Opinion
CLAIM NO. E508954
OPINION JUNE 11, 1997
Upon review before the FULL COMMISSION in Little Rock, Pulaski County, Arkansas.
Claimant represented by the HONORABLE JAMES N. MILLER, Attorney at Law, Forrest City, Arkansas.
Respondents represented by the HONORABLE BILL H. WALMSLEY, Attorney at Law, Batesville, Arkansas.
Decision of Administrative Law Judge: Affirmed.
OPINION AND ORDER
The claimant appeals an administrative law judge's order and opinion filed January 23, 1997. The administrative law judge found that claimant failed to prove that additional medical expenses incurred after August, 1995 are reasonable, necessary, and related to the compensable injury. In addition, the administrative law judge found that the claimant failed to prove that a change of physician or an independent medical examination is reasonable and necessary. After reviewing the entire record de novo, we affirm the order and opinion of the Administrative Law Judge.
On May 4, 1995, the instant claimant sustained a thoracic strain, which the respondents accepted as compensable. Dr. Zini and Dr. Earl Peeples treated the claimant conservatively. After medication, physical therapy, and treatment with a TENS unit, Dr. Peeples released the claimant to return to work on July 27, 1995. He restricted her to light duty, no lifting. In an Attending Physician's Report dated August 7, 1995, however, Dr. Zini found that the claimant was totally incapacitated. Dr. Zini acknowledged that the claimant wished to request a physician of her own choosing. The doctor recommended that the claimant see a psychiatrist. The claimant testified that she received no benefit from the treatment provided. The record contains no written work release following Dr. Zini's August, 1995 report. The claimant repeatedly testified, nevertheless, that Dr. Zini released her to light duty on or about August 21, 1995. Dr. Peeples entered the following report on October 18, 1995:
I have reviewed my file on Mary Roberts and have received the MMPI results which do not provide any additional helpful information. I did not find evidence of major physical abnormality that would cause me to rate the patient as having permanent impairment of function and I do not recommend orthopedic surgical treatment for intervention. If I can be or further help, please let me know.
The claimant testified that her physical condition since the injury has not improved. According to the claimant, she can lift very little and can do very little housework. She stated that she went back to the doctor in October, 1995, because she was still hurting. The claimant testified that she experiences pain "across my bra line and up in the muscle area." According to the claimant, on a scale of one to ten, her pain level is "about a eight" and worsens with activity.
The claimant first presented to Dr. Thrash, a chiropractor, following her previous treatment and release. Dr. Thrash treated the claimant approximately 85 times over the period of one year, but the claimant testified that she did not benefit from this treatment. Dr. Thrash also referred the claimant to Drs. Goodman, Traylor, and Olinger. A MRI taken revealed no abnormalities, except for preexisting degenerative disc disease. Dr. Olinger prescribed additional TENS unit therapy, to no avail.
The claimant asserted that the respondents should pay the medical expenses for the chiropractor and associated referrals. The administrative law judge disagreed, finding that the claimant failed to prove that the additional medical expenses incurred after August, 1995, were reasonable and related to the compensable injury. We find that the claimant has failed to prove that her prior chiropractic and associated treatment was reasonably necessary for treatment of her thoracic strain. In this regard, the record establishes Dr. Zini and Dr. Peeples provided extensive conservative treatment, which the claimant indicated did not benefit her condition. Two months after Dr. Zini's release, the claimant initiated a plethora of visits to a chiropractor who referred the claimant to two other physicians. Again, the claimant testified that this additional treatment did not benefit her or otherwise improve her condition. There are no objective findings of any ongoing injury and no finding of work-related impairment. Based on the evidence presented, we find that the claimant failed to establish that any of the treatment that she initiated after August of 1995 was reasonably necessary for treatment of her work-related injury.
Ark. Code Ann. § 11-9-514 (Repl. 1996) establishes the procedures which must be followed if the injured employee later desires to change physicians, and, except for emergency treatment, the employer is not liable unless the claimant follows this procedure. With regard to this procedure, Ark. Code Ann. § 11-9-514 provides the following:
(a)(1) If the employee selects a physician, the commission shall not authorize a change of physician unless the employee first establishes to the satisfaction of the commission that there is a compelling reason or circumstance justifying a change.
(2) If the employer selects a physician, the claimant may petition the Commission one (1) time only for a change of physician and if the Commission approves the change, with or without a hearing, the Commission shall determine the second physician and shall not be bound by the recommendation of claimant or respondent.
(B) However, if the change desired by the claimant is to a chiropractic physician, optometrist, or podiatrist, the claimant may make the change by giving advance written notification to the employer or carrier.
In a document dated October 25, 1995, the claimant provided written notice to her employer of her desire to change from Dr. Zinn to Dr. Thrash. CoreSource, the carrier, denied the request for change, in correspondence dated November 21, 1995. In Alexander v. Lee Way Motor Freight, 15 Ark. App. 41, 689 S.W.2d 3 (1985), the Court of Appeals held that the claimant's right to seek treatment from a chiropractor is not unconditional. She still must prove the treatment is reasonable and necessary and causally related to her compensable injury.
However, based on the evidence in the record, we find that claimant has not proven that any additional chiropractic or medical treatment is reasonably necessary for treatment of her compensable injury. Therefore, we also affirm this portion of the ALJ's order and opinion.
Accordingly, based on our de novo review of the entire record, and for the reasons discussed herein, we find that the claimant failed to prove that additional medical expenses incurred after August, 1995 are reasonable, necessary, and related to the compensable injury. In addition, we find that claimant failed to prove that a change of physician or an independent medical examination is reasonable and necessary. We therefore affirm the opinion and order of the Administrative Law Judge. This claim is denied and dismissed.
IT IS SO ORDERED.
Commissioner Humphrey dissents.