Opinion ID: 1670419
Heading Depth: 2
Heading Rank: 2

Heading: Permanent Disability Award

Text: Mrs. Cantrell contends that the Special Workers' Compensation Appeals Panel erred in reducing the trial court's permanent disability awards of 50% for the left arm and 45% for the right arm to 35% for the left arm and 20% for the right arm. The extent of an injured employee's permanent disability involves a question of fact. Lang v. Nissan N. Am., Inc., 170 S.W.3d 564, 569 (Tenn.2005). We must review the trial court's findings of fact in a workers' compensation case de novo upon the record of the trial court, accompanied by a presumption that these findings are correct unless the preponderance of the evidence is otherwise. Tenn. Code Ann. § 50-6-225(e)(2) (1999). In reviewing documentary proof such as expert medical testimony presented by deposition, we need not extend the same deference to the trial court's findings as required for issues concerning the credibility and weight of oral testimony. Lang, 170 S.W.3d at 569. Ultimately, we must conduct an independent review of the evidence to determine where the preponderance of the evidence lies. See Tenn.Code Ann. § 50-6-225(e)(2) (1999); Cleek v. Wal-Mart Stores, Inc., 19 S.W.3d 770, 773-74 (Tenn.2000). An employee is not required to establish vocational disability or loss of earning capacity to be entitled to benefits for the loss of use of a scheduled member. Lang, 170 S.W.3d at 569. Proof of vocational disability, however, is admissible in determining the amount of scheduled member benefits to which the employee is entitled. Duncan v. Boeing Tenn., Inc., 825 S.W.2d 416, 417-18 (Tenn.1992). Vocational disability results when the employee's ability to earn wages in any form of employment that would have been available to him in an uninjured condition is diminished by an injury. Corcoran v. Foster Auto GMC, Inc., 746 S.W.2d 452, 459 (Tenn.1988). A trial court must consider all relevant evidence, including expert and lay testimony, in determining the extent of vocational disability. Lang, 170 S.W.3d at 570. Factors that a trial court may consider include the employee's age, education, job skills and training, the extent and duration of anatomical impairment, local job opportunities, and the employee's capacity to work at the kinds of employment available to one in the employee's disabled condition. McIlvain v. Russell Stover Candies, Inc., 996 S.W.2d 179, 183 (Tenn.1999). Applying these factors to the present case, we observe that Mrs. Cantrell was fifty-three years old at the time of trial and has a ninth-grade education. She has poor writing and math skills and has no special skills or training. She has never performed clerical or computer-related tasks or held a supervisory or management position. The trial court accredited the testimony of Mrs. Cantrell and her husband, David Cantrell (Mr.Cantrell), regarding her condition. Both Mr. and Mrs. Cantrell testified that Mrs. Cantrell has problems cleaning their home, mowing their yard, sleeping, and driving as a result of her injuries. Mrs. Cantrell further testified regarding her various jobs prior to her employment with Carrier but stated that she would not be able to perform those tasks now due to her injuries. The trial court also considered the deposition testimony of Dr. Rodger Zwemer, an orthopedic surgeon who was Mrs. Cantrell's treating physician, and Dr. Robert Landsberg, an orthopedic surgeon who performed an independent medical examination of Mrs. Cantrell. Dr. Zwemer detailed the treatment that he provided to Mrs. Cantrell for her carpal tunnel syndrome and testified that Mrs. Cantrell suffered permanent impairment to both arms. With regard to the right carpal tunnel syndrome, Dr. Zwemer assigned a 10% permanent impairment rating to the upper right extremity in accordance with the fourth edition of the American Medical Association Guidelines for Permanent Impairment (AMA Guides). He stated that the permanent impairment rating is 5% under the fifth edition of the AMA Guides. Dr. Zwemer assigned a 5% permanent impairment rating to the upper left extremity pursuant to the fifth edition of the AMA Guides for the left carpal tunnel syndrome. He also observed that Mrs. Cantrell experienced problems opposing her left thumb following the left carpal tunnel release. Dr. Zwemer assigned a permanent weight-lifting restriction of ten to fifteen pounds. On October 4, 