DIVISION I

NOT DESIGNATED FOR PUBLICATION

ARKANSAS COURT OF APPEALS

WENDELL L. GRIFFEN, JUDGE

CA00-569

February 21, 2001

MARY C. OWNBEY AN APPEAL FROM ARKANSAS

APPELLANT WORKERS' COMPENSATION

COMMISSION [E813575]

V.

MOUNTAIN HOME PUBLIC

SCHOOLS

APPELLEE AFFIRMED

Mary Ownbey appeals from the order of the Workers' Compensation Commission that found that she had not sustained a compensable injury. She argues that the Commission erred in disregarding the objective evidence presented by her family doctor. We hold that the record contains a substantial basis for denial of relief and affirm the Commission's decision.

Appellant is employed as a cafeteria worker by Mountain Home Public Schools, appellee. The parties stipulated that on Thursday, April 30, 1998, she slipped and fell while carrying a bucket filled with bleach water, while cleaning the cafeteria. Appellee controverted her entitlement to workers' compensation benefits, and a hearing was held before an Administrative Law Judge (ALJ). Because the parties stipulated that appellant fell during the course of her employment, the issues at the hearing were limited to 1) whethershe sustained a compensable injury; 2) whether the medical treatment received subsequent to May 4, 1998, was reasonably necessary; and 3) whether appellee was liable for the medical treatment provided by Dr. Williams. The ALJ found that a preponderance of the evidence did not establish that she sustained a compensable injury as a result of that fall. Because the ALJ found appellant did not sustain a compensable injury, he did not reach the second and third issues. The Commission adopted and affirmed the decision of the ALJ. This appeal followed.

Appellant testified that she was injured when she stepped into a puddle of water and fell. She testified that she "had a body slam" and that she fell over the bucket and that her entire body, including her chest and head, hit the floor. She specifically stated that she did not fall on the bucket, but held onto it when she fell to try and prevent the bleach water from hitting a nearby coworker.  Appellant fell at approximately 8:15 a.m. and continued to work until the end of her shift at 2:00 p.m. She stated that she first felt pain in her pelvic area, but maintained that she hurt her left shoulder, arm, hand, and knee and experienced shortness of breath after the incident. Appellant admitted that she advised her co-workers who witnessed the fall that she was "O.K." and that she advised her supervisor that she was "all right."

She first sought medical treatment on May 3, 1998, at an emergency room. She testified that she waited a few days to go to the doctor because her supervisor indicated they would be "short of help" the next day. The medical report from the emergency room did not indicate any bruising or injuries to her head or neck area. The x-rays taken at theemergency room revealed no definite fractures and no soft tissue abnormalities, although the x-rays showed what appeared to be chronic lateral dislocation of the fifth metacarpal phalangeal joint on her hand.

Appellant sought additional treatment from Dr. Michael Hagaman, an authorized treating physician, and Dr. Patricia Williams, her regular doctor, on May 4, 1998. Dr. Williams released appellant to resume her normal duties on July 20, 1998. She worked until October 15, 1998, and has not worked since that time.

Appellant introduced into evidence the results of various x-rays, MRI, and bone scans, but relied primarily on the testimony of Dr. Williams, an osteopathic doctor who treats musculoskeletal, neurological, and vascular problems. She has treated appellant for several years for numerous conditions including obesity, poor circulation, "organic" problems due to metabolic imbalances, and female problems. Dr. Williams testified that she had treated appellant for female problems and had prescribed hormone medication for spotting and lower quadrant pain and cramps. She opined that the thickening in the endometrial lining in her uterus was aggravated by the fall. She also testified that in addition to appellant's physical problems, she suffers from depression and should not return to work. Dr. Williams further opined that appellant's depression is related to her fall, because she has "trouble getting up and down."

