Court Opinion

ID: 9880830
Source: CourtListenerOpinion
Date Created: 2023-09-28 19:09:09.880775+00
Date Added: 2024-06-11T13:57:54.495796
License: Public Domain

FILED
                                                                                Sep 28, 2023
                                                                               01:58 PM(CT)
                                                                                TENNESSEE
                                                                           WORKERS' COMPENSATION
                                                                              APPEALS BOARD

            TENNESSEE BUREAU OF WORKERS’ COMPENSATION
               WORKERS’ COMPENSATION APPEALS BOARD

Marzine Richardson                           )   Docket No.     2021-06-1257
                                             )
v.                                           )   State File No. 63576-2021
                                             )
Davidson Transit Organization, et al.        )
                                             )
                                             )
Appeal from the Court of Workers’            )
Compensation Claims                          )
Pamela B. Johnson, Judge                     )

                               Affirmed and Remanded

The employee filed an interlocutory request for additional medical benefits she claims are
reasonably necessary due to a work-related accident when she struck her left knee while
operating a bus. Although the employer accepted the compensability of the employee’s
accident, it denied that her current need for additional medical treatment arose primarily
from this accident, arguing instead that it arose primarily from a pre-existing
degenerative condition. The court considered written materials and expert opinions
submitted by each party and made a determination on the record, concluding that the
employee was entitled to return to the authorized treating physician. The employer has
appealed. Upon careful consideration of the record, we affirm the trial court’s order and
remand the case.

Presiding Judge Timothy W. Conner delivered the opinion of the Appeals Board in which
Judge Pele I. Godkin and Judge Meredith B. Weaver joined.

David M. Drobny, Nashville, Tennessee, for the employer-appellant, Davidson Transit
Organization

Timothy A. Roberto, Knoxville, Tennessee, for the employee-appellee, Marzine
Richardson

                         Factual and Procedural Background

      Marzine Richardson (“Employee”), a Davidson County resident, worked for
Davidson Transit Organization (“Employer”) as a bus driver. On August 5, 2021,
Employee reported striking her left knee on the fare box inside the bus she was operating.

                                            1
Employee also asserted that her left knee was injured due to “[r]epetitive motions for 4
years at [the] job.”

        Employer accepted the compensability of the August 5 accident and, after the
initial medical provider recommended an orthopedic referral, provided a panel of
specialists from which Employee selected Dr. Chad Price. Following a physical
examination and review of an MRI, which revealed moderate medial compartment
chondromalacia and degenerative tearing of the medial meniscus, Dr. Price concluded
that Employee suffered degenerative changes and osteoarthritis. He opined that the work
accident had exacerbated her pre-existing condition, and he ordered physical therapy and
assigned certain work restrictions. Because of scheduling difficulties, Employee was
unable to attend physical therapy sessions. Thereafter, on October 1, 2021, she reported
falling inside a bathroom at which she had stopped while driving Employer’s bus because
her left knee had given out. She was seen at an emergency room after the fall and was
diagnosed with exacerbation of her left knee meniscus injury and a right ankle sprain.

       When Employee next saw Dr. Price on October 6, 2021, she was unable to bear
weight on her left leg. Dr. Price noted her subsequent history of a fall and ordered
additional x-rays, which revealed no fractures and “unchanged moderate medial
patellofemoral osteoarthritis.” Dr. Price also commented, “I do not think either her
meniscus tear or the arthritis is related to her Workers’ Compensation claim.” Dr. Price
placed her at maximum medical improvement with respect to her work-related injury and
released her to return to work without restrictions.

       In July 2022, Dr. Price was deposed. 1 When he was asked about the MRI results,
Dr. Price agreed that the MRI did not show evidence of an acute injury. He testified that
Employee’s primary diagnosis was osteoarthritis, which he concluded was chronic and
not caused by the work accident. He also opined that the meniscal tear was not acute,
and that any need for surgery to repair that tear would not arise primarily out of the work
accident.

