COURTOFWORKERS' COMPENSATIONCLAIMS DIVISION OFWORKERS' COMPENSATION EMPLOYEE: Emily Haynes DOCKET#: 2014-05-0033 EMPLOYER: DCIDonorServices STATEFILE#: 91485-2014 FILED Fcbrual'")' 19, 201 5

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INSURANCE CARRIER: TheHartford MedicalManagementCenter/Sentinel Insurance CompanyLtd. DATE OFINJURY: November4, 2014

EXPEDITED HEARING ORDER THIS CAUSE came before the undersigned Workers' Compensation Judge upon the Request for Expedited Hearing filed on January 15, 2015, by Employee, Emily Haynes, pursuant to Tennessee Code Annotated section 50-6-239. Ms. Haynes requested an on-the-record ruling pursuant to Rule 0800-02-21-.14(2) (a) ofthe Tennessee Comprehensive Rules and Regulations to determine if Employer, DCI Donor Services ("DCI"), is obligated to provide temporary disability and/or medical benefits. On January 28, 2014, the Court found, upon review ofthe entirety ofthe claim file, the need for additional information. The Court ordered the parties to appear at atelephonic Expedited Hearing onFebruary 12, 2015. Ms. Haynes represented herself. T. Tamara Gauldin represented DCI and Carrier ("Hartford"). After reviewing Employee's Request for Expedited Hearing and the evidence presented at the Expedited Hearing, and considering the applicable law, the undersigned enters the following order denying Employee's request for medical benefits.1 ANALYSIS Issue WhetherMs. Haynessustainedan injury thataroseprimarilyoutof heremployment

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1 At the hearing, the Court observed that Ms. Haynes checked a box on a form to indicate that she seeks temporary disability benefits. The Court explained that she is ineligible for such benefits because the Workers' Compensation Law states that that no compensation is allowed for the first seven (7) days ofdisability resulting from the injury, excluding the day ofthe injury. Tenn. Code Ann. § 50-6-205(a) (2014). Ms

. Haynes agreed she missed two days ofwork and withdrew herclaim for TTDbenefits

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1Evidence Submitted The Court admitted into evidencethe following items: Exhibit 1: Records from ConcentraMedical Centers, November 5-20, 2014 Exhibit 2: Employee'srecorded statement Exhibit 3: First Report ofInjury Exhibit4: Wage statement Exhibit 5: Form C-42, Choice ofPhysician Exhibit 6: Form C-23, Notice ofDenial. The Court designated the following as the technical record:

• Petitionfor Benefit Determination • Dispute CertificationNotice • Request for Expedited Hearing. The Court did not consider attachments to the above filings unless admitted into evidence during the Expedited Hearing. The Court considered factual statements in the above filings or any attachments thereto as allegations unless establishedbythe evidence. History ofClaim Ms. Haynes is a thirty-one (31) year-old resident ofCannon County, Tennessee. She works for DCI as a seniorprocessing coordinator. She testified that on November 4, 2014, near the lunchhour, she was completingpaperwork at her desk and then "stoodup, turned left-tomy left, to go to the copier I believe, and my left kneecap popped out from the socket

- dislocated." She cried out for help before manipulatingthe kneecap backinto place herself. The parties agreed that on November 5, 2014, DCI told Ms. Haynes to go to Concentra.2 Ms. Haynes sought treatment that same day (See generally, Exhibit 1 ). Terrie Wheeler, PA, diagnosed "pain injoint involving lower leg," and, "sprain ofunspecified site ofknee and leg." She placed Ms. Haynes on restricted duty and ordered physical therapy and an MRI. On November 12, 2014, Dr. Jamira Duffy also ordered physical therapy. Dr. Duffy noted, in relevant part, "She reports 2 prior right kneecap dislocations. One was in 1998 and was associated with an ACL tearbut did not require surgery. The secondtime occurred at work with the same employer in 2012. She had an MRI done at that time which was negative." Ms. Haynes testified that she subsequently completed four or five sessions ofphysical therapy but she did not introduce the records as evidence. Hartford refusedto approve the MRI. Ms. Haynes

