1 A T NA S H V ILLE

V I NC E N T T AY LO R, E m p l o y ee, ) ) Doc k et No. 2019-06-0165

v . ) S t a te F il e No

. 78226-2014 AM E R I CAN TI R E D IST R IB U TIO N, E m pl oyer. ) ) J u d g e Jo sh u a D a v is B a k er )

C O MP E N S A TIO N O RD E R

The C ourt he l d a co mpen s a ti on hear i ng on Augu st 20, 2020, t o con si der M r. parti a l and t e m porary d is ab ility benef its for an a ll eged work-re l a t ed back i n j ury a tA m er i can T i re D ist r i bu t or s (ATD). He a ls o a s k s t he C ourt t o order ATD t o repay h is pr i va t e i n s urance for t he co stof h is m ed i ca l t rea tm en t . ATD den i e s it

owe s M r. Tay l or any t h i ng becau s e he fa il ed t o prove m ed i ca l cau s a ti on of h is back i n j ury. The C our t ho l d s tha t M r. Tay l or proved m ed i ca l cau s a ti on of h is i n j ury, and ATD mu st pay per m anen t -parti a l and t e m porary- t o t a l d is ab ilit y benef its . The C ourt fur t her ho l d s ATD m u stre im bur s e M r. Ta

C l a i m His tory

M r. Tay l or worked i n t he warehou s e for ATD ; h is pr im ary du t y wa s s orti ng ti re s for s h i p m en t . He earned an average of $889.63 per week.

M r. Tay l or worked t he overn i gh t s h i f t on S ep t e m ber 25 t o 26, 2014, then wen t ho m e t o sl eep. Upon awaken i ng, h is back hurt s o bad l y he had t roub l e ge tti ng ou tof bed. F or t una t e l y, he wa s off for t he weekend, bu t he wen t t o t he e m ergency roo mon M onday, S ep t e m ber 29, when t he pa i n con ti nued and wor s ened.

d i agno s ed s c i a ti ca and d is charged h im t ha t s a m e day. 

### F I LE D Nov 02, 2020 10:28 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 On S ep t e m ber 30, M r. Tay l or f ill ed ou t an acc i den t report a t work listi ng S ep t e mber 25 a s t he da t e of i n j ury. He cou l d no t g i ve a tim e, a s he d i d no t no ti ce h is i n j ury un til S ep t e m ber 26. He m a i n t a i ned, however, t ha t it m u st have happened wh il e he wa s s orti ng ti re s

.

M r. Tay l or s aw pane l phy si c i an, Dr. W illi a m Du tt on, on Oc t ober 3. The record s fro m t ha t v isit list ed h is da t e of i n j ury a s S ep t e mber 25 and no t ed h is st a t e m en t t ha t he

s ec ti on docu m en ts M r. Tay l or fo ll ow-up w it h h is pr im ary care doc t or. Dr. Du tt on

re l ea s ed M r. Tay l or fro m h is care, and he rece i ved no fur t her care

M r. Tay l or wen t back t o work bu t re t urned t o t he e m ergency roo m on Oc t ober 7. He co m p l a i ned t ha t he fe ltrecurr i ng pa i n upon re t urn i ng t o work and, af t er work, awoke

w it h pa i n rad i a ti ng down h is l ef t si de t ha t cau s ed h im t o exper i ence d i ff i cu lt y wa l k i ng and li f ti ng we i gh t . The e m ergency roo m aga i n d i agno s ed s c i a ti ca and excu s ed h im fro m work

un til Oc t ober 13.

M r. Tay l or never wen t back t o work af t er Oc t ober 7 bu t rece i ved s hor t - and l ongt er md is ab ility pay m en ts up un til t he s umm er of 2015. M r. Tay l or pa i d for t he d is ab ility po li c i e s

.

