Opinion

Wausau Insurance Co. v. Dorsett

  • 172 S.W.3d 538
  • 2005 Tenn. LEXIS 660
  • 2005 WL 1996619
Court
Tennessee Supreme Court
Filed
Aug 19, 2005
Status
Published
Author
Drowota
On the bench
Adolpho, Anderson, Barker, Birch, Drowota, Holder, Janice, Riley, William
Cited by
13 cases
Authority
More cited than 87.5%

The opinion

IN THE SUPREME COURT OF TENNESSEE

AT NASHVILLE

June 8, 2005 Session

WAUSAU INSURANCE COMPANY v. VIVIAN ALVINA DORSETT

Direct Appeal from the Circuit Court of Coffee County

No. 30,590, John W. Rollins, Judge

M2004-02861-SC-R9-CV - Filed August 19, 2005

We granted this interlocutory appeal to determine whether the trial court erred in awarding the

employee temporary total disability benefits in excess of 400 weeks where the employee had not

attained maximum medical improvement within the 400-week period. We hold that the statutory

“maximum total benefit” of 400 weeks applies to temporary total disability benefits. Therefore, we

reverse the judgment of the trial court and hold that the employer’s liability for temporary total

disability benefits is statutorily limited to 400 weeks. We remand this case to the trial court for

further proceedings consistent with this opinion.

Tenn. R. App. P. 9; Judgment of the Circuit Court Reversed; Case Remanded

FRANK F. DROWOTA , III, C. J., delivered the opinion of the court, in which E. RILEY ANDERSON ,

ADOLPHO A. BIRCH , JR., JANICE M. HOLDER , and WILLIAM M. BARKER, JJ., joined.

John E. Anderson and John Paul Nefflen, Nashville, Tennessee, for the Appellant, Wausau Insurance

Company.

Eric J. Burch, Manchester, Tennessee, for the Appellee, Vivian Alvina Dorsett.

OPINION

I. Factual and Procedural Background

This workers’ compensation action was originally filed on June 29, 2000, by Wausau

Insurance Company (“Wausau”) pursuant to Tennessee Code Annotated section 50-6-225 (1999 &

Supp. 2004). The defendant-appellee, Vivian Alvina Dorsett (“Dorsett”) had claimed workers

compensation benefits, alleging that on May 29, 1997, while she was working for Rawlings Sporting

Goods Incorporated at its leather-tanning facility in Tullahoma, she was bitten on the back of her left

wrist by a brown recluse spider.1 Dorsett alleges that her shift began at 4:00 p.m. that day. After

cleaning her work space she noticed, at approximately 8:00 p.m., a spot on the back of her left wrist,

smaller than the size of a penny, which appeared to be a mosquito bite. Dorsett claimed that by the

next day the affected area had spread to the size of a quarter, the skin had broken, and the center of

the area appeared black. Dorsett alleged that midway through her shift on May 30, 1997, she began

experiencing severe nausea and chills. By the next day, red “streaking” had appeared near the

affected area, and ulcers or sores had appeared near the streaking. Dorsett was treated by Dr.

Stephen Bills who opined that she had been bitten by a spider and prescribed an antibiotic.

After undergoing various treatments, including antibiotic medications and skin grafts, all of

which failed to eliminate the red streaking and ulcers on her left arm, Dorsett was referred to Dr.

Lloyd E. King. Dr. King, a board-certified dermatologist who had served as the chief of dermatology

at Vanderbilt University Medical Center since 1977, was deposed on June 5, 2001. Dr. King

explained that he had conducted extensive research of brown recluse spider bites, had written at least

fifteen articles on the subject, and had “been widely quoted in the area of brown recluse spider bites

and complications.” Dr. King opined that the history Dorsett had given was consistent with her

having been bitten by a brown recluse spider. Dr. King diagnosed Dorsett with pyoderma

gangrenosum, a condition Dr. King described as “chronic pus in the skin with ulcers in which you

can’t find the germs by standard tests. So it’s considered microbiologically sterile. ‘Sterile’ meaning

you can’t culture out any germs.” Although he could not state to a reasonable degree of medical

certainty that Dorsett’s pyoderma gangrenosum had been caused by the brown recluse spider bite,

Dr. King explained that it is not uncommon for the condition to develop in patients who had been

bitten by a brown recluse spider. Dr. King opined that Dorsett had not attained maximum medical

improvement, even though she had been treated with “all the known therapies for pyoderma

gangrenosum.” However, Dr. King remained “hopeful” that Dorsett would improve because, two

weeks earlier, he had started Dorsett on a new treatment, which had then only recently been approved

by the Federal Drug Administration.