       In August 2022, Employee sought unauthorized treatment with Dr. Sharif Abdus
Salaam, an orthopedic physician. Dr. Abdus Salaam noted Employee’s history of left
knee pain for one year following the work-related accident in August 2021. After
reviewing the MRI completed after that accident, Dr. Abdus Salaam agreed with Dr.
Price’s prior assessment of medial compartment arthritis and degenerative tearing of the
medial meniscus. He recommended conservative treatment. He also advised Employee
that “her injury did not cause the arthritis or degenerative tear of her meniscus.” At her
next visit in October 2022, Dr. Abdus Salaam recommended “left arthroscopic knee
chondroid meniscal debridement” due to “failed conservative treatment.” Dr. Abdus
Salaam again noted “patient[’s] meniscal tear appears to be degenerative.”

1
    At the time of Dr. Price’s deposition, Employee was self-represented.
                                                      2
        On October 25, 2022, Employee’s counsel sent Dr. Abdus Salaam a medical
questionnaire, which he completed and signed on October 27. Dr. Abdus Salaam
indicated that although Employee’s degenerative meniscal tear and medial compartment
arthritis were not caused by the work accident, the accident did cause an “aggravation” of
those conditions. In the questionnaire, Dr. Abdus Salaam was not asked whether
Employee needed additional treatment for the aggravation of her pre-existing conditions.

       Following a review of the records submitted in the case, the trial court issued an
order compelling Employer to authorize a return visit with Dr. Price or another panel-
selected orthopedic physician for treatment of “[Employee’s] work-related injury and
aggravation of her pre-existing condition.” Employer has appealed.

                                  Standard of Review

        The standard we apply in reviewing the trial court’s decision presumes that the
court’s factual findings are correct unless the preponderance of the evidence is otherwise.
See Tenn. Code Ann. § 50-6-239(c)(7) (2022). However, we need not give deference to a
trial court’s findings “based upon documentary evidence such as depositions.” Goodman
v. Schwarz Paper Co., No. W2016-02594-SC-R3-WC, 2018 Tenn. LEXIS 8, at *6 (Tenn.
Workers’ Comp. Panel Jan. 18, 2018). The interpretation and application of statutes and
regulations are questions of law that are reviewed de novo with no presumption of
correctness afforded the trial court’s conclusions. See Mansell v. Bridgestone Firestone
N. Am. Tire, LLC, 417 S.W.3d 393, 399 (Tenn. 2013). We are also mindful of our
obligation to construe the workers’ compensation statutes “fairly, impartially, and in
accordance with basic principles of statutory construction” and in a way that does not
favor either the employee or the employer. Tenn. Code Ann. § 50-6-116 (2022).

                                        Analysis

       Our resolution of this appeal hinges on a review of the expert medical opinions
expressed to date. In its notice of appeal, Employer asserts that the trial court erred in
determining Employee “suffered an injury as defined by statute.” In its brief, Employer
argues that “no medical expert witness has opined that the Employee’s work accident is
the primary cause of her current need for treatment.”

       Tennessee Code Annotated section 50-6-102(12) defines compensable injuries to
include “the aggravation of a preexisting disease, condition[,] or ailment” if “it can be
shown to a reasonable degree of medical certainty that the aggravation arose primarily
out of and in the course and scope of employment.” We previously addressed an
employee’s entitlement to medical benefits arising from a work-related aggravation of a
pre-existing condition:

                                            3
      [T]o qualify for medical benefits at an interlocutory hearing, an injured
      worker who alleges an aggravation of a preexisting condition must offer
      evidence that the aggravation arose primarily out of and in the course and
      scope of employment. Moreover, the employee must come forward with
      sufficient evidence from which the trial court can determine that the
      employee would likely establish, to a reasonable degree of medical
      certainty, that the work accident contributed more than fifty percent in
      causing the aggravation, considering all causes. Finally, an aggravation or
      exacerbation need not be permanent for an injured worker to qualify for
      medical treatment reasonably necessitated by the aggravation.

Miller v. Lowe’s Home Centers, Inc., No. 2015-05-0158, 2015 TN Wrk. Comp. App. Bd.
LEXIS 40, at *18 (Tenn. Workers’ Comp. App. Bd. Oct. 21, 2015).