On Oc t ober 14, M r. Tay l or wen t t o s ee h is pr im ary care doc t or, S hua i b M ohyudd i n, and u s ed h is pr i va t e i n s urance t o pay for t rea tm en t . Dr. M ohyudd i n d i agno s ed l u mbar rad i cu l opa t hy, excu s ed M r. Tay l or fro m work un til Oc t ober 20, and s chedu l ed a re t urn v isit i n t hree week s . When he re t urned, M r. Tay l or repor t ed improve m en t i n h is pa i n bu t a ls o a

new s y m p t o m , h is l eg t o h is fee t

.

B ecau s e of h is progre ssi ng s y m p t o ms , M r. Tay l or wen t t o s ee Dr. S ana t D i x it i n Nove mber, and aga i n pa i d w it h h is hea lt h i n s urance. Dr. D i x it t ook M r. Tay l or off work and reco mm ended an MR I. The MR I re s u lts s howed M r. Tay l or had an ex truded d is c and rad i cu l opa t hy a s we ll a s a foo t -drop. He perform ed a mi crod is cec t o m y l a t er t ha t m on t h. He even t ua ll y re l ea s ed M r. Tay l or on M arch 30, 2015, t o re t urn t o work w it h a re st r i c ti on of li f ti ng no m ore t han f i f

ty pound s , bu t d i d no t re l ea s e h im t o fu ll du t y work un til Oc t ober of 2015.

t rea ti ng doc t or who t e sti f i ed cond iti on i n

j ury and s urgery t o work becau s e M r. Tay l or never de s cr i bed a s pec i f i c work even t t ha t i n

j ured h im

.

Dr. Dav i d We st conduc t ed a m ed i ca l record s rev i ew bu t never exa mi ned M r. Tay l or. B a s ed on h is rev i ew, Dr. We stbe li eved t ha t M r. Tay l or i n j ured h is back a t work re s u lti ng3 i n d is c hern i a ti on t ha t l ed t o h is s urgery. He a ssi gned a s even-percen t impa i rm en tra ti ng. On cro ss -exa mi na ti on, however, Dr. We st agreed t ha t he cou l d no t de t ermi ne any i ncon sist enc i e s a m ong the i n j ury h ist or i e s M r. Tay l or prov i ded becau s e Dr. We stnever

exa mi ned h im

.

Dr. R obert Land s berg exa mi ned M r. Tay l or and co mp l e t ed a m ed i ca l eva l ua ti on. He fee l t ha t h is prob l e m a ll st art ed w it h t he work i n j ury, li f ti ng heavy ti re s a t

s urgery. He furt her st a t ed it wou l d have been rea s onab l e for M r. Tay l or t o be off work

or on re st r i c t ed du ti e s fro m S ep t e mber 26, 2014, t o M arch 2015. He add iti ona ll y s a i d he

wou l d have a ssi gned no per m anen t re st r i c ti on s on M r. Tay l or o t her t han t o be carefu l i n h is ac ti v iti e s

.

Dr. Land s berg a ls o st a t ed t ha t a ll the care M r. Tay l or rece i ved for t h is back i n j ury

wa s rea s onab l e and nece ss ary. Dr. Land s berg rev i ewed t he b ills M r. Tay l or pa i d t hrough h is pr i va t e i n s urance, and he st a t ed t he t o t a l charge s of $64,705 were norm a l and

cu st o m ary. He a ssi gned an e i gh t -percen t impa i rm en tra ti ng.

The parti e s sti pu l a t ed t o s evera l im port an t iss ue s . They agreed t o : a week l y

co mpen s a ti on ra t e of $593.09 ; M r. Tay l or reached m ax im u m m ed i ca l improve m en t on Oc t ober 12, 2015 ; and he wa s no t en titl ed t o any perm anen t -parti a l d is ab ilit y benef its beyond t he i n iti a l award.

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

M r. Tay l or reque st ed perm anen tparti a l and t e mporary d is ab ility benef its a s we ll a s

con ti nu i ng m ed i ca l care for h is back and re imbur s e m en t t o h is pr i va t e i n s urance for
pay m en ts t he i n s urer m ade. To preva il , he m u st i n iti a ll y prove by a preponderance of t he

ev i dence t ha t h is back i n j ury aro s e pr im ar il y ou t of and i n t he cour s e and s cope of h is

e mp l oy m en t

. See Tenn. C ode Ann. § 50-6-239(c)(6) (2019) ; Pan z a r e lla v. Ama z on.com, Inc. , No. E2017-01135- SC

- R 3-W C
, M ay 16, 2018).

