Galaviz, 032918 ARWC, G702924

• Case Date: March 29, 2018
• Court: Kansas

SANTOS GALAVIZ, EMPLOYEE CLAIMANT GERDAN SLIPFORMING INC., EMPLOYER RESPONDENT ARKANSAS P & C GUARANTY FUND, INSURANCE CARRIER RESPONDENT No. G702924 Arkansas Workers Compensation Before the Arkansas Workers' Compensation Commission March 29, 2018          Hearing before ADMINISTRATIVE LAW JUDGE AMY GRIMES, in Springdale, Washington County, Arkansas.           Claimant represented by NEAL L. HART, Attorney, Little Rock, Arkansas.           Respondents represented by MICHAEL E. RYBURN, Attorney, Little Rock, Arkansas.           AMY GRIMES, ADMINISTRATIVE LAW JUDGE.          STATEMENT OF THE CASE          On March 8, 2018, the above captioned claim came before the Workers’ Compensation Commission in Springdale, Arkansas, for a hearing. A pre hearing conference was conducted on October 31, 2017, and a pre hearing order filed that same date. A copy of the pre hearing order has been marked as Commission’s Exhibit No. 1 and with modification and no objection is made part of the record.          The parties agreed to the following stipulations:

1. The Arkansas Workers' Compensation Commission has jurisdiction of this case.

2. The employee/employer/carrier relationship existed on April 6, 2017.

3. The claimant sustained a compensable injury on April 6, 2017 to his cervical and lumbar spine.

4. The compensation rates are the maximum.

5. The claimant was released to return to work on June 26, 2017 without a rating.

         The issues to be litigated are limited to the following:

1. Whether the claimant is entitled to additional medical treatment.

2. Whether the claimant is entitled to temporary total disability benefits.

3. Attorney fees.

         The claimant contends that “Claimant suffered an admittedly compensable work injury on April 6, 2017, when he fell off a wall and landed on his back. He was treated initially by the company physician, Dr. David Sites, without any real improvement in his physical condition. Claimant needed to see a spine specialist, so respondents sent him for an IME with Dr. Marcus Heim. Dr. Heim apparently (as confirmed by his office) treats a multitude of orthopedic problems, but not backs or necks. The IME was conducted at ‘LaVida Massage and MedSpa.’ Dr. Heim subsequently issued an IME report confirming that claimant had sustained a compensable work injury, but he offered no recommendations for additional medical care. Prior to the IME report being issued, a ‘Steven Johnson, PA’ faxed the IME report draft to the adjuster handling this case, Kim Jackson, along with a note that reads: ‘Please review the attached IME draft and make any recommendations or suggested edits. Thank you. Steven Johnson.’ Claimant contends that this may signal an element of collusion designed to defeat this claim, and further contends that Dr. Heim’s IME report should, for the reasons outlined above and others, be given little or no evidentiary weight. Following a physician change through the Commission, claimant sought treatment from Dr. James Blankenship, a neurosurgeon. Dr. Blankenship prescribed medications and physical therapy, and also took claimant off work until at least November 2, 2017. Respondents last paid temporary total disability benefits on or about June 30, 2017. They have controverted Dr. Blankenship’s medical care. Claimant respectfully asks for an award of medical care as recommended by Dr. Blankenship, and also requests an award of temporary total disability benefits from the date last paid, through a date to be determined. A statutory attorney’s fee should attach to all controverted indemnity benefits in the claim. Claimant respectfully reserves the right to amend and/or alter the above contentions as discovery progresses. All other potential issues are expressly reserved for litigation at a later date.”          The respondents contend that “The claimant allegedly injured his back and neck. The MRI revealed only degenerative changes that were not caused by the injury. He has been released to full duty as of June 26, 2017 with no permanent partial disability. Temporary total disability was paid through the date of maximum medical improvement. Further medical treatment is not reasonable or necessary and the healing period has ended.”          The above stipulations are hereby accepted as fact. From a review of the record as a whole to include medical reports, documents, and having heard testimony and observed demeanor of all witnesses, the following decision is rendered. The claimant has failed to prove by a preponderance of the evidence that he is entitled to additional medical treatment as requested. Claimant has likewise failed to prove by a preponderance of the evidence that he is entitled to additional temporary total disability benefits.          FACTUAL BACKGROUND          The claimant in this matter is a 41-year-old male who lives with his cousin in Springdale. He began working for the respondent in 2017 as a concrete finisher. The claimant stated that prior to his April 2017 injury he was able to fulfill his job duties for the respondent. The claimant testified that on April 6, 2017, he fell from a wall onto his back. He added that he suffered pain in his back and neck and was dizzy after the fall. The claimant continued that after the fall he was sent for medical treatment by the respondents. The claimant was treated by Dr. Sitzes. He was given medicine, a neck brace and cane, and physical therapy. The claimant stated that he continues to use the cane. The claimant testified that he was improving with treatment from Dr. Sitzes, but began to have additional neck and back pain. He stated he was given a shot and pills, but received no further treatment because the insurance company would no longer pay for the treatment. Dr. Sitzes’ medical records are in evidence. They begin with a date of April 6, 2017, the date of claimant’s injury. Initially, Dr. Sitzes notes that the claimant fell at work and suffered low back and neck...