{ "id": 6142449, "name": "HERITAGE BAPTIST TEMPLE and Utica National Insurance Company v. Tammy ROBISON", "name_abbreviation": "Heritage Baptist Temple v. Robison", "decision_date": "2003-06-18", "docket_number": "CA 03-61", "first_page": "460", "last_page": "465", "citations": [ { "type": "official", "cite": "82 Ark. App. 460" }, { "type": "parallel", "cite": "120 S.W.3d 150" } ], "court": { "name_abbreviation": "Ark. Ct. App.", "id": 13370, "name": "Arkansas Court of Appeals" }, "jurisdiction": { "id": 34, "name_long": "Arkansas", "name": "Ark." }, "cites_to": [ { "cite": "Ark. Code Ann. \u00a7 11-9-102", "category": "laws:leg_statute", "reporter": "Ark. Code Ann.", "pin_cites": [ { "page": "(16)", "parenthetical": "A" } ], "opinion_index": 0 }, { "cite": "Ark. Code Ann. \u00a7 11-9", "category": "laws:leg_statute", "reporter": "Ark. Code Ann.", "opinion_index": 0 }, { "cite": "54 Ark. App. 141", "category": "reporters:state", "reporter": "Ark. App.", "case_ids": [ 6138574 ], "weight": 2, "year": 1996, "opinion_index": 0, "case_paths": [ "/ark-app/54/0141-01" ] }, { "cite": "69 Ark. App. 128", "category": "reporters:state", "reporter": "Ark. App.", "case_ids": [ 6138634 ], "weight": 2, "year": 2000, "opinion_index": 0, "case_paths": [ "/ark-app/69/0128-01" ] }, { "cite": "68 Ark. App. 24", "category": "reporters:state", "reporter": "Ark. App.", "case_ids": [ 6136393 ], "weight": 2, "year": 1999, "opinion_index": 0, "case_paths": [ "/ark-app/68/0024-01" ] }, { "cite": "302 Ark. 69", "category": "reporters:state", "reporter": "Ark.", "case_ids": [ 1884308 ], "weight": 2, "year": 1990, "pin_cites": [ { "page": "73" }, { "page": "666" } ], "opinion_index": 0, "case_paths": [ "/ark/302/0069-01" ] }, { "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": "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" ] } ], "analysis": { "cardinality": 554, "char_count": 10099, "ocr_confidence": 0.748, "pagerank": { "raw": 3.093384690657092e-07, "percentile": 0.8587950494411064 }, "sha256": "7e92ddc85b2f4f91a99b6b7a859ffe3b2393ab1621c2c2bbd1f6de8f135fe8b0", "simhash": "1:16653a4457df336e", "word_count": 1640 }, "last_updated": "2023-07-14T22:49:45.234835+00:00", "provenance": { "date_added": "2019-08-29", "source": "Harvard", "batch": "2018" }, "casebody": { "judges": [ "Neal and Crabtree, JJ., agree." ], "parties": [ "HERITAGE BAPTIST TEMPLE and Utica National Insurance Company v. Tammy ROBISON" ], "opinions": [ { "text": "John F. Stroud, Jr., Chief Judge.\nAppellants, Heritage Baptist Temple and Utica National Insurance Company, appeal the Workers\u2019 Compensation Commission\u2019s grant of benefits to appellee, Tammy Robison. On appeal, they contend that the Commission\u2019s determination that appellee sustained a compensable aggravation of her preexisting condition is not supported by substantial evidence. We affirm the Commission\u2019s decision.\nRobison, a nursery worker in appellant Heritage Baptist Temple\u2019s day-care center, suffered an admittedly compensable injury on March 7, 2000, when she crawled under a baby bed to retrieve an object for a child. Robison testified that when she stood up, she had a lot of pain in her hip and down her leg. Although she mentioned it to her supervisor at the time, Robison said that she did not think it was serious, and she did not seek medical treatment until almost two weeks later. On March 20, 2000, Robison saw Dr. Michael Sung, reporting pain in her right hip and leg, neck, and left shoulder. Dr. Sung treated Robison with medication, ordered x-rays, and scheduled an MRI. At follow-up visits on March 31 and April 4, Dr. Sung\u2019s notes indicate that Robison was still having lower back pain; he then referred her to Dr. Blankenship, an orthopedic physician. Robison saw Dr. Blankenship on April 7 and reported that she crawled under a crib and \u201ctwisted\u201d her lower back. She also reported pain in her lower extremities. Upon examination, Dr. Blankenship diagnosed Rob-ison with \u201cacute lower back pain with tight lower extremity radiculopathy, possibly on a discogenic basis.