The Te

. . . ar isi ng pr im ar il y ou tof and i n t he cour s e and s cope of e m p l oy m en t , t ha tcau s e s i n

j ury m u st be cau s ed i n t he cour s e and s cope of e mp l oy m en t on l y i f it ha s been s hown by a preponderance of t he ev i dence t ha t the e m p l oy m en t con t r i bu t ed m ore t han f i f

t y percen t (50%) i n cau si ng Tenn. C ode Ann. § 50-6-102(14) (2019).

S ep t e mber 25 s orti ng ti re s . The fo ll ow i ng day, he awoke w it h s evere back pa i n and had4 t roub l e ge tti ng ou t of bed. He tim e l y repor t ed t he i n j ury, and a lt hough he cou l d no t p i npo i n t t he exac t m o m en th is i n j ury occurred, he i den ti f i ed a s pec i f i c s e t of even ts a t work
t ha t imm ed i a t e l y preceded and produced h is back pa i n. F urt her, he prov i ded t he fac t ua l
t e stim ony concern i ng h is work on t he day of the acc i den t and h is cond iti on t he nex tday.

phy si ca l cond iti on is co mpe t en t t e stim ony t ha t is no t t o be d is regarded. Li mbe r ak is v. P r o- T ech Secu rit y, Inc., 2017 TN Wrk. C o m p. App. B d. LEXI S 53, a t *6 ( S ep t . 12, 2017). The C ourt f

i nd s h is t e stim ony cred i b l e.

M r. Tay l or a ls o proved t he m ed i ca l cau s e of h is i n j ury by a preponderance of t he

ev i dence. P rov i ng m ed i ca l cau s a ti on requ i re s an expert t ha t t he e mp l oy m en tcon t r i bu t ed m or i n j ury. A rea s onab l e degree of m ed i ca l cert a i n t y m ean s tha t it is

m ore li ke l y t han no t a ll cau s e s , a s oppo s ed t o

s pecu l a ti on or po ssi b ility. See Tenn. C ode Ann. § 50-6-102(14)( B )-(D).

Here, t hree doc t or s gave depo siti on s: Dr. Du tt on, Dr. We st , and Dr. Land s berg. Dr. Du tt on, t he au t hor i zed trea ti ng phy si c i an s aw M r. Tay l or on l y once and re l ea s ed h im t o

re t urn t o work, f i nd i ng We st t e sti f i ed t ha t M r. Tay l or hern i a t ed a d is c i n h is back wh il e work i ng, wh i ch l ed t o h is

s urgery.

foo t drop, l ead i ng t o t he s urgery.

When a C ourt rece i ve s co mpe ti ng t e stim ony fro m phy si c i an s , it m u stde t er mi ne wh i ch t e stim ony t o accep tba s ed on a var i e t y of fac t or s , i nc l ud i ng t he qua li f i ca ti on s of t he phy si c i an s , t he c i rcu mst ance s of t he i r exa mi na ti on, t he i nform a ti on ava il ab l e t o each phy si c i an, and t he im por t ance of t ha t i nform a ti on i n t he v i ew of o t her exper ts

. See O rman v. W illi am s Sonoma, Inc. , 803 S .W.2d 672, 676 (Tenn. 1991). Of t he t hree, t he C ourt op i n i on.

he ba s ed it on t he

erroneou s conc l u si on t ha t M r. Tay l or never c it ed a s pec i f i c work even t , de s p it e t he off i ce

no t e t ha t

a lt hough he cau s a ll y re l a t ed M r.

exa m d is coun ts h is op i n i on, e s pec i a ll y becau s e he t ook no m ed i ca l h ist ory.

rea s onab l e. He
recogn i zed t ha t M r. Tay l or i den ti f i ed li f ti ng ti re s a s t he cau s e of h is i n j ury when he f i r st

v isit ed Dr. Du tt on. He a ls o gave a t horough exp l ana ti on of how t he i n j ury progre ss ed over5 tim e and re s u lt ed i n s urgery. In s hort , h is op i n i on be st exp l a i n s t e stim ony abou t h is acc i den tand de t er i ora ti ng cond iti on.

