Court Opinion

ID: 9957912
Source: CourtListenerOpinion
Date Created: 2024-04-05 17:00:44.321071+00
Date Added: 2024-06-11T08:16:41.779034
License: Public Domain

FILED
                                                                                   Apr 05, 2024
                                                                                   10:04 AM(CT)
                                                                                TENNESSEE COURT OF
                                                                               WORKERS' COMPENSATION
                                                                                      CLAIMS

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

 WILLIAM JONES,                      )       Docket No.: 2022-08-0248
           Employee,                 )
 v.                                  )
 TRANSFORCE, INC.,                   )       State File No.: 36038-2021
           Employer,                 )
 And                                 )
 ACE AMERICAN INSURANCE              )       Judge Shaterra R. Marion
 COMPANY,                            )
            Carrier.                 )
 ________________________________________________________________________

               EXPEDITED HEARING ORDER DENYING BENEFITS

       The Court held an expedited hearing on March 27, 2024, on Mr. Jones’s request for
medical and temporary disability benefits for his back injury. Transforce argues Mr. Jones
did not provide proper notice of his injury and that it is not primarily related to his work.
The Court holds that Mr. Jones did provide proper notice but denies his request because
the authorized treating physician determined that Mr. Jones’s current condition is not
primarily related to his workers’ compensation injury.

                                     History of Claim

      Mr. Jones alleged he injured his back on January 15, 2021, in a motor vehicle
accident while driving for Transforce.

       A First Report of Injury form shows Transforce received notice of Mr. Jones’s
injury on the day of his work accident. He testified that he notified Transforce of the injury
and spoke to a Transforce nurse, who instructed him to seek medical attention.

       At the hospital, he was referred to NorthStar Healthcare, where he underwent
physical therapy, had a lumbar MRI, and received an epidural injection. A physical
therapist at NorthStar noted that Mr. Jones had pain after his motor vehicle collision.

                                              1
       Transforce paid for the treatment at NorthStar, and Mr. Jones selected Dr. Riley
Jones from a panel.

      Dr. Jones wrote in a causation letter that Mr. Jones’s MRI showed only degenerative
changes and no acute injury. He could not state to a reasonable degree of medical certainty
that Mr. Jones’s diagnosis arose primarily out of and in the course and scope of his
employment, considering all possible causes. He released Mr. Jones at maximum medical
improvement.

       Transforce contends that Mr. Jones failed to provide proper notice because he
admitted in his request for admissions that he did not give written notice of his injury, nor
did he report the injury by calling Transforce nurse’s line.

                       Findings of Fact and Conclusions of Law

       Mr. Jones has the burden of proving he is likely to prevail at trial on medical and
temporary benefits for his back injury. Tenn. Code Ann. § 50-6-102(12) (2023); McCord
v. Advantage Human Resourcing, 2015 TN Wrk. Comp. App. Bd. LEXIS 6, at *7-8, 9
(Mar. 27, 2015).

       Tennessee Code Annotated section 50-6-201 states that an employer needs either
actual notice or for an injured employee to submit written notice within fifteen days of the
workplace accident.

       Here, Mr. Jones testified he informed Transforce of his workplace accident. More
importantly, Transforce’s First Report of Injury, a document prepared by Transforce,
records that Transforce was notified of Mr. Jones’s injury the day it occurred. Thus, the
Court finds that Transforce had actual notice of Mr. Jones’s workplace accident.

       However, the analysis does not end there. Mr. Jones must establish that his injury
arose primarily out of and in the course and scope of his employment. Tenn. Code Ann. §
50-6-102(12).

       Transforce offered the opinion of Dr. Jones, who specifically said Mr. Jones’s work
injury did not primarily cause his back injury. Dr. Jones, as the authorized panel physician,
has a presumption of correctness on causation. Tenn. Code. Ann. § 50-6-102(12)(E). This
presumption can be rebutted by a preponderance of the evidence. Id.

