{"id":"full_commission-H204710-2024-10-31","awcc_number":"H204710","decision_date":"2024-10-31","opinion_type":"full_commission","claimant_name":"Alice Lawrence","employer_name":"Searcy County Judge","title":"LAWRENCE VS. SEARCY COUNTY JUDGE AWCC# H204710 October 31, 2024","outcome":"granted","outcome_keywords":["granted:5","denied:1"],"injury_keywords":["back","lumbar","strain","sprain","knee","hip","fracture","ankle"],"pdf_url":"https://www.labor.arkansas.gov/wp-content/uploads/Lawrence_Alice_H204710_20241031.pdf","source_index_url":"https://labor.arkansas.gov/workers-comp/awcc-opinions/full-commission-opinions/","filename":"Lawrence_Alice_H204710_20241031.pdf","text_length":52860,"full_text":"BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION \n \n \nCLAIM NO.  H204710  \n \nALICE E. LAWRENCE, \nEMPLOYEE \n \nCLAIMANT \nSEARCY COUNTY JUDGE,  \nEMPLOYER \n \nRESPONDENT \nAAC RISK MANAGEMENT SERVICES, \nINSURANCE CARRIER/TPA \nRESPONDENT \n  \n      \nOPINION FILED OCTOBER 31, 2024  \n \nUpon review before the FULL COMMISSION in Little Rock, Pulaski County, \nArkansas. \n \nClaimant represented by the HONORABLE NEAL L. HART, Attorney at \nLaw, Little Rock, Arkansas. \n \nRespondents represented by the HONORABLE JASON M. RYBURN, \nAttorney at Law, Little Rock, Arkansas. \n \nDecision of Administrative Law Judge:  Affirmed in part as modified, \nreversed in part. \n \n \n OPINION AND ORDER \nThe respondents appeal an administrative law judge’s opinion filed \nJune 20, 2024.  The administrative law judge found that the claimant proved \nshe sustained a compensable injury to her left leg and back.  The \nadministrative law judge found that the claimant proved she was entitled to \ntemporary total disability benefits beginning March 3, 2023 until a date to be \ndetermined.  After reviewing the entire record de novo, the Full Commission \nfinds that the claimant did not prove by a preponderance of the evidence \nthat she sustained a compensable back injury.  The claimant proved that \nthe medical treatment of record provided in connection with her \n\nLAWRENCE - H204710  2\n  \n \n \ncompensable left leg injury was reasonably necessary in accordance with \nArk. Code Ann. §11-9-508(a)(Repl. 2012).  The Full Commission finds that \nthe claimant proved she was entitled to additional temporary total disability \nbenefits from March 3, 2023 through January 25, 2024.       \nI.  HISTORY \n The record indicates that Alice Lawrence, now age 46, underwent a \nlumbar fusion at L5-S1 performed by Dr. Edward H. Saer, III on May 23, \n2007.  Dr. Saer noted on January 3, 2008, “She’s going to therapy and \nhasn’t completed the course yet, but she feels like she’s getting stronger.  \nThe only thing that she’s noticed is that when she walks on the treadmill \nsometimes her left toe drags.”  The claimant followed up with Dr. Saer on \nFebruary 14, 2008:  “She says occasionally she will still drag her toe when \nshe walks on the treadmill....I am going to give her a release to return to \nher regular job duties.  She is going to need to be a little careful and \nprobably needs to alter some of her body mechanics, and we discussed \nthat.  I will release her at this point, but would be happy to see her again at \nany time.”   \n Dr. Saer informed a representative of Public Employee Claims on \nApril 7, 2008, “I would estimate that she has a 2% impairment for her \nsurgery done by Dr. Williams in 2005, and an additional 5% whole body \n\nLAWRENCE - H204710  3\n  \n \n \nimpairment for her fusion done May 23, 2007.  This combines for a 7% \nwhole body impairment rating[.]”   \n Dr. Saer noted in October 2008 that a vehicle the claimant was \ndriving had been “T-boned” on the passenger side.  Dr. Saer’s impression \nwas “Lumbar strain/sprain secondary to motor vehicle accident.”  Dr. Saer \nperformed a posterior fusion/TLIF, L4-5 on November 30, 2016.  The pre- \nand post-operative diagnosis was “1.  Degenerative spondylolisthesis, L4-5.  \n2.  Facet cyst L4-5 left with significant foraminal and lateral recess stenosis.  \n3.  Prior L5-S1 fusion.” \n An APRN noted on December 20, 2016, “She still has some sense of \nsoreness and weakness in the left leg....I think her left leg will continue to \nimprove over time.”  Dr. Saer reported on January 31, 2017, “She is still \nhaving some problems with her left leg.  In the mornings when she gets up \nshe has difficulty getting out of bed.”  Dr. Saer noted on April 4, 2017, “4 \ndays ago she was walking up steps and could not pick up her left foot.  It \ncaught and she fell into the wall.”       \n The claimant testified that she became employed with the \nrespondents, Searcy County, on November 29, 2021.  The claimant \ntestified that she drove a “compacter truck” for the respondent-employer.  \nThe claimant’s testimony indicated that her work for the respondents \nsometimes required manual labor.  The parties stipulated that the \n\nLAWRENCE - H204710  4\n  \n \n \nemployee-employer-carrier relationship existed on June 16, 2022.  The \nclaimant testified on direct examination: \n Q.  Tell us what happened, please. \nA.  I had gotten out of the truck to shut the back doors to \nmake sure that no trash falls out when we are going....And I \nwalked back around the truck.  And while I was walking, \nanother truck pulled up behind us and for some reason \nhonked the horn....And he put the truck in drive, and when he \ngassed the truck to go forward, it hit me and knocked me \ndown in front of the back tires. \nQ.  Did the bed of the truck hit you? \nA.  Yes. \nQ.  Knocked you down in front of the tires and then what \nhappened? \nA.  It went up on my left foot. \nQ.  What did? \nA.  The back tires.  The dual tires.  And I couldn’t get away \nfrom it, so I tried to roll away from it.... \nQ.  And then what? \nA.  And then when he come up on my leg, and I was \nscreaming for him to stop.  And when he got up, he – my dog \nactually jumped out.  When my dog jumped out, he stopped.  \nAnd when he stopped, he was on my lower back, and I \ncouldn’t really yell anymore because it kind of squeezed the \nbreath out of me.   \nQ.  The wheels were on your back? \nA.  The wheels stopped on my lower back, yes.  And then \nwhen the dog jumped out, he stopped, and then he backed off \nof me.... \nQ.  At that point what was the condition of your leg? \nA.  I could not move it.  I could not put weight on it.  My foot \nwas twisted to the inside towards my other leg.  My knee was \ncurled.  It had it all – it was all messed up....   \n \n The respondents’ attorney cross-examined the claimant: \nQ.  So it’s your testimony that this truck ran all the way over \nyour entire left leg? \n  A.  Yes. \n  Q.  Dual truck tires? \n\nLAWRENCE - H204710  5\n  \n \n \n  A.  Yes. \n  Q.  All the way onto your lower back? \n  A.  Yes.... \n  Q.  