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Arvest Bank Group v. Beckman11/2/2005
App. 344, 925 S.W.2d 179 (1996). An aggravation, however, is a new injury resulting from an independent incident. Farmland Ins. Co. v. Dubois, 54 Ark. App. 141, 923 S.W.2d 883 (1996). Therefore, where the second complication is found to be a natural and probable result of the first injury, the employer initially liable remains liable; only where it is found that the second episode has resulted from an independent intervening cause is that liability affected. Bearden Lumber Co. v. Bond, 7 Ark. App. 65, 644 S.W.2d 321 (1983). This test of whether a causal relationship exists between the first episode of injury and the second is a question of fact for the Commission to determine. Carter v. Flintrol, Inc., 19 Ark. App. 317, 720 S.W.2d 337 (1986). When there is a change of insurance carriers, as in this case, and the only dispute is the proper source of payment of benefits, the Commission is to apportion liability for those benefits on an equal basis between the carriers. Ark. Code. Ann. ยง 11-9-806, (Repl. 2002). Any apportionment of liability between insurance carriers, where the combined effect of a previous and a subsequent injury causes a disability, is a factual determination to be made by the Commission. Browning's Restaurant v. Kuykendall, 263 Ark. 374, 565 S.W.2d 33 (1978).
Reviewing the evidence in the light most favorable to the Commission's decision, we find that there was substantial evidence for the determination that Beckman's subsequent injury and medical treatment was the result of a combined effect of a previous compensable injury and successive injuries that constituted an aggravation rather than merely a recurrence. Treating physician Dr. Gary L. Moffit wrote to Beckman's employer Arvest on December 4, 2002, and noted that while Beckman might always have "some element" of carpal tunnel syndrome, she nevertheless suffered "no permanent impairment" and was not scheduled for any return appointment for evaluation or treatment of her injury. Dr. Moffit additionally recommended that Beckman be released to her full range of duties for Arvest, which included data input. After she resumed her duties full-time, Beckman gradually began to experience problems related to carpal tunnel syndrome. After she was denied access to Dr. Moffit for treatment, Beckman sought treatment from her family physician and was referred to Dr. James F. Moore through her family physician. Dr. Moore recommended surgery after his evaluation.
The Appellant casts suspicion on the clinic note written by Dr. James F. Moore in which there are two blanks with word "worsened" hand-written into one blank space, and the word "NCS" (nerve conduction study) written into the other space. The appellant contends that because of the alleged suspiciousness of the handwritten words in Dr. Moore's statement indicating that Beckman's NCS study had worsened and required medical treatment, the Commission gave "improper weight" to this medical evidence. The appellant also attempts to counter Dr. Moore's analysis of Beckman's nerve conduction studies in 2002 and 2003 with Dr. Moffitt's statement that they were "pretty similar" in his view. With respect to both of these arguments, it is the duty of the Commission to determine credibility of medical evidence, and any conflicts are a question of fact for the Commission. Green Bay Packaging, supra.
Because there was substantial evidence to support findings of fact that the injuries Beckman suffered in 2003 were due to the combined effect of a previous compensable injury and later aggravation in the form of successive injuries occurring after the appellant assumed the risk as insurance carrier, we affirm.
Gladwin and Robbins, JJ., agree.
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