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TENNESSEE BUREAU OF WORKERS’ COMPENSATION

IN THE COURT OF WORKERS’ COMPENSATION CLAIMS

AT NASHVILLE

MUHAMAD MUSTAFA,

 Employee,

)

)

) Docket No. 2018-06-0234

v. )

)

ADP TOTALSOURCE CO. XXIII, 

INC.,

)

)

State File No. 10589-2018

Employer,

And 

NEW HAMPSHIRE INS. CO.,

 Carrier.

)

)

)

)

Judge Joshua D. Baker

ORDER GRANTING MEDICAL BENEFITS

At an Expedited Hearing on April 18, 2019, Mr. Mustafa requested reimbursement 

for unauthorized medical expenses, temporary disability benefits, and a new authorized 

treating physician. ADP Totalsource Co., XXIII, Inc. (ADP) opposed each request. For 

the reasons below, the Court denies Mr. Mustafa’s requests. Despite this denial, he

retains his right to continuing reasonable and necessary treatment with the authorized 

treating physician

History of Claim

Mr. Mustafa performed repetitive work with both hands at ADP. In May 2017, he 

complained to his primary care physician of bilateral hand pain. His doctor suspected 

work-related bilateral carpal tunnel syndrome and referred him to Dr. David West. After 

an EMG, Dr. West concluded that Mr. Mustafa had carpal tunnel syndrome and 

recommended right carpal tunnel release surgery. 

Mr. Mustafa reported his work injury in November but said ADP delayed 

involving its workers’ compensation insurance carrier because his manager wanted him 

FILED

Apr 30, 2019

02:29 PM(CT)

TENNESSEE COURT OF

WORKERS' COMPENSATION

CLAIMS
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to use his TennCare insurance instead. His doctor advised him that would be illegal and 

recommended he call the Bureau of Workers’ Compensation to initiate a claim. 

Eventually, Mr. Mustafa persuaded the Carrier to authorize treatment and allow 

Dr. West to be his authorized treating physician. He resumed treatment with Dr. West on 

February 13, 2018, and received restrictions of no lifting, pushing, or pulling greater than 

ten pounds.

After that appointment, Mr. Mustafa felt “unhappy and dissatisfied” with Dr. 

West. He asked the adjuster to “change from Dr. West to another doctor” because “he 

doesn’t do what I ask.” In response, the adjuster permitted him to choose Dr. Morgan 

Lorio from a panel and scheduled an appointment for February 23. 

Ultimately, Dr. Lorio performed right carpal tunnel release surgery on March 26.

By May, Mr. Mustafa had completed physical therapy for right-ulnar pillar pain. Dr. 

Lorio did not treat Mr. Mustafa’s left hand at that time, but the medical records reflect

that he planned to recommend a left carpal tunnel release “once the right has settled down 

completely.” In the meantime, he injected Mr. Mustafa’s right carpal tunnel and 

scheduled a follow-up appointment. 

When Mr. Mustafa returned on July 17, Dr. Lorio released him to full-duty work. 

This concerned Mr. Mustafa because as he would have been performing repetitive work 

while recovering from a repetitive trauma injury. Dr. Lorio wrote, “Patient states that he 

is not going to return to work, and that is his preogative [sic].” Dr. Lorio recommended 

physical therapy, which the carrier authorized. Mr. Mustafa was to return on August 14 

“for repeat evaluation of response to therapy.”

Mr. Mustafa did not return to work, attend any more appointments, or complete

physical therapy. He requested emergent care instead, which the carrier refused. 

However, the nurse case manager offered to reschedule his next appointment with Dr. 

Lorio from August 14 to August 6 to address his “extreme pain” complaints. Instead of 

accepting the appointment, he visited the emergency room three times between July 30 

and August 25 and also saw two other unauthorized providers. 

In his testimony and affidavit, Mr. Mustafa explained that the authorized treatment 

worsened his pain and that being returned to work without restrictions “didn’t make any 

sense.” Specifically, he complained Dr. Lorio ignored his left hand and that surgery and 

physical therapy had worsened his condition. Further, the doctor “cut off [his] 

medication and gave [him] patches to use instead, but they made [his] condition worse.”

About his decision to seek unauthorized treatment, he testified, “I had a feeling this 

particular doctor was not going to help me anymore.” 
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Mr. Mustafa also testified that he did not work from February 16 to February 23 

but was not paid temporary disability benefits. He admitting working three hours on 

February 16 but said prescription pain medication made him too drowsy, so he left. He 

sought unauthorized emergent care on February 18th and 20th. Mr. Mustafa 

acknowledged ADP provided him different, easier work while on restrictions and also 

paid temporary disability benefits while he recovered from surgery. 

Legal Principles and Analysis 

Mr. Mustafa has the burden to prove of his claim but need not prove every element 

by a preponderance of the evidence to receive relief at an expedited hearing. Instead, he

must present sufficient evidence that he would likely prevail at a hearing on the merits. 

McCord v. Advantage Human Resourcing, 2015 TN Wrk. Comp. App. Bd. LEXIS 6, at 

*7-8, 9 (Mar. 27, 2015). Mr. Mustafa sought reimbursement of his unauthorized medical 

expenses, additional temporary disability benefits, and a new treating physician. ADP 

argued it owed no further temporary disability benefits and that it had provided all 

reasonable and necessary medical treatment but Mr. Mustafa declined to accept it, 

incurring unreasonable and unnecessary medical expenses as a result.1The Court agrees 

with ADP. 

An employer is required to provide injured workers “medical and surgical 

treatment . . . as ordered by the attending physician . . . made reasonably necessary by 

accident.” Tenn. Code Ann. § 50-6-204(a)(1)(A) (2018). Likewise, employees are 

required to “accept the medical benefits afforded under this section” provided that the

“employee has suffered an injury and expressed a need for medical care” and selected a 

treating physician from the employer’s panel. Tenn. Code Ann. § 50-6-204(a)(3)(A)(i). 

