{"id":"full_commission-H304058-2025-04-02","awcc_number":"H304058","decision_date":"2025-04-02","opinion_type":"full_commission","claimant_name":"Jonathan Mohler","employer_name":"Cross Creek Ranch, LLC","title":"MOHLER VS. CROSS CREEK RANCH, LLC AWCC# H304058 April 02, 2025","outcome":"granted","outcome_keywords":["granted:1"],"injury_keywords":["back","knee"],"pdf_url":"https://www.labor.arkansas.gov/wp-content/uploads/Mohler_Jonathan_H304058_20250402.pdf","source_index_url":"https://labor.arkansas.gov/workers-comp/awcc-opinions/full-commission-opinions/","filename":"Mohler_Jonathan_H304058_20250402.pdf","text_length":47099,"full_text":"BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION \n \n \nCLAIM NO.  H304058 \n \nJONATHAN MOHLER, \nEMPLOYEE \n \nCLAIMANT \nROBERT A. YOUNG III, \n(CROSS CREEK RANCH, LLC), \nEMPLOYER \n \nRESPONDENT \nMIDWEST INSURANCE COMPANY, \nINSURANCE CARRIER/TPA \nRESPONDENT \n  \n      \nOPINION FILED APRIL 2, 2025  \n \nUpon review before the FULL COMMISSION in Little Rock, Pulaski County, \nArkansas. \n \nClaimant represented by the HONORABLE EDDIE H. WALKER, JR., \nAttorney at Law, Fort Smith, Arkansas. \n \nRespondents represented by the HONORABLE MICHAEL C. STILES, \nAttorney at Law, Little Rock, Arkansas. \n \nDecision of Administrative Law Judge:  Reversed. \n \n \n OPINION AND ORDER \nThe respondents appeal and the claimant cross-appeals an \nadministrative law judge’s opinion filed September 25, 2024.  The \nadministrative law judge found that the claimant proved he sustained a \ncompensable injury.  After reviewing the entire record de novo, the Full \nCommission finds that the claimant did not prove by a preponderance of the \nevidence that he sustained a compensable injury.       \nI.  HISTORY \n Robert Young testified in a deposition of record that he was the \nowner of the respondent-employer, Cross Creek Ranch, LLC.  Robert \n\nMOHLER - H304058  2\n  \n \n \nYoung described Cross Creek Ranch as “a cattle business.  We buy steers \nthat weigh 550, 600 pounds and graze them through the growing season, \nput additional weight on them and then we send them to a feedlot where \nthey’re finished.”  Mr. Young testified that the acreage of Cross Creek \nRanch was “a little over 1,000.”      \nThe record indicates that Jonathan Mohler, now age 50, became \nemployed with the respondents on or about August 3, 2020.  The claimant’s \nattorney examined Robert Young: \n Q.  And what did you hire Mr. Mohler to do? \nA.  Well, he’s a ranch hand.  He tends to the cattle.  They \nrequire vaccinations.  They require being de-bugged and de-\nflied, spraying them with insecticides and that sort of thing to \nkeep the critters off of them.  They would repair fence, build \nfence.  Just everything that needs to be done on the ranch.... \nQ.  How many head of cattle do you typically have? \nA.  Fourteen hundred.... \nQ.  What were his job duties? \nA.  His job duties.  Well, they varied every day.  They would \nbale hay.  They might be brush-hogging.  They might be \nputting out fertilizer.  They might be repairing fence.  It is a job \nthat requirements change daily. \nQ.  So did his job cause him to be in wooded areas on a \nregular basis or not? \nA.  Not so much wooded, although occasionally it would.  \nMore in just tall grass.... \nQ.  And what about lodging, did you provide lodging for him? \nA.  Yeah.  He had a house on the ranch.   \nQ.  And that was part of his employment package, if you will.  \nIs that correct? \nA.  Well, yes.  I wanted him on the ranch.  Cattle live there 24 \nhours a day and he is responsible for the cattle, so if a fence \nbroke and they were out on a country highway, he would be \nthere to get them up and get them in.   \n\nMOHLER - H304058  3\n  \n \n \nQ.  So would it be correct to say that he was basically a 24-\nhour-a-day employee? \nA.  He was available 24 hours. \nQ.  He is on call, basically? \nA.  Right.... \nQ.  So his job regularly required him to be in areas with tall \ngrass.  Is that correct? \nA.  That is correct.... \nQ.  Do you spend much time on the ranch itself? \nA.  I am usually out there at least once or two days a week.   \nQ.  Have you ever observed any ticks while you were out \nthere? \nA.  Yes.... \nQ.  You knew from personal experience if your kids went out \nthere on that ranch, there was a high probability that they \nwould get a tick bite.  Is that right or wrong? \nA.  That is correct.   \n \n The parties stipulated that the employee-employer-carrier \nrelationship existed at all pertinent times.  The claimant testified on direct \nexamination: \nQ.  Mr. Mohler, it has been agreed that you were in the \nemployment of Cross Creek Ranch owned by Robert Young \nback in 2022 and 2023.  Will you briefly explain what your job \nduties were at Cross Creek Ranch? \nA.  So on a day-to-day – the whole schedule is wrapped \naround the cattle and the livestock control what else I do.  So \nthe first thing I would do is tend the cattle in the morning and \nthen most of the time it was deal with the next issue.  If there \nis a tractor broke down or a fence broke, thing that we deal \nwith on a daily basis is the priority.... \nQ.  Now, your wife was talking about you having to repair a \nfence sometimes and that she thought that the fence repair \nwork was more involved than a lot of your other work.  Tell us \na little bit about what repairing the fence is involved. \nA.  Well, there is – in most of the pastures – I am trying to \nthink – I think they all have woods in them....The fence goes \ninto the woods maybe 30 yards in some places and other \nplaces it will – you have to – the trees fall down, so that’s a big \n\nMOHLER - H304058  4\n  \n \n \npart of fixing fence.  You get a windstorm, branches end up on \nthe fence and you have to repair that, and if the cattle find a \nweakness, so we try to fix it as quick as we can once we see \nit.   \nQ.  Do you agree with your wife’s description that repairing \nfence involved you basically wading through bushes and tall \ngrass and working in that environment? \nA.  