NOT DESIGNATED FOR PUBLICATION

ARKANSAS COURT OF APPEALS

ANDREE LAYTON ROAF, JUDGE

DIVISION II

WAL-MART STORES, INC.

APPELLANT

v.

PATSY WOODS

APPELLEE

CA 00-1419

JUNE 6, 2001

APPEAL FROM THE ARKANSAS WORKERS' COMPENSATION COMMISSION

[NO. E802988]

AFFIRMED

Wal-Mart Stores, Inc. appeals the Workers Compensation Commission's order awarding Patsy Woods a change of physician and finding additional treatment was reasonable and necessary to treat Woods's January 24, 1995, compensable injury. On appeal, Wal-Mart argues that substantial evidence does not support the Commission's findings. We affirm.

On January 24, 1995, Patsy Woods was working in Wal-Mart's stock room when a case of ArmorAll fell off a high shelf, hitting her on the side or the head. Woods informed Wal-Mart personnel of the accident and filed an incident and medical report. That evening, Woods went to the emergency room and was referred to Dr. Terrell Bishop, a neurologist. When Woods failed to respond to conservative treatment, Dr. Bishop referred Woods to a neurosurgeon, Dr. ScottSchlesinger. Dr. Schlesinger's notes reveal Woods's symptoms included neck and right-arm pain immediately following and continuing since her injury and left-arm pain for approximately four months. Dr. Schlesinger's diagnostic tests revealed a C5-6 herniation.

Wal-Mart referred Woods to Dr. Tad Pruitt for an independent medical evaluation, and his report stated that a C5-6 anterior discectomy and fusion was reasonable treatment that he thought would relieve Woods's neck and arm pain. He noted that her left-arm pain would possibly not be relieved if it stemmed from another disc level or posterior lesion. He also stated that he believed Woods's pain was related to her compensable injury.

Dr. Schlesinger performed a C5-6 anterior cervical discectomy and fusion on March 19, 1998. Woods experienced relief from her symptoms following her surgery and on July 20, 1998, Dr. Schlesinger assigned Woods an impairment rating of seven percent to the body as a whole, which Wal-Mart paid. In the latter part of April, Woods returned to work at Wal-Mart. Following her return, she saw Dr. Schlesinger on July 20, August 24, and September 14, 1998. At the August 24, 1998, appointment Woods had complaints of left-arm pain and numbness in her toes. Because Dr. Schlesinger did not see anything more that could be done for Woods surgically, he referred her back to Dr. Bishop on September 14, 1998, for further neurological investigation.

Woods requested authorization from Wal-Mart several times to see Dr. Bishop but did not receive authorization and subsequently found out that Dr. Bishop had closed his practice in Pine Bluff. Wal-Mart then denied Woods's request for additional medical treatment and a change of physician stating it was not reasonable and necessary for treatment of her compensable injury. The Administrative Law Judge (ALJ) granted Woods's request for a change of physician and found additional treatment to be reasonably necessary and related to her compensable injury. The Commission affirmed and adopted the findings of the ALJ.

The standard of review in workers' compensation cases is well settled. We view the evidence and all reasonable inferences deducible therefrom in the light most favorable to the Commission's 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's conclusion, we must affirm its decision. Geo Specialty, supra.

Wal-Mart first argues that there is not substantial evidence to support the Commission's finding that the additional medical treatment is reasonable and necessary and related to Woods's January 24, 1995, compensable neck injury. It asserts that the evidence does not establish a causal connection between Woods's left-arm pain and left-foot numbness and her compensable injury. Wal-Mart also asserts that because extensive conservative and surgical treatment have not resolved Woods's left-arm symptoms, additional treatment from a different neurologist would not be reasonable and necessary for treatment of her compensable injury.

When the primary injury is shown to have arisen out of and in the course of the employment, the employer is responsible for any natural consequence that flows from that injury; the basic test is whether there is a causal connection between the two episodes. Jeter v. B.R. McGinty Mechanical, 62 Ark. App. 53, 968 S.W.2d 645 (1998). Determination of whether causal connection exists between initial work-related injury and later problems so as to support compensation for later problems is a question of fact for Workers' Compensation Commission to determine. Id. Here, there is substantial evidence to support a finding that there is a causal connection between the two episodes. Woods's medical records indicate that she began complaining of left-arm pain on July24, 1995. In fact, left-arm pain is consistently mentioned as a symptom in Woods's medical reports prior to surgery. Dr. Schlesinger's November 21, 1997, report noted left-arm pain, and though Dr. Schlesinger could not determine why Woods experienced left-arm pain from his diagnostic tests, he hypothesized that the pain either stemmed from referred pain from the compensable injury or from a spur. Dr. Tad Pruitt, in his independent medical evaluation of Woods prior to her surgery, stated that he believed Woods's pain was related to her compensable injury. After surgery, Dr. Schlesinger's medical reports indicate that Woods no longer experienced pain in either arm, but on August 24, 1998, Dr. Schlesinger noted that Woods's left-arm pain had returned. Further, in a letter to Wal-Mart dated October 21, 1998, Dr. Schlesinger stated:

