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TENNESSEE BUREAU OF WORKERS’ COMPENSATION

WORKERS’ COMPENSATION APPEALS BOARD 

Marshall Beene ) Docket No. 2016-01-0264 

) 

v. ) 

) State File No. 66494-2014 

Metro Services, Inc., et al. ) 

) 

) 

Appeal from the Court of Workers’ ) 

Compensation Claims ) 

Thomas Wyatt, Judge )

Affirmed and Remanded – Filed January 12, 2017 

In this interlocutory appeal, the employer asserts the trial court erred in awarding 

temporary partial disability benefits after an authorized treating physician had opined the 

employee reached maximum medical improvement for his work-related injury. 

Following an expedited hearing, the trial court determined the authorized treating 

physician had later revised his opinion regarding maximum medical improvement, 

thereby supporting an order for additional temporary disability benefits. The employer 

has appealed. We affirm the trial court’s determination and remand the case for any 

further proceedings that may be necessary. 

Judge Timothy W. Conner delivered the opinion of the Appeals Board in which Presiding 

Judge Marshall L. Davidson, III, and Judge David F. Hensley joined. 

Gordon C. Aulgur, Lansing, Michigan, for the employer-appellant, Metro Services, Inc. 

R. Lew Belvin, III, Chattanooga, Tennessee, for the employee-appellee, Marshall Beene
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Memorandum Opinion1

Marshall Beene (“Employee”) worked for Metro Services, Inc. (“Employer”), as a 

ductwork installer. On August 21, 2014, he fell approximately six to eight feet from a 

ladder onto a slotted metal floor. He complained of immediate pain and symptoms in his 

right upper extremity. The accident was accepted as compensable and, following 

emergent care, Employee was treated by Dr. Brandon Cincere, who Employer authorized.

Over the course of the following months, disputes arose regarding the extent and 

nature of Employee’s work-related injuries. Employee alleged that he suffered injuries to 

his right arm and right shoulder. He further alleged that a pre-existing, degenerative 

condition in his neck was aggravated by the fall. Several months after the accident, he 

was diagnosed with complex regional pain syndrome in his right upper extremity. 

Employer authorized some treatment, but denied other aspects of Employee’s claim. In 

June 2015, Employee underwent right shoulder surgery, which he reported improved his 

shoulder symptoms somewhat. However, he continued to complain of pain in his right 

elbow, shoulder, and neck.

On October 29, 2015, Employee returned to Dr. Cincere for post-surgical followup. Dr. Cincere noted that the physical therapy he had ordered had not been approved by 

the insurer. A referral for pain management also had not been approved. Employee 

complained of radiating pain from his neck into his shoulder and down his right arm. Dr. 

Cincere commented that the “carrier [is] making it difficult to care for patient, interfering 

with my treatment, I have nothing left to offer the patient.” He reiterated his requests for 

referrals to Dr. Gregory Ball for pain management and to Dr. Todd Bonvallet for a 

cervical spine evaluation.

Employer sought a medical records review with Dr. Thomas Koenig, an 

orthopedic surgeon. In his November 14, 2015 report, Dr. Koenig opined that the August 

21, 2014 fall caused right elbow lacerations, a partial tear of the right triceps, medial and 

lateral epicondylitis in the right elbow, traumatic cubital tunnel syndrome, and a possible 

small closed avulsion fracture of the lateral epicondyle. He also concluded that the fall 

may have caused complex regional pain syndrome in the right upper extremity and a right 

rotator cuff tear. He did not believe the degenerative changes in Employee’s cervical 

spine were causally related to the work accident. He felt additional treatment was 

warranted in the form of two or three stellate ganglion blocks, and he opined that “[t]he 

patient is likely to reach maximum medical improvement 2 to 3 weeks after the second or 

third repeat stellate sympathetic ganglion block.”

 

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“The Appeals Board may, in an effort to secure a just and speedy determination of matters on appeal and 

with the concurrence of all judges, decide an appeal by an abbreviated order or by memorandum opinion, 

whichever the Appeals Board deems appropriate, in cases that are not legally and/or factually novel or 

complex.” Appeals Bd. Prac. & Proc. § 1.3.
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Employer did not authorize any additional treatment in response to Dr. Koenig’s 

report or Dr. Cincere’s recommendations. On February 9, 2016, Dr. Cincere completed a 

Final Medical Report (Form C-30A) indicating that Employee had reached maximum 

medical improvement on January 19, 2016. Employer continued paying temporary 

disability benefits until March 3, 2016, at which time it terminated those benefits.

