Emergency Ambulance Service, Inc. v. Burnett
2015 Ark. App. 288
Ark. Ct. App.2015Background
- Carla Burnett, a 60-year-old former EMT, injured her low back on August 6, 2011 while unloading a patient from an ambulance and has not worked since.
- She had a long preexisting history of lumbar complaints and multiple MRIs from 2002 onward showing degenerative changes and an L4-5 disc bulge/annular tear, but testified her post‑2011 symptoms were different and more disabling.
- Treating neurosurgeon Dr. Reza Shahim opined post‑2011 that CT myelogram showed lateral recess and foraminal stenosis with facet arthropathy at L4‑5 and L5‑S1, and that her pain was work related; other physicians noted preexisting findings and questioned causation.
- An FCE placed Burnett at light sedentary work with limited sit/stand tolerance; recommended injections and therapy were denied by the carrier.
- The ALJ found the 2011 event compensable and awarded additional medical treatment (authorization to return to Dr. Shahim), but held claims for permanent total disability (PTD), wage loss, and carrier credit for overpaid temporary total disability (TTD) benefits premature and reserved them for later.
- The Arkansas Workers’ Compensation Commission affirmed and Emergency Ambulance Service and AIG appealed, arguing insufficient evidence for additional treatment and that reservation of issues was improper. The court affirmed.
Issues
| Issue | Plaintiff's Argument (Burnett) | Defendant's Argument (Employer/Carrier) | Held |
|---|---|---|---|
| Entitlement to additional medical treatment | 2011 injury produced new, worsening radicular symptoms requiring further treatment with Dr. Shahim (injections/possible surgery) | Preexisting degenerative disease (MRIs since 2002) means current problems are nonwork‑related and additional treatment addresses preexisting condition | Affirmed: substantial evidence supported award of additional treatment; injury aggravated preexisting condition and ALJ credited Dr. Shahim’s opinion |
| Whether PTD/wage‑loss claims were ripe | Burnett sought continued treatment first; impairment and wage‑loss depend on outcome of further treatment | Employer wanted final determination now, arguing ALJ should decide all litigated issues | Affirmed: ALJ properly found PTD/wage‑loss premature because ongoing medical treatment could change impairment/wage‑loss outcome |
| Carrier’s entitlement to credit for overpaid TTD benefits | Burnett sought continued medical care; status of TTD overpayment depends on final entitlement/duration | Carrier sought immediate credit determination | Affirmed: issue premature and properly reserved pending medical outcome |
| ALJ/Commission reserving issues after hearing | Burnett: reservation appropriate when further medical development may affect outcomes | Employer: reservation improper; ALJ should resolve all litigated issues on the record | Affirmed: reservation was justified given unresolved medical treatment and potential change in impairment/benefit status |
Key Cases Cited
- St. Vincent Infirmary Med. Ctr. v. Brown, 917 S.W.2d 550 (Ark. App. 1996) (preexisting condition does not bar recovery when work injury aggravates or combines with it)
- Sea Ark Marine, Inc. v. Pippinger, 303 S.W.3d 102 (Ark. App. 2009) (discussing limits on reserving issues)
- Burkett v. Exxon Tiger Mart, Inc., 304 S.W.3d 2 (Ark. App. 2009) (addressing finality of ALJ determinations and reservation practice)
- Walker v. Fresenius Med. Care Holding, Inc., 436 S.W.3d 164 (Ark. App. 2014) (prematurity of impairment-rating issues where further treatment remains pending)
- Serv. Chevrolet v. Atwood, 966 S.W.2d 909 (Ark. App. 1998) (reservation of permanent‑disability issue justified while corrective treatment/outcome uncertain)