I am not sure why Woods had the intermittent left arm pain prior to surgery, but because this recurred I want to make sure there were no complications from her surgery. Therefore, I feel this was all related to the initial injury. I certainly have not found a cause for the left arm pain. The MRI scan done in September 1998 looked good. There is nothing more I can offer her neurosurgically.

He then referred Woods back to her neurologist for evaluation regarding the cause of her pain.

Wal-Mart makes much of the fact that the ALJ stated that the medical evidence with regard to Woods's left-arm pain was "equivocal," and argues this is a clear-cut admission by the ALJ that Woods did not uphold her burden of proving a causal connection. However, the ALJ noted the medical evidence previously discussed and based her findings on Woods's credibility as a witness. Woods testified that she did not have any pain in her arms until after her injury and that she had not been involved in any subsequent accidents that would cause her present complaints. It is the exclusive function of the Commission to determine the credibility of witnesses and the weight to be given their testimony. Kuhn v. Majestic Hotel, 324 Ark. 21, 918 S.W.2d 158 (1996). The Commission is not required to believe testimony of claimant or any other witness, but may accept and translate into findings of fact only those portions of testimony it deems worthy of belief. Jeter,supra. Further, whether there were objective medical findings to support the injury is not the correct standard of review in determining whether the medical treatment rendered to appellee was reasonable and necessary. Green Bay Packing v. Bartlett, 67 Ark. App. 332, 999 S.W.2d 695 (1999). An employer is obligated to promptly provide for an injured employee such services as may be reasonably necessary in connection with the injury received by the employee. See Ark. Code Ann. § 11-9-508(a) (Repl . 1996). What constitutes reasonable and necessary treatment under this section is a question of fact for the Commission. See Gansky v. Hi-Tech Eng'g, 325 Ark. 163, 924 S.W.2d 790 (1996). We cannot say that there is not substantial evidence to support the Commission's finding that the additional medical treatment was reasonable and necessary.

Wal-Mart's argument that additional treatment from a different neurologist would not be reasonable and necessary for treatment of Woods's compensable injury because extensive conservative treatment did not resolve her left-arm symptoms likewise must fail. Whether previous treatment has afforded a claimant relief is not dispositive of the question of whether a claimant is entitled to additional medical treatment. What constitutes reasonable and necessary treatment remains a question of fact for the Commission. See id. The Commission, as fact finder, must resolve any conflicts in the evidence. Warwick Electronics, Inc. v. Devazier, 253 Ark. 1100, 490 S.W.2d 792 (1973). Here, the ALJ noted the medical evidence and Woods's credibility as a witness in determining that the requested evaluation was reasonable and necessary. While the ALJ noted the possibility that subsequent tests and evaluations could determine that Woods's left-arm pain is unrelated to her compensable injury, she stated that Woods presented evidence of greater convincing force at the time of the hearing that the evaluation recommended by Dr. Schlesinger is reasonable, necessary, and related to her compensable injury. Further, Dr. Schlesinger's letter expressed concern about the recurrence of the left-arm pain following Woods's surgery and recommendedWoods see a neurologist. Hence, there is substantial evidence to support the Commission's finding.

Wal-Mart also argues that there is no substantial evidence to support the Commission's finding that a change of physician would be reasonable, necessary, and related to Woods's compensable neck injury. When a claimant seeks a change of physician, she must petition the Commission for approval. Arkansas Code Annotated Section 11-9- 514(a)(2)(A) (Repl.1996) provides: "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 recommendations of claimant or respondent." The medical services must be for reasonable and necessary treatment. Ark. Code Ann. § 11-9-508 (Repl. 1996). Wal-Mart, in essence, argues that the change of physician is not warranted because Woods did not establish that further medical treatment would be reasonably necessary for treatment of her compensable injury. We have rejected this argument in Wal-Mart's first point on appeal, and Woods petitioned for a change of physician because her treating physician no longer practiced in Pine Bluff. Consequently, the Commission's finding that a change of physician was reasonably necessary for treatment of Woods's compensable injury is supported by substantial evidence.

Affirmed.

Griffen and Vaught, JJ., agree.