Court Opinion

ID: 9376218
Source: CourtListenerOpinion
Date Created: 2023-03-02 13:23:13.072715+00
Date Added: 2024-06-11T17:17:05.413741
License: Public Domain

FILED
                                                                                  Mar 02, 2023
                                                                                  08:01 AM(ET)
                                                                              TENNESSEE COURT OF
                                                                             WORKERS' COMPENSATION
                                                                                    CLAIMS

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

 Jeannette Melton,                               )   Docket No.: 2020-01-0376
             Employee,                           )
 v.                                              )
 Amazon.com Services, LLC,                       )   State File No.: 45066-2021
             Employer,                           )
 And                                             )
 American Zurich Insurance Company,              )   Judge Audrey Headrick
             Carrier.                            )

                            EXPEDITED HEARING ORDER
                             (DECISION ON THE RECORD)

        Ms. Melton asked the Court to order Amazon to provide a panel of physicians in
New Orleans, Louisiana. Amazon denied that Ms. Melton is entitled to a panel based on a
records review evaluation, and it also took issue with her its obligation to offer care by a
neurologist in the requested locale. For the reasons below, the Court holds Ms. Melton is
entitled to a panel of physicians in New Orleans.

                                      Claim History

       On June 3, 2020, a box weighing approximately five to ten pounds fell from a bin
and struck Ms. Melton on her head. After receiving emergency treatment, Ms. Melton
selected Dr. Natasha Ballard from a panel. Dr. Ballard diagnosed a work-related
concussion, treated her conservatively, and referred her to Dr. Larry Gibson, a neurologist.

       Dr. Gibson also treated Ms. Melton conservatively after diagnosing a concussion
and acute, post-traumatic headaches. Amazon denied an EEG ordered by Dr. Gibson for
evaluation of possible seizure activity. It also denied additional physical therapy for her
neck based on utilization review.

      After almost a year, Ms. Melton still complained to Dr. Gibson of ongoing
headaches, neck pain, and difficulty performing daily activities. She reported that

                                             1
“[n]othing has changed.” In August 2022, Dr. Gibson completed a Final Medical Report
and wrote that Ms. Melton needed future medical treatment for the work injury.

       Ms. Gibson moved to New Orleans, Louisiana and requested that Amazon provide
her with a physician in her community.

        After Ms. Gibson moved, Dr. Jeffrey Hazlewood, a pain management physician,
performed a records review evaluation for Amazon. He diagnosed Ms. Melton with a mild
traumatic brain injury. Dr. Hazlewood disagreed with Dr. Gibson’s recommendation for
future treatment, stating he anticipated post-injury symptoms to resolve within six months.
He concluded he was unable to “state that the ongoing symptoms, more likely than not,
based on the record review, are still due to mild traumatic brain injury.” (Emphasis in
original).

       In its position statement, Amazon wrote that it provided a panel of physicians to Ms.
Melton on February 22, 2023. It asserted its search for neurologists in Ms. Melton’s area
was unsuccessful due to the Tennessee Medical Fee Schedule. Instead, it said: “For
purposes of quickly and efficiently determining the reason(s) for [Ms. Melton’s] continued
lack of improvement, [Amazon] contacted a number of occupational physicians instead,
who accept Tennessee workers’ compensation patients.”

                       Findings of Fact and Conclusions of Law

        Ms. Melton must prove she is likely to prevail at a hearing on the merits that she is
entitled to a panel in her new community. See Tenn. Code Ann. § 50-6-239(d)(1) (2022).

       To meet this burden, Ms. Melton must show, to a reasonable degree of medical
certainty, that the accident contributed more than fifty percent in causing the need for
additional medical treatment, considering all causes. Tenn. Code Ann. § 50-6-102(12).
The statutory presumption of correctness regarding causation and treatment
recommendations does not attach to Dr. Gibson, since he was not selected from a panel.
Id.; Tenn. Code Ann. § 50-6-204(A)(1)(I).

       Applying that standard, the Court considers the expert opinions of Drs. Gibson and
Hazlewood. Dr. Gibson wrote on a Final Medical Report that Ms. Melton needs future
treatment for her work injury. Dr. Hazlewood concluded that Ms. Melton’s ongoing
symptoms are not related to her work injury. He stated he expected post-injury symptoms
from a concussion to resolve within six months.

       In evaluating conflicting expert testimony, a trial court may consider, among other
things, “the qualifications of the experts, the circumstances of their examination, the
information available to them, and the evaluation of the importance of that information

                                             2
through other experts.” Brees v. Escape Day Spa & Salon, 2015 TN Wrk. Comp. App. Bd.
LEXIS 5, at *14 (Mar. 12, 2015).

