The opinion
FILED
Jun 04, 2026
02:47 PM(CT)
TENNESSEE COURT OF
WORKERS' COMPENSATION
CLAIMS
TENNESSEE BUREAU OF WORKERS’ COMPENSATION
IN THE COURT OF WORKERS’ COMPENSATION CLAIMS
AT COOKEVILLE
CHRISTINA MANUS HENRY, Docket No. 2025-40-3091
Employee,
v. State File No. 71026-2023
FITZGERALD COLLISION &
REPAIR, LLC, Judge Robert Durham
Employer,
And
AMTRUST GROUP,
Insurer.
EXPEDITED HEARING ORDER DENYING BENEFITS
Ms. Henry asked that Fitzgerald Collision pay for treatment of the venous
insufficiency in her left leg, which she asserted was aggravated by her work-related
knee replacement. For the reasons below, the Court denies her request.
History of Claim
On August 15, 2023, Ms. Henry suffered a work-related left-knee injury. She
came under the authorized care of orthopedist Michael Palk and underwent a knee
replacement. Afterward, Ms. Henry suffered from leg pain, swelling, and spasms
that she did not have before her surgery.
Dr. Palk referred Ms. Henry to a vascular specialist, and Fitzgerald authorized
treatment with Dr. Sina Iranmanesh. He noted her symptoms, and tests revealed
“severe reflux throughout the entirety of the great saphenous vein.”
Dr. Iranmanesh diagnosed venous insufficiency and said that the venous
reflux had “likely been present for quite some time, likely many years.” However,
he continued that since she had been “relatively asymptomatic” until after her
surgery, it was “reasonable to think that there is some exacerbation that has made
her venous symptoms appear in the forefront.” However, he did not believe the
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insufficiency was a “direct cause or complication resulting from her surgery.” He
recommended further treatment, including an ablation of the saphenous vein.
Fitzgerald did not authorize treatment, so Ms. Henry’s counsel wrote to Dr.
Iranmanesh and asked if the venous insufficiency was “made symptomatic” by her
leg injury or her surgery. Dr. Iranmanesh marked “yes.” He further marked “yes”
to the question of whether the “anatomical changes” to Ms. Henry’s leg from her
injury and surgeries “aggravated” her venous insufficiency.
In response, Fitzgerald’s counsel wrote to Dr. Iranmanesh seeking
clarification. Dr. Iranmanesh agreed that Ms. Henry’s preexisting conditions, and
not her 2023 work injury, were more than 50% of the cause of her venous
insufficiency. He explained that “likely her venous insufficiency was present prior
to injury/surgery.”
Law and Analysis
To obtain her requested relief, Ms. Henry must show a likelihood of prevailing
at a compensation hearing that she is entitled to treatment for her venous
insufficiency. Tenn. Code Ann. § 50-6-239(d)(1) (2025). Dr. Iranmanesh made it
clear that Ms. Henry’s work-related knee injury and surgery did not cause her
preexisting venous insufficiency. However, Fitzgerald may still be responsible for
any aggravation of this condition, so long as the aggravation arose “primarily out of
and in the course and scope of employment.” Id. § 50-6-102(12)(A).
In Edwards v. Peoplease, LLC, No. W2024-01034-SC-R3-WC, 2025 Tenn.
LEXIS 514, at *26 (Tenn. Dec. 22, 2025), the Supreme Court analyzed the
compensability of an aggravation of a preexisting condition. It defined an
aggravation as “an intensification or worsening of a pre-existing disease, condition
or ailment, permanent or not, that contributes more than fifty percent in causing
death, disability or the need for medical treatment.”
Edwards further held that to prove a compensable aggravation, the employee
must establish “(1) that the work accident contributed more than fifty percent in
causing the aggravation, and (2) that the aggravation, which was caused by the work
accident, contributed more than fifty percent to disablement or the need for medical
treatment.” Id. at *27.
Here, the Court finds that Dr. Iranmanesh’s records do not adequately address
either element set out in Edwards. They do not answer whether Ms. Henry’s work
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injury “contributed more than fifty percent” in causing an aggravation of her venous
insufficiency or whether the aggravation “contributed more than fifty percent” in
creating disablement or the need for medical treatment.
Thus, the Court holds that Ms. Henry has not established she is likely to
prevail on causation at trial regarding the aggravation of her venous insufficiency.
IT IS ORDERED:
1. Ms. Henry’s request for additional medical treatment with Dr. Iranmanesh is
denied at this time.
2. This case is set for a status conference on July 1, 2026, at 8:30 a.m. Central
Time, 9:30 a.m. Eastern 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.
ENTERED June 5, 2026.
____________________________________
JUDGE ROBERT DURHAM
Court of Workers’ Compensation Claims
APPENDIX
Exhibits:
1. Ms. Henry’s Rule 72 Statement
2. Dr. Iranmanesh’s February 16, 2026 medical record
3. Dr. Iranamesh’s response to Ms. Henry’s questionnaire.
4. Dr. Iranamesh’s response to Fitzgerald’s questionnaire.
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CERTIFICATE OF SERVICE
I certify that a copy of this Order was sent on June 5, 2026.
Name Email Service sent to:
Chris Markel X cmarkel@markelfirm.com
Noah Klinsky X naklinsky@mijs.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]
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