1 I N THE A T NA SH V ILLE

De b r a De Ro s a , ) Doc k et No

. 2020-06-0216 E m p l o y ee, )

v . ) I & MJ G ro ss Co

. , ) S t a te F il e No

. 76351-2019 E m p l o y er, ) A nd ) N a t i o n w id e M u t u a l Ins

. Co

. , ) J u d g e K e nn et h M

. S w i t z er C a rr i er . )

E XP E D ITE D HE AR I N G O RD E R

Debra De R o s a i n j ured her wr ist wh il e work i ng for I & MJ Gro ss , wh i ch au t hor i zed t rea tm en t

. S he a ss ert ed t ha t t he carr i er never offered a pane l of phy si c i an s or even d is cu ss ed w it h her t ha t s he had t he r i gh t t o choo s e fro m a list of t hree phy si c i an s . I & MJ Gro ss den i ed bo t h a ll ega ti on s

. Ms . De R o s a reque st ed add iti ona l t rea tm en tw it h a new doc t or.

Af t er an exped it ed hear i ng on S ep t e mber 16, t he C our t f

i nd s tha t t he carr i er t w i ce fu l f ill ed its st a t u t ory ob li ga ti on t o offer a pane l . Add iti ona ll y, I & MJGro ss au t hor i zed

w it h Dr. J ohn Weaver, wh i ch t rea tm en t Ms . De R o s a accep t ed. B ecau s e Dr. Weaver p l aced her a t m ax im u m m ed i ca l improve m en t , re l ea s ed her w it hou t

re st r i c ti on s , and an ti c i pa t ed no need for furt her t rea tm en t for add iti ona l trea tm en t

.

His tory of C l a i m

Ms . De R o s a worked for I & MJ Gro ss i n hou s ekeep i ng. On Augu st 22, 2019, s he fe ll wh il e c l ean i ng a li gh t f

i x t ure, i n j ur i ng s evera l body parts , bu t t he curren t , s o l e d is pu t e
revo l ve s around her r i gh t wr ist on l y I & MJ Gro ss offered a pane l and her

en titl e m en t t o add iti ona l t rea tm en t for it

.

I mm ed i a t e l y af t er t he fa ll
, Ms . De R o s a s ough te m ergency t rea tm en t

. P rov i der s 

### F I LE D S ep 21, 2020 08:56 A M (C T )
TE NN E SSEE C O UR T O F W O R KE R S ' C O MPE N S A T IO N C L A IMS2 ordered x-ray s , wh i ch s howed a acu t e avu lsi on frac t ure fro m t he u l nar st y l o i d[.] The d is charge docu m en ts reco mm ended fo ll ow up w it h Dr. M ar tha George, an

ort hoped ist . However, Ms . De R o s a never s aw Dr. George bu t ra t her ca m e under Dr. J ohn

Ms . De R o s a t e sti f i ed tha t , on Augu st 26, s he s poke w it h S hoop, by phone. S he t o l d Ms

. S hoop t ha t t he E R had referred her t o Dr. George. Ms

. S hoop m ade an appo i n tm en t w it h Dr. George, who prac ti ce s w it h Tenne ss ee Ort hoped i c s i n its Lebanon off i ce. When Ms . De R o s a l earned t ha t s he wou l d have t o dr i ve t o Lebanon fro m her ho m e i n Ga ll a ti n, Ms . De R o s a s a i d S he a ss ert ed t ha t Ms

. S hoop never m en ti oned
t ha t s he had t he r i gh t t o a pane l or a cho i ce of phy si c i an.

Ms

. S hoop offered a d i fferen t accoun t

. S he t e sti f i ed t ha t i n t he i r f i r stconver s a ti on

w it h Dr. George. Ms

. S hoop s a i d s he t o l d her s he wou l d prov i de a list of t hree phy si c i an s , one of who m wa s Dr. George, and Ms . De R o s a cou l d choo s e one. The nex tday, Ms

. S hoop ca ll ed Ms

. De R o s a t o s ay t ha t s he s e tan appo i n tm en t w it h Dr. George. Ms

. S hoop t e sti f i ed t ha t , dur i ng t he ca ll
, Ms . De R o s a s a i d s he d i d no t wan t t o dr i ve t o Lebanon t o s ee Dr. George. R a t her, accord i ng t o Ms

. S hoop, Ms . De R o s a prac ti ce i n Ga ll a ti n, and I s ecured her an appo i n tm en tw ith t he f i r st ava il ab l e do S hoop e m a il ed t he pane l t o Ms . De R o s a t ha t day, w it h a

on S ep t e mber 21 i n re s pon s e t o Ms . De R o s a e m a ili ng her t o st a t e t ha t s he had no t rece i ved t he pane l

. Ms

. S hoop t e sti f i ed t ha t s he a ls o s en t a hard copy by regu l ar m a il , bu t Ms . De R o s a never
re t urned t he form

.

