Larue, 030717 ARWC, G507894

• Case Date: March 07, 2017
• Court: Kansas

JIMMY LARUE, EMPLOYEE CLAIMANT CITY OF HOT SPRINGS, EMPLOYER RESPONDENT ARKANSAS MUNICIPAL LEAGUE WC TRUST, INSURANCE CARRIER/TPA RESPONDENT CLAIM NO. G507894 Arkansas Workers Compensation Before The Arkansas Workers’ Compensation Commission March 7, 2017          Hearing conducted before ADMINISTRATIVE LAW JUDGE MARK CHURCHWELL, in Hot Springs, Garland County, Arkansas.           The claimant appeared pro se.           The respondent was represented by HONORABLE KATIE BODENHAMER, Attorney at Law, Little Rock, Arkansas.           MARK CHURCHWELL Administrative Law Judge          STATEMENT OF THE CASE          A hearing was held in the above-styled claim on January 27, 2017, in Hot Springs, Arkansas. A Prehearing Order was entered in this case on November 15, 2016. The following stipulations were submitted by the parties either in the Prehearing Order or at the start of the hearing and are hereby accepted:

1. The employer-employee relationship existed on or about October 14, 2015.

2. The claimant earned an average weekly wage of $555.60.

3. The respondents controvert this claim in its entirety.

         By agreement of the parties, the issues to be litigated and resolved at the present time were limited to the following:

1. Compensability of alleged right knee injury.

2. Medical treatment.

3. Temporary total disability benefits from on or about October 14, 2015 through December 20, 2015.

4. Appropriate credit, if any, against temporary total disability liability for sick leave previously received for the same period.

Other payers/liens (PHQ #10 and #11): Health Scope.          The record consists of the January 27, 2017, hearing transcript and the exhibits contained therein.          FINDINGS OF FACT AND CONCLUSIONS OF LAW          1. The employer-employee relationship existed on or about October 14, 2015.          2. The claimant earned an average weekly wage of $555.60.          3. The respondents controvert this claim in its entirety.          4. The claimant established by a preponderance of the evidence that he sustained a compensable accidental injury to his right knee on October 14, 2015.          5. The claimant has established by a preponderance of the evidence that he was temporarily totally disabled from October 16, 2015, through December 20, 2016.          6. The claimant has established by a preponderance of the evidence that all of the medical treatment documented in the hearing record has been reasonably necessary to treat his compensable knee injury; however, the respondents are entitled to the appropriate offset under Arkansas Code Annotated section 11-9-411(a) for those medical benefits which were previous paid by Health Scope.          7. The respondents are not entitled under Arkansas Code Annotated section 11-9-807(b) to reduce the claimant's compensation for temporary disability compensation by any of the sick leave and PTO benefits that he has received because sick leave and PTO benefits are not a wage as defined by the Arkansas Workers' Compensation Law.          DISCUSSION          The claimant, Jimmy LaRue, became employed by the City of Hot Springs (hereinafter "the City") in 1999. (T. 7) Mr. LaRue drives a leaf and mulch recycle truck for the City. The truck requires Mr. LaRue to step down to exit the vehicle, and the crews are in and out of the vehicle in order to collect bags of leaves at residences. (T. 7-8)          On Thursday, October 15, 2015, at approximately 11:30 a.m., Mr. LaRue presented to the IMWell Health Clinic with right knee pain that had reportedly started at work the day before. (R. Exh. 1 p. 4) The IMWell Health Clinic is available to the City's employees through a contract for treatment of injuries and illnesses using the City's insurance plan. (T. 37) However, after examining Mr. LaRue, Erin Holleman, APN, concluded that Mr. LaRue had obviously injured his knee and should proceed with a Workers' Compensation claim. According to her report, Mr. LaRue agreed with this plan. (R. Exh. 1 p. 5)          That same day, October 15, 2015, Mr. LaRue completed a Form N and was sent to the CHI St. Vincent Hot Springs clinic where Mark Larey, DO, prescribed medications and restrictions and proposed an MRI for Mr. LaRue's knee. (R. Exh. 1 p. 8) CHI St. Vincent Hot Springs is the City's workers' compensation facility for its injured workers. (T. 39)           However, at some point after October 15, 2015, but before his MRI, Mr. LaRue was advised that workers' compensation was denying his claim for an alleged work related knee injury. (T.14) Mr. LaRue therefore used private insurance to undergo an MRI and surgery for his diagnosed medial meniscus tear. (R. Exh. 1 p. 14-15) In the present claim, Mr. LaRue contends that his doctors all agree that the medial meniscus tear was work related, and the respondents should be liable for his medical treatment and benefits for temporary disability. (Comm. Exh. 1 p. 2) The respondents contend that Mr. LaRue cannot establish the cause of his knee injury, cannot define a specific incident that caused his knee injury, and cannot identify the time and place of occurrence of his injury. (Comm. Exh. 1 p. 3)          Issue 1: Compensability          To prove the occurrence of a compensable injury as a result of a specific incident which is identifiable by time and place of occurrence, the claimant must establish by a preponderance of the evidence: (1) that an injury occurred arising out of and in the scope of employment; (2) that the injury caused internal or external harm to the body which required medical services or resulted in disability or death; (3) that the injury is established by medical evidence supported by objective findings, as defined in Ark. Code Ann. § 11-9-102(16); and (4) that the injury was caused by a specific incident and is identifiable by time and place of occurrence. Mikel v. Engineered Specialty Plastics, 56 Ark.App. 126, 938 S.W.2d 876 (1997).          In the present case, I find for the following reasons that the claimant has established each of these requirements by a preponderance of the evidence.          A. Arising Out Of And In The Scope Of Employment.          First, Mr. LaRue contends that his medial meniscus tear injury occurred on the morning of October 14, 2014. Both Mr. LaRue's hearing testimony and the Employee's Report Of Injury that he completed on October 15, 2014, each indicate that he went on his normal work route the morning of October 14, 2014, driving a truck and picking up bags of leaves. (T. 7-8; R. Exh. 2 p. 2) Mr. LaRue attributes his medial meniscus tear injury to getting into and out of the truck on October 14, 2014. (T. 17-18) Mr. LaRue started his shift that day at 6:00 a.m. (T. 9)...