PER CURIAM.
Saad's Healthcare Services, Inc. ("Saad's"), appeals from a judgment of the Mobile Circuit Court finding Cynthia Meinhardt to be permanently and totally disabled as a result of injuries she sustained in the line and scope of her employment as a home-health-care nurse. This is the second time that this case has been before this court. See Meinhardt v. SAAD'S Healthcare Servs., Inc., 952 So.2d 368 (Ala.Civ.App.2006)("Meinhardt I"). The following excerpts from our opinion in Meinhardt I are relevant to this appeal:
"Cynthia Meinhardt sued her employer, [SAAD'S], seeking workers' compensation benefits under the Workers' Compensation Act, § 25-5-1 et seq., Ala. Code 1975 (`the Act'), based on `severe physical and psychological' injuries she sustained after being stabbed repeatedly while working in the line and scope of her employment at SAAD'S. SAAD'S answered and admitted that Meinhardt had sustained injuries arising out of and in the course of her employment.
"Following an ore tenus proceeding, the trial court entered a judgment on August 23, 2004, finding that Meinhardt had suffered a permanent and total disability. However, the trial court declined to award Meinhardt permanent and total disability benefits based on its finding that Meinhardt had unreasonably refused to accept medical services, including both psychological and psychiatric care. In light of that finding, the trial court found that Meinhardt had sustained a 90% physical impairment to her body as a whole and that, as a result of her physical and psychological injuries, Meinhardt had a 90% vocational disability. The trial court determined that Meinhardt had reached maximum medical improvement (`MMI') with regard to her psychological injuries on May 1, 2004. . . ."
"We find the resolution of the following issue to be dispositive of Meinhardt's appeal. Meinhardt asserts that § 25-5-57(a)(4)[, Ala.Code 1975,] provides for the compensation of employees who suffer from `permanent total disability' and that, because one cannot be deemed permanently and totally disabled without first reaching MMI, the trial court's determination that she had reached MMI on May 1, 2004, precludes the application of § 25-5-57(a)(4)d., Ala.Code 1975. We agree.
"Section 25-5-57(a)(4)d. defines `permanent total disability' and provides that `[a]ny employee whose disability results from an injury or impairment and who shall have refused to undergo physical or vocational rehabilitation or to accept reasonable accommodation shall not be deemed permanently and totally disabled.' In Clear Creek Transportation, Inc. v. Peebles, 911 So.2d 1059 (Ala.Civ. App.2004), this court held that the penalty provision found in § 25-5-57(a)(4)d. applies to `employees who, after having reached MMI, . . . are incapable of engaging in gainful employment before undergoing any physical or vocational rehabilitation but who would have some
degree of capacity to engage in gainful employment if they were to undergo physical or vocational rehabilitation.' 911 So.2d at 1064 (emphasis added). In so holding, this court explained:
"`The last sentence of paragraph d. of § 25-5-57(a)(4) clearly applies only to those employees who are totally disabled. First, as noted, it is in that section of the statute entitled by the Legislature "Permanent Total Disability." More significantly, the language used by the Legislature makes it clear that this sentence applies to totally disabled employees. Finally, the sanction imposed by this provision for an employee's refusal to undergo rehabilitation is the disqualification of the employee from receiving total-disability benefits. If the employee were not totally disabled in the first instance (that is, in the absence of rehabilitation) the only sanction levied by the statute would be no sanction at all.'
"Peebles, 911 So.2d at 1064-65.
"In its judgment, the trial court concluded, as a matter of law, that Meinhardt was permanently and totally disabled. However, relying on § 25-5-57(a)(4)d., it declined to award permanent and total disability benefits because Meinhardt had failed to `mitigate her damages.' The trial court found that Meinhardt had refused psychological treatment as of November 2002 and that Meinhardt had refused to attend any further psychiatric appointments with Dr. Hammond after March 2003. The trial court further found that Meinhardt had resumed psychiatric treatment with Dr. [William] Wilkerson in February 2004. However, the trial court found that Meinhardt had remained noncompliant with prescribed psychological treatment and that, according to Dr. Wilkerson, Meinhardt had not begun psychological therapy as of the date of trial.