R egard i ng perm anen tpar ti a l d is ab ility benef its , Dr. Land s berg a ssi gned an e i gh t

percen t im pa i rm en t ra ti ng. The C our t accred its h is impa i r m en t op i n i on and order s ATD
t o pay M r. Tay l or $21,351.24 (36 week s x $593.09 per week) i n perm anen t parti a l d is ab ilit y benef its

. See Tenn. C ode Ann. § 50-6-207(3)(A). A lt hough M r. Tay l or d i d no t reach m ax im u m m ed i ca l im prove m en t un til Oc t ober 12, 2015, t he parti e s sti pu l a t ed he is

no t en titl ed t o any add iti ona l benef its

.

AT
t h is C ourt re j ec ts . ATD argued t ha t becau s e Tenne ss ee C ode Anno t a t ed s ec ti on 50-6- by t he t rea ti ng

defen s e, t he C ourt t urn s t o t he ru l e s of st a t u t ory con st ruc ti on.

r e Adop ti on o f A.M.H. , 215 S .W.3d 793, 808 (Tenn. 2007) (c iti ng S t a t e ex r e l . Rec to r v. W il

ke s , 436 S .W.2d 425, 427 (Tenn. 1968)). To t ha t end, un l e ss t he l anguage is a mb i guou s , t he C ourt

w it h i n t he con t ex t of t he en ti re st a t u t e w it hou t any forced or s ub tl e con st ruc ti on

c iti ng S ta t e v. F l emm i ng , 19 S .W.3d 195, 197 (Tenn. 2000). The C ourt m u st a ls o con st rue st a t u t e s i n t he con t ex tof t he o t her

s ec ti on s of t he st a t u t e. F irst T enn. S ta t e Bank, N .A. v. Doughe rt y , 963 S .W.2d 507, 509 (Tenn. Ct . App. 1997).

In con si der i ng t he s e requ i re m en ts , t he C ourt ho l d s t he st a t u t e st and s a s a d i rec ti ve requ i r i ng t rea ti ng phy si c i an s t o prov i de an im pa i r m en t ra ti ng i n a ll ca s e s , even i f t he
op i n i on is t ha t t he e m p l oyee ha s no per m anen t impa i rm en t . Th is conc l u si on is ev i den t when s ub s ec ti on 50-6-204(k)(1) is read i n t he con t ex t of t he en ti re s ec ti on. F or exa mp l e,

s ub s ec ti on 50-6-204(d)(5) a ll ow s parti e s t o app l y t o t he M ed i ca l I mpa i rm en t R a ti ng R eg ist ry for an op i n i on when t here are d i ffer i ng op i n i on s on perm anen t im pa i r m en t . Th is

s ub s ec ti on a ss u m e s a par ty m ay s eek an im pa i rm en t ra ti ng fro m a non- t rea ti ng phy si c i an. Add iti ona ll y, accep ti ng ATD

on m ed i ca l cau s a ti on ground s ba s ed on an op i n i on fro m a t rea ti ng phy si c i an fro m any ca s e. Th is is no t a re s u lt t he l eg isl a t ure i n t ended.

Turn i ng t o t e m porary t o t a l d is ab ility benef its

, M r. Tay l or m u st s how (1) he is t o t a ll y d is ab l ed and unab l e t o work due t o a co mpen s ab l e i n j ury, (2) t he work i n j ury and i nab ilit y t o work are cau s a ll y connec t ed, and (3) t he dura ti on of t he d is ab ilit y t o recover benef its

.6 Je w e ll v. C obb l e C on str . and A r cu s Re st o r a ti on , 2015 TN Wrk. C o mp. App. B d. LEXI S 1, a t *21 ( J an. 12, 2015). The C our tho l d s M r. Tay l or carr i ed h is burden.

