Thomas v. Superior Industries , 2015 Ark. App. LEXIS 412 ( 2015 )

Cite as 2015 Ark. App. 335
ARKANSAS COURT OF APPEALS
DIVISION I
No. CV-15-4
Opinion Delivered MAY 20, 2015
APPEAL FROM THE ARKANSAS
SHERWIN THOMAS WORKERS’ COMPENSATION
APPELLANT COMMISSION [NO. G305721]
V.
SUPERIOR INDUSTRIES
APPELLEE AFFIRMED
KENNETH S. HIXSON, Judge
Appellant Sherwin Thomas was working for appellee Superior Industries on June 11,
2013, when he sustained an admittedly compensable injury when a fifty-pound car rim fell
on his left foot. Superior Industries paid medical benefits associated with the accident.
A month later, on July 11, 2013, Mr. Thomas was diagnosed with bilateral peripheral
artery disease (PAD). Thereafter, Mr. Thomas filed a claim for additional medical treatment,
alleging that treatment for his PAD in his left foot was causally related to the compensable
injury. In particular, Mr. Thomas claimed that the work accident aggravated a preexisting
condition.1 Superior Industries controverted the additional medical benefits.
After a hearing, the Workers’ Compensation Commission denied Mr. Thomas’s claim
for additional medical treatment, finding that Mr. Thomas failed to prove a causal connection
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Mr. Thomas claimed in the alternative that the compensable accident caused his
PAD, but he no longer argues that on appeal.
Cite as 2015 Ark. App. 335
between the compensable injury and his PAD. Mr. Thomas now appeals, arguing that the
Commission’s decision is not supported by substantial evidence. We affirm.
The law requires an employer to provide medical services that are reasonably necessary
in connection with the compensable injury received by an employee. Ark. Code Ann. § 11-
9-508(a) (Repl. 2012). We have held that an employer takes an employee as it finds him, and
that employment circumstances that aggravate preexisting conditions are compensable. Leach
v. Cooper Tire and Rubber Co., 2011 Ark. App. 571. In Pulaski County Special School District
v. Tenner, 2013 Ark. App. 569, we stated that a preexisting medical condition does not defeat
a claim if the compensable injury aggravated, accelerated, or combined with the preexisting
condition to produce the disability for which workers’ compensation benefits are sought.
When the primary injury arises out of and in the course of employment, the employer is
responsible for any natural consequence that flows from that injury. Jeter v. B.R. McGinty
Mech., 62 Ark. App. 53, 968 S.W.2d 645 (1998). The basic test is whether a causal
connection exists between the two episodes. Id.
The claimant has the burden of proving the compensability of his claim by a
preponderance of the evidence. Williams v. Baldor Elec. Co., 2014 Ark. App. 62. On appeal,
we review the evidence in the light most favorable to the Commission’s findings and affirm
if those findings are supported by substantial evidence. Wal-Mart Stores, Inc. v. Brown, 82 Ark.
App. 600, 120 S.W.3d 153 (2003). Substantial evidence is relevant evidence that a reasonable
mind might accept as adequate to support a conclusion. Id. The Commission has the duty
to make credibility determinations, to weigh the evidence, and to resolve conflicts in the
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medical testimony. Martin Charcoal, Inc. v. Britt, 102 Ark. App. 252, 284 S.W.3d 91 (2008).
When the Commission denies benefits because the claimant failed to meet his burden of
proof, the substantial-evidence standard of review requires that we affirm if the Commission’s
decision displays a substantial basis for the denial of relief. Frances v. Gaylord Container Corp.,
341 Ark. 527, 20 S.W.3d 280 (2000).
Mr. Thomas began working for Superior Industries in February 2013, and his duties
included stacking car rims on pallets and hanging the rims on a line to be polished. On June
11, 2013, Mr. Thomas was at work when one of the rims fell about a foot and half off the line
and struck the top of his left foot. Mr. Thomas testified that he was in immediate pain. He
went outside, removed his boot and sock, and rubbed his foot to try to relieve the pain. It
was about one hundred degrees that day and, after Mr. Thomas put his sock and boot back
on and walked around for a few seconds, he became lightheaded and fainted. His coworkers
called an ambulance, and Mr. Thomas was taken to the emergency room.
Mr. Thomas stated that while at the emergency room he was in pain and his entire
left leg was numb. A left-foot exam revealed no deformity, no ecchymosis, and no swelling.
An x-ray was taken of his left foot, which showed no fracture or dislocation. In addition,
Mr. Thomas was given IV fluids because he was dehydrated.
