Court Opinion

ID: 4671935
Source: CourtListenerOpinion
Date Created: 2021-03-26 18:17:41.997989+00
Date Added: 2024-06-11T08:02:50.659552
License: Public Domain

FILED
                                                                                           Mar 26, 2021
                                                                                           12:03 PM(CT)
                                                                                       TENNESSEE COURT OF
                                                                                      WORKERS' COMPENSATION
                                                                                             CLAIMS

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

    BARBARA McGINNIS,                              )     Docket No. 2019-08-1005
             Employee,                             )
    v.                                             )     State File No. 94206-2019
    RANGE LINE DISCOUNT DELI,                      )
             Uninsured Employer.                   )     Judge Amber Luttrell

                                    COMPENSATION ORDER

       The Court held a Compensation Hearing on March 4, 2021, on Ms. McGinnis’s
request for permanent partial disability, temporary disability, and past medical expenses.
Range Line Discount Deli did not appear or participate in this case. For the reasons below,
the Court holds Ms. McGinnis proved she is entitled to permanent partial disability benefits
totaling $57,600 and future medical benefits, but she is not entitled to temporary disability
or past medical expenses.

                                         History of Claim

       Ms. McGinnis worked as a cook for Range Line Discount Deli. On July 20, 2019,
she injured her back, neck, and right side of her body when she tripped over a piece of
aluminum, slipped in water, and fell to the floor at work.

       Ms. McGinnis reported the injury, but Range Line did not provide authorized
treatment. Therefore, Ms. McGinnis sought emergency treatment at Methodist Hospital for
her injuries. The physician took x-rays, prescribed medication, and released her to follow
up with her personal physician.

       Several months later, Ms. McGinnis sought further treatment at Regional One
Health for ongoing symptoms in her neck, right shoulder, back, and right foot, which she
related to her fall at work.1 She received conservative treatment from Dr. Christopher
1
 Ms. McGinnis stated she was unable to obtain a follow-up appointment with her personal physicians for
several months.

                                                  1
Jackson throughout 2019 and 2020 for chronic back, neck, and right-shoulder pain. She
also sought acupuncture treatment for her back with Jian Yan, LAc.

        In August of 2020, Dr. Jackson reviewed thoracic and lumber MRIs and explained
to Ms. McGinnis that they showed multiple areas of disc bulge without spinal cord
impingement. They discussed initiating a long-term opioid treatment contract with plans
to initiate tramadol for her back pain.2

        In his C-32 Standard Form Medical Report, Dr. Jackson noted Ms. McGinnis’s
thoracic and lumbar back pain. He noted her injury was “disc protrusion on MRI” from
Ms. McGinnis’s slip and fall at work. He stated the injury resulted in the need for treatment
and resulted in disablement. He further concluded that her employment, more likely than
not, was primarily responsible for her injury or need for treatment. Regarding maximum
medical improvement, Dr. Jackson noted that the date was “unclear” but stated “she has
improved as of my visit on January 15, 2021.” He assigned a 50% permanent impairment
to the body as a whole.

      Ms. McGinnis introduced medical bills from the City of Memphis EMT Services,
Methodist Hospital, Regional One Health (Drs. Sethi and Jackson), Memphis Radiology,
and One Clinic Express (Jian Yan, Lac).

       After Range Line declined to provide benefits, Ms. McGinnis filed a Petition for
Benefit Determination, and the Bureau initiated an investigation. A compliance specialist’s
report found that Range Line is owned by Nabil Haimed. The specialist interviewed Ms.
McGinnis; Nassar, one of Mr. Haimed’s sons who helped run the business; and “Big Ali,”
another family member, who stated he was the manager. Big Ali said Range Line had a
workers’ compensation policy, but he could not provide any proof of coverage. The
specialist noted he found no policy for Range Line in NCCI, and Ms. McGinnis said she
worked with seven other employees. Finally, the specialist confirmed Ms. McGinnis is a
Tennessee resident and that she provided notice to the Bureau of her employer’s lack of
coverage within sixty days of her injury.

       After an Expedited Hearing, the Court ordered Range Line to provide a panel of
physicians for treatment and held Ms. McGinnis satisfied the requirements of Tennessee
Code Annotated section 50-6-801(d) to be eligible to request limited medical benefits from
the Uninsured Employer’s Fund at the Administrator’s discretion.

       Ms. McGinnis seeks permanent partial disability benefits, temporary disability
benefits, and payment of her past medical bills. She testified her average weekly wage was
$384 resulting in a compensation rate of $256.

2
    Ms. McGinnis did not introduce any of Dr. Jackson’s records after the August 28, 2020 visit.
                                                      2
                        Findings of Fact and Conclusions of Law

       At a Compensation Hearing, Ms. McGinnis must prove by a preponderance of the
evidence that she is entitled to the requested benefits. Willis v. All Staff, 2015 TN Wrk.
Comp. App. Bd. LEXIS 42, at *18 (Nov. 9, 2015); see also Tenn. Code Ann. § 50-6-
239(c)(6) (2020).

        To prove a compensable injury, Ms. McGinnis must show that her alleged injuries
arose primarily out of and in the course and scope of her employment. To do so, she must
prove a work-related incident identifiable by time and place of occurrence. Further, she
must show, to a reasonable degree of medical certainty, that the incident contributed more
than fifty percent in causing the disablement or need for medical treatment, considering all
causes. A “reasonable degree of medical certainty” means that, in the treating physician’s
opinion, it is more likely than not considering all causes as opposed to speculation or
possibility. See generally Tenn. Code Ann. § 50-6-102(14)(A)-(D). Thus, causation must
be proven by expert medical testimony.