Dr. Williams first treated appellant for the alleged injuries related to her fall on May 4, 1998. Appellant complained of shortness of breath under her breast and up the left side of the midline sternum. She had bruises on her left medial knee and left lateral thigh. Shealso had tenderness and swelling under the left knee, and complained of neck spasms. Dr. Williams stated that she observed appellant's muscles spasming and noted painful muscles of her middle-upper back, shoulder and neck. She diagnosed appellant with a contusion to the left knee, pain in her left shoulder, and soft tissue contusions. She also diagnosed appellant with contusion and swelling of the left hand, which she opined was to be expected from the weight behind appellant's fall.

Dr. Williams testified that appellant's condition is "probably as good as it is going to get." Although she released appellant to return to work on July 20, 1998, she stated that she did so at appellant's insistence, and she opined that appellant's healing period did not end until June 1999. In addition, Dr. Williams stated that appellant could not be trusted with her hand or leg movement because she may drop things or fall. Dr. Williams observed that when appellant sits for over twenty minutes, her left leg gets numb, and that she is unable to walk for over 200 feet without stopping. She opined that appellant can only work for three hours out of an eight-hour period. Appellant returned to work on July 20, 1998, and worked until October 15, 1998. She has not attempted to return to work since that time.

In November 1998, appellant reported that she still experienced pain in both knees and Dr. Williams found that she had inflamation of the cartilage around her ribs, numbness in her left hands and lumbosacral dysfunction, which Dr. Williams stated means that appellant has severe muscle spasms that restrict her range of motion and impinge upon the nerves that make her muscles work.

Finally, Dr. Williams testified that appellant also sustained injuries to her mid-thoracic region that were caused by a thrust-type injury. She stated that this injury impairs the nerves and muscles that go up to the intercostal muscles between the ribs that are important for expiration, inspiration, and for the function of the vital organs in the thoracic chest.

Appellant maintains the injury aggravated her preexisting physical conditions. An aggravation is a new injury resulting from an independent incident. See Maverick Transp. v. Buzzard, 69 Ark. App. 128, 10 S.W.3d 467 (2000). Because an aggravation is a new injury with an independent cause, it also must meet the requirements for a compensable injury. See Ford v. Chemipulp Process, Inc., 63 Ark. App. 260, 977 S.W.2d 5 (1998). Therefore, it was appellant's burden to establish her compensable injury by medical evidence that is supported by objective findings. See Ark. Code Ann. § 11-9-102(5)(D)(Repl. 1996). Objective medical findings are "those findings which cannot come under the voluntary control of the patient." Ark. Code Ann. § 16(A)(i). Further, pursuant to section 11-9-102(E)(ii), appellant had the burden to prove by a preponderance of the evidence that her injury is the major cause of her disability or need for treatment. Finally, medical opinions addressing compensability and permanent impairment must be stated within a reasonable degree of medical certainty. See Ark. Code Ann. § 11-9-102(16) (Repl. 1996).

In reviewing a decision of the Worker's Compensation Commission, we view the evidence and all reasonable inferences deducible therefrom in the light most favorable to the findings of the Commission and affirm that decision if it is supported by substantial evidence. See Geo Specialty Chem. v. Clingan, 69 Ark. App. 369, 13 S.W.3d 218 (2000). The issue on appeal 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's conclusion, we must affirm the Commission's decision. See Continental Express, Inc. v. Freeman, 66 Ark. App. 102, 989 S.W.2d 538 (1999). The substantial-evidence standard of review requires that we affirm if the Commission's opinion displays a substantial basis for the denial of relief. See Flowers v. Arkansas Hwy. & Transp. Dep't, 62 Ark. App. 108, 968 S.W.2d 660 (1998).

We hold that the record demonstrates a substantial basis for the Commission's decision denying relief. Appellant did not produce evidence 1) regarding the nature of her disability or need for treatment; or 2) establishing within a reasonable degree of medical certainly that the fall is the major cause of her disability or need for treatment. Further, on appeal, appellant fails to direct this court in her argument to the objective proof of her injuries.

