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TENNESSEE BUREAU OF WORKERS’ COMPENSATION

WORKERS’ COMPENSATION APPEALS BOARD

Kaci L. Johnson ) Docket No. 2020-08-0731

)

v. ) State File No. 23720-2020

)

Inspire Brands d/b/a )

Blazin Wings, Inc., et al. )

)

)

Appeal from the Court of Workers’ ) Heard August 10, 2022

Compensation Claims ) via Microsoft Teams

Allen Phillips, Judge )

Affirmed and Remanded

In this interlocutory appeal, the employee reported suffering a back injury when a large 

cooler fell on her at work. The trial court determined that the causation opinions of both 

the initial authorized physician and the subsequent authorized physician were entitled to 

the statutory presumption of correctness. The court then weighed the contradictory 

opinions, determined the initial authorized physician’s opinion was entitled to greater 

weight, and concluded the employee had come forward with sufficient evidence to indicate 

a likelihood of prevailing on this issue at trial. As a result, it ordered the employer to 

provide the disputed surgery. The employer has appealed. Following a careful review of 

the record and the parties’ arguments, we affirm the decision of the trial court and remand 

the case.

Judge Pele I. Godkin delivered the opinion of the Appeals Board in which Presiding Judge 

Timothy W. Conner and Judge Meredith B. Weaver joined.

A. Allen Grant and Benjamin T. Norris, Nashville, Tennessee, for the employer-appellant, 

Inspire Brands d/b/a Blazin Wings, Inc.

Monica Rejaei, Memphis, Tennessee, for the employee-appellee, Kaci L. Johnson

Factual and Procedural Background

On April 4, 2020, Kaci L. Johnson (“Employee”) was injured while working for 

Inspire Brands d/b/a Blazin Wings, Inc. (“Employer”), when a cooler estimated to weigh 

more than 300 pounds fell on the left side of her back, pinning her against a counter.

FILED

Sep 07, 2022

01:32 PM(CT)

TENNESSEE

WORKERS' COMPENSATION

APPEALS BOARD
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Employee was seen at Saint Francis Hospital-Bartlett’s Emergency Room with complaints 

of left-sided back pain. A CT scan of Employee’s chest and x-rays of her bilateral 

hip/pelvis area were normal. Upon discharge, Employee was prescribed pain medication 

and urged to follow up with her primary care physician and workers’ compensation

representative.

Two days later, Employee saw her chiropractor, Dr. Chancellor Johnson, and

records of that visit reflect that Employee was “sore, but feeling a little better today.” The 

records make no reference to the work incident. The next day, Employee was seen by 

Danielle Howell, a nurse practitioner at Methodist Healthcare. Employee provided a 

history of a cooler falling on her and striking her “back, left lower ribs and buttock at 

work.” She complained of moderate middle lower back pain, which began three to four 

days prior to her visit. Employee was diagnosed with “[b]ack pain due to injury” and 

“[a]cute left-sided low back pain without sciatica.” Employee was told she could return to 

work on Monday, April 13, and physical therapy would be ordered if needed.

Following that visit, Employee treated with MedPost Urgent Care (“MedPost”) in 

Memphis, Tennessee. She was initially seen by a nurse practitioner at MedPost on April 

9, and she reported that symptoms related to her injury had improved. Employee noted 

“pain in the left, posterior, lateral back which [she] described as aching with radiation to 

the left buttock.” Employee’s symptoms were aggravated by local pressure, movement, 

sitting, and walking. The nurse practitioner diagnosed Employee with “[a]cute left-sided 

low back pain without sciatica” and a contusion of the left side of Employee’s back. 

Medical records reflect this was a “[w]ork related injury” and Employee was taken off 

work until her next visit. Employee returned for a follow-up visit on April 13 and reported 

that symptoms related to her injury had improved. She was prescribed a muscle relaxer to 

help with back pain and was released to return to work with light-duty restrictions. During 

that visit, an orthopedic referral was made for further evaluation of Employee’s back pain.

