Court Opinion

ID: 6221010
Source: CourtListenerOpinion
Date Created: 2022-02-11 16:06:44.515708+00
Date Added: 2024-06-11T08:57:20.023168
License: Public Domain

FILED
                                                                                 Feb 11, 2022
                                                                                 09:45 AM(CT)
                                                                              TENNESSEE COURT OF
                                                                             WORKERS' COMPENSATION
                                                                                    CLAIMS

           TENNESSEE BUREAU OF WORKERS’ COMPENSATION
          IN THE COURT OF WORKERS’ COMPENSATION CLAIMS
                           AT NASHVILLE

 CHRISTOPHER CUTSINGER,            ) Docket No. 2021-06-0007
            Employee,              )
 v.                                )
 BELLSOUTH                         ) State File No. 48212-2020
 TELECOMMUNICATIONS, LLC,          )
            Employer,              )
 and                               ) Judge Joshua Davis Baker
 OLD REPUBLIC INSURANCE            )
 COMPANY,                          )
             Carrier.              )
 ___________________________________________________________________

                    EXPEDITED HEARING ORDER
 ____________________________________________________________________

       In a February 2, 2022 expedited hearing, Mr. Cutsinger requested medical and
temporary disability benefits. Specifically, he requested authorization for treatment from
neurologist Dr. James P. Anderson, three visits to a walk-in clinic after he had obtained
maximum medical improvement and referrals resulting from those visits. He also
requested temporary disability due to Bellsouth’s inability to accommodate restrictions
imposed during the unauthorized visits.

       Because Mr. Cutsinger’s authorized physician is willing to treat him and an injured
worker is not entitled to temporary disability benefits after attaining maximum medical
improvement, the Court finds he is unlikely to prevail on those requests at a final hearing.
However, the Court holds that Mr. Cutsinger can continue to see his authorized treating
physician, Dr. Scott L. Parker.

                                      Claim History

      Mr. Cutsinger injured his shoulders and neck in July 2020 while lifting traffic cones.
Bellsouth accepted his claim, and after initial treatment with CareNow, Mr. Cutsinger
chose neurosurgeon Dr. Parker from a panel of physicians.

                                             1
       Dr. Parker testified by deposition that he provided nonsurgical treatment after an
EMG demonstrated “no signs of active cervical radiculopathy,” and an MRI “only showed
some mild to moderate changes, no severe compression on the nerves or anything . . . that
would require . . . any sort of urgent surgery.” So, he focused on “other complaints and
issues,” which required referrals to other specialists.

        However, Bellsouth questioned the work-relatedness of Dr. Parker’s referral to
neurologist Dr. Anderson for a cognitive evaluation for symptoms of “significant stress
and anxiety,” as these symptoms pre-existed the work injury and seemed unrelated to
lifting traffic cones. Indeed, as recently as a year before the injury, Mr. Cutsinger had used
FMLA leave for “depression, anxiety, [and] panic attacks.”

       To clarify the relationship between work and the anxiety, the adjuster sent Dr.
Parker a yes/no questionnaire, and he checked boxes in January 2021 suggesting his
neurology referral for a cognitive evaluation and for cervical radiculopathy “primarily
arises out of the employment event.” To explain the connection between a cognitive
evaluation and the work injury, he relayed, “Patient reports significant stress and anxiety
due to radicular arm pain and subsequent treatments.” To clarify its medical necessity, he
wrote simply, “Given his symptoms and no structural cause identified on MRI[,] I would
recommend evaluation by neurology for cognitive evaluation.”

       Despite Dr. Parker’s affirmative responses, Bellsouth maintained its denial of the
neurology referral, so Mr. Cutsinger began treating with Dr. Anderson using his private
insurance.

        Dr. Parker’s opinion concerning the neurology referral changed over time, and he
confirmed in his deposition that he had no outstanding treatment recommendations or
referrals when he released Mr. Cutsinger from his care. About the neurology referral, he
testified, “I don’t believe it would be more than 50 percent related to the work injury.”

      Bellsouth did not dispute Dr. Parker’s other referrals, so Mr. Cutsinger saw Dr. Scott
Baker for pain management and Dr. Douglas Matthews for carpal tunnel and ulnar nerve
complaints. Both doctors examined him and released him without restrictions in April and
May 2021.

