ARKANSAS COURT OF APPEALS

NOT DESIGNATED FOR PUBLICATION

JOHN E. JENNINGS, JUDGE

DIVISION IV

CA 01-1273

June 5, 2002

MACMILLAN BLOEDEL CONTAINERS AN APPEAL FROM THE ARKANSAS

APPELLANT WORKERS' COMPENSATION COMMISSION

F003244

VS.

CHARLES W. WYLIE AFFIRMED

APPELLEE

Charles Wylie injured his knee walking down some stairs following a business meeting. Appellant initially accepted the injury as compensable and paid benefits until January 2000 when appellee was hospitalized for an infection. When appellee sought benefits to cover his hospitalization, appellant then controverted the claim in its entirety. The law judge ordered appellant to pay all reasonable medical expenses for appellee's compensable injury. The law judge found that appellee had experienced a reactivation of an infection stemming from his knee injury and that, in any event,appellant was estopped from denying benefits through March 25, 2000, which was when appellee was notified that his treatment would no longer be covered. The Commission affirmed and adopted the law judge's decision. Appellant argues that the Commission's opinion is not supported by substantial evidence. We disagree and affirm.

On October 7, 1999, appellee traveled to Ruston, Louisiana, for a meeting with a customer during the course of his business of selling corrugated boxes for use in the shipping industry. Following the meeting, appellee twisted his left knee on the stairs while on his way to take another customer at the plant to lunch. Appellee stated that he immediately experienced severe pain in his knee and broke out in a cold sweat. Lunch was canceled, and appellee's friend, who had traveled along with him, drove him back to Arkansas. Appellee reported the injury to the plant manager. On October 8 appellee saw Dr. Lisa Ann Wuermser who prescribed ibuprofen and ice packs. As he was still in pain, appellee had his neighbor, Dr. Julius Shepherd, examine his knee on October 10. Dr. Shepherd gave appellee a sample of anti-inflammatory medica tion. On October 12 appellee was able to speak to Mr. Bob McNeil, his supervisor, who instructed appellee to forward the medical bills to appellant for reimbursement.

Appellee's medical history shows that he had developed a staph infection following left knee surgery in 1972. In 1986 or 1987appellee was walking barefoot on the beach, rubbed a blister on his foot, and was eventually hospitalized for the treatment of an infection that developed. Appellee was again walking barefoot on the beach in 1988 and suffered a similar infection. He had no more problems with infections until 1999 when he twisted his knee on the stairs.

In January 2000, following the 1999 knee injury, appellee developed an infection in his knee that required hospitalization, and he was cared for by Dr. John Eidt. Because he had been assured that workers' compensation was covering his claim, appellee did not follow through with the pre-certification requirements in his group health care provider's handbook. There was an unpaid balance of $17,000 when appellee received notice on March 25, 2000, that appellant had controverted appellee's claim in its entirety.

On appeal in workers' compensation cases, we view the evidence and all reasonable inferences deducible therefrom in the light most favorable to the Commission's findings and will affirm if those findings are supported by substantial evidence. Jeter v. B.R. McGinty Mech., 62 Ark. App. 53, 968 S.W.2d 645 (1998). 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 mustaffirm its decision. Bearden Lumber Co. v. Bond, 7 Ark. App. 65, 644 S.W.2d 321 (1983).

In adopting the law judge's decision, the Commission relied on Dr. Eidt's opinion that appellee's 1972 surgery left him with a predisposing condition for infection that was reactivated when he sustained trauma on October 7, 1999. The Commission found that, in any event, appellant would be liable for incurred benefits through March 25, 2000, pursuant to the doctrine of estoppel. The Commission pointed out that appellant had accepted the injury as compensable and had assured appellee that it would be paid as a workers' compensation claim. Therefore, the Commission found that appellee had relied to his detriment on appellant's statements.

Appellant argues that appellee never received medical treatment for a knee injury and that the only medical care has been for an infection of idiopathic, or unknown, etiology. In addition appellant contends that Dr. Eidt's opinion was clearly conjectural. The Commission has the duty of weighing the medical evidence, and its resolution of that evidence has the force and effect of a jury verdict. Chamber Door Indus., Inc. v. Graham, 59 Ark. App. 224, 956 S.W.2d 196 (1997). The Commission was entitled to rely on Dr. Eidt's opinion that the trauma from twisting his knee on the stairs caused the flare up of appellee's infection. We note that there was no medical opinion to refute Dr. Eidt's conclusion.

Appellant argues that, assuming that appellee even suffered a knee injury, an infection requiring hospitalization is not a "natural consequence" of a minor knee strain. 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. McDonald Equip. Co. v. Turner, 26 Ark. App. 264, 766 S.W.2d 936 (1989). The determination of whether a causal connection exists is a question of fact for the Commission to determine. Goodwin v. Phillips Petroleum Co., 72 Ark. App. 302, 37 S.W.3d 644 (2001). At the hearing Dr. Eidt explained that appellee had not fully recovered from the October 1999 knee injury until he underwent surgical incision and drainage of an abscess accompanied by intravenous antibiotics administered at the hospital and that appellee's problem was just "sort of ebbing and flowing" until that time. We cannot say that no substantial evidence supports the Commission's decision.

Finally, appellant argues that the Commission did not decide an estoppel issue and that the law judge had mentioned the doctrine of estoppel only as an afterthought. We point out that the estoppel issue was effectively decided because the Commission not only affirmed but adopted the law judge's decision. In Snow v. Alcoa, 15 Ark. App. 205, 691 S.W.2d 194 (1985), we set out the elements of estoppel as follows: (1) the party to be estopped mustknow the facts; (2) he or she must intend that his or her conduct shall be acted upon or must act so that the party asserting the estoppel has a right to believe the other party so intended; (3) the party asserting the estoppel must be ignorant of the true facts; and (4) the party asserting the estoppel must rely on the other party's conduct to his or her injury. At the hearing appellee testified that after he had written out a statement of what had happened on October 7, he was told that his injury would be covered by workers' compensation. Appellee then forwarded his medical bills to appellant as instructed, and appellant reimbursed appellee for the expenses he had already incurred. Appellee also testified that his own heath insurance carrier required pre-admission notification and that his January 2000 hospitalization would not have been covered because appellee did not inform him that it had controverted his claim until March 2000. Under these circumstances the Commission did not err in concluding that appellant was estopped from denying responsibility for the cost of appellee's treatment.

Affirmed.

Robbins and Crabtree, JJ., agree.