        We have also addressed cases in which an employee whose work accident
aggravated a pre-existing condition sought additional medical treatment in circumstances
where the authorized physician had concluded the employee’s work-related aggravation
had resolved. In Stallion v. TruGreen, L.P., No. 2016-01-0292, 2017 TN Wrk. Comp.
App. Bd. LEXIS 11 (Tenn. Workers’ Comp. App. Bd. Feb. 2, 2017), the employee
reported experiencing low back pain while lifting a truck’s tailgate. Id. at *2. The
treating physician concluded the employee had suffered a low back sprain that aggravated
pre-existing degenerative conditions in his low back. Id. at *4. In response to a medical
questionnaire sent to him by the employer’s counsel, the treating physician indicated that
the employee “does not need any further medical treatment for his back sprain injury.”
Id. at *6. The treating physician placed the employee at maximum medical improvement,
released him to return to work without restrictions, and concluded the work-related sprain
caused no permanent medical impairment. Id.

        The trial court in Stallion concluded that the employee came forward with
sufficient evidence to indicate he was likely to prevail at trial in proving a compensable
aggravation of his pre-existing low back condition. Id. It therefore ordered the employer
to provide a new panel of physicians in the state to which the employee had moved, and
the employer appealed. Id. at *6-7. On appeal, we reversed, concluding that the
employee had not come forward with sufficient evidence indicating he was likely to
prevail in proving his need for additional medical care was causally related to the
compensable aggravation. Id. at *13. In so holding, we noted that the only expert
medical opinion presented to the court was that the employee did not need any additional
medical treatment for his back sprain injury. Id. at *12.

       In distinguishing our holding in Stallion from other cases in which we had
affirmed orders for medical treatment, we explained as follows:

                                            4
       [W]e note there is an important distinction between [the previous cases]
       and the matter presently before us. In each of those cases, there was
       medical proof at an expedited hearing to support a finding of an
       aggravation of a pre-existing condition. In each case, a physician had
       rendered an opinion that satisfied the statutory requirements necessary to
       establish a compensable aggravation. Here, the record does not include a
       medical opinion to support a conclusion that Employee’s current
       complaints are caused by an aggravation of a pre-existing condition or that
       any such aggravation is causally related to the employment.

Id. at *14. Thus, in circumstances where an employee seeks additional medical treatment
for the aggravation of a pre-existing condition at an interlocutory stage of the case, the
record must support a finding that the employee is likely to prevail at trial in proving a
compensable aggravation of a pre-existing condition, whether temporary or permanent.

        Finally, we reiterate a longstanding principle that an employer cannot unilaterally
terminate an employee’s entitlement to future medical benefits in circumstances where it
has accepted the compensability of a work accident. See, e.g., Yow v. Lowe’s Investment
Corp., No. 2022-08-1050, 2023 TN Wrk. Comp. App. Bd. LEXIS 41, at *7-8 (Tenn.
Workers’ Comp. App. Bd. Aug. 18, 2023); Limberakis v. Pro-Tech Security, Inc., No.
2016-08-1288, 2017 TN Wrk. Comp. App. Bd. LEXIS 53, at *6 (Tenn. Workers’ Comp.
App. Bd. Sept. 12, 2017). We have also stressed that “[u]nless a court terminates an
employee’s entitlement to medical benefits or approves a settlement in which the parties
reach a compromise on the issue of future medical benefits, an injured worker remains
entitled to reasonable and necessary medical treatment causally related to the work
injury.” Limberakis, 2017 TN Wrk. Comp. App. Bd. LEXIS 53 at *7 (emphasis added).

