{ "id": 6140536, "name": "Willie COLLINS v. LENNOX INDUSTRIES, INC.; American Motorist Insurance Company", "name_abbreviation": "Collins v. Lennox Industries, Inc.", "decision_date": "2002-05-08", "docket_number": "CA 01-1109", "first_page": "303", "last_page": "309", "citations": [ { "type": "official", "cite": "77 Ark. App. 303" }, { "type": "parallel", "cite": "75 S.W.3d 204" } ], "court": { "name_abbreviation": "Ark. Ct. App.", "id": 13370, "name": "Arkansas Court of Appeals" }, "jurisdiction": { "id": 34, "name_long": "Arkansas", "name": "Ark." }, "cites_to": [ { "cite": "12 Ark. App. 358", "category": "reporters:state", "reporter": "Ark. App.", "case_ids": [ 6142833 ], "weight": 2, "year": 1984, "opinion_index": 0, "case_paths": [ "/ark-app/12/0358-01" ] }, { "cite": "72 Ark. App. 158", "category": "reporters:state", "reporter": "Ark. App.", "case_ids": [ 6138419 ], "weight": 2, "year": 2000, "pin_cites": [ { "parenthetical": "requiring claimant to provide a compelling reason or circumstance justifying a change" }, { "parenthetical": "requiring claimant to provide a compelling reason or circumstance justifying a change" } ], "opinion_index": 0, "case_paths": [ "/ark-app/72/0158-01" ] }, { "cite": "55 Ark. App. 226", "category": "reporters:state", "reporter": "Ark. App.", "case_ids": [ 6141246 ], "year": 1996, "opinion_index": 0, "case_paths": [ "/ark-app/55/0226-01" ] }, { "cite": "69 Ark.App. 369", "category": "reporters:state", "reporter": "Ark. App.", "case_ids": [ 6142164 ], "weight": 2, "year": 2000, "opinion_index": 0, "case_paths": [ "/ark-app/69/0369-01" ] }, { "cite": "69 Ark.App. 162", "category": "reporters:state", "reporter": "Ark. App.", "case_ids": [ 6139177 ], "weight": 2, "year": 2000, "opinion_index": 0, "case_paths": [ "/ark-app/69/0162-01" ] }, { "cite": "72 Ark. App. 7", "category": "reporters:state", "reporter": "Ark. App.", "case_ids": [ 6136202 ], "weight": 2, "year": 2000, "opinion_index": 0, "case_paths": [ "/ark-app/72/0007-01" ] }, { "cite": "72 Ark. App. 450", "category": "reporters:state", "reporter": "Ark. App.", "case_ids": [ 6142248 ], "weight": 2, "year": 2001, "opinion_index": 0, "case_paths": [ "/ark-app/72/0450-01" ] }, { "cite": "Ark. Code Ann. \u00a7 11-9-711", "category": "laws:leg_statute", "reporter": "Ark. Code Ann.", "year": 2002, "pin_cites": [ { "page": "(b)(4)(d)" } ], "opinion_index": 0 }, { "cite": "Ark. Code Ann. \u00a7 11-9-508", "category": "laws:leg_statute", "reporter": "Ark. Code Ann.", "weight": 3, "year": 2002, "opinion_index": 0 } ], "analysis": { "cardinality": 638, "char_count": 11923, "ocr_confidence": 0.734, "pagerank": { "raw": 1.661697915056443e-07, "percentile": 0.6944265862604345 }, "sha256": "524a1df1f80e913294bec12c45bd8fd51f8d0e5a314d24d412d8edb37683880e", "simhash": "1:2c2ff785179e7aa2", "word_count": 1903 }, "last_updated": "2023-07-14T22:00:28.541561+00:00", "provenance": { "date_added": "2019-08-29", "source": "Harvard", "batch": "2018" }, "casebody": { "judges": [ "Griffen and Vaught, JJ., agree." ], "parties": [ "Willie COLLINS v. LENNOX INDUSTRIES, INC.; American Motorist Insurance Company" ], "opinions": [ { "text": "Karen R. Baker, Judge.\nThis is an appeal from a decision of the Arkansas Workers\u2019 Compensation Commission\u2019s denial of appellant\u2019s request for a change of physician. We hold that the Commission\u2019s finding that the employer had fulfilled the obligation of providing adequate medical treatment, diagnostic testing, and consultation with specialists, under the provisions of Ark. Code Ann. \u00a7 11-9-508 (Repl. 2002), was not supported by substantial evidence. Arkansas Code Annotated section 11-9-514(a)(3)(h) (Repl. 2002) established an absolute, statutory right to a one-time change of physician under the Workers\u2019 Compensation Act where the employer has contracted with a managed-care organization and has exercised the right to select the initial primary-care physician. The employer\u2019s denial of the one-time change of physician as a matter of law fails to fulfill the obligation imposed by section 11-9-508. Accordingly, we reverse.\nFacts\nOn January 4, 2000, appellant (while employed by Lennox Industries) reached for a coil weighing between thirty and fifty pounds that was stacked above his head. As he flipped the coil over to remove it from the stack, he injured his back. The injury was reported in a timely manner, and appellant was sent to Dr. N.B. Daniel.\nDr. Daniel diagnosed appellant with a lumbosacaral strain. Appellant requested and received a referral to an orthopedist (Dr. John Wilson). On January 27, 2000, Dr. Wilson diagnosed appellant with \u201cmild sciatia.\u201d Dr. Wilson also noted that appellant had \u201ctenderness over the right sciatic notch,\u201d and that his straight-leg raising was \u201cmildly positive.\u201d Dr. Wilson released appellant to return to work with no restrictions. On February 16, 2000, appellant returned to Dr. Wilson. After seeing appellant, Dr. Wilson noted:\n[Appellant] was reassured that he does not have operative problems with his back and should attempt to continue his normal activities at work. He wanted an MRI done on his back and, quite frankly, without objective findings or radicular findings, I do not feel the study would be necessary. He seems a bit upset with me because of my position. At any rate, this gendeman has been released to return to his normal activities at work.