Wise v. Village Inn
2015 Ark. App. 406
| Ark. Ct. App. | 2015Background
- Francis Wise sustained a compensable work-related back injury on July 31, 2009, underwent surgery in January 2010, reached MMI in February 2011, and received a 13% impairment rating and a 50% wage-loss award.
- Wise continued to suffer pain and received pain-management treatment from Dr. Amir Qureshi beginning March 2011; Dr. Qureshi discharged her in May 2012 after a positive urine screen for methamphetamine/amphetamine and an alleged narcotics-contract violation.
- In September 2013 Wise paid to see Dr. Ahmer Hussain, who prescribed narcotics, advised he did not manage chronic pain, and referred her to a pain clinic at Sparks Regional Medical Center; Wise said the prescribed meds helped but did not eliminate pain.
- The ALJ found additional pain-management treatment reasonable and necessary, crediting Wise’s testimony that she never was pain free, that she could not afford the confirmation drug test, and that Hussain’s treatment provided some benefit.
- The Arkansas Workers’ Compensation Commission reversed, relying on Dr. Qureshi’s report (early narcotic refills, positive methamphetamine screen, history of meth use), finding no treating physician had opined that continued prescription medication was reasonably necessary and concluding Wise sought only continued narcotic prescriptions.
- Wise appealed, arguing the Commission made material factual errors (she requested pain-management broadly, not just medications; Dr. Qureshi never said treatment was no longer necessary) and that the denial was not supported by substantial evidence.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Wise requested additional pain-management treatment or only continued prescriptions | Wise sought additional pain-management (meds, PT, injections, referral to clinic) as framed in pre-hearing order and at hearing | Commission found Wise sought only continued and unlimited prescription medication | Court: Commission erred — record shows Wise requested pain-management generally, not limited to prescriptions; finding was a material factual mistake |
| Whether Dr. Qureshi’s discharge meant treatment was no longer reasonably necessary | Wise: Qureshi discharged her for contract violation, never opined treatment was no longer necessary | Commission: Relied on Qureshi’s report to conclude continued treatment not reasonable | Court: Qureshi never opined treatment was unnecessary; equating discharge for contract violation with medical opinion was erroneous |
| Whether the Commission’s denial is supported by substantial evidence | Wise: Denial rests on factual mistakes and is not supported by substantial evidence | Commission: Credited Qureshi’s findings and emphasized absence of a treating physician’s opinion that meds were reasonably necessary | Court: Because Commission relied on erroneous factual findings, its decision lacked substantial-evidence support; reversal and remand required |
| Remedy on appeal | N/A (Wise sought additional treatment) | N/A (Commission denied benefits) | Court reversed and remanded for the Commission to make factual findings on whether additional pain-management treatment is reasonably necessary |
Key Cases Cited
- Goyne v. Crabtree Contracting Co., 301 S.W.3d 16 (Ark. App. 2009) (employee must prove medical treatment is reasonably necessary; ongoing treatment may be allowed for management after healing)
- Holloway v. Ray White Lumber Co., 990 S.W.2d 526 (Ark. 1999) (appellate review of Commission is limited to whether decision is supported by substantial evidence; Commission resolves conflicting evidence and may accept portions it finds credible)