{"id":"full_commission-H202890-2025-05-13","awcc_number":"H202890","decision_date":"2025-05-13","opinion_type":"full_commission","claimant_name":"Marion Pederson","employer_name":"Optum Care, Inc","title":"PEDERSON VS. OPTUM CARE, INC. AWCC# H202890 May 13, 2025","outcome":"granted","outcome_keywords":["granted:3"],"injury_keywords":["back","cervical","neck","shoulder","hip","fracture","sprain","strain"],"pdf_url":"https://www.labor.arkansas.gov/wp-content/uploads/Pederson_Marion_H202890_20250513.pdf","source_index_url":"https://labor.arkansas.gov/workers-comp/awcc-opinions/full-commission-opinions/","filename":"Pederson_Marion_H202890_20250513.pdf","text_length":22154,"full_text":"BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION \n \n \nCLAIM NO.  H202890  \n \nMARION PEDERSON, \nEMPLOYEE \n \nCLAIMANT \nOPTUM CARE, INC.,  \nEMPLOYER \n \nRESPONDENT \nFARMINGTON CASUALTY COMPANY/ \nSEDGWICK CMS, INSURANCE CARRIER/TPA \nRESPONDENT \n  \n      \nOPINION FILED MAY 13, 2025  \n \nUpon review before the FULL COMMISSION in Little Rock, Pulaski County, \nArkansas. \n \nClaimant represented by the HONORABLE LAURA BETH YORK, Attorney \nat Law, Little Rock, Arkansas. \n \nRespondents represented by the HONORABLE RANDY P. MURPHY, \nAttorney at Law, Little Rock, Arkansas. \n \nDecision of Administrative Law Judge:  Reversed. \n \n \n OPINION AND ORDER \nThe respondents appeal an administrative law judge’s opinion filed \nNovember 20, 2024.  The administrative law judge found that the claimant \nproved she was entitled to permanent partial disability benefits “in the \namount of 7% to the body as a whole.”  After reviewing the entire record de \nnovo, the Full Commission finds that the claimant did not prove by a \npreponderance of the evidence that she sustained a permanent anatomical \nimpairment as a result of the compensable injury.     \nI.  HISTORY \n\nPEDERSON - H202890  2\n  \n \n \n The record indicates that Marion Hartwick Pederson, now age 73, \ntreated with Dr. Tanner Coleman, D.C. at Beemer Back Center beginning in \nabout July 2011.  The claimant complained of “Low back pain going into \nright buttock.”  The claimant’s chiropractic treatment included “manipulation \nto the cervical region[.]”  The claimant scheduled approximately two weekly \nvisits with the chiropractor over a course of several years.   \n It was noted at NWA Neurosciences Pain Management in May 2020, \n“The patient is being seen for a routine clinic follow-up of neck pain....New \ncomplaint of neck pain.  She has had some neck issues 6 years ago on the \nleft side.  Very painful to turn her head.”  An “Active Problems” list at that \ntime included “2.  Bulge of cervical disc without myelopathy....3.  Cervical \nspondylosis.”  Dr. Brent Weilert performed a Trigger Point Injection.  \n The claimant’s testimony indicated that she became employed as a \nRadiologic Technologist with the respondents, Optum Care, Inc. in about \nJanuary 2020.  The claimant testified that she sustained an accidental injury \non April 4, 2022:  “I was doing a shoulder x-ray on a patient and I had \nalready done two views....[S]he just all of a sudden out of the blue totally \nfainted and went limp.  So I grabbed her head so she wouldn’t crack it open \non the concrete floor and what it did, it knocked us....I fell 90 degrees to the \nfloor sideways without being able to put my arms out or anything to catch \nmy fall because I held her head.  She did not get hurt at all, but I got hurt.”     \n\nPEDERSON - H202890  3\n  \n \n \nThe parties stipulated that the claimant “sustained a compensable \ninjury to her right hip, low back, and cervical/neck.”  The record contains a \nnote dated on or about April 4, 2022:  “[T]he employee states she was \ndoing an upright shoulder xray.  States the patient fainted.  The employee \nreports the patient fell on her.  She reports they fell flat to the floor, \nsideways.  States she hit the floor on the right hip.”     \nThe chiropractor noted in part on April 5, 2022, “The neck pain on \nboth sides is considerably worse since the last treatment, the mid back pain \nis considerably worse since her last treatment, and the low back pain is a \nslight worsening of the condition since the last visit.” \nAn x-ray of the claimant’s cervical spine was taken on May 2, 2022: \nBONES:  No acute fracture or aggressive appearing osseous \nlesion.  