What marks did you have to your abdomen? \n  A.  I had tire tread on my back where he stopped.... \nQ.  So it’s your testimony that you were not flat on your belly \nor your face, you were on your side as this over 5000-pound \ntruck rolled all the way to your lower back? \nA.  Yes.... \nQ.  And is it your testimony that this truck would have rolled \nover your foot, knee, hip, and then onto your lower back? \nA.  Yes.     \n \n According to the record, the claimant received emergency treatment \non June 16, 2022: \nALICE LAWRENCE is a 44-year-old female who arrives to the \nED via EMS air transport with the chief complaint that her left \nleg was run over....Patient complains of left thigh and knee \npain.  Patient states she was working and the garbage truck \ndriver was spooked and moved forward where her left leg was \ncaught under the tire and was ran over.  Associated \nsymptoms include:  left thigh and knee pain.  Patient denies \nany other associated symptoms....History limited due to acuity \nof condition and ketamine.... \nMusculoskeletal:  Normal strength, No tenderness, No \nswelling, No deformity.  Good dorsalis pedis and posterior \ntibial pulses.  Bruising and swelling to entire left lower \nextremity.  ROM decreased secondary to pain.... \n \n A physician gave the following impression on June 16, 2022:  \n“Unremarkable for vascular injury or focal hematoma within the CTA \nabdomen, pelvis and lower extremities.  Soft tissue swelling above the knee \njoint.  No fracture deformity.  Right knee Baker’s cyst.” \n An x-ray of the claimant’s pelvis was taken on June 16, 2022 with the \nfollowing findings: \n\nLAWRENCE - H204710  6\n  \n \n \nBones/joints:  Metallic posterior instrumented fusion hardware \nL4 and L5 with lateral fusion mass and L4-L5 intra discal cage \nprosthesis.  No acute fracture.  No subluxation.   \nSoft tissues:  Unremarkable. \nIMPRESSION:  No acute findings.   \n \n An x-ray of the claimant’s left tibia and fibula was taken on June 16, \n2022 with the following findings: \nBones/joints:  No definite cortical step-off deformity of the \nlateral tibial plateau region; if there is any concern for subtle \nhairline fracture, would then recommend CT knee.  Minimal \npatellar spurring superiorly.  Patella appears intact.  Tibia and \nfibula appear intact.   \nSoft tissues:  No suprapatellar effusion present and no lipo \nhemarthrosis fluid level. \nIMPRESSION:  No acute findings.   \n \n The Discharge Diagnosis on June 16, 2022 was “Crush Injury of the \nFoot” and “Knee Sprain, Adult.”  The claimant testified that she did not \nreturn to work following the June 16, 2022 accidental injury.   \nDr. Jose E. Abiseid examined the claimant on June 20, 2022 and \nnoted, “1.  WC pt was ran over by truck....SKIN:  multiple bruises on the left \nside of her leg and thigh.  BACK:  lumbar paraspinal tenderness.”  Dr. \nAbiseid assessed “1.  Multiple traumatic injuries.  2.  Intervertebral disc \ndisorders with myelopathy, lumbar region.  3.  Dorsalgia, unspecified.  4.  \nSciatica, left side.”  Dr. Abiseid noted, “Pt was ran over by a truck and ran \nback over again complaining of left leg and thigh pain and bruises and back \npain.”   \n\nLAWRENCE - H204710  7\n  \n \n \n Dr. Abiseid noted on June 27, 2022, “Pt was involved in [an] accident \nat work [where] she was ran over by a truck twice on legs pt is having \nsevere back pain from the accident then also left ankle turning on its own, \nleg is red and hot to touch going to treat her with antibiotic to prevent staph \nneeds MRI back and left ankle[.]”     \nAn MR of the claimant’s lumbar spine was taken on July 7, 2022 with \nthe impression, “Mild spinal stenosis L3-4.  Surgical changes from L4 to S1 \ndescribed above.” \nDr. Justin Cutler, D.O. began treating the claimant on July 19, 2022: \nThis is a 44 year old female who is being seen for a chief \ncomplaint of left leg.  Work comp – left leg pain.   \n[Ms. Lawrence] reports accident occurring on June 16 where \nshe ended up underneath a garbage truck truck ran up her left \nleg all the way up to her thigh.  Backed off of it.  States that \nshe was lift flighted to Springfield where pelvis and leg with \nCTs.  No fractures were identified.  Was discharged home.  \nSince that time has had pain medicine but no physical \ntherapy.  States swelling in left lower extremity is pretty still \nsevere.... \nHas extreme tenderness on the left lateral thigh at this with \nthickening of the subcutaneous tissue palpable....Has a large \namount of swelling on the medial aspect of the lower leg.  No \nerythema.  Very tense and exquisitely tender to touch.  Has a \nhard time picking her foot up secondary to the pain in her leg.  \nI can passively move her ankle and toes well.   \n2 views of her left tib-fib are taken here in the office and \nreviewed today.  See no fractures or dislocations.  Large \namounts of soft tissue swelling noted.   \nImpression/Plan:  Crush injury to left lower extremity \nsecondary to being run over by a garbage truck.  This is \nclotted just what appears to be some fluid accumulation in the \nher (sic) left lower extremity medial gastroc region.  Like to get \nan ultrasound of this to see if there is fluid that can be \n\nLAWRENCE - H204710  8\n  \n \n \naspirated or even surgically debrided as has not improved \nover the last month.  Has evidence of meralgia paresthetica \nsecondary to nerve injury that [has] occurred to her left lower \nextremity.  At the go ahead to start her on some gabapentin.  \nRecommend trying a steroid pack to see if get some of the \nswelling down as well.  Lots of elevation.  Need to \naggressively start physical therapy to help work on lymphatic \nflow and get swelling down.  See her back in 2 weeks to see \nhow the ultrasound results are and if any of these modalities \nare helping her to improve her.   \n \n Dr. Cutler took the claimant off work on July 19, 2022 “pending MRI.”   \n An Ultrasound Imaging Report was done on July 20, 2022 with the \nimpression, “Complex septated probable hematoma in the medial left calf \nmeasuring 8.0 x 2.0 x 5.5 cm.”   \n Dr. Cutler gave the following impression on July 26, 2022:  “Crush \ninjury to left lower extremity with neuropathy and severe contusions \nincluding a large 8 x 5 and half centimeter hematoma.  Will continue to treat \nnonoperatively as her symptoms are slowly improving.  Physical therapy will \nbe her biggest asset.  We will follow-up in 1 month for recheck.”   \nDr. Cutler continued to provide follow-up treatment, and he kept the \nclaimant off work. \nAn MRI of the claimant’s left knee was taken on September 8, 2022, \nwith the impression, “Examination is limited by patient motion.  There may \nbe some articular cartilage fraying in the medial compartment of the knee.”  \nIn addition, an electromyographer reported on September 8, 2022: \n\nLAWRENCE - H204710  9\n  \n \n \n44 y/o female with c/o LLE injury with being run over by a \ngarbage truck, 3 months ago.  Low back ache and sharp \nintermittent pain with LLE posterior radiation, Hx back surgery \nx4, most recent in 2016.  Ambulates on walker carrying LLE in \nflexion, will not attempt to place foot on floor.  Trace volitional \nfiring of ankle/digit flexors and extensors, inconsistent effort.  \nMarked hematoma on the LLE antero-medial lower leg.... \nFindings:  No significant peroneal motor slowing but \namplitudes are reduced.  Tibial motor values are WNLs.  EMG \nneedle exam reveals increased insertional activity in the left \nsacral paraspinals and gastrocs.  Large amplitude \nspontaneous activity in the left ant tib, gastrocs and AIIB.  \nPeroneus longus is spared.   \nConclusions:  1)  S1 radiculopathy with moderate acute axon \nloss.  Correlation with imaging should be of benefit. \n2)  Focal lesion of the left peroneal branch of the peroneal \nnerve in the anterior lower leg, with moderate acute axon loss, \nsignificant sparing is suggestive of a good prognosis for re-\ninnervation via sprouting.   \n \n Dr. Cutler gave the following impression on September 21, 2022:  \n“Crush injury to left lower extremity with left S1 radiculopathy complex \nregional pain syndrome and left foot drop.  Because of the EMG report that \nthis would like to go ahead and get an MRI of her lumbar spine.  I will \ncontinue her on the gabapentin.  I need to get her a brace for her foot drop \nto help with ambulation.  Continue to be off work.”   \n An MRI of the claimant’s lumbar spine was taken on October 3, \n2022: \nHISTORY:  Back pain.  Prior surgery.  Left lower extremity \nradiculopathy.... \nFINDINGS:  Standard lumbar spinal numbering.  Prior \nposterior decompression and interbody fusion at L4/L5 and \nL5/S1 along with posterior fusion construct in place from L4-\nS1.  Vertebral body heights are well-maintained.  No osseous \n\nLAWRENCE - H204710  10\n  \n \n \nmass or marrow edema.  Grade 1 degenerative retrolisthesis \nat L3/L4.  No significant scoliosis.   \nNo paraspinous fluid collection or inflammatory changes.  \nPostoperative denervation muscle atrophy evident.  Normal \nappearance of the visualized distal spinal cord.  The conus \nmedullaris terminates at L1/L2.  No thickening or dumping of \nthe cauda equina.  No epidural fluid collection.   \nT11/T12 M-L2/L3:  Normal. \nL3/L4:  Grade 1 degenerative retrolisthesis.  Mild disk height \nloss and disk bulging.  Mild facet hypertrophy with slight facet \nwidening.  No narrowing.   \nL4/L5:  Prior laminectomy and interbody/posterior fusion.  No \nnarrowing.  No scar tissue evident on this noncontrast study.   \nL5/S1:  Prior laminectomy and interbody/posterior fusion.  \nThere is some nonspecific intermediate signal material within \nthe left lateral recess contacting the traversing S1 nerve root.  \nNo canal or foraminal stenosis. \nIMPRESSION:  1.  Intermediate intermediate intensity signal \nmaterial within the left lateral recess at L5/S1 contacting and \npossibly encasing the traversing left S1 nerve root.  Unable to \nexclude scar tissue given the prior surgery.  Correlate with \nany left S1 radicular symptoms.   \n2.  Prior decompression and interbody/posterior fusions at \nL4/L5 and at L5/S1.  Mild adjacent segment disease at L3/L4 \nwith grade 1 retrolisthesis and mild bulging of the disk.  No \nnarrowing at L3/L4.   \n \n Dr. Cutler gave the following impression on October 4, 2022:  “Status \npost being run over by a garbage truck with severe left lower extremity \nradiculopathy and peripheral nerve issues.  Left foot drop from peripheral \nnerve as well as a large lateral L5-S1 herniation.  At this time because of \nthe continued foot drop need to get her back into her spine surgeon Dr. \nSegura Little Rock for evaluation for possibility of a selective nerve root \ninjection versus surgical intervention.”   \n Dr. Saer reported on October 25, 2022: \n\nLAWRENCE - H204710  11\n  \n \n \nMs. Lawrence is now 44 years old.  I have seen and treated \nher in the past.  She had TLIF at L5-S1 in 2007 and then at \nL4-5 in November 2016.   \nShe is back today with back and left lower extremity pain, \nespecially in her knee and ankle, that occurred on June 16, \n2022.  She got out over the passenger side of a truck driven \nby a coworker.  She was checking clearance when someone \ncame up behind the truck and honked.  Her coworker [moved] \nthe truck forward, knocking her down.  She says the truck \nactually ran over her.  She [was] on her side and her left lower \nextremity went between the rear dual wheels.   \nShe was taken to the ER and evaluated.  No fractures were \nfound but she says she had bruised kidneys.  She developed \nsignificant back pain which persists.  This is present when she \nsits or stands and gets better when she lies down.  She says it \nfeels like “something is moving” in her back.  She also reports \npain in the lateral hip area and burning down the left lower \nextremity as well as a feeling of weakness.  She [has] been \ngoing to physical therapy for her hip and leg....She is seeing \nDr. Cutler for her knee and ankle pain.   \nExam:  She is a well-developed woman who walks on a \nwalker.  She holds her left lower extremity with hip and knee \nslightly flexed and the left foot inverted and plantarflex.   \nHer back is not really tender to palpation.  Motion is limited in \nall directions.   \nLower extremities had no distal edema, intact pulses.   \nReflexes are diminished but equal at knees and ankles with \nno clonus.  Motor testing reveals weakness in all groups on \nthe left lower extremity.  She has no active dorsiflexion or \nplantarflexion of the left foot, trace inversion and eversion.  In \nfact she has trace quads and hamstrings, which does not \nexactly match up with her walking, because she is holding \nboth hip and knee slightly flexed.  SLR is negative.   \nX-rays:  Standing AP lateral lumbar films today show \ninstrumentation L4-S1 with interbody fusion at both levels.  \nFusion appears solid.  Other levels are relatively \nunremarkable although she has some very early degenerative \nchanges at L3-4 anteriorly.   \nMRI lumbar spine done October 3, 2022 shows slight \nretrolisthesis and very mild stenosis at L3-4, with mild \ndesiccation of the disc there.  Otherwise it is fairly \nunremarkable.   \n\nLAWRENCE - H204710  12\n  \n \n \nAssessment:  She does not have a definite bony injury in her \nlumbar spine and there is no definite nerve root compression.  \nShe certainly could have an injury to the peroneal nerve or a \nneuropraxia even the lumbar plexus.  I do not see anything in \nher spine now that looks like she needs any further treatment.  \nContinuing therapy is probably her best bet. \n \n Dr. Saer’s assessment on October 25, 2022 was “1.  