The opinion
FILED
Jun 02, 2026
01:10 PM(CT)
TENNESSEE COURT OF
WORKERS' COMPENSATION
CLAIMS
TENNESSEE BUREAU OF WORKERS’ COMPENSATION
IN THE COURT OF WORKERS’ COMPENSATION CLAIMS
AT GRAY
YALONDA WOODS, Docket No. 2025-20-5918
Employee,
v.
TENNOVA HEALTHCARE State File No. 17408-2025
HOSPICE,
Employer,
and Judge Brian K. Addington
AIU INS. CO.,
Carrier.
EXPEDITED HEARING ORDER
Yalonda Woods sought a total left-knee arthroplasty recommended by Dr.
Jonathan Shaver, her authorized treating physician. Tennova argued that the surgery
was not medically necessary. Based on the evidence below, the Court holds that Ms.
Woods is likely to prevail at the compensation hearing that the surgery is medically
necessary and orders Tennova to authorize it.
Claim History
Ms. Woods injured her knee at work on March 13, 2025, and suffered a
complete meniscus tear. The parties disagreed on the appropriate treatment plan.
Dr. Shaver recommended a total knee arthroplasty originally in August 2025,
noting the tear and arthritis. Tennova sent the recommendation to utilization review.
Dr. Tamara Pylawka determined the procedure was not medically necessary because
imaging only showed mild osteoarthritis. The Bureau’s Medical Director upheld the
denial based on Ms. Woods’s weight and the lack of a physical therapy trial.
Based on the denial, Dr. Shaver ordered physical therapy. Those notes showed
that Ms. Woods had daily problems walking up and down steps and swelling.
Although she made a good effort to rehabilitate her knee, it continued to cause pain.
1
After physical therapy ended without improvement, Dr. Shaver again ordered
the surgery in December 2025, based on the former symptoms and imaging and a
more recent x-ray showing increased medial joint narrowing and degenerative
changes consistent with osteoarthritis.
Tennova again sought utilization review. Once again Dr. Pylawka denied
surgery based on “no documentation of the extent of osteoarthritis. Radiology
reports and magnetic resonance imaging (MRI) reports should be included for
review.”
In January 2026, the Medical Director agreed with the denial because “the
supplied records failed to describe efforts at weight loss, nor do they describe gait
abnormalities or other findings on physical exam that would document the need for
the proposed surgery.”
Ms. Woods underwent a functional capacity evaluation on February 9, and the
therapist wrote that she gave good effort, walked with a slight limp, and experienced
increased pain throughout the test.
Ms. Woods testified that she would like to have the surgery Dr. Shaver
recommended so she can improve and return to work. Tennova argued the evidence
upholds the denials.
During the hearing, the Court observed that Ms. Woods walked with a limp
when she approached the witness stand.
Findings of Fact and Conclusions of Law
To obtain the surgery in question, Ms. Woods must show a likelihood of
prevailing at a compensation hearing that she is entitled to the recommended surgery
and a referral to a new orthopedist to treat her left-knee injury. Tenn. Code Ann. §
50-6-239(d)(1) (2025).
Dr. Shaver is entitled to a presumption that the recommended surgery is
medically necessary under Tennessee Code Annotated 50-6-204(a)(3)(H). However,
Tennova argued that the opinions of its utilization review physician and the medical
director outweigh Dr. Shaver’s opinion. The Court disagrees.
When faced with competing expert opinions, a “trial judge has the discretion
to determine which testimony to accept.” Payne v. UPS, No. M2013-02363-SC-R3-
WC, 2014 Tenn. LEXIS 1112, at *18 (Tenn. Workers’ Comp. Panel Dec. 30, 2014).
2
In doing so, the trial court can 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.”
Bass v. The Home Depot, 2017 TN Wrk. Comp. App. Bd. LEXIS 36, at *9 (May 26,
2017).
Additionally, a trial court is not bound by the determination of the utilization
review physician or the Bureau’s Medical Director but is charged with conducting a
de novo review to determine whether Tennova rebutted the presumption that the
recommended surgery is reasonably necessary to treat the work injury. Shelton v.
Joseph Constr. Co., No. M2014-01743-SC-R3-WC, 2015 Tenn. LEXIS 467, at *18
(Tenn. Workers’ Comp. Panel June 3, 2015).
Dr. Pylawka denied the surgery based on a lack of imaging results or
documentation of the extent of osteoarthritis. The Court cannot discern whether Dr.
Pylawka means they do not exist or that she just did not have them. However,
Tennova has the responsibility to supply these records to her. Tenn. Comp. Rules &
Regs. 0800-02-06-.06(2) (2022). Regardless, her opinion does not overcome the
presumption afforded Dr. Shaver, and his opinion that, after comparing newer x-rays
and the old MRI, her knee changes were consistent with osteoarthritis caused by the
work injury.
The Medical Director upheld the denial based on a lack of records describing
weight-loss efforts, gait abnormalities, or other physical findings documenting the
need for surgery. These reasons differ from Dr. Pylawka’s. Neither Dr. Pylawka nor
the medical director had the functional capacity evaluation, where the therapist
noticed that Ms. Woods walked with a limp. The therapist observed Ms. Woods, but
the utilization review doctor and the medical director did not. Also, the medical
director did not explain his concern over her weight, and the records do not reveal
any weight concerns by Dr. Shaver.
Dr. Shaver’s opinion has not changed over time, and he observed and
examined Ms. Woods, while others did not. “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.” Bass, 2017 TN Wrk.
Comp. App. Bd. LEXIS 36 at *14. The Court also observed Ms. Woods’s limp.
The Court accredits Dr. Shaver’s opinion as more persuasive and finds that
the opinions of the utilization review physician and Medical Director do not rebut
the presumption afforded Dr. Shaver.
3
Therefore, the Court holds that Ms. Woods is likely to succeed at a
compensation hearing on this issue, so Tennova shall authorize the surgery
recommended by Dr. Shaver.
IT IS ORDERED AS FOLLOWS:
1. Tennova and its carrier must authorize the recommended surgery and provide
reasonable and necessary medical treatment under Tennessee Code Annotated
section 50-6-204(a)(1)(A).
2. The Court sets a status hearing on July 27, 2026, at 2:00 p.m. Eastern. The
parties must dial 855-543-5044 to participate in the hearing.
3. Unless appealed, compliance with this order must occur no later than seven
business days from the date of entry of this order as required by Tennessee
Code Annotated section 50-6-239(d)(3).
ENTERED June 2, 2026.
Brian K. Addington
____________________________________
JUDGE BRIAN K. ADDINGTON
Court of Workers’ Compensation Claims
4
APPENDIX
Exhibits:
1. Yolanda Woods’s affidavit
2. Medical records
3. Dr. Shaver response form
4. UR Report 8/22/2025
5. Medical Director letter 9/15/25
6. UR Report 12/23/25
7. Medical Director letter 1/12/26
8. Dr. Shaver WORKlink record
CERTIFICATE OF SERVICE
I certify that a copy of this Order was sent on May--, 2026.
Name Email Service sent to:
Michael Large, michael@largelaw.com
Employee’s Attorney X donna@largelaw.com
cooper@largelaw.com
Joshua Wolfe, joshua.wolfe@mgclaw.com
Employer’s Attorney X mandi.hargis@mgclaw.com
____________________________________
PENNY SHRUM, COURT CLERK
wc.courtclerk@tn.gov
5
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]
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