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TENNESSEE BUREAU OF WORKERS’ COMPENSATION 

WORKERS’ COMPENSATION APPEALS BOARD 

Ceasar Gamble ) Docket No. 2016-01-0372 

 ) 

v. ) State File No. 63828-2015 

 ) 

Miller Industries, Inc., et al. ) 

 ) 

 ) 

Appeal from the Court of Workers’ ) 

Compensation Claims ) 

Thomas Wyatt, Judge ) 

Affirmed in Part, Vacated in Part and Remanded - 

Filed February 9, 2017 

In this interlocutory appeal, the employer contests the trial court’s award of medical 

benefits to the employee, who fell at work and suffered compensable injuries to his left 

hip and low back. The authorized treating physician recommended a hip replacement and 

the employer denied that treatment, contending the need for the hip replacement did not 

arise primarily out of the employment. At the request of the employee, and without 

objection from the employer, the trial court rendered a decision without convening an 

evidentiary hearing, determining the employee was likely to prevail at a hearing on the 

merits in establishing his entitlement to the requested medical benefits but denying the 

request for temporary disability benefits. Both parties have appealed. We affirm the trial 

court’s award of medical benefits for treatment of the employee’s compensable left hip 

and low back injuries and its denial of temporary disability benefits, but vacate the trial 

court’s finding that the employee will likely prevail in establishing that his need for the 

hip replacement surgery arose primarily out of the employment. We remand the case for 

further proceedings as may be necessary. 

Judge David F. Hensley delivered the opinion of the Appeals Board in which Presiding 

Judge Marshall L. Davidson, III, and Judge Timothy W. Conner joined. 

Eric Shen, Brentwood, Tennessee, for the employer, Miller Industries, Inc. 

Ceasar Gamble, Chattanooga, Tennessee, employee, pro se 
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Factual and Procedural Background 

 

 Ceasar Gamble (“Employee”) suffered injuries on August 14, 2015, while in the 

course and scope of his employment with Miller Industries, Inc. (“Employer”), when the 

stool he was attempting to sit on rolled out from under him, causing him to fall. The 

claim was accepted as compensable, and Employer provided authorized medical care for 

Employee’s low back and left hip injuries. Employee initially sought medical care from 

the emergency department at Memorial Hospital in Chattanooga. A pelvic CT scan 

revealed no evidence of traumatic injury, but indicated severe left hip osteoarthritis, 

evidence of a right hip arthroplasty, and lumbar degenerative disc disease and facet 

arthropathy. 

 

 On August 24, 2015, Employee treated at Physician’s Care, a walk-in clinic, 

complaining of “constant left side pain since Fri. Aug 14, 2015.” He denied a history of 

similar problems and was diagnosed with lumbar sprain or strain and left hip/thigh sprain 

or strain. 

 Employee received medical treatment at Nova Medical Centers on multiple 

occasions from August 24, 2015 through January 2016, including physical therapy. 

While the record includes several work status forms from Nova Medical Centers, it does 

not include any office notes for Employee’s visits other than a January 12, 2016 note 

signed by Dr. Daniel Callan. That record reflects that Employee reported a “sudden onset 

of pain [in his] head and hip while [at] work,” noting that Employee “claims [he] fell and 

hit his left hip and head when a chair rolled away when he went to sit down.” It states 

that a left hip MRI revealed “[a]dvanced left hip arthropathy with marked cartilage loss, 

femoral head subluxation, subchrondral cysts, mixed reactive acetabular bone changes, 

marginal osteophytes, moderate left hip effusion with 10mm probable cartilaginous loose 

body in the anterior recess, [and] diffuse labral degeneration without discrete tear.” The 

report states that Employee was “advised to follow-up with his/her primary care doctor 

for positive review of systems that are not related to the injury.” 

