{"id":"full_commission-H404754-2025-09-25","awcc_number":"H404754","decision_date":"2025-09-25","opinion_type":"full_commission","claimant_name":"Amanda Engleman","employer_name":"Washington Regional Medical Center","title":"ENGLEMAN VS. WASHINGTON REGIONAL MEDICAL CENTER AWCC# H404754 September 25, 2025","outcome":"granted","outcome_keywords":["granted:3"],"injury_keywords":["shoulder","back","fracture","rotator cuff","sprain"],"pdf_url":"https://www.labor.arkansas.gov/wp-content/uploads/Engleman_Amanda_H404754_20250925.pdf","source_index_url":"https://labor.arkansas.gov/workers-comp/awcc-opinions/full-commission-opinions/","filename":"Engleman_Amanda_H404754_20250925.pdf","text_length":53197,"full_text":"BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION \n \n \nCLAIM NO.  H404754  \n \nAMANDA ENGLEMAN, \nEMPLOYEE \n \nCLAIMANT \nWASHINGTON REGIONAL MEDICAL CENTER,  \nEMPLOYER \n \nRESPONDENT \nRISK MANAGEMENT RESOURCES, \nINSURANCE CARRIER/TPA \nRESPONDENT \n  \n      \nOPINION FILED SEPTEMBER 25, 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 MELISSA WOOD, Attorney \nat Law, Little Rock, Arkansas. \n \nDecision of Administrative Law Judge:  Reversed. \n \n \n OPINION AND ORDER \nThe respondents appeal an administrative law judge’s opinion filed \nApril 18, 2025.  The administrative law judge found that the claimant proved \nshe sustained a compensable injury.  After reviewing the entire record de \nnovo, the Full Commission reverses the administrative law judge’s opinion.  \nThe Full Commission finds that the claimant did not prove by a \npreponderance of the evidence that she sustained a compensable injury.     \nI.  HISTORY \n Amanda Engleman, now age 44, testified on direct examinaton: \n\nENGLEMAN - H404754  2\n  \n \n \nQ.  It is my understanding that you had had an injury to your \nleft shoulder before this June 2, 2023 incident ever happened.  \nIs that correct? \nA.  Yes, I did. \nQ.  Tell us what happened. \nA.  We were remodeling our home and painting the bedroom.  \nMy husband took the stepladder out of the room and I saw a \nspot a little higher up on the wall that I wanted to get.  And \nsince he had already taken the stepladder out, I thought it was \ngoing to be a smart idea to just jump on a chair and go from \nthe chair to the barstool and I fell.   \nQ.  And did you sustain any kind of injury as a result of that \nfall? \nA.  It hurt for about three weeks, I want to say three weeks, \nand then it resolved on its own.   \nQ.  When you say it, what is it?  What part of your body? \nA.  The left shoulder, elbow.  I landed on my elbow.   \nQ.  You landed on your left elbow? \nA.  Yes. \nQ.  And injured your left shoulder? \nA.  Yes.   \n \n The claimant sought treatment at Mercy Convenient Care on \nFebruary 17, 2022.  The claimant complained of left shoulder pain and it \nwas noted, “Fall occurred:  Tripped and walking.  Impact surface:  Hard \nfloor.”  An x-ray of the claimant’s left shoulder was taken on February 17, \n2022 with the impression, “Negative left shoulder x-ray.” \n The claimant testified that she became employed with the \nrespondents, Washington Regional Medical Center, in November 2022.  \nThe claimant testified that her employment position with the respondents \nwas “Operating Room Circulator.”     \n\nENGLEMAN - H404754  3\n  \n \n \nThe parties stipulated that the employment relationship existed on \nJune 2, 2023.  The claimant testified on direct examination: \nQ.  Ms. Engleman, where were you employed on June 2 of \n2023? \n A.  Washington Regional Medical Center. \n Q.  Did anything unusual happen to you on that day? \n A.  Yes. \n Q.  What? \nA.  We were in a case with Dr. Kendrick and the patient was in \na prone position at the time.  The CRNA alerted me that the \npatient was sliding off of the operating room table because Dr. \nKendrick had to put her in – well, she was prone and he had \nto put her in Trendelenburg to get to the area that he was \noperating on and he said that he needed help.  So I got under \nthe table, under the drapes, and was trying to reposition the \npatient back into a position where she wouldn’t fall off the \ntable and at that time I started feeling pain in my shoulders, so \nI changed my position and got underneath the patient a little \nbit better.  And then the CRNA said he was going to tilt the \nbed the opposite direction so that I could push against her and \nwe would have gravity to help us reposition.  Instead, he hit \nthe button and it tilted towards me so I had the patient over \nmy head and both shoulders went back.  My left shoulder \npopped.  I had to stay there because at that point I couldn’t \npush the patient any more to the operating room table.  And \nwe finished the surgery in about five minutes, so I was there \nunder her the whole five minutes holding her above my head.  \nAnd when we completed everything and got her switched over \nto the gurney to transport her to PACU, I went and told the \nboss my left shoulder had popped and my right one was \nhurting, they were both hurting, so they sent me to the \nemployee health nurse.   \n \n The claimant signed a Form AR-N, EMPLOYEE’S NOTICE OF \nINJURY, on June 2, 2023.  The ACCIDENT INFORMATION section of the \nForm AR-N indicated that the Date of Accident was June 2, 2023, and that \n\nENGLEMAN - H404754  4\n  \n \n \nthe claimant injured “Both shoulders.”  The claimant wrote regarding the \ncause of injury, “holding heavy weight of patient to prevent injury.”   \n According to the record, the claimant treated at Conservative Care \nOccupational Health on June 2, 2023: \nAmanda Engleman is a 42 year-old Female, and employee of \nWashington Regional/WRMC.... \nEmployer Description of Accident:  Employer states patient \nwas trying to reposition a patient on the surgery table and \ninjured both shoulders.  Her date of injury is June 2, 2023.... \nPatient states she was repositioning a large client on the \nsurgical table when she felt a pop and sharp pain in her left \nshoulder.  She had to hold the client with both arms for an \nextended period of time, and now her right shoulder is hurting \nas well.... \nAmanda’s primary problem is Pain located in the Left \nshoulder.  She describes it as burning, sharp....The problem \nbegan on 6/2/2023....Amanda’s secondary problem is Pain \nlocated in the Right shoulder....The problem began on \n6/2/2023.... \nIMAGING STUDIES \nX-RAY – Left Shoulder:  Degenerative changes.  Spurring \nover the acromion.  No Fracture Seen.  Acute Findings – \nAbsent. \nNumber of views:  3 views were taken of the left shoulder.   \nXRAY – Right Shoulder:  Degenerative changes.  No Fracture \nSeen.  Acute Findings – Absent.   \nNumber of views:  3 views were taken of the right shoulder.... \nPatient reports having general aches and pains to her \nshoulders in the past, last episode approximately 1 year ago, \nbut has never had to have formal treatment for either shoulder \nbefore this reported injury.  Today’s x-rays are negative for \nacute abnormalities.... \nThe cause of this problem appears to be related to work \nactivities.   \n \n\nENGLEMAN - H404754  5\n  \n \n \n Amanda Bell, APRN diagnosed “1.  Left shoulder pain” and “2.  Right \nshoulder pain.”  Ms. Bell planned conservative treatment, and she assigned \na Work Status of “Restricted Duty.” \n Dr. Konstantin V. Berestnev’s diagnosis on June 9, 2023 was “1.  \nPain in left shoulder” and “2.  Pain in right shoulder....The cause of this \nproblem appears to be related to work activities.”  Dr. Berestnev continued \nthe work status “Restricted Duty,” “No work above the shoulders.”   \n The claimant was provided a program of physical therapy.  A \nphysical therapist noted on June 14, 2023, “Pt is RHD 42 YOF with C/O \nconstant anterior/superior shoulder pain L>R.  Reports initial onset of pain \non 6/2/23 after catching a patient from sliding off of a table.  Reports table \nwas elevated at OR patient’s midsection and she slid down causing her to \nbe on her knees pushing upward to stop momentum....She is currently on \nwork restrictions.  Denies any other shoulder treatments.”  The claimant \ntestified that she did not benefit from physical therapy, and that physical \ntherapy “actually aggravated the situation.”       \n Dr. Berestnev stated on June 30, 2023, “Amanda’s recommended \nwork status is Regular Duty.”  The claimant was discharged from physical \ntherapy on July 18, 2023.  The claimant continued to occasionally follow up \nat Conservative Care Occupational Health.  Dr. Berestnev reported on \nAugust 8, 2023, “Patient states her bilateral shoulder pain is better.”   \n\nENGLEMAN - H404754  6\n  \n \n \n Dr. J. Clayton noted on March 26, 2024 that the claimant’s chief \ncomplaint was left shoulder pain.  Dr. Clayton noted: \nHistory:  This patient has had pain in her left shoulder ever \nsince she hurt it about 2 years ago when she was moving a \ndog into another seat of the car.  She is (sic) already done \nphysical therapy which was done this past June through \nAugust she has been on ibuprofen she has not had any \ninjections or used prescription NSAIDS. \nExam:  Patient does not have weakness in the shoulder but \ndoes have positive impingement signs.  Neurovascularly \nintact.   \nImaging:  Plain films of the left shoulder failed to demonstrate \nfracture or dislocation.   \nMedical decision making:  Rotator cuff impingement on the \nleft.  We are going to try some meloxicam as well as an \ninjection today.  If those things are not successful advanced \nimaging would be reasonable given that she has already done \ntherapy.   \n \n Dr. Clayton noted on April 16, 2024: \nThis patient had an injury to her left shoulder which was \nactually from a fall loading her shoulder directly though there \nwas also an incident involving repositioning a dog but that was \nnot actually the inciting event.  Short of it is this was a trauma \nto her shoulder.  She has already done injections formal \nphysical therapy and chiropractics and continues to have pain \nin her shoulder that is severe enough that it wakes her up at \nnight.... \nImaging:  Plain films of the left shoulder are unremarkable \nwithout fracture or dislocation.... \n \n Dr. Clayton arranged for an MRI of the claimant’s left shoulder, which \nwas taken on May 7, 2024 with the following impression: \n1. There is a small amount of fluid in the subacromial bursa \nwhich may be secondary to bursitis or tendinitis. \n2. There is mild degenerative change at the \nacromioclavicular joint.   \n\nENGLEMAN - H404754  7\n  \n \n \n \nDr. Clayton noted on May 14, 2024, “MRI was reviewed with the \npatient and was largely unremarkable though she does have some \ndegenerative changes at the AC joint.  Medical decision making:  Given the \npersistent pain despite nonsurgical treatments it might be reasonable to \nconsider something like a subacromial decompression and distal clavicle \nexcision.  I am going to have her see one of my partners to be evaluated \nbut we may also consider ultrasound-guided biceps and were AC joint \ninfection.”   \nDr. T. Zimmerman reported on May 17, 2024: \nMs. Engleman has chronic and symptomatically uncontrolled \nleft shoulder pain likely from multiple etiologies.  She does \nhave tendinopathy of the cuff but no overt tearing.  She is very \ntender over the bicipital groove but also over the deltoid, \ninfraspinatus, along the medial border of the scapula with \nassociated trigger point/myofascial pain.  She reported her \nmuscles calming down after a landmark guided subacromial \ncorticosteroid injection with Dr. Clayton.... \nWe discussed the various options and ultimately decided to \nstart with corticosteroid injections to the long head of the \nbiceps tendon sheath and AC joint.  After obtaining consent, \nincluding the risk of tendon rupture after biceps tendon sheath \ninjection, injections were performed as below without issue.  If \nshe experiences no relief or only partial relief from today’s \ninjections then I think before considering surgery it [would] be \nworthwhile to do some trigger point injections/therapeutic \nneedling or consider sending her dry needling.... \nHistory of Present Illness:  43 y.o. female who presents for \nevaluation of left shoulder pain.  She reports anterior left \nshoulder pain which will radiate to her upper arm and some \nposterior shoulder pain as well.  This has been present for \nover 2 years and she associates it with starting after falling off \nof a barstool onto her left elbow.  She reports associated \n\nENGLEMAN - H404754  8\n  \n \n \nclicking and difficulty with motion.  She has pain with reaching \noverhead or posteriorly.  It loosened up her muscles for about \na week and she could feel the muscles release when she \nreceived the injection.... \nRadiographs of the left shoulder are unremarkable.   \nMRI of the right shoulder demonstrates tendinosis of the \nsupraspinatus tendon, degenerative changes of the AC joint, \nand a little bit of fluid in the long head of the biceps tendon \nsheath.   \n \n Dr. Greg Jones reported on May 29, 2024: \nMs. Engleman is a 43-year-old nurse.  She has worked in the \nICU as well as a flight nurse in the past.  She is now doing \ncirculating room work at the Washington Regional Hospital \nand in particular with respect to work when she is “pushing \ncarts or lifting patients” it exacerbates her left shoulder pain.  It \nis fairly constant at 4/10 but it can get up to 10/10 after she \nhas a busy work day.   \nSymptoms began 2-1/2 years ago.  She fell off a step ladder \ndoing some painting, landed directly on her elbow, grabbed it \nup into the shoulder longitudinally and has had symptoms \never since then.  She had two episodes when a dog jerked \nher shoulder.  I have looked at her carefully for instability but \ncertainly the stress that the description implies wrenched her \nshoulder and had worsening of symptoms and she states that \nshe is having increasing trouble “pushing events” when she is \nmoving patients out of the operating room as a part of her \nnormal circulating room duties. \nShe cannot sleep on it, it wakes her up at night on occasion.  \nShe has been seen and treated conservatively by Dr. \nZimmerman of Sports Medicine and Dr. Clayton, one of my \npartners.  Injections are made both into the subacromial \nspace that lasted about a week, a second injection was made \nwith an ultrasound-guided groove injection.  It really did not do \nmuch for her and because of those failures of anti-\ninflammatories time, injections and physical therapy, she \npresents for consideration of surgery.... \nI have reviewed the 4-view shoulder x-ray series from 03/26.  \nShe has a flat acromion, non-pointed coracoid and normal \nanatomy of the glenohumeral joint.  No evidence of arthritis.  \nShe has had impingement changes of the greater tuberosity \n\nENGLEMAN - H404754  9\n  \n \n \nand chronic AC arthropathy changes without overt spur \nformation but definitely sclerosis and cystic changes on the \nclavicular and the AC joint site.   \nThe MRI is likewise reviewed.  There is no evidence of full-\nthickness tear and the biceps tendon has minimal fluid along \nthe sheath.  She has some evidence of subacromial bursitis to \nmy evaluation of the exam.  There is no full-thickness rotator \ncuff tear.   \nShe has 2-1/2 years of pain.  She has positive examination of \nthe AC joint and with impingement maneuvers that had been \nalleviated albeit temporarily with injection.  I think the biceps is \nnot particularly involved nor is there instability.  Given the \nchronicity of symptoms and failure of extended conservative \nmeasures, an arthroscopic AC joint resection and subacromial \nbursectomy given the traumatic nature of the bursitis onset I \nthink are appropriate next steps in management.   \nShe is sick of it, it is bothering her badly and she wants to \nproceed in that direction.... \n \nDr. Jones’ pre-operative diagnosis on June 13, 2024 was “AC \narthropathy – posttraumatic, biceps tendinitis, chronic subacromial bursitis – \ntraumatic.”  Dr. Jones performed a procedure on August 26, 2024:  “1.  \nGlenohumeral arthroscopy with biceps tenotomy.  2.  AC resection/Mumford \nprocedure via anterior arthroscopic approach.  3.  Extended subacromial \nbursectomy.  No acromioplasty.  CA ligament sleeve release.”  The post-\noperative diagnosis was “1.  Subluxation of the biceps tendon with \nlongitudinal split and hypervascular tenosynovitis.  2.  AC meniscus \narthropathy with torn AC meniscal elements.  3.  Moderately severe \nsubacromial bursitis, rotator cuff fully intact.”   \nDr. Jones reported on June 13, 2024: \n\nENGLEMAN - H404754  10\n  \n \n \nMs. Engleman is a healthcare provider with recurrent and \nincreasing job limiting, life-limiting symptoms from her left \nshoulder since an injury in an incident where she had a fall \nfrom a vehicle and landed on her extended left arm, drove \nover shoulder via the elbow up and sprained her AC joint.  It \nhas been symptomatic ever since as she does certain \nmaneuvers in terms of lifting patients and moving things in her \njob performance.  It acutely exacerbates the pain and she has \na combination of 3 different findings that are very focused in \nterms of our exam.  The rotator cuff appears to be intact, but \nthe biceps tendon has gotten a great deal more symptomatic \nand on careful observation has both symptomatic Speed’s \nand Yergason’s test prior to surgery on exam and a marked \ntenderness to palpation along the bicipital groove.  She also \nhas positive impingement and bursitis, signs of crepitus and \nthe AC joint remains exquisitely uncomfortable to provocative \ncross-arm and rotatory maneuvers.   \nBased on these findings, 2 and a half years since the incident \nwithout improvement, it is felt that an arthroscopic evaluation \nis appropriate.  At this time by MRI and exam, it is felt the \nrotator cuff is intact, but I certainly think the biceps has risen \nto a level of pain generator participation that it needs to be \naddressed at the same setting.... \n \n Dr. Jones noted on July 17, 2024: \nMs. Engleman is a 43-year-old nurse, who works up at \nWashington Regional.  She is in the OR, heavy lifting.  She \nhad a fall at one point from a ladder.  In my operative note, I \nhave said it was from a vehicular accident, but was from a fall \nfrom a ladder, but there were multiple other episodes were \nactually documented, one with a pop in her shoulder and she \nhad been sent to physical therapy and it had continued \nsymptoms with the biceps tendon even back in that \ntimeframe.   \nShe is an operating room nurse as with all of our patient’s, \nthey are all more frequent to 300 pounds or plus and moving \nthem, putting them on and off a bed, pushing the gurneys, \netc., has become an increasingly challenging situation for \nalmost as the particular one, who has had shoulder injury and \nsurgery.   \n\nENGLEMAN - H404754  11\n  \n \n \nI am a little bit confused and that this appears to have had \nclearly a work component.  A diagnosis is made at work that \nprompted the use of physical therapy for that purpose, I think \nconfirming this was; \n1. Reported. \n2. Recognized. \n3. In my opinion, greater than 50% contribution to the \nproblems that exist, I think she needs to pursue this in \nappropriate fashion and I have recommended same.   \nToday’s x-rays, copy as report demonstrate satisfactory AC \njoint resection or flat acromion on the outlet view, no \ndystrophic calcification or calcific tendinitis.  There are no \nfractures.  Copy that as a 2-view left shoulder x-ray report.... \nTakes at least 3 months to get over her surgery such as this.  \nIf she has to return to “full unrestricted lifting activity,” she is \nnot ready to do that and I am going to ask that she see me \nback in 2 months and we will consider return at that juncture \ndepending on her surgery was 06/13/2024 on left shoulder; \nAC resection, biceps tenotomy, and subacromial bursectomy. \n \n A pre-hearing order was filed on September 27, 2024.  The claimant \ncontended, “She is entitled to temporary total disability benefits from June \n13, 2024 to a date yet to be determined and reasonably necessary medical \ntreatment.  