        On May 18, after reviewing those doctors’ evaluations, Dr. Parker also released Mr.
Cutsinger from care. He wrote, “It is my recommendation that he is at MMI for this and
does not require a follow-up appointment. He can return to work and driving with no
restrictions.” Although the injury did not require any follow-up, Dr. Parker testified that
Mr. Cutsinger “can always return . . . any patient is always welcome to come back.”

       Only two months after Dr. Parker released him, Mr. Cutsinger returned to CareNow,
the same clinic he had visited at the outset of his claim, for treatment of the same work

                                              2
injury. He acknowledged on cross-examination that he did not seek permission from the
carrier or third-party administrator before going there. As a result of these visits, Mr.
Cutsinger obtained new referrals and work restrictions from July 15 to August 5, 2021.

       When Mr. Cutsinger sent the CareNow restrictions to his supervisor and requested
medical care, his supervisor directed him to the third-party administrator and explained he
could not accommodate the restrictions. Instead, he advised Mr. Cutsinger to use paid sick
leave from July 15 to August 5. For his part, Mr. Cutsinger could not recall whether he
had used paid sick leave or a short-term disability plan for his absence from work during
the three-week period the CareNow physician had restricted his work.

       Bellsouth refused to pay for the CareNow visits or accept the treatment
recommendations and restrictions of its physician. Bellsouth argued Mr. Cutsinger should
have returned to Dr. Parker instead of going to CareNow for treatment.

                       Findings of Fact and Conclusions of Law

       Mr. Cutsinger must present sufficient evidence that he is likely to prevail at a final
hearing to receive benefits at this expedited hearing. See Tenn. Code Ann. § 50-6-
239(d)(1) (2021); McCord v. Advantage Human Resourcing, 2015 TN Wrk. Comp. App.
Bd. LEXIS 6, at *9 (Mar. 27, 2015).

       He requested authorization for treatment by Dr. Anderson, payment for three
unauthorized visits to CareNow, and provision of the treatment recommendations and
referrals resulting from those visits. He also requested temporary disability benefits for
three weeks, the timeframe his CareNow physician restricted his work.

       Mr. Cutsinger argued that Bellsouth should have authorized the referral to Dr.
Anderson given Dr. Parker’s questionnaire responses and that, under Tennessee Code
Annotated section 50-6-204(a)(3)(E), Dr. Anderson is now his authorized treating
physician.

       However, this argument fails to consider Dr. Parker’s recent testimony that the
neurology referral was not related primarily to the work injury. And while Dr. Parker had
checked “yes” boxes to support the neurology referral as work-related, his written
explanations barely buttressed those affirmative answers, yielding somewhat vague and
confusing support. For example, he wrote that Mr. Cutsinger connected significant stress
and anxiety, which pre-existed the work injury, “to radicular arm pain and subsequent
treatments,” but he did not explain how that connection related to the work injury or the
need for a neurology referral.

      Dr. Parker’s deposition testimony is the most recent opinion the Court has
concerning the neurology referral. He has also agreed to continue seeing Mr. Cutsinger.

                                             3
For these reasons, the Court finds that Dr. Parker is still Mr. Cutsinger’s authorized treating
physician and holds that he is unlikely to prevail at a final hearing on his request for
treatment with Dr. Anderson. However, he may still see Dr. Parker if he needs further care.

        Concerning payment for his unauthorized visits to CareNow, an injured worker has
a statutory duty to accept the medical services offered by his employer. Tenn. Code Ann.
§ 50-6-204(a)(3)(A)(i). Further, an employer must first be given an opportunity to provide
treatment. Dorris v. INA Ins. Co., 764 S.W.2d 538, 541 (Tenn. 1989) (An “employee
[should] do no less than to consult [the] employer before incurring expenses called for by
the statute if the employee expects the employer to pay for them.”). Whether an employee
is justified in seeking additional medical services to be paid by the employer without
consulting him depends upon the circumstances of each case. Harris v. Kroger Co., 567
S.W.2d 161, 163 (Tenn.1978).

       Here, Mr. Cutsinger did not explain why he returned to CareNow instead of
contacting Dr. Parker’s office or the adjuster. Although he told his supervisor he needed
medical care, his supervisor appropriately directed him to contact the third-party
administrator. Given this, the Court cannot find that Mr. Cutsinger fulfilled his statutory
duty to accept the medical services provided or that he supplied reasonable justification for
incurring unauthorized treatment. Thus, he is unlikely to prevail on his request for
authorization of the CareNow visits at a final hearing.