Thereafter, Employee selected Dr. Jeffrey Dlabach, an orthopedic surgeon, from an 

Employer-provided panel. Employee first saw Dr. Dlabach on April 21 and provided a 

history of the incident and the medical care she had received to date. Medical records 

indicate Employee had returned to work with restrictions but was starting to have increased 

pain, including “having issues into her buttock and left leg . . . predominantly in the left 

lumbar area,” and that this pain was now extending down into her left leg. Dr. Dlabach 

ordered an MRI of Employee’s lumbar spine, which revealed degenerative disc changes at 

the L5-S1 level with slight retrolistheses and disc desiccation, and a left L5-S1 paracentral

subannular disc protrusion. Following an epidural steroid injection, pain medication, and 

muscle relaxers, Employee reported no improvement. As a result, Dr. Dlabach referred 

her to a neurosurgeon for further evaluation.

Employee selected Dr. Fereidoon Parsioon from a panel of neurosurgeons, and he 

first evaluated her in August 2020. Employee reported back and left lower extremity pain
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and described “[lightning] pain shooting down the leg to the ankle area and to the left big 

toe.” Employee showed Dr. Parsioon a video of the work incident, and he reviewed the 

MRI report of Employee’s lumbar spine. Significantly, according to Dr. Parsioon’s report, 

Employee also indicated that she had not experienced “any previous back issues before this 

injury.” The doctor diagnosed Employee with back and left lower extremity radiculopathy, 

prescribed physical therapy, and took Employee off work.

Dr. Parsioon next saw Employee in September 2020, and, after reviewing the MRI 

films of her lumbar spine from April, confirmed Employee had a ruptured disc on the left 

side at L5-S1. In an October follow-up visit, Dr. Parsioon noted Employee had failed to 

improve with conservative treatment and recommended surgery consisting of an L5-S1 

partial hemilaminectomy and microdiscectomy.

Thereafter, Employer sent correspondence to Dr. Parsioon with an attached therapy 

note informing him that Employee had helped with “decorations and lifting/setting up” for 

a wedding on October 4. In the letter, Employer asked Dr. Parsioon if Employee had a 

new injury at that time, to which he responded “no.” Dr. Parsioon also noted that he did 

not believe Employee’s activities of October 4 contributed more than 50% to Employee’s 

current condition. When asked whether Employee’s work accident contributed more than 

50% to her current condition, Dr. Parsioon responded “yes.”

Dr. Parsioon’s request for surgery was sent to utilization review, and the reviewing 

physician recommended that the surgery request not be certified because there was 

insufficient evidence supporting the need for the procedure. Upon administrative appeal,

the Bureau’s medical director upheld this decision. As a result, Dr. Parsioon agreed to 

perform Employee’s surgery under her private insurance, and Employee filed a request for 

expedited hearing.

Prior to the expedited hearing being scheduled, Employee was evaluated by Dr. 

Samuel Murrell at Employer’s request on March 17, 2021. After performing a physical 

examination and reviewing Employee’s medical records, Dr. Murrell noted Employee 

sustained an injury on April 4, and, according to the medical records, she was working as 

a shift manager when a “600[-]pound refrigerator” fell and struck her in the back, pinning 

her to the ground.1

 He further noted that Employee had exhausted conservative treatment

options, and he recommended surgery consisting of a left L5-S1 microdiscectomy. 

Thereafter, Employee withdrew her request for an expedited hearing, and Employer agreed 

to authorize surgery.

When the parties learned that Dr. Parsioon was not performing surgeries at that time,

Employer provided a new panel of physicians that included Dr. Murrell. Employee 

1 The exact weight of the cooler was not established in the record, but Employer does not dispute that it 

was heavy.
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selected Dr. Murrell as her authorized physician based on his representation that he 

believed surgery was reasonable and necessary to treat the work injury. Employee saw Dr. 

Murrell on June 23, and he recommended another MRI of her lumbar spine. Upon review 

of the new MRI, Dr. Murrell reiterated his recommendation for lumbar surgery.

Following Dr. Murrell’s recommendation for surgery, Employer obtained 

Employee’s chiropractic records from Arlington Family Chiropractic and Dr. Johnson. 

These records documented Employee’s prior complaints of low-back pain dating back to 

October 2017 and included a diagnosis of segmental dysfunction at multiple levels of 

Employee’s spine. Records further revealed Employee received treatment consisting of 

traction, electrical stimulation, and manipulation at the cervical, thoracic, and lumbar levels

while receiving chiropractic care. Further, Employee saw Dr. Johnson two days before the 

April 4 work incident and complained that her right hip and right lower back were sore.