2002, Dr. Zwemer released Mrs. Cantrell to return to work. Carrier did not have any jobs available to someone with Mrs. Cantrell's permanent restrictions, and Mrs. Cantrell did not return to work. On January 22, 2003, Dr. Landsberg conducted an independent medical examination of Mrs. Cantrell who complained of aches and numbness in her forearms. She did not complain of numbness or tingling in her hands with the exception of occasional occurrences in one of her little fingers. She reported basal thumb pain in her right thumb which worsened with gripping and resulted in cramping into the base of the thumb. Mrs. Cantrell also reported stiffness in her left hand and the inability to move her left thumb across to her little finger as she could do with her right thumb. Dr. Landsberg also noted Mrs. Cantrell's report of stinging and tingling in her right wrist which did not radiate into her fingers. Upon examining Mrs. Cantrell's wrists, Dr. Landsberg found that Mrs. Cantrell's right cubital tunnel was tender but there was no tingling into her fingers. The wrist flexion test caused pressure in her right carpal tunnel, pulling into her right wrist, and cramping into both hands. Dr. Landsberg found decreased range of motion in her left thumb, but the remaining ranges of motion were quite good. Dr. Landsberg diagnosed Mrs. Cantrell with mild residual bilateral carpal tunnel syndrome with hand inflammation and stiffness in her left thumb. Dr. Landsberg testified that Mrs. Cantrell suffered permanent impairment as a result of the carpal tunnel syndrome. He did not assign anatomical impairment ratings for these injuries but relied upon Dr. Zwemer's ratings. Dr. Landsberg assigned an anatomical impairment rating of 1% to the left hand or left upper extremity due to the mild decrease in adduction of the left thumb across the palm. He assigned permanent restrictions and instructed Mrs. Cantrell to avoid repetitive gripping and squeezing, repetitive pounding with her hands, and repetitive use of vibratory or pneumatic tools. The trial court also considered the report of a Functional Capacity Evaluation of Mrs. Cantrell on July 20, 2001. Upon examining the report, Dr. Zwemer testified that Mrs. Cantrell's performance was better than he had anticipated. The trial court, however, found that the evaluation likely was not as extensive as other evaluations because Mrs. Cantrell was required to perform the tasks for only one hour. While she was able to perform the physical activities during the hour of the evaluation, Mrs. Cantrell testified that she would be unable to perform those activities for longer than an hour. Finally, the trial court considered the testimony of Dr. Rodney Caldwell, a vocational expert, who opined that Mrs. Cantrell has a vocational disability of 95%. The trial court, however, expressed doubt with regard to the rating because Dr. Caldwell failed to explain why Mrs. Cantrell would be unable to perform light duty tasks. Upon reviewing the record, we conclude that the evidence does not preponderate against the trial court's findings and that the record supports the trial court's award of 50% to the left arm and 45% to the right arm. Therefore, the Panel erred in reducing the awards. We further conclude that the trial court and the Panel erred in making separate awards for the loss of each arm. The parties agree that the carpal tunnel syndrome to both of Mrs. Cantrell's arms occurred on the same date. The loss of two arms is a scheduled member injury pursuant to Tennessee Code Annotated section 50-6-207(3)(A)(ii)(w) (1999). Therefore, only one award is required. See Scales v. City of Oak Ridge, 53 S.W.3d 649, 651 n. 1 (Tenn.2001). We average the separate awards and conclude that Mrs. Cantrell is entitled to one award of 47.5% for the loss of two arms. See Lock v. Nat'l Union Fire Ins. Co., 809 S.W.2d 483, 487 (Tenn.1991). The trial court also awarded compensation for an injury to both shoulders that occurred prior to the carpal tunnel syndrome. The trial court assigned a separate permanent impairment rating of 15.75% to the body as a whole regarding each shoulder. On appeal, the Special Workers' Compensation Appeals Panel modified the trial court's judgment to provide a single award of 31.5% to the body as a whole for the injury to both shoulders. Neither party has requested a review of this award, and we adopt the Panel's modification of the trial court's award.