2 Tennessee CodeAnnotated section 50-6-204(a)(3)(A) (2014) provides that in any case where an employee has suffered an injury and expressed aneed for medical care the employer shall designate a group ofthree (3) ormore independentreputable physicians from which the injured employee shall select oneto bethe treating physician. DCI did not follow this procedure. DCI's noncompliance is notdeterminative ofthe outcome in this case, butthe Court nonetheless advises DCIprospectively to adhere to the law'srequirement should any other employee allege a workplace injury. 2gave a recorded statement to Hartford on November 21, 2014 (Exhibit 2). Hartford denied Ms. Haynes' claim onDecember 3, 2014 (Exhibit 6). Ms. Haynes testified that after the denial, she sought additional treatment from her private-pay orthopedic physician, whose treatment records she did not introduce as evidence. Ms. Haynes testified, without objection, that her physician performed an MRI and ruled out an ACL tear, but opined the need for surgery. Her physician lifted PA Wheeler's restrictions and she returnedto regular duty. On cross-examination, Ms. Haynes confirmed that she suffered two previous left-knee dislocations: in 2013, while standing up from her desk at work, and in 1998. In the 1998 incident, she suffered an ACL tear, which did not require surgery. With regard to the incident itself, Ms. Haynes admitted not holding or lifting anything when she got up from her desk. She further agreedthat, givenhertwo prior left-knee dislocations, no doctor diagnosedthe November 4, 2014, incident as the primary cause ofherknee popping out ofplace. Ms. Haynes' Contentions Ms. Haynes contends she suffered a compensable workplace injury and is entitled to additional medical benefits. DCI's Contentions DCI asserts thatMs. Haynes suffered an idiopathic injury. Ms. Haynes merely stood and turned. Her injury is personal to her because she previously suffered two dislocations. Further, there is no medical proof that the injury is work-related. Because Ms. Haynes' injury is idiopathic in nature, she did not sustain an injury arising primarily out ofher employment. DCI also argues that no additional medical treatment is necessary because Ms. Haynes' private-pay physicianreleasedherto regular duty. Findings ofFactand Conclusions ofLaw StandardApplied When determining whether to award benefits, the Judge must decide whether the moving party is likely to succeed on the merits at trial given the information available. See generally, McCall v. Nat'! Health Care Corp., 100 S.W.3d 209, 214 (Tenn. 2003) and Tenn. Code Ann. § 50-6-239(d)(1)(2014). In a workers' compensation action, pursuant to Tennessee Code Annotated section 50-6-239(c)(6), the employee shall bear the burden ofproving each and every element of the claim by a preponderance ofthe evidence. The employee must show the injury arose primarily out of and in the course and scope of employment. Tenn. Code Ann. § 50-6- 102(13)(2014). FactualFindings The Court finds that, on November 4, 2014, Ms. Haynes sustained an injury to her left kneecap at workwhen she stood up from a desk and turned to her left. She stood up to go to the 3copier. She was not lifting or carrying anything at the time. On November 5, 2014, DCI directed Ms. Haynes to Concentra. Ms. Haynes suffered a left-knee strain, requiring physical therapy and follow-up care. The Concentra medical records do not state whether the injury is work-related. Application of Law to Facts Justice Wade authored two opinions that explaincausation as itrelatesto idiopathic mJunes. First, in Wilhelm v. Krogers, he reiterated: Itis well-established that an injury must both "arise out of' as well as be "in the course" of employment in order to be compensable under the workers' compensation statute. The phrase "in the course of' refers to time, place and circumstances, and "arising out of' refers to cause or origin. An injury by accident to an employee is "inthe course of' employment ifit occurred while he was performing a duty he was employed to do; and it is an injury "arising out of' employment ifcaused by a hazard incident to such employment. An accidental injury arises out of one's employment when there is apparent to the rational mind, upon a consideration of all the circumstances, a causal connection between the conditions under which the work is required to be performed and the resulting injury

.... The mere presence of an employee at the place ofinjurybecause ofhisemploymentwill not alone result in the injury being considered as arising out of the employment. Wilhelm v. Krogers, 235 S.W.3d 122, 127 (Tenn. 2007) (citations omitted). In this case, Ms. Haynes was clearly in "the course ofher employment" when the injury occurred. The important question for purposes of compensability is whether the injury arose primarily out ofthe employment or was idiopathic in nature. In workers' compensation cases, benefits have generally not been allowed where the cause ofan injury has been found to be due to "some diseases or other idiopathic condition personal to the employee, absent some special hazard ofthe employment." Wilhelm, 235 S.W.3d at 128. In a subsequent Panel opinion discussing idiopathic injuries, Justice Wade wrote that examples of injuries deemed idiopathic by the Supreme Court have included an unexplained seizure orfainting episode and a knee "givingway"resulting in a fall. Veler v. Wackenhut, 2011 Tenn. LEXIS 78, 2011 WL 336465, at 3 (Tenn. Workers' Comp. Panel Jan. 28, 2011) (citations omitted). Further, in Wilhelm, Justice Wade wrote that inMcCain v. Allied-Bendix. Inc., 1994 WL 901486 (Tenn. Workers' Comp. Panel Apr. 5, 1994), the employee's knee "went out" at work while he was walking after the completion ofhis daily duties. Wilhelm, 235 S.W. at 128. The 4employee had injured his knee some six years earlier and his physician testified that the preexisting condition predisposed him to a tom meniscus injury. 

