{ "id": 6140977, "name": "SOUTHERN HOSPITALITIES d/b/a Quality Inn, et al. v. Lorie BRITAIN", "name_abbreviation": "Southern Hospitalities v. Britain", "decision_date": "1996-07-03", "docket_number": "CA 95-710", "first_page": "318", "last_page": "335", "citations": [ { "type": "official", "cite": "54 Ark. App. 318" }, { "type": "parallel", "cite": "925 S.W.2d 810" } ], "court": { "name_abbreviation": "Ark. Ct. App.", "id": 13370, "name": "Arkansas Court of Appeals" }, "jurisdiction": { "id": 34, "name_long": "Arkansas", "name": "Ark." }, "cites_to": [ { "cite": "15 Ark. App. 205", "category": "reporters:state", "reporter": "Ark. App.", "case_ids": [ 6140679 ], "weight": 2, "year": 1985, "opinion_index": 0, "case_paths": [ "/ark-app/15/0205-01" ] }, { "cite": "Ark. Code Ann. \u00a7 11-9-102", "category": "laws:leg_statute", "reporter": "Ark. Code Ann.", "weight": 3, "year": 1996, "pin_cites": [ { "page": "(16)(A)(i)" }, { "page": "(5)(E)" } ], "opinion_index": 0 }, { "cite": "661 S.W.2d 403", "category": "reporters:state_regional", "reporter": "S.W.2d", "case_ids": [ 6136734, 6136615 ], "year": 1983, "opinion_index": 0, "case_paths": [ "/ark-app/10/0034-01", "/ark-app/10/0028-01" ] }, { "cite": "10 Ark. App. 28", "category": "reporters:state", "reporter": "Ark. App.", "case_ids": [ 6136615 ], "year": 1983, "opinion_index": 0, "case_paths": [ "/ark-app/10/0028-01" ] }, { "cite": "40 Ark. App. 120", "category": "reporters:state", "reporter": "Ark. App.", "case_ids": [ 6138147 ], "weight": 2, "year": 1992, "opinion_index": 0, "case_paths": [ "/ark-app/40/0120-01" ] }, { "cite": "38 Ark. App. 223", "category": "reporters:state", "reporter": "Ark. App.", "case_ids": [ 6140469 ], "weight": 2, "year": 1992, "opinion_index": 0, "case_paths": [ "/ark-app/38/0223-01" ] }, { "cite": "Ark. Code Ann. \u00a7 11-9-510", "category": "laws:leg_statute", "reporter": "Ark. Code Ann.", "opinion_index": 1 }, { "cite": "760 S.W.2d 382", "category": "reporters:state_regional", "reporter": "S.W.2d", "case_ids": [ 1891379, 6137694 ], "year": 1988, "opinion_index": 1, "case_paths": [ "/ark/297/0281-01", "/ark-app/26/0083-01" ] }, { "cite": "26 Ark. App. 83", "category": "reporters:state", "reporter": "Ark. App.", "case_ids": [ 6137694 ], "year": 1988, "opinion_index": 1, "case_paths": [ "/ark-app/26/0083-01" ] }, { "cite": "Ark. Code Ann. \u00a7 11-9-1001", "category": "laws:leg_statute", "reporter": "Ark. Code Ann.", "weight": 3, "year": 1996, "opinion_index": 2 }, { "cite": "Ark. Code Ann. \u00a7 11-9-523", "category": "laws:leg_statute", "reporter": "Ark. Code Ann.", "weight": 2, "year": 1996, "opinion_index": 2 }, { "cite": "738 S.W.2d 104", "category": "reporters:state_regional", "reporter": "S.W.2d", "case_ids": [ 6661917 ], "year": 1987, "opinion_index": 2, "case_paths": [ "/ark-app/22/0217-01" ] }, { "cite": "22 Ark. App. 219", "category": "reporters:state", "reporter": "Ark. App.", "year": 1987, "opinion_index": 2 }, { "cite": "18 Ark. App. 200", "category": "reporters:state", "reporter": "Ark. App.", "case_ids": [ 6140458 ], "weight": 2, "year": 1986, "opinion_index": 2, "case_paths": [ "/ark-app/18/0200-01" ] }, { "cite": "18 Ark. App. 82", "category": "reporters:state", "reporter": "Ark. App.", "case_ids": [ 6137849 ], "weight": 2, "year": 1986, "opinion_index": 2, "case_paths": [ "/ark-app/18/0082-01" ] }, { "cite": "Ark. Code Ann. \u00a7 11", "category": "laws:leg_statute", "reporter": "Ark. Code Ann.", "opinion_index": 2 }, { "cite": "Ark. Code Ann. \u00a7 11-9-510", "category": "laws:leg_statute", "reporter": "Ark. Code Ann.", "weight": 2, "opinion_index": 2 }, { "cite": "Ark. Code Ann. \u00a7 11-9-102", "category": "laws:leg_statute", "reporter": "Ark. Code Ann.", "weight": 4, "year": 1996, "pin_cites": [ { "page": "(4)" }, { "page": "(16)" }, { "page": "(16)(A)(ii)" } ], "opinion_index": 2 } ], "analysis": { "cardinality": 1121, "char_count": 40450, "ocr_confidence": 0.78, "pagerank": { "raw": 8.399435591192063e-08, "percentile": 0.48252253316699156 }, "sha256": "790fb4902a873f010944641aef4f20b9ea6dec642b9c6263ee7b666a60e6270c", "simhash": "1:cd86a5bbd4db466c", "word_count": 6443 }, "last_updated": "2023-07-14T17:04:29.533878+00:00", "provenance": { "date_added": "2019-08-29", "source": "Harvard", "batch": "2018" }, "casebody": { "judges": [ "ROGERS, J., agrees.", "Mayfield and Griffen, JJ., concur.", "Jennings, C.J., and Cooper, J., dissent.", "COOPER, J., joins in this concurrence and dissent." ], "parties": [ "SOUTHERN HOSPITALITIES d/b/a Quality Inn, et al. v. Lorie BRITAIN" ], "opinions": [ { "text": "John B. Robbins, Judge.\nLorie Britain brought a workers\u2019 compensation claim against Southern Hospitalities, alleging that she sustained a work-related back injury on July 3, 1993. The Commission found that Ms. Britain failed to prove a compensable injury and thus denied her claim for temporary total disability benefits. However, the Commission also held that Southern Hospitalities was responsible for medical treatment provided by Dr. Bruce Smith. Southern Hospitalities now appeals, arguing that the Commission erred in holding it liable for any medical expenses. On cross-appeal, Ms. Britain contends that the Commission erred in concluding that she failed to prove a compensable injury. We affirm on appeal and on cross-appeal. Specifically, we hold that Ms. Britain cannot prevail on cross-appeal because substantial evidence supports the Commission\u2019s finding that she failed to establish a compensable injury under the new requirements set forth by Act 796 of 1993. Despite the fact that Ms. Britain cannot sustain her claim for a compensable injury, we agree with the Commission\u2019s ruling that Southern Hospitality is responsible for those medical expenses which were incurred by Ms. Britain at her employer\u2019s direction.