The opinion
FILED
Apr 20, 2026
12:26 PM(CT)
TENNESSEE COURT OF
WORKERS' COMPENSATION
CLAIMS
TENNESSEE BUREAU OF WORKERS' COMPENSATION
IN THE COURT OF WORKERS' COMPENSATION CLAIMS
AT MURFREESBORO
MATTHEW SMITH Docket No. 2025-05-5304
Employee,
v.
COCA COLA CONSOLIDATED,
INC. State File No. 15567-2025,
Employer,
and
INDEMNITY INS. CO. OF N.A. Judge Robert Durham
Carrier.
EXPEDITED HEARING ORDER GRANTING BENEFITS
Mr. Smith asked Coca-Cola to authorize the neck surgery recommended by
Dr. John Burleson and pay additional temporary disability benefits. Coca Cola
denied the surgery and temporary benefits based on lack of medical causation. For
the following reasons, the Court orders Coca Cola to authorize the surgery and pay
additional temporary disability benefits.
History of Claim
In late January 2025, Mr. Smith began working for Coca Cola as a mechanic,
repairing and maintaining machines at the plant. His job required strenuous physical
activity with constant walking, stooping, kneeling and working in cramped spaces.
He testified that before his injury, he had no problems performing these activities.
On February 26, Mr. Smith slipped in an oil puddle while walking sideways
between a machine and some oil drums. He fell backwards against the barrels,
striking his back. He was caught between the barrels and the machine but did not
hit the ground.
Mr. Smith testified that he experienced immediate pain in his right pelvis and
hip. At the hearing, he illustrated his pain began just above his right buttock. The
fall bruised his lower back, but no other body parts. He did not experience any pain
or numbness in his neck or his arms.
After informing his supervisor, he completed his shift and went home. The
next day, his pain was so severe that Coca Cola authorized treatment at a walk-in
clinic. Mr. Smith's pain, weakness, and numbness continued to worsen. Coca Cola
then authorized treatment with orthopedist, Dr. Matthew Sarb.
Dr. Sarb obtained an MRI that showed moderate degenerative changes
without disc protrusion as well as moderate arthritis in both hips. However, Dr. Sarb
did not think that Mr. Smith's symptoms originated in his hip. He recommended a
neurosurgical consultation, and Mr. Smith chose Dr. John Burleson from a panel.
Mr. Smith saw Dr. Burleson in June 2025. He described intense pain in his
right lower back that radiated to his right buttock and thigh. He was experiencing
weakness and numbness in his right leg and foot. He had difficulty walking, balance
issues, and spasms that prevented him from driving.
Mr. Smith began physical therapy, but while at a session, he felt an "electric
shock" go through his body that caused him to fall off the bed. At that point, Dr.
Burleson felt that Mr. Smith's symptoms might be coming from his cervical spine.
Dr. Burleson ordered an MRI that showed a cervical fusion at C5-6, which
Mr. Smith said resulted from a 2013 work injury. However, Dr. Burleson also noted
that it "very clearly" showed a "C6-7 acute disc herniation" which was causing
"central severe stenosis with pressure on his spinal cord." The C6-C7 level further
had "some buckling of the ligamentum flavum creating a pincer effect on his spinal
cord."
Dr. Burleson explained that the herniation looked acute, there was cord
compression, and the findings were consistent with Mr. Smith's symptoms. Based
on the MRI and Mr. Smith's symptoms, Dr. Burleson recommended a C6-C7
cervical fusion.
Regarding causation, Dr. Burleson acknowledged Mr. Smith's earlier fusion
but said, "Given the acute nature of his injury here as well as the symptoms for which
he had afterwards and the fact that he is myelopathic with an acute disc herniation
here leads me to believe that greater than 50% of his need for a fusion surgery is
related to his work accident."
Coca Cola denied the surgery and on October 1 sent Mr. Smith to orthopedist
Ryan Snowden for evaluation. Mr. Smith complained of low back pain that radiated
into his right hip and leg as well as trouble standing and walking. Dr. Snowden also
noted that Mr. Smith now complained of neck pain. Examination revealed normal
strength and symmetrical reflexes in his upper extremities. However, Mr. Smith did
exhibit abnormal lower extremity reflexes as well as a limp and difficulty walking
heel-to-toe.
