{"id":"full_commission-H206753-2023-08-29","awcc_number":"H206753","decision_date":"2023-08-29","opinion_type":"full_commission","claimant_name":"Daniela Grana","employer_name":"Rockline Industries, Inc","title":"GRANA VS. ROCKLINE INDUSTRIES, INC. AWCC# H206753 AUGUST 29, 2023","outcome":"denied","outcome_keywords":["denied:1"],"injury_keywords":["carpal tunnel","back","wrist","repetitive","neck","cervical"],"pdf_url":"https://labor.arkansas.gov/wp-content/uploads/Grana_Daniela_H206753_20230829.pdf","source_index_url":"https://labor.arkansas.gov/workers-comp/awcc-opinions/full-commission-opinions/","filename":"Grana_Daniela_H206753_20230829.pdf","text_length":29389,"full_text":"BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION \n \n \nCLAIM NO.  H206753  \n \nDANIELA GRANA, \nEMPLOYEE \n \nCLAIMANT \nROCKLINE INDUSTRIES, INC.,  \nEMPLOYER \n \nRESPONDENT \nCNA INSURNACE COMPANY, \nINSURANCE CARRIER/TPA \nRESPONDENT \n  \n      \nOPINION FILED AUGUST 29, 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 KAREN H. McKINNEY, \nAttorney at Law, Little Rock, Arkansas. \n \nDecision of Administrative Law Judge:  Reversed. \n \n \n OPINION AND ORDER \nThe claimant appeals an administrative law judge’s opinion filed \nMarch 13, 2023.  The administrative law judge found that the claimant failed \nto prove she sustained a compensable injury.  After reviewing the entire \nrecord de novo, the Full Commission finds that the claimant proved she \nsustained a compensable bilateral carpal tunnel syndrome injury.  The \nclaimant proved that she was entitled to reasonably necessary medical \ntreatment and a period of temporary total disability benefits.     \nI.  HISTORY \n\nGRANA - H206753  2\n  \n \n \n Daniela Grana, now age 27, testified that she became employed with \nthe respondents as an Auxiliary Machine Operator in 2019.  The claimant \ntestified on direct examination: \nQ.  And as an Auxiliary Machine Operator, what were your \nduties? \nA.  They consist of fixing down machinery, working on the line \nwith packages, putting them into a box, and palletizing them.   \nQ.  Okay.  So fixing down machinery, what did you do in that \nwork? \nA.  If the machinery is jammed up, we go open it up, fix it, get \nit back up to running for the line so the line won’t stop.... \nQ.  So the work that you were doing at Rockline before April \nof 2022, was that all line work? \nA.  Yes.   \nQ.  And was it on a line that was moving as you were working \non it? \nA.  Yes.  The line is always moving.   \nQ.  Okay.  And these different duties that you would do \nthroughout the day, were there ever any duties that did not \nrequire the constant use of your hands? \nA.  No.   \n \n The claimant agreed on cross-examination that she also worked for \nother employers other than the respondents, including Walmart Optical \nLabs and Famous Footwear.  The claimant agreed that she operated a \ncash register and occasionally counted money while employed with \nFamous Footwear.  Additionally, the claimant agreed that she owned her \nown business, MB Creations, where she customized T-shirts and cups.     \nThe parties stipulated that the employee-employer-carrier \nrelationship existed on April 6, 2022.  The claimant testified on direct \nexamination: \n\nGRANA - H206753  3\n  \n \n \n  Q.  Now, in April of 2022, what symptoms did you develop? \n  A.  Pain, numbness, loss of strength. \n  Q.  In what area of my body? \n  A.  Of my wrists....The right one first.   \n  Q.  Okay.  And did you report that? \n  A.  Yes. \n  Q.  Who did you report it to? \n  A.  My supervisor.... \nQ.  Do you recall about how long it was after you reported it \nthat you were sent to a doctor? \nA.  I want to say two weeks.   \n \n The record corroborated the claimant’s testimony.  The claimant \nreceived treatment visits at Conservative Care Occupational Health \nbeginning April 20, 2022.  Dr. Konstantin V. Berestnev reported at that time: \nDaniela Grana is a 26 year-old female, and employee of \nRockline Industries Springdale.... \nEmployer Description of Accident:  Ms. Grana states that she \nhas been having on going pain to her right wrist since April 06, \n2022 but did not report it until April 11, 2022.... \nPatient states that she was turning over packages and \ngradually developed pain in her right wrist.  