The opinion
FILED
May 22, 2026
10:11 AM(ET)
TENNESSEE COURT OF
WORKERS' COMPENSATION
CLAIMS
TENNESSEE BUREAU OF WORKERS’ COMPENSATION
IN THE COURT OF WORKERS’ COMPENSATION CLAIMS
AT MURFREESBORO
MICHAEL WRIGHT, Docket No. 2025-50-2322
Employee,
v.
BOULDIN CORP., State File No. 64621-2024
Employer,
And
BUSINESSFIRST INSURANCE Judge Thomas Wyatt
COMPANY,
Carrier,
And
TROY HALEY,
ADMINISTRATOR, TENNESSEE
BUREAU OF WORKERS’
COMPENSATION SUBSEQUENT
INJURY AND VOCATIONAL
RECOVERY FUND.
EXPEDITED HEARING ORDER
__________________________________________________________________
In a May 6, 2026 expedited hearing, Michael Wright sought medical and
temporary partial disability benefits for a work-related, right-leg injury. Bouldin
Corporation argued that a non-work-related, flesh-eating infection in Mr. Wright’s
left leg severed the work-relatedness of the requested benefits. It also raised Mr.
Wright’s alleged failure to respond to communications about light duty as a defense
to the temporary disability benefits he seeks.
For the reasons below, the Court awards Mr. Wright medical benefits of pain
management and treatment for post-traumatic stress disorder but denies treatment
for the flesh-eating infection. Additional temporary partial disability benefits are
also awarded.
1
History of Claim
On September 12, 2024, Mr. Wright fell and “bounced” down a flight of stairs
while fleeing pressurized steam and burning garbage that suddenly escaped from a
machine at Bouldin. When he came to rest, he suffered six broken ribs and two
broken bones in his right leg. One of the broken bones protruded from his leg, and
his body was covered with burned garbage. He testified that he thought “it was all
over” for him as the accident unfolded.
Dr. David Hunter Boyce surgically implanted a rod and screws to repair the
broken leg. Mr. Wright was hospitalized for a month after surgery and received a
psychiatric evaluation that recorded his reports of “frequent and often intense”
“flashbacks” of the accident resulting in “restlessness, insomnia, and nightmares.”
The evaluating psychiatrist diagnosed him with “symptoms of [an] adjustment
disorder with high risk of development of PTSD.”
On October 8, Mr. Wright reported continuing severe right-leg and rib pain
and flashbacks of the accident. The surgeon referred him for pain management and
treatment of PTSD. Utilization review certified the reasonableness and necessity of
the PTSD treatment, but not the pain management.
Bouldin offered a panel for PTSD from which Mr. Wright selected Dr. Keith
Caruso; however, he never saw him. Mr. Wright testified that the case manager first
said the company did not like his selection, and later, she claimed Dr. Caruso did not
take workers’ compensation. Mr. Wright requested a new panel, but said that the
case manager insisted he select another physician from the first panel. He did not
receive a new panel and has never undergone PTSD treatment.
Dr. Boyce also noted during the first post-surgery visit that an infection
developed near the surgery staples in his right leg. Over the ensuing weeks, home
physical therapists noted open sores, skin tears, scabbing, pitting edema, and
inflamed skin on Mr. Wright’s right shin.
In November, Dr. Boyce again noted that Mr. Wright was limited by
flashbacks and had to use crutches to bear weight on his right leg. He was not ready
to return to work. Notes of a December 3 visit again documented blisters and redness
around the “right anterior leg” that were “widely separated from his surgical site”
and “entirely similar to his prior [episodes of deep vein thrombosis.]” Mr. Wright
had taken prescribed medication for the thrombosis for several years before going to
work at Bouldin.
2
During a later December visit, Mr. Wright’s right-leg infection was better.
Dr. Boyce concluded that he could return to sedentary work with no lifting greater
than 25 pounds. He estimated maximum medical improvement in six months.
Mr. Wright then flew to the Philippines to visit a friend, arriving on December
19. He testified that he took the trip because he was not getting help for his PTSD,
needed to clear his mind, and intended to return home for his next doctor’s
appointment in six weeks. He testified that he told his supervisor at Bouldin he was
going on the trip.