### !d. The Panel held that the employee's fall at work was caused by an idiopathic condition and thatthere was no condition of the employment that presented a peculiar or additional hazard to the employee. !d. Using similar reasoning, the Veler Panel observed, when finding the injury compensable, that the employee's "duties included gaining access to forms to be filled out, and his work required him to reach above his head to retrieve those forms," and, "there was no evidence ofa prior infirmity that might create a risk ofa serious knee injury that was personal to the employee." Veler, 2011 Tenn. LEXIS 78 at 4-5. In this case, Ms. Haynes credibly testifiedthat, immediately priorto herknee dislocation, while completing paperwork at her desk, she stood up to go to the copier and nothing was in her hands at the time. When describing the incident, she failed to identify a peculiar or additional hazard related to her employment. This incident could have happened when Ms. Haynes stood up from a chair in settings other than work. Her mere presence at work is insufficientto classify the injury as work-related. Employer's assertion thatthetwo prior dislocations indicate this type of injury is personal to Ms. Haynes is persuasive. Arguably, like the claimant in Veler, Ms. Haynes' duties might include accessing forms to be filled out or to reach above her head to retrieve forms. However, her testimony failed to specify herjob duties. And, unlike the Veler employee, there is substantial evidence that Ms. Haynes suffered a prior infirmity, as recently as 2013, which might create a risk of knee injury that is personal to her. Moreover, as DCI's Counsel pointed out, no medical evidence states that Ms. Haynes' injury is work-related. Therefore, Employee failed to meet her burden of establishing that her injury arose primarily out ofher employment. The Court finds Employee's injury is idiopathic innature and, as such, she is not entitledto workers' compensationbenefits.

IT IS, THEREFORE, ORDERED as follows: 1. Employee's claim against DCI or its workers' compensation carrier for the requested temporary disabilitybenefits is denied, atthis time, onthe grounds ofcompensability. 2. This matteris set for Initial Hearing onMarch 17, 2015, at 10:30 a.m. ENTERED this the 19th day ofFebruary, 2015.

5 ChiefJudge Kennet Tennessee CourtofWorkers' Compensation ClaimsInitial Hearing: An Initial Hearing has been set with Chief Judge Kenneth M. Switzer, Court of Workers Compensation. You must dial in at 615-532-9552 or 866-943-0025 toll free to participate in your scheduled conference. Please Note: You must call in on the scheduled date/time to participate. Failure to call in may result in a determination ofthe issues without your further participation. All conferences are setusing Central Time (CT). Rightto Appeal: Tennessee Law allows any party who disagrees with this Expedited Hearing Order to appeal the decision to the Workers' Compensation Appeals Board. To file a Notice ofAppeal, youmust: 1. Completethe enclosedform entitled: "ExpeditedHearingNotice ofAppeal". 2. File the completed form with the Court Clerk within seven (7) business days ofthe date the Workers' CompensationJudge enteredthe Expedited Hearing Order. 3. Serve a copy ofthe Expedited HearingNotice ofAppeal uponthe opposingparty. 4. The parties, having the responsibility of ensuring a complete record on appeal, may request from the Court Clerk the audio recording ofthe hearing for the purpose ofhaving a transcriptprepared by a licensed courtreporter and filing it with the Court Clerk within ten (10) calendar days of the filing of the Expedited Hearing Notice of Appeal. Alternatively, the parties may file a statement ofthe evidence within ten (10) calendar days ofthe filing ofthe Expedited Hearing Notice ofAppeal. The Judge must approve the statement of the evidence before the Clerk of the Court of Workers' Compensation Claims shall submitthe record to the Clerk ofthe Appeals Board. 5. Ifthe appellant elects to file a position statement in support ofthe interlocutory appeal, the appealingparty shall file suchposition statementwiththe Court Clerkwithinthree (3) business days ofthe filing ofthe Expedited Hearing Notice of Appeal, specifying the issues presented for review and including any argument in support thereof. If the appellee elects to file a response in opposition to the interlocutory appeal, appellee shall do so withinthree (3) business days ofthefiling ofthe appellant'sposition statement.

6CERTIFICATE OF SERVICE I hereby certify that a true and correct copy ofthe Expedited Hearing Order was sent to the following recipients by the following methods of service on this the 19th day ofFebruary, 2015.

Name Certified First Via Fax Via Email Address Mail Class Fax Number Email Mail EmilyHaynes, X EHaynes@dcids.org Employee T.Tamara Gauldin, X Tamara.gauldin@thehartford.com Employer's attorney

u , ClerkofCourt rkers' Compensation Claims

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