       Turning to temporary disability benefits, Bellsouth offered unrefuted expert
testimony from the authorized physician that Mr. Cutsinger was at maximum medical
improvement concerning his work-related conditions on May 18, 2021. Temporary total
disability benefits are terminated either by the ability to return to work or attainment of
maximum recovery. Simpson v. Satterfield, 564 S.W.2d 953, 955 (Tenn.1978).

       Mr. Cutsinger asked for temporary disability benefits from July 15 to August 5,
2021. Because Dr. Parker placed him at maximum medical improvement before July 15—
thereby extinguishing his right to temporary disability—Mr. Cutsinger is unlikely to
prevail at a final hearing on his claim for temporary disability benefits.

IT IS ORDERED as follows:

   1. The Court denies Mr. Cutsinger’s requested relief at this time.

   2. The Court orders Bellsouth to continue paying for Mr. Cutsinger to receive
      reasonable and necessary treatment from Dr. Scott Parker.

   3. The Court sets this claim for a scheduling hearing on Monday, March 28, 2022,
      at 10:30 a.m. Central Time. The parties must call (615) 741-2113 or toll-free at
                                              4
     (855) 874-0474 to participate. Failure to call might result in a determination of the
     issues without the party’s participation.

ENTERED February 11, 2022.

                                 ___________________________________
                                 Joshua Davis Baker, Judge
                                 Court of Workers’ Compensation Claims

                                           5
                                          APPENDIX

Exhibits

   1.   Medical Records with Table of Contents
   2.   Deposition of Dr. James Parker
   3.   Choice of Physician form, unsigned with CareNow as a potential selection
   4.   Choice of Physician form, selecting Dr. Scott Baker
   5.   Triage Notes
   6.   Job Description of an AT&T facility technician
   7.   Choice of Physician form, selecting Dr. Scott Parker
   8.   Rule 72 Declaration of Christopher Cutsinger
   9.   Plan of Care from Dr. James Anderson dated January 4, 2022

Technical Record

   1. Petition for Benefit Determination
   2. Dispute Certification Notice
   3. Request for Expedited Hearing
   4. Employer’s Dispute Certification Notice Submission
   5. Order Setting Expedited Hearing
   6. Employer’s Response to Employee’s Request for Expedited Hearing
   7. Employer’s Exhibit List
   8. Employee’s Motion to Approve Cognitive Evaluation
   9. Employer’s Response to Motion to Approve Cognitive Evaluation
   10. Employee’s Motion to Approve CareNow visits
   11. Employer’s Response to Motion to Approve CareNow visits
   12. Employee’s Motion to Receive Dr. Parker’s Questionnaire
   13. Employer’s Response to Motion to Receive Dr. Parker’s Questionnaire
   14. Notice of Filing Deposition Transcript of Christopher Cutsinger
   15. Motion for Extension
   16. Order Granting Extension
   17. Notice of Filing the Deposition Transcript of Dr. Scott Parker

                                            6
                             CERTIFICATE OF SERVICE

    I certify that a copy of this Order was sent as indicated on February 11, 2022.

Name                      Certified   Via      Via Service sent to:
                           Mail       Fax     Email
Christopher Cutsinger,                         X    gotsync@bellsouth.net
Employee
Kristen Stevenson,                             X     kcstevenson@mijs.com
Employer’s Attorney                                  ssshell@mijs.com

                                ____________________________________________
                                Penny Shrum, Court Clerk
                                Court of Workers’ Compensation Claims
                                Wc.courtclerk@tn.gov

                                          7
                           Expedited Hearing Order Right to Appeal:

     If you disagree with this Expedited Hearing Order, you may appeal to the Workers’
Compensation Appeals Board. To appeal an expedited hearing order, you must:

   1. Complete the enclosed form entitled: “Notice of Appeal,” and file the form with the
      Clerk of the Court of Workers’ Compensation Claims within seven business days of the
      date the expedited hearing order was filed. When filing the Notice of Appeal, you must
      serve a copy upon all parties.