On cro ss -exa mi na ti on, Ms . De R o s a acknow l edged t ha t t he carr i er had her correc t

e m a il addre ss

. S he s a i d her e m a il work s now, bu t s he De R o s a added, I s poke w it h her [ Ms

. S hoop] af t er t he fac t , s he c l a im ed s he had a

st a t ed t ha t s he d i d no t rece i ve a copy by m a il

.

s aw h im on Augu st28. He no t ed he rev i ewed x-ray s , . . . [ S ]he ha s exce ll en t m o ti on and exce ll en t st reng

Af t er t h is v isit
, Ms . De R o s a e m a il ed Ms

. S hoop on S ep t e mber 19 t o t e ll her t ha t Dr.

of been g i ven a list of t hree prov i der s fro m t he beg i nn i ng t o choo s e fro m wh i ch I never3 on S ep t e mber 21 on 8 / 27, w it h t he pane l of 3 doc t or s a tt ached? t hen

wro t e :

I wan t t o re mi nd you t ha t I ge t t o choo s e wh i ch 3 doc t or s are pu t on t he pane l

. You had i n sist ed on Dr. M ar t ha George, and I wen ta l ong w it h your w is he s , and s he is one of the t hree doc t or s on t he a tt ached pane l . A ls o, th is wa s w it h who mI s e t up your i n iti a l appo i n tm en t . Once you l earned s he wa s no t l oca t ed i n t he off i ce c l o s e st t o you, we wen t w it h t he or t hopaed i c off i ce t ha t you de si red i n Ga ll a ti n, and go t you i n w it h t he doc t or who had t he ear li e st

ava il ab ility.

De s p it e her concern s , Ms . De R o s a re t urned t o Dr. Weaver for t wo m ore v isits . In Oc t ober, Dr. Weaver rev i ewed an MR I and xchron i c f i nd i ng t o t he u l nar st y l o i d no t an acu t e frac t ure. A t t he f i na l v isit i n Nove mber, he p l aced her a t m ax imu m m ed i ca l improve m en t and re l ea s ed her t o fu ll -du t y work. Dr. Weaver l a t er co mp l e t ed a f i na l m ed i ca l report tha t a ssi gned a zero-percen t impa i r m en t

ra ti ng and st a t ed t ha t no fu t ure t rea tm en t w ill be nece ss ary.

Ms . De R o s a argued t ha t , fro m Af t er her ca s e wa s c l o s ed, s he began t rea ti ng on her own.

or wa s t o l d s he

In re s pon s e, I & MJ Gro ss argued t ha t it s en t t he pane l s evera l tim e s . Wh il e Ms

. De R o s a never re t urned the pane l for m , s he accep t ed t he t rea tm en t I & MJ Gro ss offered. Dr. Weaver p l aced her a t m ax im u m m ed i ca l improve m en tand s aw no need for add iti ona l
t rea tm en t . I & MJGro ss a ss ert ed it prov i ded a ll t he m ed i ca l benef its t o wh i ch s he is

en titl ed.

F indin g s of Fact a nd Co n c lusi o ns of L aw

Ms . De R o s a m u st s how t ha t s he is li ke l y t o preva il a t a hear i ng on t he m er its regard i ng whe t her I & MJ Gro ss offered a pane l a s we ll a s whe t her s he is en titl ed t o add iti ona l t rea tm en t

. See Tenn. C ode Ann. § 50-6-239(d)(1) (2019) ; Mc C o rd v. Advan t age Human Re s ou r c i ng , 2015 TN Wrk. C o mp. App. B d. LEXI S 6, a t *7-8, 9 ( M ar. 27, 2015).

To preva il
, s he m u st s how t ha t I & MJ Gro ss d i d no t s a tis fy its ob li ga ti on under t he prov i de trea tm en t . The m ed i ca l benef its prov isi on of t he st a

s ec ti on ; prov i ded t ha t

. . . t he e mp l oyer s ha ll de si gna t e a group of three (3) or m ore i ndependen t repu t ab l e phy si c i an s . . . fro m wh i ch the i n j ured e mp l oyee s ha ll s e l ec t one (1)4 The C ourt f i r st con si der s whe t her I & MJ Gro ss offered a pane l a s t he st a tu t e requ i re s . The parti e s offered va stl y d i fferen t accoun ts , s o t he C ourt m u st m ake a cred i b ility de t ermi na ti on t o dec i de t h is fac t ua l iss ue.

Here, nor wa s it d is cu ss ed on Augu st 26 or 27. S he acknow l edged t ha t Ms

. S hoop had t he correc t e m a il addre ss , bu t s he s a i d s he her s he had t he i ncorrec t e m a il addre ss , and Ms . De R o s a gave her t he correc t one.

