Jackson v. O'Reilly Auto. Inc.
2013 Ark. App. 755
| Ark. Ct. App. | 2013Background
- Leon Jackson, an O’Reilly counter salesman, suffered a compensable left-knee injury on Feb. 24, 2011 (coworker kicked his knee).
- Employer accepted the injury and paid for conservative care; MRI showed medial meniscus tear and degenerative lateral meniscal tears.
- Jackson underwent steroid injection and arthroscopic partial medial and lateral meniscectomies, but continued to have pain.
- Treating surgeon Dr. Kenneth Gati diagnosed preexisting osteoarthritis, assessed a 10% left-leg impairment from the meniscectomies, and recommended total knee arthroplasty through Jackson’s private insurance.
- Jackson had a left-knee replacement on Oct. 3, 2011, sought workers’ compensation coverage for the surgery and temporary total-disability benefits; ALJ awarded benefits but the Workers’ Compensation Commission reversed and dismissed.
- The Commission credited Dr. Gati’s unequivocal opinion that the replacement was caused by preexisting arthritis and was not causally connected to the compensable February 2011 injury; the Court of Appeals affirmed.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Jackson’s total knee replacement was reasonable and necessary medical treatment arising from his compensable knee injury | Jackson: the compensable injury aggravated dormant preexisting arthritis and was at least a factor necessitating the replacement | Employer: treating physician attributed need for replacement solely to preexisting osteoarthritis, not the compensable injury | Commission and Court: held Jackson failed to prove the surgery was reasonably necessary for the compensable injury; affirmed denial |
| Standard of proof and causation for medical benefits (aggravation vs. major-cause) | Jackson: need not prove compensable injury was the major cause—only that it was a factor | Employer: relied on Dr. Gati’s testimony that injury did not cause the replacement | Court: reaffirmed that for medical/temporary benefits plaintiff need only show compensable injury was a factor, but plaintiff failed to make that showing here |
Key Cases Cited
- Whitlach v. Southland Land & Dev., 84 Ark. App. 399 (Ark. Ct. App.) (standard of review; view evidence in light most favorable to Commission)
- K II Constr. Co. v. Crabtree, 78 Ark. App. 222 (Ark. Ct. App.) (definition of substantial evidence)
- Geo. Specialty Chem., Inc. v. Clingan, 69 Ark. App. 369 (Ark. Ct. App.) (affirming Commission if reasonable minds could reach its conclusion)
- Stone v. Dollar Gen. Stores, 91 Ark. App. 260 (Ark. Ct. App.) (employee bears burden to prove treatment reasonable and necessary)
- Bohannon v. Wal-Mart Stores, Inc., 102 Ark. App. 37 (Ark. Ct. App.) (reasonable and necessary medical treatment is a question of fact for the Commission)
- Cedar Chem. Co. v. Knight, 372 Ark. 233 (Ark. 2008) (credibility and weight of testimony are for the Commission)
- Poulan/Weed Eater v. Marshall, 79 Ark. App. 129 (Ark. Ct. App.) (Commission may accept or reject medical opinion)
- Heritage Baptist Temple v. Robison, 82 Ark. App. 460 (Ark. Ct. App.) (employer takes employee as found; compensable aggravation of preexisting condition is compensable)
- Williams v. L & W Janitorial, Inc., 85 Ark. App. 1 (Ark. Ct. App.) (for medical/temporary benefits, plaintiff need not show compensable injury was the major cause—only that it was a factor)