\u201d\nThe MRI performed on April 12 was normal. Robison returned to Dr. Blankenship on April 13, and he ordered a triple-phase bone scan, which was performed on April 19. The bone scan found increased activity at the level of the anterior-superior iliac spine on the right, with increased uptake at the level of the right anterior-superior iliac spine. The bone-scan report from the radiographer stated that an avulsion injury of the sartorius was suspected. Robison returned to Dr. Blankenship on April 26, and he recommended an MRI of the right hip and right anterior-superior iliac crest area in light of the bone-scan findings. The second \u25a0 MRI, performed on April 28, found abnormal signal intensity within the anterior-superior margin of the right iliac bone involving the anterior-superior iliac spine. The report stated that the findings were worrisome for an intrinsic lesion near the anterior-superior iliac spine and recommended a CT scan of this region.\nA CT scan of the pelvis/right hip was performed on May 12. This scan revealed a lytic lesion within the anterior aspect of the right iliac crest. Robison returned to Dr. Blankenship on May 15 with some slight tenderness in the anterior superior iliac spine area. In light of the results of the CT scan, Dr. Blankenship referred her to Dr. Berry Thompson, who examined her that same day. After examination and review of the medical reports, Dr. Thompson\u2019s impression was that the lytic lesion probably represented an enchondroma in the area of the anterior-superior iliac spine. In his letter of May 15, Dr. Thompson stated:\nThe increased uptake on the bone scan would suggest that she fractured into it at the time of her on the job injury. I believe that it does need excision by curettage for treatment and to confirm the diagnosis. It is my opinion that while the underlying lesion is not directly related to her on the job injury, the fracture into it is and this represents a pre-existing condition with an aggravation at work. The aggravation accounting [sic] for more than 50 percent of the problem and thus does qualify under workers\u2019 compensation laws to be covered.\nDr. Thompson performed surgery on Robison on July 31, 2000, and the biopsy revealed a benign bone tumor, a fibrous dys-plasia, instead of a fracture. However, in his deposition testimony, Dr. Thompson stated that there had been ample time for a fracture to have healed. Although he did not see evidence of a healed fracture at the time of the surgery, he stated that the surgical findings did not change his opinion that the tumor was made symptomatic by Robison\u2019s work-related incident. He said that he would not expect a fibrous dysplasia to become symptomatic without some trauma.\nDr. Bruce Safman, an independent consultant, reviewed Robi-son\u2019s medical records and came to the conclusion that there was no supporting evidence in the medical records that any pathology to the anterior portion of the iliac crest occurred at the time of Robi-son\u2019s injury. However, upon review of Dr. Sung\u2019s notes, Dr. Safman conceded that he was unable to state whether Robison\u2019s condition was caused by the admittedly compensable injury:\nBased on the lack of information in the notes, I have no basis on which to determine whether of not there was any iliac crest pain initially. It is not known whether Dr. Sung\u2019s reference to right \u201chip\u201d pain referred to the iliac crest or not. Thus, I believe that we will have to accept the patient\u2019s verbalization that her symptoms are related to her initial injury, as there is no good documentation regarding the specific localization of her pain no [sic] the findings on her initial examinations between March 20th and April 4, 2000.\nOur standard of review in workers\u2019 compensation cases is well-settled. We view the evidence and all reasonable inferences deducible therefrom in the light most favorable to the Commission\u2019s findings and affirm the decision if it is supported by substantial evidence. Geo Specialty Chem. v. Clingan, 69 Ark. App. 369, 13 S.W.3d 218 (2000). Substantial evidence is such relevant evidence as a reasonable mind might accept as adequate to support 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, supra.