{"id":"full_commission-H303428-2025-07-17","awcc_number":"H303428","decision_date":"2025-07-17","opinion_type":"full_commission","claimant_name":"Joyce Johnson","employer_name":"Booker T. Washington Elementary School","title":"JOHNSON VS. BOOKER T. WASHINGTON ELEMENTARY SCHOOL AWCC# H303428 July 17, 2025","outcome":"unknown","outcome_keywords":[],"injury_keywords":["back","lumbar","shoulder","hip","knee","neck","sprain","fracture"],"pdf_url":"https://www.labor.arkansas.gov/wp-content/uploads/Johnson_Joyce_H303428_20250717.pdf","source_index_url":"https://labor.arkansas.gov/workers-comp/awcc-opinions/full-commission-opinions/","filename":"Johnson_Joyce_H303428_20250717.pdf","text_length":35605,"full_text":"BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION \n \n \nCLAIM NO.  H303428  \n \nJOYCE JOHNSON, \nEMPLOYEE \n \nCLAIMANT \nBOOKER T. WASHINGTON ELEMENTARY \nSCHOOL, EMPLOYER \n \nRESPONDENT \nARKANSAS SCHOOL BOARDS ASSN., \nINSURANCE CARRIER/TPA \nRESPONDENT \n  \n      \nOPINION FILED JULY 17, 2025 \n \nUpon review before the FULL COMMISSION in Little Rock, Pulaski County, \nArkansas. \n \nClaimant represented by the HONORABLE GREGORY R. GILES, Attorney \nat Law, Texarkana, Arkansas. \n \nRespondents represented by the HONORABLE MELISSA WOOD, Attorney \nat Law, Little Rock, Arkansas. \n \nDecision of Administrative Law Judge:  Affirmed as Modified. \n \n \n OPINION AND ORDER \nThe claimant appeals an administrative law judge’s opinion filed \nFebruary 26, 2025.  The administrative law judge found that the claimant \ndid not prove she sustained a compensable injury.  After reviewing the \nentire record de novo, the Full Commission finds that the claimant did not \nprove she sustained a compensable injury in accordance with Ark. Code \nAnn. §11-9-102(4)(A)(i)(Repl. 2012).  In addition, the claimant did not \nestablish a compensable injury by medical evidence supported by objective \nfindings, pursuant to Ark. Code Ann. §11-9-102(4)(D)(Repl. 2012).     \nI.  HISTORY \n\nJOHNSON - H303428  2\n  \n \n \n Joyce Johnson, now age 59, testified that she became employed as \na classroom teacher for the respondents, Booker T. Washington \nElementary, in 1990.  Dr. Adam Smith reported in February 2023 that the \nclaimant had been suffering from a large number of chronic health \nconditions, including low back pain, “Onset:  06/25/2012 – Lumbago....X-\nrays of her lumbar spine shows slight loss of her lordosis and significant \nforaminal stenosis at L5-S1 with retrolisthesis.”  Dr. Smith assessed \n“Lumbar degenerative disc disease with foraminal stenosis.” \n An MRI of the claimant’s lumbar spine was taken on April 12, 2023 \nand was compared to an MRI taken November 9, 2011, with the following \nimpression: \n1. Multilevel degenerative disc disease.   \n2. A broad-based central protrusion of the L4-5 disc is \nsuperimposed on generalized bulging of the disc.  Central \nspinal canal stenosis at the L4-5 level due to the abnormal \ndisc, facet arthropathy, and thickening of the ligamentum \nflavum.  Right facet arthropathy mildly effaces the right \nside of the thecal sac.   \n3. There is narrowing of the right lateral recess at the L4-5 \nlevel, with impingement on the descending right L5 nerve \nroot. \n \nThe claimant underwent a lumbar transforaminal epidural injection in \nApril 2023.   \nThe parties stipulated that the employment relationship existed on \nMay 2, 2023.  The claimant testified on direct examination: \n\nJOHNSON - H303428  3\n  \n \n \nQ.  So take us to the date in question here, May the 2\nnd\n of ’23, \nwhat was the age group of children that you were dealing with \nthat day? \nA.  I had third graders, which were probably eight – around \neight years old or nine.... \nQ.  Were you having any issues with any disciplinary \nproblems during the day in the classroom? \nA.  It started from the very beginning, when the teacher left.  I \nwas trying to shut the door and this particular student decided \nto just go stand in the door.... \nQ.  And so as you came to the end of your class time, did you \nimplement  procedure that day in terms of how you were \ngoing to dismiss the children from the classroom? \nA.  Yes.  I decided to dismiss based on their behavior, which \nis something that I used to do regularly anyway....And this \nstudent started walking towards the door....and so we got \nthere about the same time and we both was – he was trying to \nget out the door....I just shut the door and he rammed into me \nreally hard ... And when he rammed me, he rammed me into \nthe door really hard. \nQ.  