Employer provided Dr. Murrell with Employee’s chiropractic records for review, 

and submitted four medical questionnaires related to Employee’s condition, including the 

following causation inquiry:

In your expert medical opinion and answered to a “reasonable degree of 

medical certainty,” – that is without speculation or possibility – taking into 

account the video footage of [Employee’s] alleged injury, the diagnostic 

imaging of [Employee’s] lumbar spine to date, the medical records from 

[Employee’s] chiropractors, and all information you believe is germane, is 

[Employee’s] herniated disk at L5-S1 primarily related (more than 50%) to 

the work incident on April 4, 2020?

Dr. Murrell responded in the negative, and, as a result, Employer reversed its earlier 

decision to authorize surgery. Employee filed another request for an expedited hearing, 

and the parties agreed to obtain medical proof prior to scheduling the hearing.

Dr. Murrell’s deposition was taken in November 2021, at which time he testified 

that Employee had a L5-S1 disc protrusion with left lumbar radiculopathy, noting “she did 

have degenerative changes, but there was also the disc protrusion on top of that.” Dr. 

Murrell confirmed that he reviewed Employee’s chiropractic records and testified that he 

did not see any MRI scans that were performed or any recommendations for orthopedic or 

neurosurgical evaluation during the course of her prior chiropractic treatment. He

acknowledged viewing a video of the work incident and thought the counter seemed to 

break the fall and full impact of the cooler when it hit Employee. When questioned, Dr. 

Murrell agreed that Employee’s leg pain developed after the work incident. At the 

conclusion of direct examination, Dr. Murrell addressed causation during the following 

exchange:
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Q: . . . Would you mind clarifying your opinion? To a reasonable degree 

of medical certainty, is the need for her surgery and her diagnosis to the 

L5-S1 [disc] more than 50 percent related to the work injury?

A: If that history is correct, yes.

Q: And just to make sure we clarify, are you talking about the history in 

your medical records?

A: The history that she provided me.

Q: That she provided you. Okay. All right. So, I feel like I know the 

answer to this question, but I need to ask it. Is the surgery recommended 

medically necessary for her?

A: I believe so.

On cross-examination, Dr. Murrell testified that Employee’s description of the work 

incident was different than what he observed in the video.2

 He reiterated his opinion that 

the full impact of the weight of the cooler did not fall on Employee and noted she was not 

pinned to the ground as indicated in his initial report. Dr. Murrell stated Employee had

complaints of pain and stiffness in her lumbar spine in October 2017, prior to the work 

accident, and noted documentation of subluxation at L5 and adjustments made at L5-S1, 

the same level recommended for surgery. Dr. Murrell testified that Dr Johnson’s medical 

records from two days prior to the incident also “suggest[ed] that [she wasn’t] 

asymptomatic.” When questioned as to whether degenerative changes themselves could 

lead to a disc protrusion such as that sustained by Employee, Dr. Murrell testified, in part:

So, again, she’s got a disc protrusion there. Whether – she certainly was 

having issues with her back prior to the injury. We have one snapshot in 

time. It could very well have been that she had degenerative changes that led 

to a disc protrusion. There could be some very remote incident that is – is 

not even being discussed here, and those are all things that – that could have 

resulted in that disc protrusion.

At the conclusion of cross-examination, Dr. Murrell was asked to review the 

questionnaires previously sent to him by Employer. Following his review, Dr. Murrell 

testified it was still his opinion that Employee’s condition is not more than 50 percent 

related to work. In addition, he agreed there is no further treatment for Employee’s lumbar 

2 In his March 17, 2021 medical note, Dr. Murrell noted that “[a]ccording to the medical records,” 

Employee was working when a “600[-]pound refrigerator fell and struck [Employee] on the back pinning 

her to the ground.” (Emphasis added.)
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spine that is medically necessary and more than 50 percent related to the work incident. 

When questioned about his seemingly contradictory testimony as to causation, Dr. Murrell 

stated he was getting “confused” before repeating his opinion that Employee’s need for 

surgery at the L5-S1 level was not more than 50 percent related to the work incident.

On redirect examination, Dr. Murrell was asked to provide a percentage for his 

causation analysis, to which he responded “[p]robably 50/50.” He expounded further by 

stating “I think that what I’m essentially saying is, we don’t have something before and 

after that shows that the disc protrusion led to her – her symptoms, her radicular symptoms, 

and then I really don’t have a crystal ball that says that that specific incident caused it.” He 

testified that he “would feel much more confident in saying that [the work incident] caused 

it if – if she had never had any treatment previously, and I think that’s the thing that makes 

it difficult.” Dr. Murrell ultimately stated “the waters are sort of muddy. I think it will 

ultimately be up to the workers’ compensation judge to decide whether this gets 

addressed.” He went on to state, “And I wish I could help him or her, but I can’t, and he’s 

going to need to decide.”

