Full Opinion

Cite as 2026 Ark. App. 505 ARKANSAS COURT OF APPEALS DIVISION IV No. CV-25-771 AMANDA ENGLEMAN Opinion Delivered October 28, 2026 APPELLANT APPEAL FROM THE ARKANSAS WORKERS’ COMPENSATION V. COMMISSION [NO. H404754] WASHINGTON REGIONAL MEDICAL CENTER AND RISK MANAGEMENT RESOURCES, CARRIER/TPA APPELLEES AFFIRMED ROBERT J. GLADWIN, Judge Amanda Engleman appeals the September 25, 2025 decision of the Arkansas Workers’ Compensation Commission that reversed the April 18, 2025 opinion of the administrative law judge (ALJ) and denied her claim for compensable injuries to both shoulders. On appeal, she argues that the Commission improperly required objective medical findings to establish causation and arbitrarily rejected her credibility. Because the Commission separately found that she failed to prove a causal connection between the June 2, 2023 workplace incident and the shoulder conditions at issue, and because that finding provides a substantial basis for denying relief, we affirm. I. Facts and Procedural History Engleman worked as an operating-room circulator for Washington Regional Medical Center. Her duties included preparing operating rooms, moving patients and equipment, and positioning patients during surgery. On June 2, 2023, a patient began sliding from an operating table. Engleman went beneath the table to support the patient, pushed upward for approximately three to five minutes, felt a pop in her left shoulder, and experienced pain in both shoulders. She promptly reported the incident, was sent to the employee-health nurse, and completed an injury report identifying both shoulders. Appellees do not materially dispute that the incident occurred. Engleman sought treatment the same day at Conservative Care Occupational Health. She reported a pop and sharp left-shoulder pain and subsequent right-shoulder pain. X-rays revealed bilateral degenerative changes, including spurring at the left acromion, but no fracture or acute abnormality. Amanda Bell, APRN, diagnosed bilateral shoulder pain, restricted her work, referred her to physical therapy—which she began at Total Spine at Washington Regional on June 14, and observed that the symptoms appeared to be related to work activities. The physical therapy did not alleviate Engleman’s symptoms, and she saw the physician, Dr. Konstantin Berestnev, on June 9. Dr. Berestnev continued restrictions, and after her condition remained unchanged after a week, she received a steroid injection. Engleman reported that the continued physical therapy aggravated her symptoms and that, even after a second injection, she felt they were getting worse. Dr. Berestnev returned her to 2 regular duty on June 30 and released her without restrictions on August 8, noting that her shoulder pain had improved. The record before us also reveals that Engleman had previous shoulder complaints. In early February 2022, Engleman was painting at home and fell from a barstool onto her left shoulder, and she sought treatment for left-shoulder pain. An x-ray was negative. She testified that the pain resolved after about three weeks. She also described an April 2023 incident that involved moving her approximately fifty-pound dog across a vehicle seat; subsequent medical histories varied as to whether the dog jerked or wrenched her shoulder. After returning to unrestricted employment, Engleman continued her regular duties until June 2024. At a February 26, 2024 chiropractic visit, she reported problems beginning approximately two years earlier and identified January 1, 2021, as an injury date, marking the left shoulder and neck on an intake diagram. On March 26, Engleman saw Dr. J. Clayton, who recorded that she had reported experiencing left-shoulder pain since moving a dog in a car about two years earlier. On April 16, his record instead identified a fall onto her shoulder as the inciting event. A May 7, 2024 left-shoulder MRI disclosed mild AC-joint degenerative change and a small amount of subacromial-bursal fluid consistent with bursitis or tendonitis. Dr. Clayton wanted Engleman to see his partner, Dr. Greg Jones, but before that occurred, she was treated by Dr. T. Zimmerman. On May 17, Dr. Zimmerman performed ultrasound-guided corticosteroid injection into her left shoulder and described in his notes her chronic 3 shoulder pain of multiple possible etiologies and recorded symptoms extending more than two years to the barstool fall. On May 29, at her first visit with Dr. Jones, he noted a history of symptoms beginning approximately two and a half years earlier with a painting-related fall along with dog-related incidents. His initial history noted work activities that exacerbated symptoms but did not identify the June 2, 2023 operating-room incident. On June 13, 2024, Dr. Jones operated on Engleman’s left shoulder. His operative