       Mr. Jones offered medical records from NorthStar but no causation opinion from a
qualified expert. Rather, a physical therapist merely noted that he had pain after his work
accident. A physical therapist’s notation of Mr. Jones’s history is not a causation opinion.
Further, Tennessee Code Annotated section 50-6-102(12)(D) requires “the opinion of [a]

                                             2
physician” on causation. Therefore, Mr. Jones’s proof is insufficient to rebut the
presumption afforded Dr. Jones.

        Thus, the Court holds that Mr. Jones is not likely to prevail at trial in establishing
that his back injury arose primarily out of and in the course and scope of his employment.

       IT IS THEREFORE ORDERED as follows:

   1. Mr. Jones’s request for medical and temporary benefits is denied at this time.

   2. The court sets a status conference for June 3, 2024, at 10:00 a.m. Central Time.
      The parties must call (866) 943-0014 to participate. Failure to call might result in a
      determination of the issues without the party’s participation.

       ENTERED April 5, 2024.

                                    ________________________________________
                                    Judge Shaterra R. Marion
                                    Court of Workers’ Compensation Claims

                                        APPENDIX
Exhibits:
   1. Medical Records Submitted by Mr. Jones
   2. Panel of Physicians
   3. Declaration of Dr. Riley Jones
   4. Dispute Certification Notice
   5. Medical Questionnaire of Dr. Riley Jones
   6. Dr. Riley Jones’s Independent Medical Exam and Records
   7. First Report of Injury

                                              3
   8. Request for Admissions and Order
   9. Northstar Pain Management Consent Form
   10. Medical Bills

Marked for Identification Only:
Medical Records submitted by Mr. Jones on the hearing date

Technical Record:
   1. Petition for Benefit Determination
   2. Dispute Certification Notice
   3. Request for Status Hearing
   4. May 10, 2023 Status Order
   5. Feb. 20, 2024 Status Order
   6. Feb. 22, 2024 Order Resetting Expedited Hearing
   7. Employer Prehearing Statement
   8. Employer Witness and Exhibit List

                            CERTIFICATE OF SERVICE

      I certify that a copy of this Order was sent as indicated on April 5, 2024.

  Name                      U.S.     Email Service sent to:
                            Mail
  William Jones,             X         X      6764 Clarmore Drive
  Employee                                    Olive Branch, MS 38654
                                              williamjones202322@gmail.com
  Jennifer Thomas,                     X      jdthomas@mijs.com
  Employer’s Attorney                         inhoward@mijs.com

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

                                             4
                                          Right to Appeal:
      If you disagree with the Court’s Order, you may appeal to the Workers’ Compensation
Appeals Board. To do so, you must:
   1. Complete the enclosed form entitled “Notice of Appeal” and file it with the Clerk of the
      Court of Workers’ Compensation Claims before the expiration of the deadline.
               If the order being appealed is “expedited” (also called “interlocutory”), or if the
                 order does not dispose of the case in its entirety, the notice of appeal must be filed
                 within seven (7) business days of the date the order was filed.
               If the order being appealed is a “Compensation Order,” or if it resolves all issues
                 in the case, the notice of appeal must be filed within thirty (30) calendar days of
                 the date the Compensation Order was filed.
      When filing the Notice of Appeal, you must serve a copy on 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 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 are responsible for ensuring a complete record is presented on appeal. If no court
      reporter was present at the hearing, you may request from the Court Clerk the audio
      recording of the hearing for a $25.00 fee. If you choose to submit a transcript as part of your
      appeal, which the Appeals Board has emphasized is important for a meaningful review of
      the case, a licensed court reporter must prepare the transcript, and you must file it with the
      Court Clerk. The Court Clerk will prepare the record for submission to the Appeals Board,
      and you will receive notice once it has been submitted. For deadlines related to the filing of
      transcripts, statements of the evidence, and briefs on appeal, see the applicable rules on the
      Bureau’s website at https://www.tn.gov/wcappealsboard. (Click the “Read Rules” button.)

   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.
      If neither party timely files an appeal with the Appeals Board, the Court Order
      becomes enforceable. See Tenn. Code Ann. § 50-6-239(d)(3) (expedited/interlocutory
      orders) and Tenn. Code Ann. § 50-6-239(c)(7) (compensation orders).

       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