 Employee was provided authorized medical treatment with Dr. Alexander Roberts, 

an orthopedist, whom he first saw on February 4, 2016 for complaints of “lumbar spine 

and [left lower extremity] pain with [numbness and tingling] and weakness.”1

 At a 

March 7, 2015 visit, Dr. Roberts injected Employee’s left hip for therapeutic and 

diagnostic purposes, noting that prior to leaving, Employee reported “100% total 

improvement of [his] symptoms.” At the following visit on March 31, 2016, Dr. Roberts 

noted that although the hip injection provided significant relief of hip pain, Employee 

“continues to experience left lower back pain consistent with a lumbar etiology.” Dr. 

 

1 Dr. Roberts provided treatment for Employee’s low back complaints, which ultimately resolved. 

Because the low back is not at issue in this appeal, we have not addressed that aspect of Employee’s 

medical treatment. 
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Roberts recommended a lumbar MRI and also recommended a referral to an orthopedic 

surgeon for a hip evaluation, stating that Employee “does continue to complain of 

intermittent left lower extremity weakness which is most likely secondary to left hip 

injury/degenerative joint disease.” Dr. Roberts also expressed the opinion in his report 

that “[i]t appears the patient had a pre-existing left degenerative hip, which was injured 

during a trauma on 8/14/2015.” 

 Employee returned to Dr. Roberts on May 6, 2016 for follow-up after undergoing 

an MRI of his lumbar spine, reporting that his lumbar pain had improved. Based on the 

results of the MRI, Dr. Roberts concluded that Employee “does have facet arthritis which 

could’ve been aggravated during the injury.” However, due to the improvement in 

Employee’s lumbar symptoms, he did not recommend any further treatment of the 

lumbar spine, but again recommended Employee “continue with his orthopedic consult 

for a left hip.” He noted the MRI “[did] not indicate any significant neural compression 

which could result in his left lower extremity weakness,” and stated “[t]he left lower 

extremity symptoms are most likely related to the left hip injury and not the lumbar 

spine.” 

 Employer authorized the recommended examination, and on May 24, 2016, 

Employee saw hip specialist Dr. Matthew Bernard. He noted that Employee complained 

of severe, intermittent left hip pain and observed that Employee had been “dealing with 

longstanding avascular necrosis since at least back in 2012.” He stated that Employee 

“has been managing this and has been able to work.” He observed that “[n]ew 

radiographs are available on our system, as well as an MRI . . . that was done back in 

October 2015 after the fall, that did show his advanced arthropathy, but it also showed 

the 10mm probable cartilaginous loose body in the anterior joint recess.” He expressed a 

causation opinion, stating “I believe that this represents fractured osteophyte from his 

fall, based on our comparative films available on our system.” Additional x-rays were 

obtained at Dr. Bernard’s office on May 24, 2016, and he addressed them as follows: 

Severe arthrosis with loss of joint space. Positive osteophytes. Several 

broken osteophytes representing loose bodies within the joint, in the area of 

consistent osteonecrosis [present on] his prior films and today’s films. 

Interval change from 2013 films to today’s films are these osteochondral 

loose bodies within the joint space. 

 Dr. Bernard noted that the October 20, 2015 MRI revealed “[a]dvanced left hip 

arthropathy with marked cartilage loss, femoral head subluxation, subchondral cysts, 

mixed reactive acetabular bone changes, and marginal osteophytes”; “[m]oderate left hip 

effusion with 10mm probable cartilaginous loose body in the anterior joint recess”; 

“[d]iffuse labral degeneration without discrete tear”; and “[n]o acute bony abnormality, 

tendinopathy, or periarticular soft tissue injury.” Ultimately, Dr. Bernard recommended 

that Employee undergo a left total hip replacement, stating that Employee “is no longer 
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able to ambulate to perform his duties, secondary to the hip pain and the catching from 

the loose bodies.” He expressed the opinion that “arthroscopically removing the loose 

bodies is not the appropriate answer and that to take care of his entire problem and get 

him back to a functional manual labor type job will require total hip arthroplasty.” 