M r. Tay l or hurt h ims e l f wh il e li f ti ng ti re s on t he overn i gh t s h i f t end i ng on t he

m orn i ng of S ep t e mber 26, 2014. He report ed t he i n j ury on S ep t e mber 29, bu t t hen re t urned
t o work un til v isiti ng t he e m ergency roo m on Oc t ober 7. Af t erward, t he m ed i ca l record s

s how s evera l doc t or s t ook h im off work, w it h Dr. Land s berg st a ti ng h is ab s ence fro m work

un til M arch 31 rea s onab l e under t he c i rcu mst ance s

. Th is is a per i od of twen ty-f i ve week s . The C our t cred its h is t e stim ony and order s ATD t o pay M r. Tay l or t e m porary t o t a l d is ab ility benef its of $15,417.61 (25 week s x $593.09 per week). The C ourt m u st deny M r. Tay l or any perm anen tpar ti a l d is ab ilit y benef its af t er M arch 31, a s Dr. Land s berg s a i d he wou l d no t have impo s ed any ac ti v it y re st r i c ti on s on M r. Tay l or af t er t ha t da t e excep t t o be carefu l i n h is ac ti v iti e s

. 1

A lt hough M r. Tay l or rece i ved s hor t - and l ong- t erm d is ab ilit y pay m en ts over h is
per i od of t e mporary d is ab ilit y, M r. Tay l or s a i d he pa i d for t he po li c i e s . Thu s , ATD canno t deduc t t he s e pay m en ts

. See Tenn. C ode Ann. § 50-6-114(b) (prov i d i ng for an off s e t on l y

Fi na ll y, M r. Tay l or s eek s re imbur s e m en t t o h is pr i va t e i n s urance for care pa i d for

of t he s e s erv i ce s

.

s uch

m ed i ca l and s urg i ca l t rea tm en t

. . . m ade rea s onab l y nece ss ary by acc i den t a s def i ned i n

a t § 50-6-

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)
t o be t he t rea ti ng ph a t 50-6-204(a)(3)(A)( i ). If an e mp l oyer fa ils t o prov i de a
pane l

, it r is k s hav i ng t o pay for a ll rea s onab l e and nece ss ary m ed i ca l expen s e s i ncurred by

an e m p l oyee for t rea tm en t w it h an unau t hor i zed phy si c i an, and a ls o r is k s hav i ng t o prov i de

con ti nu i ng care w it h the unau t hor i zed phy si c i an. See Y oung v. Y oung E l ec. , 2016 TN Wrk. C o m p. App. B d. LEXI S 24, a t *16-17 ( M ay 25, 2016).

Here, ATD prov i ded M r. Tay l or a pane l , bu t t he s e l ec t ed phy si c i an d ismiss ed h is

co mp l a i n ts a s no twork-re l a t ed af t er on l y one v isit

. M r. Tay l or con ti nued t o s uffer, s o he

M r. Tay l or rece i ved fro m pr i va t e prov i der s wa s a ll rea s onab l e and nece ss ary. He furt her rev i ewed the b ills

, t o t a li ng $64,705, and st a t ed t he charge s were norm a l and

1 A lt hough Dr. M ohyudd i n p l aced t e m porary re st r i c ti on s on M r. Tay l or accord i ng t o the m ed i ca l record s , t he doc t or d i d no t t e sti fy, s o t he C ourtd i d no tcon si der tho s e re st r i c ti on s i n award i ng t e m porary- t o t a l d is ab ilit y benef its

.7 cu st o m ary for t he t rea tm en t

. B a s ed on t h is ev i dence, t he C ourt ho l d s M r. Tay l or had no cho i ce bu t t o s eek unau t hor i zed care. Accord i ng l y, h is dec isi on t o s eek unau t hor i zed care

wa s rea s onab l e, and t he C our t order s t ha t t he co st of t h is care.

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

1. ATD s ha ll prov i de M r. Tay l or a pane l of three phy si c i an s for con ti nu i ng t rea tm en t of h is back i f M r. Tay l or reque sts add iti ona l t rea tm en t

.