Dr. Parsioon’s deposition was taken in March 2022. Dr. Parsioon testified that his 

causation opinion was “absolutely not” changed in any way after reviewing Employee’s 

chiropractic records. He noted there was no reference to imaging or recommendation for 

Employee to see an orthopedic provider or neurosurgeon contained in any of the 

chiropractic records he reviewed. Dr. Parsioon testified that chiropractors “don’t do back 

surgeries or spine surgeries” and stated that x-rays obtained by a chiropractor would not 

reveal a disc herniation. After reviewing the video of Employee’s work incident again, Dr. 

Parsioon stated “you can’t have a better traumatic injury than that for a ruptured disc in the 

spine.” Dr. Parsioon repeated his opinion that Employee’s condition was “more than 51 

percent related to the work injury” and stated he was willing to perform surgery.

During cross-examination, Dr. Parsioon agreed that Employee was not entirely 

truthful when she denied having back issues prior to the work incident. Despite this, he 

testified on re-direct that Employee’s chiropractic records provided no documentation of 

any sort of nerve impingement and noted “there is no leg pain. That’s what is important. 

There is back pain, neck pain, thoracic pain. There is no radiation.” Ultimately, Dr. 

Parsioon did not deviate from his opinion as to causation.

An expedited hearing was held on May 13, 2022, and Employee requested 

authorization for back surgery and attorneys’ fees based on Employer’s alleged wrongful 

denial of surgery. Conversely, Employer contended Employee had not shown her back 

condition was causally related to the work incident. Employee testified the chiropractic 

treatment she received was for aches and pains that were different than the disabling pain

she currently was experiencing. Employee also testified that she was able to work until the 

April 4 incident and now is unable to work. Employee ascribed her current symptoms to 
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the work incident and contended she was entitled to attorneys’ fees due to Employer’s 

wrongful denial of surgery.

Employer argued that Employee was not credible and misled providers regarding 

her history of medical treatment for her back. In addition, Employer contended that Dr. 

Parsioon’s “bias” against chiropractors influenced his opinions and that Dr. Murrell’s 

causation opinion should be presumed correct pursuant to Tennessee Code Annotated 

section 50-6-102(14)(E). Employer asserted that Dr. Murrell became the authorized 

treating physician after Dr. Parsioon stopped treatment. Employer did not argue against 

the medical necessity of surgery for Employee but instead asserted that she failed to show 

a greater-than-fifty-percent correlation between the work incident and her injury.

In considering the causation opinions of both providers, the trial court first 

determined that the qualifications of each were essentially equal. The court also noted that 

because both providers were chosen from panels, each of their causation opinions was

entitled to a presumption of correctness. Specifically, the court “reject[ed] [Employer’s] 

argument that Dr. Parsioon’s opinion lost its presumption when Dr. Murrell began 

treatment.” The court considered the specialty of each physician, the proximity of their 

respective initial evaluations to the time of the work incident, and their treatment of 

Employee. The court also considered “the importance each expert attached to the 

[chiropractic] information” they reviewed. In giving more weight to Dr. Parsioon’s

opinion, the court noted that the chiropractic records contained information consistent with 

the testimony provided by Dr. Parsioon and a letter provided by Employee’s chiropractor,

Dr. Johnson, noting he found changes for “the worse” in Employee’s condition following 

the work incident.

The court also considered photographs and social media evidence introduced by 

Employer at trial but noted Employee testified that although the photos accurately depicted 

her activities on those specific dates, she still felt pain on those occasions. In addition, the 

court determined Employee testified credibly that her disabling symptoms were related to 

the work incident. After considering the expert medical testimony in conjunction with 

Employee’s lay testimony, the court accorded greater weight to Dr. Parsioon’s causation 

opinion. The trial court ordered Employer to authorize and pay for the back surgery 

recommended by Dr. Parsioon and designated Dr. Parsioon as the treating physician, but it 

declined to address the claim for attorneys’ fees for a wrongful denial under Tennessee 

Code Annotated section 50-6-223(d)(1)(B) until a later hearing. Employer has appealed.