Dr. Snowden believed that Mr. Smith's symptoms were due to several
conditions. He said the work injury exacerbated Mr. Smith's pre-existing low back
and right hip pain. He did not find an acute disc herniation or stenosis attributable
to the work injury, and believed the symptoms warranted non-surgical management.
As for the cervical spine, Dr. Snowden noted that Mr. Smith had "progressive
symptomatic adjacent degeneration" with spinal cord compression at C6-C7 due to
his 2013 C5-C6 fusion. He noted that Mr. Smith did not complain of neck pain until
more than five months after the work injury. Thus, he did not believe Mr. Smith's
cervical condition was related to his work injury.
In December, Mr. Smith's counsel sent Dr. Snowden's report to Dr. Burleson
along with several questions. Dr. Burleson confirmed that Mr. Smith needed a C6-
C7 discectomy and fusion due to spinal cord compression causing his lower
extremity symptoms. He related the need for surgery to Mr. Smith's fall at work.
He conceded that the 2013 fusion made the C6-C7 level more vulnerable, but
the sudden onset of myelopathic symptoms after the accident led him to relate the
injury to employment. He further explained that Mr. Smith's symptoms might not
include neck or arm pain since most of the pressure would be on nerves stemming
from the thoracic and lumbar spine. Dr. Burleson determined that the myelopathy
created a "surgical urgency" since delay could lead to increased and/or permanent
symptoms.
Mr. Smith testified at the hearing that he continues to have severe pain from
his right lower back through his right leg and spasms in his right leg and foot. He
cannot walk or stand for long and requires his wife's assistance. He testified that
certain activities or positions, such as brushing his teeth, can result in a burst of
intense pain.
He also testified that after he healed from his cervical fusion in 2013 until his
2025 fall, he did not have any neck, low back, or lower extremity complaints, or
physical limitations.
Mr. Smith testified that when he first got restrictions, Coca Cola offered him
office work. His restrictions were no lifting more than 20 pounds, no squatting,
kneeling or walking on uneven terrain. However, his supervisors eventually asked
him to return to maintenance, although they said he could ask for help if needed.
But Mr. Smith testified that as his symptoms progressed, he could not walk up the
sloped floor of the plant or even walk to the factory from the parking lot.
He said he talked to his supervisors and told them he couldn't do the job. Coca
Cola terminated him on May 23 for absenteeism. When he asked about it, Coca
Cola said they thought he had quit, even though he still had tools in the plant. On
July 14, Dr. Burleson took Mr. Smith completely off work until post-surgery.
The parties did not submit an accurate wage statement given that Mr. Smith
only worked a few weeks before his injury. They agreed to obtain a comparative
wage statement to determine Mr. Smith's average weekly wage and supplement the
record with a late-filed exhibit.
Law and Analysis
To obtain his requested benefits, Mr. Smith must show a likelihood of
prevailing at a hearing on the merits that he is entitled to cervical fusion surgery and
additional temporary disability benefits. Tenn. Code Ann. § 50-6-239(d)(1) (2025).
To establish entitlement, Mr. Brown must show he is likely to prove: (1) a
work-related injury; (2) that surgery is reasonable and necessary for treating his
injury; and (3) he has yet to reach maximum medical improvement and has been
unable to work since last receiving temporary disability benefits. The Court will
address each issue in turn.
To prove a work-related injury, Mr. Smith must show that he sustained an
injury arising primarily out of and in the course of employment. Id. § 50-6-
102(14)(A). Dr. Burleson, the authorized physician, testified to a reasonable degree
of medical certainty that Mr. Smith's condition arose primarily from his work injury.
As the authorized physician, Dr. Burleson's opinion is presumed correct. Id. § 50-6-
102(12)(E).
However, Dr. Snowden offered a different opinion. He believed that Mr.
Smith's condition existed primarily due to degeneration caused by the fusion at C5-
C6. He did not see any connection between the cervical condition and the work
injury.
When confronted with conflicting opinions, the Court has discretion to
determine which opinion to accept. Patterson v. Huff & Puff Trucking, 2018 TN
Wrk. Comp. App. Bd. LEXIS 33, at *9 (July 6, 2018). The 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 by other experts." Orman v. Williams Sonoma, Inc., 803 S.W.2d
672, 676 (Tenn. 1991).
Here, neither party produced any evidence as to either doctor's qualifications,
so neither doctor has the edge on this factor.
