Court Opinion

ID: 9757596
Source: CourtListenerOpinion
Date Created: 2023-08-28 22:49:15.704462+00
Date Added: 2024-06-11T07:28:41.383682
License: Public Domain

Sam Bird, Judge, concurring. I agree that this case should be affirmed because there was no objective evidence that supported Watson’s claim of a head injury. I write separately, however, to express my concern about the majority’s strained effort to distinguish Wentz v. Service Master, 75 Ark. App. 296, 57 S.W.3d 753 (2001). Instead of trying to distinguish Wentz, we should admit that Wentz was wrongly decided and overrule it. In Wentz, this court was directly presented with the issue of whether the results of neuropsychological testing constituted “objective findings” as defined in Ark. Code Ann. § 11-9-102(16)(A)(i) (Supp. 1999). Rather than answering that question, the Wentz court dodged the- issue by simply holding that “there was no evidence that suggested appellant manipulated the testing.” However, to constitute “objective findings” under § 11-9-102(16)(A)(i), the inquiry is not whether this patient did not manipulate the results of this test this time, but whether the results of the testing “cannot come under the voluntary control of the patient.” In other words, it is not an objective finding if the symptom detected by the physician or the response of the patient under examination is subject to the patient’s control, and it is immaterial whether, in any given case, the patient, in fact, exercised such control. The objectivity of findings is not determined on a case-by-case basis by an analysis of whether the patient manipulated the testing. Rather, objective findings are those that cannot be manipulated by the patient; it is irrelevant whether the patient in each case chose to exercise or not to exercise such control. After concluding that there was no evidence that the patient had manipulated the test results, the Wentz court went on to hold that in addition to the neuropsychological testing, there was “other objective evidence,” establishing the injury, thereby implying that the result of neuropsychological testing is an objective finding when there is evidence that the patient did not manipulate the test results. As appellee argues, this determination by the Wentz majority erroneously equates “objective findings” to “reliable findings.” The “other objective evidence” in Wentz consisted of a doctor’s opinion that Wentz suffered nausea and that light made her symptoms worse; two doctors’ conclusions, without supporting objective evidence, that Wentz had suffered a closed-head injury; a doctor’s report of behavioral and cognitive agitation and decreased intellectual capacity; and testimony of Wentz about memory problems, periodic headaches, anxiety and emotional changes. I do not agree that these are “objective findings” within the meaning of Ark. Code Ann. §ll-9-102(16)(A)(i). Nausea, light sensitivity, and headaches are all complaints of symptoms that the doctor must necessarily be told by the patient. Cognitive agitation, decreased intellectual capacity, anxiety, and emotional changes are all results of testing that is necessarily within the patient’s control. The Wentz court erroneously states that “objective findings are also defined as medical opinions stated with a reasonable degree of medical certainty,” citing Ark. Code Ann. § 11 — 9— 102(16)(B) and Freeman v. Con-Agra Frozen Foods, 344 Ark. 296, 40 S.W.3d 760 (2001), as its authority. I do not agree that this is an accurate interpretation of the statute or of the holding in Freeman. The only definition of “objective findings” in our workers’ compensation law is contained in § ll-9-102(16)(A)(i) where it clearly states that “[ojbjective findings are those findings which cannot come under the voluntary control of the patient.” Subsection (B) then sets forth the requirement that “[mjedical opinions addressing compensability and permanent impairment must be stated within a reasonable degree of medical certainty.” The only reasonable meaning that can be attributed to subsection (B) is that medical opinions as to the existence of a compensable injury or permanent impairment must be stated to a reasonable degree of medical certainty. Clearly, the requirement cannot be reasonably interpreted to mean that a medical opinion stated to a reasonable degree of medical certainty, standing alone, constitutes an objective finding. The Wentz court’s reliance on Freeman is also misplaced. Although Freeman contains the questionable language that medical opinions stated to a reasonable degree of medical certainty are included within the definition of objective findings, the issue in Freeman was whether the medical opinions proffered were sufficiently certain and definite to establish that Freeman’s injuries were caused by her work-related fall; our supreme court held that medical opinions stated with a reasonable degree of medical certainty can be considered objective evidence of a causal link between the injury and the work-related incident. Causation is not in issue in the case at bar. Rather, the issue here is solely the establishment of the existence and extent of a closed-head injury. In the case at bar, the denial of Watson’s workers’ compensation claim was proper because there was no objective evidence establishing the existence of a closed-head injury. The only difference in this case and the Wentz case is that, in Wentz, in addition to the patient’s responses to neurological testing, the doctors and this court accepted as reliable a laundry list of subjective complaints by the patient and considered them adequate to conclude that she had sustained a closed-head injury. Neuropsychological test results are not objective findings, regardless of the reliability of the results or the medical opinions interpreting them. Objective findings are only those that cannot come under the control of the patient, and the same evidence that is lacking in the case at bar was also lacking in Wentz. I advocate that Wentz was wrongly decided and that the court should utilize this opportunity to overrule Wentz, rather than distinguish it from the case at bar.