Standard of Review

The standard we apply in reviewing the trial court’s decision presumes that the 

court’s factual findings are correct unless the preponderance of the evidence is otherwise. 

See Tenn. Code Ann. § 50-6-239(c)(7) (2021). When the trial judge has had the 

opportunity to observe a witness’s demeanor and to hear in-court testimony, we give 
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considerable deference to factual findings made by the trial court. Madden v. Holland Grp. 

of Tenn., Inc., 277 S.W.3d 896, 898 (Tenn. 2009). Moreover, a trial court has the discretion 

to determine which testimony to accept when presented with conflicting expert opinions, 

and we review such determinations using an abuse-of-discretion standard. Johnston v. 

Siskin Steel & Supply Co., No. E2020-00799-SC-R3-WC, 2021 Tenn. LEXIS 241, at *30-

31 (Tenn. Workers’ Comp. Panel Feb. 10, 2021). However, “[n]o similar deference need 

be afforded the trial court’s findings based upon documentary evidence.” Goodman v. 

Schwarz Paper Co., No. W2016-02594-SC-R3-WC, 2018 Tenn. LEXIS 8, at *6 (Tenn. 

Workers’ Comp. Panel Jan. 18, 2018). We are also mindful of our obligation to construe 

the workers’ compensation statutes “fairly, impartially, and in accordance with basic 

principles of statutory construction” and in a way that does not favor either the employee 

or the employer. Tenn. Code Ann. § 50-6-116 (2021).

Analysis

In its brief on appeal, Employer first contends that when medical proof is limited to 

deposition testimony and other documentary evidence, we are to review the court’s 

findings regarding the documentary evidence de novo without affording the trial court’s 

conclusions a presumption of correctness. We previously addressed the appropriate 

standard of review for expert medical evidence in Moore v. Beacon Transport, LLC, No. 

2018-06-1503, 2021 TN Wrk. Comp. App. Bd. LEXIS 39 (Tenn. Workers’ Comp. App. 

Bd. Oct. 29, 2021).3

 In a concurrence, our colleague argued that documentary expert 

evidence is necessarily reviewed de novo on appeal. We disagreed, explaining as follows:

[T]his approach ignores a substantial body of case law directing us to 

acknowledge the trial court’s role as factfinder and accord the trial court the 

discretion to choose which expert offered the more probable explanation 

based on the totality of the evidence. This framework was discussed by the 

Supreme Court’s Special Workers’ Compensation Appeals Panel as recently 

as June 2021 in Jumper v. Kellogg Co., No. W2020-01274-SC-R3-WC, 2021 

Tenn. LEXIS 175 (Tenn. Workers’ Comp. Panel June 23, 2021), a case in 

which the expert medical proof was by deposition: “When presented with 

conflicting expert opinions, a trial court has discretion to determine which 

testimony to accept . . . . A trial court abuses its discretion when it applies an 

incorrect legal standard, reaches an illogical result, or bases its decision on a 

clearly erroneous assessment of the evidence.” Id. at *17-18 (internal 

citations omitted). The Tennessee Supreme Court adopted the Appeals 

Panel’s opinion in Jumper as its own. See Jumper v. Kellogg Co., No. 

W2020-01274-SC-R3-WC, 2021 Tenn. LEXIS 174 (Tenn. June 23, 2021).

3 Our decision in Moore v. Beacon Transport is currently on appeal to the Tennessee Supreme Court’s 

Special Workers’ Compensation Appeals Panel.
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Id. at *7 n.1; see also Lavender v. Saturn Corp., No. M2002-00759-SC-R3-CV, 2003 Tenn. 

LEXIS 348, at *4 (Tenn. Workers’ Comp. Panel May 5, 2003) (“We may make an 

independent assessment of the medical proof which is submitted by depositions, reports or 

records. We do not, however, disagree with the discretion exercised by the trial judge in 

this regard unless the record clearly shows an abuse of this discretion.”).

Thus, we conclude a reviewing court can review documentary evidence, including 

expert depositions, de novo in order to determine where the preponderance of the evidence 

lies. However, with respect to the trial court’s ultimate determination, a reviewing court 

should acknowledge the trial court’s discretion to evaluate which expert’s opinion is 

entitled to greater weight based on the totality of the evidence presented to the court and is 

to review such a determination under an abuse-of-discretion standard.

