The opinion
FILED
Mar 12, 2025
09:10 AM(CT)
TENNESSEE COURT OF
WORKERS' COMPENSATION
CLAIMS
TENNESSEE BUREAU OF WORKERS’ COMPENSATION
IN THE COURT OF WORKERS’ COMPENSATION CLAIMS
AT GRAY
SPENCER KING, ) Docket No. 2024-20-8017
Employee, )
v. )
RENTOKIL NORTH AMERICA, )
INCORPORATED, ) State File No. 41030-2023
Employer, )
and )
ARH INDEMNITY INSURANCE )
COMPANY, ) Judge Brian K. Addington
Carrier. )
EXPEDITED ORDER ON MEDICAL DIRECTOR’S OPINION
Rentokil North America, Incorporated filed a Motion to Stay the Medical Director’s
November 13, 2024, order for an autologous chondrocyte implantation (ACI) surgery on
Spencer King’s right knee, which was granted. The Court held an expedited hearing on
March 7, 2025, to determine whether the procedure is medically necessary.1 For the reasons
below, the Court holds Rentokil shall authorize the surgery.
Claim History
Mr. King injured his right knee in 2023 while working for Rentokil, which accepted
the claim. Mr. King’s authorized doctor, Johnathan Bryant, repaired a meniscus tear in
May 2024. The surgeon also biopsied Mr. King’s knee to see if he was a candidate for a
procedure to repair a cartilage defect (ACI). He then recommended the procedure.
Utilization Review physician Eddie Sassoon denied the surgery recommendation. Dr.
Bryant appealed to the Bureau’s Medical Director, who overturned the denial and approved
the procedure.
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Rentokil argued that Mr. King did not file an affidavit for an expedited hearing. However, Rentokil filed
the motion to terminate the provision of benefits and requested a hearing under the utilization review
system, not Mr. King. It also did not file an affidavit.
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On November 21, Rentokil filed a Petition for Benefit Determination and a Motion
to Stay Enforcement of Medical Director Order requesting this Court overrule the Medical
Director’s decision. The motion was filed per Rule 0800-02-06-.07(6) of the Tennessee
Compilation Rules and Regulations (2022), which requires a party who disagrees with the
Medical Director’s determination to file a petition within 15 calendar days. The rule also
requires the party to request a hearing and file a motion to stay enforcement of the Medical
Director’s decision. Rentokil followed that rule, so the Court granted the motion to stay
and scheduled a telephone expedited hearing.
The parties submitted records from Dr. Bryant, Dr. Sassoon, and Dr. T. Lisle
Whitman, who performed an independent medical examination. They also submitted the
Medical Director’s decision. The records reflect that Drs. Bryant, Whitman, and the
Medical Director are Tennessee-licensed physicians; Dr. Sassoon is not.
Mr. King stated he wanted the recommended surgery. Rentokil argued that the need
for surgery was not causally related to the injury.
Findings of Fact and Conclusions of Law
The Court must determine whether Mr. King is entitled to the surgery ordered for
his right knee. The authorized doctor’s recommendation is considered medically necessary
under Tennessee Code Annotated section 50-6-204(a)(3)(H) (2024), and Rentokil has the
burden of rebutting this presumption.
Rentokil challenged the authorized treating physician’s surgery recommendation by
using the utilization review system, which may only consider whether the surgery
recommendation was medically necessary, not causation. All denials must be performed
by a utilization physician and communicated to the parties with a written utilization report
under Rule 0800-02-06-.03(3). Importantly, a utilization physician must be licensed to
practice in Tennessee under Rule 0800-02-06-.01(26).
Here, the facts show that the utilization physician was not licensed to practice in
Tennessee, so the utilization review report denying the surgery was invalid. For that reason,
the Court removes its stay and orders Rentokil to authorize the surgery recommended by
Dr. Bryant and affirmed by the Medical Director.
IT IS THEREFORE ORDERED as follows:
1. Rentokil shall authorize the right ACI surgery as ordered by Dr. Bryant. Rentokil
shall inform Mr. King of the date of the surgery.
2. The parties shall appear for a Status Hearing on May 5, 2025, at 10:00 a.m. Eastern
Time. The parties must call 855-543-5044 to participate in the hearing. Failure to
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call in may result in a determination of the issues without the parties’ further
participation.
3. Unless interlocutory appeal of the order is filed, compliance with this order must
occur no later than seven business days from the date of the 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.
4. For compliance questions, please contact the Workers’ Compensation Compliance
Unit by email at WCCompliance.Program@tn.gov.
It is ORDERED.
ENTERED March 12, 2025.
Brian K. Addington
______________________________________
BRIAN K. ADDINGTON, JUDGE
Court of Workers’ Compensation Claims
CERTIFICATE OF SERVICE
I certify that a copy of this Order was sent on March 12, 2025.
Name Certified Fax Email Service sent to:
Spencer King, X spencer.king990@gmail.com
Self-Represented
Employee
Sarah Best, X shbest@mijs.com
Employer’s Attorney
______________________________________
PENNY SHRUM, COURT CLERK
wc.courtclerk@tn.gov
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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.
¾ 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.
¾ 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;ĐŚĞĐŬŽŶĞŽƌŵŽƌĞĂƉƉůŝĐĂďůĞďŽdžĞƐĂŶĚŝŶĐůƵĚĞƚŚĞĚĂƚĞĨŝůĞͲ
ƐƚĂŵƉĞĚŽŶƚŚĞĨŝƌƐƚƉĂŐĞŽĨƚŚĞŽƌĚĞƌ;ƐͿďĞŝŶŐĂƉƉĞĂůĞĚͿ͗
□ 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 *
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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]
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