"SAAD'S contends that Meinhardt's alleged noncompliance with prescribed psychological treatment at the time of trial reveals that Meinhardt continued to refuse treatment, not only before she reached MMI, but also after she reached MMI. Although we recognize that a trial court's findings on disputed evidence in a workers' compensation case are conclusive, and although we are not allowed to reweigh the evidence before the trial court, this court is authorized to determine whether the trial court's decision is supported by sufficient evidence. Ex parte Golden Poultry Co., 772 So.2d [1175, 1176-77 (Ala.2000)]. The findings of the trial court will be reversed if they are not supported by substantial evidence. See § 25-5-81(e)(2), Ala.Code 1975 (`In reviewing pure findings of fact, the finding of the circuit court shall not be reversed if that finding is supported by substantial evidence.').
"After reviewing the record, including Dr. Wilkerson's deposition testimony, we conclude that the record does not contain substantial evidence supporting the trial court's finding that Meinhardt continued to refuse treatment after she reached MMI. In his deposition testimony, Dr. Wilkerson testified that he `thought [Meinhardt] needed to return to therapy.' However, Dr. Wilkerson testified that he did not refer Meinhardt to a psychotherapist. Furthermore, during a June 10, 2004, appointment with Meinhardt, Dr. Wilkerson noted that, at that time, Meinhardt was seeing a psychologist. It is undisputed that Meinhardt attended all of her scheduled monthly appointments with Dr. Wilkerson after February 2004. Given the evidence presented at trial, we cannot agree with SAAD'S contention that Meinhardt
failed to comply with prescribed psychological treatment after she reached MMI.
"The trial court determined from the evidence that Meinhardt had reached MMI for her mental condition on May 1, 2004, and it found that Meinhardt had refused treatment during a period of time before she had reached MMI, i.e., before she was entitled to any permanent benefits. This court recognized in Peebles that the penalty provision found in § 25-5-57(a)(4)d. applies to employees who have reached MMI and are thereafter deemed totally disabled. Therefore, we must reverse the judgment of the trial court insofar as it declined to award Meinhardt permanent and total disability benefits and remand this cause for the trial court to reconsider its judgment in a manner consistent with this opinion."
Meinhardt I, 952 So.2d at 370-71, 375-76 (footnotes omitted). In Meinhardt I, this court did not address whether the penalty provision found in § 25-5-57(a)(4)d. applied to an employee's refusal to undergo psychological or psychiatric treatment.
After this court released its opinion in Meinhardt I, the trial court set the case for review. Before the trial court reviewed the case on remand, Saad's filed a motion on October 10, 2006, to set an evidentiary hearing or, in the alternative, for a ruling that Meinhardt was non-compliant with physical or vocational rehabilitation due to her alleged refusal of psychological and psychiatric treatment since March 24, 2005. On October 23, 2006, the trial court conducted a hearing to review the case on remand, and on October 31, 2006, it entered an amended order stating, in pertinent part, as follows:
"[T]he Court hereby VACATES and AMENDS its `Findings of Fact, Conclusions of Law, and Final Judgment' entered on August [23], 2004, as follows:
"a. The Court finds that although Cynthia Meinhardt was non-compliant with her prescribed psychological and/or psychiatric treatment between March 2003 and May 1, 2004, Cynthia Meinhardt was compliant with her prescribed treatment thereafter.
"b. The Court finds that, as a proximate result of the March 7, 2002, assault, Cynthia Meinhardt is Permanently and Totally Disabled from gainful employment within the meaning of § 25-5-57(a)(4) of [the Workers' Compensation Act]. After giving due consideration to her age, education, work skills, physical disabilities and psychological disabilities, Cynthia Meinhardt cannot be successfully re-trained for any substantial gainful employment.
"c. The Court finds that [Meinhardt's] average weekly wage at the time of the injury was $417.76. The weekly benefit rate for disability benefits is $278.51."
(Emphasis in original.) The trial court did not address Saad's allegations that Meinhardt had been noncompliant with treatment since March 2005 in its October 31, 2006, amended order.
On November 15, 2006, Saad's filed a motion to alter, amend, or vacate the trial court's October 31, 2006, amended order and/or a petition to alter, amend, or revise the amended order.1 In its motion, Saad's
argued that Meinhardt had stopped taking her antidepressant medication after March 24, 2005, and that Meinhardt was noncompliant with her treatment after having reached MMI. Based on what it alleged was Meinhardt's failure to comply with treatment after March 24, 2005,...