The emergency-room report documented that the chief complaint was syncope, and
also that the patient stated he had experienced a minor trauma. The primary diagnosis was
heat exhaustion, with an additional diagnosis of a foot sprain.
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Mr. Thomas was off work for a few days, and then he returned to light duty for two
weeks. According to Mr. Thomas, he was told to return to regular duty after that, but
because he was unable to return to regular duty he quit reporting for work and was ultimately
terminated.
Mr. Thomas visited his primary-care physician, Dr. Mark Bonner, one month after the
injury on July 11, 2013. Dr. Bonner documented left-foot pain with numbness and swelling.
Dr. Bonner diagnosed PAD and ordered further testing of both lower extremities. An
arterial-doppler test detected an abnormal right-ankle brachial index of 0.5, which suggested
moderate arterial-vascular obstruction. The doppler test showed no detectable pulses in the
left lower extremity, and detected only PVR wave forms. A CT angiogram resulted in the
following impression:
In the left lower extremity, there is complete occlusion of the left external iliac artery
down to the level just proximal to the inguinal canal where it is reconstituted. Then,
there is complete occlusion of the left superficial femoral artery from its origin down
to the adductor hiatus where it is reconstituted. Next, there is complete occlusion of
the popliteal artery. Finally, there is reconstitution of the posterior and anterior tibialis
arteries and the peroneal arteries with normal runoff to the foot.
The right lower extremity contains complete occlusion of the right superficial femoral
artery from its origin down to the adductor hiatus where it is reconstituted via
collateral flow. The right tibialis anterior artery contains a long segment of stenosis just
distal to its origin and multifocal areas of complete stenosis throughout its course.
There is concern for near-complete occlusion of portions of the bilateral internal iliac
arteries.
The arterial-doppler testing and CT angiogram confirmed appellant’s vascular issues.
At the request of Superior Industries, Mr. Thomas was evaluated by Dr. Konstantin
Berestnev on July 16, 2013. In a physician’s report dated July 25, 2013, Dr. Berestnev
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gave a diagnosis of foot contusion, syncope and collapse, and psychosocial circumstances.
Dr. Berestnev also noted, “PAD—not work-related.”
In his testimony, Mr. Thomas stated that ever since the rim had fallen on his left foot
his symptoms have remained the same. He stated that he experiences numbness and
throbbing pain in his left leg and foot that keeps him awake at night. Mr. Thomas further
stated that his left foot is discolored, and that when he tries to sleep he experiences shaking
in both his left and right legs and feet. Although Mr. Thomas had experienced minor
swelling and redness in his feet prior to the work-related accident, which was documented
in earlier medical reports, he maintained that his symptoms have become much worse since
the rim fell on his foot.
In this appeal, Mr. Thomas argues that substantial evidence does not support the
Commission’s decision denying him additional medical treatment for his PAD. He contends
that his work injury aggravated his preexisting PAD, causing it to become symptomatic and
resulting in the need for treatment. Although Mr. Thomas had experienced minor swelling
prior to the accident, he asserts that his left-leg symptoms became severe after the rim fell on
his foot, resulting in medical testing that confirmed the existence of PAD. Mr. Thomas
contends that the only reasonable conclusion is that the exacerbation of his PAD was a natural
consequence of the work injury, and therefore that the associated treatment is for a
compensable condition that is the responsibility of the employer.
We hold that the Commission’s opinion displays a substantial basis for its denial
of appellant’s claim for additional medical benefits associated with his PAD. After the
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compensable event on June 11, 2013, Mr. Thomas was taken to the emergency room after
fainting due to heat exhaustion, where he reported a “minor trauma” to his left foot. The
emergency-room exam and x-rays showed no deformity, no ecchymosis, no swelling, no
fracture, and no dislocation. One month later, when Dr. Bonner diagnosed PAD, he did not
relate this diagnosis to the work-related accident. The claimant’s vascular problems were
bilateral and were detected in both legs commencing at or just below the hips, continuing
through the thighs all the way to the feet. Shortly thereafter, Dr. Berestnev reported that the
PAD was not work related. The record is devoid of any medical evidence that the claimant’s
PAD was work related. It was for the Commission to weigh the evidence and medical
opinions, and on this record reasonable minds could conclude that the work injury was not
causally related to appellant’s subsequent vascular diagnosis.
Affirmed.
GLADWIN, C.J., and VIRDEN, J., agree.
Tolley & Brooks, P.A., by: Evelyn E. Brooks, for appellant.
Bassett Law Firm LLP, by: Curtis L. Nebben, for appellee.
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