\nWhen reviewing decisions from the Workers\u2019 Compensation Commission, we view the evidence and all reasonable inferences deducible therefrom in the light most favorable to the Commission\u2019s findings and affirm if supported by substantial evidence. Welch\u2019s Laundry & Cleaners v. Clark, 38 Ark. App. 223, 832 S.W.2d 283 (1992). Substantial evidence is that which a reasonable person might accept as adequate to support a conclusion. City of Fort Smith v. Brooks, 40 Ark. App. 120, 842 S.W.2d 463 (1992). A decision by the Workers\u2019 Compensation Commission should not be reversed unless it is clear that fair-minded persons could not have reached the same conclusions if presented with the same facts. Silvicraft, Inc. v. Lambert, 10 Ark. App. 28, 661 S.W.2d 403 (1983).\nThe facts of this case are as follows. On July 3, 1993, Ms. Britain was working in the laundry room for Southern Hospi-talities pulling towels from a washer when she felt a pain in her lower back and right leg. Ms. Britain reported her injury to a coworker, and later informed management about the injury. She continued working that day, but took some pain medication for relief and did not do any more lifting. After work, she was examined by a doctor at a local hospital and was told that she appeared to have a lumbar strain. The doctor prescribed muscle relaxers and pain pills. Ms. Britain returned to the hospital two or three days later when her pain persisted, and was referred to Dr. James Arthur, a neurosurgeon. However, a representative from the employer\u2019s compensation insurer informed her that she was not authorized to be treated by Dr. Arthur, and directed her to consult Dr. Bruce Smith, an orthopedic surgeon.\nMs. Britain complied with the direction from the compensation insurer to consult Dr. Smith, and he examined her on July 22, 1993. Dr. Smith diagnosed a mild back sprain, prescribed more pain medication and muscle relaxers, and directed her to return to work and contact him if she had any problems. Ms. Britain attempted to return to work but, after working for only a few hours, began experiencing additional pain in her lower back and legs. She telephoned Dr. Smith\u2019s office, reported her symptoms, and was told to remain off work until an MRI study of her lumbar spine could be performed. That study was performed on August 11, 1993, and indicated evidence of a prior surgery. However, no recurrent disc herniation was detected, and no nerve-root impingement was found. Based upon that study, Dr. Smith released Ms. Britain to return to work effective August 12, 1993, without restrictions, and released her from care. On September 8, 1993, Dr. Smith again released Ms. Britain to work, but this time he directed that she restrict her lifting to no more than thirty pounds. Ms. Britain returned to work following the August 11, 1993, study and examination and continued to work through September 16, 1993, when she was fired.\nIt is undisputed that Southern Hospitalities accepted Ms. Britain\u2019s July 3, 1993, back sprain as compensable, and that it paid for the medical treatment that Ms. Britain received from the hospital and paid temporary total disability benefits through July 21, 1993. The parties stipulated that an incident occurred on July 3, 1993, which Ms. Britain immediately reported as a work-related injury. The Commission found that the appellants initially accepted responsibility for the claim. Furthermore, it is undisputed that Southern Hospitalities and its insurance carrier refused to authorize medical treatment by Dr. Arthur, but instead directed Ms. Britain to obtain treatment from Dr. Smith. Nonetheless, Southern Hospi-talities denied liability for any of Ms. Britain\u2019s medical care, including the cost of Dr. Smith\u2019s services and the MR.I study that she received under his care, as well as her claim for temporary total disability benefits associated with the time that she was off work pursuant to Dr. Smith\u2019s direction. Southern Hospitalities denied Ms. Britain\u2019s claim by contending that her injury was not supported by objective findings so that it was not a \u201ccompensable injury\u201d within the meaning of various provisions of Ark. Code Ann. \u00a7 11-9-102 (Repl. 1996), as amended by Section 2 of Act 796 of 1993.\nAs the Commission noted in its opinion, the only positive medical finding resulting from any of the examinations of Ms. Britain was that of lumbar tenderness. Following an examination which revealed a good range of motion and a negative straight leg-raising maneuver, Dr. Smith opined that Ms. Britain sustained a \u201cmild sprain.\u201d An MRI was also performed, but the results were negative. Under the new act, a compensable injury must be established by medical evidence supported by \u201cobjective findings,\u201d which are findings \u201cwhich cannot come under the voluntary control of the patient.\u201d Ark. Code Ann. \u00a7 ll-9-102(5)(D) (Repl. 1996); Ark. Code Ann. \u00a7 11-9-102(16)(A)(i) (Repl. 1996). The burden of proof of a compensable injury is on the employee. Ark. Code Ann. \u00a7 11-9-102(5)(E) (Repl. 1996). In the instant case, the Commission correcdy concluded that the medical evidence was not supported by \u201cobjective findings,\u201d and that Ms. Britain thus failed to establish entitlement to compensation for a compensable injury.\nAfter deciding to deny Ms. Britain\u2019s claim for compensability, the Commission nevertheless awarded benefits against the appellants for medical expenses incurred under the treatment of Dr. Smith. In doing so, the Commission explained:\n[W]e note that the respondents are seeking to avoid liability for medical treatment which was provided to the claimant at their direction during the time that they accepted the compensability of the claim. In this regard, the respondents initially accepted the compensability of this claim, and they accepted responsibility for the medical services provided to the claimant by and at the direction of Dr. Smith. Consequently, we find that they cannot now deny liability for those services, including liability for the expenses for the MRI.