Patient states that \nshe was seen by a chiropractor.   \nHISTORY OF PRESENT ILLNESS \nDaniela’s primary problem is pain located in the right wrist.  \nShe describes it as aching.  She considers it to be medium.  \nThe problem began on 4/6/2022.  Daniela says that it seems \nto be intermittent.  She has noticed that it is made worse by \ntwisting, lifting.  It is improved with muscle cream, ibuprofen.  \nShe is currently receiving chiropractic therapy which she finds \nhelpful.... \nShe is working full time on regular duty. \nTime with current employer:  2 years.   \n \n Dr. Berestnev assessed “Right wrist extensor tendinitis.  Repetitive \nuse disorder.”  Dr. Berestnev’s Treatment Plan was “Discussed ergonomic \nmodifications with the patient and the company representative.  Best to \n\nGRANA - H206753  4\n  \n \n \nmodify her workplace with engineering solutions to prevent the need to \nmanually flip boxes to attach a label to the opposite side.”  Dr. Berestnev \nstated, “The cause of this problem appears to be related to work \nactivities....Daniela’s recommended Work Status is Regular Duty.”   \n Dr. Berestnev signed a Form AR-3, PHYSICIAN’S REPORT on April \n20, 2022 and diagnosed “Right wrist tendinitis.”  Dr. Berestnev planned \nconservative treatment and he returned the claimant to unrestricted work. \n Dr. Berestnev noted on April 27, 2022, “Patient states that her right \nwrist is about the same, she is still having pain.  Patient states that her left \nwrist is starting to hurt due to over compensating.”  Dr. Berestnev assessed \n“Right wrist extensor tendinitis.  Repetitive use disorder.  Now left wrist \nhurts after she was scraping glue with her left hand....The cause of this \nproblem appears to be related to work activities....Daniela’s recommended \nwork status is Regular Duty.”   \n The claimant followed up with Dr. Berestnev on May 18, 2022:  \n“Patient states that her wrists are about the same, she is still having pain.  \nPatient has been to 6 sessions of physical therapy.”  Dr. Berestnev \nassessed “Symptoms of median neuropathy....Referral for nerve \nconduction velocity study....The cause of this problem appears to be \nrelated to work activities.”     \n The claimant followed up with Dr. Berestnev on May 27, 2022: \n\nGRANA - H206753  5\n  \n \n \nDaniela Grana is a 26 year-old Female, and employee of \nRockline Industries Springdale.... \nMs. Grana states that she has been having on going pain to \nher right wrist since April 06, 2022 but did not report it until \nApril 11, 2022.  She has been seeing her Chiropractor.... \nPatient states that she was turning over packages and \ngradually developed pain in her right wrist.... \nPatient states that she feels like both wrists are hurting a little \nmore.  Patient states that she does not feel like physical \ntherapy helped.... \nDaniela’s primary problem is pain located in the both wrist \n(sic)....The problem began on 4/6/2022.  Daniela says that it \nseems to be constant.  She has noticed that it is made worse \nby using them.  She feels it is not improving.  She is here to \nreview her laboratory studies.... \nASSESSMENT \nLabwork shows elevated ESR and anti-ANA suggestive of \nlupus. \nNumber and Complexity of Problems Addressed:  1 \nundiagnosed new problem with uncertain prognosis. \nTREATMENT PLAN \nNeeds to see PCP. \nMEDICAL CAUSATION \nThe cause of this problem does not appear to be related to \nwork activities. \nRECOMMENDED WORK STATUS \nDaniela’s recommended work status is Regular Duty....The \npatient has been released.   \n \n Dr. Berestnev diagnosed “1.  Other specified disorders of tendon, \nright wrist” and “2.  Other lesions of median nerve, unspecified upper limb.”   \n Dr. Berestnev signed a Form AR-3, PHYSICIAN’S REPORT on May \n27, 2022 and diagnosed “Lupus – not work-related....Needs to see her \nPCP.” \n\nGRANA - H206753  6\n  \n \n \n The claimant’s testimony on cross-examination indicated that she \nwas off work after May 27, 2022.  The claimant testified that she sought \nmedical treatment on her own following Dr. Berestnev’s release.     \n Rachel Hudman, APN noted on May 31, 2022, “Pt was diagnosis \n(sic) with lupus from work after running blood test on Friday.  Pt here to \ndiscuss diagnosis, wrist pain and headaches.”  