Employer then raises two issues, which we have restated as follows: (1) whether the 

trial court erred in determining Dr. Parsioon’s causation opinion was entitled to a 

presumption of correctness; and (2) whether the trial court erred in concluding Employee 

was likely to prevail at a hearing on the merits in proving her herniated disc and need for 

surgery are more than 50% related to the April 4, 2020 work incident.

Statutory Presumption of Correctness

Tennessee Code Annotated section 50-6-102(14)(E) provides that “the treating 

physician” who was “selected by the employee from the employer’s designated panel” is 

entitled to a presumption of correctness that is rebuttable by a preponderance of the 

evidence. Tenn. Code Ann. § 50-6-102(14)(E) (2021). We have previously addressed the 

various presumptions of correctness set out in Tennessee’s Workers’ Compensation Law:

The Tennessee Workers’ Compensation Act contains several provisions that 

favor certain opinions of a treating physician selected from a panel in 

accordance with Tennessee Code Annotated section 50-6-204(a)(3)(A)(i) 

(2016). For example, in section 50-6-102(14)(E), “[t]he opinion of the 

treating physician, selected by the employee from the employer’s designated

panel of physicians . . ., shall be presumed correct on the issue of causation 

but this presumption shall be rebuttable by a preponderance of the evidence.” 

Additionally, section 50-6-204(a)(3)(H) states that “[a]ny treatment

recommended by a physician or chiropractor selected pursuant to this 

subdivision (a)(3) or by referral, if applicable, shall be presumed to be 

medically necessary for treatment of the injured employee.” Also relevant is 

section 50-6-204(a)(3)(E), which states that in circumstances where a 

treating physician makes a referral to a specialist, the specialist physician to 

whom the employee was referred “shall become the treating physician until 

the treatment by the specialist physician . . . concludes and the employee has 
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been referred back to the treating physician selected by the employee from 

the initial panel.”

Endsley v. Benchmark Contractors, LLC, No. 2016-05-0743, 2017 TN Wrk. Comp. App. 

Bd. LEXIS 47, at *5-7 (Tenn. Workers’ Comp. App. Bd. Aug. 11, 2017).

Here, Employer takes issue with the trial court’s conclusion that both Dr. Parsioon’s

and Dr. Murrell’s causation opinions are presumed correct given that both physicians were 

selected from Employer’s panels. Employer contends the court conflated the presumption 

of correctness set forth in Tennessee Code Annotated section 50-6-102(14)(E) with the 

presumption of correctness accorded to a physician pursuant to Tennessee Code Annotated 

section 50-6-204(a)(3)(A)(i). Employer further asserts the court “misinterpreted” our 

analysis in Endsley by stating in its order that “the presumption of correctness under section 

102(14)(E) applies to the opinion of ‘a physician’ selected from a panel, not only to the 

opinion of the current treating physician.”

First, Employer argues that the phrase “a physician” does not appear anywhere in 

section 50-6-102(14)(E) but does appear in section 50-6-204(a)(3)(H), a provision of the 

statute dealing with the medical necessity of treatment, and asserts this is not an issue in 

the case at hand. Employer contends that “a physician” is a more general term and can 

apply to any physician that falls within the described category; whereas, when a statute 

references “the physician,” as it does in section 50-6-102(14)(E), it can only mean one 

particular physician, namely the current authorized doctor. Conversely, Employee asserts 

that the statutory sections “warrant analogous interpretations” since both pertain to the 

presumption of correctness afforded to the authorized treating physician and “were 

intended to go hand-in-hand.”

In Endsley, the employee was under the care of an authorized physician who did not 

believe that surgery was necessary. Id. at *4. Following a referral for pain management, 

the employee requested a second opinion, which the employer provided. Id. at *3. The 

second opinion physician opined that surgery was medically necessary and related to the 

work incident. Id. After a hearing, the court concluded that, as the initial physician was 

no longer the treating physician, his opinions were not entitled to a presumption of 

correctness and that the opinions expressed by the subsequent physician were entitled to 

greater weight. Id. On appeal, we considered the presumption of correctness afforded to 

each physician within the framework of Tennessee Code Annotated sections 50-6-

204(a)(3)(H) and -102(14)(E). In doing so, we explained as follows:

In considering the plain and ordinary meaning of these statutes, we note that 

subsection 204(1)(3)(H) applies the presumption of correctness to “a

physician . . . selected pursuant to this subdivision (a)(3)” (emphasis added), 

not only to the current treating physician as implied by the trial court. Thus, 

we agree with Employer that [the initial authorized physician] remained an 
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authorized treating physician even after the referral to pain management and, 

to the extent [that physician] expressed opinions as described in subsections 

102(14)(E) and/or 204(a)(3)(H), such opinions would be entitled to a 

presumption of correctness.

