Jack Nelson Jones Professional Association
September 16-22, 2019
LAVACA SCHOOL DISTRICT AND ARKANSAS SCHOOL BOARDS ASSOCIATION V. PAT HATFIELD, 2019 Ark. App.360 (Sept. 4, 2019)
This case comes on appeal from the Arkansas Workers’ Compensation Commission. The Lavaca School District and Arkansas School Boards Association (“the District”) appealed the Arkansas Workers’ Compensation Commission’s (“the Commission”) decision reversing the decision of the administrative law judge (ALJ) who denied Pat Hatfield’s (“Hatfield”) request for additional medical benefits. The ALJ concluded that Hatfield’s claim was barred by the statute of limitations, but the Commission disagreed and found that she had received reasonable and necessary medical treatments that tolled the statute of limitations. The Court of Appeals found this factual finding was supported by substantial evidence and affirmed the Commission’s decision.
Hatfield was employed by the District when she first sustained an undisputedly compensable injury to her right knee as a result of falling in the bathroom on April 11, 2014. She filed for workers’ compensation benefits on Oct. 3, 2014, and the District subsequently paid for medical treatment, including surgery.
Hatfield had what she called a “flare up with her right knee” in July 2015 and received medical treatment until Dec. 29, 2015 when her treating physician, Dr. Trent Johnson, released her to work with no restrictions. On March 14, 2016, the District’s attorney emailed Hatfield’s attorney and Dr. Johnson, advising them that Hatfield must request and receive advance authorization for any additional medical treatment related to her knee injury. On May 6 and again on June 21, 2016, Hatfield was treated by Dr. Johnson, without requesting or obtaining advanced authorization. At both of these appointments, Hatfield complained of pain in her right leg, shooting down from her back and hip. She was prescribed physical therapy for her back and given a steroid injection in her hip. On April 27, 2017, she was again seen by Dr. Johnson, without advance authorization, for problems specifically related to her right knee. The District did not pay for any of the three treatments for which Hatfield failed to obtain prior approval.
On March 1, 2018, Hatfield filed a claim for additional medical benefits for her right knee stemming from her compensable injury. Although the District initially claimed to have provided all reasonable and necessary treatment up to and through June 21, 2016, it later revised its position and asserted that the last benefits that had been paid on Hatfield’s claim were in December 2015, which would make her claim for additional benefits time-barred under the applicable statute of limitations.
The ALJ agreed with the District, concluding that Hatfield’s claim for additional benefits was time-barred. Hatfield appealed to the Commission, which found that Hatfield had received periodic medical treatment that was reasonable and necessary to treat her compensable injury and that the statute of limitations was therefore tolled, giving her an extended time for treatment for the injury. The Commission reversed the ALJ’s decision, and this appeal followed.
To the extent that the issue before the Court of Appeals (“the Court”) included pure questions of law, the Court observed that such issues are reviewed de novo. This meant that it was up to the Court to decide what the statute meant, and it was not bound by the Commission’s interpretation and application of the statute. Regarding findings of fact, however, the Court noted that it must view the evidence and all reasonable inferences deducible therefrom in the light most favorable to the Commission’s findings and affirm if the decision was supported by substantial evidence. Substantial evidence exists if reasonable minds could reach the Commission’s conclusion, and the Court observed it would not reverse the Commission’s decision unless fair-minded persons with the same facts before them could not have reached the Commission’s conclusions. The issue was not whether the Court might have reached a different result or whether the evidence would have supported a contrary finding. Questions of weight and credibility rested within the sole province of the Commission, which was not required to believe the testimony of the claimant or of any other witness but could accept and translate into findings of fact only those portions of the testimony it deemed worthy of belief. Once the Commission made its decision on issues of credibility, the Court noted it was bound by that decision.
The only issue before the Court was whether Hatfield’s March 5, 2018 application for additional medical benefits was barred by Arkansas Code Annotated section 11-9-702(b), which states in pertinent part:
– (b) Time for Filing Additional Compensation.
(1) In cases in which any compensation, including disability or medical, has been paid on account of injury, a claim for additional compensation shall be barred unless filed with the commission within one (1) year from the date of the last payment of compensation or two (2) years from the date of the injury, whichever is greater.
– (c) A claim for additional compensation must specifically state that it is a claim for additional compensation.
The Court noted that the Arkansas Supreme Court has construed the term “last payment of compensation” as including the date the employer or carrier last furnished medical services. Therefore, the one-year limitations period ran from the date of the last furnishing of medical services, not the payment therefor.
The parties disagreed on the legal significance of Hatfield’s failure to obtain prior authorization for the treatments as requested by the District. The District argued that it did not furnish medical services to Hatfield because it only agreed to pay if she obtained prior authorization; Hatfield contended that the District’s request had no legal effect because Dr. Johnson was an authorized provider to treat Hatfield’s admittedly compensable injury, and the District had no authority to unilaterally impose conditions and restrictions on those benefits. The Court affirmed the Commission’s finding that failure to comply with the District’s pre-authorization requirements was no bar to Hatfield seeking additional benefits. It noted that the District cited no authority for the idea that one party may unilaterally impose such conditions on the benefits it provides for a compensable injury. Additionally, the Court noted that Arkansas caselaw made clear that it was the furnishing of treatment that tolled the statute of limitations, not the payment for such treatment.
The parties also disputed whether Hatfield’s visits to Dr. Johnson in 2016 tolled the statute of limitations. The District argued that the issue here was a question of statutory interpretation, but the substance of its argument on appeal challenged the Commission’s finding that the medical services furnished to Hatfield in May and June 2016 were reasonable and necessary to treat her compensable knee injury.
In determining that Hatfield’s application for additional benefits was not time-barred, the Court noted that the Commission found that the May and June 2016 treatments were sufficiently related to her knee injury, stating that “Dr. Johnson’s continued treatment was reasonable and necessary, and was related to continued difficulty related to the claimant’s right knee, as well as complications resulting from the compensable injury.”
The Court noted this finding of fact was sustained because it was supported by substantial evidence. It noted that Dr. Johnson’s notes from both visits stated that Hatfield was being seen “as a follow-up,” indicating that her complaints of right-leg pain were related to her prior visits at which she received treatment for her compensable right-knee injury. Also, Dr. Johnson’s notes for both 2016 appointments also specifically mentioned her history of knee problems. Moreover, Hatfield testified that the generalized leg pain for which she was seen in 2016 was the result of an uneven gait, stating that it was caused by “favoring other parts of the body to try and stay off this leg.” Hatfield attributed the leg and hip pain to “the way I was walking” due to her knee pain which the Court found was part of the substantial evidence supporting the Commission’s decision. Following these 2016 treatments, Hatfield saw Dr. Johnson in April 2017 for treatment that was clearly related to her compensable knee injury. In light of these facts, the Court found no error in the Commission’s finding that the continued treatment of her right leg in 2016 was reasonable and necessary.
The remaining analysis was simple and straightforward. The Court observed that Dr. Johnson was Hatfield’s authorized treating physician for an admittedly compensable injury. He provided reasonable and necessary medical treatment for Hatfield’s compensable knee injury at least once per year between the date of her injury in April 2014 and her last treatment in April of 2017. Hatfield then filed an application for additional benefits in March 2018, which fell within one year of the 2017 treatment. Under a plain reading of Arkansas Code Annotated section 11-9-702(b), her application for additional medical benefits was not time-barred, and the decision of the Commission was affirmed.