Yes.... \nQ.  Now, you have filed a claim indicating that you got bitten \nby a tick on October 29\nth\n of 2022.  How do you know that you \ngot bit by a tick on that day? \nA.  I didn’t – I couldn’t think of an example, but somebody told \nme to look through my pictures in my phone.  I looked through \nmy pictures in my phone and realized I had gotten bit by a tick \non a day when I had repaired fence.  I took a picture of a tree, \nwhich was rubbed on is what was noteworthy about it, and \nthat is what helped me recall. \nQ.  Repeat what you said about the tree.  It was rubbed on.  Is \nthat correct? \nA.  Yes.  It was just unique.  You know, you see all over the \npastures, you see deer rubs on the side of those trees and \nthis one happened to be on the edge of where I stopped and \ntook that picture and I wouldn’t have ever remembered.  It \nwas significant that I took a picture.  Just neat that we had a \nlittle bigger tree that a deer had rubbed on, so it was just cool.   \nQ.  So that is the only thing that caused you to specifically be \nable to identify one time when you got bit by a tick.  Is that \nright? \nA.  Correct.   \nQ.  Were there other times that you got bit and you just don’t \nknow when they were? \nA.  Yes.  The only way I knew it was then was just because of \nthat picture.... \nQ.  Was there ever a time when you worked at Cross Creek \nRanch that you found a tick on your body when you were not \nactually on the premises? \nA.  No.... \n \n Courtney Mohler, the claimant’s wife, testified on direct examination: \nQ.  Mr. Mohler testified in a deposition that he believes he got \nbitten by a tick on October 29\nth\n of 2022 and that his memory \n\nMOHLER - H304058  5\n  \n \n \nwas jogged by a photograph.  Have you seen that \nphotograph? \nA.  Yes, I have.   \nQ.  Are you familiar with the location that that photograph \nshows? \nA.  I couldn’t tell you the exact tree, but if I remember \ncorrectly, the pasture is Graham 7 and I know where Graham \n7 is.     \n \n According to the record, the claimant treated at Washington Regional \nMedical Center on January 14, 2023: \nThe patient is a 48-year-old male who presents to the ED due \nto dizziness.  He reports this been (sic) ongoing for the last \nseveral days.  He saw his primary care physician and was \nnotably hypointensive per his report.  He reports he stopped \ntaking blood pressure medication about 1 month ago.  He has \nhad some nausea vomiting for the last 6 weeks.... \nMedical Decision Making \nThe patient presents to ED due to reported dizziness and low \nblood pressure.  He has also had some nausea vomiting and \nabdominal pain.  He is evaluated with a history and physical \nexam and labs and EKG and imaging.  His EKG does not \nreveal an obvious cause his symptoms (sic).  He is given IV \nfluids in the ED.  His lab work was reassuring.  The CT scan \nof his abdomen pelvis showed no acute intra-abdominal \npathology.  The chest x-ray showed no acute abnormality as \nwell.  He is given prescription for nausea medication....He \nwas stable time of being discharged to follow up with primary \ncare physician.   \n \n The assessment on January 14, 2023 was “1.  Dizziness.  2.  \nNausea and vomiting.  3.  Abdominal pain.”  The claimant was instructed to \n“Follow-up with primary care physician.  Return for any worrisome \nsymptoms.  Take medication as prescribed.”   \n\nMOHLER - H304058  6\n  \n \n \n The claimant began treating with Dr. Jantzen Slater on January 26, \n2023: \nJONATHAN MOHLER presents with complaints of sudden \nonset of frequent episodes of vomiting.  Episodes started 11 \nmonths ago.  He is currently experiencing vomiting.  \nSymptoms are worsening.  He states his symptoms worsened \nabout 5 months ago.  Pt was recently taken off his \nAmitriptyline by his doctor that he had been taking for the past \n10 years and his symptoms have started since stopping this \nmedication.  There are numerous other meds that have been \nchanged during this time.  Associated symptoms include \nnausea, headache, lightheadedness, fatigue and weakness.... \nLabs today to check food allergy panel, celiac panel & alpha \ngal panel.   \n \n The claimant underwent an “ALPHA GAL PANEL-91380” at WR \nFamily Clinic Farmington on January 26, 2023.  It was noted at that time, \n“Previous reports (JACI 2009; 123: 426-433) have demonstrated that \npatients with IgE antibodies to galactose-a-1,3 -galactose are at risk for \ndelayed anaphylaxis, angioedema, or urticaria following consumption of \nbeef, pork, or lamb.\"  The interpretation of the Alpha Gal Panel was “Very \nHigh Positive.”   \n It was reported at WR Family Clinic Fayetteville on March 1, 2023, \n“JONATHAN MOHLER presents with complaints of sudden onset of \nfrequent episodes of vomiting.  Episodes started 11 months ago.  He is \ncurrently experiencing vomiting.  Symptoms are improving.  He states he \nhasn’t vomiting (sic) in the past 2 weeks, but he has had severe fatigue and \ndiscomfort in his upper esophogus (sic).  Associated symptoms include \n\nMOHLER - H304058  7\n  \n \n \nnausea, headache, lightheadedness, fatigue and weakness.”  The \nassessment at that time was “1.  Chronic vomiting,” “2.  Depression with \nanxiety,” “3.  Allergy to alpha-gal,” “4.  Chronic pain,” and “5.  Headache.” \n Upon a referral by Dr. Slater, Dr. Tina Merritt examined the claimant \nat The Allergy Asthma Clinic of Northwest Arkansas on March 29, 2023: \nHe feels bad, can’t work, since the first of the year, and he is a \ncattle farmer[.]   \n  Reacting to cleaning chemical.... \nc/o fatigue Severe, not able to get out of bed.  Very pale, \ndiagnosed in Ft. Smith in Dec with anemia, iron and vitamin C \ngiven, was getting worse.  Colonoscopy and endoscopy Jan, \nlooking for a bleed, they said his stomach was inflamed, \nesophagus looked good, then 2 weeks later bothering him, \nnow the esophagus is better.  Worse if he tries to eat, better \nwith throwing up.... \nHistory of systemic reaction[.]  Difficulty swallowing.  \nDecreased blood pressure.  