Opinion

Marzette, Shelton v. Pat Salmon and Sons, Inc.

  • 2015 TN WC App. 30
Court
Tennessee Workers' Compensation Appeals Board
Filed
Sep 18, 2015
Status
Published
On the bench
Marshall L. Davidson III, David F. Hensley, Timothy W. Conner
Cited by
0 cases
Authority
More cited than 12.4%

The opinion

TENNESSEE BUREAU OF WORKERS’ COMPENSATION

WORKERS’ COMPENSATION APPEALS BOARD

Shelton Marzette ) Docket No. 2014-08-0058

)

v. )

) State File No. 61901-2014

Pat Salmon and Sons, Inc. )

CERTIFICATE OF SERVICE

I hereby certify that a true and correct copy of the Appeals Board’s decision in the

referenced case was sent to the following recipients by the following methods of service

on this the 18th day of September, 2015.

Name Certified First Class Via Fax Via Email Address

Mail Mail Fax Number Email

Shelton Marzette X ssmarzette63@gmail.com

Frank B. Thacher, III X fthacher@bpjlaw.com

Jim Umsted, Judge X Via Electronic Mail

Kenneth M. Switzer, X Via Electronic Mail

Chief Judge

Penny Shrum, Clerk, X Penny.Patterson-Shrum@tn.gov

Court of Workers’

Compensation Claims

Jeanette Baird

Deputy Clerk, Workers’ Compensation Appeals Board

220 French Landing Dr., Ste. 1-B

Nashville, TN 37243

Telephone: 615-253-0064

Electronic Mail: Jeanette.Baird@tn.gov

TENNESSEE BUREAU OF WORKERS' COMPENSATION

WORKERS' COMPENSATION APPEALS BOARD

FILED

September 18, 2015

Shelton Marzette ) Docket No. 2014-08-0058 TENNESSEE

WORKERS' COMPENSATION

) APPEALS BOARD

v. ) Time: 8:00 AM

) State File No. 61901-2014

Pat Salmon and Sons, Inc. )

)

)

Appeal from the Court of Workers' )

Compensation Claims )

Jim Umsted, Judge )

Affirmed and Remanded - Filed September 18, 2015

In this interlocutory appeal the employee alleges he sustained work-related hearing loss

and vertigo when his left ear popped and he experienced dizziness, a loss of balance, and

nausea while driving a truck at a high altitude. ,The employee sought medical care on his

own before the employer provided a panel of medical providers that included a

chiropractor, two orthopedics and a medical center. The employee was examined by a

doctor with the medical center that the employee selected from the panel who opined that

the employee's condition was not caused by his work. The employer thereafter denied

the claim. Following an expedited hearing, the trial court determined that to resolve the

compensability issue the employee is entitled to additional medical benefits limited to the

employer's providing a panel of physicians who specialize in hearing loss injuries from

which the employee can select a physician to provide a causation opinion. The trial court

determined that the panel offered by the employer did not meet the statutory requirements

and that the causation opinion of the physician from the medical center was not entitled

to the statutory presumption of correctness. The employer has appealed. Having

carefully reviewed the record, we affirm the trial court's decision to award the additional

medical benefits and remand the case for such additional proceedings as may be

necessary.

Judge David F. Hensley delivered the opinion of the Appeals Board, in which Judge

Marshall L. Davidson, III, and Judge Timothy W. Conner joined.

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Frank B. Thacher, III, Memphis, Tennessee, for the employer-appellant, Pat Salmon and

Sons, Inc.

Shelton Marzette, Memphis, Tennessee, employee-appellee, prose

Factual and Procedural Background

Shelton Marzette ("Employee") is a fifty-one-year-old resident of Memphis,

Tennessee employed as a truck driver by Pat Solomon & Sons, Inc. ("Employer"). He

was performing his usual duties on July 31, 2014, and while driving into Denver,

Colorado with a co-driver his left ear popped and he experienced immediate pain, hearing

loss, and vertigo. He called his supervisor and reported the incident. After describing the

event to his supervisor, Employee's co-worker drove him back to Memphis. Upon

reaching Employer's premises, Employee told his supervisor that he still could not hear

anything. He got in his car and drove himself to the emergency room at the Veterans'

Administration Medical Center ("VA Medical Center") in Memphis.

Records of Employee's visits to the VA Medical Center were admitted into

evidence. These records indicate the following: (1) Employee was seen on August 1,

2014 for vertigo at which time head and chest x-rays and aCT of Employee's head were

obtained and interpreted as normal; (2) Employee was seen on August 3, 2014 for vertigo

and kept off work for two days; and (3) on August 26, 2014 an MRI of Employee's head

and brain was obtained due to "sudden sensorineural hearing loss (Left) and

dizziness/imbalance." The MRI report indicated "no acute infarction, hemorrhage, mass,

abnormal enhancement or abnormal susceptibility in the brain."