On July 14, 2016, Dr. Cincere responded to a written inquiry from Employee’s 

attorney concerning various disputed medical issues in the case. He opined that 

Employee’s work accident caused a right shoulder rotator cuff tear, right elbow tendinitis, 

right cubital tunnel syndrome, and complex regional pain syndrome of the right upper 

extremity. He recommended additional treatment with Dr. Ball and opined that 

Employee should engage in no lifting, reaching, or repetitive use of the right upper 

extremity pending additional treatment. He concluded that Employee was not at 

maximum medical improvement until such treatment was completed. However, he 

agreed with Dr. Koenig that Employee’s cervical spine condition did not primarily arise 

from the work accident, though he commented that the chronic cervical spine problems 

were “likely aggravated” by the work injury.

Employee returned to Dr. Ball on July 21, 2016, more than one year after his 

previous authorized visit. Dr. Ball again diagnosed complex regional pain syndrome in 

the right upper extremity and right shoulder pain. He prescribed additional stellate 

ganglion blocks and “aggressive physical therapy for the shoulder and elbow.”

During the expedited hearing, Employer argued that no additional temporary 

disability benefits were owed following Dr. Cincere’s completion of Form C-30A, which

placed Employee at maximum medical improvement as of January 19, 2016. It further 

argued that the additional medical treatment recommended by Dr. Cincere and Dr. Ball 

was related to the cervical spine condition, which did not arise primarily from the work 

accident. The trial court rejected both arguments, concluding instead that Dr. Cincere 

had, in effect, retracted his earlier statement regarding maximum medical improvement in 

response to the written inquiry from Employee’s attorney and had recommended further 

treatment for the shoulder and elbow injuries. Consequently, the trial court ordered the 

payment of temporary disability benefits from the date they were terminated to the 

present, as well as additional medical treatment. Employer appealed the award of 

additional temporary benefits but did not appeal the award of additional medical benefits.

On appeal, Employer makes essentially the same arguments it made to the trial 

court. Specifically, Employer argues that “[t]here was no evidence introduced at the 

[h]earing to establish the ATP had revised or modified the MMI date for the compensable 

right shoulder injury.” It also asserted that Dr. Cincere’s responses to the written inquiry 

from Employee’s counsel pertained to “additional medical and MMI for the cervical 

spine.” We disagree. Dr. Cincere’s July 14, 2016 response to the written inquiry clearly 

indicates he believed additional treatment was warranted for the right shoulder and arm. 
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He further indicated that Employee should work with temporary restrictions until such 

treatment was completed and that Employee was not at maximum medical improvement 

pending the additional treatment. He also reiterated his opinion that the “work comp 

carrier significantly limited my treatment of this [patient].” These opinions supported the 

trial court’s award of additional temporary disability benefits in light of the authorized 

physician’s revised opinion concerning maximum medical improvement for the shoulder 

and arm conditions. Thus, we affirm the trial court’s order and remand the case for any 

further proceedings that may be necessary.
 TENNESSEE BUREAU OF WORKERS’ COMPENSATION

 WORKERS’ COMPENSATION APPEALS BOARD 

Marshall Beene ) Docket No. 2016-01-0264

) 

v. ) State File No. 66494-2014

) 

Metro Services, Inc., et al. ) 

CERTIFICATE OF SERVICE 

I hereby certify that a true and correct copy of the Appeals Board’s decision in the 

referenced case was sent to the following recipients by the following methods of service 

on this the 12th day of January, 2017. 

Name Certified 

Mail

First Class 

Mail

Via 

Fax

Fax 

Number

Via 

Email

Email Address

R. Lew Belvin, III X lew.belvin@mcmahanlawfirm.com

Gordon C. Aulgur X gordon.aulgur@accidentfund.com

Thomas Wyatt, Judge X Via Electronic Mail

Kenneth M. Switzer, 

Chief Judge

X Via Electronic Mail

Penny Shrum, Clerk, 

Court of Workers’ 

Compensation Claims

X Penny.Patterson-Shrum@tn.gov

Matthew Salyer

Clerk, Workers’ Compensation Appeals Board

220 French Landing Dr., Ste. 1-B 

Nashville, TN 37243

Telephone: 615-253-1606 

Electronic Mail: Matthew.Salyer@tn.gov