In the Philippines, Mr. Wright stayed at a private residence, saw the sights,
and attended church. About a week into the trip, the swelling, burning, and blisters
on his right leg returned and, 48 hours later, a flesh-eating condition called
necrotizing fasciitis appeared in his left leg. He was hospitalized from January 27
until March 16 for numerous surgeries to remove tissue from his left leg.
The treating plastic surgeon in the Philippines diagnosed “severe soft tissue
infection on both legs with the necrotizing fasciitis in his left leg.” He added, “On
investigation of his case, I found no definitive and causative etiology for his
condition/diagnosis.”1
While hospitalized in the Philippines, Mr. Wright learned about a termination
letter from Bouldin. The letter stated that Bouldin terminated him because he failed
to respond to repeated communications “to see if there is a light duty accommodation
by which you could return to work.” Mr. Wright denied receiving communications
about returning to work.
He testified that Bouldin had three employees, one of whom was a secretary.
His and the other operator’s jobs could not be performed while sitting. He added
that his PTSD would have kept him from working any job at Bouldin at that time.
David Britton, a non-employee safety contractor for Bouldin, appeared as
company representative. He stated the principals at Bouldin told him that, before
Mr. Wright left for the Philippines, they unsuccessfully tried several times to contact
him about returning to work under restrictions. He admitted that he reached Mr.
Wright by telephone in December 2024 to discuss medical treatment but did not
1
He testified that an infectious disease physician in the Philippines told him the flesh-eating infection was transported
from his right leg to the left through his blood. He did not present written documentation of this opinion.
3
discuss a return to work. Mr. Britton also testified that the principals at Bouldin
told him that they received a special contract which would have provided a sit-down
job for Mr. Wright from mid-November 2024 until the New Year.2 Finally, he
testified that he recommended Bouldin terminate Mr. Wright in early February 2025
after he searched Facebook and learned about Mr. Wright’s trip to the Philippines
and the flesh-eating infection.
Mr. Wright remained in the Philippines until September 2025 for treatment of
his left leg. He saw Dr. Boyce in October and reported ongoing pain in both legs.
Dr. Boyce concluded that the right-leg fractures had healed and that Mr. Wright
might reach maximum medical improvement in two months. He also wrote that Mr.
Wright had “necrotizing soft tissue infection [in the left leg] treated in another
country [without a] definitively established connection to the right lower extremity.”
Dr. Boyce ordered physical therapy for gait training and strengthening of the right
leg; pain management; and referral to a primary care physician for assessment of his
mental-health needs, including PTSD.
Mr. Wright reported to Dr. Boyce in December that he never received
authorization for the treatment ordered at the previous visit. In the notes from this
visit, Dr. Boyce clarified he was not treating the left-leg conditions and again ordered
physical therapy for persistent pain and tenderness around the fracture site. He also
reordered a “PTSD evaluation related to work injury of the right leg from 9/20/24.”
(Emphasis added).
At a February 2026 visit, Dr. Boyce declined to reorder physical therapy due
to “a gap in care.” On each of the visits from December 2024 to February 2026, Dr.
Boyce limited Mr. Wright to sedentary work with no lifting over ten or 25 pounds
and no climbing.
Mr. Wright testified that his right leg still hurts. He continues to experience
PTSD symptoms that he believes would keep him from returning to Bouldin even if
he was physically able to work there.
Both sides offered reports from physicians performing independent
examinations. Mr. Wright relied on Dr. Robert Landsberg, who concluded that he
could not give an opinion about the work-relatedness of the flesh-eating infection
because he did not know the infectious agents that invaded either of Mr. Wright’s
legs.
2
Bouldin did not produce as witnesses the persons in its control that had direct information on this point.
4
Bouldin relied on the report of Dr. Jeffrey Hazlewood, who saw Mr. Wright
once. He concluded that additional physical therapy and pain management are
unnecessary because Mr. Wright’s broken right leg has healed and his ongoing
problems primarily relate to non-work-related deep-vein thrombosis and the flesh-
eating virus in his left leg. He added that Mr. Wright does not require permanent
restrictions from his right-leg condition. Finally, Dr. Hazlewood stated that a one-
time assessment of Mr. Wright’s need for PTSD treatment was reasonable, providing
the assessment is by a psychiatrist.