Vertebral body height are (sic) maintained.  \nAtlantoaxial relationship with intact (sic). \nDISCS/DEGENERATIVE CHANGES:  Mild disc space \nnarrowing is seen at C4/C5 and C5-C6 with small osteophyte \nformation.  Posterior vertebral body alignment is within normal \nlimits.   \nSOFT TISSUES:  No prevertebral soft tissue swelling.  The \nvisualized lung apices are clear. \nIMPRESSION:  No acute cervical spine abnormality.  Minimal \ndegenerative disc disease.   \n \n The claimant was evaluated for physical therapy on May 10, 2022: \n“Injured Worker reports an injury to R hip, low back, and L neck while a \npatient fainted from a standing position and she held the patient and she fell \ndirectly onto her R side without being able to put her arms out to brace her \n\nPEDERSON - H202890  4\n  \n \n \nfall....We will develop a home exercise program.”  The record indicates that \nthe claimant subsequently underwent a large number of physical therapy \nvisits.   \n An MRI of the claimant’s cervical spine was taken on May 13, 2022 \nwith the impression, “Multilevel cervical spondylosis, worst at the C3-4 \nthrough C6-7 levels.”     \nAn MRI of the claimant’s cervical spine was apparently taken on or \nabout May 16, 2022 and showed “Moderate to Severe arthritic changes \nnoted.” \nCandace Harper, P.A. reported on June 1, 2022: \nPatient presents for evaluation of her cervical spine.  She had \na work related injury 2 months ago when a patient passed out \nwhile getting xrays and she cradled the patient’s head, and fell \nlaterally to the floor.  Has neck pain.  Cervical MRI reviewed \nshowing multilevel degenerative changes with disc/osteophyte \ncausing canal stenosis worse at C5-6.  I measure a 7.6 mm \ncanal.  She is currently in physical therapy.  Recommend she \ncontinue this.  Will review imaging w/Dr. Armstrong as well \ngiven her hyperflexia which may be her normal.  I will call \nonce he has reviewed imaging.  Pt. agrees w/plan.   \n \n Ms. Harper assessed “1.  Neck pain,” “2.  Work related injury,” and \n“3.  Cervical spondylosis.”   \nAn MRI of the claimant’s cervical spine was taken on November 28, \n2022, with the following impression: \n1. MULTILEVEL CERVICAL SPONDYLOSIS WITH \nMODERATE CANAL STENOSIS AT C4/5 AND C5/6. \n\nPEDERSON - H202890  5\n  \n \n \n2. SEVERE BILATERAL NEURAL FORAMINAL \nNARROWING AT C3/4, SEVERE RIGHT NEURAL \nFORAMINAL NARROWING AT C4/5 AND SEVERE \nBILATERAL NEURAL FORAMINAL NARROWING AT \nC5/6.   \n \n   Dr. Owen L. Kelly corresponded with the respondents’ attorney on \nMarch 23, 2023 and reported in part: \nMs. Pederson has a degenerative disc disease of the cervical \nspine confirmed by objective imaging.  She may have \nsustained a cervical sprain/strain at the time of the accident, \nbut no identifiable injury is noted.  Her functional and \nneurologic status are normal.  The degenerative findings are \nnot related the the (sic) 4/4/21 accident.... \nMs. Pederson has reached maximum medical improvement \nas it relates to the 4/4/21 accident.... \nNo impairment rating would be associated with the 4/4/21 \naccident.   \n \n An x-ray of the claimant’s cervical spine was taken on May 22, 2023 \nwith the impression, “NO ACUTE OSSEOUS ABNORMALITY.  \nMULTILEVEL CERVICAL SPONDYLOSIS WITH INTERVERTEBRAL DISC \nSPACE NARROWING WORST AT C4-5 AND C5-6.” \n On October 16, 2023, Dr. David Knox completed a questionnaire \nprovided by the claimant’s attorney.  Dr. Knox opined that the claimant had \nreached maximum medical improvement.  Dr. Knox opined that the \nclaimant had sustained a 7% whole-body impairment rating.   \n Dr. Knox reported on October 17, 2023: \nPatient 1 and half years status post work comp injury \ncontinuing difficulty with cervical radiculopathy.  Reviewed \nMRI scan demonstrating significant disc herniation on the right \n\nPEDERSON - H202890  6\n  \n \n \nat C4-5 C5-6.  I informed her that surgical options do exist.  \nShe wants to settle her course a (sic) filled out her paperwork \nrecommended that she close her case she would qualify for a \n7% permanent partial disability.... \n \n A pre-hearing order was filed on June 26, 2024.  