When the selected physician refuses to treat the employee, the employer is required to 

provide a new authorized treating physician. See Limberakis v. Pro-Tech Security, Inc., 

2017 TN Wrk. Comp. App. Bd. LEXIS 53, at *9-10 (Sept. 12, 2017). When treatment is 

disputed, the employee has the burden of demonstrating unauthorized treatment was

reasonable and necessary. Id. at *5.

Here, the Court finds Mr. Mustafa is not likely to prevail at a final hearing 

concerning reimbursement of unauthorized medical expenses incurred through 

emergency room visits. Dr. Lorio provided a treatment plan for his bilateral wrist injuries

that Mr. Mustafa rejected in favor of unauthorized treatment at the emergency. Further,

although he requested care before visiting the emergency room, the carrier responded 

 

1 The Court is compelled to address the allegation that ADP instructed Mr. Mustafa to seek treatment 

under TennCare for a work-related injury. Tennessee Code Annotated section 50-6-128 provides that any 

employer who “knowingly, willfully, and intentionally causes a medical or wage loss claim to be paid 

under health or sickness and accident insurance” may be assessed a penalty of $500 by the Administrator 

of the Bureau of Workers’ Compensation. As the evidence at the hearing indicated this occurred, the 

Court has notified the Administrator by sending her a copy of this order. 
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reasonably by offering the earliest available appointment with the authorized treating 

physician. Mr. Mustafa presented no expert medical evidence contradicting Dr. Lorio’s

treatment plan or establishing the reasonable medical necessity of the unauthorized 

treatment. The Court declines to substitute its or Mr. Mustafa’s judgment for the opinion

of a trained physician. See Scott v. Integrity Staffing Solutions, 2015 TN Wrk. Comp. 

App. Bd. LEXIS 24, at *8; see also Lurz v. Int’l Paper Co., 2018 TN Wrk. Comp. App. 

Bd. LEXIS 8, at *17 (Feb. 14, 2018). Thus, the Court denies his request for 

reimbursement of unauthorized medical expenses. 

The Court also declines Mr. Mustafa’s request for a different authorized treating 

physician. In his medical notes, Dr. Lorio provided a reasonable plan to treat his bilateral 

carpal tunnel condition. The Court heard no testimony showing that Dr. Lorio intended 

to stop treating Mr. Mustafa before completing that plan. Rather, the evidence showed 

that Mr. Mustafa diverted from Dr. Lorio’s treatment plan and sought care on his own. 

Mr. Mustafa had the duty to accept the care provided by ADP, and his failure to do so, in 

this Court’s view, likely extended his recovery period. Under the circumstances, the 

Court holds that ADP has no duty to provide an additional panel.

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Lastly, the Court denies Mr. Mustafa’s claim for payment of temporary disability

from February 16 to February 23. To recover those benefits, Mr. Mustafa must show his 

injury disabled him from working; a causal connection exists between his injury and 

inability to work; and the duration of his disability. Jones v. Crencor, 2015 TN Wrk. 

Comp. App. Bd. LEXIS 48, at *7 (Dec. 11, 2015). 

Here, Mr. Mustafa established that he missed work from February 16 to 23. 

However, he failed to show that his carpal tunnel condition disabled him from working,

as Dr. West did not take him off work completely, and ADP provided alternative work

within his medical restrictions. While Mr. Mustafa rejected the alternative work because 

his prescription caused drowsiness, his own opinion about his inability to work is 

insufficient to prove his claim for temporary disability.

3 Based on the evidence presented 

at the hearing, the Court cannot find he would likely prove his injury disabled him from 

working at a trial on the merits. For this reason, the Court holds he is not entitled to 

temporary disability benefits. 

It is ORDERED as follows: 

 

2 Additionally, ADP offered Mr. Mustafa a new panel when he expressed dissatisfaction with the 

treatment received from Dr. West. 

3 The Court also notes that Mr. Mustafa sought emergent care twice during that week for symptoms 

unrelated to his work injury. 
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1. The Court denies Mr. Mustafa’s request for reimbursement, temporary 

disability benefits, and for a new treating physician. Mr. Mustafa may 

continue to treat with Dr. Lorio for his work-related injury. 

2. This matter is set for a status conference on June 14, 2019, at 10:30 

a.m. (CDT). The parties, or their counsel, must call (615) 741-2113 or 

(855) 874-0474 toll-free to participate. Failure to call may result in a 

determination of the issues without that party’s participation. 

It is ORDERED. 

 ENTERED APRIL 30, 2019. 

______________________________________ 

Judge Joshua Davis Baker 

Court of Workers’ Compensation Claims
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APPENDIX

Exhibits:

1. Medical Records 

2. Mr. Mustafa’s Affidavit

3. Receipts from Elite Sports Medicine

4. Choice of Physician Forms

Technical Record:

1. Petition for Benefit Determination 

2. Dispute Certification Notice

3. Request for Expedited Hearing

4. ADP’s Pretrial Brief
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CERTIFICATE OF SERVICE

I certify that a true and correct copy of this Expedited Hearing Order was sent to 

the following recipients by these methods of service on April 30, 2019.

Name Certified 

Mail

Fax Email Service sent to:

Muhamad Mustafa,

Self-represented 

Employee

X 4025 Providence Ln

Nashville, TN 37211

Sarah Best,

Employer’s Attorney

X shbest@mijs.com;

clalmeida@mijs.com

______________________________________

PENNY SHRUM, COURT CLERK

wc.courtclerk@tn.gov