Regarding the claim for temporary disability benefits, the parties stipulated
that the applicable weekly compensation rate is $468.67, and Bouldin stopped
paying temporary benefits on January 28, 2025. Mr. Wright testified that he has not
worked since the accident. Dr. Boyce and Dr. Hazlewood placed Mr. Wright at
maximum medical improvement on February 17, 2026, and February 2, 2026,
respectively.
Findings of Fact and Conclusions of Law
To recover at this expedited hearing, Mr. Wright must show that he will likely
prevail at a final hearing on his requested benefits. Tenn. Code Ann. § 50-6-
239(d)(1) (2025). During the hearing, he requested pain management, PTSD
treatment, a panel for treatment of the flesh-eating infection, and temporary partial
disability benefits.
Pain Management
A foundational benefit of the workers’ compensation law is that the employer
“shall furnish, free of charge to the employee, such medical and surgical treatment,
medicine . . . [and] psychological services as ordered by the attending physician[.]”
Id. § 50-6-204(a)(1)(A). However, an employee’s need for treatment is covered
under workers’ compensation only if the employee shows by medical expert
testimony that it “arises primarily out of and in the course and scope of
employment.” Id. § 50-6-102(12). In other words, the employee must show that the
employment contributed “more than fifty percent (50%) in causing the . . . need for
treatment, considering all causes.” Id. § 50-6-102(12)(C).
During the hearing, Mr. Wright testified credibly that he continues to suffer
pain in the right leg he injured at Bouldin. Dr. Boyce accepted the legitimacy of his
5
report of right-leg pain in October 2025 and afterward by reordering pain
management treatment, just as he did before Mr. Wright left for the Philippines. In
December 2025, Dr. Boyce reiterated he had never undertaken treatment of the left-
leg conditions and had ordered pain management for the right-leg injury.
Bouldin countered with Dr. Hazlewood’s opinion that further treatment of Mr.
Wright’s right leg is: (1) medically unnecessary because the bones had healed and
(2) not work-related because any pain he now endures is more than 50% causally
related to his more serious, non-compensable left-leg conditions.
When confronted with opposing medical opinions, the trial judge shall
conclude which opinion “contains the more probable explanation.” Ledford v. Mid
Georgia Courier, Inc., 2018 TN Wrk. Comp. App. Bd. LEXIS 28, at *7-8 (June 4,
2018). The Court may consider the qualifications of the experts, the circumstances
of their evaluations, the information available to them, and an evaluation of the
importance of the available information.
Here, both doctors are qualified. However, Dr. Boyce has much more context
to determine the level and causation of Mr. Wright’s current right-leg pain, since he
performed surgery and has followed him clinically before and after the left-leg
conditions arose. On the other hand, Dr. Hazlewood only saw Mr. Wright once.
Also, the methodologies employed by the physicians separate the usefulness
of their opinions. Dr. Boyce assessed Mr. Wright’s need for right-leg treatment
independent of the conditions in his left leg. Dr. Hazlewood considered which of
the two conditions causes more than 50% of Mr. Wright’s total pain.
Dr. Boyce’s methodology more closely aligns with the clear obligation under
the law that employers pay for reasonable and necessary treatment of an employee’s
work injury. He determined on his first post-surgery visit that Mr. Wright’s work-
related, right-leg injury was painful and needed pain management. He maintained
that opinion even after Mr. Wright contracted the flesh-eating infection.
On the other hand, Dr. Hazlewood assessed the work-relatedness of Dr.
Boyce’s pain-management order by comparing whether the work injury or the
damage caused by the flesh-eating infection was worse. The Court finds this
methodology is less helpful than that employed by Dr. Boyce. The unfortunate fact
that Mr. Wright contracted the flesh-eating infection in his left leg does not negate
Bouldin’s obligation to provide medical treatment for his compensable right-leg
injury, even if the pain from the left-leg condition is worse than that from the right-
6
leg injury.
For the reasons above, the Court finds that the opinion of the authorized
surgeon—that Mr. Wright’s work-related, right-leg injury is painful and needs
treatment—best aligns with workers’ compensation law. Also, his extensive
treatment with Mr. Wright provides better context for resolving these issues. For
those reasons, Mr. Wright will likely prevail at trial in showing that he is entitled to
the pain management ordered by the authorized surgeon.