Dizziness.  Nausea or vomiting.  \nDiarrhea. \nReferred for alpha-gal allergy.  Other allergies include \nVancomycin HC1 SOLR, shrimp, and wheat (unable to add \nuncoded allergies).... \n5 days in the hospital on multiple antibiotics, septic, acute \nkidney failure and high calcium.  The referral was before this, \nfor Alpha-gal allergy....Not sure when tick bite, but he is a \ncattle farmer.  Weak and throwing up, started late \nOctober....In bed all day now.   \n \n The Social History also indicated, “Tick exposure:  May have pulled a \ntick off last summer 2022, does not recall ever having been bitten.”   \n Dr. Merritt’s assessments on March 29, 2023 were “1.  Dermatitis \ndue to ingested food,” “2.  Allergy to mammalian meats,” “3.  Illness, \nunspecified,” “4.  Encounter for screening for other metabolic disorders,” “5.  \n\nMOHLER - H304058  8\n  \n \n \nAllergic urticaria,” and “6.  Other spotted fevers.”  Dr. Merritt also noted on \nMarch 29, 2023, “Alpha-gal allergies develop after a person has been bitten \nby the Lone Star Tick in the United States.  2019 research found Alpha-gal \nin the saliva of both Lone Star ticks and Black-legged ticks.  Alpha-gal is not \nnaturally present in apes and humans, but is in all other mammals.”    \n The record contains the following notation: \n  LYME AB SCREEN \nTina Merritt Tue Apr 04 06:30:14 PM CDT 2023>Negative \nLyme screen and negative for other tick diseases tested.  Has \nappointment on the seventh but okay to give results and \nplease change the results from pending to normal on this lab \nSams, Heather 04/06/2023 4:17 PM > \nInformed patient[.]...Discussed with patient, needs to avoid \ndairy.   \n \n The claimant continued to follow up with Dr. Merritt.   \n A “WORKERS COMPENSATION – FIRST REPORT OF INJURY \nOR ILLNESS” was prepared on June 13, 2023.  The FIRST REPORT \nindicated that the DATE OF INJURY/ILLNESS was 8:00 a.m. on April 1, \n2023.  The DATE EMPLOYER NOTIFIED was April 1, 2023 and the DATE \nDISABILITY BEGAN was April 1, 2023.  The TYPE OF INJURY/ILLNESS \nwas “All Other Occupational Disease Injury.”  The PART OF BODY \nAFFECTED was “Insufficient info to properly identify.”  A box was checked \n“Yes” under the question, “DID INJURY/ILLNESS/EXPOSURE OCCUR ON \nEMPLOYER’S PREMISES?”  It was reported, “While IW was working with \ntick, IW was bitten and has caused incurable disease.”   \n\nMOHLER - H304058  9\n  \n \n \n Another “FIRST REPORT OF INJURY OR ILLNESS” was prepared \non June 20, 2023.  It was reported, “CLAIMANT RECEIVED AN \nINFECTION FROM A TICK BITE.”  The DATE OF INJURY/ILLNESS WAS \nJanuary 14, 2023 and the DATE EMPLOYER NOTIFIED was January 16, \n2023.     \n Dr. Slater corresponded on August 17, 2023: \nI am writing on behalf of Jonathan Mohler who, while \nemployed with his current workplace, suffered an unfortunate \nincident while on the job.  I am requesting your assistance in \ninitiating a Worker’s Compensation claim for Mr. Mohler due \nto a tick bite acquired during work hours, resulting in the \ndevelopment of an alpha-gal allergy.   \nUnfortunately, during his work, he was bitten by a tick.  \nSubsequent medical evaluation and tests have confirmed that \nMr. Mohler has developed an alpha-gal allergy as a direct \nresult of the tick bite.  This is thought to be at the root of his \ncurrent symptoms which have rendered him essentially \nincapacitated to his previous and presumably any occupation.   \nAlpha-gal allergy, also known as mammalian meat allergy, is \na serious condition that can lead to severe allergic reactions \nupon consumption of red meat and other mammalian \nproducts.  This condition poses a significant challenge to Mr. \nMohler’s quality of life and his ability to perform his job \neffectively.  He now requires constant vigilance and \nadjustments to his lifestyle to avoid potential triggers.   \nAt this juncture, the potential of full recovery is unknown, but \nMr. Mohler has seen some interval improvement in his \nfunctional status and is hopeful to return to productive \nemployment in the coming weeks and months.   \nEnclosed with this letter, please find all relevant medical \ndocumentation, medical assessments, and diagnostic test \nresults.  These documents substantiate the causal link \nbetween the tick bite, the subsequent development of the \nalpha-gal allergy, and the resulting medical treatment.... \n \n\nMOHLER - H304058  10\n  \n \n \n The parties deposed Robert Young on June 7, 2024.  The \nrespondents’ attorney examined Mr. Young: \nQ.  Have you ever known any employee to formally report a \ntick bite? \n  A.  No. \nQ.  At any point in time did Mr. Mohler contact you or your \ndesignated representative about saying, hey, I removed a tick \nlast night or last week? \nA.  No.   \nQ.  Okay.  Do you recall ever receiving any kind of report, \nverbal, written or made aware of a tick bite or tick removal \nfrom Mr. Mohler in late 2022? \nA.  No.   \nQ.  When was it that you were made aware that this illness of \nMr. Mohler’s may have originated from a tick or tick bite? \nA.  Well, he was ill for quite a while before he saw a doctor \nwho diagnosed the disease being a result of a tick bite.  I don’t \nremember what the dates were.   \nQ.  But you said originally you thought it was just the flu? \nA.  That’s right.   \nQ.  And when you first learned of the tick bite, what was Mr. \nMohler’s version of events about getting bit by a tick to cause \nthis? \nA.  I don’t understand the question. \nQ.  Well, did he say that there was any specific date involved \nor was he doing any specific activity? \nA.  No.... \nQ.  Has any specific day or event been associated with this \ntick bite from Mr. Mohler’s perspective? \nA.  No. \n \n Dr. Slater stated on June 17, 2024, “I am writing on behalf of \nJonathan Mohler who as you know is undergoing medical treatment for a \nwork-related injury.  Although his treatment has improved his symptoms, he \nremains unable to work due to his condition.”   \n\nMOHLER - H304058  11\n  \n \n \nA pre-hearing order was filed on June 19, 2024.  