TENNESSEE BUREAU OF WORKERS’ COMPENSATION

IN THE COURT OF WORKERS’ COMPENSATION CLAIMS

AT NASHVILLE

SONIA PURVIS

, ) Docket No. 2019

- 06

- 1189

Employee, )

v. ) )

CLARKSVILLE MONTGOMERY

COUNTY CAA

, ) ) State File No. 58922

- 2018 Employer,

ACCIDENT FUND INSURANCE CO.

OF AMERICA

,

Carrier. ) ) ) ) ) Judge Joshua Davis Baker

EXPEDITED HEARING ORDER

DENYING BENEFITS

The Court held an expedited hearing on December 12, 2019, to consider Ms. Purvis’s request for temporary disability benefits and reinstatement of medical benefits

. Clarksville Montgomery County Community Action Agency (CMCCAA) terminated her

medical benefits when she refused to sign release s for medical r ecords from providers who treated her for previous work

- related accidents and other conditions

. CMCCAA asked that the Court deny her request s

. For the reasons below, t he Court denies Ms.

Purvis’s request for temporary disability and reinstatement of her medical benefits

.

History of Claim

The crux of the parties’ disagreement concerns the cause of Ms. Purvis’s current need for treatment. Before her most recent injury, s he injured her right shoulder and neck

at work in 2011

. She settled that claim with Auto

- Owners Insurance for benefits that

included lifetime future medical treatment. Additionally, Ms. Purvis suffers from lupus ; a condition she testified regularly causes h er considerable pain.

Ms. Purvis suffered her most recent workplace accident on August 8, 2018

, when she fell while walking up a wheelchair ramp. She claimed she injured her hip, back, 

### FILED Dec 18, 2019 11:33 AM(CT)

TENNESSEE COURT OF

WORKERS' COMPENSATION

CLAIMS2

neck, right shoulder and right arm in the accident. CMCCAA accepted the claim and

offered a panel of physicians from which she chose Doctor’s Care

. 1

Ms. Purvis saw providers at Doctor’s Care three times. While she agreed that

none of the physicians too k her off work, Ms. Purvis said she could not work because of severe pain . She testified that the physicians were essentially prohibited from taking her

off from work but introduced no proof to support her testimony

.

Following the 2018 accident

, Auto

- Owners canceled Ms. Purvis’s treatment provided through her 2011 workers’ compensation settlement. It assert ed that the 2018 accident was an “intervening cause” of her current need for treatment.

CMCCAA also suspended Ms. Purvis’s medical benefits

, claiming that it could

not determine if the 2018 accident caused her need for treatment , considering her lupus and the prior injury. It asked Ms. Purvis to provide releases so it could submit her

records to the authorized treating physician for a causation opinion.

Ms. Purvis g ave a release for one doctor but failed to do so for other doctors who

treated her for the 2011 accident

. S he also refused to sign releases for providers treating her for lupus

, argu ing that her lupus had no relevance to her workers’ compensation

claim

.

Findings of Fact and Conclusions of Law

Ms. Purvis has the burden of proving entitlement to the requested benefits. To carry that burden, she must present sufficient evidence to prove s 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). The Court finds she failed to carry

that burden

.

While the parties agree that Ms. Purvis had an accident at work and CMCCAA initially provided treatment for her injuries, CMCCAA terminated those benefits when questions arose about the medical cause of her need for treatment. Thus

, the parties dispute medical causation.

Ms. Purvis must prove medical causation through a doctor’s opinion to prevail at this hearing; she cannot prove her claim through lay testimony alone. See Berdnik v. Fairfield Glade Cmty

. Club , 2017 TN Wrk. Comp. App. Bd. LEX IS 32, at *11 (Mar. 31, 2017) ; Scott v. Integrity Staffing Solutions , 2015 TN Wrk. Comp. App. Bd. LEXIS 24, at *12 (Aug. 18, 2015)

. Ms. Purvis provided no medical opinion to prove her current need

for treatment arose primarily from her 2018 accident

, s o she failed to establish she w ould

1 Neither party introduc ed any medical records.3

likely prevail on this issue at trial. Accordingly, the Court denies her claim for

reinstatement of her medical benefits

.

The Court’s denial does not prevent Ms. Purvis from getting medical proof of

causation. CMCCAA terminated benefits because it questioned whe ther her need for treatment arose from other conditions, but it did so only after asking Ms. Purvis several

times t o sign releases so the authorized treating physician could review her records. The Court finds CMCCAA’s decision to suspend her benefits rea sonable under the circumstances, and this hearing m ay have been avoided if Ms. Purvis had signed the requested releases.

Given that Ms. Purvis did not establish the likelihood of proving medical causation, the Court also denies her request for temporary disability benefits. See Jewell

v. Cobble Const r. and Arcus Restoration, 2015 TN Wrk. Comp. App. Bd. LEXIS 1, at *21 (Jan. 12, 2015).

It is ORDERED as follows:

1. Ms. Purvis’s request for temporary disability and reinstatement of her medical

benefits is denied.

2. This matter is set for a status conference on Monday, March 9, 2020, at 9:00 a.m. (CDT). You must call 615-741-2113 or toll-free 855-874-0474 to participate in the Hearing. Failure to call might result in a determination of issues without your participation.

ENTERED DECEMBER 18, 2019.

________ ___________________________ Joshua Davis Baker, Judge Court of Workers’ Compensation Claims4 APPENDIX

Exhibits :

1. Ms. Purvis’ s A ffidavit

2. HIPAA Medical Release

Technical Record :

1. Petition for Benefit Determination

2. Dispute Certification Notice

3. Request for Expedited Hearing

CERTIFICATE OF SERVICE

I certify that a correct copy of this O rder was sent as indicated on December 18

, 2019

.

Name Regular

Mail Via

Fax Via

Email Service sent to:

Sonia Purvis X X 804 Parkview Ct. Clarksville, TN 37042 epurvis496@aol.com

Gordon Aulgur X gordon.aulgur@accidentfund.com rosemary.marlatt@accidentfund.com

____________________________________________ Penny Shrum, Court Clerk Court of Workers’ Compensation Claims Wc.courtclerk@tn.gov