Unfortunately, Dorsett’s condition did not improve as Dr. King had hoped. Subsequently,

at the request of Wausau, Dorsett was referred for a second opinion to the Mayo Clinic in Rochester,

Minnesota, because of its expertise in evaluating patients with chronic ulcers and pyoderma

gangrenosum. Dr. Arnold Schroeter, who had served as chairperson of dermatology at the Mayo

Clinic, evaluated Dorsett. Dr. Schroeter determined that Dorsett has a genetic enzyme deficiency,

a condition known as methylenetetrahydrofolate reductase. This deficiency results in abnormal

1

W ausau denies that Dorsett can establish that the brown recluse spider bite occurred in the course and

scope of her employment. However, whether the spider bite arose in the course and scope of employment is not at

issue in this interlocutory appeal, and we recount Dorsett’s allegations to provide context for the issue presented in

this appeal.

-2-

coagulation and thrombophilia2 and is known “for its role in strokes and heart attacks.” As treatment

for this condition, Dr. Schroeter recommended that Dorsett take folic acid to compensate for the

enzyme deficiency and coumadin, or another comparable anticoagulant drug, to prevent clotting.

Dr. King implemented the recommended treatment regimen, and when he was deposed again

on October 8, 2004, Dr. King confirmed that Dorsett had responded well to the new treatment, with

the most significant improvements in her condition occurring during the preceding three months.

Dr. King diagnosed Dorsett with “chronic ulceration of the left forearm secondary to a brown recluse

bite in the context of someone who has a genetic deficiency of an enzyme called

methylenetetrahydrofolate reductase.” He explained that, despite the treatment, Dorsett has

continued to experience migraine headaches, allergies and sensitivity to various chemicals, chronic

pain syndrome, ulcerations on her left arm, a large ventral hernia on which surgeons had refused to

operate because of her history of clotting, and weight gain and fluid retention resulting from her

inability to perform daily living activities. When asked to estimate the permanency of Dorsett’s

injuries, Dr. King replied “I have no specific timetable. It—she is currently, I think, improving, but

we have had her improved before. So I cannot give a definite timetable of when she would be

‘well.’” Dr. King was “not hopeful” that Dorsett would be able to return to work. Dr. King

acknowledged, however, that he had not assigned Dorsett any permanent restrictions because she had

not attained maximum medical improvement.

Six days after Dr. King was deposed, Wausau filed a motion to continue the trial, which had

been scheduled for December 13, 2004. Relying upon Dr. King’s deposition, Wausau alleged that

Dorsett had not attained maximum medical improvement. Wausau requested a continuance of the

trial until Dorsett had reached maximum medical improvement.

In her response to Wausau’s motion, Dorsett maintained that the trial court should proceed

to trial and find her permanently and totally disabled, despite her not having attained maximum

medical improvement. Alternatively, Dorsett asked the trial court to direct Wausau to continue

paying her temporary total disability benefits until she reached maximum medical improvement. On

February 3, 1998, the Tennessee Department of Labor, Workers’ Compensation Division ordered

Wausau to pay temporary total disability benefits to Dorsett, and Wausau has paid temporary total

disability benefits since that time.3 In her response to the motion to continue, Dorsett acknowledged

that “[u]nder the Tennessee Workers Compensation Statutes, an employee is entitled to four hundred

2

“Thrombophilia is a term used to describe a group of conditions in which there is an increased tendency,

often repeated and often over an extended period of time, for excessive clotting.” Amy D. Shapiro, An Overview of

Thrombophilia, Hemaware, Vol. 6, Issue 5 at 13, at www.hemophilia.org/bdi/Thrombo_article.pdf (last visited July

26, 2005).

3

On February 20, 2002, the Department of Labor ordered W ausau to cease temporary total disability benefit

payments, but on May 9, 2002, the Department of Labor ordered W ausau to resume the payments and ordered

W ausau to pay Dorsett a lump sum representing the temporary total disability benefits which W ausau would have

paid had the February 20, 2002 order not allowed it to cease the payments. Thus, W ausau has paid temporary total

benefits from February 3, 1998, to the present.

-3-

(400) weeks of compensation unless the employee is deemed permanently and totally disabled,” but

Dorsett nonetheless asserted that the trial court should order Wausau to continue paying her

temporary total disability benefits “irrespective of the four hundred (400) week cap” because the

workers’ compensation statutes are intended to provide compensation for employees who are

disabled as a result of a work-related accident. Dorsett pointed out that terminating her temporary

total disability benefits after 400 weeks would leave her “without income while she awaits maximum

medical improvement, which may not be for some time, if ever.” Finally, Dorsett asked the trial

court to grant an interlocutory appeal on the issue of whether temporary total disability benefits may

be extended beyond 400 weeks when an employee fails to attain maximum medical improvement

during the 400-week period.