\nAn employer is generally only responsible for medical expenses when an employee is determined to have suffered a compensable injury. See Ark. Code Ann. \u00a7 ll-9-102(5)(F)(i) (Repl. 1996). However, in this case the employer directed Ms. Britain to see Dr. Smith and led Ms. Britain to reasonably believe that such treatment would be covered by workers\u2019 compensation. Although the Commission did not specifically state that it was invoking the equitable doctrine of estoppel, it is implicit in its opinion that it did so. In Snow v. Alcoa, 15 Ark. App. 205, 691 S.W.2d 194 (1985), we set out the elements of estoppel as follows:\n1) The party to be estopped must know the facts; 2) he or she must intend that his or her conduct shall be acted upon or must act so that the party asserting the estoppel has a right to believe the other party so intended; 3) the party asserting the estoppel must be ignorant of the true facts; and 4) the party asserting the estoppel must rely on the other party\u2019s conduct to his or her injury.\nThe facts of this case constitute substantial evidence in support of the Commission\u2019s decision. The employer is estopped from denying responsibility for the cost of treatment rendered by Dr. Smith notwithstanding the fact that Ms. Britain\u2019s back injury was ultimately deemed to be noncompensable. Southern Hospitalities directed Ms. Britain to visit a specific physician and represented that it was accepting her injury as compensable, thus prompting Britain to visit Dr. Smith and incur medical expenses. The Commission did not err in concluding that these expenses should be borne by the appellants.\nAffirmed on direct appeal.\nROGERS, J., agrees.\nMayfield and Griffen, JJ., concur.\nJennings, C.J., and Cooper, J., dissent.\nAffirmed on cross-appeal.\nRogers, J., agrees.\nJennings, C.J., and Cooper J., concur.\nMayfield and Griffen, JJ., dissent.", "type": "majority", "author": "John B. Robbins, Judge." }, { "text": "John E. JENNINGS, Chief Judge,\nconcurring in part and dissenting in part. I concur in the court\u2019s affirmance on cross-appeal. I agree with Judge Robbins that the Commission\u2019s finding that Ms. Britain\u2019s injury is not \u201ccompensable\u201d under the new act is supported by substantial evidence.\nI cannot agree that the case can be affirmed on direct appeal, however. There are several problems with affirming on an estoppel theory. First, the Commission did not make a specific finding that the employer was estopped. Estoppel is ordinarily a question of fact. See Dickson v. Delhi Seed Co., 26 Ark. App. 83, 760 S.W.2d 382 (1988). Second, Ark. Code Ann. \u00a7 ll-9-508(a) requires the employer to provide medical services. I do not understand how the employer can be estopped by doing something the statute requires.\nFinally, Ark. Code Ann. \u00a7 11-9-510 expressly provides that there is no liability here. \u201cThe employer shall not be liable for any of the payments provided for in \u00a7\u00a7 11-9-508 \u2014 11-9-516 in the case of a contest of liability where the Commission shall decide that the injury does not come within the provisions of this chapter.\u201d My conclusion is that, under the new act, we have no choice but to reverse on direct appeal, and for that reason I respectfully dissent. I concur in the court\u2019s affirmance on cross-appeal.\nCOOPER, J., joins in this concurrence and dissent.", "type": "concurrence", "author": "John E. JENNINGS, Chief Judge," }, { "text": "WENDELL L. Griffen, Judge,\nconcurring in part and dissenting in part. Is a low-back strain that a worker suffers while performing her job and which her employer acknowledges as having occurred within the scope of and arising out of her employment a \u201ccompen-sable injury\u201d within the meaning of the changes to the Arkansas Workers\u2019 Compensation Law enacted as Act 796 of 1993? This is the question presented by this case of first impression under the 1993 changes. Although one might first think that this question is easily answered given the history of workers\u2019 compensation in Arkansas, this case shows that the definition of \u201ccompensable injury\u201d under the new act may pose somewhat novel and nagging difficulties to employers, injured workers, the Workers\u2019 Compensation Commission, and this court.\nSouthern Hospitalities d/b/a Quality Inn [hereinafter \u201cSouthern Hospitalities\u201d] and Union Standard Insurance Company (its workers\u2019 compensation insurer) have appealed the March 18, 1995, decision by the Workers\u2019 Compensation Commission holding that Lorie Britain was entitled to medical benefits under the Workers\u2019 Compensation Law arising from a back injury that Britain suffered on July 3, 1993, even though the Commission found her injury non-compensable. Britain has cross-appealed from the Commission\u2019s decision denying her claim for temporary total disability benefits associated with that injury based upon its determination of non-compensability. We conclude that the Commission\u2019s decision finding Southern Hospitalities liable for the cost of the medical services and treatment that Britain received is supported by substantial evidence. Therefore, we would affirm on the appeal. However, that part of the Commission\u2019s decision finding that Britain failed to prove that she sustained a compensable injury is not supported by substantial evidence. Thus, we would reverse the decision denying Britain\u2019s claim for temporary total disability benefits, and we would remand the case to the Commission so that an order awarding those benefits can be entered.