\nOn February 22, 2000, appellant returned to Dr. Daniel, who reported:\nOn exam today he moves very well. . . My impression still is that he has a lumbosacral strain . . . [Appellant] has it in his mind that neither myself or the specialty physician, that I don\u2019t personally know, don\u2019t care about him and we are limiting services in that we haven\u2019t done a MRI and we haven\u2019t done a myelogram and we are not trying to really find out what is wrong with his back. He doesn\u2019t believe me when I tell him that the likelihood of finding something abnormal on a MRI of his back, or a mye-logram is very small and even if we did find that he has for instance a bulging disc with the degree of symptoms that he has \u2014 nothing would be done therapeutically such as surgery, trigger point injection, epidural steriods, so forth, so forth.\nDespite these two reports, appellant continued to request a MRI, and appellees eventually approved of the diagnostic test. Dr. Wilson performed the test and on March 9, 2000, reported that the findings revealed nothing \u201cof an operative nature.\u201d He also noted that the MRI showed early disc degenerative disease and again released appellant to return to work. On March 22,'2000, appellant presented to Dr. Wilson again. After the visit, Dr. Wilson reported:\nI have advised [appellant] that he does not have an operative problem with his back and that he has some early degenerative disc disease and superimposed lumbosacral strain but certainly nothing that needs surgery and this is something that he should be able to work through. He asked for medication and related that he had been scheduled for a myelogram. When asked the circumstances of who was doing this, he said he was not supposed to tell me. At any rate, I do not suggest a myelogram. His MRI did not reveal anything of an operative nature.\nOn March 27, 2000, appellant returned to Dr. Daniel and was approved for an independent medical examination by Dr. Bruce Safman, which was conducted on April 12, 2000. Dr. Safman\u2019s findings were consistent with Dr. Wilson\u2019s. Additionally, Dr. Safman noted that appellant wanted to tape-record the examination and was not happy with the fact his degenerative changes were not related to the injury. Finally, on May 10, 2000, appellant saw Dr. Wilson again. Dr. Wilson reported \u201cmild restriction of motion of the lumbar spine with tenderness,\u201d \u201cmild spasm,\u201d and \u201cearly degenerative disk disease\u201d and \u201csignificant herniation.\u201d\nOn May 23, 2000, appellant (through counsel) requested a change of physician. The request was denied by appellee. Appel-lee responded that further medical treatment was not reasonable and necessary.\nOn October 4, 2000, the Administrative Law Judge, filed a pre-hearing order stating, in relevant part, \u201cBy agreement of the parties, the issues to be litigated at the hearing are limited to the following: Continuing medical treatment; change of physician; controversion and attorney\u2019s fees. All other issues are reserved.\u201d The parties stipulated that appellant suffered a compensable injury on January 4, 2000, that an employee-employer-carrier relationship existed on that date, that his compensation rate for TTD purposes was $371.00, and that Lennox was associated with a managed-care organization.\nThe ALJ fashioned her opinion around an analysis of \u201cwhether or not additional medical treatment is reasonable, necessary and related to the compensable injury.\u201d Although she did not directly address the change of physician request in her findings, the opening sentence of her March 5, 2001, order states that \u201cA hearing was conducted to determine the claimant\u2019s entitlement to payment of continuing medical treatment, a change of physician, and attorney\u2019s fees.\u201d The ALJ in its finding and conclusions found that the employer had fulfilled the obligation of providing adequate medical treatment, diagnostic testing, and consultation with specialists under the provisions of Ark. Code Ann. \u00a7 11-9-508. Further findings stated as follows:\n1. The Workers\u2019 Compensation Commission has jurisdiction of this claim in which the relationship of employee-employer-carrier existed among the parties on January 4, 2000, at which time the claimant sustained a compensable injury at a compensation rate of $371. Medical expenses and temporary total disability were paid.\n2. The respondents have paid all appropriate benefits and expenses.\n3. The claimant has failed to prove by a preponderance of the credible evidence of record that further medical treatment is reasonable, necessary, or related to the compensable injury.\nThe Full Commission affirmed these findings, and this appeal followed.\nAppellant asserts two points on appeal: (1) Arkansas Code Annotated \u00a7 11-9-514 provides claimant employee an absolute right to a one-time-only change of physician, so long as he has not selected the initial physician, and (2) the Commission, by adopting the decision of the Administrative Law Judge, incorrectly placed a burden of proof upon the claimant employee \u2022 for purposes of deciding the issue of a change-of-physician request.