   2. You must pay, via check, money order, or credit card, a $75.00 filing fee within ten
      calendar days after filing of the Notice of Appeal. Payments can be made in-person at
      any Bureau office or by U.S. mail, hand-delivery, or other delivery service. In the
      alternative, you may file an Affidavit of Indigency (form available on the Bureau’s
      website or any Bureau office) seeking a waiver of the fee. You must file the fully-
      completed Affidavit of Indigency within ten calendar days of filing the Notice of
      Appeal. Failure to timely pay the filing fee or file the Affidavit of Indigency will
      result in dismissal of the appeal.

   3. You bear the responsibility of ensuring a complete record on appeal. You may request
      from the court clerk the audio recording of the hearing for a $25.00 fee. If a transcript of
      the proceedings is to be filed, a licensed court reporter must prepare the transcript and file
      it with the court clerk within ten business days of the filing the Notice of
      Appeal. Alternatively, you may file a statement of the evidence prepared jointly by both
      parties within ten business days of the filing of the Notice of Appeal. The statement of
      the evidence must convey a complete and accurate account of the hearing. The Workers’
      Compensation Judge must approve the statement before the record is submitted to the
      Appeals Board. If the Appeals Board is called upon to review testimony or other proof
      concerning factual matters, the absence of a transcript or statement of the evidence can be
      a significant obstacle to meaningful appellate review.

   4. If you wish to file a position statement, you must file it with the court clerk within ten
      business days after the deadline to file a transcript or statement of the evidence. The
      party opposing the appeal may file a response with the court clerk within ten business
      days after you file your position statement. All position statements should include: (1) a
      statement summarizing the facts of the case from the evidence admitted during the
      expedited hearing; (2) a statement summarizing the disposition of the case as a result of
      the expedited hearing; (3) a statement of the issue(s) presented for review; and (4) an
      argument, citing appropriate statutes, case law, or other authority.

For self-represented litigants: Help from an Ombudsman is available at 800-332-2667.
                                              NOTICE OF APPEAL
                                      Tennessee Bureau of Workers’ Compensation
                                        www.tn.gov/workforce/injuries-at-work/
                                        wc.courtclerk@tn.gov | 1-800-332-2667

                                                                                  Docket No.: ________________________

                                                                                  State File No.: ______________________

                                                                                  Date of Injury: _____________________

         ___________________________________________________________________________
         Employee

         v.

         ___________________________________________________________________________
         Employer

Notice is given that ____________________________________________________________________
                         [List name(s) of all appealing party(ies). Use separate sheet if necessary.]

appeals the following order(s) of the Tennessee Court of Workers’ Compensation Claims to the
Workers’ Compensation Appeals Board (check one or more applicable boxes and include the date file-
stamped on the first page of the order(s) being appealed):

□ Expedited Hearing Order filed on _______________ □ Motion Order filed on ___________________
□ Compensation Order filed on__________________ □ Other Order filed on_____________________
issued by Judge _________________________________________________________________________.

Statement of the Issues on Appeal
Provide a short and plain statement of the issues on appeal or basis for relief on appeal:
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________

Parties
Appellant(s) (Requesting Party): _________________________________________ ☐Employer ☐Employee
Address: ________________________________________________________ Phone: ___________________
Email: __________________________________________________________
Attorney’s Name: ______________________________________________ BPR#: _______________________
Attorney’s Email: ______________________________________________ Phone: _______________________
Attorney’s Address: _________________________________________________________________________
                           * Attach an additional sheet for each additional Appellant *

LB-1099 rev. 01/20                              Page 1 of 2                                              RDA 11082
Employee Name: _______________________________________ Docket No.: _____________________ Date of Inj.: _______________

Appellee(s) (Opposing Party): ___________________________________________ ☐Employer ☐Employee
Appellee’s Address: ______________________________________________ Phone: ____________________
Email: _________________________________________________________
Attorney’s Name: _____________________________________________ BPR#: ________________________
Attorney’s Email: _____________________________________________ Phone: _______________________
Attorney’s Address: _________________________________________________________________________
                              * Attach an additional sheet for each additional Appellee *

                                             CERTIFICATE OF SERVICE

I, _____________________________________________________________, certify that I have forwarded a
true and exact copy of this Notice of Appeal by First Class mail, postage prepaid, or in any manner as described
in Tennessee Compilation Rules & Regulations, Chapter 0800-02-21, to all parties and/or their attorneys in this
case on this the __________ day of ___________________________________, 20 ____.

                                                           ______________________________________________
                                                            [Signature of appellant or attorney for appellant]

LB-1099 rev. 01/20                                 Page 2 of 2                                        RDA 11082