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COX v. KLIPSCH & ASSOCIATES11/15/2000
Appellant Betty Cox appeals from a decision of the Arkansas Workers' Compensation Commission finding that she failed to prove by a preponderance of the evidence that she was entitled to surgical treatment performed by Dr. Robert Abraham, and that the percutaneous diskectomy performed by Dr. Abraham was reasonable or necessary in relation to appellant's compensable injury. On appeal, appellant argues that the evidence does not support the Commission's findings.
Appellant sustained a compensable back injury on September 26, 1991, while employed with appellee, Klipsch & Associates. Appellant injured her back while pushing stereo speakers that had jammed on an assembly line. On March 10, 1995, a hearing was held before the administrative law judge (ALJ) to determine appellant's entitlement to wage-loss disability benefits. Following the hearing, the ALJ found that appellant suffered a five percent physical
impairment rating to the body as a whole and was entitled to a ten percent wage-loss disability. In its opinion and order filed October 31, 1995, the full Commission affirmed the decision of the ALJ. The Commission found that the evidence established that appellant suffered from "a small degree of degenerative disc disease which became symptomatic as a result of the work-related injury ," but found that "there no evidence of a herniated nucleus pulposus or of any nerve root involvement." Appellant appealed, and we, in an unpublished opinion, affirmed the decision of the Commission in Cox v. Klipsch & Assoc., CA 96-160, slip op. (Ark. App. November 6, 1996).
Appellant was initially treated for her compensable injury under the care of Dr. Steven Clark from the period of September 27, 1991, through at least October 31, 1991. Dr. Clark diagnosed appellant with lumbar strain and treated appellant's symptoms with steroid injections, back adjustments, and anti-inflammatory injections. Dr. Clark released appellant to perform light duty work on October 7, 1991. Appellant continued to work until July of 1992, at which time she quit due to complaints of severe headaches which she contributed to steroid injections or chemicals used by the appellee. In February 1992, appellant began receiving conservative treatment from appellee's designated medical provider, Dr. George Finley, a family practitioner.
In January 1993, appellant saw Dr. Norris Knight, an orthopedic physician. Under Dr. Knight's care, appellant underwent an MRI and CT of her lumbar spine. Dr. Knight's examination of appellant revealed a full range of motion and no neurological deficits. An x-ray revealed minor scoliosis and minor degenerative disc disease. On May 18, 1993, Dr. Knight diagnosed appellant with degenerative disc disease at L-4 and L-5 with mild posterior bulging of the L-4 disc. Appellant was last seen by Dr. Knight on June 8, 1993, when he opined that appellant was not an operative candidate because she "has no clear extrinsic or root compression."
On June 15, 1993, pursuant to Act 444 of 1983, appellant served advance written notice to appellee stating her request to change to a chiropractic physician. After apparent approval of the change by appellee, Dr. David Volentine became appellant's primary physician in June of 1993. On September 30, 1993, appellant was evaluated by Dr. Jim Moore, a Little Rock neurosurgeon. Dr.
Moore's medical report dated September 30, 1993, reflected the following:
The studies reviewed, the MRI shows only a very slight amount of disk prominence with some minimal degeneration. Apparently, Dr. Knight, proceeded with the myelogram and CT in view of her persisted complaints. The myelogram itself as reviewed does show quite of a bit of
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