The trial court granted Wausau’s motion to continue the trial, but also ordered Wausau to pay

temporary total disability benefits until Dorsett attains maximum medical improvement, even if the

payment period exceeded 400 weeks. The trial court granted Wausau permission to seek an

interlocutory appeal from its order. The trial court also granted Dorsett permission to seek an

interlocutory appeal “to interpret the issue of first impression of whether [Dorsett] is entitled to

temporary total disability benefits beyond the four hundred week point.”4

We granted Wausau’s and Dorsett’s applications for interlocutory appeal. We now reverse

the trial court and hold that temporary total disability benefits are statutorily limited to 400 weeks.

II. Standard of Review

Whether the trial court erred in awarding Dorsett temporary total disability benefits in excess

of 400 weeks is a legal issue, involving statutory interpretation, which we review de novo with no

presumption of correctness afforded to the trial court’s conclusions. Gray v. Cullom Machine, Tool

& Die, 152 S.W.3d 439, 443 (Tenn. 2004); Kyle v. Williams, 98 S.W.3d 661, 663-64 (Tenn. 2003);

Ki v. State, 78 S.W.3d 876, 879 (Tenn. 2002).

III. Statutory Construction

We start from the premise that “‘[w]hile the Workers’ Compensation Act is to be liberally

construed for the employee’s benefit, that policy does not authorize the amendment, alteration or

extension of its provisions beyond its obvious meaning.’” Wilkins v. Kellogg Co., 48 S.W.3d 148,

152 (Tenn. 2001) (quoting Pollard v. Knox County, 886 S.W.2d 759, 760 (Tenn. 1994)). “This

premise is simply a specific application of the most basic rule of statutory construction: courts must

attempt to give effect to the legislative purpose and intent of a statute, as determined by the ordinary

meaning of its text, rather than seek to alter or amend it.” Id. at 152. When a statute lacks

4

The trial court also granted Dorsett permission to seek an interlocutory appeal on the issue of “whether

[Dorsett] is entitled to permanent and total disability benefits if she has not reached maximum medical improvement

by the time four hundred weeks have passed since the injury.” Although Dorsett initially raised this issue in her

application, her supplemental brief did not address this issue. We have found no authority suggesting that Dorsett

should be considered permanently and totally disabled based solely upon her failure to attain maximum medical

improvement within 400 weeks.

-4-

contradiction or ambiguity, courts are not at liberty to depart from the words of the statute. Gleaves

v. Checker Cab Transit Corp., 15 S.W.3d 799, 803 (Tenn. 2000). If “the language contained within

the four corners of a statute is plain, clear, and unambiguous, the duty of the courts is simple and

obvious, ‘to say sic lex scripta, and obey it.’” Hawk v. City of Westmoreland, 960 S.W.2d 10, 16

(quoting Carson Creek Vacation Resorts, Inc. v. State Dept. of Revenue, 865 S.W.2d 1, 2 (Tenn.

1993)). Therefore, “‘[i]f the words of a statute plainly mean one thing they cannot be given another

meaning by judicial construction.’” Gleaves, 15 S.W.3d at 803 (quoting Henry v. White, 250

S.W.2d 70, 72 (Tenn. 1952)). Courts instead must “‘presume that the legislature says in a statute

what it means and means in a statute what it says there.’” Id. at 803 (quoting Jackson v. Jackson,

210 S.W.2d 332, 334 (Tenn. 1948)). Finally, a court must not question the “reasonableness of [a]

statute or substitut[e] [its] own policy judgments for those of the legislature.” Id. at 803 (quoting

BellSouth Telecomms., Inc.v. Greer, 972 S.W.2d 663, 673 (Tenn. Ct. App. 1997)). Applying these

familiar rules, we conclude that an employer’s liability for temporary total disability benefits is

limited to 400 weeks.

IV. Analysis

The Workers’ Compensation Act classifies compensable disabilities into four distinct

categories: (1) temporary total disability; (2) temporary partial disability; (3) permanent partial

disability; and (4) permanent total disability. Tenn. Code Ann. § 50-6-207 (1999 & 2004 Supp.);

Cleek v. Wal-Mart Stores, 19 S.W.3d 770, 776 (Tenn. 2000); Redmond v. McMinn County, 354

S.W.2d 435, 437 (Tenn. 1962). Employees are entitled to compensation for each class of disability

resulting from a single compensable injury for which they qualify. Redmond, 354 S.W.2d at 437.