According to the \ntext of the pre-hearing order, the claimant contended, “The claimant \ncontends he sustained a compensable injury on October 29, 2022 as the \nresult of a tick bite.  Although the Commission’s file shows a January 14, \n2023 date of injury, said date was actually the date on which the claimant \nbecame disabled and his actual injury date should be October 29, 2022.  In \nthe alternative, claimant contends that if his condition is not due to the \nspecific tick bite of October 29, 2022, it is due to the cumulative effect of tick \nbites that he received during the course of his employment from January 1, \n2022 until his condition became disabling in January of 2023.  Further, \nclaimant contends that his job duties exposed him to ticks at a much greater \nfrequency than members of the general public are exposed to ticks; \ntherefore, even if his condition is determined to be an occupational disease \nit is still compensable in the same way that histoplasmosis is still \ncompensable for people who develop it as a result of working in the poultry \nindustry.  Claimant contends he is entitled to temporary total disability \nbenefits from January 15, 2023 until a date yet to be determined and \nreasonably necessary medical treatment.  In addition, claimant contends \nthat the respondent carrier is not entitled to any credit for payments that the \nrespondent employer has made; rather, the claimant should be ordered to \nreimburse the respondent employer to the extent that the claimant is \n\nMOHLER - H304058  12\n  \n \n \nawarded temporary total disability benefits, minus attorney’s fees, during \nany period of time for which the respondent employer paid full wages while \nthe claimant was temporarily totally disabled.  Claimant contends his \nattorney is entitled to an appropriate attorney’s fee.”   \n The parties contended that the respondents “have controverted this \nclaim in its entirety.”  The respondents contended, “The respondents \ncontend the claimant did not sustain a compensable injury in the form of an \noccupational disease while employed by the respondent employer.  The \nrespondents have denied and controverted this claim in its entirety.  \nAccordingly, the respondents have not and are not paying any benefits to or \non behalf of the claimant for his supposed occupational disease injury.  The \nclaimant’s physical problems and need for medical treatment, if any, are not \nrelated to his employment with the respondent employer.  Rather, the \nclaimant’s physical problems and need for medical treatment, if any, stem \nfrom an unrelated and/or pre-existing condition.  Also, the respondents \nassert A.C.A. §11-9-601, as there is no causal connection between the \nclaimant’s occupation for the respondent employer and the alleged \noccupational disease.  Additionally, no compensation is owed ‘for any \nordinary disease of life to which the general public is exposed.’  See A.C.A. \n§11-9-601(e)(3).  The respondents had no notice of the claimant’s alleged \ninjury until January 16, 2023.  Accordingly, the respondents are not liable \n\nMOHLER - H304058  13\n  \n \n \nfor any benefits whatsoever prior to January 16, 2023.  Also, if it is \ndetermined the claimant is entitled to any indemnity benefits with regard to \nthis claim, then the respondents are entitled to a credit for the respondent \ncarrier’s wage continuation payments to the claimant subsequent to \nJanuary 2023.”   \n The parties agreed to litigate the following issues: \n1. Compensability of injury to claimant in the form of a tick \nbite on October 29, 2022.  Alternatively, compensability of \ninjury due to the cumulative effect of tick bites that he \nreceived during the course of his employment from \nJanuary 1, 2022 until his condition became disabling in \nJanuary of 2023.   \n2. Related medical treatment. \n3. Temporary total disability benefits from January 15, 2023 \nthrough a date yet to be determined. \n4. Attorney’s fee.   \n5. Compensation rate. \n6. Notice.   \n \nDr. Joshua L. Kennedy corresponded with the respondents’ attorney \non July 29, 2024: \nMy name is Dr. Joshua L. Kennedy, MD, and I will provide \nexpert insight into alpha-gal syndrome (AGS).  I am currently \naffiliated with the Arkansas Children’s Research Institute and \nthe University of Arkansas for Medical Sciences (UAMS), \nspecializing in allergy and immunology.  I started at UAMS in \n2013 as an Assistant Professor and was promoted with tenure \nto Associate Professor in 2019.... \nThe plaintiff is a 50-year-old white male with h/o possible \nfibromyalgia who presented, based on the entirety of the \nhistory, with vomiting, heartburn, chronic fatigue, headache, \npalpitations, anemia, dizziness, tongue numbness, diarrhea, \nand possible alpha-gal (0.51→0.11) syndrome vs. mast cell \nactivation disorder vs. other primary GI disorder.... \n\nMOHLER - H304058  14\n  \n \n \nIn summary, the plaintiff has a low-positive IgE to alpha-gal \n(0.51 kU/L), which became even lower (0.11 kU/L) on a \nsecond test.  While there is very little dietary history in the \nnotes that were received, one can assume that the plaintiff \nwas eating red meat at the time of the first test.  At the visit \nwith Dr. Merritt on 3/23, he was told to avoid animal meat and \nby-products.  If the patient was avoiding these items, he \nshould no longer have symptoms associated with the alpha-\ngal syndrome (AGS).  Because of the low levels of IgE to \nalpha-gal and the poor response to the removal of alpha-gal \nfrom his diet, it is my opinion that other diagnoses should be \nconsidered, including diseases with a primary gastrointestinal \netiology.... \nWhile at the emergency department on 1/14/23, he has \ndocumented low blood pressure (75/45).  At that visit, there \nare no other symptoms that are discussed except dizziness (a \nsymptom of hypotension) and vomiting.  He is admitted and \ntreated for sepsis with antibiotics.  He returned later (1/17/23) \nwith high blood pressure (not a symptom of either MCAD/S or \nalpha-gal), jitteriness, and generalized flushing.  