Ms. Hudman assessed “1.  \nBilateral wrist pain,” “2.  Anti-nuclear factor positive,” and “3.  Fatigue.”   \n Dr. Miles M. Johnson provided a Neurological \nEvaluation/Electrodiagnostic Report on June 23, 2022: \nPatient is a 26-year-old right-handed female with a 2 months \nhistory of bilateral hand pain, numbness, tingling, and \nweakness.  Symptoms are worse at night or with repetitive \nactivity.  Some improvement with braces.  Denies any neck \npain.  Patient has been seen by Dr. Hurtado and is referred \nfor electrodiagnostic testing of the bilateral upper \nextremities.... \nSUMMARY:  Bilateral median and ulnar motor studies are \nnormal.  Right and left median ulnar orthodromic latency \ndifference is mildly abnormal.  Radial sensory response is \nnormal bilaterally.  EMG examination of the bilateral upper \nextremities is within normal limits.   \nASSESSMENT:  Mild bilateral carpal tunnel syndrome.  There \nis no electrodiagnostic evidence of radiculopathy, plexopathy, \ngeneralized peripheral neuropathy or other peripheral nerve \nentrapment syndromes.   \n \n Dr. Johnson recommended “conservative management with wrist \ncock-up splints, nonsteroidals, possibly intracarpal corticosteroids.”   \n Dr. Mark Allard began treating the claimant on July 7, 2022: \n\nGRANA - H206753  7\n  \n \n \n26-year-old right-hand-dominant young lady works at a \nrepetitive manufacturing job comes in with a 3-month history \nof bilateral radial hand numbness and pain.  Dr. Hurtado has \nbeen seeing her and has her in wrist splints which help a little \nbit.  He sent her to therapy which helped a little bit.  It does \nnot wake her up much at night, but consistently bothers her at \nwork.  She occasionally takes an Advil which helps.  It is \nalways her thumb, index and long fingers.  She has as much \nproblem with pain as she does with numbness.  She got nerve \nconduction studies with Miles Johnson that showed mild \nchanges.  I reviewed that report.   \n \n Dr. Allard assessed “Bilateral carpal tunnel syndrome.  Her \nsymptoms are certainly worse than her nerve conduction studies would \nimply.  Cervical spine films look normal.  We will start with scheduled anti-\ninflammatory medicine along with her splints.”   \n Dr. Song Zang noted on August 16, 2022, “Pt was referred for +ANA.  \nIn concern of lupus.”  Dr. Zang assessed “1.  ANA positive” and noted, \n“Clinically not typical for lupus.  Will do some labs to confirm....The fatigue \nis more stress related.  RTC as needed.”   \n Dr. Allard performed a Right Carpal Tunnel Release on August 24, \n2022.  The pre- and post-operative diagnosis was “Right carpal tunnel \nsyndrome.”   \n Dr. Allard’s assessment on or about September 9, 2022 was \n“Bilateral carpal tunnel syndrome, status post right carpal tunnel release.  \nSutures removed today.  She can increase her activity as pain allows.  I do \nnot think she needs any therapy.  She will let us know when she is ready to \n\nGRANA - H206753  8\n  \n \n \ngo back to work and we can write her a note.  I will plan on seeing her here \n4 weeks from now for repeat clinical exam.  She is leaning toward left \ncarpal tunnel release later in the year.”   \n Dr. Allard noted on October 6, 2022, “Pt here today 4 wk f/u Rt CTR.  \nPt states she is doing good, but did notice the pain she was having returned \nafter she went back to work....Surgery date was 08/24/2022.”  Dr. Allard \nassessed “Bilateral carpal tunnel syndrome, status post right carpal tunnel \nrelease.  She has had some radial wrist pain as she has tried to go back to \nher repetitive labor job.  I thought we might build to get her through this \nwithout any therapy, but I will bet occupational therapy helps her get back to \nwork and get her strength back.  We will get her in therapy now and I will \nsee her back in 6 weeks for repeat clinical exam.  She is still considering \nleft carpal tunnel release later this year.”  Dr. Allard provided a WORK \nSTATUS REPORT:  “Daniela had an increase in pain following her right \nhand surgery and missed work Sunday, Monday and Tuesday, October 2-4.  \nShe can return without restrictions.”   \n The claimant received Occupational Therapy visits beginning \nOctober 13, 2022. \n The claimant testified on direct examination: \nQ.  