Appellant maintains that the Commission disregarded the objective evidence in this case and required proof beyond a reasonable doubt instead of a preponderance of the evidence. The Commission has the duty to weigh medical evidence as it does any other evidence, and its resolution of conflicting medical evidence has the force and effect of a jury verdict. See McClain v. Texaco, Inc., 29 Ark. App. 218, 780 S.W.2d 34 (1989). However, the Commission may not arbitrarily disregard the testimony of any witness. See Boyd v. Dana Corp., 62 Ark. App. 78, 966 S.W.2d 946 (1998). There is nothing in the record to support that the Commission arbitrarily disregarded Dr. William's testimony, or any of themedical evidence.

First, we note that appellant provides scant evidence of her physical limitations, other than Dr. William's statements that she cannot sit for more than twenty minutes or walk for more than 200 feet or work for more than three hours, which appear to be based solely on Dr. William's subjective observations. In addition, the record is devoid of objective tests indicating that appellant's range of motion is limited. To the contrary, Dr. Michael Hagaman found that she had full range of motion. Although Dr. Williams testified that appellant's range of motion was affected, appellant failed to present any evidence that Dr. Williams conducted objective range of motion tests indicating her limitations. Further, while Dr. Williams reported in her office notes that appellant experienced numbness and reported that she sometimes dropped objects, Dr. Williams never indicated that she any performed objective tests to determine that appellant experienced numbness or had difficulty gripping objects.

Second, the evidence appellant presents does not show a causal relationship between her symptoms, her medical limitations, and the injuries she sustained in the fall. Appellant and her doctor asserted that she has difficulty breathing. Dr. Williams indicated that this problem arose from a thrust-type injury and she indicated in her office notes that appellant fell on the bucket. However, appellant testified that Dr. Williams misunderstood what she had told her, and that she did not fall on the bucket. Thus, there was no evidence of a thrust-type injury, and thus no evidence of a causal connection between the fall and appellant's breathing difficulties.

Further, the only abnormalities revealed by the numerous bone scans, x-rays, and MRIs performed were 1) lateral dislocation to the fifth metacarpal phalangeal joint on her hand; 2) a tumor comprised of blood tissue on her vertebra; 3) bony spurring and degenerative changes in the acromioclavicular joint; and 4) degenerative changes with mild bulging of some of the discs in her cervical lumbar spine. However, one doctor opined that the problem with her phalangeal joint was chronic and there was no evidence presented to the contrary to indicate that it was injury-related. Further, Dr. Williams did not opine that the fall caused the tumor on her spine. In fact, she testified that "we do not know that it was there before."

With regard to the spurring and changes in the acromioclavicular joint, Dr. Williams testified that the she related appellant's reactive inflammation, impingement, and contusions to the spurring, but that the spurring was probably already present prior to the injury, and the degenerative changes had already begun prior to the injury. Dr. Williams opined that appellant's condition is "not normal" because she has the "threat of a herniated disc" and because bulging discs can cause nerve impingement problems. However, appellant presented no medical evidence that these bulges are causing any of her current symptoms and Dr. Williams did not opine that appellant's bulging discs were impinging on any of her nerves. Therefore, the Commission did not err in finding that appellant did not prove that the injuries sustained as a result of her fall caused the symptoms indicated by the only objective findings presented.

Finally, nothing in the record suggests that the Commission required proof beyonda reasonable doubt. Apparently, appellant would have this court hold that some proof preponderates. She seems to equate proof of her injuries as proof of a causal connection between her fall and her current symptoms. Yet, numerous tests performed on appellant's thoracic and cervical spine, left shoulder, and left hand revealed no abnormalities, and the evidence regarding the few abnormalities that were revealed did not establish that those abnormalities were caused by appellant's fall. Reasonable minds could certainly find that the medical evidence, including Dr. Williams' testimony, does not preponderate in favor of the conclusion that appellant's physical conditions or limitations resulted from her fall at work. Therefore, we hold that the record demonstrates a substantial basis for denial of relief.

Affirmed.

Robbins and Neal, JJ., agree.