Court Opinion

ID: 9667963
Source: CourtListenerOpinion
Date Created: 2023-08-24 01:59:20.42042+00
Date Added: 2024-06-11T18:15:41.990213
License: Public Domain

Melvin Mayfield, Judge, dissenting. In this appeal from a decision of the Worker’s Compensation Commission appellant challenges only the denial of benefits for a five percent permanent partial disability rating. The administrative law judge had awarded the appellant temporary total disability through June 10, 1993; permanent disability equal to 5 percent to the right upper extremity; and held that she was entitled to a vocational rehabilitation evaluation and possible training program. The Commission affirmed the award of temporary total disability, reversed the award of permanent partial disability, and vacated the rehabilitation evaluation because it had not been raised by either party below. Appellant has appealed only the issue of permanent partial disability. The appellant, Caron Sue Whaley, age 48, had been employed by Hardee’s for approximately three years making biscuits. She mixed the ingredients with her fingers and manually kneaded the dough. She then rolled the dough out with a three foot rolling pin. She made between 13 and 20 batches of biscuits a day, depending on demand. In early 1992 appellant began to experience pain in her right elbow. Her family physician, Dr. Randall Oates, diagnosed “overuse” syndrome and relieved her from work. When she was not making biscuits her condition improved. When she would return to work, she would again experience pain in her right elbow. And when appellant began to have pain in her left arm, Dr. Oates referred her to Dr. Thomas R. Dykman, a rheumatologist. Dr. Dykman diagnosed appellant as having epicondylitis (also called tennis elbow) and mild fibrositis. He returned her to the care of Dr. Oates and recommended continuing conservative treatment. In late November 1992 Dr. Oates again removed appellant from work and recommended vocational rehabilitation for appellant. In February 1993 Hardee’s informed appellant that it had no work within her physical restrictions. At the time of the hearing, June 29, 1993, appellant had not worked since November 1992. Dr. James F. Moore, an orthopaedist, in a report dated March 25, 1993, diagnosed appellant’s condition as right tennis elbow and injected her with DepoMedrol. Dr. Alice M. Martinson, an orthopaedist, examined appellant at the request of the employer on June 10,1993. She also diagnosed, right lateral epicondylitis (tennis elbow). However, by the time Dr. Martinson examined appellant, appellant had not worked since the prior November and her condition had greatly improved. Dr. Martinson reported that appellant told her she had “only a mild non-disturbing soreness in the lateral side of her right elbow. It is more an awareness of that part of her anatomy than it is a pain.” However, the doctor gave her a 5 percent permanent physical impairment rating to her dominant right upper extremity. In reversing the administrative law judge’s award of 5 percent permanent partial disability the Commission stated that Dr. Martinson’s impairment rating was based on her assumption that scar tissue had formed in appellant’s elbow. What Dr. Martinson actually said was: The customary course of this condition is one of exacerbation and remission. . . . The underlying pathology is believed to be one of microscopic tears within the substance of the muscle origin. These heal with scar which, like all scar, responds poorly to additional repetitive stretching producing chronic inflammatory signs and symptoms! After quoting this statement and emphasizing that Dr. Martin-son found appellant to have “no objective physical abnormalities in her right upper extremity with the exception of the tenderness” (Emphasis in Dr. Martinson’s report), the Commission held that the findings of increased pain and tenderness around the elbow only established the presence of inflammation, not scar tissue, and were not adequate to support an award of permanent disability. The Commission also said: In the present claim, the physical examination of each of the physicians who examined the claimant revealed prominent tenderness in the area of the lateral epicondyle of the humerus, and the examinations of Dr. Dykman, Dr. Moore, and Dr. Martinson revealed increased pain with resisted extension maneuvers of the elbow, wrist or fingers. . .. [W]e find that the findings of tenderness over the lateral epicondyle and the increased pain with resisted extension maneuvers satisfies the statutory requirements of Ark. Code Ann. § ll-9-704(c)(l). [objective and measurable physical findings] However, we note that both of these procedures are subject to manipulation by the patient, and there is no evidence that any controls were utilized to minimize the possibility of contrived responses. Consequently, although there is no suggestion that the claimant contrived her responses, the reliability and dependability of the findings are diminished, and the weight given to the findings must be adjusted accordingly. Appellant notes that the Commission then apparently gave “no weight” to the rating of permanent impairment by Dr. Mar-tinson and characterizes this as a “totally arbitrary standard set by the Commission” and that any claimant “would find it impossible to win any case under this standard of review.” I am in complete agreement with the appellant. The Commission in its opinion cited our cases of Keller v. L.A. Darling Fixtures, 40 Ark. App. 94, 845 S.W.2d 15 (1992); Reeder v. Rheem Manufacturing Co., 38 Ark. App. 248, 832 S.W.2d 505 (1992); and Taco Bell v. Finley, 38 Ark. App. 11, 826 S.W.2d 313 (1992), and recognized that under these cases there is medical evidence here to support the requirement of Ark. Code Ann. § ll-9-704(c)(l) that the existence or extent of physical impairment shall be supported by “objective and measurable physical or mental findings.” However, the Commission, although finding “there is no suggestion that the claimant contrived her responses,” found that “the reliability and dependability of the findings are diminished” because the procedures used by the doctor to make her determination “are subject to manipulation.” In other words, without making a finding of fact on the point, the Commission rejects the evidence because it might not be true. I think this is wrong. The Commission is also wrong in holding that a finding of inflammation — which occurs every time the appellant returns to work — cannot support an award of permanent wage loss disability. See Johnson v. General Dynamics, 46 Ark. App. 188, 194, 878 S.W.2d 411, 414 (1994); and Bragg v. Evans-St. Clair, Inc., 15 Ark. App. 53, 688 S.W.2d 956 (1985). I would reverse and remand this case for the Commission to examine the evidence and make findings of fact and conclusions of law in keeping with this dissenting opinion.