 Two months later on July 27, 2016, and in apparent response to an inquiry from 

Employer’s insurance carrier concerning the rationale for his opinion for the left total hip 

replacement, Dr. Bernard provided the following opinion: 

After review of all of [Employee’s] films, as well as my office notes, my 

intent in that note was to convey the medical rationale for his need for a hip 

arthroplasty and not to imply that this was greater than 50% causally related 

to his fall at work. While the fall at work certainly was the proverbial straw 

that broke the camel’s back, it is certainly evident radiographically that his 

avascular necrosis was long standing and would represent greater than 51% 

of the need for hip replacement. I do think there were interval changes 

prior to the fall and post-fall, including fractured osteophytes. This 

however is the natural course of pre-collapse to post-collapse avascular 

necrosis. In regards to the last statement in this letter, that it appears that 

[Employee] was already a candidate for a left total hip arthroplasty prior to 

the 08-14-2015 injury, I do agree that radiographically [Employee] was a 

candidate for this hip replacement prior to this [08-14-2015] event. 

 Employer denied authorization for the left hip replacement, asserting the work 

accident did not result in Employee’s need for the surgery. The parties agreed to forego 

an evidentiary hearing and, after concluding no additional information was necessary, the 

trial court rendered a decision requiring Employer to provide ongoing treatment for the 

left hip. Specifically, the judge determined that “at a hearing on the merits, [Employee] 

will likely prevail in establishing that his need for left hip replacement surgery arose 

primarily out of and in the course and scope of employment.” The trial court additionally 

denied Employee’s request for temporary disability benefits. Both parties have appealed. 

Standard of Review 

The standard we apply in reviewing a trial court’s decision is statutorily mandated 

and limited in scope. Specifically, “[t]here shall be a presumption that the findings and 

conclusions of the workers’ compensation judge are correct, unless the preponderance of 

the evidence is otherwise.” Tenn. Code Ann. § 50-6-239(c)(7) (2015). The trial court’s 

decision may be reversed or modified if the rights of a party “have been prejudiced 

because findings, inferences, conclusions, or decisions of a workers’ compensation judge: 

(A) Violate constitutional or statutory provisions; 

(B) Exceed the statutory authority of the workers’ compensation judge; 
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(C) Do not comply with lawful procedure; 

(D) Are arbitrary, capricious, characterized by abuse of discretion, or 

clearly an unwarranted exercise of discretion; or 

(E) Are not supported by evidence that is both substantial and material 

in the light of the entire record.” 

Tenn. Code Ann. § 50-6-217(a)(3) (2015). 

Analysis 

Employee’s Appeal 

 For his statement of the issues or basis for relief on appeal, Employee wrote on the 

notice of appeal that he was “threatened by employer to return from light duty to perform 

job that cause[d] injury.” Employee has provided no other statement regarding any issues 

he attempts to raise on appeal, and he has provided no argument, brief, or position 

statement setting out how the trial court erred in deciding the case. As stated by the 

Tennessee Supreme Court, “[i]t is not the role of the courts, trial or appellate, to research 

or construct a litigant’s case or arguments for him or her.” Sneed v. Bd. of Prof’l 

Responsibility of the Supreme Court of Tenn., 301 S.W.3d 603, 615 (Tenn. 2010). 

Indeed, were we to search the record for possible errors and raise issues and arguments 

for Employee, we would essentially be acting as his counsel, which the law clearly 

prohibits us from doing. Courts on appeal will not “dig through the record in an attempt 

to discover arguments or issues that [a party] may have made” because doing so “would 

place [the opposing party] in a distinct and likely insurmountable and unfair 

disadvantage.” Webb v. Sherrell, No. E2013-02724-COA-R3-CV, 2015 Tenn. App. 

