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COX v. KLIPSCH & ASSOCIATES11/15/2000
on is entitled to review the basis for a doctor's opinion in deciding the weight and credibility of the opinion and medical evidence. Id.
Arkansas Code Annotated section 11-9-508 (a) (Repl. 1996) requires employers to provide such medical services as may be reasonably necessary in connection with the employee's injury . American Greetings Corp. v. Garey, supra. Whether a medical procedure or device is reasonable and necessary treatment is a question of fact to be decided by the Commission. Air Compressor Equipment v. Sword, 69 Ark. App. 162, 11 S.W.3d 1 (2000).
For reversal, appellant contends that the Commission's decision is not supported by substantial evidence. Specifically, she argues that the evidence was insufficient to find that her treatment under Dr. Robert Abraham was not reasonable and necessary with respect to her compensable injury . We do not agree.
[3, 4] The full Commission noted in its October 31, 1995, order and opinion, that "the evidence establishes that [appellant] suffers from a small degree of degenerative disc disease which became symptomatic as a result of the work-related injury ," and that "there is no evidence of a herniated nucleus pulposus or of any nerve root involvement." This evidence is directly contrary to Dr. Abraham's preoperative diagnosis of right L4-5 herniated nucleus pulposus on December 15, 1993, which the Commission was entitled to weigh. Subsequent to Dr. Moore's evaluation of appellant in September of 1993, Dr. Moore agreed with Dr. Knight that appellant was not a surgical candidate, and opined that appellant was at the end of her healing period. Despite the opinions of Drs. Moore and Knight, Dr. Abraham evaluated appellant on October 18, 1993, and gave an assessment of right lumbar radiculopathy, which "may be helped" by percutaneous diskectomy. Following the surgery, Dr. Abraham stated that appellant was "doing about the same" and that she still had pain "in the lower lumbar region bilaterally." Dr. Abraham opined in a letter dated April 27, 1994, that "the patient's [claimant's] healing period in my estimation should have plateaued at approximately September 1992." Furthermore, the Commission noted that following the additional surgery, appellant testified that she was unable to return to work, but was able to stand on Thanksgiving to prepare a pot of sweet potatoes. However, the Commission stated that appellant claimed to be permanently and totally disabled, contradicting her contention that she benefitted from the surgery. Postsurgical improvement is a proper consideration in determining whether surgery was reasonable and necessary. Winslow v. D & B Mechanical Contractors, 69 Ark. App. 285, 13 S.W.3d 180 (March 15, 2000). Based on this record where no postsurgical improvement took place and where the Commission gave little weight to Dr. Abraham's opinion, we cannot say that the Commission erred in finding that appellant's surgical treatment by Dr. Abraham was not reasonable and necessary in relation to her compensable injury.
Affirmed.
Pittman, Bird, and, Koonce, JJ., agree.
Stroud, and Roaf, JJ., dissent.
JOHN F. STROUD, JR., Judge, dissenting.
In finding that the treatment and surgery rendered by Dr. Abraham was neither reasonable, necessary, nor related to appellant's compensable injury, the Workers' Compensation Commission found that his opinion regarding her need for such care was entitled to less weight than the opinions of Dr. Knight and Dr. Moore stating that she was not a surgical candidate. Those two doctors, however, examined appellant in June and September 1993, before Dr. Abraham saw her in October of that year, and, as the dissenting commissioner noted,
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