1 TENNESSEE BUREAU OF WORKERS’ COMPENSATION

IN THE COURT OF WORKERS’ COMPENSATION CLAIMS

AT NASHVILLE

SONDRA L. CLAYBROOKS, ) Docket No 2020

- 06

- 0489 Employee, )

v. ) INSIGHT GLOBAL, LLC

, ) State File No. 23248

- 2020 Employer, )

And ) TWIN CITY FIRE INS. CO.,

Carrier

. ) ) Judge Robert Durham

EXPEDITED HEARING ORDER

This case came before the Court on February 26 , 202 1

, for an Expedited Hearing.

Ms. Claybrooks sought medical and temporary disability benefits for various injuries she allegedly sustained from a slip and fall at work. The Court holds that Ms. Claybrooks did not establish she is likely to prove entitlement to reimbursement for past expenses or

temp orary disability benefits . H owever, Insight is required to provide a panel of orthopedists to treat any injuries caused by her fall.

History of Claim

Ms. Claybrooks’ s undisputed testimony was that o n May 9, 2019, she went to the

rest room while at a work meeting

. She slipped on the wet rest room floor, causing her legs to “split” before she fell on her right side. She immediately reported the fall to her

manager , Kwaneka Fields, completed an accident report, and sought care at Vanderbilt

Health Clini c (VHC)

. 1 Insight did not provide a panel.

Ms. Claybrooks treated with Deborah Baker, P.A. at VHC. She complained of pain in her right hip and buttock , and her x

- rays revealed mild osteoarthritis. P.A. Baker diagnosed a right hip/hamstring/low back strain and recommended over

- the

- counter pain

medications after Ms. Claybrooks declined a n NSAID injection. PA Baker

1 It is unclear from the record whether Insight authorized Ms. Claybrooks’ visit to VHC. 

### FILED Mar 03, 2021 07:45 AM(CT)

TENNESSEE COURT OF

WORKERS' COMPENSATION

CLAIMS2 recommended that s he follow up with an orthopedist if her symptoms persisted . Ms. Claybrooks testified that P.A. Baker took her off work for five days, but the note does not

address work status

. She did not submit any more records from VHC.

Ms. Claybrooks stated that she returned to work on May 14 after Ms. Fields said company policy required her to do so. Th at same day, Abbi Livingston

, with Insight’s

human resource s, told her she was turning the claim over to the workers’ compensation

carrier. Again, Insight did not provide a panel.

Ms. Claybrooks further testified that she returned to VHC several times un til Ms. Fields told her that she could not take any more time off work. She stated that Insight terminated her on July 19 without explanation

.

Ms. Claybrooks submitted emails with Ms. Livingston ask ing about lost wages

, which stated that the claim had been submitted to Insight’s carrier. However, Ms. Claybrooks stated that the emails were not her only conversations regarding benefits

, and

she had also requested reimbursement for medical expenses a nd additional care.

In February and March 2020, Ms. Claybrooks underwent x

- rays and an EMG/NCS at Vanderbilt Orthopedics due to right

- hand numbness and tingling

. The EMG/NCS

report showed evidence of mild right

- carpal tunnel syndrome ; however, nothing suggested it was work

- related

. Ms. Claybrooks did not submit any other records regarding her hand, hip, knee or low back, although she introduced several pages of medical bills from various providers. 2

Findings of Fact and Conclusions of Law

M s. Claybrooks must present evidence from w hich this Court can determine that

s he is likely to pr ove at trial that she is entitled to workers’ compensation benefits

. See generally McCord v. Advantage Human Resourcing , 2015 TN Wrk. Comp. App. Bd. LEXIS 6, at *9 (Mar. 27, 2015). The Court has no re ason to doubt that she fell at work as she described. However, she must show that her fall caused injuries that require d further

treatment and left her temporarily disabled. The Court finds she has not done so at this

time.

To prove causation, M s. Claybrooks must show to a reasonable degree of medical certainty that h er work injury contributed more than fifty percent in causing h er

co mplaints , considering all causes. “Reasonable degree of medical certainty” means “it is more likely than not conside ring all causes, as opposed to speculation or uncertainty.”

2 The day before the hearing, Ms. Claybrooks filed another Petition for Benefit Determination alleg ing she

suffered a n ear injury due to use of her headphones at Insight. The Court informed her that the petition would be processed as a separate injury and would not be considered at this h earing.3 See Tenn. Code Ann. § 50

- 6

- 102(14) (2020). Given that the standard requires “medical certainty,” causation generally must be shown through an expert medical opinion. Id

.