       Applying these principles, Ms. McGinnis’s undisputed testimony and the medical
proof showed that she injured her back when she fell on July 20, 2019. Therefore, the Court
holds she established a specific incident, identifiable by time and place of occurrence.

       Further, the proof showed that Ms. McGinnis’s work injury resulted in the need for
treatment and that the employment activity, more likely than not, was primarily responsible
for the injury and need for treatment. She reached maximum medical improvement on
January 15, 2021, and her injury resulted in 50% permanent impairment. Thus, based on
Dr. Jackson’s opinions, the Court holds Ms. McGinnis’s back injury arose primarily out of
and in the course and scope of her employment and resulted in 50% permanent impairment
to the whole person.

       Accordingly, the Court holds Ms. McGinnis proved by a preponderance of the
evidence that she is entitled to permanent partial disability benefits totaling $57,600, which
was calculated by multiplying 225 weeks by her compensation rate of $256. See Tenn.
Code Ann. § 50-6-207(3)(A). Further, she is entitled to future medical benefits for her back
injury with Dr. Jackson. See Tenn. Code Ann. § 50-6-204(a)(1)(A).

        Turning to Ms. McGinnis’s request for temporary disability benefits, Ms. McGinnis
must show (1) she became disabled from working due to a compensable injury, (2) a causal
connection between that injury and her inability to work, and (3) the duration of the period
of disability. Jones v. Crencor Leasing and Sales, TN Wrk. Comp. App. Bd. LEXIS 48, at
*7 (Dec. 11, 2015). While Ms. McGinnis introduced medical records concerning her
treatment for the work injury, she did not introduce any off-work notes or other evidence
sufficient to satisfy these factors. Thus, her request for temporary disability benefits is
denied.

                                              3
        Ms. McGinnis also requested payment of her medical bills. While Ms. McGinnis
submitted bills corresponding with her medical records, the Court finds some records and
bills included treatment for unrelated health conditions, and Ms. McGinnis did not prove
the charges were reasonable and necessary for the work injury. Without an expert opinion,
the Court cannot speculate as to the reasonableness, necessity, and causal relationship of
the treatment and charges to the work injury. See Eaves v. Ametek, Inc., 2018 TN Wrk.
Comp. App. Bd. LEXIS 57, at *8-9 (Sept. 14, 2018) (Trial court erred in ordering employer
to pay medical expenses when the employee offered no proof that the expenses were
reasonable, necessary, or causally related to the work accident). Thus, the Court holds that
Ms. McGinnis did not show she is entitled to payment of past medical expenses.

        Finally, the Court previously held in its Expedited Hearing Order that Ms. McGinnis
satisfied the requirements of Tenn. Code Ann. §50-6-801(d) such that the Uninsured
Employers Fund has discretion to pay limited medical expenses. The Court incorporates
those findings by reference and holds this Order serves as a judgment for benefits.

IT IS, THEREFORE, ORDERED as follows:

   1. Range Line shall pay Ms. McGinnis permanent partial disability benefits totaling
      $57,600, for which execution may issue.

   2. Range Line shall provide Ms. McGinnis medical benefits with Dr. Christopher
      Jackson under Tennessee Code Annotated section 50-6-204.

   3. Ms. McGinnis’s requests for temporary disability benefits and past medical benefits
      are denied.

   4. Ms. McGinnis satisfied the requirements of Tennessee Code Annotated section 50-
      6-801(d).

   5. The filing fee of $150.00 is taxed to Range Line and shall be paid within five
      business days of this order becoming final or all appeals are exhausted. Execution
      might issue if necessary.

   6. Ms. McGinnis shall file a Statistical Data Form (SD-2) within ten business days of
      entry of this order.

   7. Unless appealed, this Order shall become final thirty calendar days after entry.

       ENTERED March 26, 2021.

                                             4
                                          _____________________________________
                                          JUDGE AMBER E. LUTTRELL
                                          Court of Workers’ Compensation Claims

                                      APPENDIX

Exhibits:
   1. Request for Investigation and Expedited Request for Investigation Report
   2. Text messages
   3. Medical bills- City of Memphis EMS Services
   4. Medical records- Methodist Hospital
   5. Medical bills- Methodist Hospital
   6. Medical records-Regional One Health
   7. Medical bills- Regional One Health (Drs. Sethi and Jackson)
   8. Medical Bills- Memphis Radiology
   9. Medical records and bills- One Clinic Express
   10. Dr. Jackson letter
   11. Dr. Jackson’s C-32 and CV

Technical record:
   1. Petition for Benefit Determination
   2. Dispute Certification Notice
   3. Expedited Hearing Order
   4. Scheduling Order
   5. List of proposed exhibits
   6. Pre-Compensation Hearing Statement
   7. Order Converting In-Person Compensation Hearing to Telephonic Hearing
   8. Dispute Certification Notice – (post-discovery)

                             CERTIFICATE OF SERVICE

      I certify that a copy of this Order was sent as indicated on March 26, 2021.

           Name               Certified    First    Email            Service sent to:
                               Mail        Class
                                           Mail
 Barbara McGinnis,                          X         X     2448 Wellons Ave.,
 Self-represented Employee                                  Memphis, TN 38127
                                                            barbaramcginnis9@gmail.com
 Range Line Discount Deli,       X          X               3467 Range Line Rd.,
 Uninsured Employer                                         Memphis, TN 38127
 LaShawn Pender,                                      X     lashawn.pender@tn.gov
 Program Coordinator
                                            5
Compliance Unit             X    amanda.terry@tn.gov

                  _____________________________________
                  Penny Shrum, Court Clerk
                  Court of Workers’ Compensation Claims

                    6
                         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 fullycompleted
      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 filestamped 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