\nOn appeal, we view the evidence and all reasonable inferences deducible therefrom in the light most favorable to the Commission and will affirm the Commission\u2019s decision if it is supported by substantial evidence. See Ark. Code Ann. \u00a7 11-9-711(b)(4)(d) (Repl. 2002); Spencer v. Stone Container Corp., 72 Ark. App. 450, 38 S.W.3d 909 (2001); Superior Indus, v. Thomaston, 72 Ark. App. 7, 32 S.W.3d 52 (2000). Substantial evidence is such relevant evidence as a reasonable mind might accept as adequate to sustain a conclusion. Air Compressor Equip, v. Sword, 69 Ark.App. 162, 11 S.W.3d 1 (2000). The issue is not whether we might have reached a different result or whether the evidence would have supported a contrary finding; if reasonable minds could reach the Commission\u2019s conclusion, we must affirm its decision. Geo Specialty Chem. v. Clingan, 69 Ark.App. 369, 13 S.W.3d 218 (2000).\nOur analysis focuses on the issue of whether an injured employee is entitled as an absolute right to a one-time change of physician. Arkansas Code Annotated section 11-9-514(a)(3)(h) (Repl. 2002) provides a claimant with an absolute one-time right to a change of physician. The language in subsection (a)(3)(h) mandates that \u201cwhere the employer has contracted with a managed care organization certified by the commission, the claimant employee, however, shall be allowed to change physicians by petitioning the commission one (1) time only for a change of physician.\u201d (Emphasis added.) The Commission\u2019s lack of discretion regarding the grant or denial of the employee\u2019s right to a change becomes especially clear when considering the language of \u00a7 11-9-514(a)(1) and (2), which became null and void with the adoption of the managed health-care system in Arkansas. The now inapplicable section included the phrase \u201cif the Commission approves the change,\u201d which allowed the Commission the discretion to approve or disapprove any change of physician. See Torrey v. City of Fort Smith, 55 Ark. App. 226, 934 S.W.2d (1996); Byars Const. Co. v. Byars, 72 Ark. App. 158, 34 S.W.3d 797, (2000) (requiring claimant to provide a compelling reason or circumstance justifying a change).\nAppellee argues that appellant\u2019s request for a change of physician is simply his effort to obtain additional treatment which the Commission found was not warranted upon the facts in this case and the provisions of section 11-9-508. However, even under the former standard where the Commission had discretion in granting a change-of-physician request, the healing period of an employee who had no initial choice of physicians at time of his injury, was of no significance in a proceeding by employee to have change of physician approved by the Commission. See Wright Contracting Co. v. Randall, 12 Ark. App. 358, 676 S.W.2d 750 (1984).\nThe currently applicable subsection, (a)(3), contains no discretionary phrase regarding approval of the change, but simply states that the right to a one-time change \u201cshall be allowed, by petitioning the commission.\u201d Therefore, there is no discretion left to the Commission. The majority of the section deals with \u201chow\u201d the physician for this change will be selected, not \u201cif\u201d the physician will be selected.\nThe only suggestion of any type of discretion available to the Commission in the application of this statute is in the method by which one acquires such a change. The statute orders that one acquires the change by petitioning the Commission. The code section goes on to order that the Commission \u201cshall\u201d expedite the petition for change and that \u201ca request for a hearing on a change of physician by either the employer or the injured employee shall be given preference on the Commission\u2019s docket over all other matters.\u201d (Emphasis added.)\nBecause we find that a one-time change of physician is mandatory, we hold that the Commission\u2019s finding that the employer had fulfilled the obligation of providing adequate medical treatment, diagnostic testing, and consultation with specialists, under the provisions of Ark. Code Ann. \u00a7 11-9-508 was not supported by substantial evidence and accordingly reverse. We do not address appellant\u2019s second argument in light of our reversal on the first issue. Therefore, we reverse and remand with instructions to order a change of physician.\nGriffen and Vaught, JJ., agree.", "type": "majority", "author": "Karen R. Baker, Judge." } ], "attorneys": [ "Baim, Gunti, Mouser, Robinson & Havner, PLC, by: Michael W. Boyd, for appellant.", "Friday, Eldredge & Clark, by: Betty J. Demory, for appellee." ], "corrections": "", "head_matter": "Willie COLLINS v. LENNOX INDUSTRIES, INC.; American Motorist Insurance Company\nCA 01-1109\n75 S.W.3d 204\nCourt of Appeals of Arkansas Division IV\nOpinion delivered May 8, 2002\nBaim, Gunti, Mouser, Robinson & Havner, PLC, by: Michael W. Boyd, for appellant.\nFriday, Eldredge & Clark, by: Betty J. Demory, for appellee." }, "file_name": "0303-01", "first_page_order": 325, "last_page_order": 331 }