The claimant contends that her attorney is entitled to an \nappropriate attorney’s fee.”   \n The parties stipulated that the respondents “have controverted the \nclaim in its entirety.”  The respondents contended, “Claimant’s bilateral \nshoulder injuries were initially accepted as a medical-only claim, but the \nclaim has now been denied in its entirety due to a lack of objective findings.  \nAdditionally, respondents contend that claimant has pre-existing issues with \nher shoulders and possibly underwent new injuries after June 2, 2023.”   \n\nENGLEMAN - H404754  12\n  \n \n \n The parties agreed to litigate the following issues: \n1. Whether the claimant sustained a compensable injury on \nJune 2, 2023, specifically bilateral shoulder injuries.   \n2. If compensable, whether the claimant is entitled to \ntemporary total disability benefits, and reasonably \nnecessary medical treatment. \n3. Fees for legal services.  The parties reserve all other \nissues.   \n \nDr. Jones corresponded with the claimant’s attorney on or about \nOctober 21, 2024: \nI write in response to your letter dated 10/14/2024 regarding \nyour client and my patient, Amanda Engleman.   \nAs you are aware from the medical records, I had first \nopportunity to see her 05/29/2024 and will detail those \nfindings. \nI have also had opportunity to go through medical records \nfrom Mercy Convenient Care from conservative care, \nOccupational Health from her work-related injury, on June 2, \n2023 and more recent visits in our office with Dr. Zimmerman \nand Dr. Clayton with respect to her bilateral shoulder \ndifficulties.   \nAs is outlined in my office note from 05/29/2024, the principal \nreason in which she had presented to me with an increased \nand life-limiting level of pain that had failed to respond to \nconservative care, left worse than right shoulder was the \ninjury sustained and subsequent pushing “patients” after June \n2, 2023, work injury.   \nI am well aware that she had 2 other incidents, one of fall with \na contusion that subsequently healed without problem.  \nSecond, a dog moving incident on a couple of occasions, but \nnothing that rose to the level of the nature of symptomatology \nwith which she presented to me.   \nHer history and physical examination at that time were \nconsistent with injuries from a mechanical nature and were \nconsistent with the pattern of injury that she had described. \nIt was because she had received optimum opportunity for \nconservative care including extended physical therapy with a \nconservative care, occupation health department or positions \n\nENGLEMAN - H404754  13\n  \n \n \nand as detailed notes revealed that was considered a work-\nrelated injury and persistent in its character and although did \nnot rise to the level of “needing surgery” had remained of the \nprincipal diagnosis when she completed care under their \nauspices.   \nWhen she saw me her symptoms had continued to worsen \nand despite injections and extended physical therapy and \nobservation, they have become life-limiting.   \nIt is my opinion that the nature of the injury sustained in the \nwork incident described and detailed historically both by her \nand in the medical record previously making clear to me that \nwithin a reasonable medical degree of certainty that June 2, \n2023 incident is more than 50% the cause of the injury, \nsubsequent symptomatology and findings that led me to \nrecommend the surgical procedure undertaken 06/13/2024.   \nThere had been some question I gather as to whether or not a \nvehicular accident, had been involved at any time with this \ninjury and I do not recall nor do I see documentation of that \nbeing the case.   \nHaving reviewed all these records, I remain convinced that \nwith medical certainty, greater than 50% of the cause of her \nneed for surgery on the left shoulder was due to the work-\nrelated incident.   \n \n Dr. Jones noted on December 4, 2024: \nMs. Engleman is seen in followup regarding her left shoulder.  \nShe has been plagued since the incident when she caught the \n300 pounds plus person in her role as a circulating nurse, had \nbilateral AC sprain, she had continued difficulties.  We had \ntaken her to surgery on the left shoulder, did biceps release, \nAC resection arthroscopically and while the biceps relieved \nher symptoms remarkably better.  She is still having some \ntenderness over the top side of her AC joint and provocative \ntesting increased anteroposterior plane, not superior, but \nanteroposterior.   \nI think this is a setting in which we got traumatic AC joint injury \nthat all looked better.  Since the AC resection has enough \nresidual instability, but it is limiting her ability to return to her \nprevious work and in this instance, I would recommend an \nopen deltotrapezial fascial repair.  90% of people who are \nsuccessful in alleviating the symptoms that she is \n\nENGLEMAN - H404754  14\n  \n \n \nexperiencing and displaying on both my examination and \nhistorical evidence provided. \nShe has ongoing problems with severely injured right shoulder \nin terms of the AC joint flexibility and pain with provocative \ncross-arm rotatory range of motion and if and when we get to \nthe point of taking care of the right shoulder, I would just do it \nas open AC resection given the display that she has made \nwith returns to the bilateral stretching injury and catching the \npatient is likely to have the same sort of AC sprain on the right \nas we have seen on the left.   \nIn a nutshell, she has residual AC joint resection site pain, it is \nrelated to anteroposterior instability and deltotrapezial fascial \nrepair would be the next best step in management.  Rationale \nfor same, necessary perioperative activity modification, rehab \nparticipation are detailed.  She voiced understanding and we \nwill proceed in that direction.  We will hold off the MMI \ndeclaration with respect to her work injury made previously \nuntil that surgery is completed and I might again note that the \nright shoulder was also injured in the same work injury at the \nhospital as described previously.   \nBilateral shoulder x-rays are made today and they \ndemonstrate subtle superior displacement of the right distal \nclavicle compared to the acromion.  The left shoulder has a \nwide AC resection, flat acromion.  No glenohumeral arthritis or \nevidence of fracture or destructive lesion with respect to the \nleft, 4-view series.  The right 4 view series demonstrates mild-\nto-moderate AC arthropathy with slight dorsal displacement.  \nNo glenohumeral fracture displacement and no calcifications \nin the rotator cuff insertion on either shoulder.  