\nThe facts are essentially undisputed. On July 3, 1993, Britain was working in the laundry room for Southern Hospitalities pulling towels from a washer when she felt a sharp pain in her lower back and down her right leg. She reported her injury to a co-worker, and she informed management about the injury. She continued working that day, but took some pain medication for relief and did not do any more lifting that day. After work she went to a local hospital, was examined by a doctor there and told that she appeared to have a lumbar strain, and was prescribed muscle relaxers and pain pills. Britain returned to the hospital two or three days later when her pain persisted, and was referred to a local neurosurgeon, Dr. James Arthur. However, a representative from the employer\u2019s compensation insurer informed her that she was not authorized to be treated by Dr. Arthur, and directed her to consult Dr. Bruce Smith, an orthopedic surgeon, instead. Britain had formerly been a patient under Dr. Smith\u2019s care for another back injury that occurred when she worked for a different employer.\nBritain complied with the direction from the compensation insurer to consult Dr. Smith, who examined her on July 22, 1993. He diagnosed a mild back sprain, prescribed more pain medication and muscle relaxers, and directed her to return to work and contact him if she had any problems. Britain attempted to return to work but began experiencing additional pain in her lower back and legs after working for less than three hours. She telephoned Dr. Smith\u2019s office, reported her symptoms, and was told to remain off work until a magnetic resonance imaging (MR.I) study of her lumbar spine could be performed. That study, performed on August 11, 1993, produced findings of desiccation of Britain\u2019s intervertebral disc at L5-S1, slight bulging of the disc on the right at that level, and post-surgical scarring on the right at that level. No recurrent disc herniation was detected, and no nerve-root impingement was found in that study. Based upon that study, Dr. Smith released Britain to return to work effective August 12, 1993, without restrictions, and released her from care. On September 8, 1993, Dr. Smith again released Britain to work, but this time he directed that she restrict her lifting to no more than thirty pounds. Britain returned to work following the August 11, 1993, study and examination and worked through September 16, 1993, when she was fired. She brought a claim for workers\u2019 compensation benefits related to the medical treatment that she received, including the cost of the MRI study, as well as for temporary total disability benefits related to the time that she was off work as directed by Dr. Smith from July 22 to August 12, 1993, She subsequently obtained work from a different employer.\nIt is undisputed that Southern Hospitalities accepted Britain\u2019s July 3, 1993, back sprain as compensable, and that it paid, through its insurance carrier, for the medical treatment that Britain received from the hospital and paid temporary total disability benefits through July 21, 1993. The parties stipulated that an incident occurred on July 3, 1993, which Britain immediately reported as a work-related injury, and that the incident arose out of and occurred in the course of her employment. The Commission found that the appellants initially accepted responsibility for the claim. Furthermore, it is undisputed that Southern Hospitalities and its insurance carrier refused to authorize medical treatment by Dr. Arthur, but instead directed Britain to obtain treatment from Dr. Smith. Nevertheless, Southern Hospitalities denied liability under the Workers\u2019 Compensation Law concerning the cost of all of Britain\u2019s medical' care, including the cost of Dr. Smith\u2019s services and the MRI study that she received under his care, as well as her claim for temporary total disability benefits associated with the time that she was off work pursuant to Dr. Smith\u2019s direction. Southern Hospitalities denied Britain\u2019s claim by contending that her injury was not supported by objective findings so that it was not a \u201ccompensable injury\u201d within the meaning of various provisions of Ark. Code Ann. \u00a7 11-9-102 (Repl. 1996) as amended by Section 2 of Act 796 of 1993.\nAn administrative law judge found that Britain did sustain a \u201ccompensable injury,\u201d and awarded her temporary total disability benefits for the period in question plus her medical expenses and a controverted attorney\u2019s fee. Southern Hospitalities appealed that determination to. the Commission, which affirmed the award of medical benefits because Southern Hospitalities initially accepted the claim as compensable and accepted responsibility for the medical services provided to Britain by Dr. Smith at its direction. However, the Commission reversed the award of temporary total disability benefits from July 22 to August 12, 1993, and the finding that Britain sustained a compensable injury, holding that she failed to establish a compensable injury with medical evidence supported by objective findings as defined by Ark. Code Ann. \u00a7 11 \u2014 9\u2014 102(16)(Repl. 1996). Southern Hospitalities has appealed from the decision holding it liable for all medical benefits, including the MRI expense and the cost of Dr. Smith\u2019s care. Britain has cross-appealed from the decision holding that she failed to prove that she sustained a compensable injury.