Low back pain” \nand “2.  Body mass index 30+ - obesity.”   \n Dr. Cutler reported on November 9, 2022: \nThis is a 44 year old female who is being seen for a chief \ncomplaint of left lower extremity.  Work comp – left lower \nextremity radiculopathy and foot drop post referral. \nAlice comes in today continuing to make progress in her lower \nextremity and the motion and pain.  But still very frustrated as \nshe cannot sit comfortably because of left hip and low back \npain.  She still has a foot drop on the left.  States that she \nwent to previous spine surgeon in Little Rock where she was \nextremely disappointed with.  States that she did not feel \nlistened to at all.  States that he asked the same question 8 \ntimes about her having an EMG where she is already had 1.... \nImpression/Plan:  Status post to run over by a garbage truck \nwhich is caused severe left lower extremity radiculopathy and \nfoot drop.  EMG and MRI of the lumbar spine are consistent \nwith new herniations from this injury.  Do recommend having \nsecond opinion performed as she did not feel like she got any \nadditional treatments from this spine evaluation.  Continue \nwith physical therapy and gabapentin.  Unfortunately off work \nstill.  Follow-up in 4 weeks.   \n \n Dr. Cutler performed an injection into the claimant’s left SI joint on \nNovember 9, 2022.   \n Dr. Rodrigo Cayme performed electrodiagnostic testing on \nDecember 15, 2022 and gave the following impression: \n  1.  Abnormal electrodiagnostic study. \n\nLAWRENCE - H204710  13\n  \n \n \n2.  There is electrodiagnostic evidence suggestive of a mild \nnonlocalizable peroneal neuropathy with no focal slowing \nseen at the fibular head and no active denervation in any \nperoneal innervated muscles tested.  In addition, there were \ninconsistencies seen between functional and volitional activity \nthroughout the study as pt seen doing activities such as \nambulating, able to get on exam table on own accord, rotate \non table, extend and flex legs, but volitional activity was \nminimally seen.   \n3.  There is no electrodiagnostic evidence of any other focal \nnerve entrapment, generalized peripheral neuropathy, or left \nlumbar radiculopathy. \n4.  Of note, EMG is not a completely sensitive study, and does \nnot evaluate small sensory pain fibers.  Thus, lack of active \ndenervation on today’s study does not exclude an active \nradiculopathy.  Clinical correlation is needed to determine the \nsignificance of today’s electrodiagnostic examination findings.   \n \n Dr. Saer reported on December 15, 2022: \nMs. Lawrence returns today in follow-up after an EMG/NCV of \nthe left lower extremity.  She continues to complain of pain \nmedially and laterally in the left knee, as well as some pain \nthat comes out of the back and goes into the groin.  Sitting \ncauses pain down the left lower extremity posteriorly.   \nShe has been going to physical therapy.  She says not much \nis really changed since she was here.   \nShe still walks with a walker with the left knee and hip slightly \nflexed and the foot inverted, dragging her toes a little bit.   \nEMG/NCV study done earlier today was reviewed.  I spoke \nwith [the] APRN.  There is no slowing of the peroneal nerve at \nthe fibular head and no active denervation in any of the \nperoneal muscles.  The tester also noted some \ninconsistencies in patient’s actual movement spontaneously \nand when observed.   \nI reassured her that this did not show anything that she \nneeded surgery for.  I think this will improve with time.  She \nneeds to continue working on this on her own also.  I will see \nher as needed.   \n \n\nLAWRENCE - H204710  14\n  \n \n \n The claimant continued to follow up with Dr. Cutler, who noted on \nDecember 28, 2022 that the claimant wished to be referred to another spine \nsurgeon.   \nDr. Cutler reported on February 6, 2023: \nThis is a 45 year old female who is being seen for a chief \ncomplaint of left lower extremity.  Patient is following up for left \nlower extremity radiculopathy from work injury on 6/16/22. \nContinues to complain of pain and weakness in her left lower \nextremity.  States she is still unable to pick up her foot.  Did \nfinally get the brace for her left lower extremity but it does not \nhelp her foot dorsiflexion secondary to the foot drop but it \ndoes help keep it from rolling.  She states that she can tell a \ndifference if she misses a dose of her gabapentin.   \nExam:  Comes in today using a walker and her left ankle \narthrosis.  Is ambulating much better than she has been \nthrough still has a foot drop.  Straight leg raise on the left is \nless positive than it was.  Still has 2 out of 5 strength for \ndorsiflexion of her foot.  Her hip and knee range of motion is \nmuch improved.  Passive motion of her ankle is nearly normal.   \nImpression/Plan:  Status post crush injury to left lower \nextremity.  Her refill on gabapentin.  Continue physical therapy \nas she continues to make improvements.  We will have her \nfollow-up in 3 months to see how progress is.  Hopefully by \nthen she has been able to get into pain management and a \nsecond opinion on her back.   \n \n Dr. Cutler assigned Work Restrictions on February 6, 2023.  Dr. \nCutler instructed, “No driving, alternate sitting and standing if she can.”  If \nno alternative work was available, then the claimant was to remain off work \nuntil May 8, 2023.  Dr. Cutler also signed a form on or about February 6, \n2023 indicating, “Pain management for left LE pain.”     \n\nLAWRENCE - H204710  15\n  \n \n \nThe parties stipulated that the respondents paid temporary total \ndisability benefits through March 2, 2023, and that no temporary total \ndisability had been paid since that time. \n Dr. Cutler gave the following impression on March 22, 2023: \nLow back pain with severe left lower extremity radiculopathy \nsecondary to being crushed by a garbage truck almost a year \nago now.  This time watching the patient ambulate and get \naround.  I do not think she is doing well with this.  She has \nmade great progress with pain control with physical therapy \nand recommend continuing that to help with the pain.  I would \nalso recommend a C brace to her left lower extremity to assist \nwith [her] function and ability to be more independent with \nsimple ambulation.  I would also recommend [an] independent \nspine evaluation as I still think that many of these problems \nare coming from her lumbar spine or even lumbar plexus.  \nRecommend pain management to see if she is a candidate for \na spinal stimulator or if any injections would be of help with \nher pain.   \n \n Dr. Cutler planned on May 10, 2023, “Discussed with patient how I \nam still advocating for her to get a brace for her left lower extremity to help \nher ambulate.  