Let me ask you this, what part of your body did he strike, \nphysically, when he hit you?  Where are you saying that he \nstruck you? \nA.  Okay.  My hands were both on the door knob, and so \nwhen he came in and he came into my right side and it felt like \nit was his elbows that hit – like, his elbows and shoulder, \nmaybe, that hit, because it was like all through the upper part \nand, like, down to my waist.... \nQ.  Did you strike the door? \nA.  Yes, I struck the door, the door knob, ‘cause I was up on \nthe door shutting it, so my body went into the door....I bumped \nhim off with my hip and I yelled at him, “Don’t you ram me into \nthat door.”... \nQ.  Were you experiencing any symptoms or problems at that \npoint in time? \nA.  I was mainly, like, the parts of my body that hit the door, \nbut my left – left leg was – was hurting pretty badly and –  \nQ.  Where, specifically, was your left leg hurting? \nA.  It was like my hip down.   \n \n\nJOHNSON - H303428  4\n  \n \n \n According to the record, the claimant signed a Form AR-N, \nEMPLOYEE’S NOTICE OF INJURY, on May 3, 2023.  The ACCIDENT \nINFORMATION section of the Form AR-N indicated that the Date of \nAccident was May 2, 2023, and the claimant described the alleged injury: \nRight hip, hamstrings, slight right side shoulder blade pain; \nslight left knee (right side) pain.  I was already having some \npains for which I had had.  My calf pains have also increased.  \nI just stopped using a cane.  A male student rammed me into \na door as I was turned sideways, pinning me between the \ndoor and his body.  I had my hands holding the door, so I \nused my right hip to push him off of me to free myself.   \n \n Dr. Scott Carle saw the claimant on May 3, 2023 and reported, \n“Attacked yesterday at school.  Hit from the right side.  Pain pelvic rim, right \nthigh and left knee.  Has recent LESI for her back and feels like this has \nmade it worse again.  She has not cuts or bruises at this point.  Admits to \nbeing with some anxiety about this event.  Neck and posterior shoulders \nsore.”  Dr. Carle’s physical examination showed “Lumbosacral Spine:  \nnormal SLR, normal heel/toe gait, no spasms.”  Dr. Carle’s assessment on \nMay 3, 2023 was “1.  Assault,” “2.  Stress reaction,” “3.  Pelvic contusion, \ninitial encounter,” and “4.  Sprain of other ligament of left knee, initial \nencounter.”   \n Dr. Carle e-mailed the respondents on May 5, 2023: \n  Joyce Johnson \nAssaulted by a student.  Recent and pre existing back and hip \ntrouble s/p injection. \n\nJOHNSON - H303428  5\n  \n \n \nStudent rammed her from the side.  No visible bruises.  Doubt \nserious physical injury but she is emotionally rattled. \nRecommended some PT and get records and use EAP \nservices for now.  Also, gave her a couple of meds.   \nShe may not be very easy to get back into a classroom \nquickly..........:/ \n \n The record indicates that the claimant returned to light duty work for \nthe respondents on or about May 15, 2023.   \nAn MRI of the claimant’s lumbar spine was taken on May 19, 2023 \nwith the following impression: \n1. L4-L5:  Mild disc bulge and right paracentral to right \nforaminal disc herniation with moderate spinal canal \nstenosis, severe mass effect on the right lateral recess, \nsevere right and moderate left neural foraminal narrowing. \n2. L5-S1:  Mild disc bulge with moderate bilateral neural \nforaminal narrowing. \n3. No other spinal canal stenosis for moderate to high-grade \nneural foraminal narrowing.   \n4. The disc bulges and disc herniations are age \nindeterminate.  These could be chronic and degenerative \nin etiology, however also could be related to recent \nreported injury.  Clinical correlation is recommended.   \n \nThe record indicates that the claimant stopped returning to work on \nor about May 22, 2023.   \nA Claims Adjuster for the respondents wrote to Dr. Carle on June 7, \n2023: \nIt is my understanding that you are currently treating Ms. \nJohnson for a workers’ compensation claim with her \nemployer, Little Rock School District.  As you know, for \nworkers’ compensation claims to be compensable in the state \nof Arkansas, there must be objective and measurable \nfindings.  The Commission has defined “objective findings” as \n\nJOHNSON - H303428  6\n  \n \n \nfindings that cannot come under the voluntary control of the \npatient.   \nTherefore, we ask that you please advise what, if any, \nobjective findings Ms. Johnson has to support her injury.  I \nhave prepared a space at the bottom of this page for your \nconvenience in responding.... \nMs. Joyce Johnson’s objective findings are the following:   \n \n Dr. Carle replied on June 12, 2023, “None” and wrote, “Negative \nstudies for fracture or internal injuries.  No measurable aggravation to pre-\nexisting spine disorder.” \n The claimant began treating with Dr. Bernard Crowell on July 27, \n2023: \nMs. Johnson is a very pleasant 57-year-old female who [is] \nseen today with complaints of back pain along with left lower \nextremity radiculopathy.  She noticed the symptoms several \nmonths ago.  She underwent an MRI which showed she had a \nbulging disc at L4-L5.  She underwent an epidural steroid \ninjection.  However, shortly afterward she was involved in a \nschool altercation.  She continued to have increasing back \npain with right lower extremity radiculopathy.  The \nradiculopathy is quite severe in nature.  She walks with a limp \nfavoring the right lower extremity....She is now using a cane \nfor assistance.... \nMRI scan lumbar spine reveals large right paracentral disc \nherniation at L4-L5.  It occupies approximately 1/3 of the \ncanal.  Disc desiccation also noted.... \nWe discussed surgical intervention.  This would be a \nhemilaminectomy with discectomy.... \n \n A Claims Adjuster informed a representative of the Workers’ \nCompensation Commission on August 8, 2023, “We are in receipt of your \nletter dated 08/07/23, regarding the above captioned claim.  Please be \n\nJOHNSON - H303428  7\n  \n \n \nadvised that we have denied this claim for any additional medical \ntreatment.”   \n Dr. Crowell performed surgery on August 11, 2023:  \n“Hemilaminectomy and diskectomy, L4-L5.”  Dr. Crowell provided follow-up \ntreatment after surgery. \n The record indicates that the claimant retired from employment with \nthe respondents effective November 1, 2023.     \n Dr. Crowell noted on February 1, 2024, “She is complaining of \nincreased low back pain along with right lower extremity radiculopathy.  She \nhas undergone physical therapy.  However, her therapist terminated further \ntreatment secondary to increased back and right leg pain....She is now \nusing a cane, walking with a significant limp.”   \n Dr. Crowell corresponded with the claimant’s attorney on April 23, \n2024: \nThis letter is written in response to your query regarding Mrs. \nJohnson reaching maximum medical improvement and \nproviding an impairment rating using the AMA Guides to \nEvaluation of Permanent Impairment Fourth Edition.  Mrs. \nJohnson is a 58-year-old patient who was initially evaluated \non 07/23/2023 for an L4-L5 right paracentral disc herniation.  \nShe had noticed the symptoms several months prior to \npresentation.  She underwent an MRI which revealed a \nbulging disc at L4-L5.  She underwent non-operative \ntreatment consisting of an epidural steroid injection.  This did \nprovide her with relief.  However, shortly afterwards she was \ninvolved in a school altercation.  She noticed an increase in \nback pain and right lower extremity radiculopathy.  The \nradiculopathy had become quite severe in nature, resulting in \n\nJOHNSON - H303428  8\n  \n \n \nher ambulating with a limp.  She underwent another MRI scan \nof her lumbar spine which revealed a large right paracentral \ndisc herniation at L4-L5 occupying approximately 1/3 of the \ncanal.  She underwent a hemilaminectomy with discectomy at \nL4-L5 on 8/11/2023.  She initially showed improvement \nfollowing surgery, however, she was unable to undergo \nphysical therapy due to financial circumstances.  MRI scan \nwith contrast was performed on 02/09/2024 revealing right \nlaminectomy, discectomy with enhancing granulation tissue at \nthe discectomy and lateral recess.... \nBased on the AMA Guides to the Evaluation of Permanent \nImpairment chapter 3, page 113, table 75, section II E she \nshould receive a percent impairment of the whole body of 10.   \n \n Dr. Wayne L. Bruffett reported on June 22, 2024: \nI interviewed the patient, examined the patient and reviewed \nall the pertinent imaging.  I performed the medical decision \nmaking component in its entirety.  The patient readily reported \nthat she had pain in her back and leg prior to the work injury \nthat occurred on May 2, 2023.  In fact she had an injection for \nthis pain on April 28, 2023.  