Copy that as a \nbilateral shoulder 4 view series.   \nWe will see her when she comes in for the left shoulder open \ndeltotrapezial fascial repair at the AC joint residual instability.   \n \n After a hearing, an administrative law judge found that the claimant \nproved she sustained a compensable injury.  The administrative law judge \nawarded medical treatment and temporary total disability benefits.  The \nrespondents appeal to the Full Commission. \nII.  ADJUDICATION \n\nENGLEMAN - H404754  15\n  \n \n \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 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).  The requirement that a compensable injury be established by \nmedical evidence supported by objective findings applies only to the \nexistence and extent of the injury.  Ford v. Chemipulp Process, Inc., 63 Ark. \nApp. 260, 977 S.W.2d 5 (1998), citing Stephens Truck Lines v. Millican, 58 \nArk. App. 275, 950 S.W.2d 472 (1997).     \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\nENGLEMAN - H404754  16\n  \n \n \nAn administrative law judge found in the present matter, “2.  \nClaimant has met her burden of proving that she suffered a compensable \nbilateral shoulder injury on June 2, 2023, and is entitled to reasonable and \nnecessary medical treatment for that injury as recommended by Dr. Greg \nJones.”  The Full Commission does not affirm this finding.  We find that the \nclaimant did not prove by a preponderance of the evidence that she \nsustained a compensable injury to her left shoulder or right shoulder.   \nThe claimant’s testimony indicated that she first injured her left \nshoulder in 2022 after she fell from a chair at home.  The claimant sought \nmedical treatment for this nonwork-related injury in February 2022.  The \nclaimant testified that she became employed as an Operating Room \nCirculator for the respondents in November 2022.  The parties stipulated \nthat the employment relationship existed on June 2, 2023.  The claimant \ntestified that she injured her left and right shoulders that day while \npositioned underneath a table, holding a hospital patient.  The claimant \nsigned a Form AR-N, EMPLOYEE’S NOTICE OF INJURY, on June 2, \n2023.  The claimant reported that she injured “both shoulders” while \n“holding heavy weight of patient to prevent injury.”   \nThe Full Commission finds that the claimant did not establish a \ncompensable injury by medical evidence supported by objective findings.  \nThe claimant treated at Conservative Care Occupational Health on June 2, \n\nENGLEMAN - H404754  17\n  \n \n \n2023.  No objective findings were shown during this treatment.  No fracture \nwas seen and no injury was demonstrated after x-rays of the claimant’s left \nand right shoulders.  An APRN diagnosed “left shoulder pain” and “right \nshoulder pain” but did not report any objective medical findings.  Dr. \nBerestnev returned the claimant to regular work duty on June 30, 2023.  \nThe record does not corroborate the claimant’s testimony that Dr. \nBerestnev refused to provide additional diagnostic testing.       \nThe 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 it deems worthy of belief.  Whaley \nv. Hardee’s, 51 Ark. App. 166, 912 S.W.2d 14 (1995).  In the present \nmatter, the Full Commission is constrained to find that the claimant was not \na credible witness.  The claimant sought treatment with Dr. Clayton on \nMarch 26, 2024.  The claimant informed Dr. Clayton that she had injured \nher left shoulder two years earlier in a dog-related incident.  Dr. Clayton \nnoted on April 16, 2024 that the claimant’s left shoulder condition “was \nactually from a fall loading her shoulder directly though there was also an \nincident involving repositioning a dog but that was not actually the inciting \nevent.”  Dr. Clayton also noted, “Plain films of the left shoulder are \nunremarkable without fracture or dislocation.”  Dr. Clayton reported on May \n14, 2024 that a left shoulder MRI showed “degenerative changes at the AC \n\nENGLEMAN - H404754  18\n  \n \n \njoint.”  The evidence does not demonstrate that these “degenerative \nchanges” were causally related to the June 2, 2023 incident.   \nDr. Zimmerman reported on May 17, 2024 that the claimant was \nsuffering from “uncontrolled left shoulder pain likely from multiple etiologies \n[emphasis supplied].”  Dr. Zimmerman reported that the claimant had \ninjured her left shoulder two years earlier “after falling off of a barstool onto \nher left elbow.”  Dr. Zimmerman did not report an incident occurring June 2, \n2023.  The claimant began treating with Dr. Jones on May 29, 2024.  Dr. \nJones noted, “She fell off a step ladder doing some painting, landed directly \non her elbow, grabbed it up into the shoulder longitudinally and has had \nsymptoms ever since then.”  Dr. Jones also reported that “a dog jerked her \nshoulder.”  Dr. Jones did not report an incident occurring June 2, 2023.  Dr. \nJones stated on June 13, 2024 that the claimant had injured her left \nshoulder after “a fall from a vehicle.”  Dr. Jones noted on July 17, 2024 that \nthere had been “multiple other episodes” involving the claimant’s left \nshoulder.  Dr. Jones finally reported on October 21, 2024 that, in his \nopinion, “within a reasonable degree of medical certainty that [the] June 2, \n2023 incident is more than 50% the cause of the injury, subsequent \nsymptomatology and findings that led me to recommend the surgical \nprocedure undertaken 06/13/2024.”   \n\nENGLEMAN - H404754  19\n  \n \n \nIt is within the Commission’s province to weigh all of the medical \nevidence and to determine what is most credible.  Minnesota Mining & Mfg. \nv. Baker, 337 Ark. 94, 989 S.W.2d 151 (1999).  In the present matter, the \nFull Commission finds that Dr. Jones’ October 21, 2024 causation opinion is \nnot supported by the record and is entitled to minimal evidentiary weight.  \nNor does the record support Dr. Jones’ conclusion on December 4, 2024 \nthat the claimant sustained a “bilateral AC sprain” on June 2, 2023. \nThe Full Commission finds in the present matter that the claimant \nwas not a credible witness.  The claimant reported several alleged causes \nfor her bilateral shoulder pain, including a fall at home and an alleged injury \nrelated to handling a dog.  Dr. Jones reported “multiple other episodes” \nallegedly causing injury to the claimant’s shoulders.  The Full Commission \nrecognizes that an APRN diagnosed “Left shoulder pain” and “Right \nshoulder pain\" following the specific incident on June 2, 2023.  \nNevertheless, we find that the claimant did not prove that the June 2, 2023 \nincident caused internal or external physical harm to the left shoulder or \nright shoulder.  