And at some point after surgery, did you return to \nRockline? \n  A.  Yes. \n  Q.  And do you recall about when that was? \n\nGRANA - H206753  9\n  \n \n \n  A.  October, like the 20 – the 25\nth\n, I think. \nQ.  Okay.  Now, when you returned to Rockline, what job did \nyou return to? \n  A.  My same position as Auxiliary. \nQ.  And is the actual work that you’ve been doing since you \nreturned to Rockline the same as what you were doing before \nor is it different? \nA.  It was the same.   \nQ.  And how did you hand react once you returned to work? \nA.  They started bothering me again.   \nQ.  Do you feel like your right hand is better than it was before \nsurgery even though you are working again? \nA.  It is better, but not how I felt before the surgery – or before \nthe hurting or anything.   \nQ.  Okay.  Do you intend to have surgery on your left hand at \nsome point? \nA.  Yes.   \n \n A pre-hearing order was filed on November 2, 2022.  The claimant \ncontended, “The claimant contends she sustained a compensable injury to \nher bilateral hands and wrists.  She contends she is entitled to medical \ntreatment and temporary total disability benefits from May 26, 2022 to a \ndate yet to be determined as a result of her bilateral wrist and hand injuries.  \nClaimant reserves all other issues.”   \n The respondents contended, “The respondents contend that the \nclaimant did not sustain a compensable injury.  After seeking treatment for \nbilateral wrist pain and undergoing conservative treatment, Dr. Berestnev \nopined in his May 27, 2022 report that the claimant has elevated ESR and \nanti-ANA titer suggestive of Lupus and that her current wrist complaints are \nnot work related but the result of her underlying pre-existing condition.”   \n\nGRANA - H206753  10\n  \n \n \n The parties agreed to litigate the following issues: \n1.  Compensability of bilateral injuries to hands and wrists. \n2.  Medical.   \n3.  Temporary total disability benefits from May 26, 2022 \nthrough a date yet to be determined.   \n4.  Attorney fee.   \n \nAfter a hearing, an administrative law judge filed an opinion on \nMarch 13, 2023.  The administrative law judge found that the claimant failed \nto prove she sustained a compensable injury.  The administrative law judge \ntherefore denied and dismissed the claim.  The claimant appeals to the Full \nCommission.  \nII.  ADJUDICATION \nA.   Compensability \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(ii)  An injury causing internal or external physical harm to \nthe body and arising out of and in the course of \nemployment if it is not caused by a specific incident or is \nnot identifiable by time and place of employment, if the \ninjury is: \n(a) Caused by rapid repetitive motion.  Carpal tunnel \nsyndrome is specifically categorized as a compensable \ninjury falling within this definition[.]     \n \nThe Arkansas Supreme Court has recognized that carpal tunnel \nsyndrome is a gradual-onset injury; hence, it is not necessary that the \nemployee prove her injury was caused by rapid repetitive motion.  Freeman \n\nGRANA - H206753  11\n  \n \n \nv. Con-Agra Frozen Foods, 344 Ark. 296, 40 S.W.3d 760 (2001), citing \nKildow v. Baldwin Piano & Organ, 333 Ark. 335, 969 S.W.2d 190 (1998).   \nA compensable injury must also 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).   \nArk. Code Ann. §11-9-102(4)(Repl. 2012) additionally provides in \npertinent part: \n(E)  BURDEN OF PROOF.  The burden of proof of a \ncompensable injury shall be on the employee and shall be as \nfollows: \n(ii)  For injuries falling within the definition of compensable \ninjury under subdivision (4)(A)(ii) of this section, the burden of \nproof shall be by a preponderance of the evidence, and the \nresultant condition is compensable only if the alleged \ncompensable injury is the major cause of the disability or need \nfor treatment.    \n \n  Preponderance of the evidence means the evidence having greater \nweight or convincing force.  Metropolitan Nat’l Bank v. La Sher Oil Co., 81 \nArk. App. 269, 101 S.W.3d 252 (2003).  “Major cause” means more than \nfifty percent of the cause, and a finding of major cause shall be established \naccording to the preponderance of the evidence.  