Wright Steel & MacHine, Inc. v. Heimer
2017 Ark. App. 643
| Ark. Ct. App. | 2017Background
- James Heimer, a welder for Wright Steel, had prior neck and low-back surgery in 2012 and returned to heavy lifting duties; he had intermittent back/left-leg symptoms documented since 2009–2014.
- On May 6, 2015, Heimer reported a new severe low-back injury with left-leg radiation after lifting heavy steel; he sought treatment and had injections and physical therapy without lasting relief.
- June 2015 MRI showed annular fissuring at L5–S1 and worsened foraminal narrowing compared with a 2012 MRI; 2012 MRI did not identify an annular tear.
- Dr. Cathey (independent evaluator) opined Heimer was at maximum medical improvement and not a candidate for further surgery, attributing findings to chronic degenerative disease and preexisting problems.
- Dr. Blankenship (treating/chosen physician) recommended anterior lumbar interbody fusion at L5–S1 (and L4–L5) and, after review of imaging and additional history, concluded the May 2015 incident was a factor in the need for surgery.
- The ALJ and the Arkansas Workers’ Compensation Commission credited Dr. Blankenship’s opinion and the objective MRI change (annular fissuring) and awarded authorization for the proposed surgery; appellants appealed claiming lack of substantial evidence and causation.
Issues
| Issue | Plaintiff's Argument (Heimer) | Defendant's Argument (Wright/Security) | Held |
|---|---|---|---|
| Whether Heimer proved entitlement to additional medical treatment (surgery) | May 2015 work incident was a factor causing need for surgery; MRI shows new annular tear and worsening compared to 2012 | MRI findings reflect preexisting degenerative disease; Dr. Blankenship relied on incomplete/misleading history; Dr. Cathey—no objective acute injury attributable to May 2015 | Commission credited Blankenship and MRI change; affirmed—substantial evidence supports award of surgery |
| Whether objective medical evidence establishes a compensable injury/need for treatment | June 2015 MRI objectively shows annular fissuring and worsened foraminal narrowing vs. prior MRI | Causation of annular tear not established; annular fissuring may preexist degenerative disease | Court held objective MRI change combined with physician causation opinion sufficed to meet burden (for medical benefits) |
| Whether preexisting condition bars compensation (major-cause issue) | Employment aggravated preexisting condition; aggravation is compensable if work is a factor | Preexisting disease was primary cause; surgery addresses preexisting changes not the workplace injury | Court applied rule that employee need only show compensable injury was a factor for medical benefits; affirmed compensation for aggravation |
| Whether Commission properly resolved conflicting medical opinions | Crediting treating surgeon who found causation and objective change is permissible | Commission should have favored independent evaluator (Dr. Cathey) who reviewed images and opined no surgery needed | Court defers to Commission’s credibility determinations and finds substantial evidence supports its choice |
Key Cases Cited
- Heritage Baptist Temple v. Robison, 82 Ark. App. 460, 120 S.W.3d 150 (discusses substantial-evidence review in workers’ compensation)
- Univ. of Ark. Pub. Emp. Claims Div. v. Tocci, 2015 Ark. App. 505, 471 S.W.3d 218 (Commission may accept or reject medical opinion and assess probative force)
- Hopkins v. Harness Roofing, Inc., 2015 Ark. App. 62, 454 S.W.3d 751 (scope of "reasonably necessary" medical treatment under Ark. Code Ann. § 11-9-508)
- Owens Planting Co. v. Graham, 102 Ark. App. 299, 284 S.W.3d 537 (burden to prove medical treatment is reasonable and necessary)
- Ozark Natural Food v. Pierson, 2012 Ark. App. 133, 389 S.W.3d 105 (aggravation of preexisting condition by employment is compensable)
- Jackson v. O’Reilly Auto. Inc., 2013 Ark. App. 755 (for medical benefits, employee must show the compensable injury was a factor in the need for treatment)
- Freeman v. Con-Agra Frozen Foods, 344 Ark. 296, 40 S.W.3d 760 (physician’s causation opinion need not use "major cause" language when only medical benefits are sought)
- Adams v. Bemis Co., 2010 Ark. App. 859 (deference to Commission’s resolution of conflicting medical evidence)