PTSD Treatment
All the medical evidence in this record supports the conclusion that Mr.
Wright has long needed treatment and evaluation for PTSD symptoms. Dr. Boyce,
a utilization review physician, and even Dr. Hazlewood all reached the same
conclusion. Thus, Mr. Wright will likely prevail at trial in showing that he developed
PTSD that is: (1) causally related to his work injury at Bouldin and (2) needs
evaluation and treatment.
It is concerning that, a year and a half after his injury, Mr. Wright has received
no treatment for PTSD. At the hearing, Bouldin failed to explain why it had not
authorized PTSD treatment. It did not produce witnesses to rebut Mr. Wright’s
testimony that the carrier did not like the physician he selected from the panel and
tried to steer him to another physician. It did not explain why it failed to follow the
recommendation of its own doctor that Mr. Wright needed evaluation for PTSD
symptoms.
Tennessee Code Annotated section 50-6-118(8) permits an administrative
penalty when an employer fails to timely provide medical treatment recommended
by the authorized treating physician. Here, Mr. Wright has not received the PTSD
treatment prescribed a year and a half ago by the authorized surgeon. Thus, the
Court refers this case to the Bureau’s compliance unit for assessment of a penalty
for the failure to timely authorize Mr. Wright’s PTSD treatment.
Infectious Disease Panel
Mr. Wright’s entitlement to a panel of infectious disease physicians rests on
his ability to show by medical expert testimony that he will likely prevail at trial in
proving the work-relatedness of the flesh-eating infection in his left leg. The record
here is devoid of the requisite medical evidence. Dr. Boyce concluded that Mr.
Wright’s left-leg conditions are unrelated to his work-related, right-leg injury.
7
Neither independent physician established the causation of the left-leg infection.
Mr. Wright incorrectly argues that he has proven enough to require Bouldin
to send him to an infectious disease physician for a causation analysis. Section 50-
6-204 does not impose on employers the obligation to pay a physician to evaluate
the causation of an employee’s alleged injury and/or need for treatment. Pool v.
Jarmon D&Q Transport, 2016 TN Wrk. Comp. App. Bd. LEXIS 1, at *9 (Jan. 4,
2016).
For the above reasons, the Court denies Mr. Wright’s request for a panel of
infectious disease physicians.
Temporary Disability Benefits
Mr. Wright argued that, since he has remained under restrictions for his
compensable right-leg injury to the present, he is entitled to both accrued temporary
partial disability benefits back to January 28, 2025, when Bouldin stopped paying,
and on-going benefits. Bouldin countered that he lost his right to temporary
disability benefits when he failed to communicate with them about returning to light
duty work. Also, his non-work-related, flesh-eating infection severed the causation
of any disability arising after the appearance of the infection.
Tennessee Code Annotated section 50-6-207(2) provides for the payment of
benefits for each week of compensable temporary partial disability calculated at the
rate of “sixty-six and two-thirds percent (66⅔%) of the difference between the
average weekly wage of the worker at the time of the injury and the wage the injured
worker is able to earn in the worker’s partially disabled condition.” (Emphasis
added.) A work injury causes disablement “only if it has been shown to a reasonable
degree of medical certainty that it contributed more than fifty percent (50%) in
causing [the . . . disablement], considering all causes.” Id. § 50-6-102(12)(C).
In Jewell v. Cobble Construction, 2015 TN. Wrk. Comp. App. Bd. LEXIS 1,
at *22-23 (Jan. 12, 2015), the Appeals Board held that entitlement to temporary
partial disability benefits occurs when, before attaining maximum medical
improvement, the employee retains disability that is not total such that the employee
might resume some gainful employment if available. In Lasser v. Waste
Management, Inc., TN Wrk. Comp. App. Bd LEXIS 20, at *21-22 (May 24, 2028),
the Appeals Board stated that the issue of whether an employee failed to return to
light duty turns on the reasonableness of the employer’s offer of work and the
employee’s failure to return to work. In Lasser, the employee could not recover
8
temporary partial disability benefits when his failure to return to light duty was
“purely personal.”
Mr. Wright testified he received no communication about returning to work
under restrictions. Bouldin countered Mr. Wright’s testimony with that of Mr.