Nor did the claimant establish a compensable injury by \nmedical evidence supported by objective findings.  The evidence does not \ndemonstrate that the subluxation of the biceps tendon or “torn AC meniscal \nelements” shown during surgery on June 13, 2024 were causally related to \nthe June 2, 2023 incident.  See Ford, supra.  Additionally, there is no \n\nENGLEMAN - H404754  20\n  \n \n \nprobative evidence demonstrating that the purported “subtle superior \ndisplacement of the right distal clavicle” described by Dr. Jones on \nDecember 4, 2024 was causally related to the June 2, 2023 specific \nincident. \nAfter reviewing the entire record de novo, the Full Commission finds \nthat the claimant did not prove she sustained an accidental injury causing \ninternal or external physical harm to her left shoulder or right shoulder.  In \naddition, we find that the claimant did not prove she established a \ncompensable injury to her left shoulder or right shoulder by medical \nevidence supported by objective findings.  We therefore reverse the \nadministrative law judge’s finding that the claimant proved she “suffered a \ncompensable bilateral shoulder injury on June 2, 2023[.]”  The respondents \nare not liable for medical treatment provided by Dr. Jones, and this claim is \nrespectfully denied and dismissed. \nIT IS SO ORDERED. \n \n    ___________________________________ \n    SCOTTY DALE DOUTHIT, Chairman \n \n    ___________________________________ \n    MICHAEL R. MAYTON, Commissioner \n \n \n \n \nCommissioner Willhite dissents. \n \n \n\nENGLEMAN - H404754  21\n  \n \n \nDISSENTING OPINION \n \nThe Administrative Law Judge (hereinafter referred to as “ALJ”) found \nthat the Claimant had proved by a preponderance of the evidence that she \nsuffered a compensable bilateral shoulder injury on June 2, 2023, and was \nentitled to reasonable and necessary medical treatment for that injury as \nrecommended by Dr. Greg Jones.  Further, the ALJ found that the Claimant \nhad met her burden of proof that she is entitled to temporary total disability \nfrom June 13, 2024, to a date yet to be determined.  The Respondent \nappeals this decision.  After conducting a thorough review of the record, I \nfind that the Claimant proved she sustained a compensable bilateral \nshoulder injury, and is entitled to temporary total disability from June 13, \n2024, to a date yet to be determined.  \n1. The Claimant has proven by a preponderance of the evidence that she \nsuffered compensable bilateral shoulder injuries on June 2, 2023, and \nis entitled to reasonable and necessary medical treatment for those \ninjuries as recommended by Dr. Greg Jones. \n \nTo establish a compensable injury by a preponderance of the evidence \nthe Claimant must prove: (1) an injury arising out of and in the course of \nemployment; (2) that the injury caused internal or external harm to the body \nwhich required medical services or resulted in disability or death; (3) medical \nevidence supported by objective findings, as defined in Ark. Code Ann. §11-\n9-102(16), establishing the injury; and (4) that the injury was caused by a \n\nENGLEMAN - H404754  22\n  \n \n \nspecific and identifiable time and place of occurrence.  A compensable injury \nmust be established by medical evidence supported by objective findings and \nmedical opinions addressing compensability must be stated within a degree \nof medical certainty.  Smith-Blair, Inc. v. Jones, 77 Ark. App. 273, 72 S.W.3d \n560 (2002).  \nAn 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).  \nReasonable and necessary medical services may include those necessary \nto accurately diagnose the nature and extent of the compensable injury; to \nreduce or alleviate symptoms resulting from the compensable injury; or to \nmaintain the level of healing achieved; or to prevent further deterioration of \nthe damage produced by the compensable injury.  Jordan v. Tyson Foods, \nInc., 51 Ark. App. 100, 911 S.W.2d 593 (1995).  \nOn June 2, 2023, Claimant was working in her capacity as an \nOperating Room Circulator for Respondent when a patient started slipping \noff of an operating table.  The Claimant placed herself under the operating \ntable and began pushing it up to keep the patient from sliding off of the \ntable.  The Claimant remained in this position pushing up for several \nminutes and the Claimant felt her left shoulder pop.  After the incident, the \nClaimant also began suffering from right shoulder pain.  \n\nENGLEMAN - H404754  23\n  \n \n \n Claimant was seen by Amanda Bell, APRN on June 2, 2023.  Bell \nnoted in relevant portions of the medical report as follows:  \nPatient states she was repositioning a large client \non the surgical table when she felt a pop and \nsharp pain in her left shoulder. She had to hold \nthe client with both arms for an extended period \nof time and now her right shoulder is hurting as \nwell.  \n[...] \nPatient reports having general aches and pains \nto  her  shoulders  in  the  past,  last  episode \napproximately 1 year ago, but has never had to \nhave formal treatment for either shoulder before \nthis reported injury.  Today’s x-rays are negative \nfor acute abnormalities. \nFurther, Bell restricted the Claimant’s work activities and noted that “Medical \ncausation:    The  cause  of  this  problem  appears  to  be  related  to  work \nactivities.”  \n On June 9, 2023, Claimant was seen by Dr. Konstantin Berestnev.  At \nthis visit, Dr. Berestnev noted:  \nEmployer  Description  of  Accident:  Employer \nstates patient was trying to reposition a patient on \nthe surgery table and injured both shoulders.  \n[...] \nMusculoskeletal:  Positive  for  joint  pain,  joint \nswelling and limited motion.  \n[...]  \nMedical causation:  The cause of this problem \nappears to be related to work activities.  \nClaimant was subsequently given an injection of methylprednisone and \nreferred to physical therapy by Dr. Berestnev as Claimant was symptomatic \nbilaterally in her shoulders as a result of the June 2, 2023, work accident. \n\nENGLEMAN - H404754  24\n  \n \n \nClaimant was also given the work restrictions of “no work above the \nshoulders.”  On June 30, 2023, Claimant followed up with Dr. Berestnev \nafter completing four physical therapy sessions and reported that her \nbilateral shoulder pain “is getting tolerable.”  At that visit, Dr. Berestnev \nreleased Claimant to work at regular duty.  On July 21, 2023, Claimant \nfollowed up with Ceth Dawson, PA, who found that the Claimant had \nbilateral impingement to her shoulders as a result of the June 2, 2023, work \naccident.  The Claimant was seen again on August 8, 2023, at which time \nshe was given a home exercise plan and instructions to take over the \ncounter medication for her bilateral shoulder injuries.  \n On March 26, 2024, Claimant was seen by Dr. J. Clayton.  At this visit, \nthe Claimant’s medical history was taken in regard to her left shoulder pain \nas follows:  \nHistory:  This  patient  has  had  pain  in  her  left \nshoulder ever since she hurt it about two years \nago when she was moving a dog into another \nseat  of  the  car.  She  is  already  done  physical \ntherapy which was done this past June through \nAugust she has been on ibuprofen she has not \nhad any injections or used prescription NSAIDs.  \nThis history was corrected by the Claimant at her next visit with Dr. J. Clayton \non April 16, 2024 as follows:  \nHistory: This patient had an injury to her left \nshoulder which was actually from a fall loading \nher shoulder directly though there was also an \nincident involving repositioning a dog but that \nwas not actually the inciting event.  Short of it is \nthis was a trauma to her shoulder.  She has \n\nENGLEMAN - H404754  25\n  \n \n \nalready done injections formal physical therapy \nand chiropractics and continues to have pain in \nher shoulder that is severe enough that it wakes \nher up at night.  \nDr. Clayton then referred the Claimant to his medical partner, Dr. T. \nZimmerman for consideration of a subacromial decompression and distal \nclavicle excision.  \n On May 17, 2024, Claimant was seen by Dr. T. Zimmerman.  Dr. \nZimmerman reviewed Claimant’s MRI and noted “right shoulder \ndemonstrates tendinosis of the supraspinatus tendon, degenerative \nchanges of the AC joint, and a little bit of fluid in the long head of the biceps \ntendon sheath.”  Dr. Zimmerman concurred with Dr. Clayton that a \nsubacromial decompression and distal clavicle excision would be \nappropriate along with trigger point injections and therapeutic needling.  Dr. \nZimmerman then referred the Claimant to Dr. G. Jones for analysis of \nClaimant’s bilateral shoulder injury.  \n Claimant was seen by Dr. Jones on May 29, 2024.  Dr. Jones provided \na  complete  narrative  summary  as  to  the  Claimant’s  bilateral  shoulder \nsymptomology:  \nSymptoms began 2-1/2 years ago. She fell off a \nstep ladder doing some painting, landed directly \non  her  elbow,  grabbed  it  up  into  the  shoulder \nlongitudinally and has had symptoms ever since \nthen.  She had two episodes when a dog jerked \nher shoulder.  I have looked at her carefully for \ninstability  but  certainly  the  stress  that  the \ndescription implies wrenched her shoulder and \nhad worsening symptoms and she states that she \n\nENGLEMAN - H404754  26\n  \n \n \nis  having  increasing  trouble  “pushing  events” \nwhen she is moving patients out of the operating \nroom as a part of her normal circulating room \nduties.  \n Dr. Jones then reviewed the Claimant’s imaging and found:  \nI have reviewed the 4-view shoulder x-ray series \nfrom 03/26.  She has a flat acromion non-\npointed coracold and normal anatomy of the \nglenohumeral joint.  No evidence of arthritis.  \nShe has had impingement changes of the \ngreater tuberosity and chronic AC arthropathy \nchanges without over spur formation but \ndefinitely sclerosis and cystic changes on the \nclavicular and AC joint site.  \nThe  MRI  is  likewise  reviewed.  There  is  no \nevidence of full-thickness cuff tear and the biceps \ntendon has minimal fluid along the sheath.  She \nhas some evidence of subacromial bursitis to my \nevaluation of the exam.  There is no full-thickness \nrotator cuff tear.  \nDr. Jones then recommended the Claimant for a left shoulder arthroscopic \nAC resection, and subacromial bursectomy surgery and provided that these \nsurgeries were appropriate due to the “traumatic nature of the bursitis onset.” \nThis surgery was performed on June 13, 2024.  The operative report showed \nevidence  of  “dense  hypertrophic  bursitis”  that  was  “clearly  mechanically \nimpinging.”  As a result, Dr. Jones completed an arthroscopy with tenotomy, \nAC resection and a bursectomy.  \n The Claimant’s post-operative appointment with Dr. Jones was on July \n17, 2024.  In his note Dr. Jones stated:  \nMs. Engleman is a 43-year-old nurse, who works \nup at Washington Regional. She is in the OR, \nheavy lifting. She had a fall at one point from a \nladder.  In my operative note, I have said it was \nfrom a vehicular accident but was from a fall from \n\nENGLEMAN - H404754  27\n  \n \n \na ladder, but there were multiple other episodes \n[that] were actually documented, one with a pop \nin her shoulder and she had been sent to physical \ntherapy and it had continued symptoms with the \nbiceps tendon even back in that timeframe.  \nShe is an operating room nurse as with all of our \npatients, they are all more frequent to 300 pounds \nor plus and moving them, putting them on and off \na bed, pushing the gurneys, etc., has become an \nincreasingly challenging situation for almost as \nthe particular one, who has had shoulder injury \nand surgery.  \nI am a little bit confused [in] that this appears to \nhave had clearly a work component.  A diagnosis \nis made at work that prompted the use of physical \ntherapy for that purpose, I think confirming this \nwas;  \n1. Reported \n2. Recognized \n3. In my opinion, greater than 50% contribution \nto the problems that exist, I think she needs to \npursue this in appropriate fashion and I have \nrecommended same.  \n \nDr. Jones then took the Claimant off of work until her next post-operative \nappointment in October of 2024.  \nOn August 28, 2024, Claimant followed up with Dr. Jones for a wound \ncheck after her recent surgery. In this note Dr. Jones stated:  \nI have made clear my thoughts as to it being \nreported, recognized and a greater than a 50% \ncontribution to the problems that required \ntreatment and now off-work status.  \nDr. Jones also stated that he was concerned as Claimant was so “anxious to \nget back to work” she is really “pressuring her shoulder in terms of her range \nof  motion  and  recovery  and  even  early  strengthening  and  basically  her \nshoulder is very inflamed with bursitis at present.”  \n\nENGLEMAN - H404754  28\n  \n \n \n At Claimant’s follow-up appointment on October 2, 2024, Dr. Jones \ncontinued  Claimant’s  off-work  status  as  a  result  of  her  recent  surgery, \nspecifically noting Claimant’s functional limitations in terms of lifting at most \n5-10 pounds.  These work restrictions remained in place for at least two \nmonths following the appointment.  \n Dr. Jones wrote a letter on Claimant’s behalf on October 14, 2024, in \nwhich he stated:  \nI am well aware that she had two other incidents, \nonce of fall with a contusion that subsequently \nhealed without problem. Second, a dog moving \nincident on a couple of occasions, but nothing \nthat  rose  to  the  level  of  the  nature  of \nsymptomatology with which she presented to me.  \nHer history and physical examination at that time \nwere consistent with injuries from a mechanical \nnature and were consistent with the pattern of \ninjury that she had described.  \n(...) \nIt  is  my  opinion  that  the  nature  of  the  injury \nsustained  in  the  work  incident  described  and \ndetailed historically both by her and in the medical \nrecord previously making clear to me that within \na  reasonable  degree  of  certainty  that  June  2, \n2023, incident is more than 50% the cause of the \ninjury, subsequent symptomatology and findings \nthat led me to recommend the surgical procedure \nundertaken on June 13, 2024. \nRegardless of Claimant’s prior incidents with either shoulder, it is clear \nfrom the record that she was not seeking medical care and was able to work \non a full-time basis prior to the work accident on June 2, 2023.  Dr. Jones \nfully evaluated the Claimant’s history in the medical records and provided a \n\nENGLEMAN - H404754  29\n  \n \n \ncredible analysis of the causation of the Claimant’s shoulder injuries, and \nneed for medical care, including surgery.  \nAn employer takes the employee as he finds him, and employment \ncircumstances which aggravate pre-existing conditions are compensable. \nHeritage Baptist Temple v. Robinson, 82 Ark. App. 460, 464, 120 S.W.3d \n150, 152 (2003).  An aggravation of a pre-existing, non-compensable \ncondition by a compensable injury is, itself, compensable.  Williams v. L&W \nJanitorial, Inc., 85 Ark. App. 1, 145 S.W.3d 383 (2004).  \nThe lack of significant medical care prior to the work accident, and the \nClaimant’s continued ability to work up to the work accident support Dr. \nJones’s  statements  on  these  issues.  The  medical  notes  prior  to  the \nClaimant’s left shoulder surgery reveal the traumatic nature of the injury to \nthe bursa, and the operative report confirms the treatment necessary to \nalleviate  the  impingement  resulting  from  this  injury.  This  finding  clearly \ndemonstrates an objective injury that Dr. Jones attributes with a reasonable \ndegree of medical certainty to the Claimant’s work accident.  The Claimant’s \nright shoulder became symptomatic shortly after her work accident and the \ndiagnostic testing revealed supraspinatus tendinosis, degenerative changes \nof the AC joint and fluid in the tendon sheath, as well as a subtle superior \ndisplacement  of  the  right  distal  clavicle.  These  findings  demonstrate  an \nobjective injury to the right shoulder.  As noted in the medical records, the \n\nENGLEMAN - H404754  30\n  \n \n \nClaimant also had at least two other incidents which may have affected her \nshoulders.  However, the evidence shows that neither of those incidents \nresulted  in  significant  treatment  of  her  shoulders  or  inhibited  her  from \nworking.  As previously stated, aggravation of a pre-existing condition can \nresult in a compensable injury.  Therefore, based upon the credible evidence \nin the record, I find that the objective problems in the Claimant’s shoulders \nidentified above were either caused by or made symptomatic, or both, by her \nwork accident on June 2, 2023, and that she suffered a compensable injury \nto both of her shoulders as a result of this work accident.  The Claimant is \nentitled to reasonable and necessary medical treatment for her compensable \ninjuries including the treatment recommended by Dr. Jones.  \n2. The Claimant has met her burden of proof by a preponderance of the \nevidence that she is entitled to temporary total disability from June 13, \n2024, to a date yet to be determined.  \n \nTemporary total disability benefits are appropriate where the employee \nremains in the healing period and is totally incapacitated from earning wages. \nArk. State Highway Dep’t v. Breshears, 272 Ark. 244, 613 S.W.2d 392 (1981).  \nOn June 13, 2024, Claimant underwent a glenohumeral arthroscopy \nwith biceps tenotomy, AC resection and an extended subacromial \nbursectomy with Dr. Jones.  Claimant had a post-operative appointment \nwith Dr. Jones on July 17, 2024.  At this time, Dr. Jones stated:  \n\nENGLEMAN - H404754  31\n  \n \n \nTakes at least 3 months to get over her surgery \nsuch as this.  If she has to return to “full \nunrestricted lifting activity,” she is not ready to do \nthat and I am going to ask that she see me back \nin 2 months and we will consider return at that \njuncture depending on her surgery was \n06/13/2024 on left shoulder, AC resection, \nbiceps tenotomy, and subacromial bursectomy.  \nDr. Jones then wrote a letter specifically stating that the Claimant is “unable \nto work until seen in 2 months.” Claimant followed up with Dr. Jones on \nOctober 2, 2024.  As to Claimant’s work status Dr. Jones stated:  \nShe has functional limitations in terms of lifting at \nmost 5- to 10-pound weight limit.  Unfortunately, \nbecause  of  the  nursing  activities  in  previous \nposition, there is a lot of lifting requirements and \nthe  lesser  sedentary  one-armed  position  at  5-\npound weight duty status, she is not yet ready for \nwork.  \nDr. Jones concluded this visit by stating he will see the Claimant in two \nmonths to assess activity increase and potential return to work.  The last \nmedical record in evidence shows that the Claimant was seen by Dr. Jones \non December 4, 2024.  At that visit, Dr. Jones specifically noted that he is \nholding off on a maximum medical improvement designation as the Claimant \nhad residual instability since the June 13, 2024, surgery.  \nTherefore, based upon these limitations by the treating physician, I \nfind that the Claimant has remained within her healing period and suffers a \ntotal incapacity to earn wages.  Thus, making her entitled to temporary total \ndisability benefits from June 13, 2024, to a date yet to be determined.  \n                \n        \n\nENGLEMAN - H404754  32\n  \n \n \n            \n    ___________________________________ \n       M. SCOTT WILLHITE, Commissioner","preview":"BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION CLAIM NO. H404754 AMANDA ENGLEMAN, EMPLOYEE CLAIMANT WASHINGTON REGIONAL MEDICAL CENTER, EMPLOYER RESPONDENT RISK MANAGEMENT RESOURCES, INSURANCE CARRIER/TPA RESPONDENT OPINION FILED SEPTEMBER 25, 2025","fetched_at":"2026-05-19T22:29:44.044Z","links":{"html":"/opinions/full_commission-H404754-2025-09-25","pdf":"https://www.labor.arkansas.gov/wp-content/uploads/Engleman_Amanda_H404754_20250925.pdf","source_publisher":"https://labor.arkansas.gov/workers-comp/awcc-opinions/full-commission-opinions/"}}