On August 8, 2014, Employer provided Employee a panel of four medical

providers that included Concentra Medical Center ("Concentra"), two orthopedics (Drs.

Mark Harriman and James Varner), and a chiropractor. The document indicates that

Employee selected Concentra from the panel on August 8, 2014, and records from

Concentra indicate that Employee was seen on that date by Dr. James D. Rucker.

The Concentra records are limited to four pages that include a two-page report of

Employee's August 8, 2014 visit with Dr. Rucker, a note dictated by Dr. Rucker the same

date stating the diagnosis to be "Conductive Hearing Loss, Inner Ear," and a separate

"Physician Work Activity Status Report" ("Status Report") describing Employee's

"Patient Status" as "Modified Activity- Transferred Care." The Status Report restricted

Employee's activity until the next medical appointment stating, "[u]nable to drive or

operate machinery," "no climbing," and "may not function in a safety sensitive position."

A section for remarks in the Status Report states: "No DOT driving. No work on

machines. Follow up with ENT [at] VA [Medical Center]."

Dr. Rucker's report states that Employee's chief complaint concerns his head

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"which was injured on 7/3112014." It also includes Employee' s statement that "I was

driving in to Denver and became dizzy and now suffer hearing loss." The "History of

Present Illness" includes more details concerning the alleged July 31, 2014 incident and

Employee's subsequent medical care at the VA Medical Center. The report details Dr.

Rucker's examination and states that Employee "should continue receiving testing and

treatment by ENT whose care he is already under." Of particular significance in the

report are Dr. Rucker's medical opinions regarding causation:

It is my opinion that this is not a work caused condition. This problem

could begin at any elevation and could begin at work or off duty. It is [] my

opinion that this reported condition is unlikely work-related. The above

medical statements have been made within a reasonable degree of medical

probability.

On August 25, 2014, Employer submitted a Notice of Denial of Claim for

Compensation, stating as the basis for its denial that Employee's "[i]njury did not arise

out of his employment." A letter from Dr. Julia Archer at the VA Medical Center dated

June 21, 2014, was admitted into evidence, which states "[Employee] requested I write a

letter telling you that a change in barometric pressure can cause vertigo. That is true."

Employee filed two Petitions for Benefit Determinations, both of which requested

that temporary disability and medical benefits be awarded. Following an unsuccessful

mediation, a Dispute Certification Notice ("DCN") was filed on July 21, 2015, indicating

the "Disputed Issues" to include medical benefits, temporary disability benefits and

compensability. A "Dispute Certification Checklist" included as page two of the three-

page DCN identifies four of the 35 listed issues as being disputed:

Whether Employee sustained an injury that arose primarily out of and in the

course and scope of employment with Employer.

Whether Employer is obligated to pay for any past medical expenses and/or

mileage expense.

Whether Employee is entitled to additional medical care as recommended

by a physician.

Whether Employee is entitled to any past or future temporary total

disability benefits, and if so, in what amount.

On the same date the DCN was filed, Employee filed a Request for Expedited

Hearing supported by his affidavit. The request indicates that Employee wanted an

evidentiary hearing and asserts that "[a]ccording to worker[s'] compensation law my

rights to medical care as an employee was [sic] violated, [plus] my rights to the panel of

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physicians. The employee may select the treating physician." Employee's supporting

affidavit, which was admitted into evidence by agreement, states, among other assertions,

that "my company never sent me to [an] ENT."

Employee was the only person to testifY at the expedited hearing. The transcript

of the hearing includes statements by Employee that the trial court stated would be

considered "as [Employee's] opening statement." Those statements questioned the panel

of physicians that Employer provided and asserted that Employee was given "two

orthopedic doctors to choose from and a chiropractor." In his testimony, Employee

reiterated that the panel included two orthopedic physicians and "one chiropractor."

Employee testified that the panel also included a medical center but not the name of any

doctor with the medical center. He testified without objection that "I knew I couldn't

choose an orthopedic surgeon," and "I knew I couldn't choose a chiropractor because I

had - my injury was hearing loss and my ear . . . ." Employee also testified without

objection that when he went to Concentra "I'm thinking I'm seeing anENT doctor. But

the person I seen [sic] ... was Dr. Rucker. And he's not anENT specialist. He doesn't

have any way to diagnose hearing loss or any vertigo."