Id. at *6-7. Hence, we concluded that an authorized physician retained the presumption of 

correctness on the issue of causation even after the employee began treating with another 

authorized doctor, but, under the circumstances of that case, the presumption did not apply 

to the first doctor’s opinion of the medical necessity of treatment recommended by a 

subsequent authorized physician.

In its brief on appeal, Employer contends that the facts of this case are 

distinguishable because Dr. Murrell “supplant[ed]” Dr. Parsioon as the authorized treating 

physician and, unlike in Endsley, was not chosen from a panel solely for the purpose of 

providing a second opinion on the issue of surgery and diagnosis pursuant to Tennessee 

Code Annotated section 50-6-204(a)(3)(C). Instead, Employer characterized Dr. Murrell 

as a “replacement treating physician” for Dr. Parsioon and argued that, as such, his opinion 

rather than Dr. Parsioon’s should be entitled to the presumption of correctness on the issue 

of causation. Employer further contends that the legislature’s use of the term “the treating 

physician” in section 50-6-102(14)(E) makes clear the legislature’s intent for there to be 

only one physician entitled to the presumption of correctness on medical causation at any 

given time. We are unpersuaded.

The plain language of Tennessee Code Annotated section 50-6-102(14)(E) provides 

that “[t]he opinion of the treating physician, selected by the employee from the employer’s 

designated panel of physicians . . ., shall be presumed correct on the issue of causation but 

this presumption shall be rebuttable by a preponderance of the evidence.”4

 Here, Dr. 

Parsioon was selected from an Employer-provided panel of physicians and provided an 

opinion as to causation while he was still the authorized treating physician. After Dr. 

Parsioon indicated he was unable to perform surgery, Dr. Murrell was selected from an 

Employer-provided panel of physicians and, as the authorized treating physician, also 

provided a causation opinion. As such, both physicians provided causation opinions at the 

time they were authorized treating physicians, and, therefore, each opinion is entitled to 

the presumption of correctness in accordance with the plain language of section 50-6-

102(14)(E). Employer has provided no legal authority to support its argument that the 

provision of a new or different causation opinion, even from a newly-designated authorized 

treating physician, serves to negate a previously offered causation opinion from an 

authorized, panel-selected physician. Thus, we discern no error in the trial court’s 

4 During oral argument, counsel for Employer acknowledged that its insistence that there can be only one 

“treating physician” at a time whose causation opinion is entitled to a presumption of correctness is 

problematic in situations where, for example, a single work accident causes more than one injury, 

necessitating more than one treating physician for each injury.
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conclusion that both Dr. Parsioon’s and Dr. Murrell’s causation opinions are presumed 

correct.

Trial Court’s Consideration of Medical Evidence

Given our conclusions as stated above, it is unnecessary to address Employer’s 

contention that the trial court erred in concluding that Employee came forward with 

“sufficient evidence to overcome the presumption of correctness afforded to Dr. Murrell’s 

causation opinion.” As both opinions were entitled to the presumption, we turn to the trial 

court’s assessment of the weight of expert proof and its ultimate conclusion that Dr. 

Parsioon’s opinion was more persuasive than that of Dr. Murrell. When a trial court is 

faced with competing medical expert opinions, the judge has the discretion to determine 

which opinion to accept and can consider, among other things, the qualifications of the 

experts, circumstances of their examinations, information available to each expert, and an 

evaluation of the importance attached to the information by other experts. Bass v. The 

Home Depot U.S.A., Inc., No. 2016-06-1038, 2017 TN Wrk. Comp. App. Bd. LEXIS 36, 

at *9 (Tenn. Workers’ Comp. App. Bd. May 26, 2017).

In considering the qualifications of each expert, the trial court first determined that 

both Dr. Parsioon and Dr. Murrell were well qualified and that this factor did not weigh in 

favor of either expert. However, the trial court noted that Dr. Parsioon saw Employee

earlier than Dr. Murrell following the incident, which allowed Dr. Parisoon to assess 

Employee’s complaints closer in time to the work accident. Further, the court noted that 

Dr. Parsioon saw Employee on more occasions than Dr. Murrell. With regard to the 

information available to each doctor, both physicians examined Employee on multiple 

occasions, and each reviewed the initial MRI and chiropractic records. Although Dr. 

