The opinion
FILED
Aug 11, 2025
08:54 AM(CT)
TENNESSEE COURT OF
WORKERS' COMPENSATION
CLAIMS
TENNESSEE BUREAU OF WORKERS’ COMPENSATION
IN THE COURT OF WORKERS’ COMPENSATION CLAIMS
AT NASHVILLE
ALICIA HOWARD, ) Docket No.: 2021-60-2344
Employee, )
v. ) State File No.: 38780-2024
)
DAVIDSON TRANSIT ORG., ) Judge Robert Durham
Employer. )
EXPEDITED HEARING ORDER DENYING BENEFITS
This Court held an Expedited Hearing on July 30, 2025, on Ms. Howard’s request
that Davidson Transit authorize additional medical treatment for injuries she asserted arose
primarily out of her work-related fall. Ms. Howard also requested reimbursement of
expenses from unauthorized doctors as well as temporary disability benefits from her
termination date.
For the reasons below, the Court denies additional medical treatment for her current
symptoms and reimbursement of unauthorized medical expenses. Temporary disability
benefits are also denied because Ms. Howard’s authorized doctors placed her at maximum
medical improvement before her termination. However, Davidson Transport must
continue to pay for medical care from authorized physicians for injuries causally related to
Ms. Howard’s fall.
History of Claim
On May 31, 2024, Ms. Howard, a bus driver for Davidson Transport, tripped and
fell over a culvert at a bus stop. Ms. Howard testified she fell on her left side, injuring her
left leg and arm and her head. After an emergency room visit and treatment at an urgent-
care clinic, Davidson authorized Ms. Howard to treat with orthopedist Peter Casey. 1
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Ms. Howard saw nine doctors. The Court read all those records but will only summarize those that are
relevant to this decision.
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Dr. Casey saw Ms. Howard in June for her left wrist and hand, although he noted
she also injured her head. Dr. Casey noted mild swelling over her left-thumb area, but a
CT scan did not reveal any fractures. He diagnosed a left-thumb CMC joint sprain and
ordered physical therapy. An MRI did not reveal any abnormalities.
Ms. Howard went through a work-hardening program, and in early October, Dr.
Casey noted that her condition had “significantly improved.” She had minimal pain with
full range of motion and sensation. Ms. Howard disagreed with this statement at the
hearing. In any event, Dr. Casey released her to return to full-duty work, stating she could
return on an as-needed basis. He completed a Final Medical Report in mid-October,
declaring that Ms. Howard was at maximum medical improvement on October 1 with a
0% impairment rating and that he did not anticipate the need for further care. Despite Dr.
Casey’s release, Ms. Howard continued to complain of left-hand and wrist pain.
Davidson authorized her to see orthopedist Douglas Weikert, M.D. for further
treatment in April 2025. Ms. Howard described work difficulties with pushing her
emergency brake and using the steering wheel that left her unable to drive. Dr. Weikert
examined her and reviewed her earlier medical records and diagnostic tests. He did not
observe any abnormalities to explain her symptoms.
Dr. Weikert diagnosed a left-wrist strain. He released her to return to work with no
restrictions and noted she had already received an impairment rating and was placed at
maximum medical improvement. He referred her to physiatrist Jeffrey Hazlewood for pain
management.
Dr. Hazlewood saw Ms. Howard in May. On exam, Dr. Hazlewood did not observe
any swelling or signs of chronic regional pain syndrome. He observed that Ms. Howard’s
tenderness and pain were global and non-focused. He noted inconsistencies in her
presentation and atypical pain behavior. He wrote that her “subjective symptoms far
outweigh any objective findings of which there are really none at this point.”
Dr. Hazlewood concluded that he had no explanation for Ms. Howard’s chronic
pain. He could not justify further conservative treatment through therapy, opioids, or
injections, and two surgeons had decided surgery would not help. He did not feel she had
any objective limitations against working. In his final medical report, he wrote she had a
permanent impairment, but her rating was 0% under the AMA Guides.
Dr. Hazlewood reasoned that symptoms that manifested a year later could not be
due to her accident. He concluded that Ms. Howard had no objective basis for her ongoing
pain and she could return to regular duty. He did not believe she needed further treatment
for her work injury.
