FILED

Jan 25, 2019

10:31 AM(ET)

TENNESSEE COURT OF

WORKERS' COMPENSATION

CLAIMS
History of Claim 

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 impairment rating. 

Following the first Expedited Hearing, the Court held that Mr. Huffaker presented 

sufficient evidence entitling him to a panel of physicians for evaluation and treatment of 

any work-related back or knee injury but not evaluations of his elbows or shoulders. As a 

result of that order, CAC provided two panels of orthopedic physicians, and Mr. Huffaker 

selected Dr. Michael Casey for evaluation of his knee and Dr. Colin Booth for his back. 

Dr. Casey evaluated Mr. Huffaker and noted: 

I do not feel that over two years later that this is truly an event from his fall. 

My diagnosis today is more patellofemoral pain with some early 

patellofemoral wear. I see no other evidence of internal 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 of his 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 Code Annotated section 50-6-204(3)(C) (2018). 

CAC argued it provided Mr. Huffaker medical treatment related to his work injury 

and he is not entitled to a second opinion of his 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 proof establishing a connection between his current need for treatment and the 

work injury. 

2 
Findings of Fact and Conclusions of Law 

Mr. Huffaker need not prove every element by a preponderance of the 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 of and in the course and scope of employment. To establish that the injury 

arose primarily out of the employment, he must show "to a reasonable degree of medical 

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 of medical certainty" means that "in the opinion of the physician, it is more likely 

than not considering all causes, as opposed to speculation or possibility." See Tenn. 

Code Ann. §50-6-102(14)(C)-(D). Thus, causation must be established by expert medical 

testimony. 

First, Mr. Huffaker seeks MRis, which no physician recommended, for multiple 

body parts. Although the Court is aware of Mr. Huffaker's sincerely held belief that his 

current conditions and need for treatment arose primarily out of his work injury, his lay 

opinion alone is legally insufficient to establish the essential element of medical 

causation. Thus, the Court holds Mr. Huffaker failed to establish he is likely to prevail at 

a hearing on the merits that he is entitled to the 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 of surgery 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 on the merits that he is entitled to 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. 

3 
ENTERED on January 25, 2019. 

LISA A. LOWE, JUDGE 

Court of Workers' Compensation Claims 

APPENDIX 

Technical Record: 

1. Petition for Benefit Determination 

2. Dispute Certification Notice 

3. Motion for Extension of Time 

4. Order Granting Motion for Extension of Time 

5. Order Granting Employee's Second Motion for Extension of Time 

6. Request for Expedited Hearing 

7. Expedited Hearing Order Granting Medical Benefits 

8. Motion for Further Diagnostic Testing with photographs 

9. Employer's Response and Memorandum in Opposition to Employee's Motion 

for Further Diagnostic Tes ting 

10. Mr. Huffaker's position statement (email dated January 13, 2019) 

Exhibits: 

1. Affidavit of Jack T. Huffaker 

2. Hand-written Statement of Jack T. Huffaker 

3. First Report of Work Injury 

4. MRI of Outpatient Diagnostic Center at Knoxville, dated March 7, 2016 

5. Panel of Physicians, Form C-42, Selection Date of February 19, 2016 

6. Medical Report of Dr. M. Chris Testerman, dated November 8, 2016 

7. Medical Records of Knoxville Orthopedic Clinic 

8. Photographs of Lower Extremities 

9. Text Message to Susan Dowling, dated August 29, 2016 

10. Email of Kellie Earls, dated October 12, 2016 

11. Affidavit of Kellie Earls 

12. Executed Panel of Physicians for Back Injury 

13. Executed Panel of Physicians for Knee Injury 

14.August 30, 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 of Dr. Colin Booth 

4 
CERTIFICATE OF SERVICE 

I hereby certify that a true and correct copy of the Expedited Hearing Order was 

sent to the following recipients by the following methods of service on January 25, 2019. 

Name Certified Fax Email Service sent to: 

Mail 

Jack T. Huffaker, x x Jack T. Huffaker 

Self-Represented 516 Kay Drive 

Employee Strawberry Plains, TN 37871 

debandj ackc@comcast.net 

Hanson R. Tipton, x htrigton@watsonroach.com 

Employer's Attorney 

QL.k-v sg,,,.,.._J) t<~Ot'- PENNY SiIRUM, Court Cler ~ 

WC.CourtClerk@tn.gov 

5