The claimant \ncontended, “The claimant contends that as a result of her compensable \ninjury of April 4, 2022, she is entitled to permanent partial disability benefits \nbased on a 7% rating to the body as a whole, interest, and an attorney’s \nfee.  Claimant reserves all other issues.”  The respondents contended, “The \nrespondents controvert the 7% impairment assigned by Dr. Knox.”   \n The parties agreed to litigate the following issues: \n1. Claimant’s entitlement to permanent partial disability \nbenefits based on a 7% rating assigned by Dr. Knox.   \n2. Interest. \n3. Attorney fee.   \n \nAfter a hearing, an administrative law judge filed an opinion on \nNovember 20, 2024.  The administrative law judge found that the claimant \nproved she was “entitled to payment of permanent partial disability benefits \nin an amount equal to 7% to the body as a whole as a result of her \ncompensable cervical injury.”  The administrative law judge determined that \nthe respondents were “liable for payment of permanent partial disability \nbenefits in an amount equal to 7% to the body as a whole.”  The \nrespondents appeal to the Full Commission.    \nII.  ADJUDICATION \n\nPEDERSON - H202890  7\n  \n \n \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 \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).  \n\nPEDERSON - H202890  8\n  \n \n \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“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, “3.  \nClaimant has met her burden of proving by a preponderance of the \nevidence that she is entitled to payment of permanent partial disability \nbenefits in an amount equal to 7% to the body as a whole as a result of her \ncompensable cervical injury.”  The Full Commission finds that the claimant \ndid not prove she sustained a permanent anatomical impairment as a result \nof the compensable injury. \n According to the record before the Commission, the claimant began \ncomplaining of chronic neck pain no later than 2011.  It was reported in \n2020 that that the claimant had a “2.  Bulge of cervical disc without \n\nPEDERSON - H202890  9\n  \n \n \nmyelopathy.”  The claimant was also diagnosed with “Cervical spondylosis” \nin 2020.   \n The claimant’s testimony indicated that she became employed with \nthe respondents in about January 2020.  The claimant testified that she \nsustained an accidental injury on April 4, 2022.  The claimant testified that \nshe fell while holding a patient who had fainted.  The parties stipulated that \nthe claimant “sustained a compensable injury to her right hip, low back, and \ncervical/neck.\"  An x-ray of the claimant’s cervical spine taken May 2, 2022 \nshowed “No acute cervical spine abnormality [emphasis supplied].  Minimal \ndegenerative disc disease.”  An MRI of the claimant’s cervical spine was \ntaken on May 13, 2022 with the impression, “Multilevel cervical spondylosis, \nworst at the C3-4 through C6-7 levels.”  An MRI of the claimant’s cervical \nspine on or about May 16, 2022 showed “Moderate to Severe arthritic \nchanges[.]”  A physician’s assistant reported on June 1, 2022 that a cervical \nMRI showed “multilevel degenerative changes with disc/osteophyte causing \ncanal stenosis worse at C5-6.”  An MRI of the claimant’s cervical spine on \nNovember 28, 2022 confirmed, among other things, “Multilevel cervical \nspondylosis.”   \n Dr. Kelly opined on March 23, 2023 that the claimant had reached \nmaximum medical improvement.  Dr. Kelly opined, “No impairment rating \nwould be associated with the 4/4/21 accident.”  An x-ray of the claimant’s \n\nPEDERSON - H202890  10\n  \n \n \ncervical spine was taken on May 22, 2023 with the impression, “NO ACUTE \nOSSEOUS ABNORMALITY.”  Yet Dr. Knox opined on October 17, 2023 \nthat the claimant had sustained a herniated disc, and that the claimant was \ntherefore entitled to a 7% permanent anatomical impairment rating.   \n It is the Full Commission’s duty to translate the evidence of record \ninto findings of fact.  Gencorp Polymer Prods. v. Landers, 36 Ark. App. 190, \n820 S.W.2d 475 (1991).  It is within the Commission’s province to weigh all \nof the 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. Kelly’s opinion is credible \nand is entitled to more evidentiary weight than Dr. Knox’s opinion.  