Th is doe s no t s quare w it h t e stim ony, or w it h t he e m a ils t he parti e s exchanged. The Augu st 27 and S ep t e m ber 21 e m a ils fro m Ms

. S hoop t o Ms . De R o s a bear
t he s a m e e m a il addre ss a s t he one Ms . De R o s a wro t e on her pe titi on for benef it de t ermi na ti on. The Augu st27 e m a il p l a i n l y st a t e s t ha t t hey d is cu ss ed the pane l t he prev i ou s day, i n accordance w it h C our t sim p l y doe s
no t be li eve t ha t Ms . De R o s a never rece i ved t he pane l , when Ms

. S hoop cred i b l y t e sti f i ed
t ha t s he u s ed t wo d i fferen t m ean s of t ran smissi on, e m a il and regu l ar m a il
, t o s end it

. Therefore, t he C ourt f i nd s t ha t I & MJ Gro ss d is cu ss ed its ob li ga ti on t o offer a pane l of phy si c i an s w it h Ms . De R o s a and s en t t he form; t hu s , it s a tis f i ed t he st a t u t ory requ i re m en t

.

t he st a t u t e requ i re s

. t w i ce, when s he pu t Dr. George on t he pane l and then s e tan appo i n tm en t w it h Tenne ss ee Or t hoped i c s w it h t he f i r stava il ab l e ort hoped ist , Dr. Weaver,

a t t he Ga ll a ti n B ranch.

In Ms . De R o s a s he cand i d l y ad mitt ed t ha t s he d i d no t wan t t o dr i ve t o Lebanon. R a t her, s he t w i ce a tt ended appo i n tm en ts w it h Dr. Weaver before expre ssi ng d iss a tis fac ti on. Then s he con ti nued s ee i ng h im un til he p l aced her a t m ax im u m m ed i ca l im prove m en t , re l ea s ed her fro m t rea tm en t , and an ti c i pa t ed no need for fu t ure t rea tm en tfor
t he work i n j ury. docu m en t tha t he ba s ed h is op i n i on s af t er exa mi n i ng her and order i ng x-ray s and an MR I. The C our t f

i nd s t ha t Ms . De R o s a accep t ed t rea tm en t , and i n h is expert op i n i on s he doe s no tneed add iti ona l t rea tm en tfor the work i n j ury.
Therefore, Ms . De R o s a ha s no t pre s en t ed s uff i c i en tev i dence fro mwh i ch t h is C ourt

can conc l ude s he is li ke l y t o preva il a t a hear i ng on t he m er its t ha t I & MJ Gro ss fa il ed t o offer her a pane l and is en titl ed t o add iti ona l trea tm en t

.5 IT IS , THE R E F O R E , O RD E R E D a s fo ll ow s:

1. for add iti ona l t rea tm en t is den i ed a t t h is tim e.

2. Th is ca s e is s e t for a s chedu li ng hear i ng on O cto b er 26, 2020, at 9:15 a.m. Ce n tra l

. You m u st ca ll 615-532-9552 or t o ll -free a t 866-943-0025 t o parti c i pa t e. F a il ure t o

ca ll mi gh t re s u lt i n a de t er mi na ti on of the iss ue s w it hou t your par ti c i pa ti on.

E N TE R E D S e p tem b er 21, 2020.

_____________________________________ JUD GE KE NN ETH M. S W ITZE R Co u rt of Com p e ns at i o n C l a i m s

APP E ND I X

Exh i b its: 1. 2. s en t it 3. of m ed i ca l record s 4. 5. E m a ils be t ween Ms . De R o s a and Ms

. S hoop

Techn i ca l R ecord : 1. P e titi on for B enef it De t er mi na ti on 2. D is pu t e C erti f i ca ti on No ti ce 3. S how- C au s e Order, J une 1, 2020 4. S how- C au s e Order, J une 30, 2020 5. R eque st for Exped it ed Hear i ng 6. Order S e tti ng Exped it ed Hear i ng 7. 8. t he A lt erna ti ve, R eque st for R ea s onab l e Ex t en si on 9. 10. Order C on ti nu i ng Exped it ed Hear i ng 11. Order S e tti ng Exped it ed Hear i ng 12. B r i ef 13.6 C E R TI F I CA TE O F SE RV I C E

I certi fy t ha t a copy of t he Exped it ed Hear i ng Order wa s s en t a s i nd i ca t ed on S ep t e m ber 21, 2020.

Name Cert i f i e d M a il Reg ul ar

m a il E ma il S e n t to

Debra De R o s a, s e l frepre s en t ed

e mp l o y ee X X 300 K i rk Lane Ga ll a ti n, TN 37066 De b r a6254 @ g m a il .co m Lynn Lawyer, X Lawye l 2@na ti onw i de.co m B urruc1@na ti onw i de.co m

_____________________________________ Pe nn y Sh r u m, C l er k of Co u rt

WC.Co u rtC l er k @t n .gov