The trial court concluded that Employee "is entitled to additional medical

benefits," and found that the panel of physicians offered by Employer ''was defective"

and effectively provided only one physician for Employee to select, Dr. Rucker at

Concentra. Noting that Dr. Rucker opined that Employee "should follow-up with testing

and treatment with ENT specialist," the trial court was persuaded that, "in order to

resolve the issue of compensability, it is necessary for [Employer] to provide a panel of

physicians who specialize in treating hearing injuries." Consistent with Dr. Rucker's

recommendation, the trial court, on August 19, 2015, entered its order granting medical

benefits and requiring Employer to provide Employee a panel of physicians who

specialize in treating hearing injuries from which the selected physician "shall provide an

opinion on causation and, if necessary, an opinion on the period of disability from

. .... "

work mg

Employer timely filed a notice of appeal and asserts two issues stated as follows:

(1) whether the court erred by ordering a new panel of physicians when that issue was not

listed in the DCN, and (2) whether the court erred by finding the panel of physicians

provided to Employee was improper. The record was submitted to the Clerk of the

Appeals Board on August 9, 2015.

Standard of Review

The standard of review to be applied by the Appeals Board in reviewing a trial

court's decision is statutorily mandated and limited in scope. Specifically, "[t]here shall

be a presumption that the findings and conclusions of the workers' compensation judge

are correct, unless the preponderance of the evidence is otherwise." Tenn. Code Ann. §

4

50-6-239(c)(7) (2014). The limited circumstances warranting reversal or modification of

a trial court's decision are specified in the statute:

The workers' compensation appeals board may reverse or modifY

and remand the decision of the workers' compensation judge if the rights of

any party have been prejudiced because findings, inferences, conclusions,

or decisions of a workers' compensation judge:

(A) Violate constitutional or statutory provisions;

(B) Exceed the statutory authority of the workers' compensation judge;

(C) Do not comply with lawful procedure;

(D) Are arbitrary, capricious, characterized by abuse of discretion, or clearly

an unwarranted exercise of discretion; or

(E) Are not supported by evidence that is both substantial and material in the

light of the entire record.

Tenn. Code Ann. § 50-6-217(a)(3) (2015). Like other courts applying the standard

embodied in section 50-6-217(a)(3), we will not disturb the decision of the trial court

absent the limited circumstances identified in the statute.

Analysis

We are compelled, initially, to address what may be considered an inconsistency

in the trial court's Expedited Hearing Order Granting Medical Benefits. The trial court

recognized in its order that "to date, there is no medical opinion establishing that

[Employee's] injury arose primarily out of his employment," and that "(i]n the absence of

medical proof that the injury arose primarily out of the employment, [Employee] cannot

establish ... entitlement to additional medical benefits under the statute." However, the

trial court "concludes that [Employee] is entitled to additional medical benefits," and the

trial court limited the award of additional medical benefits to requiring Employer to

provide a panel of physicians who specialize in treating hearing injuries from which

Employee can select a physician to provide a causation opinion. Employer contests the

trial court's order, asserting the trial court erred in ordering a new panel of physicians

"when that issue was not listed in the [DCN]."

Tennessee Code Annotated section 50-6-239(b)(l) (2015) states that "only issues

that have been certified by a workers' compensation mediator within a dispute

certification notice may be presented to the workers' compensation judge for

adjudication," unless permission has been granted by the assigned workers'

compensation judge for parties to present additional issues. Tennessee Code Annotated

section 50-6-239(b)(2) addresses what is necessary for a workers' compensation judge to

grant permission for parties to present issues that have not been certified in the DCN. To

determine what issues were certified by the mediator in the DCN as contemplated in

5

section 50-6-239(b)(1), it is necessary to consider the document as a whole without

reading the Dispute Certification Checklist on page two in a vacuum. Here, "Medical

Benefits" is checked as one of the "Disputed Issues" on page one of the DCN. Moreover,

in the Dispute Certification Checklist on page two, "[w ]hether Employee is entitled to

additional medical care as recommended by a physician" is also checked. Employer

contends that because other items in the checklist, specifically "[w ]hether the panel of

physicians provided by Employer was in compliance with the law," and "[w]hether

Employee is entitled to another panel of physicians in compliance with the law," were not

checked, the trial court was not authorized to consider the panel of physicians that

Employer provided or to order that another panel be provided. Our review of the DCN as

a whole, when considered in the context of the entire record, convinces us that the

provision of medical care for Employee's alleged hearing loss injury was certified by the

mediator as contemplated in Tennessee Code Annotated section 50-6-239(b)(l).

