FROM THE ARKANSAS WORKERS COMPENSATION COMMISSION [NO.
Cogbill, Arnold & Harrison, LLP, by: R. Scott Zuerker, Fort
Smith and Victor L. Crowell, for appellant.
and Gramlich, LLP, Fort Smith, by: M. Jered Medlock, for
J. GLADWIN, Judge
Poultry, Inc. (Tyson), appeals the March 15, 2019 opinion of
the Arkansas Workers Compensation Commission (Commission)
reversing the September 5, 2018 opinion of the administrative
law judge (ALJ) and finding that Frederico Montelongo was
entitled to additional medical treatment. Tyson argues that
the Commission erred in arbitrarily accepting Montelongos
experts medical opinion that
the compensable injury was the cause of the need for
additional medical treatment in the form of a total
right-knee replacement. We affirm.
Montelongo had been employed by Tyson for twenty-three years
when he suffered a compensable injury after he slipped off a
ladder and injured his right knee on September 3, 2016.
Although he claims to have reported the incident to his
supervisor and a nurse at Tyson, Montelongo did not receive
any medical treatment until December 7, Montelongo was seen
by Dr. Greg Loyd, who diagnosed him with "unspecified
superficial injury of right knee" and prescribed Vimovo.
Dr. Loyd noted that Montelongo "likely has a medial
menisceal [sic] tear" and planned to try conservative
therapy for a few weeks. Because of Montelongos continuing
symptoms, Dr. Loyd recommended an MRI on December 28.
Loyds January 12, 2017 medical record notes, "MRI of
right knee show: joint effusion, tear of anterior horn of
medial meniscus, possible associated loose body, and bakers
[sic] cyst." Dr. Loyd also noted that Montelongo had
some degenerative changes of the knee joint. He referred
Montelongo to an orthopedist for further evaluation and
began treatment with Dr. Russell Allison on January 25. Dr.
Allison diagnosed a lateral meniscal tear and medial meniscal
tear and recommended right-knee arthroscopy. On April 10,
Montelongo underwent a right-knee arthroscopy with partial
medial and lateral meniscectomies and a right-knee
chondroplasty of patellofemoral and medial compartments.
Allison released Montelongo at maximum medical improvement on
June 7. Montelongo was assessed with an impairment rating of
1 percent to the person as a whole and 3 percent left lower
extremity based on Table 64 on page 3/85 of
Guides to the Evaluation of Permanent Impairment,
returned to see Dr. Allison on July 24 with complaints that
his symptoms had worsened since his last visit. During this
visit, Dr. Allison performed an intraarticular cortisone
injection and noted that Montelongo "has arthritis and
will need a knee replacement at some point."
on his own, then saw Dr. Charles Pearce, another orthopedist,
on July 31, and his chief complaint was noted as chronic
right-knee pain. Dr. Pearce noted that x-rays he ordered and
interpreted "do show moderate patellofemoral arthritis
and some change of the tibial femoral joint as well."
Dr. Pearce treated Montelongo with over-the-counter
medications, gave him a brace for his knee, and asked him to
return in six weeks, noting that an "[i]njection may be
helpful but ultimately knee replacement may be
returned to Dr. Allison on October 11, 2017. Dr. Allison
stated that x-rays revealed moderate arthritis with moderate
loss of joint space, sclerosis, spurring, and degenerative
changes. He diagnosed Montelongos condition as unilateral
primary osteoarthritis of the right knee and gave him a
Montelongo exercised his right to a one-time change of
physician to Dr. Tarik Sidani. He saw Dr. Sidani on November