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ARKANSAS COURT OF APPEALS
DIVISION II
No. CV-14-871
TARGET CORPORATION and Opinion Delivered FEBRUARY 18, 2015
SEDGWICK CLAIMS MANAGEMENT
APPELLANTS APPEAL FROM THE ARKANSAS
WORKERS’ COMPENSATION
V. COMMISSION
[NO. G303657]
RENE BUMGARNER
APPELLEE
AFFIRMED
CLIFF HOOFMAN, Judge
Appellants Target Corporation (“Target”) and Sedgwick Claims Management appeal
from an August 26, 2014 opinion by the Arkansas Workers’ Compensation Commission
(“Commission”) affirming and adopting the findings of fact and conclusions of law made by
the Administrative Law Judge (“ALJ”) in favor of appellee Rene Bumgarner. On appeal,
appellants contend that no substantive proof exists to connect appellee’s desired additional
medical treatment to her May 1, 2013 work injury. We affirm.
On April 16, 2014, Bumgarner testified that she was fifty-one years old at the time of
the hearing and had been working for Target since August of 2002. Prior to her May 1, 2013
injury, Bumgarner worked as the “hard lines team lead.” Her job duties consisted of putting
products on shelves, zoning, and lifting heavy products. Her job also included placing
furniture on shelves and using ladders to get products from the warehouse. It is undisputed
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that appellee sustained a compensable injury on May 1, 2013. Bumgarner testified that she
injured herself after she used a ladder to take a product down from the back room. She
thought she was on the last step but instead was on the second to last step. When she stepped
off, she testified that her left foot made contact on the ground but her “knee pushed away
from [her] body laterally, snapped, and [she] fell down.” She initially was sent to a walk-in
clinic in Springdale, Arkansas, after which she was referred to Dr. Christopher A. Arnold in
Fayetteville.
Prior to her 2013 injury, Bumgarner had been seen and treated by Dr. Arnold for pre-
existing problems with her left knee. She had undergone a surgical procedure by Dr. Robert
Tomlinson on her left knee in August of 2009, which she admitted was not caused by any
specific event. After injuring her knee again in Afghanistan during her service in the Kansas
National Guard, she underwent another surgical procedure by Dr. Arnold on April 1, 2011.
She testified that she continued to see Dr. Arnold until her 2013 injury and received cortisone
injections for arthritic problems that she was having.
After the May 1, 2013 injury, she testified that Dr. Arnold performed another surgery
in August of 2013. Afterward, she returned to light duty work, involving a “sit-down job,”
but her employment with Target was subsequently terminated. Bumgarner testified on
redirect examination that she wanted to undergo the additional surgery recommended by Dr.
Arnold.
The medical evidence corroborated Bumgarner’s testimony. The January 14, 2011
MRI report of Bumgarner’s left knee reflected that there was an irregularity of the cartilage
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in the medial compartment consistent with low-grade chondromalacia, no evidence of bone
contusion or occult fracture, and a cleavage tear of the medial meniscus. However, the lateral
meniscus was intact. In Dr. Arnold’s May 31, 2011 notes, he states that Bumgarner may
someday be a candidate for meniscal allograft or cartilage salvaging procedure. However, he
also stated that he wanted her to “get over this” before he assessed her for that. The June 21,
2013 MRI report of Bumgarner’s left knee reflected that there was a high-grade partial tear
of the anterior cruciate ligament, likely degenerative tearing of the posterior horn and body
of the medial meniscus, a Grade IV chondromalacia of the weight-bearing surface of the
medial femoral condyle, and a bone marrow contusion involving the posterior aspect of the
lateral tibial plateau and lateral aspect of the lateral femoral condyle. In Dr. Arnold’s June 25,
2013 notes, he stated that he reviewed the MRI report and that while she had some pre-
existing wear in her knee, she had new findings after her 2013 injury. “I scoped her knee two
years ago. At that point, the ACL was intact. At that point, her medial femoral condyle had
grade 2 chondral changes. On her exam today, she has a grossly positive Lachman which is
new compared to prior to the injury. She also has MRI findings consistent with a pivot shift
phenomenon which is indicative of the ACL insufficiency.”
On December 17, 2013, Dr. Charles Pearce opined that Bumgarner was not at
maximum medical improvement and that she would benefit from another two to four months
of physiotherapy. He also opined that it was premature to discuss any further treatment for
the chondral lesion of her medial femoral condyle. Furthermore, he speculated that there was
some abnormality at the time of her 2011 arthroscopy, but he did not have anything to
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confirm that. Dr. Arnold disagreed with Dr. Pearce’s findings in a March 19, 2014 letter.
Instead, he explained that the “full thickness chondral defect of the medial femoral condyle”
was new after her 2013 injury, and he opined that the best option for Bumgarner was
autologous chondrocyte reimplantation.