\nOur task on appellate review of decisions by the Workers\u2019 Compensation Commission is to review the evidence and all reasonable inferences from it in the light most favorable to the Commission\u2019s findings, and we must uphold the Commission\u2019s findings if there is any- substantial evidence to support them, even if the preponderance of the evidence would indicate a different result. Tahu tini v. Tastybird Foods, 18 Ark. App. 82, 711 S.W.2d 173 (1986). In order to reverse a decision of the Commission, we must be convinced that fair-minded persons, with the same facts before them, could not have reached the conclusion arrived at by the Commission. Franklin Collier Farms v. Chapple, 18 Ark. App. 200, 712 S.W.2d 334 (1986). We are required to give findings of fact by the Commission the same force and effect as a jury\u2019s verdict when they are supported by substantial evidence. General Indus. v. Gipson, 22 Ark. App. 219, 738 S.W.2d 104 (1987).\nThus, as to the appeal, our concern is whether the Commission\u2019s decision holding Southern Hospitalities liable for Britain\u2019s medical expenses upon a finding it accepted the compensability for her claim during the time that the services were provided is supported by substantial evidence. As to the cross-appeal, we review to determine whether the Commission\u2019s finding that Britain failed to prove that she suffered a compensable injury as that term is defined by the Workers\u2019 Compensation Law, as amended by Act 796 of 1993, is supported by substantial evidence.\nUnder prior law, Arkansas defined an injury for purposes of workers\u2019 compensation benefits to mean an accidental injury arising out of and in the course of employment. Ark. Code Ann. \u00a7 11-9-102(4) (1987). However, the Arkansas General Assembly rewrote the definition of injury when it enacted Act 796 in 1993, and specified the meaning of \u201ccompensable injury,\u201d at Ark. Code Ann. \u00a7 ll-9-102(5)(A) (Repl. 1996). For our purposes in this appeal, the operative statutory definition is found at \u00a7 ll-9-102(5)(A)(i), which reads, in pertinent part, as follows:\n\u201cCompensable injury\u201d means:\n(i) An accidental injury causing internal or external physical harm to the body . . . arising out of and in the course of employment and which requires medical services or results in disability or death. An injury is \u201caccidental\u201d only if it is caused by a specific incident and is identifiable by time and place of occurrence.\nThat definition must also be understood in light of \u00a7 11-9\u2014 102(5)(D) (Repl. 1996) which provides that a compensable injury must be established by medical evidence, supported by \u201cobjective findings\u201d as defined in \u00a7 ll-9-102(16)(A), which reads as follows:\n(i) \u201cObjective findings\u201d are those findings which cannot come under the voluntary control of the patient.\n(ii) When determining physical or anatomical impairment, neither a physician, any other medical provider, an administrative law judge, the Workers\u2019 Compensation Commission, nor the courts may consider complaints of pain; for the purpose of making physical or anatomical impairment ratings to the spine, straight-leg-raising tests or range-of-motion tests shall not be considered objective findings.\nBecause we would hold that Britain suffered a compensable injury within the meaning of the foregoing statutory definitions, we have no difficulty concluding \u2014 indeed, it logically follows \u2014 that there is substantial evidence to support the Commission\u2019s decision that Southern Hospitalities is liable for the cost of the medical services and treatment that Britain obtained. Britain\u2019s claim is governed by \u00a7 ll-9-102(5)(A)(i), which expressly defines compensable injury to mean accidental injury causing internal or external physical harm to the body, arising out of and in the course of employment, and which requires medical services or results in disability or death. There is no argument about whether Britain\u2019s injury was accidental because the parties agree that it arose from a specific incident and is identifiable by time and place of occurrence. There is no dispute that the July 3, 1993, incident involving the pulling of towels from a washer was the precipitating incident for Britain\u2019s injury, although Southern Hospitalities argued before the Commission that her symptoms following that incident were merely a recurrence of her previous back problems from an injury sustained under different employment. As already indicated, Britain\u2019s condition required medical services on July 3, 1993, and it resulted in her inability to work. Her condition required medical services thereafter, as proven by the fact that she returned to the hospital for additional examination, was prescribed medication for pain relief and muscle relaxers, and had been referred by the hospital to Dr. Arthur, a neurosurgeon. The fact that Southern Hospitalities, through its workers\u2019 compensation insurer, directed Britain to be examined by Dr. Bruce Smith rather than Dr. Arthur is additional proof that her condition required medical services. Dr. Smith diagnosed her condition as a lumbar strain, prescribed medication, and eventually directed her to refrain from working because of her increased symptoms of lower-back and right-leg pain. These facts are established by Britain\u2019s testimony. They are also proven by the medical records related to Britain\u2019s treatment on July 3 and 7, 1993, as well as Dr. Smith\u2019s clinic notes and other records beginning with his treatment on July 22, 1993, and continuing through his return to work slip dated September 8, 1993.