Elizabeth Bledsoe v. Viskase Companies, Inc., and Trumball Insurance Company

Cite as 2020 Ark. App. 53

Digitally signed by Elizabeth
ARKANSAS COURT OF APPEALS
Perry
Date: 2022.08.10 13:06:54 DIVISION IV
-05'00' No. CV-19-483
Adobe Acrobat version:
2022.001.20169 Opinion Delivered January 29, 2020
ELIZABETH BLEDSOE
APPELLANT APPEAL FROM THE ARKANSAS
WORKERS’ COMPENSATION
V. COMMISSION
[NO. G605236]
VISKASE COMPANIES, INC., AND
TRUMBALL INSURANCE
COMPANY AFFIRMED
APPELLEES

N. MARK KLAPPENBACH, Judge

Appellant Elizabeth Bledsoe appeals from the opinion of the Arkansas Workers’

Compensation Commission that affirmed and adopted the findings of fact and conclusions

of law made by the administrative law judge (ALJ) in favor of appellees. Bledsoe was

admittedly injured in a workplace accident on June 7, 2016, that caused a hairline fracture

in her sternum. The employer accepted the claim and paid benefits related to the sternum

injury. Bledsoe also sought benefits for a cervical injury that she contended she sustained in

the same accident, but she did not prevail on that aspect of her claim. On appeal, Bledsoe

contends that the findings related to the denial of her claim for cervical-injury benefits are

not supported by substantial evidence. We affirm.

Under Arkansas law, the Commission is permitted to adopt the ALJ’s opinion, and

when it does, the Commission makes the ALJ’s findings and conclusions the findings and

conclusions of the Commission. Woods v. Tyson Poultry, Inc., 2018 Ark. App. 186, 547
S.W.3d 456. In reviewing decisions from the Commission, we view the evidence and all

reasonable inferences in the light most favorable to the Commission’s decision and affirm if

it is supported by substantial evidence. Skinner v. Tango Transp., Inc., 2016 Ark. App. 304,

495 S.W.3d 637. Substantial evidence is that which a reasonable mind might accept as

adequate to support a conclusion. Id. The issue is not whether this court might have reached

a different result from the Commission. Id. Additionally, questions concerning the

credibility of witnesses and the weight to be given to their testimony are within the exclusive

province of the Commission. Id. When there are contradictions in the evidence, it is within

the Commission’s province to reconcile conflicting evidence and determine the facts. Id.

Finally, this court will reverse the Commission’s decision only if it is convinced that fair-

minded persons with the same facts before them could not have reached the conclusions of

the Commission. Lybyer v. Springdale Sch. Dist., 2019 Ark. App. 77, 568 S.W.3d 805.

Bledsoe, a woman in her late forties, worked for appellee, Viskase Companies, Inc.,

a hotdog casing manufacturer. On June 7, 2016, Bledsoe was operating a machine that

pulled and rolled hotdog casings onto reels. She was manually guiding hotdog casing when

a reel fell and hit her left forearm and chest. She estimated that the part that hit her weighed

about thirty pounds. She reported the accident to her employer, which offered medical

treatment. Instead, Bledsoe sat in the break room and applied an ice pack. Bledsoe’s schedule

was three days on and then three days off, and her injury occurred on her third day of work.

By June 17, Bledsoe was still hurting, so the employer took her to the emergency room.

The June 17, 2016 emergency-room medical records indicated that Bledsoe’s chief

complaint was “chest wall pain,” and she described the pain as moderate. A CT scan

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revealed a “linear hairline fracture” in her sternum, and physical examination indicated that

she had swelling and tenderness in her sternum, but Bledsoe’s neck had “soft, easy range of

motion,” with no tenderness or limits in range of motion. She was prescribed twelve

Tylenol with codeine to treat her sternum pain and directed to follow up with her doctor

if her symptoms did not improve in ten days. Bledsoe was placed on light duty at work.

Bledsoe presented to Dr. Thakor at Great River Medical Center on June 21 for a

follow up on her sternum injury. She complained of sternum pain that was not well

controlled by her prescription medication. She also complained of upper back and neck

pain. Dr. Thakor noted tenderness and spasm in the cervical region. She was prescribed pain

and muscle-spasm medications.

On June 28, Bledsoe presented to her family doctor, Dr. Cullom, complaining of

ankle swelling. She told Dr. Cullom about her chest injury; there was no mention of neck

pain or spasms, either by patient history or by physical examination.

Bledsoe was referred to an orthopedic specialist, Dr. Yao, to follow up on her

sternum injury, and Dr. Yao saw her several times starting in August 2016. Dr. Yao

diagnosed her with the clavicle fracture and, given Bledsoe’s complaints of neck and back

tenderness, a cervical and thoracic strain. A September 2016 MRI of her cervical spine

showed mild degenerative spondylosis and a small disc protrusion at C5-6. Nerve-

conduction studies revealed no nerve injury. Also in September 2016, Dr. Yao determined

that Bledsoe’s sternal fracture had healed. Dr. Yao relied on Bledsoe’s statements at the first

clinical visit in August 2016 in opining that her neck problem was causally connected to her

work accident.