As a consequence of this work \nrelated (sic) of that a child charged her and pushed her into a \ndoor I believe.  She ultimately had surgery in the form [of] a \nmicroscopic partial diskectomy L4-5 on the right by Dr. \nBernard Crowell.  She sought him out and had this surgery \nwith her regular medical insurance.  After surgery she \ncontinued physical therapy and had some worsening pain.  In \nJanuary of this year she had further therapy.  In February of \nthis year she had an MRI scan.... \nI had an opportunity to review an MRI scan that was dated \n11/09/2011 that scan shows some mild degenerative changes \nalso reviewed the report.  There was no significant disc \nherniation at that time noted at the L4-5 level.  Another MRI \nscan was reviewed from 04/12/2023 and another one from \n05/19/2023 and a final study from 02/09/2024.  The study \nfrom April was done prior to the work related incident and the \n[May] study was done afterwards.  These 2 studies are \nbasically identical.  I see no objective change in the MRI \nfindings after this work related event.  The final MRI scan \ndoes reveal postsurgical changes.  X-rays today show \npostsurgical and degenerative changes as well.   \n\nJOHNSON - H303428  9\n  \n \n \nAlthough the work related incident that occurred on May 2, \n2023 caused some worsening pain for Mrs. Johnson, I would \nsay with a reasonable degree of medical certainty based on \nthe objective imaging and her history of pre-existing \ncomplaints and treatments for this problem, specifically an \ninjection 4 days prior to the event, the surgery that was \nperformed and the subsequent treatment was more than 51% \nrelated to her pre-existing disc herniation stenosis and \nradiculopathy that emanated from the L4-5 motion segment.  \nPut another way, I see no objective evidence of injury as a \nconsequence of the incident that occurred on May 2, 2023 at \nwork.  With regards to her work injury she is at maximum \nmedical improvement and there is no applicable impairment \nrating that can be linked to said incident.  I have no \nrestrictions to place upon her as a consequence of this work \ninjury.   \n \n A pre-hearing order was filed on July 2, 2024.  The claimant \ncontended, “a.  Claimant contends she sustained compensable injuries.  \nThe primary injury [being an] aggravation of a pre-existing condition of her \nlow back which has subsequently required surgery; b.  Claimant contends \nentitlement to temporary total disability benefits from the date she began \nmissing work; c.  Claimant contends Respondents should be ordered to pay \nthe medical treatment received to date and additional medical treatment; d.  \nClaimant contends Respondents should be ordered to pay attorney’s fees \nas provided by law.”   \n The parties stipulated that the respondents “have controverted this \nclaim in its entirety.”  The respondents contended, “Respondents contend \nthat Claimant did not suffer a compensable injury on or about 5/2/23.  In \n\nJOHNSON - H303428  10\n  \n \n \nlight of this, it is Respondents’ position that Claimant is not entitled to \nbenefits associated with her alleged injury.” \n Dr. Crowell corresponded with the claimant’s attorney on October 14, \n2024: \nThis letter is in response to your query regarding Mrs. \nJohnson’s evaluation by Dr. Bruffett.  I have read his \nevaluation and have also reviewed the MRI scans of Mrs. \nJohnson’s lumbar spine.  The first was obtained on April 12, \n2023 prior to the altercation, and the second was obtained on \nMay 19, 2023 after the altercation.  The scans were reviewed \nin side-by-side comparison.  I must preface my statement by \nnoting that the MRI scans were performed by two different \nMRI scanners.  I still believe that the herniation seen in the \nMay scan is slightly larger albeit it is only seen on a few \nimages and may appear to be open to opinion.  I still believe \nthat by her description and my evaluation of her, the work-\nrelated accident exacerbated her pre-existing condition.  This \nis based on the fact she had undergone a lumbar epidural \nsteroid injection and was feeling well enough to return to work.  \nIf she had not obtained a positive response from the injection, \nit is doubtful she would have returned to work.  It is my opinion \nthat when I evaluated her, surgery was necessary due to my \nfindings on physical examination and the location and size of \nthe disc herniation....   \n \n Dr. Ryan T. Fitzgerald corresponded with the respondents’ attorney \non January 6, 2025 and reported in part: \nMs. Johnson was involved in work-place incident on 5/2/23, \nhereafter for the purposes of this report referred to as the \nsubject event.... \nMR imaging of the lumbar spine 05/19/2023 was negative for \nany evidence of an acute traumatic injury.  No bone marrow \nedema, paraspinous soft tissue inflammation, or paraspinous \nmuscle edema was evident at any level.  As demonstrated on \nthe prior MRI exam from April 2023, chronic degenerative \ndisease was apparent at multiple levels, most advanced at L4-\n\nJOHNSON - H303428  11\n  \n \n \n5.  Ongoing impingement of the right L5 nerve root within the \nseverely stenotic right subarticular recess at L4-5 was \nunchanged.  No new disc abnormality had developed at L4-5 \nor elsewhere in the lumbar spine.... \nIn summary, Ms. Johnson’s medical record includes a well-\ndocumented history of chronic low back pain and active \nsymptomatology requiring treatment within 1 week of the \nsubject event.  On my person (sic) review, MR imaging \nobtained in May 2023 was negative for any objective evidence \nof an acute traumatic injury.  Severe subarticular recess \nstenosis on the right at L4-5 and impingement of the right L5 \nnerve root secondary to a diffuse disc bulge and degenerative \nfacet/ligamentum flavum hypertrophy were unchanged on the \n5/19/23 exam relative to the 4/12/23 exam.  As such, in my \nopinion lumbar treatments provided subsequent to the subject \nevent were more likely than not attributable to Ms. Johnson’s \nlong-standing lumbar degenerative disease and independent \nof the subject event.   \n \n A hearing was held on January 14, 2025.  At that time, the parties \nagreed to litigate the following issues: \n1. Whether the claimant sustained a compensable injury to \nher back by specific incident. \n2. Whether the claimant is entitled to reasonably necessary \nmedical treatment from May 3, 2023 to July 5, 2024. \n3. Whether the claimant is entitled to temporary total \ndisability benefits from September 1, 2023 to April 23, \n2024.   \n4. Whether the claimant is entitled to temporary partial \ndisability benefits from June 1, 2023 to August 30, 2023.   \n5. Whether the claimant is entitled to permanent partial \ndisability benefits, specifically, a 10% impairment rating to \nthe body as a whole.   \n6. Fees for legal services.   \n \n   An administrative law judge filed an opinion on February 26, 2025.  \nThe administrative law judge found that the claimant did not prove she \n\nJOHNSON - H303428  12\n  \n \n \nsustained a compensable injury.  The claimant appeals to the Full \nCommission. \nII.  ADJUDICATION \n Act 796 of 1993, as codified at Ark. Code Ann. §11-9-102(4)(Repl. \n2012), provides, in pertinent part: \n(A)  “Compensable injury” means: \n(i) An accidental injury causing internal or external \nphysical harm to the body ... arising out of and in \nthe course of employment and which requires \nmedical services or results in disability or death.  An \ninjury is “accidental” only if it is caused by a specific \nincident and is identifiable by time and place of \noccurrence[.]   \n \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). \nAn aggravation is a new injury resulting from an independent \nincident, and being a new injury with an independent cause, it must meet \nthe definition of a compensable injury in order to establish compensability of \nthe aggravation.  Hickman v. Kellogg, Brown & Root, 372 Ark. 501, 277 \nS.W.3d 591 (2008), citing Jim Walter Homes v. Beard, 82 Ark. App. 607, \n120 S.W.3d 160 (2007).       \n\nJOHNSON - H303428  13\n  \n \n \nThe 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 \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 the \nevidence.  Tyson Foods, Inc. v. Watkins, 31 Ark. App. 230, 792 S.W.2d 348 \n(1990). \nAn administrative law judge found in the present matter, “3.  The \nClaimant has not proven that she has sustained an aggravated \ncompensable spinal injury with objective findings.”  The Full Commission \nfinds that the claimant did not prove by a preponderance of the evidence \nthat she sustained a compensable injury. \n\nJOHNSON - H303428  14\n  \n \n \nThe claimant became employed as a classroom music teacher for \nthe respondents in 1990.  Dr. Smith reported in February 2023 that the \nclaimant had been suffering from chronic low back pain since at least 2012.  \nDr. Smith assessed “Lumbar degenerative disc disease with foraminal \nstenosis.”  