Davidson submitted a statement signed by Dr. Weikert in June, in which he said that
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“any and all treatment” Ms. Howard may need for her left arm is unrelated to and not the
natural consequence of her May 2024 work injury. He wrote that it was “apparent” to him
that no one could find any condition to treat in her left arm caused by her work injury, nor
was the neuropathy she now complained of related to it. He concluded that Ms. Howard’s
emergency room visit in May (discussed below) was due to symptoms unrelated to her
work injury.
While treating for her wrist, Ms. Howard also began receiving authorized care with
orthopedist Damon Petty, M.D for left-knee symptoms. Dr. Petty first saw Ms. Howard in
September 2024. She told him that she bruised her left leg in her work-related fall, and
while doing squats during work-hardening for her wrist, she began experiencing pain
around her quadriceps tendon. She said that she was unable to “lock her left knee straight
while standing” without severe pain.
Dr. Petty ordered an MRI and felt it showed a possible small lateral meniscus tear,
along with some mild degenerative and congenital changes. Ms. Howard continued to
report difficulty in straightening her knee and said it felt subjectively unstable. Dr. Petty
gave her a cortisone shot, but Ms. Howard said it caused an allergic reaction that required
her to go to the emergency room. Dr. Petty felt the knee looked “pretty normal,” despite
Ms. Howard describing persistent pain and swelling, and he could not identify the reason
for her knee problems. He did not think the MRI result warranted an arthroscopy, so he
recommended Ms. Howard get a second opinion.
Orthopedist Robert Fitch, M.D. agreed to treat Ms. Howard. Dr. Fitch ordered
another MRI in January 2025. The report stated that Ms. Howard suffered from early
chondromalacia patella, but it did not record any meniscal tears. Dr. Fitch agreed that the
MRI did not show anything requiring surgery. He ordered additional therapy.
Dr. Fitch saw Ms. Howard in February and said she was slowly improving with
therapy. He believed she could return to employment without restrictions, and he placed
her at maximum medical improvement with a 0% impairment.
In addition to her knee and arm, Ms. Howard also asserted that she injured her head
in the fall. At this point Ms. Howard visited several different physicians, including a
neurosurgeon, a neurologist, a pain specialist, and a psychiatrist. None of these physicians
offered an opinion that her conditions were directly related to her fall.
Ms. Howard also testified about her attempts to return to work as a bus driver for
Davidson. She tried to return to work after she was released for her left wrist and knee but
could not do so because she had difficulty turning the steering wheel and operating the
brake.
Ms. Howard additionally submitted two “Human Performance Evaluations,” the
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first on June 10 and the second on June 30, that Davidson required her to pass before
returning to work. Both evaluations determined Ms. Howard could not perform the
essential functions of her job due to her physical symptoms. As a result, Davidson
terminated her employment after the second evaluation.
Findings of Fact and Conclusions of Law
Ms. Howard must prove a likelihood of prevailing at a hearing on the merits that
she is entitled to the requested benefits. Tenn. Code Ann. § 50-6-239(c)(6) (2024).
To prove causation, Ms. Howard must establish that her current symptoms and need
for treatment primarily arose out of her alleged work injury. § 50-6-102(12)(A). Further,
causation must be proven to a “reasonable degree of medical certainty,” which requires an
expert medical opinion. § 50-6-102(12)(C).
Since her fall, Ms. Howard has treated with multiple doctors of varying specialties
for conditions she asserted were due to her work injury. She underwent authorized care
from two orthopedists and a physiatrist for her left upper extremity. None of them could
explain Ms. Howard’s continued complaints or had any further treatment to offer. They
all assigned a 0% impairment and said she could return to work without restrictions. Dr.
Weikert went further and recently expressed his opinion that none of Ms. Howard’s current
symptoms involving her left arm, including pain, weakness, and numbness, were due to
her work injury.
Davidson also authorized care with two orthopedists for Ms. Howard’s left knee.
At best, diagnostic tests showed a questionable small lateral meniscus tear that did not
warrant surgery and some mild degenerative changes that were not work-related. Both
doctors released Ms. Howard at maximum medical improvement with 0% impairment, no
restrictions, and no anticipated future medical care.
Ms. Howard also asserted that she suffers from debilitating headaches that she
attributed to her fall and striking her head on concrete. No doctor has said that her
headaches primarily arose out of her fall.
