1 TENNESSEE BUREAU OF WORKERS’ COMPENSATION

IN THE COURT OF WORKERS’ COMPENSATION CLAIMS

AT GRAY

JOSHUA RAMEY

, ) Docket No. : 2020

- 02

- 0173

Employee, )

v. )
SLEEP ZONE, INC.

, ) State File No. : 334112019

Employer, )

A nd )

FLAGSHIP CITY INSURANCE CO.

, ) Judge Brian K. Addington

Carrier

, And ABIGAIL HUDGENS, Administrator, Subsequent Injury Fund. )
)
)
)

EXPEDITED HEARING ORDER DENYING REQUESTED BENEFITS

Mr. Ramey asked the Court to order Sleep Zone to provide additional workers’ compensation benefits f

or injuries when he fell backward while carrying a mattress . Sleep

Zone denied the claim because , after viewing surveillance video, the authorized treating physician determined Mr. Ramey’s current complaints are not causally related to the fall

. For the reasons below, the Court holds Mr. Ramey is not entitled to the requested benefits.

History of Claim

Mr. Ramey fell backward while carrying a mattress on May 7, 2019, and alleged

injuries to multiple body parts. Dr. Jody Helms , an authorized treating physician, referr ed

him to physical therapy and order ed epidural steroid injections . Mr. Ramey missed several

physical therapy a ppointments and the injections

, so t h ose provi ders discharged him from

care.

Sleep Zone became suspicious of Mr. Ramey’s complaints after his non

- compliance

with medical treatm ent and began surveillance of his activities beginning in June 2019.

Mr. Ramey testified that in December 2020 he experienced an inability to get out of bed or 

### FILED Mar 18, 2021 01:16 PM(CT)

TENNESSEE COURT OF

WORKERS' COMPENSATION

CLAIMS2

walk any distance, his l eft shoulder popp ing out its socket

, severe ankle pain

, and neck pain

from turning his head. However, t he surveillance which continued into December 2020

, suggested that Mr. Ramey participated in normal everyday activities of driving, shopping,

playing sports, and working.

Sleep Zone provided the initial surveillance videos to Dr. Helms. After reviewing

the videos and watch ing Mr. Ramey walk to his car without any hesitation on July 8, 2019

, he noted he would not expect Mr. Ramey to perform the activities on the videos based on

how he presented in his office. That same day, Dr. Helms released Mr. Ramey from

treatment a nd placed him at maximum medical improvement without restrictions or

impairment.

In response to Dr. Helms’s discharge , Mr. Ramey argued that the man in the

surveillance video was his twin brother. Mr. Ramey acknowledged he has worked for most

of the time since his injury but complained of constant pain and requested additional

treatment. Aside from requesting medical treatment, Mr. Ramey also requested temporary

disability benefits

, although he was unsure of the dates of employment and amounts earned

.

Sleep Zone argued that Mr. Ramey has been untruthful about his need for medical
treatment as shown by the surveillance and Dr. Helms’s opinion, and it requested that the

Court deny his request s

.

Findings of Fact and Conclusions of Law

Mr. Ram ey must show that he is likely to prevail at a hearing on the merits. See

Tenn. Code Ann. § 50

- 6

- 239(d)(1) (2020) The Court holds he did not.

To recover medical benefits , M r

. Ramey must show

, to a reasonable degree of medical certainty, that the May 7, 2019 fall contributed more than fifty percent in causing

the need for medical treatment. See Burleson v. Germantown Par t ners Supercuts, 2017 TN Wrk. Comp. App. Bd. LEXIS 49, at *9

- 10 (Aug. 15, 2017).

Here, the Court finds that Mr. Ramey presented no testimony or other proof to contradict Dr. Helms’s opinions

. No medical proof established that his employment

contributed more than fifty percent in causing the need for medical treatment

. T he Court

also finds that Mr. Ramey was not credible. He grossly misrepresented his condition to

Dr. Helms and to the Court. Mr. Ramey’s argument that the video showed his twin brother

was unconvin cing

. Therefore, t he Court holds M r. Ramey is not likely to prevail at a hearing on the merits a nd denies h is request for medical benefits.

Mr. Ramey also requested temporary disability benefits. There are two kinds of temporary disability benefits : temporary total and temporary partial. To receive temporary3

total disability benefits, Mr. Ramey must prove (1) he became disabled from working due

to a work injury; (2) a causal connection between the injury and h is inability to work; and
(3) the durat ion of h is disability. Jones v. Crencor Leasing and Sales , TN Wrk. Comp. App. Bd. LEXIS 48, at *7 (Dec. 11, 2015 ). Concerning temporary partial disability
benefits, Mr. Ramey is eligible for benefits if he earned less than h is average weekly wage

due to work restrictions. See Tenn. Code Ann. § 50

- 6

- 207(2)(A).

Here, Mr. Ramey submitted no medical proof taking him off work after July 8, 2019

. Instead, Mr. Ramey testified he continued to work for other employers but could not recall the dates of his employment or the amount s he earned. Considering th e lack of evidence

, the Court finds Mr. Ramey is not likely to succeed at a hearing on the merits regarding additional temporary disability benefits.

It is ORDERED as follows:

1. The Court denies Mr. Ramey’s request ed medical and temporary disability

benefits

.

2. This case is scheduled for a Status Hearing on May 14, 2021, at 10:00 a .m.
E astern T ime . You must dial 855

- 543

- 5044 to participate. Failure to call may

result in a determination of the issue s without your participation.

ENTERED March 18

, 20 2 1

.

/S Brian K. Addington

BRIAN K. ADDINGTON , JUDGE Court of Workers’ Compensation Claims4 A PPENDIX

Exhibits:

1. A ffidavits

2. Wage Statement

3. Panel

4. Medical Record Table of Contents

5. Final Medical Report

6. Declaration s of Robert Gox and Ryan Bordis

7. Face b ook business advertisement

8. Bicycle photos

9. Four v ideos

Technical Record:

1. P etition for Benefit Determination 2. Dispute Certification Notice

3. Show Cause Order

4. Show Cause Order 5. Request for Expedited Hearing

6. Sleep Zone’s Motion to Dismiss for Failure to Prosecute 7. Order Denying Motion to Dismiss 8. Motion for Virtual Participation 9. Order Permitting Subsequent Injury Fund’s Attendance by Phone or Video

10. Sleep Zone’s Motion to Deem Admitted 11. Order Denying Motion to Deem Admitted

12. Sleep Zone ’s Expedited Hearing Witness and Exhibit List

13. Sleep Zone ’s Position Statement for Expedited Hearing5 CERTIFICATE OF SERVICE

I certify that a correct copy of this Order was sent on March ___ , 202 1

.

Name Certified

Mail Email Service sent to:

Joshua Ramey

, Employee X X 365 May Ave. Kingsport, TN 37665 rameycain@yahoo.com

Jennifer White, Stephen Stovall, Employer’s Attorney s X jennifer@petersonwhite.com setphen.stovall@petersonwhite.com

Lindsay Hall

, Subsequent Injury Fund Attorney X lindsay.n.hall@tn.gov

______________________________________ PENNY SHRUM, COURT CLERK wc.courtclerk@tn.gov