## FILED Jan 25, 2019 10:31 AM(ET) TENNESSEE COURT OF WORKERS' COMPENSATION

CLAIMSHistory ofClaim

Mr. Huffaker's work injury occurred when he fell while exiting his bus. After
some initial treatment, orthopedist Dr. William R. Fly provided conservative treatment including a boot walker and physical therapy from February to June 2016. Due to Mr. Huffaker's persistent left-ankle swelling, Dr. Fly referred him to fellow orthopedist and foot specialist Dr. Mary Testerman. Dr. Testerman treated him from June to November 2016 with medications and physical therapy then released him with permanent restrictions and an impairmentrating. Following the first Expedited Hearing, the Court held that Mr. Huffakerpresented sufficient evidence entitling him to a panel ofphysicians for evaluation and treatment of any work-related back or knee injury but not evaluations ofhis elbows or shoulders. As a result ofthat order, CAC provided two panels oforthopedic physicians, and Mr. Huffaker selectedDr. Michael Casey for evaluation ofhis knee and Dr. Colin Booth for his back.

Dr. Casey evaluated Mr. Huffaker and noted:

I do not feel that overtwo years laterthatthis is truly an event from his fall. My diagnosis today is more patellofemoral pain with some early patellofemoral wear. I see no other evidence ofinternal derangement. I do not feel that this is directly related to his workers' compensation injury back in February 2016.

Dr. Booth evaluated Mr. Huffaker and wrote "the patient's issues are due to degenerative disc disease, which is long standing. His injury may have aggravated these symptoms but at two years out, I cannot say his current symptoms are due to any work injury." Having received the above opinions, Mr. Huffaker requested MRis ofhis neck, shoulders, elbows, arms, and left leg. Additionally, he was not satisfied with the ankle treatment received from Drs. Fly and Testerman and requested a second opinion under Tennessee CodeAnnotated section 50-6-204(3)(C) (2018).

CAC argued it provided Mr. Huffakermedical treatment related to his work injury and he is not entitled to a second opinion ofhis ankle injury. Further, neither Dr. Casey
nor Dr. Booth related Mr. Huffaker's current complaints to the work injury, and no treating physician recommended the requested MRis. Finally, CAC argued Mr. Huffaker's request for additional treatment should be denied because he offered no medical proofestablishing a connection between his current need for treatment and the work injury.

2Findings ofFact and Conclusions ofLaw

Mr. Huffaker need not prove every element by a preponderance ofthe evidence to receive relief at an expedited hearing. Instead, he must present sufficient evidence showing 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).

To prove a compensable injury, Mr. Huffaker must establish that the injury arose primarily out ofand in the course and scope ofemployment. To establish that the injury
arose primarily out ofthe employment, he must show "to a reasonable degree ofmedical certainty that [the injury] contributed more than fifty percent (50%) in causing the death, disablement or need for medical treatment, considering all causes." The term "reasonable degree ofmedical certainty" means that "in the opinion ofthe physician, it is more likely than not considering all causes, as opposed to speculation or possibility." See Tenn. CodeAnn. §50-6-102(14)(C)-(D). Thus, causation mustbe established by expertmedical testimony.
First, Mr. Huffaker seeks MRis, which no physician recommended, for multiple body parts. Although the Court is aware ofMr. Huffaker's sincerely held beliefthat his current conditions and need for treatment arose primarily out ofhis work injury, his lay opinion alone is legally insufficient to establish the essential element of medical causation. Thus, the Courtholds Mr. Huffaker failed to establish he is likely to prevail at a hearing on the merits that he is entitledtothe requested MRis.
Second, Mr. Huffaker seeks a second opinion for his ankle under Tennessee Code Annotated section 50-6-204(3)(C), which affords an employee a second opinion on the issue ofsurgery and diagnosis. Petty v. Convention Prod. Rigging, 2016 TN Wrk. Comp. App. Bd. LEXIS 95, at *19-21 (Dec. 29, 2016). None of the treating physicians recommended surgery. Therefore, the Court holds Mr. Huffaker failed to establish he is likely to prevail at a hearing onthe merits that he is entitledto a second opinion.

IT 

### IS, THEREFORE, ORDERED as follows:

1. CAC is not obligated to provide the requested MRis or a second opinion on his ankle injury. However, Mr. Huffaker may return to Dr. Testerman for ongoing reasonable, necessary, and related medical treatment for his work-related left ankle mJury.

2. This matter is set for a Status Hearing/Scheduling Conference on March 28, 2019, at 2:30 p.m. Eastern Time. The parties must call 865-594-0109 or 855- 383-0003 toll-free to participate in the Status Hearing. Failure to appear by telephone may result in a determination of the issues without the party's participation.

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### ENTERED on January25, 2019.

LISAA. LOWE,JUDGE CourtofWorkers' Compensation Claims

APPENDIX
Technical Record: 1. Petition for BenefitDetermination 2. Dispute CertificationNotice 3. Motion for Extension ofTime 4. Order Granting Motion for Extension ofTime 5. Order Granting Employee's SecondMotion for Extension ofTime 6. Request for ExpeditedHearing 7. Expedited Hearing Order Granting Medical Benefits 8. Motion for FurtherDiagnostic Testing withphotographs 9. Employer's Response and Memorandum in Oppositionto Employee's Motion for FurtherDiagnostic Testing 10. Mr. Huffaker's position statement (email dated January 13, 2019)
Exhibits: 1. Affidavit ofJack T. Huffaker 2. Hand-written Statement ofJackT. Huffaker 3. FirstReport ofWork Injury 4. MRI ofOutpatient Diagnostic Center at Knoxville, dated March 7, 2016 5. Panel ofPhysicians, Form C-42, Selection Date ofFebruary 19, 2016 6. Medical Report ofDr. M. Chris Testerman, datedNovember 8, 2016 7. Medical Records ofKnoxville Orthopedic Clinic 8. Photographs ofLowerExtremities 9. TextMessage to Susan Dowling, dated August 29, 2016 10. Email ofKellie Earls, dated October 12, 2016 11.Affidavit ofKellie Earls 12.ExecutedPanel ofPhysicians for Back Injury 13.ExecutedPanel ofPhysicians for Knee Injury 14.August30, 2018 letter from The Poole to Mr. Huffaker 15. September 26, 2018 Medical Record of Dr. Michael Casey and causation response 16.October 3, 2018 Medical Record ofDr. Colin Booth

4CERTIFICATE OF SERVICE

I hereby certify that a true and correct copy ofthe Expedited Hearing Order was sentto the following recipients by the following methods ofservice on January 25, 2019.

Name Certified Fax Email Service sentto: Mail JackT. Huffaker, 

## x x JackT. Huffaker Self-Represented 516 KayDrive Employee Strawberry Plains, TN 37871 debandjackc@comcast.net HansonR. Tipton, 

## x htrigton@watsonroach.com Employer'sAttorney 

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## SiIRUM, Court Cler

### ~ WC.CourtClerk@tn.gov

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