The \nevidence does not demonstrate that the claimant sustained a herniated disc \nas a result of the compensable injury sustained on April 4, 2022.  The \nCommission reiterates that an x-ray of the claimant’s cervical spine taken \non May 2, 2022 showed “No acute cervical spine abnormality.”  Subsequent \ndiagnostic testing revealed degenerative spondylosis with no probative \nevidence demonstrating that the claimant sustained a herniated cervical \ndisc as a result of the April 4, 2022 compensable injury.  The evidence of \nrecord corroborates Dr. Kelly’s expert opinion, “No impairment would be \nassociated with the 4/4/21 accident.    \n\nPEDERSON - H202890  11\n  \n \n \n The Full Commission finds that the claimant did not sustain any \npercentage of permanent anatomical impairment as a result of the April 4, \n2022 compensable injury.  The claimant did not prove that she sustained \npermanent anatomical impairment in accordance with the 4\nth\n Edition of the \nGuides, and the claimant did not prove she sustained permanent \nanatomical impairment established by objective or measurable physical \nfindings.  The claimant did not prove that the compensable injury was the \nmajor cause of any percentage of permanent physical impairment.  The Full \nCommission finds that Dr. Kelly’s opinion is entitled to significant evidentiary \nweight and Dr. Knox’s opinion is entitled to minimal evidentiary weight.   \n After our de novo review of the entire record, therefore, the Full \nCommission reverses the administrative law judge’s award of 7% \npermanent anatomical impairment.  The claimant did not prove by a \npreponderance of the evidence that she sustained any percentage of \npermanent physical impairment as a result of the compensable injury, and \nthis claim is respectfully denied and dismissed. \n IT IS SO ORDERED. \n    ___________________________________ \n    SCOTTY DALE DOUTHIT, Chairman \n \n    ___________________________________ \n    MICHAEL R. MAYTON, Commissioner \n \n \n \nCommissioner Willhite dissents. \n\nPEDERSON - H202890  12\n  \n \n \nDISSENTING OPINION \n \nThe Respondent  appeals  an  administrative  law  judge  (hereinafter \nreferred to as “ALJ”) opinion filed November 20, 2024.  The ALJ found that \nthe Claimant proved she was entitled to permanent partial disability benefits \n“in the amount of 7% to the body as a whole.”  After reviewing the entire \nrecord de novo, I would agree with the ALJ’s findings and dissent with the \nmajority finding that the Claimant did not prove she was entitled to permanent \npartial disability benefits.  \n The Claimant sustained an admittedly compensable injury to her right \nhip, low back and cervical spine on April 4, 2022.  At that time the Claimant \nwas performing an x-ray on a patient when the patient “fainted and went \nlimp.”  The Claimant attempted to catch the patient and fell on the floor on \nthe  right  side  of  her  body.  The  Claimant  received  treatment  for  her \ncompensable injuries which included medications, injections and physical \ntherapy.  At some point prior to March 23, 2023, Dr. Owen Kelly, a board-\ncertified orthopedic surgeon, was hired by the Respondent to review the \nClaimant’s medical records.  Dr. Kelly found the Claimant to be at maximum \nmedical  improvement  and  anticipated  that  no  future  treatment  would  be \nnecessary for the Claimant’s neck and hip injuries.  Although Dr. Kelly’s \ncredentials as an orthopedic surgeon qualify him to provide insight, I do note \n\nPEDERSON - H202890  13\n  \n \n \nthat his evaluation refers to a date of injury that was one year prior to the \nactual work accident in question.  \nIt appears that shortly after Dr. Kelly’s report, Claimant exercised her \none time right to a change of physician.  On August 24, 2023, Claimant was \nseen by Dr. Luke Knox, a board-certified neurosurgeon, who reviewed her \nhistory, medical records, and diagnostic tests including an MRI.  Following \nhis examination and review, Dr. Knox assessed the Claimant as suffering \nfrom cervical disc disorder with radiculopathy, cervical spondylosis, cervical \nstenosis of the spinal canal, and chronic right shoulder pain. The Claimant \nwas again seen by Dr. Knox on October 17, 2023, at which time Dr. Knox \nidentified cervical disc herniations at C4-5 and C5-6.  