Parsioon did not see Employee’s chiropractic records before providing his initial causation 

opinion, after reviewing the records, he testified that his opinion had not changed. In 

addition, after reviewing the video of Employee’s work incident, Dr. Parsioon testified that 

“you can’t have a better traumatic injury . . . for a ruptured disc in the spine.”

Although Dr. Parsioon acknowledged he did not review the second MRI, Dr. 

Murrell testified that the second study revealed “similar, if not the same” findings as the 

imaging performed in April 2020. With regard to the importance each expert attached to 

information it reviewed, the trial court noted that Dr. Murrell attached greater weight to the 

chiropractic records than Dr. Parsioon. In considering the reasoning of each provider, the 

court noted that Dr. Parsioon testified Employee’s chiropractic records essentially 

replicated consistent notes and findings typical of treatment provided by chiropractors, and

did not suggest the presence of radiating pain or a herniated disc that would merit referral 

to a specialist. Conversely, Dr. Murrell relied upon the pain complaints and chiropractic 

treatment described in these records to formulate an opinion that Employee’s condition and 

need for surgery are not more than 50% related to her employment. Despite this, when 

deposed, Dr. Murrell first testified that Employee’s need for recommended surgery and 
13

diagnosis of the L5-S1 disc injury was more than fifty percent related to the work injury, 

then testified to the contrary on cross-examination before ultimately stating that the “waters 

are sort of muddy” and “it will be up to the workers’ compensation judge to decide whether 

this gets addressed.” Thus, after considering the above factors, the trial court accorded Dr. 

Parsioon’s causation opinion greater weight than the equivocal testimony of Dr. Murrell. 

Under these circumstances, given the trial court’s discretion to give greater weight to the 

opinion of the physician who offered the more probable explanation of causation, we 

conclude it was not error for the trial court to assign greater weight to the causation opinion 

of Dr. Parsioon.

Finally, the trial court determined Employee testified credibly that her disabling 

symptoms occurred after the work incident. In addition, Employee was able to explain to 

the court’s satisfaction photographic evidence offered by Employer related to her postinjury activities. After considering the medical proof in conjunction with Employee’s lay 

testimony, the trial court concluded Employee was likely to prevail at a hearing on the 

merits in proving her herniated disc and need for surgery are more than 50% related to the 

April 4, 2020 work incident. We discern no error in this regard.

Conclusion

For the foregoing reasons, we conclude the evidence does not preponderate against 

the trial court’s determinations. We affirm the trial court’s order and remand the case for 

any further proceedings that may be necessary. Costs on appeal are taxed to Employer.
 

 

 

 TENNESSEE BUREAU OF WORKERS’ COMPENSATION 

 WORKERS’ COMPENSATION APPEALS BOARD 

Kaci L. Johnson ) Docket No. 2020-08-0731 

) 

v. ) State File No. 23720-2020 

)

Inspire Brands d/b/a ) 

Blazin Wings, Inc., et al. ) 

) 

) 

Appeal from the Court of Workers’ ) Heard August 10, 2022 

Compensation Claims ) via Microsoft Teams

Allen Phillips, Judge ) 

CERTIFICATE OF SERVICE

 

I hereby certify that a true and correct copy of the Appeals Board’s decision in the referenced 

case was sent to the following recipients by the following methods of service on this the 7th day 

of September, 2022. 

Name Certified 

Mail

First Class 

Mail

Via 

Fax

Via 

Email

Sent to: 

A. Allen Grant X agrant@eraclides.com

bnorris@eraclides.com

kewing@eraclides.com

Monica R. Rejaei X mrejaei@nstlaw.com

atarbania@nstlaw.com

Allen Phillips, Judge X Via Electronic Mail

Kenneth M. Switzer, Chief Judge X Via Electronic Mail

Penny Shrum, Clerk, Court of 

Workers’ Compensation Claims

X penny.patterson-shrum@tn.gov

 

Olivia Yearwood

Clerk, Workers’ Compensation Appeals Board

220 French Landing Dr., Ste. 1-B 

Nashville, TN 37243 

Telephone: 615-253-1606 

Electronic Mail: WCAppeals.Clerk@tn.gov