\nThere is no medical evidence in the record that questions the fact that Britain sustained internal physical harm to her body (in the form of a lumbar strain diagnosed by Dr. Smith and by the doctors that treated Britain before he did). Similarly, there is no evidence questioning whether her lumbar strain required medical services. The fact that she was off work because of the lumbar strain is also undisputed. Based upon these undisputed facts, we are driven to conclude that reasonable minds could not have decided that Britain did not suffer a compensable injury.\nSouthern Hospitalities contends that Britain did not suffer a compensable injury because the medical evidence is not supported by \u201cobjective findings.\u201d Operating from that reasoning, the argument proceeds that because Britain did not suffer a compensable injury, the employer cannot be held liable for medical treatment and services under the Workers\u2019 Compensation Law. Southern Hospitalities disputes the Commission\u2019s decision holding it liable for the cost of Britain\u2019s medical treatment, including the treatment and services she received from Dr. Smith and at his direction, by arguing that it merely authorized Britain to obtain that treatment, but that it did not accept responsibility for paying for it. None of this reasoning is persuasive.\nThere is no proof before us that Britain\u2019s lumbar strain \u2014 the medical condition diagnosed by every doctor that examined her \u2014 comes under her voluntary control. The medical evidence shows that she initially complained of pain along the right side of her back running to her right buttock and leg, and that she described the pain as a pulling type. Although she had good range of motion in the lumbar spine, negative straight leg raising, and normal neurological findings when Dr. Smith examined her on July 22, 1993, Dr. Smith unequivocally stated that she had suffered a mild sprain for which he recommended conservative treatment. If the record contained proof that the medical findings associated with Britain\u2019s back sprain were under her voluntary control, we would have no difficulty affirming the Commission\u2019s decision that she had not suffered a compensable injury based upon the substantial evidence standard of review. But we do not read the governing provisions of \u00a7 11-9-102 on this issue as constituting a wholesale exclusion of back sprains.\nObjective findings are those that cannot come within the voluntary control of the patient. Ark. Code Ann. \u00a7 11-9-102(16) (Repl. 1996). A patient with a strained back can voluntarily control her responses to pain associated with the sprain, to be sure, but that is manifestly different from being able to voluntarily control the pain itself and the stretching of the muscles affected. It is important to note that Act 796 only provides that pain may not be considered \u201cwhen determining physical or anatomical impairment.\u201d Ark. Code Ann. \u00a7 11-9-102(16)(A)(ii) (Repl. 1996). The inquiry to determine impairment is distinct from the more fundamental inquiry to determine compensability in the first instance.\nThe General Assembly has never eliminated pain as a consideration when the issue is compensability, either by enacting Act 796 or otherwise. Act 796 clearly eliminated pain as a factor for determining impairment as shown at Ark. Code Ann \u00a7 11-9-102(16)(A)(ii). Likewise, at \u00a7\u00a7 ll-9-521(h)(l)(B) and 11-9-522(g)(1)(B) (Repl. 1996), pain has been eliminated as a basis for an impairment-rating guide that the Commission was required to adopt pursuant to Act 796. However, the General Assembly has not eliminated pain as a factor for determining compensability in strains. The clearest proof that it has not is found at Ark. Code Ann. \u00a7 11-9-523 (Repl. 1996), which provides for the compensability of hernia injuries. That statute and its predecessors include the existence of pain as a valid factor for determining compensability. Indeed, the statute requires affirmative proof that the claimant suffered severe pain in the hernial region, \u201cthat the pain caused the employee to cease work immediately,\u201d and that \u201cthe physical distress following the occurrence of the hernia was such as to require the attendance of a licensed physician within seventy-two (72) hours after the occurrence.\u201d Section 11-9-521 (a). Proof of pain is required in \u201call cases of claims for hernia\u201d which also requires proof that hernia occurred immediately following the result of sudden effort, severe strain, or the application of force directly to the abdominal wall. Id.\nThe Workers\u2019 Compensation Law has included the foregoing proof requirement regarding pain for the abdominal-strain condition known as hernia since 1948, when Arkansas adopted its workers\u2019 compensation scheme. The General Assembly has always known that pain is a required element of proof for hernia claims, and that other sprain or strain injuries \u2014 including back strains such as suffered by Britain in the present case \u2014 are typically characterized by the presence of pain as a diagnostic finding and have repeatedly been upheld as compensable. If the General Assembly intended to change more than forty years of Arkansas law and eliminate pain as a permissible factor for determining compensability in workers\u2019 compensation cases involving strains, it clearly could have done so by using plain language to that effect in Act 796. Instead, the General Assembly did nothing to legislate strains and sprains out of our Workers\u2019 Compensation Law. It left the hernia statute unchanged regarding the requirement that pain be shown to establish compensability. It expressly declared pain to be an impermissible factor only for determining impairment. At Ark. Code Ann. \u00a7 ll-9-704(c)(3), the General Assembly directed that administrative law judges, the Commission, \u201cand any (sic) revieudng courts shall construe the provisions of this chapter stricdy.