observations included biceps-tendon subluxation and a longitudinal split, tenosynovitis, AC- joint meniscus arthropathy with torn AC meniscus elements, and moderately severe subacromial bursitis with the rotator cuff intact. He performed a biceps tenotomy, AC resection, and bursectomy. Dr. Jones subsequently concluded that the June 2023 incident had a substantial work-related component and, responding to an October 2024 inquiry from counsel, opined that it was more than 50 percent responsible for the injury, symptoms, and need for surgery. Later right-shoulder imaging showed AC arthropathy and slight distal- clavicle displacement. Dr. Jones suggested a similar AC sprain on that side. An ALJ held a hearing on January 21, 2025. The issues included compensability of both shoulders, medical and temporary total-disability benefits, and attorney’s fees. On April 18, the ALJ found bilateral compensable injuries and awarded medical treatment and temporary total-disability benefits beginning on June 13, 2024. Appellees appealed to the Full Commission, and on September 20, 2025, the Commission reversed, with one commissioner dissenting. The majority emphasized the nonacute initial imaging, subsequent 4 return to regular work duties, inconsistent accounts of symptom onset and earlier events, and the changing foundation for Dr. Jones’s causation opinion. It found Engleman not credible concerning the claimed origin of her condition, assigned minimal weight to Dr. Jones’s later causation opinion, and expressly determined that she had not proved that the June 2, 2023 incident caused internal or external physical harm to either shoulder. II. Standard of Review and Applicable Law We view the evidence and all reasonable inferences in the light most favorable to the Commission’s findings and affirm if they are supported by substantial evidence. Melius v. Chapel Ridge Nursing Ctr., 2025 Ark. App. 406. Evidence is substantial if reasonable minds could have reached the same conclusion without resort to speculation or conjecture. Id. When the Commission denies benefits because the claimant has failed to meet his or her burden of proof, the substantial-evidence standard of review requires this court to affirm the Commission’s decision if the opinion displays a substantial basis for the denial of relief. Id. Credibility questions and the weight to be given to witness testimony are within the Commission’s exclusive province. See id.; Watson v. Highland Pellets, LLC, 2022 Ark. App. 132, 643 S.W.3d 267. A compensable specific-incident injury must arise out of and in the course of employment, cause internal or external physical harm requiring medical services or resulting in disability or death, and be caused by a specific incident identifiable by time and place. Ark. Code Ann. § 11-9-102(4)(A)(i) (Repl. 2025). The claimant must establish compensability by a preponderance of the evidence. Id. § 11-9-102(4)(E)(i). A compensable 5 injury must be established by medical evidence supported by objective findings, which are findings beyond the patient’s voluntary control. Id. § 11-9-102(4)(D), (16)(A)(i). But objective medical evidence is required to establish the existence and extent of an injury, not necessarily to establish the causal relationship between an injury and a workplace occurrence. Mohler v. Young, 2026 Ark. App. 105, 731 S.W.3d 395 (holding that while objective medical evidence is required to establish the existence and extent of an injury, causation may be established by a preponderance of other nonmedical evidence); see also Wal-Mart Stores, Inc. v. VanWagner, 337 Ark. 443, 990 S.W.2d 522 (1999). III. Discussion Engleman first contends that the Commission conflated objective proof of an injury with proof of causation. She correctly notes that medical evidence supported by objective findings is not independently required to prove that a diagnosed injury resulted from a specific workplace incident. VanWagner, supra. Nor is the existence of degenerative pathology necessarily fatal to compensability. See N. Ark. College v. Sparks, 2026 Ark. App. 367, __ S.W.3d __. An aggravation of a preexisting condition may constitute a compensable injury if the statutory requirements are established. See id. But the presence of objective pathology and the occurrence of a workplace incident do not, standing alone, compel a finding that the incident caused the pathology. Here, the Commission expressly recognized that the objective-findings requirement applies only to the existence and extent of an injury. Although portions of its opinion do refer to a failure to establish a compensable injury through objective findings, the 6 Commission did not rest solely on the absence of objective evidence connecting Engleman’s shoulder abnormalities to the June 2 workplace incident. It separately