2. ATD s ha ll pay M r. Tay l or $21,351.24 i n perm anen tpar ti a l d is ab ility benef its

.

3. ATD s ha ll pay M r. Tay l or $15,417.62 i n accrued t e mporary d is ab ilit y benef its

.

4. m ed i ca l
t rea tm en t

.

5. A tt orney Luve ll G l an t on s ha ll rece i ve a fee of t wen t y percen t of t he per m anen t parti a l d is ab ilit y award, or $4,270.25, and t wen t y percen t of t he t e mporary d is ab ilit y award, or $3,083.52.

6. C o sts of $150.00 are a ss e ss ed aga i n st ATD under Tenne ss ee C o mp il a ti on R u l e s and R egu l a ti on s 0800-02-21-.07 (Augu st 2019), for wh i ch execu ti on mi gh t iss ue a s

nece ss ary.

7. ATD s ha ll f il e a co mp l e t ed F or m S D-2 w it h i n f i ve day s af t er t h is order beco m e s f

i na l

.

8. Un l e ss appea l ed, the order s ha ll beco m e f i na l t h i rt y day s af t er iss uance.

E N TE R E D Novem b er 2, 2020.

_____________________________________ Jo shu a Dav is B a k er, J ud ge8 APP E ND I X

Exh i b its:

1. Depo siti on of Dr. R ober tLand s berg 2. Depo siti on of Dr. W illi a m Du tt on da t ed Dece m ber 18, 2017 3. Depo siti on of B ryan Garr is on 4. ATD E mp l oyee Inc i den t R eport 5. C oncen t ra P a ti en t Infor m a ti on F or m 6. P e titi on for B enef it De t er mi na ti on f il ed M ay 20, 2015 7. R e s pon s e s 8. 9. ATD P ayro ll R ecord 10. Depo siti on of Dr. W illi a m Du tt on da t ed Oc t ober 27, 2017 11. Depo siti on of Dr. Dav i d We st and a tt ached exh i b its

Techn i ca l R ecord :

1. P e titi on for B enef it De t er mi na ti on f il ed M arch 19, 2018
2. D is pu t e C erti f i ca ti on No ti ce f il ed Nove mber 15, 2018
3. D is pu t e C erti f i ca ti on No ti ce f il ed M ay 29, 2020 4. R eque st for S chedu li ng Hear i ng 5. S chedu li ng Order en t ered 6.

7. C o sts 8. and C o sts 9. No ti ce of In t en t t o U s e B u si ne ss R ecord s 10.

11. Order Gran ti ng M o ti on t o St r i ke en t ered 12.

13. t o Exc l ude C au s a ti on Te stim ony of Dr. W illi a m J

. Du tt on 14.

15.

16. Exc l ude Te stim ony of Dr. W illi a mDu tt on9 17. of In t en t t o U s e B u si ne ss R ecord s 18. Order Gran ti ng M o ti on for R e li ef fro m S chedu li ng Hear i ng Order and C on ti nuance 19. 20. 21. Order Gran ti ng M o ti on t o C on ti nue 22. M o ti on t o Qua s h t he S ubpoena s of Anna M ue ll er or for P ro t ec ti ve Order 23. Agreed P ro t ec ti ve Order L imiti ng t he Depo siti on of Anna M ue ll er 24. Order Deny i ng M o ti on for P ena lt y 25. Order S e tti ng M ed i a ti on en t ered 26. A m ended S chedu li ng Hear i ng Order 27. L ist and P re-Hear i ng St a t e m en t f

il ed 28. 29.

30. Order Deny i ng M o ti on t o St r i ke10 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 h is Order wa s s en t a s i nd i ca t ed on Nove m ber 2, 2020.

Na m e C erti f i ed M a il V i a F ax V i a E m a il S erv i ce s en t t o :

Luve ll G l an t on, A tt orney X g l an t onf i r m @g m a il .co m

J ohn Lew is , A tt orney X j ohn@ j ohn l ew is a tt orney.co m

______________________________________ P E NNY SH RUM, C O UR T C LE R K

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