Ark. Code Ann. §11-9-\n102(14)(Repl. 2012). \n\nGRANA - H206753  12\n  \n \n \n An administrative law judge found in the present matter, “2.  \nClaimant has failed to meet her burden of proving by a preponderance of \nthe evidence that she suffered a compensable injury to her bilateral hands \nand wrists.”  The Full Commission does not affirm this finding. \n The claimant testified that she became employed as an Auxiliary \nMachine Operator for the respondents in 2019.  The claimant described her \nwork duties as including “fixing down machinery, working on the line with \npackages, putting them into a box, and palletizing them.”  The claimant \ntestified that her work for the respondents required “constant use” of her \nhands.  The claimant testified that she began suffering from pain, \nnumbness, and weakness in her right hand initially beginning in April 2022.  \nThe company physician, Dr. Berestnev, began treating the claimant on April \n20, 2022 and reported, “Patient states that she was turning over packages \nand gradually developed pain in her right wrist.”  Dr. Berestnev assessed \n“Repetitive use disorder....The cause of this problem appears to be related \nto work activities.”  Dr. Berestnev returned the claimant to regular duty.   \n Dr. Berestnev noted during an April 27, 2022 follow-up appointment, \n“Repetitive use disorder.  Now left wrist hurts after she was scraping glue \nwith her left hand....The cause of this problem appears to be related to \nwork activities.”  Dr. Berestnev again returned the claimant to regular duty, \n\nGRANA - H206753  13\n  \n \n \nand he again noted on May 18, 2022, “The cause of this problem appears \nto be related to work activities.”   \n However, Dr. Berestnev stated on May 27, 2022 that diagnostic \nstudies purportedly showed “elevated ESR and anti-ANA suggestive of \nlupus.”  Dr. Berestnev diagnosed “Lupus – not work-related....The cause of \nthis problem does not appear to be related to work activities.”  It is within \nthe Commission’s province to weigh all of the medical evidence and to \ndetermine what is most credible.  Minnesota Mining & Mfg. v. Baker, 337 \nArk. 94, 989 S.W.2d 151 (1999).  In the present matter, the Full \nCommission attaches minimal evidentiary weight to Dr. Berestnev’s \nmodified opinion beginning May 27, 2022 that the claimant’s symptoms \nwere the result of “Lupus.”  In this regard, we note Dr. Zang’s opinion on \nAugust 16, 2022 that the claimant’s symptoms were “Clinically not typical \nfor lupus.”       \n It is within the Commission’s sole discretion to determine the \ncredibility of each witness and the weight to be given to their testimony.  \nGeneral Electric Railcar Repair Servs. v. Hardin, 62 Ark. App. 120, 929 \nS.W.2d 667 (1998).  An administrative law judge’s findings with regard to \ncredibility are not binding upon the Full Commission.  Roberts v. Leo Levi \nHosp., 8 Ark. App. 184, 649 S.W.2d 402 (1983).  In the present matter, the \nFull Commission finds that the claimant was a credible witness.  We find \n\nGRANA - H206753  14\n  \n \n \nthat the claimant’s symptoms were the causal result of her hand-intensive \nwork for the respondents and were not related to the claimant’s other retail \nor clerical employment.  Nor does the probative evidence demonstrate that \nnonwork-related “Lupus” was the cause of the claimant’s problems in her \nbilateral upper extremities beginning in April 2022.   \n Dr. Johnson performed objective electrodiagnostic testing on June \n23, 2022 and reported, “Right and left median ulnar orthodromic latency \ndifference is mildly abnormal.”  Dr. Johnson assessed “Mild bilateral carpal \ntunnel syndrome.”  Dr. Allard reported on July 7, 2022 that the claimant \ncomplained of bilateral hand numbness and pain which resulted from a \n“repetitive manufacturing job.”  Dr. Allard assessed “Bilateral carpal tunnel \nsyndrome.”  Dr. Allard performed a Right Carpal Tunnel Release on August \n24, 2022.   \n The Full Commission finds that the claimant proved by a \npreponderance of the evidence that she sustained a “Compensable injury” \nin accordance with Ark. Code Ann. §11-9-102(4)(A)(ii)(a)(Repl. 2012).  The \nclaimant proved that she sustained an injury causing physical harm to the \nbody and arising out of and in the course of employment, which was not \nidentifiable by time and place of occurrence, but was caused by bilateral \ncarpal tunnel syndrome.  