found that Engleman “did not prove that the June 2, 2023 incident caused internal or external physical harm to the left shoulder or right shoulder” and that the later left-shoulder operative findings and right-shoulder radiographic abnormalities had not been proved causally related to the work incident. This independent causation determination by the Commission is central to our decision to affirm. The record before us does contain evidence favorable to Engleman: (1) the workplace event was promptly reported; (2) Engleman experienced pain that day and received treatment and restrictions to work; and (3) later surgery revealed objective abnormalities in her left shoulder. Dr. Jones also ultimately connected her shoulder conditions to the workplace incident. But the Commission was not required to accept that evidence as establishing causation. Initial x-rays showed degeneration without an acute abnormality. Also, Engleman was released to and resumed unrestricted work and continued her physically demanding job for months. Most importantly, several later medical histories attributed the commencement of her persistent symptoms to the earlier barstool fall at home or dog-related events. And Dr. Jones’s first evaluation described a lengthy preexisting history without identifying the June 2, 2023 workplace event. The Commission was also entitled to consider the development of Dr. Jones’s opinion. His October 2024 notes followed his initial examination and surgery, and those recorded histories emphasized earlier events as well as a later inquiry that specifically asked 7 about the June 2, 2023 incident. That later opinion provided evidence supporting Engleman’s claim, but the Commission had the authority to consider its foundation and assign it minimal weight in light of both the contemporaneous and earlier records. This court’s task is not to decide whether another fact-finder could have credited Dr. Jones’s opinion or inferred an aggravation of a preexisting injury. It is whether fair-minded persons could reach the Commission’s conclusion. Melius, supra. Engleman also argues that a specific-incident claimant seeking medical and temporary benefits need not show that the incident was the major cause of the need for treatment. See Estridge v. Waste Management, 343 Ark. 276, 33 S.W.3d 167 (2000). Instead of a major-cause requirement, the Commission determined that Engleman did not prove the threshold causal connection between the identified workplace event and a compensable physical injury to either shoulder. In light of the record before us, the Commission’s conclusion displays a substantial basis for the denial of relief. Engleman next challenges the Commission’s adverse credibility finding, arguing that it lacked an articulated, reasonable basis. Although it is true that we defer to the Commission on the weight of evidence and credibility of witnesses, the Commission may not arbitrarily disregard testimony and is not so insulated that it renders appellate review meaningless. Humphries v. FNA Grp., LLC, 2025 Ark. App. 304, 716 S.W.3d 196. But that is not what occurred here. The Commission identified specific inconsistencies: (1) the chiropractic intake information indicating an earlier onset; (2) Dr. Clayton’s differing histories relating symptoms to the dog and a prior fall; (3) the histories given to Drs. Zimmerman and Jones 8 describing symptoms lasting more than two years; and (4) the omission of the June 2, 2023 event from Dr. Jones’s first recorded history. It also noted the absence of corroboration for Engleman’s testimony that Dr. Berestnev declined additional diagnostic testing or referral. The Commission’s findings need not be construed as a rejection of the fact that the operating-room episode occurred or that Engleman reported pain afterward. Those circumstances were substantially corroborated. Rather, the Commission questioned Engleman’s account of the origin and continuity of the conditions ultimately treated in 2024. Because its credibility determination rests on identified record evidence rather than an unsupported assertion, we cannot say that the Commission arbitrarily disregarded Engleman’s testimony. The ALJ’s contrary assessment and the dissenting commissioner’s analysis do not authorize us to reweigh the evidence. In sum, the Commission acknowledged the proper distinction between medical proof of injury and proof of causation, expressly found that the June 2, 2023 incident was not shown to have caused compensable physical harm to either shoulder, and provided record- supported reasons for its evaluation of credibility and medical-opinion evidence. We therefore affirm. Affirmed. VIRDEN and TUCKER, JJ., agree. Walker Law Group, PLC, by: Eddie H. Walker, Jr., for appellant. Worley, Wood & Parrish, P.A., by: Melissa Wood, for appellees. 9