LEXIS 645, at *5 (Tenn. Ct. App. Aug. 12, 2015). Accordingly, we decline to conduct 

an “archaeological dig” into the record in an attempt to discover errors that might benefit 

either party. McEarl v. City of Brownsville, No. W2015-00077-COA-R3-CV, 2015 

Tenn. App. LEXIS 894, at *7 (Tenn. Ct. App. Nov. 6, 2015). Here, it is unclear from 

Employee’s comment on the notice of appeal how he contends the trial court erred in 

resolving the case, and we decline to speculate. 

Employer’s Appeal 

 Employer raises a single issue on appeal questioning whether Employee’s claim 

for medical benefits for his left hip injury should be denied based on Dr. Bernard’s 

written statement that Employee’s need for a left hip replacement “was more than 51% 

due to pre-existing avascular necrosis.” For the reasons that follow, we agree with 

Employer that the medical proof to date is insufficient to show that Employee will likely 

prevail at a hearing on the merits in establishing that the work injury contributed more 

than 50% in causing the need for his left hip replacement. Accordingly, to the extent the 

trial court’s order requires Employer to authorize and pay for a left total hip replacement, 
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the order is vacated. Employee is, however, entitled to ongoing medical treatment 

reasonably necessary as a result of the work-related left hip and low back injuries. 

 As our prior opinions have consistently stated, although an injured worker has the 

burden of proof on every essential element of his or her claim, at an expedited hearing an 

employee need not prove every element by a preponderance of the evidence, but must 

come forward with sufficient evidence from which the trial court can determine that the 

employee would likely prevail at a hearing on the merits consistent with Tennessee Code 

Annotated section 50-6-239(d)(1) (2015). McCord v. Advantage Human Resourcing, No. 

2014-06-0063, 2015 TN Wrk. Comp. App. Bd. LEXIS 6, at *9 (Tenn. Workers’ Comp. 

App. Bd. Mar. 27, 2015). We have described the burden of proof at an expedited hearing 

as a lesser evidentiary standard that “does not relieve an employee of the burden of 

producing evidence of an injury by accident that arose primarily out of and in the course 

and scope of employment . . ., but allows some relief to be granted if that evidence does 

not rise to the level of a ‘preponderance of the evidence.’” Buchanan v. Carlex Glass 

Co., No. 2015-01-0012, 2015 TN Wrk. Comp. App. Bd. LEXIS 39, at *6 (Tenn. 

Workers’ Comp. App. Bd. Sept. 29, 2015). 

 Tennessee Code Annotated section 50-6-102(14) (2015) defines “injury” as “an 

injury by accident . . . arising primarily out of and in the course and scope of 

employment, that causes death, disablement or the need for medical treatment.” 

(Emphasis added.) Furthermore, “[a]n injury causes death, disablement or the need for 

medical treatment only if it has been shown to a reasonable degree of medical certainty 

that it contributed more than fifty percent (50%) in causing the death, disablement or 

need for medical treatment, considering all causes.” Tenn. Code Ann. § 50-6-102(14)(C) 

(emphasis added). 

 In this case, Employee has failed to produce evidence suggesting that the work 

injury contributed more than 50% in causing the need for the total hip replacement 

surgery. Although Dr. Roberts expressed a causation opinion stating Employee’s left hip 

complaints are “most likely secondary to the left hip injury/degenerative joint disease,” 

and that Employee’s hip was “injured during a trauma on 8/14/2015,” he did not express 

an opinion as to the treatment reasonably necessary or recommended for the left hip 

injury or whether the injury contributed more than 50% in causing the need for such 

medical treatment. While Dr. Bernard’s medical records reflect his opinion that the fall 

at work caused one or more osteophytes to break off and enter the “anterior joint space,” 

there is no medical opinion suggesting that this work accident contributed more than 50% 

in causing the need for the recommended hip replacement. To the contrary, Dr. Bernard 

stated in response to Employer’s inquiry that “[w]hile the fall at work certainly was the 

proverbial straw that broke the camel’s back, it is certainly evident radiographically that 

his avascular necrosis was long standing and would represent greater than 51% of the 

need for hip replacement.” There is no medical proof in the record contradicting Dr. 

