACKAGED FOODS, LLC, EMPLOYER RESPONDENT BROADSPIRE SERVICES, INC., INSURANCE CARRIER/TPA RESPONDENT OPINION FILED JULY 13, 2023","fetched_at":"2026-05-19T22:29:46.229Z","links":{"html":"/opinions/full_commission-H201972-2023-07-13","pdf":"https://labor.arkansas.gov/wp-content/uploads/Beauchamp_James_H201972_20230713.pdf","source_publisher":"https://labor.arkansas.gov/workers-comp/awcc-opinions/full-commission-opinions/"}}