Section 50-6-102(12)(E) states that an authorized doctor’s causation opinion is
presumed correct. Section 50-6-204(a)(3)(H) states that the authorized doctor’s opinion as
to reasonableness and necessity is also presumed correct. The Court holds that Ms. Howard
is entitled to treatment with authorized physicians for any conditions involving her left
wrist or her left knee that primarily arose from her fall in May 2024.
However, none of the authorized physicians has ascribed Ms. Howard’s current
symptoms to her accident, and all have stated that no further care for her injuries is
necessary or anticipated at this time. Further, none of the unauthorized doctors who have
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treated Ms. Howard has said that her current symptoms primarily arose from her work
accident.
Therefore, Ms. Howard has not offered sufficient proof to overcome the authorized
doctors’ opinions as to causation and the reasonableness and necessity of continued care
for her current symptoms. Thus, the Court holds that Ms. Howard is not likely to prevail
at a hearing on the merits that she is entitled to treatment for her current symptoms at this
time, nor is she entitled to reimbursement for past unauthorized expenses. But the Court
further holds that she remains entitled to reasonable and necessary treatment with
authorized physicians for conditions to her left wrist and knee that arose primarily from
her work accident.
Ms. Howard also asserted she is entitled to psychiatric care for increased stress and
anxiety caused by the injury and her employment situation. However, as with her
headaches and perceived radiculopathy, no doctor has linked her fall as the primary cause
of her need for psychiatric treatment. More important, section 50-6-204(h) states that
psychiatric or psychological care is limited to services ordered upon the referral of
authorized physicians. Here, no authorized physician has recommended any treatment.
Thus, Ms. Howard’s request for treatment of her alleged mental injury is also denied.
Finally, Ms. Howard additionally requested temporary disability benefits after her
termination by Davidson because she could not perform the essential functions of her job
as a bus driver. To receive benefits, Ms. Howard must prove: (1) disability from working
as the result of a compensable injury; (2) a causal connection between the injury and the
inability to work; and (3) the duration of the period of disability. Shepherd v. Haren Const.
Co., Inc., 2016 TN Wrk. Comp. App. Bd. LEXIS 15, at *13 (Mar. 30, 2016).
Ms. Howard was placed at maximum medical improvement by all authorized
physicians before Davidson fired her. They also said she could return to work without
restrictions. Ms. Howard did not submit any contrary medical evidence. Thus, the Court
denies Ms. Howard’s request for temporary disability benefits.
This case is set for a Scheduling Hearing on September 30, 2025, at 1:30 p.m.
Central Time. The parties must call 615-253-0010. Failure to appear might result in a
determination of the issues without the party’s participation.
IT IS ORDERED.
ENTERED August 11, 2025.
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_____________________________________
ROBERT DURHAM, JUDGE
Court of Workers’ Compensation Claims
Exhibits:
1. Wage Statement
2. Emergency Room Report
3. CareNow records
4. Medical records from Dr. Raygor
5. Medical records from Dr. Fitch
6. Medical records from The Brain Institute
7. Medical records from Dr. Weikert
8. Dr. Weikert’s report and DOT certification
9. Additional records from The Brain Institute
10. May 25 Vanderbilt Health records
11. Vanderbilt Pain Management records
12. Concentra records
13. Dr. Hazlewood records
14. DOT Medical Examiner letter
15. Concentra HPE evaluations and termination notice
16. Text chains with attachments
17. Emails between Ms. Howard and Davidson
18. Medical records filed by Davidson
19. Emergency room records
20. Affidavit of Trent Edwards with attachments
21. Panel selection forms
22. Emails from Dr. Crosby
23. First Report of Injury
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CERTIFICATE OF SERVICE
I certify that a copy of the Order was sent as indicated on August 11, 2025.
Name Certified Via Via Service sent to:
Mail Fax Email
Alicia Howard X Mshoward39@gmail.com
David Drobny X ddrobny@manierherod.com
Rhoberta Orsland X rorsland@manierherod.com
_____________________________________
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
ප Expedited Hearing Order filed on _______________ ප Motion Order filed on ___________________
ප Compensation Order filed on__________________ ප 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]
LB-1099 rev. 01/20 Page 2 of 2 RDA 11082