In this note, \nthere was no mention of rash.  On 3/23/23, the plaintiff \nreturned to the ED, where he again had documented low \nblood pressure (92/70), but the only other symptom \nmentioned was vomiting....It is also important to note that \nMCAD/S is not associated with tick bites.   \nIt is my medical opinion, within a reasonable degree of \nmedical certainty, that the patient should be able to avoid red \nmeat and animal by-products and live a normal quality life.  If \nthis does not happen, the diagnoses should be in question, or \nthe patient’s compliance with dietary measures should be \nevaluated.  It is my opinion, within a reasonable degree of \nmedical certainty, that the plaintiff should be capable of \nreturning to work if he is avoiding mammalian meat.  While I \nhave heard of patients who must stop working secondary to \nfood allergy because they work in the restaurant industry, \nthere are very few, if any, other instances where one might \nhave to stop working because of food allergy, including alpha-\ngal, as the symptoms subside when the allergen is avoided.  \nSome might suggest that “alpha-gal is everywhere,” therefore \nmaking it difficult to avoid; however, I have hundreds of \npatients who can live a good quality life with this disease who \nhave much higher IgE to alpha-gal than the plaintiff.   \n\nMOHLER - H304058  15\n  \n \n \nI am available to provide further details on my research and \nclinical findings regarding alpha-gal syndrome and to answer \nany questions that may arise.   \n \n  A hearing was held on August 5, 2024.  The respondents’ attorney \ncross-examined the claimant: \nQ.  Now, in your deposition you told me that this accident, this \nwork-related incident occurred on October 29, 2022.  Is that \nstill your testimony, your contention today? \nA.  That is when I can decisively recall being bit by that tick.  I \ncan’t give you other dates because I don’t have that picture, \nyou know.... \nQ.  And this tick that you found on October 29, 2022, in your \ndeposition you told me you found it on the back of your leg.  \nCorrect? \nA.  Yes.  It was on the back side of my knee, in that –  \nQ.  Which leg? \nA.  My right leg.... \nQ.  And upon finding or seeing this tick, did you immediately \nremove it? \nA.  Yes.... \nQ.  Can you state with certainty that that tick that you removed \non October 29, 2022, contained alpha-gal to introduce it into \nyour bloodstream? \nA.  I would have either burned the tick or –  \nQ.  What? \nA.  I would have either burned it, so there is no –  \nQ.  You can’t state what was inside of that tick, can you? \nA.  No.   \nQ.  Did you report this incident or this tick removal to anyone \nassociated with Cross Creek Ranch? \nA.  No. \n \n The claimant’s attorney re-examined the claimant: \nQ.  Now, I understand your testimony as being that the \nOctober 29, 2022 tick bite is the only tick bite that you can \nactually specifically identify date-wise and that is because of \nthe photograph? \nA.  Correct. \n\nMOHLER - H304058  16\n  \n \n \nQ.  But you have had multiple other tick bites during your \nemployment with Cross Creek Ranch? \nA.  Correct.   \n \n An administrative law judge filed an opinion on September 25, 2024.  \nThe administrative law judge found, among other things, that the claimant \nproved he sustained a compensable injury.  The administrative law judge \nawarded medical treatment and temporary total disability benefits.  The \nadministrative law judge found that the respondents were “entitled to a \ncredit for wages claimant was paid beginning January 14, 2023 and \ncontinuing through a date yet to be determined.”  The respondents appeal \nto the Full Commission and the claimant cross-appeals. \nII.  ADJUDICATION \nA.  Alleged Accidental Injury \nArk. 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 \nphysical harm to the body ... arising out of and in the \ncourse of employment and which requires medical \nservices or results in disability or death.  An injury is \n“accidental” only if it is caused by a specific incident \nand is identifiable by time and place of occurrence[.]   \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. \n\nMOHLER - H304058  17\n  \n \n \n2012).  Causation does not need to be established by objective findings, so \nlong as objective medical evidence establishes the injury’s existence and a \npreponderance of other nonmedical evidence establishes a causal relation \nto a work-related incident.  Bean v. Reynolds Consumer Products, 2022 \nArk. App. 276, 646 S.W.3d 655, citing Wal-Mart Stores, Inc. v. VanWagner, \n337 Ark. 443, 990 S.W.2d 522 (1999).     \n The employee has the burden of proving by a preponderance of the \nevidence that he sustained a compensable injury.  Ark. Code Ann. §11-9-\n102(4)(E)(i)(Repl. 2012).  Preponderance of the evidence means the \nevidence having greater weight or convincing force.  Metropolitan Nat’l \nBank v. La Sher Oil Co., 81 Ark. App. 269, 101 S.W.3d 252 (2003). \n An administrative law judge found in the present matter, “3.  \nClaimant has met his burden of proving by a preponderance of the \nevidence that he suffered a compensable injury in the form of a tick bite \nresulting in alpha-gal allergy.”  The Full Commission does not affirm this \nfinding.   \n The record indicates that the claimant became employed as a ranch \nhand for Cross Creek Ranch on or about August 3, 2020.  The claimant \nperformed a variety of activities on the respondent-employer’s ranch, \nincluding cattle work, fence repair, and hay baling.  The claimant’s work for \nthe respondents routinely required him to be in grassy and wooded areas.  \n\nMOHLER - H304058  18\n  \n \n \nRobert Young, the owner of Cross Creek Ranch, testified that ticks were \nprevalent on the property.   \n The claimant testified that he was bitten by a tick while performing \nemployment services on October 29, 2022.  The claimant testified that he \ndid not know he had been bitten until looking through pictures on his phone.  \nThe claimant testified, “I looked through my pictures on my phone and \nrealized I had gotten bit by a tick on a day when I had repaired fence.  I took \na picture of a tree, which was rubbed on is what was noteworthy about it, \nand that is what helped me recall.”  The claimant’s wife, Courtney Mohler, \nconfirmed that she had seen pictures of a tree but did not directly \ncorroborate the claimant’s testimony that he removed a tick from his right \nleg.  There is no probative evidence before the Commission demonstrating \nthat the claimant actually received a tick bite on or about October 29, 2022 \nor any other pertinent date.  The Full Commission recognizes that the \nstatute does not require, as a prerequisite to compensability, that the \nclaimant identify a precise time or numerical date upon which an alleged \naccidental injury occurred.  See Edens v. Superior Marble & Glass, 346 Ark. \n487, 58 S.w.3d 369 (2001).  Instead, the statute only requires that the \nclaimant prove that the occurrence of the injury is capable of being \nidentified.  Id. \n\nMOHLER - H304058  19\n  \n \n \n The Commission is not required to believe the testimony of the \nclaimant or any other witness, but may accept and translate into findings of \nfact only those portions of the testimony that are deemed worthy of belief.  \nMorelock v. Kearney Co., 48 Ark. App. 227, 894 S.W.2d 603 (1995).  In the \npresent matter, with regard to whether the claimant was bitten by a tick on \nor about October 29, 2022, the Full Commission is constrained to find that \nthe claimant was not a credible witness.  There was no probative evidence \nof record corroborating the claimant’s testimony that he was bitten by a tick \non or about October 29, 2022 or any other date.  Robert Young, the owner \nof respondent-employer Cross Creek Ranch, testified that the claimant \nnever reported a tick bite to him in 2022.  The evidence in the present \nmatter does not corroborate the existence of a tick bite.  See Bean, supra.   \n Moreover, the claimant initially did not inform the medical providers \nthat he had allegedly received a tick bite.  The claimant began treating at \nWashington Regional Medical Center on January 14, 2023.  The claimant \nreported that he had been suffering from dizziness, nausea, and vomiting \nsince he had stopped taking blood pressure medication one month earlier.  \nA physician assessed “1.  Dizziness,” “2.  Nausea and vomiting,” and “3.  \nAbdominal pain.”  There was no report of a tick bite.  The claimant began \ntreating with Dr. Slater on January 26, 2023.  Dr. Slater reported that the \nclaimant’s symptoms of nausea and vomiting had begun “11 months ago” \n\nMOHLER - H304058  20\n  \n \n \nwith no reference to an alleged tick bite.  The claimant underwent an \n“ALPHA GAL PANEL – 91380” at WR Family Clinic on January 26, 2023.  It \nwas noted that Alpha-Gal was related to “consumption of beef, pork, or \nlamb.”  There was no reference to a tick bite, and there was no report that \nthe claimant had sustained a tick bite. \n The first medical report of record that the claimant had allegedly \nbeen bitten by a tick occurred on March 29, 2023, over five months after the \ndate contended by the claimant, October 29, 2022.  Dr. Merritt noted at that \ntime, “Not sure when tick bite, but he is a cattle farmer.”  The Social History \non March 29, 2023 also indicated, “May have pulled a tick off last summer \n2022, does not recall ever having been bitten [emphasis supplied].”  It was \nalso reported on or about April 6, 2023, “Negative Lyme screen and \nnegative for other tick diseases tested [emphasis supplied].  The evidence \nof record does not demonstrate that the claimant contracted Alpha-Gal \nSyndrome as the result of being bitten by a tick at Cross Creek Ranch on \nOctober 29, 2022 or any other pertinent date.  The Commission’s authority \nto resolve conflicting evidence also extends to medical testimony.  Maverick \nTransp. v. Buzzard, 69 Ark. App. 128, 10 S.W.3d 467 (2000).  The \nCommission is entitled to review the basis for a doctor’s opinion in deciding \nthe weight and credibility of the opinion and medical evidence.  Id.  In the \npresent matter, the Full Commission attaches minimal evidentiary weight to \n\nMOHLER - H304058  21\n  \n \n \nDr. Slater’s opinion written August 17, 2023 that the claimant developed an \nalpha-gal allergy following an alleged tick bite at work.  The probative \nevidence of record does not corroborate Dr. Slater’s opinion.                 \n The Full Commission finds that the claimant did not prove by a \npreponderance of the evidence that he sustained a “compensable injury” in \naccordance with Ark. Code Ann. §11-9-102(4)(A)(i)(Repl. 2012).  The \nclaimant did not prove he sustained an accidental injury causing internal or \nexternal physical harm to the body.  The claimant did not prove that he \nsustained an injury which arose out of and in the course of employment, \nrequired medical services, or resulted in disability.  The claimant did not \nprove that he sustained an injury which was caused by a specific incident \nidentifiable by time and place of occurrence on October 29, 2022 or any \nother pertinent date.  Additionally, the claimant did not establish a \ncompensable injury supported by objective medical findings.  The claimant \ndid not prove that he sustained a tick bite at work, and the claimant did not \nprove he sustained Alpha-Gal Syndrome as the result of an alleged tick bite \nat work.   \nB.  Alleged Occupational Disease \nArk. Code Ann. §11-9-601(Repl. 2012) provides, in pertinent part: \n(e)(1)(A)  “Occupational disease”, as used in this chapter, \nunless the context otherwise requires, means any disease \nthat results in disability or death and arises out of and in the \ncourse of the occupation or employment of the employee or \n\nMOHLER - H304058  22\n  \n \n \nnaturally follows or unavoidably results from an injury as that \nterm is defined in this chapter.   \n(B)  However, a causal connection between the occupation or \nemployment and the occupational disease must be \nestablished by a preponderance of the evidence....   \n(3)  No compensation shall be payable for any ordinary \ndisease of life to which the general public is exposed.... \n(g)(1)  An employer shall not be liable for any compensation \nfor an occupational disease unless: \n(A)  The disease is due to the nature of an employment in \nwhich the hazards of the disease actually exist and are \ncharacteristic thereof and peculiar to the trade, occupation, \nprocess, or employment and is actually incurred in  his or her \nemployment[.]   \n \n An occupational disease is characteristic of an occupation, process, \nor employment where there is a recognizable link between the nature of the \njob performed and an increased risk in contracting the occupational disease \nin question.  Sanyo Mfg. Corp. v. Leisure, 12 Ark. App. 274, 675 S.W.2d \n841 (1984).  Occupational diseases are generally gradual rather than \nsudden in onset.  Hancock v. Modern Indus. Laundry, 46 Ark. App. 186, \n878 S.W.2d 416 (1994).   \n Ark. Code Ann. §11-9-603(a)(2)(A)(Repl. 2012) provides, “Written \nnotice shall be given to the employer of an occupational disease by the \nemployee, or someone in his or her behalf, within ninety (90) days after first \ndistinct manifestation thereof.”  The 90-day statutory period does not begin \nto run until the employee knows or should reasonably be expected to know \nthat he is suffering from an occupational disease.  Quality Service Railcar v. \nWilliams, 36 Ark. App. 29, 820 S.W.2d 878 (1991).  Failure to give notice \n\nMOHLER - H304058  23\n  \n \n \nshall not bar any claim if the employer had knowledge of the injury; of the \nemployee had no knowledge that the condition arose out of and in the \ncourse of employment; or if the Commission excuses the failure on the \ngrounds that, for some satisfactory reason, the notice could not be given.  \nArk. Code Ann. §11-9-701(b)(Repl. 2012).    \n An administrative law judge found in the present matter, “2.  \nClaimant’s claim for a compensation injury is an accidental injury, not an \noccupational disease.”  The claimant states on appeal, “The claimant \ncontended that his tick bite injury is the result of an occupational disease \ninjury, or in the alternative, it is due to a specific incident injury....As \nindicated above, the claimant also considers this tick bite and the \ndevelopment of AGS to be compensable as an occupational disease.”  The \nFull Commission finds that the claimant did not prove by a preponderance \nof the evidence that he sustained a compensable “occupational disease” in \naccordance with Ark. Code Ann. §11-9-601(Repl. 2012).   \n As we have discussed, the claimant became employed with the \nrespondents, Cross Creek Ranch, on or about August 3, 2020.  The \nclaimant’s work for the respondents routinely required him to work in \nwooded and grassy areas.  The claimant began receiving medical treatment \nat Washington Regional Medical Center on January 14, 2023.  The claimant \ncomplained of dizziness, nausea, and vomiting.  There was no reference in \n\nMOHLER - H304058  24\n  \n \n \nthe medical records to gradual or “cumulative tick bites.”  There was no \nprobative or physical evidence in the record which demonstrated that the \nclaimant ever became sick as the result of a tick bite or tick bites he \nallegedly sustained on the respondents’ premises.  The ALPHA GAL \nPANEL done on January 26, 2023 related the claimant’s symptoms to \n“consumption of beef, pork, or lamb.”  The evidence does not demonstrate \nthat the claimant became ill as the result of eating an animal which had \nbeen bitten by a tick.  The Full Commission also reiterates the April 6, 2023 \nmedical report which indicated, “Negative Lyme screen and negative for \nother tick diseases tested [emphasis supplied].”  The claimant was advised \nto “avoid dairy.”   \n The Full Commission reiterates that we have attached minimal \nevidentiary weight to Dr. Slater’s opinion that the claimant suffered from a \ntick bite “resulting in the development of an alpha-gal allergy.”  The \nprobative evidence of record does not corroborate the claimant’s contention \nthat his Alpha-Gal condition was \"due to the cumulative effect of tick bites \nthat he received during the course of his employment from January 1, 2022 \nuntil his condition became disabling in January of 2023.\"  A finding of a \ncompensable injury cannot be based on speculation and conjecture.  Smith-\nBlair, Inc. v. Jones, 77 Ark. App. 273, 72 S.W.3d 560 (2002).  In the present \nmatter, the Full Commission would be forced to resort to speculation and \n\nMOHLER - H304058  25\n  \n \n \nconjecture to find that the claimant proved he sustained a compensable \noccupational disease in accordance with Ark. Code Ann. §11-9-601(Repl. \n2012).   \n After reviewing the entire record de novo, the Full Commission \nreverses the administrative law judge’s finding that the claimant proved he \nsustained a compensable injury.  The Full Commission finds that the \nclaimant did not prove by a preponderance of the evidence that he \nsustained a compensable injury in accordance with Ark. Code Ann. §11-9-\n102(4)(Repl. 2012).  The claimant did not prove by a preponderance of the \nevidence that he sustained a compensable occupational disease in \naccordance with Ark. Code Ann. §11-9-601(Repl. 2012).  This claim is \nrespectfully denied and dismissed. \n IT IS SO ORDERED. \n \n    ___________________________________ \n    SCOTTY DALE DOUTHIT, Chairman \n \n    ___________________________________ \n    MICHAEL R. MAYTON, Commissioner \n \n \nCommissioner Willhite dissents. \n \nDISSENTING OPINION \n  The   ALJ   in   this   case   found   that   the   Claimant   proved   by   a \npreponderance of the evidence that he suffered a compensable injury in the \n\nMOHLER - H304058  26\n  \n \n \nform of a tick bite resulting in alpha-gal allergy, that Respondent is liable for \npayment  of  all  reasonable  and  necessary  medical  treatment  provided  in \nconnection with the Claimant’s compensable injury, and that Claimant has \nmet  his  burden  of  proving  by  a preponderance  of  the  evidence  that  he  is \nentitled to temporary total disability benefits beginning January 14, 2023 and \ncontinuing through a date yet to be determined.  