\u201d (emphasis added). Moreover, at \u00a7 11-9-1001 the General Assembly served notice to the Commission and the courts that any changes to the Workers\u2019 Compensation Law were its exclusive business, by the following unmistakable language:\nWhen, and if, the workers\u2019 compensation statutes of this state need to be changed, the General Assembly acknowledges its responsibility to do so. It is the specific intent of the Seventy-Ninth General Assembly to repeal, annul, and hold for naught all prior opinions or decisions of any administrative law judge, the Workers\u2019 Compensation Commission, or courts of this state contrary to or in conflict with any provision in this act. In the future, if such things as the .. . extent to which any physical condition, injury, or disease should be excluded from or added to coverage by the law, or the scope of the workers\u2019 compensation statutes need to be liberalized, broadened, or narrowed, those things shall be addressed by the General Assembly and should not be done by administrative law judges, the Workers\u2019 Compensation Commission, or the courts.\nTherefore, to conclude that Britain\u2019s strain was somehow unproven requires that one dismiss the opinion of every doctor that treated her injury. It further requires us to judicially legislate pain out of the permitted factors that may be considered when compensability determinations are made and legislate back strains out of the medical conditions covered by the Workers\u2019 Compensation Law, despite the fact that the General Assembly has flatly declared that it alone will decide if \u201cany physical condition, injury, or disease should be excluded from\u201d coverage under the Workers\u2019 Compensation Law.\nWe also find the employer\u2019s argument concerning its liability for Britain\u2019s medical treatments and their cost to be fundamentally flawed. Ark. Code Ann. \u00a7 ll-9-508(a) (1996) requires that an employer promptly provide for an injured employee such medical, surgical, hospital, chiropractic, and other medical treatment as may be reasonably necessary in connection with an injury received by the employee. Neither that statute nor anything else in the Workers\u2019 Compensation Law obligates an employer to provide and pay for treatment for conditions that are not ultimately found to be com-pensable. Workers\u2019 compensation is a scheme of social legislation aimed at protecting employees from the disabling consequences and financial costs of injuries that are work-related. The Seventy-Ninth General Assembly made this point plain at Section 35 of Act 796, codified as Ark. Code Ann. \u00a7 11-9-1001 (Repl. 1996), which includes the following pertinent observation:\nThe Seventy-Ninth General Assembly realizes that the Arkansas workers\u2019 compensation statutes must be revised and amended from time to time. Unfortunately, many of the changes made by this act were necessary because administrative law judges, the Workers\u2019 Compensation Commission, and the Arkansas courts have continually broadened the scope and eroded the purpose of the workers\u2019 compensation statutes of this state. The Seventy-Ninth General Assembly intends to restate that the major and controlling purpose of workers\u2019 compensation is to pay timely temporary and permanent disability benefits to all legitimately injured workers that suffer an injury or disease arising out of and in the course of their employment, to pay reasonable and necessary medical expenses resulting therefrom, and then to return the worker to the workforce .... (emphasis added).\nIn view of this plain expression of legislative intent that workers\u2019 compensation benefits are intended to pay the cost of reasonable and necessary medical expenses that result from injuries and diseases arising out of and in the course of the employment, we cannot read the statutory duty imposed by \u00a7 11-9-508(a) to mean that the obligation to provide prompt and reasonably necessary services and treatment for a compensable injury does not include liability for the cost of the services and treatment. If workers\u2019 compensation benefits are intended to provide payment for injuries arising out of and in the course of the employment, including the cost of reasonable and necessary medical expenses associated with those injuries, then the statutory duty imposed by that section of the workers\u2019 compensation law simply means that an employer has a duty to provide and is liable to pay the cost of reasonable and necessary medical expenses associated with work-related injuries. The appellants here have made no claim that the medical expenses were not reasonable and necessary. The idea that the General Assembly intended by the workers\u2019 compensation scheme to impose the cost of medical care and treatment upon an employer for an injury that does not arise out of and occur in the course of the employment where the employer has disputed the injury is beyond rational belief, in addition to being contrary to the explicit declaration of legislative intent that accompanied Act 796.\nAny lingering doubt about this issue is resolved by reference to Ark. Code Ann. \u00a7 11-9-510 (Repl. 1996) which states that the employer \u201cshall not be liable for any of the payments provided for in \u00a7\u00a7 11-9-508 \u2014 11-9-516 in the case of a contest of liability where the Markers\u2019 Compensation Commission shall decide that the injury does not come within the provisions of the Workers Compensation Law.\u201d (emphasis added). Likewise, it is illogical to conclude that a worker who suffers a compensable injury, as we believe Britain did, should be forced to pay the cost of her treatment when her employer knows that the injury was work-related and has directed her to obtain the very treatment for which it refuses to pay.