Collins v. Lennox Industries, Inc.

75 S.W.3d 204, 77 Ark. App. 303, 2002 Ark. App. LEXIS 300
CourtCourt of Appeals of Arkansas
DecidedMay 8, 2002
DocketCA 01-1109
StatusPublished
Cited by7 cases

This text of 75 S.W.3d 204 (Collins v. Lennox Industries, Inc.) is published on Counsel Stack Legal Research, covering Court of Appeals of Arkansas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Collins v. Lennox Industries, Inc., 75 S.W.3d 204, 77 Ark. App. 303, 2002 Ark. App. LEXIS 300 (Ark. Ct. App. 2002).

Opinion

Karen R. Baker, Judge.

This is an appeal from a decision of the Arkansas Workers’ Compensation Commission’s denial of appellant’s request for a change of physician. We hold that the Commission’s finding that the employer had fulfilled the obligation of providing adequate medical treatment, diagnostic testing, and consultation with specialists, under the provisions of Ark. Code Ann. § 11-9-508 (Repl. 2002), was not supported by substantial evidence. Arkansas Code Annotated section 11-9-514(a)(3)(h) (Repl. 2002) established an absolute, statutory right to a one-time change of physician under the Workers’ Compensation Act where the employer has contracted with a managed-care organization and has exercised the right to select the initial primary-care physician. The employer’s denial of the one-time change of physician as a matter of law fails to fulfill the obligation imposed by section 11-9-508. Accordingly, we reverse.

Facts

On January 4, 2000, appellant (while employed by Lennox Industries) reached for a coil weighing between thirty and fifty pounds that was stacked above his head. As he flipped the coil over to remove it from the stack, he injured his back. The injury was reported in a timely manner, and appellant was sent to Dr. N.B. Daniel.

Dr. Daniel diagnosed appellant with a lumbosacaral strain. Appellant requested and received a referral to an orthopedist (Dr. John Wilson). On January 27, 2000, Dr. Wilson diagnosed appellant with “mild sciatia.” Dr. Wilson also noted that appellant had “tenderness over the right sciatic notch,” and that his straight-leg raising was “mildly positive.” Dr. Wilson released appellant to return to work with no restrictions. On February 16, 2000, appellant returned to Dr. Wilson. After seeing appellant, Dr. Wilson noted:

[Appellant] was reassured that he does not have operative problems with his back and should attempt to continue his normal activities at work. He wanted an MRI done on his back and, quite frankly, without objective findings or radicular findings, I do not feel the study would be necessary. He seems a bit upset with me because of my position. At any rate, this gendeman has been released to return to his normal activities at work.

On February 22, 2000, appellant returned to Dr. Daniel, who reported:

On exam today he moves very well. . . My impression still is that he has a lumbosacral strain . . . [Appellant] has it in his mind that neither myself or the specialty physician, that I don’t personally know, don’t care about him and we are limiting services in that we haven’t done a MRI and we haven’t done a myelogram and we are not trying to really find out what is wrong with his back. He doesn’t believe me when I tell him that the likelihood of finding something abnormal on a MRI of his back, or a mye-logram is very small and even if we did find that he has for instance a bulging disc with the degree of symptoms that he has — nothing would be done therapeutically such as surgery, trigger point injection, epidural steriods, so forth, so forth.

Despite these two reports, appellant continued to request a MRI, and appellees eventually approved of the diagnostic test. Dr. Wilson performed the test and on March 9, 2000, reported that the findings revealed nothing “of an operative nature.” He also noted that the MRI showed early disc degenerative disease and again released appellant to return to work. On March 22,'2000, appellant presented to Dr. Wilson again. After the visit, Dr. Wilson reported:

I have advised [appellant] that he does not have an operative problem with his back and that he has some early degenerative disc disease and superimposed lumbosacral strain but certainly nothing that needs surgery and this is something that he should be able to work through. He asked for medication and related that he had been scheduled for a myelogram. When asked the circumstances of who was doing this, he said he was not supposed to tell me. At any rate, I do not suggest a myelogram. His MRI did not reveal anything of an operative nature.

On March 27, 2000, appellant returned to Dr. Daniel and was approved for an independent medical examination by Dr. Bruce Safman, which was conducted on April 12, 2000. Dr. Safman’s findings were consistent with Dr. Wilson’s. Additionally, Dr. Safman noted that appellant wanted to tape-record the examination and was not happy with the fact his degenerative changes were not related to the injury. Finally, on May 10, 2000, appellant saw Dr. Wilson again. Dr. Wilson reported “mild restriction of motion of the lumbar spine with tenderness,” “mild spasm,” and “early degenerative disk disease” and “significant herniation.”

On May 23, 2000, appellant (through counsel) requested a change of physician. The request was denied by appellee. Appel-lee responded that further medical treatment was not reasonable and necessary.

On October 4, 2000, the Administrative Law Judge, filed a pre-hearing order stating, in relevant part, “By agreement of the parties, the issues to be litigated at the hearing are limited to the following: Continuing medical treatment; change of physician; controversion and attorney’s fees. All other issues are reserved.” The parties stipulated that appellant suffered a compensable injury on January 4, 2000, that an employee-employer-carrier relationship existed on that date, that his compensation rate for TTD purposes was $371.00, and that Lennox was associated with a managed-care organization.

The ALJ fashioned her opinion around an analysis of “whether or not additional medical treatment is reasonable, necessary and related to the compensable injury.” Although she did not directly address the change of physician request in her findings, the opening sentence of her March 5, 2001, order states that “A hearing was conducted to determine the claimant’s entitlement to payment of continuing medical treatment, a change of physician, and attorney’s fees.” The ALJ in its finding and conclusions found that the employer had fulfilled the obligation of providing adequate medical treatment, diagnostic testing, and consultation with specialists under the provisions of Ark. Code Ann. § 11-9-508. Further findings stated as follows:

1. The Workers’ Compensation Commission has jurisdiction of this claim in which the relationship of employee-employer-carrier existed among the parties on January 4, 2000, at which time the claimant sustained a compensable injury at a compensation rate of $371. Medical expenses and temporary total disability were paid.
2. The respondents have paid all appropriate benefits and expenses.
3. The claimant has failed to prove by a preponderance of the credible evidence of record that further medical treatment is reasonable, necessary, or related to the compensable injury.

The Full Commission affirmed these findings, and this appeal followed.

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Bluebook (online)
75 S.W.3d 204, 77 Ark. App. 303, 2002 Ark. App. LEXIS 300, Counsel Stack Legal Research, https://law.counselstack.com/opinion/collins-v-lennox-industries-inc-arkctapp-2002.