After my de novo review of \nthe  record,  I  dissent  with  the  majority  and  would  concur  with  the  ALJ’s \nfindings regarding compensability but would find that Claimant sustained an \noccupational disease in the form of a tick bite resulting in an alpha-gal allergy \nrather than a specific incident injury.   \n Claimant began working for Respondent at Cross Creek Ranch in July \nof  2020.  Respondent’s owner, Robert Young III testified that he hired the \nClaimant as a ranch hand to tend cattle.  Young testified that Claimant was \nresponsible for anything that needed to be done on the ranch. Claimant was \nprovided with a home for he and his family to live in on the ranch.  Testimony \nfrom the Claimant, Courtney Mohler (Claimant’s wife), and Young all state \nthat ticks are prevalent on Cross Creek Ranch.  \nClaimant testified that he suffered a tick bite on October 29, 2022.  In \nNovember  2022, Claimant  began  vomiting  without  warning.  Ms. Mohler \ntestified that she began noticing Claimant was having new health issues in \nDecember of 2022. On January 14, 2023, Ms. Mohler took Claimant to the \n\nMOHLER - H304058  27\n  \n \n \nemergency room due to uncontrollable vomiting, stomach pain, and irritation \nin  the  throat  and  esophagus.  Claimant  followed  up  with  his  primary  care \nphysician,  Dr.  Jantzen  Slater,  who  tested  Claimant  for  alpha-gal  which  is \ndescribed as an allergy triggered by a tick bite.  Claimant was diagnosed with \nalpha-gal syndrome on February 7, 2023.  \nClaimant contended that his diagnosis of alpha-gal syndrome is an \noccupational disease resulting from a tick bite, I agree.  Occupational \ndisease “means any disease that results in disability or death and arises out \nof and in the course of the occupation or employment of the employee or \nnaturally follows or unavoidably results from an injury” Ark. Code Ann. § 11-\n9-601(e)(1)(A). Ark. Code Ann. § 11-9-601 does not define the distinction \nbetween “accidental injury” and “disease,” but a widely accepted distinction \nis that occupational diseases are generally gradual rather than sudden in \nonset.  Johnson v. Democrat Printing and Lithograph, 57 Ark. App. 274, 944 \nS.W.2d 138 (1997); Hancock v. Modern Indus. Laundry, 46 Ark. App. 186, \n878 S.W.2d 416 (1994).  Further “a worker must establish that his or her \noccupational disease came about as a matter of course as a natural \nconsequence or incident of distinctive conditions of his or her particular \nemployment.” Crossett Sch. Dist. V. Gourley, 50 Ark. App. 1, 899 S.W.2d \n482 (1995). \nAlpha-gal syndrome is:  \n\nMOHLER - H304058  28\n  \n \n \n[A]n allergic reaction to a type of sugar community called alpha-\ngal.  It is found in the meat and organ meats of mammals, such \nas cows, pigs, and sheep.  It may also be found in products that \ncome  from  animals,  such  as  gelatin,  medicines,  medicine \ncapsules,   some   milk   products,   vaccines,   and   cosmetics. \n(Claimant’s Exhibit 1, p. 95).  \n Further:  \nThis  allergy  is first  triggered  by a  tick  bite  from a  lone  star or \nblackleg tick.  These ticks bite animals, such as cows, pigs, or \nsheep, and pick up the alpha-gal sugar from their blood.  If this \nsame tick bites you, it may cause your body’s defense system \n(immune system) to produce antibodies to alpha-gal and cause \nthe allergic reaction.  Id. \n \n Claimant   became   symptomatic   in   November   2022   shortly   after \nsuffering  a  tick  bite  on  October  29,  2022.  Claimant  exhibited  additional \nsymptoms and health issues in December of 2022.  On January 14, 2023, \nClaimant  began  experiencing  such  uncontrolled  symptoms  of  alpha-gal \nsyndrome that he sought emergency treatment.  These unusual symptoms \nappear to be logically related to the tick bite.  Lastly, Claimant was living on \nthe  ranch  as  a  condition  of  his  employment  and  the  Respondent’s  own \nwitness admitted that ticks were prevalent.  As such, a tick bite resulting in \nthe alpha-gal syndrome appears to be a natural consequence or incident of \nthe distinctive conditions of Claimant’s employment.  \n Based  upon  the  credible  evidence  in  the  record,  I  find  that  the \nClaimant received a tick bite which caused him to experience the alpha-gal \nsyndrome.  I also find that due to the nature of Claimant’s employment he \nwas exposed to a greater risk of this disease than the general public.  I further \n\nMOHLER - H304058  29\n  \n \n \nfind that the Claimant’s symptoms and disability arose soon after the tick bite \nwith  nothing  to  suggest  any  alternate  explanation  for  his  condition  so  that \nthere is a logical connection between them.  Additionally, since an employee \nis not required to prove the source of an infection with absolute certainty, I \nfind that the Claimant met his burden of proof that he suffered a compensable \noccupational  disease  from  this  course  of  events  and  is  entitled  to all \nreasonable  and  necessary  medical  benefits required from the  tick bite and \nassociated symptoms.  \n Therefore, I dissent with the majority and would rule that the Claimant \nsuffered a compensable occupational disease as a result of a tick-bite and is \nentitled to associated medical benefits.   \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. H304058 JONATHAN MOHLER, EMPLOYEE CLAIMANT ROBERT A. YOUNG III, (CROSS CREEK RANCH, LLC), EMPLOYER RESPONDENT MIDWEST INSURANCE COMPANY, INSURANCE CARRIER/TPA RESPONDENT","fetched_at":"2026-05-19T22:29:44.364Z","links":{"html":"/opinions/full_commission-H304058-2025-04-02","pdf":"https://www.labor.arkansas.gov/wp-content/uploads/Mohler_Jonathan_H304058_20250402.pdf","source_publisher":"https://labor.arkansas.gov/workers-comp/awcc-opinions/full-commission-opinions/"}}