       After considering these factors, the Court finds the opinion of Dr. Gibson more
persuasive than Dr. Hazlewood’s. Dr. Gibson, a neurologist, treated Ms. Melton for almost
a year for acute, post-traumatic headaches caused by her work-related concussion. On the
other hand, Dr. Hazlewood, a pain management physician, did not examine Ms. Melton
but only performed a record review over two years after the incident. Therefore, the Court
holds Ms. Melton is likely to prove at trial that she is entitled to additional medical benefits.

          Next, the Court considers Ms. Melton’s request for a panel of neurologists in New
Orleans, Louisiana. Tennessee Code Annotated section 50-6-204(a)(3)(A)(i) requires that
an employer “shall designate a group of three (3) or more independent reputable physicians
. . . if available in the injured employee’s community.” (Emphasis added).

       Here, Amazon asserted a dispute no longer exists; the Court disagrees. Amazon did
not offer Ms. Melton a valid panel of neurologists within her community. Instead, it offered
her a panel of occupational physicians to determine “the reason(s) for [Ms. Melton’s]
continued lack of improvement.” However, Ms. Melton’s first authorized physician did
not refer her to an occupational medicine specialist, but to a neurologist, and Amazon has
no legal basis to override that referral. Its late-offered panel of occupational physicians
does not comply with its obligation to furnish appropriate and necessary medical care for
Ms. Melton’s injury as required by Tennessee Code Annotated section 50-6-204. The
Court holds that Ms. Melton is likely to prevail at a hearing on the merits regarding this
request.

       Finally, Amazon failed to timely provide Ms. Melton with a panel of neurologists
within her community, which delayed Ms. Melton in receiving ongoing medical
treatment. Therefore, the Court refers this case to the Compliance Program for
consideration of penalty assessments stemming from Amazon’s failure to provide a
compliant panel and failure to continue to provide medical benefits, as well as any other
applicable penalties. See Tenn. Code Ann. § 50-6-118.

        IT IS, THEREFORE, ORDERED as follows:

    1. Amazon shall provide Ms. Melton a neurologist panel located in New Orleans for
       her work injury under Tennessee Code Annotated section 50-6-204 on or before
       March 31, 2023.1

1
 An employer may request a waiver from the Bureau permitting it to pay a physician according to the
medical fee schedule, law, and rules governing the physician’s jurisdiction. Tenn. Comp. R. & Regs. 0800-
02-17-.18 (February 2018).

                                                   3
2. The case is referred to the Compliance Program for investigation as outlined above.

3. This case is set for a Status Hearing on Wednesday, May 3, 2023, at 1:30 p.m.
   Eastern Time. The parties must call 423-634-0164 or toll-free at 855-383-0001 to
   participate. Failure to call might result in a determination of the issues without the
   party’s participation.

4. Unless interlocutory appeal of this Expedited Hearing Order is filed, compliance
   with this Order must occur by seven business days of entry of this Order as required
   by Tennessee Code Annotated section 50-6-239(d)(3). The Insurer or Self-Insured
   Employer must submit confirmation of compliance by email to
   WCCompliance.Program@tn.gov by the compliance deadline. Failure to do so may
   result in a penalty assessment for non-compliance.

5. For compliance questions, please contact the Workers’ Compensation Compliance
   Unit by email at WCCompliance.Program@tn.gov.

   ENTERED March 2, 2023.

                                ________________________________________
                                Audrey A. Headrick
                                Workers’ Compensation Judge

                                          4
                                   APPENDIX

Exhibits:
   1. Rule 72 Declaration of Ms. Melton
   2. Medical records of Dr. Natasha Ballard
   3. Medical records of Dr. Gibson
   4. Independent Medical Evaluation of Dr. Hazlewood
   5. First Report
   6. Job Description
   7. Panel
   8. Email from Amazon to Ms. Melton

Technical record:
   1. Petition for Benefit Determination
   2. Dispute Certification Notice
   3. Show Cause Order
   4. Order on Show Cause Hearing
   5. Request for Expedited Hearing
   6. Employer’s Response to Employee’s Request for Expedited Hearing
   7. Docketing Notice

                                        5
                            CERTIFICATE OF SERVICE

I certify that a copy of this Expedited Hearing Order was sent as indicated on March 2,
2023.

             Name                 U.S.      Email    Service sent to:
                                  Mail
   Jeannette Melton,                            X    jeannettek1@bellsouth.net
   Employee
   C.J. Statham,                                X    cjstatham@mijs.com
   Employer’s Attorney
   Compliance Program                           X    WCCompliance.Program@tn.gov

                                         /s/Penny Shrum    w/permission JD
                                         ______________________________________
                                         Penny Shrum, Court Clerk
                                         WC.CourtClerk@tn.gov

                                            6