Continue with therapy to help stimulate.  Vascular referral \nher again for pain management to assist her to see if there is anything far \n(sic) and plan wise to help her left lower extremity.”  Dr. Cutler continued to \nkeep the claimant off work.   \n A pre-hearing order was filed on August 3, 2023.  According to the \npre-hearing order, the claimant contended, “She suffered a compensable \ninjury to her left lower extremity, low back, and other body parts after she \nwas run over by a garbage truck at work.  The low back was and is, at the \n\nLAWRENCE - H204710  16\n  \n \n \nvery least, an aggravation of a preexisting condition, and is, therefore, \nrespondents’ continued responsibility, for medical care purposes, payment \nof indemnity benefits, and for any and all other benefits related thereto and \nallowed by the Act.  The workers’ compensation doctor is Justin Cutler, \nD.O., a Harrison orthopedic surgeon.  While respondents continue to pay \nfor Dr. Cutler’s medical care, they have denied at least two of his treatment \nrecommendations, namely a C-brace for claimant’s leg and a referral to \npain management for left lower extremity pain.  This constitutes reasonable, \nnecessary, and related medical care, and respondents should be required \nto provide it.  Claimant continues to treat with Dr. Cutler at respondent’s \nexpense; she remains in a healing period and in an ‘off work’ capacity \nsecondary to her various injuries; at least one of her injuries is scheduled; \nand she has not returned to work.  She is, therefore, entitled to an award of \nadditional temporary total disability benefits from the date last paid \n(approximately May 10, 2023) through a date to be determined.  Claimant’s \ncounsel is entitled to payment of a statutory attorney’s fee on all \ncontroverted indemnity benefits.  Claimant respectfully reserves the right to \namend and/or otherwise alter the above contention as discovery \nprogresses.  All other potential issues are expressly reserved for litigation at \na later date including, but not necessarily limited to, anatomical impairment, \npermanent total disability, wage-loss disability, vocational rehabilitation, \n\nLAWRENCE - H204710  17\n  \n \n \nSection 11-9-505(a) benefits, and any other additional benefit allowed by \nlaw.  This is a claim for additional compensation, and claimant renews her \nrequest for an award of any and all benefit to which she may be entitled, \nunder the Arkansas Workers’ Compensation Act.” \n The respondents contended, “The claimant’s left lower extremity was \naccepted, and all appropriate benefits have been paid.  The claimant’s back \ncondition is preexisting and there is no objective evidence to support a \ncompensable injury to the lower back.  The treatment suggested by Dr. \nCutler is for the back and symptoms related to the back.  The claimant’s \nperiod of disability, if there is one, is related to her back which is not \ncompensable.”   \n The parties agreed to litigate the following issues: \n  1.  Compensability, regarding claimant’s back injury. \n2.  If compensable, whether claimant is entitled to additional \nmedical treatment. \n3.  Whether claimant is entitled to temporary total disability \nbenefits.   \n  4.  Compensation rate. \n5.  Attorney’s fees.  All other issues are reserved by the \nparties. \n \n The claimant followed up with Dr. Cutler on August 16, 2023: \nThis is a 45 year old female who is being seen for a chief \ncomplaint of left leg.  Patient is here severe left lower \nextremity radiculopathy. \nPatient comes in with continued minimal use of her left lower \nextremity.  Complains of inability to drive to take herself to and \nfrom doctors appointments or physical therapy appointments.  \nPatient has not been able to work and so her husband has \n\nLAWRENCE - H204710  18\n  \n \n \nhad to pick up additional jobs including long haul truck driving \nto pay their bills.  Patient states that she is following (sic) a \nmultitude of times and shows evidence of her walker having \nmultiple did not send it from her falls (sic).  Continues to \ncomplain of inability to be able to sit upright secondary to the \nsevere low back pain and hip pain that it causes.  Has to stay \nin a semirecumbent position.   \nExam:  Patient is clean and well-groomed today.  Her skin is \nintact without rash lesion or open wounds.  She ambulates \nwith a walker with her left foot completely abducting and \nunderneath of her walking on the dorsal aspect of it.  She has \nto swing her leg through.  On exam she has good passive \nmotion of her hip elbow and ankle....Today I took a needle \npuncture into her legs throughout.  Nearly the entire leg a \nseparate small area of the anterior thigh is without sensation.  \nPatient reacted extremely well to the contralateral leg and 2 \nareas above the hip line to be improved.   \nImpression/Plan:  Patient is status post being run over by a \ndump truck with a complete loss of function of the left lower \nextremity.  [Has] been reported from Worker’s Comp that she \nhad a previous low back injury with a nerve root impingement.  \nThis is nothing like that type of injury.  This is a completely \nadditional ordeal.  Patient has no functional use of her left \nlower extremity.  Patient requires of substantial on the amount \nof assistance and cannot drive or even ambulate without \nsignificant help.  Patient would greatly benefit from a C brace \nto help control her hip knee and ankle motions.  This would \nallow her to have more independence with activities of daily \nliving.  Even where patient did have a documented previous \nback injury from many years ago.  This is an injury that has \nmore than aggravated those problems.  In reality this is a \ncompletely new injury causing severe nerve function \ndysfunction to her entire left lower extremity.     \n \n Dr. Cutler signed a form on August 16, 2023 indicating that the \nclaimant was to remain off work until November 16, 2023.   \nOn or about September 28, 2023, the respondents filed a MOTION \nFOR INDEPENDENT MEDICAL EXAM....Respondents ask that the \n\nLAWRENCE - H204710  19\n  \n \n \nclaimant be ordered to attend an appointment with Dr. Robert Martin \npursuant to A.C.A. §11-9-511 and A.C.A. §11-9-811.”   \n A hearing was held on October 26, 2023.  At that time, the parties \nstipulated that an accident occurred on June 16, 2022 and that the \nrespondents accepted a left leg injury.  An administrative law judge took \nunder advisement the respondents’ motion for an independent medical \nexamination. \n The claimant’s testimony indicated that the respondent-carrier \ncontinued to pay for treatment provided by Dr. Cutler.  The claimant \ntestified, however, that the respondents had terminated her employment.           \n Dr. Chelsea S. Mathews provided a report on January 25, 2024: \n“46-year-old female presents today for IME secondary to \nspasticity and poor motor control of left lower extremity.  She \nhas a history of lumbar spine surgery by Dr. Saer in \nNovember of 2015.  At some time surrounding the procedure \nshe had radiculopathy and footdrop which improved.  This \nseems to have again worsened after the crush injury in June \nof 2022.  She has been seen by Dr. Cutler who has performed \na very thorough workup including multiple EMG used to \nevaluate her peroneal nerve.     \nShe has pain with standing and difficulty using the left lower \nextremity secondary to spasm and equina varus positioning of \nthe foot and ankle.  She has very limited motor control and \nambulates with a walker.”   \nShe is here today for follow-up of MR neurography on the left \nlower extremity.... \n“Inspection:  Examination of the left lower extremity \ndemonstrates some atrophy of the subcutaneous fat on the \nmedial aspect of the calf.  There is no evidence of this \nlaterally.  When resting she maintains the foot and \nequinovarus position.  There does appear to be some spasm \n\nLAWRENCE - H204710  20\n  \n \n \nof the tibialis anterior.  I made a full to passively reduce to \nneutral.  She exhibits no voluntary motor function in eversion \nor dorsiflexion....When standing her foot naturally [rests] on \nthe lateral aspect of the mid and forefoot.  When ambulating \nthis foot drags.  The tibialis anterior tendon does appear to be \nfiring when performing this.  She is able to passively correct \nthe foot it begins to drag underneath her again.  Regards to \nmore proximal exam she is able to perform quad extension 2+ \nout of 5.”   \nI have reviewed the following images/outside documentation: \n1.  MR enterography of the left lower extremity demonstrates \nno evidence of nerve damage around the knee or fibular head \nthat would explain changes in this area after her crush injury.   \n \nAssessment \n46-year-old female with history of prior insult to lumbar spine \nand nerves resulting in footdrop which reportedly improved \nand has again worsened since her crush injury.   \n \nPlan \nWe had a long discussion today regarding her MR \nenterography results.  There is no radiographic evidence of \ndamage to the nerve at the area of her leg crush injury.  She \ndoes report to me today that the vehicle ran over her leg as \nhigh as her thigh which was unclear to me prior to today’s \nvisit.  None the less I do not see any evidence of peroneal \nnerve damage or compartment damage in the leg to explain \nher foot contracture and spasticity.  This may be explained by \na double hit phenomenon to the nerve more proximally.  This \nis outside the realm of my expertise as a foot ankle orthopedic \nsurgeon.  If she would like a more clear answer she may seek \nindependent examination by someone who specializes in \nspine and hip pathology.   \nBased upon her clinical examination I do not feel that she is \ncapable of caring (sic) out prior work duties including working \na truck.  She would be unable to ambulate any long distance \nover 10 ft.  She will be unable to climb ladders, stairs, squat or \ncarry any weighted objects.   \n \n An administrative law judge filed an opinion on June 20, 2024.  The \nadministrative law judge found, among other things, that the claimant \n\nLAWRENCE - H204710  21\n  \n \n \nproved she sustained a compensable injury to her left leg and back on June \n16, 2022.  The administrative law judge found that the claimant was entitled \nto temporary total disability benefits beginning March 3, 2023 until a date to \nbe determined.  The administrative law judge ordered the respondents to \npay benefits in accordance with the findings of fact.  The respondents \nappeal to the Full Commission. \nII.  ADJUDICATION \n A.  Compensability \n Ark. Code Ann. §11-9-102(4)(Repl. 2012) provides, in pertinent part: \n  (A)  “Compensable injury” means: \n(i)  An accidental injury causing internal or external physical \nharm to the body ... arising out of and in the course of \nemployment and requires medical services or results in \ndisability or death.  An injury is “accidental” only if it is caused \nby a specific incident and is identifiable by time and place of \noccurrence [.]   \n \n A compensable injury must be established by medical evidence \nsupported by objective findings.  Ark. Code Ann. §11-9-102(4)(D)(Repl. \n2012).  “Objective findings” are those findings which cannot come under the \nvoluntary control of the patient.  Ark. Code Ann. §11-9-102(16)(A)(i)(Repl. \n2012).   \n The employee has the burden of proving by a preponderance of the \nevidence that she sustained a compensable injury.  Ark. Code Ann. §11-9-\n102(4)(E)(i)(Repl. 2012).  Preponderance of the evidence means the \n\nLAWRENCE - H204710  22\n  \n \n \nevidence having greater weight or convincing force.  Metropolitan Nat’l \nBank v. La Sher Oil Co., 81 Ark. App. 269, 101 S.W.3d 252 (2003). \n It is the duty of the Full Commission to enter findings in accordance \nwith the preponderance of the evidence and not on whether there is \nsubstantial evidence to support an administrative law judge’s findings.  \nRoberts v. Leo Levi Hospital, 8 Ark. App. 184, 649 S.W.2d 402 (1983).  The \nFull Commission reviews an administrative law judge’s opinion de novo, \nand it is the duty of the Full Commission to conduct its own fact-finding \nindependent of that done by an administrative law judge.  Crawford v. Pace \nIndus., 55 Ark. App. 60, 929 S.W.2d 727 (1996).  The Full Commission \nenters its own findings in accordance with the preponderance of evidence.  \nTyson Foods, Inc. v. Watkins, 31 Ark. App. 230, 792 S.W.2d 348 (1990).     \n An administrative law judge found in the present matter, “2.  \nClaimant has met her burden of proving that she suffered a compensable \ninjury to her left leg and back on June 16, 2022.”  The Full Commission \nfinds that the claimant did not prove by a preponderance of the evidence \nthat she sustained a compensable back injury.  The evidence demonstrates \nthat the claimant began suffering from chronic low back pain no later than \n2007.  Dr. Saer performed surgery in 2007 and noted in January 2008, “her \nleft toe drags.”  Dr. Saer reported in February 2008 that the claimant “will \nstill drag her toe when she walks on the treadmill.”  An APRN reported in \n\nLAWRENCE - H204710  23\n  \n \n \nDecember 2016 that the claimant “was walking up steps and could not pick \nup her left foot.  It caught and she fell into the wall.”   \n The claimant testified that she became employed with the \nrespondents, Searcy County, on November 29, 2021.  The parties \nstipulated that the employment relationship existed on June 16, 2022.  The \nclaimant testified that, while performing employment services, she was hit \nand knocked down by a moving truck.  