\nAccordingly, we find no support for the argument advanced by Southern Hospitalities that authorizing medical services for a compensable injury does not make an employer liable for their costs. If Britain did not sustain a compensable injury then Southern Hospitalities was not liable for the cost of her treatment. Ark. Code Ann. \u00a7 11-9-510. (Repl. 1996). However, where Southern Hospi-talities authorized the treatment for an injury it initially considered compensable, it also made itself liable for its cost. An employer may authorize treatment and be liable for its cost even when it has not determined an injury to be compensable, as when it is trying to investigate whether a condition may have originated from or been caused by a workplace hazard or condition. As the prevailing opinion indicates, an employer may be estopped to deny liability when it has engaged in a course of conduct that is inconsistent with an attempt to avoid or deny liability for the cost of medical care and treatment. We believe, however, that compensability here has been conclusively established so that the employer should be held liable for all reasonable and necessary medical expenses without resort to the estoppel principle embraced by the prevailing opinion.\nIt necessarily follows from our conclusion that Britain suffered a compensable injury that the Commission\u2019s decision denying her claim for temporary total disability benefits should be reversed because it is not supported by substantial evidence. As we observed in our analysis of the medical benefits issue, all of the evidence conclusively demonstrates that Britain\u2019s back strain occurred from her effort of pulling towels from a washer on her job on July 3, 1993. The evidence shows that she was unable to work from July 22 to August 12, 1993, because of the back strain. There is no evidence showing that her incapacity from working occurred due to any other reason.\nWe are unable to conclude that fair-minded persons faced with this conclusive body of proof could decide that Britain\u2019s incapacity to work from July 22 to August 12, 1993, was not caused by her July 3, 1993, back strain that arose out of and occurred in the course of her employment by Southern Hospitalities. Therefore, we would reverse the Commission\u2019s decision denying her claim for temporary total disability benefits for that period of time, and would remand the case to the Commission to award the benefits appellee is rightfully due.\nWe recognize that the changes to the Workers\u2019 Compensation Law that were enacted as Act 796 of 1993 were intended to narrow what some observers considered overly broad interpretations of the law, that the law is to be construed strictly, and that Ark. Code Ann. \u00a7 11-9-1001 specifies that any alteration of the scope of the law shall be addressed by the General Assembly rather than the courts or the Commission. Our decision today is fully consistent with that legislative intent. Britain\u2019s back strain is a compensable injury because there is clear and conclusive proof that it arose out of and occurred in the course of her employment, required medical services, and resulted in disability. Our conclusion on that point is based upon the undisputed medical proof of her condition, and the total absence of any proof that her medical findings came under her voluntary control.\nAccording to the 1993 Survey of Nonfatal Occupational Injuries and Illnesses published by the Arkansas Department of Labor, sprain and strain was, by far, the leading injury and illness category in every major industry division in Arkansas. The survey also reported that the back and other portions of the trunk were the major parts of the body affected, with sprains accounting for nearly a fourth of the survey case total. Sprains and strains may rely, perhaps more than other maladies, on a claimant\u2019s assertion of pain, but we refuse to judicially eliminate pain as a consideration for determining compensability when the Arkansas General Assembly has not done so. In fact, the General Assembly has blundy declared that the courts shall not exclude any physical condition from coverage (i.e. compensability) under the Workers\u2019 Compensation Law because it has reserved the task of narrowing or broadening coverage to itself. See Ark. Code Ann. \u00a7 11-9-1001 (Repl. 1996). We find no justification for concluding that the General Assembly intended to exclude back strains from being covered by the Workers\u2019 Compensation Law.\nIf the proof presented for sprain and strain injuries is conflicting, the substantial evidence standard of review will result in the Commission\u2019s decisions in those cases being affirmed. Where, as here, the proof concerning a sprain or strain is undisputed and unequivocal, we are convinced that a compensable injury has been established entitling the affected worker to the benefits allowed by the Workers\u2019 Compensation Law.\nWe concur in the result affirming the award of the medical benefits, and dissent from the decision holding appellee\u2019s injury noncompensable.\nI am authorized to state that MAYFIELD, J., agrees with this opinion.", "type": "concurrence", "author": "WENDELL L. Griffen, Judge," } ], "attorneys": [ "Frye & Boyce, BA., by: Mary A. Jones, for appellants.", "Lane, Muse, Arman & Pullen, by: Donald C. Pullen, for appellee." ], "corrections": "", "head_matter": "SOUTHERN HOSPITALITIES d/b/a Quality Inn, et al. v. Lorie BRITAIN\nCA 95-710\n925 S.W.2d 810\nCourt of Appeals of Arkansas En Banc\nOpinion delivered July 3, 1996\nFrye & Boyce, BA., by: Mary A. Jones, for appellants.\nLane, Muse, Arman & Pullen, by: Donald C. Pullen, for appellee." }, "file_name": "0318-01", "first_page_order": 344, "last_page_order": 361 }