Britton, who testified only about what the principals at Bouldin told him.
Furthermore, the termination letter did not say that Bouldin had light duty available,
but instead, charged Mr. Wright with failing to discuss if light duty was available.
Based on this evidence, Mr. Wright will likely prevail at trial in showing that
he did not receive communications to contact Bouldin about returning to work.
The Court now moves to whether the non-work-related, flesh-eating infection
in Mr. Wright’s left leg severed the causation of the disablement that he endured
after the infection arose. During all periods involved, Mr. Wright remained under
partial disability by being limited to sedentary work with a lifting restriction. Thus,
had the flesh-eating infection not arisen, Mr. Wright would likely prevail at trial in
proving entitlement to temporary partial disability benefits.
But beginning in late January 2025, the flesh-eating infection did appear.
Until March 16, he remained in a hospital in the Philippines for this condition.
During the hospitalization, Mr. Wright was disabled from working by a non-work-
related condition. Thus, he will not likely prevail in showing his entitlement to
temporary partial disability benefits from January 28 to March 16, 2025, while he
was hospitalized.
Mr. Wright’s claim for temporary partial disability benefits after March 16,
2025, presents a close issue. The medical evidence on the disabling effect of the
flesh-eating infection is not well-developed. Mr. Wright says he endures pain from
the conditions in both legs. Dr. Boyce has continued Mr. Wright under sedentary
and lifting restrictions due to his work-related injury, while Dr. Hazlewood placed
no restrictions due to the right leg and believes any current pain and need for
treatment suffered by Mr. Wright relates to his left-leg conditions. For the reasons
discussed above distinguishing the usefulness of Drs. Boyce’s and Hazlewood’s
opinions, the Court finds that Dr. Boyce’s placement of restrictions based on the
right-leg condition presents the most probable explanation for Mr. Wright’s
disablement from March 16, 2025, to the present.
Based on the above, Mr. Wright will likely prevail at trial in showing his
entitlement to temporary partial disability benefits from March 16, 2025, until
9
February 17, 2026, the date on which Dr. Boyce placed him at maximum medical
improvement. Thus, the Court awards Mr. Wright $22,696.05 in temporary partial
disability benefits (339 days at $66.95 per day.)
IT IS, THEREFORE, ORDERED as follows:.
1. Bouldin shall promptly authorize pain management and PTSD treatment and
pay $22,696.05 in temporary partial disability benefits.
2. The Court refers this case to the Bureau’s compliance unit for assessment of
an administrative penalty for Bouldin’s failure to timely authorize PTSD
treatment ordered by Dr. Boyce and certified by utilization review.
3. The Court approves an attorney’s fee of 20% of the award of temporary partial
disability benefits to Steve Waldron, counsel for Mr. Wright.
4. The Court sets a telephone status hearing on August 21, 2026, at 9:00 a.m.
Central Time/10:00 a.m. Eastern Time.
ENTERED May 22, 2026.
JUDGE THOMAS WYATT
Court of Workers’ Compensation Claims
APPENDIX
The technical record consists of all documents filed on the TNComp
electronic filing system, which the Court will consider in reaching its decision.
Exhibits:
1. Rule 72 declaration of Michael Wright
2. Photograph
3. Wage Statement
4. Employee’s compilation of medical records
10
5. Employer’s compilation of medical records
6. Choice of Physician form—PTSD
7. Intake form—Dr. Caruso
8. Utilization review documents—Claims Eval
9. Restrictions and pain management referral form—Dr. Boyce
10. Additional records—Dr. Boyce
11. Termination communications
11
CERTIFICATE OF SERVICE
I certify that a copy of this order was sent as shown on May 22, 2026.
Name Mail Email Service sent to:
R. Steven Waldron, X arlenesmith@wfptnlaw.com
Employee’s Attorney
Nick Peterson, X Nick.peterson@petersonwhite.com
Ashley Dilly, Ashley.dilly@petersonwhite.com
Employer’s Attorneys
Laurenn Disspayne, X Laurenn.disspayne@tn.gov
Attorney for TN
Subsequent Injury Fund
____________________________________
PENNY SHRUM, COURT CLERK
wc.courtclerk@tn.gov
12
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 *
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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