Bernard’s opinion or supporting the contention that the August 14, 2015 work injury 
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contributed more than 50% in causing the need for the left hip replacement as required by 

Tennessee Code Annotated section 50-6-102(14)(C). 

Furthermore, there is no suggestion in the trial court’s order that it disregarded Dr. 

Bernard’s opinion or did not find the opinion to be credible. Instead, the trial court 

considered that, prior to Employee’s work-related injury, he “had not received treatment 

for, nor been impaired from working at [Employer] by, left hip pain.” The trial court 

considered Dr. Bernard’s statement that Employee was a “candidate” for left hip 

replacement surgery before his fall “with the fact that the submitted evidence failed to 

establish that any physician had recommended treatment on [Employee’s] left hip before 

he fell.” In addition, the trial court observed that “after enduring left-hip pain for six 

months following his work-related fall, [Employee] is not now a candidate for hip 

surgery as he was before he fell, but, according to Dr. Bernard, is currently a surgical 

patient.” (Emphasis added.) Although these observations and considerations are relevant 

to the issue at hand, the only medical opinion addressing the statutory requirement that an 

injury “contribute[] more than fifty percent (50%) in causing the . . . need for medical 

treatment” is Dr. Bernard’s opinion that Employee’s pre-existing avascular necrosis 

“would represent greater than 51% of the need for hip replacement.” While Employee 

may ultimately succeed in presenting medical evidence sufficient to establish that his 

work injury contributed more than 50% in causing the need for the left hip replacement, 

the record does not contain such evidence at this stage of the proceedings. Although our 

review begins with the presumption that the trial court’s conclusion that Employee would 

likely prevail at trial in establishing “his need for left hip replacement surgery arose 

primarily out of and in the course and scope of employment” is correct, the 

preponderance of the evidence in the record on appeal is otherwise. See Tenn. Code Ann. 

§ 50-6-239(c)(7) (2016). 

 There is, however, no dispute that Employee fell at work and suffered injuries to 

his left hip and low back as a result of the incident. Thus, Employee remains entitled to 

medical treatment made reasonably necessary by and causally related to the work injury 

in accordance with Tennessee Code Annotated sections 50-6-204 and 50-6-102(14). 

Conclusion 

For the foregoing reasons, we hold that the evidence preponderates against the 

trial court’s determination that Employee will likely prevail at trial in establishing that the 

need for left hip replacement surgery arose primarily out of and in the course and scope 

of the employment. However, the preponderance of the evidence supports the conclusion 

that Employee is entitled to ongoing medical treatment made reasonably necessary by 

and causally related to the work injury. Accordingly, the trial court’s order that 

Employee is entitled to medical benefits for treatment of his left hip and low back injuries 

is affirmed, as is the trial court’s denial of temporary disability benefits. The trial court’s 

finding that Employee will likely prevail in establishing that his need for left hip 
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replacement surgery arose primarily out of and in the course and scope of the 

employment is vacated and the case is remanded to the trial court for any further 

proceedings that may be necessary. 
 TENNESSEE BUREAU OF WORKERS’ COMPENSATION 

 WORKERS’ COMPENSATION APPEALS BOARD 

) Docket No. 2016-01-0372

) 

) State File No. 63828-2015

) 

Ceasar Gamble

v.

Miller Industries, Inc., et al. )

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 9th day of February, 2017. 

Name Certified 

Mail 

First Class 

Mail 

Via 

Fax 

Fax 

Number 

Via 

Email 

Email Address 

Ceasar Gamble X C/O 5131 Mimosa Circle, Chattanooga, TN 

37416 

Eric Shen X Eric.shen@LibertyMutual.com 

Thomas Wyatt, 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

Jeanette Baird

Deputy Clerk, Workers’ Compensation Appeals Board

220 French Landing Dr., Ste. 1-B 

Nashville, TN 37243 

Telephone: 615-253-0064 

Electronic Mail: Jeanette.Baird@tn.gov