The claimant established a compensable injury by \nmedical evidence supported by objective findings, namely the \n\nGRANA - H206753  15\n  \n \n \nelectrodiagnostic testing performed by Dr. Johnson.  The claimant proved \nthat the compensable injury was the major cause of her disability and need \nfor treatment.  The evidence does not demonstrate that the claimant’s \ncarpal tunnel syndrome was caused by Lupus or that her symptoms were \nthe result of employment outside of the claimant’s work for the respondents. \nB.   Medical Treatment \nThe 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 750 (1984).   \nIn the present matter, the claimant proved that she sustained a \ncompensable bilateral carpal tunnel syndrome injury.  The claimant proved \nthat the medical treatment of record was reasonably necessary in \nconnection with the compensable injury.  Dr. Allard performed a Right \nCarpal Tunnel Release on August 24, 2022.  The claimant testified that, \nalthough she continued to complain of symptoms, surgery performed by Dr. \n\nGRANA - H206753  16\n  \n \n \nAllard had somewhat reduced the level of pain in her right upper extremity.  \nPost-surgical improvement is a relevant consideration in determining \nwhether surgery was reasonably necessary.  Hill v. Baptist Medical Center, \n74 Ark. App. 250, 48 S.W.3d 544 (2001).  The Full Commission finds that \nsurgery performed by Dr. Allard on August 24, 2022 was reasonably \nnecessary in accordance with Ark. Code Ann. §11-9-508(a)(Repl. 2012).  \nWe recognize that the claimant anticipates undergoing a left carpal tunnel \nrelease in the future.  However, there is not currently a recommendation in \nthe record for such a procedure.   \nAfter reviewing the entire record de novo, the Full Commission finds \nthat the claimant proved she sustained a compensable bilateral carpal \ntunnel syndrome injury.  The claimant proved that the medical treatment of \nrecord was reasonably necessary in accordance with Ark. Code Ann. §11-\n9-508(a)(Repl. 2012).  The claimant’s testimony indicated that she was off \nwork beginning May 28, 2022 and continuing until October 25, 2022.  An \nemployee who has suffered a scheduled injury is entitled to receive \ntemporary disability benefits during her healing period or until she returns to \nwork.  Wheeler Constr. Co. v. Armstrong, 73 Ark. App. 146, 41 S.W.3d 822 \n(2001).  Dr. Allard provided a WORK STATUS REPORT on October 6, \n2022 and stated, “She can return without restrictions.”  The Full \nCommission finds that the claimant reached the end of her healing period \n\nGRANA - H206753  17\n  \n \n \nno later than October 6, 2022.  Temporary total disability benefits cannot be \nawarded after a claimant’s healing period has ended.  Milligan v. West Tree \nServ., 57 Ark. App. 14, 946 S.W.2d 697 (1997).  We therefore find that the \nclaimant proved she was entitled to temporary total disability benefits from \nMay 28, 2022 through October 6, 2022.  The respondents are entitled to \nany appropriate offset in accordance with Ark. Code Ann. §11-9-411(Repl. \n2012).   \nThe claimant’s attorney is entitled to fees for legal services in \naccordance with Ark. Code Ann. §11-9-715(a)(Repl. 2012).  For prevailing \non appeal, the claimant’s attorney is entitled to an additional fee of five \nhundred dollars ($500), pursuant to Ark. Code Ann. §11-9-715(b)(Repl. \n2012).   \nIT IS SO ORDERED.        \n \n    ___________________________________ \n    SCOTTY DALE DOUTHIT, Chairman \n \n    ___________________________________ \n    M. SCOTT WILLHITE, Commissioner \n \n \nCommissioner Mayton dissents. \nDISSENTING OPINION \nI must respectfully dissent from the Majority’s determination that the \nclaimant has proved she sustained a compensable bilateral carpal tunnel \nsyndrome injury. \n\nGRANA - H206753  18\n  \n \n \nTo establish a compensable gradual-onset injury, a claimant must \nprove by a preponderance of the evidence that (1) the injury arose out of \nand in the course of his employment; (2) the injury caused internal or \nexternal physical harm to the body that required medical services or \nresulted in disability or death; (3) the injury was caused by rapid repetitive \nmotion; (4) the injury was a major cause of the disability or need for \ntreatment.  