       Here, although the issue is close, we conclude that the circumstances of this case
are more akin to Miller than Stallion. Significantly, both physicians concluded that
Employee had exacerbated or aggravated her pre-existing knee condition as a result of
the work accident. When Dr. Price last saw Employee in October 2021, he did not
release her from his care, indicate that she no longer needed any treatment for her work-
related condition, or advise her not to return. In fact, as of that date, Employee was still
experiencing significant symptoms, and Dr. Price acknowledged in his report that “she is
unable to bear weight on her left leg.” Moreover, Dr. Price did not state that her
aggravation or exacerbation had resolved as of the last date he examined her. He opined
that “she has sustained a knee contusion that has further exacerbated her pre-existing
underlying arthritis and degenerative meniscus tear.” On the other hand, when Dr. Price
was deposed in July 2022, he testified that, if Employee requires additional treatment for
her knee, such treatment would not be primarily related to the August 2021 work
accident. Yet, at the time he offered that opinion, Dr. Price had not examined Employee
in more than nine months.

                                             5
       Moreover, when Dr. Abdus Salaam was asked in October 2022 to provide his
expert medical opinion, he noted that Employee had suffered an aggravation of her
degenerative meniscal tear and an aggravation of her medial compartment arthritis as a
result of the work accident. Yet, Dr. Abdus Salaam was not asked to comment on
whether the aggravation of her pre-existing conditions had resolved or whether her
aggravation reasonably necessitated additional medical care.

        In essence, the crux of this dispute hinges on the burden of proof. In
circumstances where the compensability of an employee’s accident has been accepted
and medical care authorized, the question is whether the employee has the burden of
proving that the need for any additional medical care arose primarily out of the accident.
We conclude the answer to that question depends on the particular facts and attendant
circumstances of the case. Here, in considering the expert medical opinions offered in
this case, the trial court noted, “both [physicians] determined that the work accident
exacerbated or aggravated her underlying preexisting knee conditions.” Consequently,
the court concluded that Employee had come forward with sufficient evidence indicating
a likelihood of prevailing at trial in proving the occurrence of a compensable aggravation
of her pre-existing knee conditions. We conclude the evidence does not preponderate
against that finding.

        Furthermore, given that Dr. Price has not indicated he would refuse to see
Employee again, and given that an employer cannot unilaterally terminate an employee’s
entitlement to reasonable and necessary future medical benefits in a compensable claim,
the trial court did not err in ordering Employer to authorize a return appointment with Dr.
Price, or another panel-selected physician should Dr. Price decline to see her again, to
determine whether Employee needs any additional medical care that is reasonable,
necessary, and causally related to her compensable work-related accident. Notably, the
court did not order Employer to authorize any specific treatment but instead left that
determination to the authorized treating physician.

                                       Conclusion

       For the foregoing reasons, we affirm the trial court’s order and remand the case.
Costs on appeal are taxed to Employer.

                                            6
                      TENNESSEE BUREAU OF WORKERS’ COMPENSATION
                        WORKERS’ COMPENSATION APPEALS BOARD

Marzine Richardson                                    )      Docket No. 2021-06-1257
                                                      )
v.                                                    )      State File No. 63576-2021
                                                      )
Davidson Transit Organization, et al.                 )
                                                      )
                                                      )
Appeal from the Court of Workers’                     )
Compensation Claims                                   )
Pamela B. Johnson, Judge                              )

                                   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 28th day
of September, 2023.

 Name                              Certified   First Class   Via   Via     Sent to:
                                   Mail        Mail          Fax   Email
 Timothy A. Roberto                                                  X     troberto@brownandroberto.com
                                                                           cwilliams@brownandroberto.com
 David M. Drobny                                                     X     ddrobny@manierherod.com
                                                                           mgrimmig@manierherod.com
 Jenna M. Macnair                                                          jmacnair@manierherod.com
 Pamela B. Johnson, Judge                                            X     Via Electronic Mail
 Kenneth M. Switzer, Chief Judge                                     X     Via Electronic Mail
 Penny Shrum, Clerk, Court of                                        X     penny.patterson-shrum@tn.gov
 Workers’ Compensation Claims

Matthew Keene
Acting Clerk, Workers’ Compensation Appeals Board
220 French Landing Dr., Ste. 1-B
Nashville, TN 37243
Telephone: 615-532-1564
Electronic Mail: WCAppeals.Clerk@tn.gov