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Bledsoe continued on light duty at work, but her last day of work was December 2,

2016. Thereafter, she received six months of short-term disability benefits and then

commenced a two-year period of long-term disability benefits.

Bledsoe was treated by Dr. Abraham, a neurosurgeon, beginning in April 2017, ten

months after the work accident. Dr. Abraham performed a carpal-tunnel release surgery on

her left hand in August 2017. Dr. Abraham’s medical notes indicated that Bledsoe also

complained of neck and shoulder pain, which she attributed to the June 2016 work accident.

Dr. Abraham consequently attributed her neck and shoulder pain to the work accident based

on Bledsoe’s explanation. Her cervical problem did not require a surgical intervention; Dr.

Abraham recommended physical therapy. Dr. Abraham opined in a letter that Bledsoe’s

neck pain was caused by the work accident.

Dr. Yao was unaware of what Bledsoe’s earlier medical records disclosed until he was

deposed in March 2018. Dr. Yao was advised of the information gathered in her first visit

to the emergency room ten days after the work accident, which had particular assessments

about her neck and cervical region showing no complaints or objective signs of cervical

injury. With that knowledge, Dr. Yao stated that, as to what was seen on the September

2016 MRI, it was “not possible to determine if maybe it’s degenerative or perhaps

traumatic.” Dr. Yao ultimately stated his opinion that her cervical problem was not related

to the workplace accident unless the earlier medical records could be clarified or edited by

those medical providers.

Dr. Abraham was deposed in April 2018 and was presented with Bledsoe’s earlier

medical records. At that point, Dr. Abraham acknowledged that he could not identify the

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cause of the cervical problem, stating that it could be degenerative or could be related to

trauma. Nonetheless, Dr. Abraham stood by his opinion that, given Bledsoe’s statements

to him, he thought her neck pain was related to the work accident. He said that Bledsoe’s

two-week delay in reporting neck pain would “not necessarily” mean the two were not

causally related and that the accident “could cause her to have some difficulties with her

neck.” When informed of the absence of neck issues at the emergency-room visit, the

doctor was asked if that indicated her neck problems were from another source, and he

replied, “I really don’t know.”

Bledsoe denied having any neck problems prior to the June 2016 accident at work,

and she denied having done anything else that might have hurt her neck after the work

accident. She was convinced that her cervical problem was caused by the work accident.

Bledsoe’s shift supervisor, Donnie Ammons, testified about the job Bledsoe did and

how the machine worked; he presented photographs of the machine and a person working

the machine. Ammons remained Bledsoe’s supervisor until she quit working and stated that

she never complained to him about neck pain.

On this evidence, the ALJ found that although Bledsoe had a compensable injury to

her sternum, she failed to prove by a preponderance of the evidence that she suffered a

compensable cervical injury. The ALJ reasoned that Bledsoe did not complain of neck or

back pain until two weeks after the work accident; that she was seen by medical providers

ten days after the accident, and those records did not disclose any cervical problems; that

Dr. Yao was unable to establish a nexus between her neck complaints and the work accident;

that Dr. Abraham was unable to testify within a reasonable degree of medical certainty that

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the work accident caused her neck complaints; that the evidence supported the existence of

a noncompensable preexisting degenerative condition in her cervical spine; and that Bledsoe

had failed to carry her burden to prove by a preponderance of the credible evidence that

she sustained a compensable injury or compensable aggravation to her cervical spine. Absent

a causal connection, Bledsoe’s claim for compensation related to her cervical issue was

denied.

Bledsoe argues on appeal that the causal connection between her cervical problem

and the work accident did not have to be proved by medical evidence, but that even so,

Dr. Abraham provided a medical opinion that her cervical problem was causally related to

the work accident. We agree with Bledsoe that medical-opinion testimony is not essential

to establish the causal relationship between the injury and a work-related accident. See

Kiswire Pine Bluff, Inc. v. Segars, 2018 Ark. App. 296, 549 S.W.3d 410. However, when a

medical opinion is relied on to establish compensability, it must be stated within a reasonable

degree of medical certainty. See Ark. Code Ann. § 11-9-102(16)(B) (Repl. 2012). Dr. Yao

ultimately opined that her cervical issues were not related to the work accident. It is the

Commission’s duty to use its experience and expertise in translating the testimony of medical

experts into findings of fact and to draw inferences when testimony is open to more than a

single interpretation. Ark. Health Ctr. v. Burnett, 2018 Ark. App. 427, 558 S.W.3d 408.

The Commission relied on the fact that Bledsoe did not convey any problems with

her neck for two weeks, and the initial medical records ten days after the accident

affirmatively indicated that there were no problems with her neck. Whether a causal

connection between employment and an injury exists is a question of fact for the

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Commission. Webb v. Wal-Mart Assocs., Inc., 2018 Ark. App. 627, 567 S.W.3d 86. Even

if we might have weighed the evidence differently, based on our standard of review, we

cannot say that fair-minded persons with the same facts before them could not have reached

the conclusions of the Commission. Thus, we affirm the Commission’s decision.

Affirmed.

VAUGHT and HIXSON, JJ., agree.

Caldwell Law Firm, P.A., by: Andy L. Caldwell, for appellant.

Smith, Williams, Hughes & Meeks, LLP, by: Gene Williams, for appellees.

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