Tennessee Code Annotated section 50-6-204(a) (2014) addresses the medical

benefits that an employer is required to provide to an injured employee. It requires an

injured employee to accept those medical benefits in any case when the employee has

suffered an injury and expressed a need for medical care, "provided that ... the employer

shall designate a group of three (3) or more independent reputable physicians, surgeons

chiropractors or specialty practice groups if available in the injured employee's

community ... from which the injured employee shall select one (1) to be the treating

physician." Tenn. Code Ann. § 50-6-204(a)(3)(A)(i) (2014) (emphasis added). In the

case before us, and as noted above, the DCN clearly identifies "Medical Benefits" as one

of the "Disputed Issues" on page one along with "Temporary Disability Benefits" and

"Compensability." Additionally, the checklist comprising page two of the DCN includes

a check by the issue "[w ]hether Employee is entitled to additional medical care as

recommended by a physician." Furthermore, the transcript of the trial court proceedings

discloses that the parties represented to the trial court that the court's recitation of the

issues, including whether Employee "is entitled to additional medical care as

recommended by a physician," correctly stated the disputed issues. The trial court was

persuaded by the opinion of the Concentra doctor, Dr. Rucker, that Employee should

follow-up with testing and treatment ''with ENT specialists." This, the court stated,

"persuades the Court that, in order to resolve the issue of compensability, it is necessary

for [Employer] to provide a panel of physicians who specialize in treating hearing

injuries."

Tennessee Code Annotated section 50-6-239(d)(1) (2014) authorizes a trial judge,

at the judge's discretion, to "hear disputes over issues provided in the dispute certification

notice concerning the provision of temporary disability or medical benefits on an

expedited basis .... " Here, not only was "Medical Benefits" checked on the initial page

of the DCN and additionally identified in the checklist as an issue, but the parties

presented proof on the issue at the expedited hearing. The trial court noted Employee's

initial remarks at the hearing concerning the lack of Employer-provided medical care and

6

the physicians included in the Employer-provided panel, stating that the court would

consider the remarks as Employee's "opening statement." Employee testified, without

objection, about Employer's failure to provide appropriate medical care and about

Employer providing two orthopedics and a chiropractor on the panel of physicians.

Moreover, although cross-examination on the issue was very limited, Employer cross-

examined Employee about the panel of physicians. Our independent review of the record

leaves no serious question concerning whether the issues of Employee's entitlement to

additional medical benefits and to additional medical care recommended by a physician

were identified in the DCN. Not only were these issues identified in the notice, but both

issues were acknowledged by the trial court and the parties. We are convinced based on

the record as a whole that Employer was fairly put on notice that Employee disputed

whether he received proper medical benefits for his alleged hearing loss injury as

mandated by the Tennessee Workers' Compensation Act. Accordingly, the issue of

Employee's entitlement to additional medical benefits was properly considered by the

trial court.

Employer relies on Dorsey v. Amazon.com, Inc., No. 2015-001-0017, 2015 Tenn.

LEXIS 13 (TN Wrk. Comp. App. Bd. May 14, 20 15), to support its position that the trial

court erred by ordering a new panel. Dorsey is easily distinguishable from the case

before us. In Dorsey the issue was whether the employee sustained an injury that

primarily arose out of and in the course and scope of her employment. Page one of the

DCN in Dorsey did not identifY medical benefits as a disputed issue in the case, and the

checklist of issues on page two of the DCN did not indicate that medical benefits or the

panel of physicians was disputed. Furthermore, the parties in Dorsey stipulated that the

physician panel provided to the employee was "proper" and "legally compliant."

Nonetheless, the trial court ordered that the employer provide a new panel of physicians.

We vacated the trial court's order for the new physician panel because (1) there was no

indication that the issue had been certified by the mediator on the DCN, and (2) the

parties stipulated that a legally complaint panel had been provided.

Tennessee Code Annotated section 50-6-239(c)(7) (2014) provides a presumption

that the findings and conclusions of the workers' compensation judge are correct, unless

the preponderance of the evidence is otherwise. We conclude from our review of the

record that the evidence does not preponderate against the trial court's decision to order

Employer to provide additional medical benefits to Employee.

Conclusion

For the foregoing reasons, we hold that the evidence does not preponderate against

the trial court's findings and decisions at this interlocutory stage of the proceedings.

Further, we find that the trial court's decision does not violate any of the standards set

forth in Tennessee Code Annotated section 50-6-217(a)(3). Accordingly, the trial court's

7

decision is affrrmed and the case is remanded for any further proceedings as may be

necessary.

~

Workers' Compensation Appeals Board

8

This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.

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