Lay v. United Parcel Service, 58 Ark. App. 35, 944 S.W.2d 867 \n(1997); Ark. Code Ann. § 11-9-102(4) (Repl. 2002).  “Carpal tunnel \nsyndrome is specifically categorized as a compensable injury” falling within \nthe definition of rapid repetitive motion. Ark. Code Ann. § 11-9-\n102(4)(A)(ii)(a). \nThe claimant has not proved by a preponderance of the evidence \nthat her carpal tunnel injury arose out of the course and scope of her \nemployment with Rockline Industries.  Most importantly, after multiple \nexaminations of the claimant’s wrist and lab work indicating elevated ESR \nand anti-ANA titer suggestive of lupus, Dr. Konstantin Berestnev attributed \nthe claimant’s ongoing wrist pain to “Lupus – not work-related” and referred \nclaimant to her primary care physician on May 18, 2022, releasing the \nclaimant from his care.  (See Resp. Ex. 1). \nIt is impossible for the Commission to attribute the claimant’s carpal \ntunnel syndrome to a single employer when the claimant was working for \n\nGRANA - H206753  19\n  \n \n \nmultiple employers, and owned her own business, at the time of her injury. \nThe claimant worked for the respondent employer from 2019 through April \nof 2022 with no complaints of wrist pain.  (See Hrng. Tr, Pp. 6-8, 25). \nDuring this time, the claimant worked various other jobs with duties that \ninvolved wrist-intensive activities such as typing or machine work.  (Hrng. \nTr., Pp 12-15).  These included working at Lindsey Management, C&W \nProperties, and Staffmark where she regularly operated a computer and \nlater at Tyson as a machine operator and at Walmart Optical monitoring \nmachinery. Id.  The claimant testified that her work with Walmart involved \n“monitoring the screens,” but “when the machine jams up.  Yes.  I would go \nin and take out the jam.” (Hrng. Tr., P. 13).  In December 2021, the claimant \nbecame employed as a manager at Famous Footwear where she was \nresponsible for opening boxes and rotating and examining shoes when \npurchased; operating the cash register; operating a computer; and counting \nmoney.  (Hrng. Tr., Pp. 13-14, 35).  She was employed with both Famous \nFootwear and Rockline Industries when her complaints of wrist pain began. \n(Hrng. Tr., P. 15).  Finally, at the beginning of 2022, the claimant became \nself-employed at MB Creations, where the claimant would personalize items \nfor customers such as t-shirts and cups.  (Hrng. Tr., P. 16, 35).  There is no \nindication in the record that any of the claimant’s treating physicians were \never notified of the claimant’s concurrent employment. \n\nGRANA - H206753  20\n  \n \n \nThe record is clear that the claimant has failed to prove by a \npreponderance of the evidence that her condition arose out of the course \nand scope of her employment with Rockline Industries.  Throughout her \nemployment with Rockline, the claimant worked multiple jobs concurrently, \nwith each requiring extensive use of her hands and wrists.  At the time her \ncomplaints of wrist pain began, the claimant had been working for a new \nemployer, Famous Footwear, for nearly six months using her hands and \nwrists twenty hours per week.  In the months before her injury arose, \nclaimant began her own business holding, rotating, and manipulating \nobjects.  There is no way to attribute the claimant’s injury to one single \ncause or to any one employer and for this reason the claimant has failed to \nmeet her burden of proving by the preponderance of the evidence that her \nwork with the respondent employer led to her injury. \nFor the reasons stated above, I respectfully dissent. \n  \n    ___________________________________ \n    MICHAEL R. MAYTON, Commissioner","preview":"BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION CLAIM NO. H206753 DANIELA GRANA, EMPLOYEE CLAIMANT ROCKLINE INDUSTRIES, INC., EMPLOYER RESPONDENT CNA INSURNACE COMPANY, INSURANCE CARRIER/TPA RESPONDENT OPINION FILED AUGUST 29, 2023","fetched_at":"2026-05-19T22:29:46.202Z","links":{"html":"/opinions/full_commission-H206753-2023-08-29","pdf":"https://labor.arkansas.gov/wp-content/uploads/Grana_Daniela_H206753_20230829.pdf","source_publisher":"https://labor.arkansas.gov/workers-comp/awcc-opinions/full-commission-opinions/"}}