Ms. Claybrooks did not submit any medical opinion that addresse d the cause of her symptoms, the reason for any past treatment, or whether her symptoms restricted her employment. Given the record before it, the Court cannot find that she is likely to prove

causation and thus denies her requests for reimbursement of medical expenses and temporary disability benefits.

E ven though Ms. Claybrooks did not show a likelihood of prevailing on causation,

the Court must still consider her entitle ment to a panel of physicians under Ten nessee Code Annotated section 50

- 6

- 204(a)(4)(A). It is undisputed that Insight never offered

her a panel upon receiving notice of her accident. The Appeals Board has held that a lack of medical evidence regarding causation does not necessarily eliminate the employer’s obligation to provide a physician panel. See Lewis v. Molly Maid

, 2016 TN Wrk. Comp. App. Bd. LEXIS 19, at *8

- 9 (Apr. 20, 2016)

.

Here, it bears repeating that neither Insight nor its carrier presented Ms. Claybrooks with a panel of physicians after receiving notice of her work

- related accident. Insight did not provide any justification for this failure

, other than contending that Ms. Claybrooks did not establish she required additional care. The Court holds this is an insufficient reason and orders Insight to provide Ms. Brooks with a panel of orthopedists from which she may choose a doctor to treat any injuries caused by her fall at work. In addition, the Court refers the issue to the Bureau’s Compliance Program to investigate

and determine if, and to what extent, it should issue a penalty.

IT IS, THEREFORE, ORDERED that:

1. Ms. Claybrooks ’ s request for reimbursement for past medical expenses and temporary disability benefits is denied at this time.

2. Insight shall provide Ms. Claybrooks with a panel of orthopedists from which she can select a doctor to treat any injuries caused by her fall at work.

3. This case is referred to the Bureau’s Compliance Program to determine if, and to what extent, a penalty is warranted.

4. Unless interlocutory appeal of the Expedited Hearing Order is filed, compliance with this Order must occur no later than seven business days from the date of entry of this Order as required by Tennessee Code Annotated section 50

- 6

- 239(d)(3).

The Insurer o r Self

- Insured Employer must submit confirmation of compliance with this Order to the Bureau by email to WCCompliance.Program@tn.gov no later than the seventh business day after entry of this Order. Failure to submit the4 necessary confirmation within the period of compliance might result in a penalty

assessment for non

- compliance. For questions regarding compliance, please contact the Workers’ Compensation Compliance Unit via email at WCCompliance.Program@tn.gov

.

5. This case is set for a Scheduling Hearing on April 16 , 202 1 at 9:0 0 a.m. Central

Time. T he parties must call 615

- 253

- 0010 or 855

- 689

- 9049 toll

- free to participate in the Scheduling Hearing. Failure to appear m ight result in a determination of the issues without the party’s participation.

ENTERED on March 3 , 202 0

.

_____________________________________ ROBERT DURHAM, JUDGE Court of Workers’ Compensation Claims

APPENDIX

Technical R ecord:

1. Petition for Benefit Determination

2. Dispute Certification Notice

3. Request for Expedited Hearing

4. Ord er Granting Employer’s Motion for Witness by Telephone

5. Order Granting Continuance

6. Employer’s Response to Request for Expedited Hearing

7. Order Granting Co ntinuance

Exhibits:

1. EMG/NCS Study

2. Various Medical Bills

3. Advanced Imaging Bill

4. Medical Note Excusing Absence dated July 11, 2019

5. X

- Rays of Right Hand

6. Right Hip X

- Ray Report

7. C

- 32 Form Regarding Right Ear

8. Additional Medical Bills

9. Emails between Ms. Claybrooks and Ms. Livingston

10. Petition for Benefit Determination filed on February 25, 2021 (for

identification only)

11. Medical Records from VHC

12. Operative Report dated February 5, 2021 (for ident i fication only)5 13. Emails between Ms. Claybrooks and Ms. Livingston

CERTIFICATE OF SERVICE

I certify that a copy of this Order was sent as indicated on March 3, 2021.

Name Certified

Mail Via

Fax Via

Email Service sent to:

Sondra Claybrooks X Slclay2228@gmail.com

L. Blair Cannon X Blair.cannon@thehartford.com Compliance Program X WCComplaince.Program@tn.gov

_____________________________________ Penny Shrum, Clerk of Court Court of Workers’ Compensation Claims WC.CourtClerk@tn.gov