An MRI of the claimant’s lumbar spine in April 2023 showed, \namong other things, a “broad-based central protrusion of the L4-5 disc.”  \nThe claimant underwent a lumbar transforaminal steroid injection in April \n2023.   \nThe parties stipulated the employment relationship existed on May 2, \n2023.  The claimant contends that she injured her back that day as the \nresult of an alleged assault by a student.  The claimant testified that she \nwas “rammed” into a doorknob by a student who was trying to forcibly exit \nthe classroom.  The claimant signed a Form AR-N, EMPLOYEE’S NOTICE \nOF INJURY, on May 3, 2023 but she did not report a back injury.  The \nclaimant wrote that she injured her “Right hip, hamstrings, slight ride side \nshoulder blade pain; slight left knee (right side) pain.”  Dr. Carle examined \nthe claimant on May 3, 2023 and reported “Pain pelvic rim, right thigh and \nleft knee.”  Dr. Carle’s assessment included “4.  Sprain of other ligament of \nleft knee, initial encounter,” but he did not report a back injury allegedly \noccurring on May 2, 2023.  Dr. Carle informed the respondents on May 5, \n2023, “Student rammed her from the side.  No visible bruises.  Doubt \n\nJOHNSON - H303428  15\n  \n \n \nserious physical injury but she is emotionally rattled.”  The claimant \nreturned to light duty work for the respondents on or about May 15, 2023.   \nAn MRI of the claimant’s lumbar spine was taken on May 19, 2023 \nand showed, among other things, a “Mild disc bulge” which had already \nbeen reported in April 2023, before the May 2, 2023 incident.  The claimant \nstopped returning to work for the respondents on or about May 22, 2023.  \nDr. Carle informed the respondents on June 12, 2023 that there were no \nobjective findings of an injury.  Dr. Carle opined that there were “Negative \nstudies for fracture or internal injuries.  No measurable aggravation to pre-\nexisting spine disorder [emphasis supplied].”   \nThe Full Commission finds that the claimant did not prove by a \npreponderance of the evidence that she sustained a compensable injury in \naccordance with Ark. Code Ann. §11-9-102(4)(A)(i)(Repl. 2012).  The \nclaimant did not prove that she sustained an accidental injury causing \ninternal or external physical harm to her low back on May 2, 2023.  The \nclaimant did not prove that she sustained an injury to her low back which \narose out of and in the course of employment, required medical services, or \nresulted in disability.   \nThe Full Commission also finds that the claimant did not establish a \ncompensable injury by medical evidence supported by objective findings.  \nDr. Carle opined on June 22, 2024 that there were no objective findings of a \n\nJOHNSON - H303428  16\n  \n \n \ncompensable injury to the claimant’s back.  Dr. Bruffett opined that there \nwas “no objective change” in MRI findings taken before and after the \nalleged May 2, 2023 classroom assault.  Dr. Bruffett expressly stated, “I see \nno objective evidence of injury as a consequence of the incident that \noccurred on May 2, 2023 at work.”  Dr. Fitzgerald opined on January 6, \n2025 that that MR imaging was “negative for any objective evidence” of an \ninjury to the claimant’s low back.  Dr. Fitzgerald stated, “As such, in my \nopinion lumbar treatments provided subsequent to the subject event were \nmore likely than not attributable to Ms. Johnson’s long-standing lumbar \ndegenerative disc disease and independent of the subject event.”   \nWe recognize Dr. Crowell’s opinion on April 23, 2024 that the \nclaimant had essentially sustained a herniated disc as result of the alleged \nlow back injury.  Dr. Crowell informed the claimant’s attorney in October \n2024, “I still believe that the herniation seen in the May scan is slightly \nlarger albeit it is only seen on a few images and may appear to be open to \nopinion.”  The Commission has the duty of weighing medical evidence and, \nif the 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 \n\nJOHNSON - H303428  17\n  \n \n \nmatter, the Full Commission finds that the opinions of Dr. Carle, Dr. Bruffett, \nand Dr. Fitzgerald are corroborated by the evidence of record and are more \ncredible than the opinion of Dr. Crowell.   \nAfter 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 injury in accordance with Ark. Code Ann. §11-9-\n102(4)(A)(i)(Repl. 2012).  The claimant did not prove she sustained an \naccidental injury causing internal or external physical harm to her low back.  \nThe claimant did not prove that she sustained an injury to her low back \nwhich arose out of and in the course of employment, required medical \nservices, or resulted in disability.  In addition, the claimant did not establish \na compensable injury to her back by medical evidence supported by \nobjective medical findings, in accordance with Ark. Code Ann. §11-9-\n102(4)(D)(Repl. 2012).  The Full Commission therefore respectfully denies \nand dismisses the claim.   \nIT IS SO ORDERED. \n \n    ___________________________________ \n    SCOTTY DALE DOUTHIT, Chairman \n \n    ___________________________________ \n    MICHAEL R. MAYTON, Commissioner \n \n \n \nCommissioner Willhite dissents. \n\nJOHNSON - H303428  18\n  \n \n \nDISSENTING OPINION \n  The Administrative Law Judge (hereinafter referred to as “ALJ”) \nfound that the Claimant had not proved that Claimant sustained an \naggravated compensable spinal injury with objective findings.  After my de \nnovo review of the record, I would dissent with the ALJ’s findings.  \nTo establish a compensable injury by a preponderance of the \nevidence the Claimant must prove: (1) an injury arising out of and in the \ncourse of employment; (2) that the injury caused internal or external harm \nto the body which required medical services or resulted in disability or \ndeath; (3) medical evidence supported by objective findings, as defined in \nArk. Code Ann. §11-9-102(16), establishing the injury; and (4) that the injury \nwas caused by a specific and identifiable time and place of occurrence.  A \ncompensable injury must be established by medical evidence supported by \nobjective findings and medical opinions addressing compensability must be \nstated within a degree of medical certainty.  Smith-Blair, Inc. v. Jones, 77 \nArk. App. 273, 72 S.W.3d 560 (2002).  \nThe employer takes the employee as he finds him.  Conway \nConvalescent Center v. Murphree, 266 Ark. 985, 585 S.W.2d 462 (Ark. \nApp. 1979).  A pre-existing disease or infirmity does not disqualify a claim if \nthe employment aggravated, accelerated, or combined with the disease or \ninfirmity to produce the disability for which compensation is sought.  See, \n\nJOHNSON - H303428  19\n  \n \n \nNashville Livestock Commission v. Cox, 302 Ark. 69, 787 S.W.2d 664 \n(1990); Conway Convalescent Center v. Murphree, 266 Ark. 985, 585 \nS.W.2d 462 (Ark. App. 1979); St. Vincent Medical Center v. Brown, 53 Ark. \nApp. 30, 917 S.W.2d 550 (1996).  An increase in symptoms of a pre-\nexisting degenerative condition is sufficient to establish a compensable \ninjury.  Parker v. Atlantic Research Corp., 87 Ark. App. 145, 189 S.W.3d \n449 (2004). \n The Claimant has a prior history of symptomology and diagnoses for \nher lumbar spine.  Claimant underwent a lumbar spine MRI on April 12, 2023, \nwhich showed:  \n1. Multilevel degenerative disc disease.  \n2. A broad-based central protrusion of the L4-5 disc is \nsuperimposed on generalized bulging of the disc.  Central \nspinal canal stenosis at the L4-5 level due to the abnormal \ndisc, facet arthropathy, and thickening of the ligamentum \nflavum.  Right facet arthropathy mildly effaces the right \nside of the thecal sac.  \n3. There is narrowing of the right lateral recess of the L4-5 \nlevel, with impingement on the descending right L5 nerve \nroot.  \n \nBased  on  this  MRI,  Claimant  was  given  a  lumbar  epidural  steroid  injection \n(hereinafter referred to as “LESI”) on April 28, 2023.  On  May  2,  2023, \nClaimant  was  pushed by  a  student  while  working  for  the  Respondent.  On \nMay 3, 2023, Claimant was seen by Dr. Scott Carle where she reported that \nshe had a LESI for her back and that her back felt “worse again” after the \n\nJOHNSON - H303428  20\n  \n \n \naccident.  On May 19, 2023, Claimant underwent another lumbar spine MRI \nwhich showed:  \n1. L4-L5:  Mild  disc  bulge  and  right  paracentral  to  the  right \nforaminal   disc   herniation   with   moderate   spinal   canal \nstenosis,  severe  mass  effect  on  the  right  lateral  recess, \nsevere right and moderate left neural foraminal narrowing.  \n2. L5-S1:  Mild  disc  bulge  with  moderate  bilateral  neural \nforaminal narrowing.  \n3. No other spinal canal stenosis for moderate to high-grade \nneural foraminal narrowing.  \n4. The disc bulges and disc herniations are age indeterminate. \nThese  could  be  chronic  and  degenerative  in  etiology, \nhowever  also  could  be  related  to  recent  reported  injury. \nClinical correlation is recommended.  \n \nBased on this MRI, Dr. Scott Carle e-mails a representative of the \nRespondent on Claimant’s condition where he states that Claimant’s \nneurogenic claudication or radiculopathy was significantly worsening. \nClaimant was referred to Dr. Bernard Crowell who stated on July 27, 2023, \nthat Claimant’s May 19, 2023, MRI revealed “a large lumbar disc herniation \ndisplacing the exiting nerve root and occupying one third of the central \ncanal.”  Dr. Crowell then recommends Claimant for a hemilaminectomy with \ndiscectomy which was performed on August 11, 2023.  \n On June 21, 2024, Dr. Wayne Bruffett was asked by the Respondent \nto perform an independent medical evaluation.  In this evaluation Dr. Bruffett \nfound that there was “no objective evidence of injury as a consequence of \nthe incident that occurred on May 2, 2023.”  In response to this, Dr. Crowell \n\nJOHNSON - H303428  21\n  \n \n \nis asked by the Claimant to render his opinion on Claimant’s injury for which \nhe stated:  \nI still  believe  that  the  herniation  seen  in  May  scan  is  slightly \nlarger albeit it is only seen on a few images and may appear to \nbe open  to  opinion.  I still  believe  that  by  her  description and \nmy  evaluation  of  her,  the  work-related  accident  exacerbated \nher pre-existing condition.  This is based on the fact she had \nundergone a lumbar epidural steroid injection and was feeling \nwell enough to return to work.  If she had not obtained a positive \nresponse  from  her  injection,  it  is  doubtful  she  would  have \nreturned to  work.  It  is  my  opinion  that  when  I  evaluated  her, \nsurgery   was   necessary   due   to   my   findings   on   physical \nexamination and the location and size of the disc herniation. \n \nWhen medical opinions conflict, the Commission may resolve the \nconflict based on the record as a whole and reach the result consistent with \nreason, justice, and common sense.  Barksdale Lumber v. McAnally, 262 \nArk. 379, 557 S.W.2d 868 (1977).  It is within the Commission’s province to \nweigh all of the medical evidence and to determine what is most credible. \nMinnesota Mining & Mfg. v. Baker, 337 Ark. 94, 989 S.W.2d 151 (1999). \nBased on my review of the record, I find that Dr. Crowell’s medical opinion \nshould be given more weight as he is an orthopedic surgeon, had personal \ncontact with the patient and extensively reviewed the Claimant’s current \nand past medical history in relation to her spine.  It is somewhat rare for \nthere to be objective evaluations of an injured employee’s spine shortly \nbefore and after a work accident.  However, in this case the MRIs of April \n12, 2023, and May 19, 2023, provide the physicians with a reasonably clear \n\nJOHNSON - H303428  22\n  \n \n \nbasis to determine the effect of the May 2, 2023, work accident.  It appears \nthat the physician who interpreted the MRI results agreed with Dr. Crowell’s \nassessment that the Claimant’s condition was progressively worse after the \nwork accident.  \nAlthough the Claimant clearly had a pre-existing condition, there is \nclear and credible evidence that she suffered from an aggravation of the \ninjury after the work accident on May 2, 2023.  The Courts have held in \nseveral cases that an increase in symptoms following a work-related \naccident is sufficient proof to establish compensability.  Parker v. Atlantic \nResearch Corp., 87 Ark. App. 145, 189 S.W.3d 449 (2004).  There was an \nobjective change in the condition of Claimant’s lumbar spine following her \nwork accident and Dr. Crowell opined that this change was related to the \nMay 2, 2023, work incident.  Therefore, I find that the Claimant has \nsustained compensable injury to her back.  \nFor the reasons stated above, I respectfully dissent.  \n \n \n    ___________________________________ \n    M. SCOTT WILLHITE, Commissioner","preview":"BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION CLAIM NO. H303428 JOYCE JOHNSON, EMPLOYEE CLAIMANT BOOKER T. WASHINGTON ELEMENTARY SCHOOL, EMPLOYER RESPONDENT ARKANSAS SCHOOL BOARDS ASSN., INSURANCE CARRIER/TPA RESPONDENT OPINION FILED JULY 17, 2025","fetched_at":"2026-05-19T22:29:44.167Z","links":{"html":"/opinions/full_commission-H303428-2025-07-17","pdf":"https://www.labor.arkansas.gov/wp-content/uploads/Johnson_Joyce_H303428_20250717.pdf","source_publisher":"https://labor.arkansas.gov/workers-comp/awcc-opinions/full-commission-opinions/"}}