ARKANSAS COURT OF APPEALS

NOT DESIGNATED FOR PUBLICATION

ANDREE LAYTON ROAF, JUDGE

DIVISION III

WAL-MART STORES, INC

APPELLANT

v.

BETTY YATES

APPELLEE

CA01-402

October 17, 2001

APPEAL FROM THE ARKANSAS WORKERS' COMPENSATION COMMISSION

E805267

HON. ELDON F. COFFMAN, CHAIRMAN

AFFIRMED

This is a workers' compensation case in which Wal-Mart Stores, Inc. (Wal-Mart) appeals the Workers' Compensation Commission's determination that the appellee, Betty Yates, established a causal connection between her compensable injury and subsequent diagnosis of vasospastic disorder and proved her entitlement to benefits. Wal-Mart claims that the Commission's opinion, which decided that Yates's upper left extremity vasospasm was a natural cause of her compensable fracture injury of November 28, 1997, is not supported by substantial evidence. We affirm.

On November 28, 1997, while working for Wal-Mart, Betty Yates tripped and fell, landing on her hands. Wal-Mart accepted her injuries as compensable and paid benefits. Yates was initially treated by the company physician, Dr. Michael Westbrook, but after the condition failed to improve, Dr. Westbrook referred Yates to Dr. Michael Wolfe, an orthopedist. Dr. Wolfe diagnosed Yates witha healing distal radius or carpal fracture, mild carpal tunnel syndrome, and saddle joint arthritis. After conservative treatment, Yates's symptoms persisted, and she was referred to Dr. Jeffrey Evans for a surgical consultation. On April 24, 1998, Dr. Evans performed a carpal tunnel release.

The initial postoperative notes were encouraging. However, on November 24, 1998, Dr. Evans documented Yates's report of numbness while holding objects. Dr. Evans ordered new electrodiagnostic tests which were normal, and thus, he recommended an arteriogram which was performed on May 5, 1999. Dr. Evans diagnosed Yates with a "vasospastic disorder of the left wrist, probably secondary to trauma." Dr. Evans then referred Yates to Dr. Lane Wilson, but Wal-Mart refused to approve this treatment.

On June 16, 1999, Wal-Mart scheduled an independent medical examination for Yates with Dr. Reginald Rutherford. Dr. Rutherford noted that the arteriogram of Yates's left upper extremity was abnormal and recommended repeating the study. On July 13, 1999, Yates had a bone scan and the results were consistent with remote trauma. On July 29, 1999, Dr. Rutherford confirmed the presence of vasospasm on Yates's left arm. However, he stated that in the absence of an arteriogram on Yates's asymptomatic right arm, it was impossible to determine whether the disease was a result of trauma. Yates declined the arteriogram on her asymptomatic arm, stating that she was concerned about the risks involved with the procedure.

Based upon Dr. Rutherford's findings, Wal-Mart refused to pay benefits for the vasospastic disorder under workers' compensation coverage. Yates claimed that her vasospastic disorder was a natural consequence of her compensable left wrist fracture and that she was entitled to continuing treatment. However, Wal-Mart claimed that there was insufficient evidence within a reasonabledegree of medical certainty to causally link Yates's vasospastic disease to the compensable fracture.

The Workers' Compensation Commission held that Yates established a causal connection and proved entitlement to benefits. It is from this decision that Wal-Mart brings this appeal, claiming that the Commission's opinion which decided that Yates's left upper extremity vasospasm was a natural consequence of her compensable fracture injury of November 28, 1997, is not supported by substantial evidence.

On review, the appellate court will affirm if the Commission's decision is supported by substantial evidence. Spencer v. Stone Container Corp., 72 Ark. App. 450, 38 S.W.3d 909 (2001). To determine if the decision is supported by substantial evidence, this Court views the evidence in a light most favorable to the Commission's findings and affirms if reasonable minds could have reached the same conclusion. Id.

Wal-Mart argues that reasonable and fair-minded persons faced with considering whether a vasospasm is the natural consequence of Yates's fracture could not have reached the same conclusion as the Commission. The Commission stated that it found Yates to be credible in her testimony, and that Dr. Evans's opinion is "entitled to great weight" because he stated within a reasonable degree of medical certainty that Yates's vasospastic disorder is "probably secondary to trauma." Wal-Mart claims that Dr. Evans gives no rationale for stating that Yates's injury is "probably secondary to trauma" and that the record provides no reasonable basis to support the opinion of probability. Yates counters by arguing that Dr. Evans's opinion was properly given great weight because he stated his opinion within a reasonable degree of medical certainty and established causation.