\n\u201cIn workers\u2019 compensation law, an employer \u2018takes the employee as he finds him,\u2019 and employment circumstances which aggravate pre-existing conditions are compensable.\u201d Nashville Livestock Comm\u2019n v. Cox, 302 Ark. 69, 73, 787 S.W.2d 664, 666 (1990). An aggravation of a preexisting noncompensable condition by a compensable injury is, itself, compensable. Oliver v. Guardsmark, Inc., 68 Ark. App. 24, 3 S.W.3d 336 (1999). An aggravation is a new injury resulting from an independent incident. Maverick Transp. v. Buzzard, 69 Ark. App. 128, 10 S.W.3d 467 (2000). An aggravation, being a new injury with an independent cause, must meet the definition of a compensable injury in order to establish compensability for the aggravation. Farmland Ins. Co. v. DuBois, 54 Ark. App. 141, 923 S.W.2d 883 (1996).\nArkansas Code Annotated section 11-9-102(4) (A) (i) (Supp. 1999) defines \u201ccompensable injury\u201d as\nAn 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.\nA compensable injury must be established by medical evidence supported by \u201cobjective findings.\u201d Ark. Code Ann. \u00a7 11-9\u2014 102(4)(D). \u201cObjective findings\u201d are those findings which cannot come under the voluntary control of the patient. Ark. Code Ann. \u00a7 11-9-102(16) (A) (i).\nAppellants argue that in the present case, no medical evidence of an injury was presented in connection with the bone tumor. In support of their contention, they point to the deposition testimony of Dr. Thompson, who testified that such lesions become symptomatic when aggravated by a fracture or muscle loosened from the bone; however, he also testified that when he performed the surgery, he saw no evidence of a fracture or a healed fracture, or of torn or loosened muscle. They contend that Dr. Thompson\u2019s opinion that there was an injury was simply speculation and conjecture because he found no' evidence of an injury while performing the surgery and because the surgery did nothing to repair any injury, but instead only removed the preexisting tumor.\nAppellants also contend that the speculation of an injury stemmed from a positive bone scan, which Dr. Thompson testified usually indicated an injury. Appellants categorize the bone-scan results in this case as only indicating the lesion because no injury was seen by Dr. Thompson when he performed the surgery.\nWe disagree with appellants\u2019 contentions. Dr. Thompson testified in his deposition that the bone lesion was not the only objective finding, that there was a positive bone scan that he described as \u201chot,\u201d which showed an increased uptake; he stated that such a bone scan \u201csuggested that if that was the major factor, that suggested it was an acute injury.\u201d Based upon this positive bone scan, Dr. Thompson determined that Robison needed surgery, and the surgery revealed that the bone tumor was benign. The positive bone scan is an objective medical finding of injury that was out of Robison\u2019s control, and it formed the basis for the recommendation of surgery. Furthermore, Dr. Thompson also testified that although he did not find evidence of a fracture or a healed fracture at the time he performed Robison\u2019s surgery, the surgical findings did not change his opinion that the bone tumor was made symptomatic by the work-related incident. We hold that substantial evidence exists to support the Commission\u2019s determination that Robison sustained an aggravation of her preexisting condition. Therefore, we affirm the award of benefits to Robison.\nAffirmed.\nNeal and Crabtree, JJ., agree.", "type": "majority", "author": "John F. Stroud, Jr., Chief Judge." } ], "attorneys": [ "Friday, Eldredge & Clark, by: Betty J. Demory and Amanda Capps Ross, for appellant.", "Gary Davis, for appellee." ], "corrections": "", "head_matter": "HERITAGE BAPTIST TEMPLE and Utica National Insurance Company v. Tammy ROBISON\nCA 03-61\n120 S.W.3d 150\nCourt of Appeals of Arkansas Division III\nOpinion delivered June 18, 2003\nFriday, Eldredge & Clark, by: Betty J. Demory and Amanda Capps Ross, for appellant.\nGary Davis, for appellee." }, "file_name": "0460-01", "first_page_order": 480, "last_page_order": 485 }