The claimant testified, “It went up on \nmy left foot....The wheels stopped on my lower back[.]...I had tire tread on \nmy back where he stopped.”  In workers’ compensation cases, the \nCommission functions as the trier of fact.  Blevins v. Safeway Stores, 25 \nArk. App. 297, 757 S.W.2d 569 (1988).  The Commission is not required to \nbelieve the testimony of the claimant or any other witness but may accept \nand translate into findings of fact only those portions of the testimony it \ndeems worthy of belief.  Farmers Co-op v. Biles, 77 Ark. App. 1, 69 S.W.3d \n899 (2002).  An administrative law judge’s credibility determination is not \nbinding on the Full Commission.  Roberts, supra.       \n In the present matter, the Full Commission does not find credible the \nclaimant’s testimony that there was “tire tread” on her back following the \nJune 16, 2022 accidental injury.  The medical evidence did not corroborate \nthe claimant’s testimony in that regard.  As we have discussed, the claimant \nreceived emergency medical treatment on June 16, 2022, at which time she \n\nLAWRENCE - H204710  24\n  \n \n \ncomplained of “left thigh and knee pain.  Patient denies any other \nassociated symptoms.”  There was no indication that the claimant had \nsustained a back injury.  An x-ray of the claimant’s pelvis on June 16, 2022 \ndid not indicate that the claimant had sustained a back injury.  The claimant \nwas discharged on June 16, 2022 with the diagnoses “Crush Injury of the \nFoot” and “Knee Sprain, Adult.”   \n The Full Commission recognizes Dr. Abiseid’s notation on June 20, \n2022 that the claimant was complaining of low back pain.  However, the \nevidence does not demonstrate that Dr. Abiseid’s assessment of \n“intervertebral disc disorders” was causally related to the June 16, 2022 \naccidental injury.  An MR of the claimant’s lumbar spine on July 7, 2022 \nshowed “mild spinal stenosis L3-4” but there is no indication that this \ndegenerative condition was causally related to the accidental injury.  Dr. \nSaer reported on October 25, 2022, “MRI lumbar spine done October 3, \n2022 shows slight retrolisthesis and very mild stenosis at L3-4, with mild \ndesiccation of the disc there.  Assessment:  She does not have a definite \nbony injury in her lumbar spine and there is no definite nerve root \ncompression [emphasis supplied].”  Yet Dr. Cutler opined in part on \nNovember 9, 2022, “EMG and MRI of the lumbar spine are consistent with \nnew herniations from this injury.”   \n\nLAWRENCE - H204710  25\n  \n \n \n The Commission has the duty of weighing medical evidence and, if \nthe evidence is conflicting, its resolution is a question of fact for the \nCommission.  Green Bay Packaging v. Bartlett, 67 Ark. App. 332, 999 \nS.W.2d 695 (1999).  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. 94, 989 S.W.2d 151 (1999).  In the present \nmatter, the Full Commission finds that Dr. Saer’s opinion is credible and is \nentitled to more evidentiary weight than Dr. Cutler’s opinion.  The medical \nevidence corroborates Dr. Saer’s expert opinion, “She does not have a \ndefinite bony injury in her lumbar spine[.]”   \n The Full Commission finds that the claimant did not prove by a \npreponderance of the evidence that she sustained a “compensable injury” \nto her low back or lumbar spine.  The claimant did not prove that she \nsustained an accidental injury causing internal or external physical harm to \nthe low back or lumbar spine.  The claimant did not prove she sustained an \ninjury to her low back or lumbar spine which arose out of and in the course \nof employment, required medical services, or resulted in disability.  The \nclaimant did not prove she sustained an injury to her low back or lumbar \nspine as the result of a specific incident identifiable by time and place of \noccurrence on June 16, 2022 or any other date.  Additionally, the claimant \ndid not establish a compensable injury to her low back or lumbar spine by \n\nLAWRENCE - H204710  26\n  \n \n \nmedical evidence supported by objective findings.  Nor did the claimant \nproved that she sustained a compensable aggravation of a pre-existing \ncondition.  See Farmland Ins. Co. v. Dubois, 54 Ark. App. 141, 923 S.W.2d \n883 (1996).  The dragging or “foot drop” of the claimant’s left lower \nextremity, which was first noted in January 2008, cannot be interpreted as \nobjective medical evidence establishing a compensable injury to the \nclaimant’s back or lumbar spine.     \n B.  Medical Treatment \n The employer shall promptly provide for an injured employee such \nmedical treatment as may be reasonably necessary in connection with the \ninjury received by the employee.  Ark. Code Ann. §11-9-508(a)(Repl. 2012).  \nThe employee has the burden of proving by a preponderance of the \nevidence that medical treatment is reasonably necessary.  Stone v. Dollar \nGeneral Stores, 91 Ark. App. 260, 209 S.W.3d 445 (2005).  What \nconstitutes reasonably necessary medical treatment is a question of fact for \nthe Commission.  Wright Contracting Co. v. Randall, 12 Ark. App. 358, 676 \nS.W.2d 70 (1984).        \n An administrative law judge found in the present matter, “3.  \nRespondent is liable for payment of all reasonable and necessary medical \ntreatment provided in connection with claimant’s compensable injuries.”  \nThe claimant did not prove she sustained a compensable injury to her low \n\nLAWRENCE - H204710  27\n  \n \n \nback or lumbar spine.  However, the respondents agreed that the claimant \nsustained a compensable injury to her left lower extremity as a result of the \naccidental injury occurring June 16, 2022.  The Full Commission finds that \nthe claimant proved the medical treatment of record provided in connection \nwith her left lower extremity injury on and after June 16, 2022 was \nreasonably necessary in accordance with Ark. Code Ann. §11-9-\n508(a)(Repl. 2012).  An emergency physician noted on June 16, 2022 that \nthe claimant’s “left leg was run over....Patient complains of left thigh and \nknee pain.”  The claimant was diagnosed with “Crush Injury of the Foot” and \n“Knee Sprain, Adult.”  Dr. Abiseid reported “multiple bruises on the left side \nof her leg and thigh” on June 20, 2022.  The claimant began treating with \nDr. Cutler on July 19, 2022.   \n Dr. Cutler’s recommendation on February 6, 2023 was “Pain \nmanagement for left LE pain.”  The Full Commission finds that pain \nmanagement for the claimant’s left lower extremity, as recommended by Dr. \nCutler, was reasonably necessary in accordance with Ark. Code Ann. §11-\n9-508(a)(Repl. 2012).  Dr. Cutler stated on March 22, 2023, “I would also \nrecommend a C brace to her left lower extremity to assist with [her] function \nand ability to be more independent with simple ambulation.”  