Arkansas court upholds ankle surgery award despite worker’s earlier operation

The doctor who performed her 2020 surgery reviewed her new imaging and concluded that none of the MRI findings were related to the January 2022 injury. He said she had reached maximum medical improvement and carried a “0% impairment rating” from the work accident. 

The worker switched physicians. A second doctor reviewed her scans, found “posttraumatic arthritis” in her foot and ankle, and she had surgery in September 2023. 

The employer asked the Arkansas Workers’ Compensation Commission to decide whether that surgery was reasonable and necessary treatment for the work injury. An administrative law judge found the worker had suffered a compensable ankle sprain but sided with the employer on the surgery, leaning on the first doctor’s opinion and tying the operation to a preexisting degenerative condition. 

The full Commission reversed. The worker did not have to prove the work injury was the major cause of her need for surgery – only that it was “a factor.” Post-fall imaging showed a tendon tear that had not appeared on earlier scans, so the Commission gave the first doctor’s causation opinion “minimal weight” and credited the second doctor. It also noted her pain and mobility improved after the operation. 

On appeal, the college argued the Commission arbitrarily brushed aside the first doctor’s causation opinion. The court disagreed. The Commission had not ignored that opinion, it said – it weighed the opinion against the rest of the file and gave it less weight.