542 S.W.3d 155
Ark.2018Background
- On February 24, 2012, claimant Rick Yousey suffered catastrophic facial and head trauma while working as a tractor-trailer driver for Multi-Craft, including multiple facial and skull fractures, pneumocephalus, a broken hand and foot, torn rotator cuff, and lasting cognitive, sensory, and emotional symptoms.
- Yousey now has diplopia (double vision) from a sunken, downward-displaced left eye, daily headaches treated with medication and periodic injections, short-term memory deficits, numbness and cold sensation on left face, anosmia/ageusia, slowed speech, and depressive symptoms.
- ALJ initially denied a 29% whole-body brain-impairment rating and 100% vision-system loss but awarded facial-disfigurement benefits and a 20% rating for uncontrolled facial neuralgia pain; both parties appealed to the Commission.
- The Arkansas Workers’ Compensation Commission reversed in part and found Yousey entitled to a 29% whole-body impairment for brain injury, 24% whole-body impairment for loss of the left eye (deriving from a 100% left-eye loss under AMA Guides), and $3,500 statutory facial-disfigurement benefits; it denied a permanent-impairment rating based on pain/nerve injury.
- Multi-Craft appealed those impairment findings; Yousey cross-appealed seeking a 100% left-eye award and a 24% whole-body rating for trigeminal/cranial-nerve injury. The Supreme Court affirmed in part and modified the left-eye award to treat it as a scheduled injury; it affirmed denial of nerve-pain-based impairment.
Issues
| Issue | Yousey's Argument | Multi-Craft's Argument | Held |
|---|---|---|---|
| Whether there was substantial evidence of objective findings to support a 29% whole-body impairment for brain injury | Severe skull fractures, pneumocephalus, MRI evidence of shearing, neuropsychological testing, and treating physicians’ opinions establish compensable brain injury and 29% rating | Neuropsych testing and physicians’ opinions are subjective; there are no objective, measurable findings conclusively showing brain injury causation (MRI/CT findings equivocal) | Affirmed: Commission’s award of 29% whole-body impairment for brain injury supported by substantial evidence (severity of skull fractures, pneumocephalus, MRI shearing + neuropsych tests and physician testimony) |
| Whether the left-eye impairment should be treated as scheduled injury and whether 100% loss of the left eye was supported | Dr. Lawton (ophthalmologist) opined left eye functionally equivalent to total loss because of diplopia; AMA Guides equate covering one eye to loss of vision—so 100% left-eye loss -> 25% visual system -> 24% whole body | Eye retains 20/20 acuity; peripheral vision not lost; not a scheduled loss of enucleation or >=80% vision loss | Commission’s finding of 100% loss of the left eye is supported; court modified award to treat it as a scheduled injury (scheduled-benefit framework) rather than a 24% whole-body conversion |
| Whether trigeminal/cranial nerve injury supports a 24% whole-body impairment for uncontrolled facial neuralgia pain | Yousey asserts nerve damage produced objective deficits warranting 24% whole-body impairment | Multi-Craft argues pain-based complaints cannot form the basis for anatomical impairment under statute | Affirmed: Denial of permanent-anatomical impairment for nerve injury; medical rating was based solely on pain, which statute forbids in impairment calculation |
| Whether neuropsychological testing alone suffices as objective evidence of organic brain injury | Yousey: testing plus imaging and skull-fracture evidence together satisfy objective finding requirement | Multi-Craft: neuropsych testing alone is insufficient; prior cases reject testing standing alone | Court held testing plus objective imaging and fracture evidence distinguish this case from precedents where testing alone failed; substantial evidence supports brain injury finding |
Key Cases Cited
- Johnson v. Bonds Fertilizer, 375 Ark. 224, 289 S.W.3d 431 (Ark. 2008) (appellate review limited to Commission findings)
- Freeman v. Con-Agra Frozen Foods, 344 Ark. 296, 40 S.W.3d 760 (Ark. 2001) (same)
- Crudup v. Regal Ware, Inc., 341 Ark. 804, 20 S.W.3d 900 (Ark. 2000) (substantial-evidence standard explained)
- Wallace v. W. Fraser South, Inc., 365 Ark. 68, 225 S.W.3d 361 (Ark. 2006) (appellate deference to Commission when reasonable minds could agree)
- Cedar Chem. Co. v. Knight, 372 Ark. 233, 273 S.W.3d 473 (Ark. 2008) (credit and weight of testimony are Commission province)
- Parson v. Arkansas Methodist Hosp., 103 Ark. App. 178, 287 S.W.3d 645 (Ark. Ct. App. 2008) (neuropsychological testing alone insufficient to establish objective findings of organic brain injury)
- Rippe v. Delbert Hooten Logging, 100 Ark. App. 227, 266 S.W.3d 217 (Ark. Ct. App. 2007) (same)
- Watson v. Tayco, Inc., 79 Ark. App. 250, 86 S.W.3d 18 (Ark. Ct. App. 2002) (same)
- Patterson v. Ark. Dep’t of Health, 343 Ark. 255, 33 S.W.3d 151 (Ark. 2000) (deference on credibility determinations)