As to their examinations, Dr. Burleson is Mr. Smith's authorized physician,
which means his opinion as to the reasonableness and necessity of recommended
treatment is presumed correct. Id. § 50-6-204(H). Dr. Burleson also treated Mr.
Smith on more than one occasion as opposed to Dr. Snowden, who only saw Mr.
Smith once. "It seems reasonable that the physicians having greater contact with the
Plaintiff would have the advantage and opportunity to provide a more in-depth
opinion, if not a more accurate one." Id. at 677. The examinations weigh in favor
of Dr. Burleson.
Finally, the Court considers the information available to each doctor and the
weight they afforded it. Although both doctors had the same information, Dr.
Snowden did not give many details to bolster his assertion that the work injury was
not related to the spinal cord compression. He did not seem to consider the timing
of the onset of symptoms, other than noting Mr. Smith did not complain of neck pain
until his evaluation. Dr. Snowden did not clearly express whether he attributed Mr.
Smith's low back and right leg symptoms to the cervical myelopathy or some other
cause. Finally, Dr. Snowden did not refute Dr. Burleson's opinion that the cervical
spine compression created a "surgical urgency" to minimize further damage.
On the other hand, Dr. Burleson provided a more in-depth explanation for his
opinion that the C6-C7 compression is causing Mr. Smith's symptoms and that the
work injury necessitated cervical fusion. He explained that cord compression at the
C6-7 level affects nerves that control the lower part of the body. He also cited the
immediate onset of symptoms as evidence that the work injury caused the
compression. He further made clear that Mr. Smith needs surgery to relieve the
pressure on the spinal cord as soon as possible to minimize damage. The Court finds
this explanation and the weight given to the information at hand lends credibility to
Dr. Burleson's opinion.
After weighing all the evidence, the Court finds that Coca Cola failed to
overcome the presumption given to Dr. Burleson's opinions. Mr. Smith has proven
he is likely to prevail on entitlement to surgery, and Coca Cola must authorize the
recommended C6-7 fusion.
Regarding temporary total disability benefits, Mr. Smith must show the
duration of his work-related inability to work. Shepherd v. Haren Const. Co., Inc.,
2016 TN Wrk. Comp. App. Bd. LEXIS 15, at *13 (Mar. 30, 2016). On July 14,
2025, Dr. Burleson took Mr. Smith off work until after his surgery. Given that he
has yet to undergo surgery, the Court holds that Mr. Smith is entitled to temporary
disability benefits from July 14 through the present and continuing until he reaches
maximum medical improvement from his surgery or returns to work.
As to temporary partial disability benefits before July 14, Mr. Smith was
assigned restrictions and terminated on May 23, 2025, for absenteeism. He did not
provide sufficient testimony about communications with Coca Cola regarding
accommodating his restrictions. Without further evidence, the Court holds that Mr.
Smith has not established he is likely to prevail on temporary partial disability
benefits from May 23 through July 13.
IT IS ORDERED.
1. Coca Cola shall authorize and pay for Dr. Burleson to perform the
recommended fusion at C6-7.
2. Coca Cola shall pay Mr. Smith past temporary total disability benefits from July
14, 2025, through the present at a compensation rate to be determined by the
parties. Should the parties fail to agree, they shall file a joint motion asking the
Court to determine Mr. Smith's average weekly wage. Mr. Smith's attorney is
entitled to 20% attorney's fees from the past temporary total disability benefits
owed. Coca Cola shall continue to pay Mr. Smith's temporary total disability
benefits until he reaches maximum medical improvement or is able to return to
work. Mr. Smith's request for temporary partial disability benefits is denied at
this time.
3. This case is set for a Scheduling Hearing on June 1, 2026, at 2:00 p.m. Central
Time. The parties must call 615-253-0010 or 855-689-9049 to participate.
Failure to call might result in a determination of the issues without the party's
participation.
4. Unless interlocutory appeal of the 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).
ENTERED April 20, 2026.
____________________________________
JUDGE ROBERT DURHAM
Court of Workers' Compensation Claims
APPENDIX
Exhibits:
1. Documents attached to Petition for Benefit Determination
2. Causation letter from Dr. Burleson
3. Mr. Smith's responses to interrogatories
4. Dr. Snowden's independent medical evaluation
5. Mr. Smith's affidavit
6. Collective medical records filed by Mr. Smith