Dr. Knox stated that \nsurgical options were available for this injury, and that physical therapy was \nrecommended.  Apparently, the  insurance carrier  refused  to  provide  this \ntreatment.  Considering these factors and the Claimant’s stated desire to \nsettle her claim, Dr. Knox then assessed permanent impairment of 7% to the \nbody as a whole.  It appears that this rating, as well as confirmation of \nmaximum medical improvement, work restrictions, and reasonable certainty \nof the opinions was previously addressed in correspondence between Dr. \nKnox and counsel for Claimant on or about August 30, 2023.  \n The  primary  issue  to  be  resolved  relates  to  the  assessment  of \nClaimant’s cervical condition by Dr. Kelly versus the assessment by Dr. Knox. \n\nPEDERSON - H202890  14\n  \n \n \nWhen medical opinions conflict, the Commission may resolve the conflict \nbased on the record as a whole and reach the result consistent with reason, \njustice, and common sense.  Barksdale Lumber v. McAnally, 262 Ark. 379, \n557 S.W.2d 868 (1977).  It is within the Commission’s province to weigh all \nof the medical evidence and to determine what is most credible.  Minnesota \nMining & Mfg. v. Baker, 337 Ark. 94, 989 S.W.2d 151 (1999). \nArk. Code Ann. §11-9-102(4)(Repl. 2012) provides, in pertinent part:  \n(F)(ii)(a)  Permanent  benefits  shall  be  awarded  only  upon  a \ndetermination that the compensable injury was the major cause of the \ndisability or impairment.  \n “Major cause” means “more than fifty percent (50%) of the cause,” and a \nfinding of major cause shall be established according to the preponderance \nof the evidence.   Ark. Code Ann. §11-9-102(14)(Repl. 2012).  Preponderance \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). \nThe Claimant was injured on April 4, 2022, when a patient fell on her \nas she was conducting an x-ray.  The pre-hearing Order states that the \nparties agreed that the Claimant sustained compensable right hip, low back, \nand cervical/neck injuries as the result of this work accident.  The medical \nnotes dated April 7, 2022, reveal symptoms including left-sided neck pain. \nThe Claimant was seen again on April 18, 2022, and complained of constant \n\nPEDERSON - H202890  15\n  \n \n \ncervical pain with radiating symptoms into her left upper extremity.  As the \ncervical  treatment  continued  the  Claimant’s  pre-existing  problems  were \nnoted, with indications of the progression of her symptoms and restrictions. \nAn MRI was conducted on May 13, 2022, which revealed abnormalities at \nseveral levels of the Claimant’s cervical spine.  During a medical appointment \non May 25, 2022, the Claimant reported numbness in the 4\nth\n and 5\nth\n digits of \nthe right hand and was referred for a neurosurgical consult.  \nClaimant exercised her one-time right to change her physician began \ntreatment with Dr. Knox.  Dr. Knox found that the Claimant was at maximum \nmedical improvement and was entitled to an impairment rating of 7% to the \nbody as a whole.  Dr. Kelly did not treat the Claimant and only reviewed the \nmedical  records.  Based  upon  the  qualifications  of  Dr.  Knox  as  a \nneurosurgeon, the multiple personal visits and evaluations he provided, the \ntreatment  he  recommended and  the  clear reason for  his assessment  of \npermanent impairment, I find his opinion regarding impairment to be entitled \nto more weight than the opinion of Dr. Kelly.  Therefore, I would rule in favor \nof the Claimant and find that the Claimant is entitled to a 7% impairment \nrating to the body as a whole, and dissent with the majority.    \n  \n    ___________________________________ \n    M. SCOTT WILLHITE, Commissioner","preview":"BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION CLAIM NO. H202890 MARION PEDERSON, EMPLOYEE CLAIMANT OPTUM CARE, INC., EMPLOYER RESPONDENT FARMINGTON CASUALTY COMPANY/ SEDGWICK CMS, INSURANCE CARRIER/TPA RESPONDENT OPINION FILED MAY 13, 2025","fetched_at":"2026-05-19T22:29:44.304Z","links":{"html":"/opinions/full_commission-H202890-2025-05-13","pdf":"https://www.labor.arkansas.gov/wp-content/uploads/Pederson_Marion_H202890_20250513.pdf","source_publisher":"https://labor.arkansas.gov/workers-comp/awcc-opinions/full-commission-opinions/"}}