Medical opinions that address compensability and impairment must be stated "within a reasonable degree of medical certainty." Ark. Code Ann. § 11-9-102(16)(B) (Supp. 1999). Medical opinions in workers' compensation cases must do more than state a possible causal connection between work and the injury. Freeman v. Con-Agra Frozen Foods, 344 Ark. 296, 40 S.W.3d 760 (2001). However, doctors need not be absolute in their opinions. The medical opinion must be more than speculation, and if a doctor renders an opinion about causation with language that exceeds possibilities and establishes that work was the reasonable cause of the injury, then the evidence should pass muster. Id.

In Wackenhut Corp. v. Jones, the appellant appealed the Commission's finding that the appellee's left knee replacement was a reasonable and necessary consequence of her compensable injury. 73 Ark. App. 158, 40 S.W.3d 333 (2001). The doctor stated that appellee's compensable injury was the start of deterioration of appellee's knee and that it was "probably predestined that this was going to occur...." Id. at 161. This Court stated that "probably," as defined in The American Heritage Dictionary, New College Edition, means "most likely." Id. at 162. This Court held that the use of "probably" is sufficient to satisfy the requirement of Ark. Code Ann. § 11-9-102(16)(B) (Supp. 1999) that medical opinions be stated within a reasonable degree of certainty. Id.

Based on our holding in Wackenhut Corp., supra, Dr. Evans's statement that Yates's vasospasm was "probably secondary to trauma" is sufficient to pass muster under Ark. Code Ann. § 11-9-102(16)(B) (Supp. 1999), and thus, he stated his opinion within a reasonable degree of medical certainty. There is substantial evidence to support the Commission's finding that Dr. Evans's evaluation of Yates was stated with reasonable medical certainty and that there is a causalconnection between work and her injury.

Wal-Mart also contends that the Commission's determination that Dr. Rutherford's opinion "is entitled to no weight" is not substantiated by the record. Credibility as well as the weight to be given conflicting medical testimony are factual determinations solely in the province of the Commission to resolve. Dallas County Hospital v. Daniels, 74 Ark. App. 177, ___ S.W.3d ___ (2001); see also Morrow v. Mulberry Lumber Co., 5 Ark. App. 260, 635 S.W.2d 283 (1982). The Commission has the authority to accept or reject medical opinions, and its resolution of such evidence has the force and effect of a jury verdict. Smith v. County Market/Southeast Foods, 73 Ark. App. 333, 44 S.W.3d 737 (2001). However, the Commission may not arbitrarily disregard any witness's testimony. Patterson v. Frito Lay, Inc., 66 Ark. App. 159, 992 S.W.2d 130 (1999).

The Commission did not arbitrarily disregard Dr. Rutherford's testimony. The Commission stated its reasons for finding that Dr. Rutherford's opinion was entitled to no weight. The Commission specifically found Dr. Rutherford's letter from September 21, 1999, to be "problematic." Dr. Rutherford's letter stated in part:

The only means to ascertain [causation] with absolute certainty would be to perform an angiographic study of the asymptomatic arm. My concern in doing this would be that it would not lend itself to treatment in Ms. Yates' case and thus does pose a potential ethical dilemma [sic]. However, from a strictly legalistic standpoint pertaining to potential etiology and compensability...this is the only measure with which I am aware could answer your question with certainty....This is an evasive procedure with attentive [sic] risk which would not serve to address or treat the complaints or symptoms she has in her left upper extremity.

The Commission stated that Dr. Rutherford misinterpreted the law with respect to medical opinions addressing causation, offered an opinion on major cause when it was determined that Yates did not need to satisfy the major cause requirement, and conceded that subjecting Yates to anotherarteriogram raised ethical concerns. The Commission concluded that Dr. Rutherford's opinion was outcome-determinative, and based upon all these factors, the Commission found that Dr. Rutherford's opinion is entitled to no weight. Additionally, the Commission may accept or reject conflicting medical testimony, and in this case, the Commission chose to reject the opinion of Dr. Rutherford and accept the opinion of Dr. Evans. There is no evidence that the Commission acted arbitrarily and, based upon our standard of review, there is substantial evidence to support the Commission's findings that Yates's vasospastic disorder was a natural consequence of her compensable fracture injury and that she is entitled to continuing workers' compensation benefits.

Affirmed.

Robbins and Baker, JJ., agree.