Court Opinion

ID: 5119260
Source: CourtListenerOpinion
Date Created: 2021-10-19 13:45:58.925164+00
Date Added: 2024-06-11T08:22:11.762944
License: Public Domain

FILED
                                                                                   Oct 15, 2021
                                                                                   11:01 AM(CT)
                                                                                TENNESSEE COURT OF
                                                                               WORKERS' COMPENSATION
                                                                                      CLAIMS

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

 KELLY ROLLINS,                               ) Docket No. 2021-05-0232
          Employee,                           )
 v.                                           )
 UNITED PARCEL SERVICE, INC.,                 ) State File No. 94527-2019
          Employer,                           )
 And                                          )
 LIBERTY MUTUAL,                              ) Judge Dale Tipps
          Carrier.                            )

                               COMPENSATION ORDER

        The Court held a Status Hearing in this case on October 13, 2021. The parties agreed
that their previously filed stipulations and the compromised disability benefits within their
proposed settlement documents leave no factual issues for resolution. The only issue is
whether Mr. Rollins is entitled to lifetime medical benefits. Therefore, by the parties’
agreement, the Court will decide this matter on the record. For the reasons below, the
Court holds that Mr. Rollins is entitled to permanent disability benefits, temporary
disability benefits, and lifetime medical benefits.

                        Findings of Fact and Conclusions of Law

       Mr. Rollins, as the employee in a workers’ compensation claim, has the burden of
proof on all essential elements of his claim. Scott v. Integrity Staffing Solutions, 2015 TN
Wrk. Comp. App. Bd. LEXIS 24, at *6 (Aug. 18, 2015). At a compensation hearing, he
must show by a preponderance of the evidence that he is entitled to the requested benefits.
Willis v. All Staff, 2015 TN Wrk. Comp. App. Bd. LEXIS 42, at *18 (Nov. 9, 2015).

                                        Stipulations

       Mr. Rollins suffered physical injuries in the course and scope of his employment
with UPS when he was involved in an automobile accident on September 10, 2019. He
suffered multiple injuries, including a fractured hip, fractured right patella, fractured left

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scapula, lumbar fractures, right-wrist sprain, and post-traumatic stress disorder. UPS
accepted the claim and provided medical treatment.

       UPS also paid temporary total disability benefits at the weekly rate of $1,056.00
through August 27, 2020. Because Mr. Rollins did not reach maximum medical
improvement until September 15, 2020, he is entitled to additional temporary total
disability benefits of $2,866.34.

      As a result of his injuries, Mr. Rollins was unable to return to work at UPS, which
made him an offer under its Voluntary Separation Allowance Plan. He accepted the offer,
which resulted in his voluntary retirement in exchange for “specific consideration.”

      Mr. Rollins’s weekly compensation rate for permanent disability benefits is
$960.00. His permanent partial disability original award and increased benefits total
$115,000.00. He is not entitled to any additional permanent disability benefits.

      UPS agreed to reimburse Mr. Rollins $300.00 for his payment of C-32 Medical
Report fees.

                                     Medical Benefits

        The Workers’ Compensation Law is clear on this point: “the employer or the
employer’s agent shall furnish, free of charge to the employee, such medical and surgical
treatment . . . made reasonably necessary by accident[.]” Tenn. Code Ann. § 50-6-
204(a)(1)(A). As the parties have stipulated to the compensability of Mr. Rollins’s injuries,
UPS is responsible for his future medical treatment under this provision. Thus, he is
entitled to continuing medical treatment with Drs. Stephen Engstrom, Robert Boyce,
Donald Lee, Byron Stephens, and Melissa Thorne-Smith.

IT IS, THEREFORE, ORDERED as follows:

       1. United Parcel Service, Inc., shall provide Mr. Rollins future medical benefits
          under Tennessee Code Annotated section 50-6-204(a)(1)(A). Drs. Stephen
          Engstrom, Robert Boyce, Donald Lee, Byron Stephens, and Melissa Thorne-
          Smith remain the treating physicians.

       2. United Parcel Service, Inc., shall pay Mr. Rollins permanent partial disability
          benefits of $115,000.00 in a lump sum.

       3. United Parcel Service, Inc., shall pay Mr. Rollins temporary total disability
          benefits of $2,866.34 in a lump sum.

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      4. United Parcel Service, Inc., shall reimburse Mr. Rollins $300.00 for his C-32
         Medical Report fee expenses.

      5. The Court further finds Mr. Rollins’s counsel, Terry Fann, provided good and
         valuable services to Mr. Rollins in pursuit of his claim and is therefore entitled
         to recover a fee of twenty percent of his permanent disability award under
         Tennessee Code Annotated section 50-6-226, as well as reimbursement of his
         expenses of $1,213.85.

      6. United Parcel Service, Inc., shall pay to the Court Clerk the $150.00 filing fee
         under Tennessee Compilation Rules and Regulations 0800-02-21-.06 within five
         days of entry of this order.

      7. United Parcel Service, Inc., shall file an SD-2 with the Court Clerk within five
         days of entry of this order.

      8. Unless appealed, this order shall become final thirty days after entry.

      ENTERED OCTOBER 15, 2021.

                                  _____________________________________
                                  Judge Dale Tipps
                                  Court of Workers’ Compensation Claims

                                      APPENDIX

Technical record:
   1. Petition for Benefit Determination
   2. Dispute Certification Notice
   3. Joint Stipulations
   4. Proposed settlement documents

                           CERTIFICATE OF SERVICE

      I certify that a copy of the Compensation Hearing Order was sent as indicated on
October 15, 2021.

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Name                  Certified   Via     Service Sent To
                      Mail        Email
Terry Fann,                          X    terryfann@wfptnlaw.com
Employee’s Attorney
David T. Hooper,                     X    dhooper@hooperzinn.com
Employer’s Attorney

                                   _____________________________________
                                   Penny Shrum, Clerk of Court
                                   Court of Workers’ Compensation Claims
                                   WC.CourtClerk@tn.gov

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                        Compensation Hearing Order Right to Appeal:
     If you disagree with this Compensation Hearing Order, you may appeal to the Workers’
Compensation Appeals Board or the Tennessee Supreme Court. To appeal to the Workers’
Compensation Appeals Board, 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 thirty calendar days of the
      date the compensation hearing order was filed. When filing the Notice of Appeal, you
      must serve a copy upon the opposing party (or attorney, if represented).

   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 filing 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 your 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. A licensed court
      reporter must prepare a transcript and file it with the court clerk within fifteen calendar
      days of the filing the Notice of Appeal. Alternatively, you may file a statement of the
      evidence prepared jointly by both parties within fifteen calendar 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
      of the evidence 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. After the Workers’ Compensation Judge approves the record and the court clerk transmits
      it to the Appeals Board, a docketing notice will be sent to the parties. The appealing
      party has fifteen calendar days after the date of that notice to submit a brief to the
      Appeals Board. See the Practices and Procedures of the Workers’ Compensation
      Appeals Board.
To appeal your case directly to the Tennessee Supreme Court, the Compensation Hearing
Order must be final and you must comply with the Tennessee Rules of Appellate
Procedure. If neither party timely files an appeal with the Appeals Board, the trial court’s
Order will become final by operation of law thirty calendar days after entry. See Tenn.
Code Ann. § 50-6-239(c)(7).

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