On May 14, 2014, the ALJ filed its opinion, finding that Bumgarner had met her
burden of proving that she was entitled to additional medical treatment for her compensable
left knee injury in the form of the recommended surgical procedure recommended by Dr.
Arnold. The ALJ explained that Dr. Arnold’s opinion was entitled to a greater weight than
Dr. Pearce’s opinion because Dr. Arnold had evaluated her on multiple occasions as opposed
to the one time that Dr. Pearce evaluated her. The ALJ quoted the following opinion from
Dr. Arnold’s March 19, 2014 letter:
I respectfully disagree with [Dr. Pearce’s] recommendations of need for further therapy
and not the need for cartilage restoration procedure. My rationale is this. She is 50
years of age. She had a prior knee scope by myself in 2011 at which point the ACL
was intact and she had minimal chondral injury. She had subsequent injury at work. I
ended up scoping her knee and she had ACL tear as well as a full thickness chondral defect of
the medial femoral condyle. This was new. The arthroscopy which I performed, was in
August 2013 which was approximately 7 months ago. At the time of my last visit, she
had a well preserved joint space, she had a stable knee, she had an intact meniscus and
she was ideal body weight. She continues to complain of medial joint line pain. I do
not agree with Dr. P[ea]rce that physical therapy will continue to improve as she is
now 7 months postop. I think what she has is what she has.
(Emphasis added.)
Subsequently, on August 26, 2014, the Commission affirmed and adopted the ALJ’s
opinion as its own. Under Arkansas law, the Commission is permitted to adopt the ALJ’s
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opinion. SSI, Inc. v. Cates, 2009 Ark. App. 763, 350 S.W.3d 421. In doing so, the
Commission makes the ALJ’s findings and conclusions the findings and conclusions of the
Commission. Id. Therefore, for purposes of our review, we consider both the ALJ’s opinion
and the Commission’s majority opinion. Id.
In appeals involving claims for workers’ compensation, the appellate court views the
evidence in the light most favorable to the Commission’s decision and affirms the decision if
it is supported by substantial evidence. Prock v. Bull Shoals Boat Landing, 2014 Ark. 93, 431
S.W.3d 858. Substantial evidence is evidence that a reasonable mind might accept as adequate
to support a conclusion. Id. The issue is not whether the appellate court might have reached
a different result from the Commission, but whether reasonable minds could reach the result
found by the Commission. Id. Additionally, questions concerning the credibility of witnesses
and the weight to be given to their testimony are within the exclusive province of the
Commission. Id. When there are contradictions in the evidence, it is within the
Commission’s province to reconcile conflicting evidence and determine the facts. Id. Finally,
the court will reverse the Commission’s decision only if it is convinced that fair-minded
persons with the same facts before them could not have reached the conclusions arrived at by
the Commission. Id.
Arkansas Code Annotated § 11-9-508(a) (Repl. 2012) requires an employer to provide
an employee with medical and surgical treatment “as may be reasonably necessary in
connection with the injury received by the employee.” However, a claimant bears the
burden of proving entitlement to additional medical treatment. LVL, Inc. v. Ragsdale, 2011
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Ark. App. 144, 381 S.W.3d 869. What constitutes reasonably necessary treatment is a
question of fact for the Commission. Id. The Commission has authority to accept or reject
medical opinion and to determine its medical soundness and probative force. Id.
Furthermore, it is the Commission’s duty to use its experience and expertise in translating the
testimony of medical experts into findings of fact and to draw inferences when testimony is
open to more than a single interpretation. Id.
On appeal, appellants contend that no substantive proof exists to connect appellee’s
desired additional medical treatment to her May 1, 2013 work injury. Appellants do not
dispute that appellee sustained a compensable injury, but appellants allege that appellee’s desire
for the recommended surgery is not related to the compensable injury. We disagree.
The Commission, by adopting the ALJ’s opinion, specifically found that Bumgarner
met her burden of proof that she was entitled to additional medical treatment based in large
part on the opinion of Dr. Arnold, which it found to be credible and entitled to the greater
weight. The Commission recognized that Bumgarner had experienced pre-existing knee
issues and recognized Dr. Pearce’s opinion. However, the Commission placed a greater
weight on Dr. Arnold’s opinion in his March 19, 2014 letter. He stated that the “full
thickness chondral defect of the medial femoral condyle” was new after her 2013 injury, and
he further opined that the best option for Bumgarner was autologous chondrocyte
reimplantation. The weight and interpretation of the medical evidence, on which this
decision turned, are matters for the Commission. LVL, supra. Therefore, under this court’s
standard of review, we must affirm the Commission’s decision.
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Affirmed.
ABRAMSON and HIXSON, JJ., agree.
Friday, Eldredge & Clark, LLP, by: Guy Alton Wade and T.J. Fowler, for appellants.
Tolley & Brooks, P.A., by: Evelyn E. Brooks, for appellee.
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