FR O M T HE AR KANSAS WORKERS' COMPENSATION COMMISSION
Freeman Law Firm, PLC, by: Mark Freeman, for appellant.
Ledbetter, Cogbill, Arnold & Harrison, LLP, by: E. Diane
Graham and Joseph Karl Luebke, for appellee Tyson Poultry,
LARRYD. VAUGHT, Judge.
Ayers appeals the Arkansas Workers' Compensation
Commission's (Commission) order reversing the
Administrative Law Judge's (ALJ) decision and finding
that he is not entitled to additional medical treatment for a
compensable low-back injury he suffered in 2002. We affirm.
a sixty-seven-year-old man, began working for Tyson Poultry,
Inc., as a truck driver in the late 1990s. He suffered a
compensable back injury in May 2002. Ayers returned to work
with permanent lifting restrictions. In May 2006, Ayers
suffered another compensable low-back injury in a
slip-and-fall accident. Ayers was treated after this accident
by Dr. Kelly Danks. Dr. Danks specifically noted that Ayers
had "chronic back pain" and had been prescribed
"chronic narcotics" due to significant degenerative
changes. Dr. Danks found that most of Ayers's back
problems were due to a preexisting issue, and he did not
expect Ayers's condition to improve significantly. The
parties stipulated to Dr. Danks's conclusion that
Ayers's healing period for the May 2006 injury ended on
July 11, 2016.
August 2006, Ayers received a change of physician to Dr. Eric
Spann. For several years, Dr. Spann made a variety of
referrals for conservative treatment therapies and prescribed
Ayers prescription narcotic medication. Since 2012, Ayers has
seen Dr. Spann either quarterly or monthly to receive refills
of his narcotic prescriptions and occasionally receive
suffered a broken left hip on April 14, 2015, and underwent
surgery to repair the fracture. After his hip surgery, Ayers
saw Dr. Spann seven times between May 19, 2015, and November
16, 2015, for regular medication checks. On November 20,
2015, Dr. Spann ordered Ayers to undergo twelve weeks of
physical therapy for postoperative hip pain and lumbar
radiculopathy. Ayers testified at the hearing that he did not
participate in physical therapy at that time. Ayers continued
to see Dr. Spann monthly regarding his narcotic pain
medication in 2016.
20, 2016, Dr. Spann sent Tyson a letter requesting that it
cover prescribed physical therapy for Ayers designed to
address his back and core muscle abdominal issues, which had
been exacerbated by his hip surgery the previous year. On
July 18, 2016, Dr. Spann again ordered twelve weeks of
physical therapy for core strengthening and lumbar-spine
issues. At an office visit on July 25, 2016, Dr. Spann's
examination noted that Ayers had "full range of motion,
normal gait, [and] no obvious dysfunction or atrophy."
Ayers had his initial physical-therapy visit four days later
at Spine and Sports Rehab in Harrison, Arkansas.
August 22, 2016, Dr. Spann examined Ayers and again noted
that Ayers had "full range of motion, normal gait, [and]
no obvious dysfunction or atrophy" and noted no abnormal
findings when examining Ayers's back. Two days later on
August 24, 2016, Dr. Spann sent two letters requesting that
Ayers receive an additional twelve weeks of physical therapy.
In one of the letters, Dr. Spann noted that Ayers had
"reached a steady state with his chronic pain, "
had "now stabilized at a new . . . slightly lowered
baseline" after his hip fracture, and his condition was
"likely to never change." Ayers finished his first
twelve weeks of physical therapy on September 9, 2016.
September 12, 2016, Dr. John Park reviewed Ayers's
medical records and evaluated Ayers's request for an
additional twelve weeks of physical therapy. Dr. Park first
made note of Dr. Spann's own observations in the August
24 letter regarding the stability of Ayers's condition.
He further noted that Ayers's records indicated that
Ayers could walk without a limp or assistive device. Dr. Park
noted that post-hip-fracture physical therapy was typically
done within the first two to three months after surgery to
help the patient relearn how to walk without assistance and
that the use of assistive devices while walking after a hip
fracture could aggravate preexisting back pain. He concluded
that because Ayers was already able to walk without a limp or
assistance, was in a stable condition as noted by Dr. Spann,
and had no trauma since the hip fracture, additional physical
therapy was not medically warranted.
was seen by Dr. Spann again four times between September 21
and November 18, 2016, and each time was noted as having
"full range of motion, normal gait, [and] no obvious
dysfunction or atrophy" on Dr. Spann's examination.
denied Ayers's request for additional physical therapy.
On October 26, 2016, a prehearing conference was conducted
and the parties agreed to litigate Ayers's entitlement to
an additional twelve weeks of physical therapy and whether
continued treatment with Dr. Spann, a general-practice
physician located over one hundred miles from Ayers's
house, was reasonably necessary medical treatment.
a hearing on December 21, 2016, the ALJ issued an opinion
finding that Ayers was entitled to additional physical
therapy and that treatment with Dr. Spann was reasonably
necessary treatment. Tyson appealed to the Commission, which
reversed the ALJ and found that Ayers was not entitled to
additional medical treatment related to his ...