Dr. Cutler \nreiterated on May 10, 2023, “Discussed with patient how I am still \nadvocating for her to get a brace for her left lower extremity to help her \n\nLAWRENCE - H204710  28\n  \n \n \nambulate.”  The Full Commission finds that the claimant proved the \nprescription for a “C brace,” as recommended by Dr. Cutler, was reasonably \nnecessary in connection with the compensable injury to the claimant’s left \nlower extremity.   \n C.  Temporary Disability \n Finally, for scheduled injuries the injured employee is to receive \ncompensation for temporary total disability during the healing period or until \nthe employee returns to work, whichever occurs first.  Ark. Code Ann. §11-\n9-521(a)(Repl. 2012); Wheeler Constr. Co. v. Armstrong, 73 Ark. App. 146, \n41 S.W.3d 822 (2001).  The healing period is that period for healing of the \ninjury which continues until the employee is as far restored as the \npermanent character of the injury will permit.  Nix v. Wilson World Hotel, 46 \nArk. App. 303, 879 S.W.2d 457 (1994).  If the underlying condition causing \nthe disability has become more stable and if nothing further in the way of \ntreatment will improve that condition, the healing period has ended.  Id.  \nWhether an employee’s healing period has ended is a question of fact for \nthe Commission.  Ketcher Roofing Co. v. Johnson, 50 Ark. App. 63, 901 \nS.W.2d 25 (1995).   \n An administrative law judge found in the present matter, “4.  \nClaimant is entitled to temporary total disability benefits beginning March 3, \n2023 until a date to be determined.”  The Full Commission finds that the \n\nLAWRENCE - H204710  29\n  \n \n \nclaimant proved she was entitled to additional temporary total disability \nbenefits beginning March 3, 2023 and continuing through January 25, 2024.  \nAs we have discussed at length, the claimant proved by a preponderance of \nthe evidence that she sustained a compensable injury to her left lower \nextremity on June 16, 2022.  The claimant’s compensable injury was \nscheduled in accordance with Ark. Code Ann. §11-9-521(a)(Repl. 2012).  \nThe claimant testified that she did not return to work following the \ncompensable scheduled injury.  The claimant treated conservatively with \nseveral physicians including Dr. Abiseid, Dr. Cutler, and Dr. Saer.  Dr. \nCutler assigned Work Restrictions on February 6, 2023 and stated, “No \ndriving, alternate sitting and standing if she can.”  If no alternative work was \navailable, then the claimant was to remain off work until May 8, 2023.   \n The parties stipulated that the respondents paid temporary total \ndisability benefits through March 2, 2023.  Dr. Mathews examined the \nclaimant on January 25, 2024 and reported, “1.  MR enterography of the left \nlower extremity demonstrates no evidence of nerve damage around the \nknee or fibular head that would explain changes in this area after her crush \ninjury....There is no radiographic evidence of damage to the nerve at the \narea of her leg crush injury....I do not see any evidence of peroneal nerve \ndamage or compartment damage in the leg to explain her foot contracture \nand spasticity.”   \n\nLAWRENCE - H204710  30\n  \n \n \n Based on the evidence of record to include Dr. Mathews’ report, the \nFull Commission finds that the claimant reached the end of the healing \nperiod no later than January 25, 2024.  The evidence demonstrates that the \nunderlying condition causing the claimant’s disability had become more \nstable no later than January 25, 2024, and nothing further in the way of \ntreatment would improve the underlying condition related to the crush injury \nsustained by the claimant on June 16, 2022.  See Nix, supra.  The record \nshows that, by January 25, 2024, the claimant was as far restored as the \npermanent character of the injury would permit.  Milligan v. West Tree \nServ., 57 Ark. App. 14, 946 S.W.2d 697 (1997).  Temporary total disability \nbenefits cannot be awarded after the healing period has ended.  Id.  We \nrecognize Dr. Mathew’s assignment of work restrictions, including “She will \nbe unable to climb ladders, stairs, squat or carry any weighted objects.”  \nNevertheless, the Full Commission finds that the work restrictions assigned \nby Dr. Mathews can be classified as permanent and do not alter our finding \nthat the claimant has reached the end of the healing period for the crush \ninjury she sustained on June 16, 2022.   \n The Full Commission’s finding that the claimant has reached the end \nof her healing period is not inconsistent with our award of pain management \nand a “C brace.”  It is well-settled that a claimant may be entitled to ongoing \nmedical treatment after the healing period has ended, if the medical \n\nLAWRENCE - H204710  31\n  \n \n \ntreatment is geared toward management of the claimant’s injury.  Patchell \nv. Wal-Mart Stores, Inc., 86 Ark. App. 230, 184 S.W.3d 31 (2004).  We find \nin the present matter that additional pain management and a “C brace” are \ngeared toward management of the claimant’s compensable injury.   \n After reviewing the entire record de novo, the Full Commission finds \nthat the claimant did not prove by a preponderance of the evidence that she \nsustained a compensable back injury.  We find that the claimant proved the \nmedical treatment of record provided in connection with her compensable \nleft leg injury, including pain management and a “C brace,” was reasonably \nnecessary in accordance with Ark. Code Ann. §11-9-508(a)(Repl. 2012).  \nThe Full Commission finds that the claimant proved she was entitled to \nadditional temporary total disability benefits from March 3, 2023 through \nJanuary 25, 2024.  The claimant did not continue within a healing period for \nher compensable scheduled injury after January 25, 2024.  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 in part on appeal, the \nclaimant’s attorney is entitled to an additional fee of five hundred dollars \n($500), pursuant to Ark. Code Ann. §11-9-715(b)(Repl. 2012). \n  \n \n \n\nLAWRENCE - H204710  32\n  \n \n \nIT IS SO ORDERED.  \n \n    ___________________________________ \n    SCOTTY DALE DOUTHIT, Chairman \n \n    ___________________________________ \n    M. SCOTT WILLHITE, Commissioner \n \n    ___________________________________ \n    MICHAEL R. MAYTON, Commissioner","preview":"BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION CLAIM NO. H204710 ALICE E. LAWRENCE, EMPLOYEE CLAIMANT SEARCY COUNTY JUDGE, EMPLOYER RESPONDENT AAC RISK MANAGEMENT SERVICES, INSURANCE CARRIER/TPA RESPONDENT OPINION FILED OCTOBER 31, 2024","fetched_at":"2026-05-19T22:29:44.903Z","links":{"html":"/opinions/full_commission-H204710-2024-10-31","pdf":"https://www.labor.arkansas.gov/wp-content/uploads/Lawrence_Alice_H204710_20241031.pdf","source_publisher":"https://labor.arkansas.gov/workers-comp/awcc-opinions/full-commission-opinions/"}}