However, unless an employee is adjudged to be entitled to permanent total disability benefits,5 the

disability benefits that an employee may receive for a single injury may not exceed the “maximum

total benefit.” See Tenn. Code Ann. § 50-6-205(b)(1) (1999 & 2004 Supp.) (“The total amount of

compensation payable under this part shall not exceed the maximum total benefit . . . in any case,

exclusive of travel reimbursement, medical, hospital and funeral benefits.”); Vinson v. United Parcel

Serv., 92 S.W.3d 380, 384 (Tenn. 2002). This statutory limitation is defined as follows:

“Maximum total benefit” means the sum of all weekly benefits to which a worker

may be entitled; and . . . [f]or injuries occurring on or after July 1, 1992, the

maximum total benefit shall be four hundred (400) weeks times the maximum

weekly benefit except in instances of permanent total disability . . . .

Tenn. Code Ann. § 50-6-102(13)(C) (1999) (recodified at § 50-6-102(14) (2004 Supp.). Although

we have never been squarely faced with the issue raised in this interlocutory appeal, we have

previously acknowledged that the 400-week maximum total benefit limitation applies to temporary

disability benefits. Vinson, 92 S.W.3d at 384 (Tenn. 2002) (citing Tennessee Code Annotated

section 50-6-102(13)(C) and stating that “[p]ursuant to the statutory scheme, temporary disability

benefit payments may not exceed 400 weeks”). Having thoroughly considered the issue, we now

5

Awards of permanent total disability are not subject to the maximum total benefit. See Tenn. Code Ann. §

50-6-207(4)(A)(i).

-5-

hold that the 400-week statutory limitation applies to temporary total disability benefits. The

statutory definition of maximum total benefit is clear. The only category of disability benefits

exempted from this 400-week limitation is permanent total disability benefits. Thus, we conclude

that the maximum total benefit 400-week limitation applies to temporary total disability benefits.

In arguing that the maximum total benefit does not apply, Dorsett points out that Tennessee

Code Annotated section 50-6-207(2) & (3) (1999 and 2004 Supp.), which provide the method for

calculating temporary partial disability benefits and permanent partial disability benefits, specifically

mention the 400-week limitation, while the statute which provides the method for calculating

temporary total disability benefits, Tennessee Code Annotated section 50-6-207(1) (1999)

(recodified at § 50-6-207(1)(A) (2004 Supp.), does not mention the 400-week limitation. Dorsett

maintains that had the legislature intended to limit temporary total disability benefits, it would have

included the 400-week limitation in section -207(1). As support for her argument, Dorsett relies

upon Bomely v. Mid-Am. Corp., 970 S.W.2d 929 (Tenn. 1998), in which this Court held that the

400-week maximum total benefit limitation does not apply to permanent total disability benefits.

Dorsett’s reliance is misplaced. Although we noted in Bomely that the statute providing the

method for calculating permanent total disability benefits did not mention the 400-week limitation,

we held that the 400-week limitation did not apply “[b]ecause the statutory definition of maximum

total benefit exempts permanent total disability awards from the 400-week limitation . . . .” Id. at

933. In contrast, the statutory definition of “maximum total benefit” does not expressly exempt

temporary total disability benefits from the 400-week limitation. Accordingly, we hold that the

maximum total benefit applies to temporary total disability benefits. We conclude therefore that the

trial court erred in ordering Wausau to pay temporary total disability benefits in excess of this

statutory 400-week limitation.

We are aware that the maximum total benefit, and our application of it, places Dorsett in a

difficult position. As recently as October 8, 2004, Dr. King, Dorsett’s treating physician, opined that

she had not attained maximum medical improvement and thus refused to assign her a permanent

disability rating. Based upon this testimony, Wausau sought and obtained a continuance of the trial.6

Although we are sympathetic to Dorsett’s situation, this Court has no authority to alter the statutory

definition of maximum total benefit. Whether this statutory definition should be revised to exclude

temporary total disability benefits from the 400-week limitation is a question for the legislature, not

the judiciary.

V. Conclusion

6

Over ten months have passed since Dr. King was deposed. Dorsett may have now attained maximum

medical improvement such that on remand Dr. King may be able to evaluate whether Dorsett has sustained

permanent disability from her condition. Expeditiously resolving this case would appear to be in the best interest of

all involved.

-6-

We hold that the maximum total benefit of 400 weeks applies to temporary total disability

benefits. Thus, Wausau’s liability to Dorsett for temporary total disability benefits is limited to the

statutory maximum total benefit of 400 weeks. Accordingly, we reverse the judgment of the trial

court ordering Wausau to pay temporary total disability benefits in excess of 400 weeks. We remand

this case to the trial court for further proceedings consistent with this decision. Costs of this appeal

are taxed to the defendant-appellee,Vivian Alvina Dorsett.

____________________________________

FRANK F. DROWOTA III,

CHIEF JUSTICE

-7-

This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.

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