Opinion

Gumm, Sara v. Buffalo Wild Wings

  • 2015 TN WC 176
Court
Tennessee Court of Workers' Compensation Claims
Filed
Dec 4, 2015
Status
Published
On the bench
Lisa A. Knott
Cited by
0 cases
Authority
More cited than 12.4%

The opinion

IN THE COURT OF WORKERS' COMPENSATION CLAIMS

AT KNOXVILLE

SARA M. GUMM, ) Docket No.: 2015-03-0197

Employee, )

)

v. ) State File Number: 36951-2015

BUFFALO WILD WINGS, )

Employer, ) Judge Lisa A. Knott

)

And )

)

SEDGWICK CLAIMS )

MANAGEMENT SERVICES, )

Insurance Carrier. )

EXPEDITED HEARING ORDER GRANTING MEDICAL AND TEMPORARY

DISABILITY BENEFITS

(RECORD REVIEW)

This matter came before the undersigned Workers' Compensation Judge on the

Request for Expedited Hearing filed by the Employee, Sara Gumm, pursuant to

Tennessee Code Annotated section 50-6-239 (2014), and requested an on-the-record

determination of the issues set forth in the Dispute Certification Notice. The Employer,

Buffalo Wild Wings, did not request an in-person evidentiary hearing. This Court finds

that no additional information is needed to determine whether Ms. Gumm is likely to

prevail at a hearing on the merits of the claim. Accordingly, pursuant to Rule 0800-02-

21-.14(l)(c) (2015) of the Tennessee Compilation Rules and Regulations, the Court

decided the issues in this case upon a review of the written materials and without benefit

of an evidentiary hearing.

The present focus of this case is Ms. Gumm's left knee injury. The central legal

issue is whether Ms. Gumm is likely to prevail at a hearing on the merits that her left

knee injury arose primarily out of and in the course and scope of her employment, thus

entitling her to medical and temporary disability benefits. For the reasons set forth

below, the Court finds Ms. Gumm is likely to prevail at a hearing on the merits that her

left knee injury arose primarily out of and in the course of her employment, such that she

is entitled to medical and temporary disability benefits. 1

History of Claim

Ms. Gumm is an eighteen-year-old resident of Blount County, Tennessee. Buffalo

Wild Wings employed Ms. Gumm as a hostess. Ms. Gumm alleges that on May 5, 2015,

she slipped on ice and twisted her left knee. On May 6, 2015, Ms. Gumm presented to

Blount Memorial Hospital emergency room. The triage physician gave Ms. Gumm a

knee immobilizer and crutches and advised to weight bear as tolerated. Ms. Gumm

returned to Blount Memorial emergency room department on May 12, 2015, where she

was referred directly to Springbrook Occupational Therapy.

Dr. Bryan Thompson evaluated Ms. Gumm at Springbrook on May 14, 2015, for

ongoing left knee pain. He diagnosed Ms. Gumm with internal derangement, and

assigned restrictions of both walking and standing up to fifteen minutes per hour. Dr.

Thompson contacted Buffalo Wild Wings to advise that the diagnosis was not yet clear

and further testing would be necessary. Dr. Thompson referred Ms. Gumm back to Dr.

Michael Campbell because Dr. Campbell performed her previous left knee surgery.

Buffalo W·ild Wings provided a panel of physicians. (Ex. 8.) However, neither

party provided a signed copy indicating the selected physician. Dr. Brandon S. A bury 2

OrthoTennessee, evaluated Ms. Gumm on May 29, 2015. (Ex. 5.) He recommended an

MRI for consideration of an ACL tear, and restricted Ms. Gumm from working until her

follow-up appointment. !d. On June 17, 2015, Dr. Asbury reviewed the MRI results,

which demonstrated a patella contusion and no evidence of tears. Dr. Asbury opined:

I do believe that this is a new injury. She has no history of patellar

dislocation in the past so I do believe this is work-related. We will hold her

out of work approximately two further weeks, while we focus on therapy

and re-strengthening of the quadriceps. I do not think this is related to

chondromalacia of the patella, which actually had no evidence of this on

MRI today. !d.

It is unclear which treatment Ms. Gumm underwent and whether her work restrictions

continued post-June 17, 2015, because she did not provide any of Dr. Asbury's

subsequent records.

Ms. Gumm filed a Petition for Benefit Determination seeking temporary disability

and medical benefits. The parties did not resolve the disputed issues through mediation,

1

A complete listing of the technical record and exhibits admitted at the Expedited Hearing is attached to this Order

as an appendix.

2

The panel of physicians did not contain Dr. Asbury. It is unclear whether he was an authorized treating physician.

2

and the Mediating Specialist filed a Dispute Certification Notice. This matter was set for

a show cause hearing, wherein Ms. Gumm advised that she filed a Request for Expedited

Hearing for an on-the-record determination. The undersigned Judge explained to Ms.

Gumm that only the submitted medical records would be considered, and provided

Buffalo Wild Wings an opportunity to respond to the Request for Expedited Hearing.

Subsequently, Ms. Gumm contacted the Court and requested permission to submit

additional medical records. Court staff informed Ms. Gumm if she wanted to submit

additional records, this matter would need to be scheduled for an in-person evidentiary

hearing. On November 19, 2015, Ms. Gumm advised the Court that she would like to

proceed with the previously submitted information.

Based on a review of the record, Ms. Gumm asserts she sustained a work-related

knee injury for which she is entitled to medical and temporary disability benefits. (Ex.

1.) Buffalo Wild Wings countered that Ms. Gumm delayed reporting her injury and

seeking medical treatment. It further countered that the medical records do not state that

Ms. Gumm's injury arose primarily out of and in the course of her employment. (T.R. p.

10.)

Findings of Fact and Conclusions of Law

The Workers' Compensation Law shall not be remedially or liberally construed in

favor of either party but shall be construed fairly, impartially and in accordance with

basic principles of statutory construction favoring neither the employee nor

employer. Tenn. Code Ann. § 50-6-116 (2014). The employee in a workers'

compensation claim has the burden of proof on all essential elements of a claim. Tindall

v. Waring Park Ass 'n, 725 S.W.2d 935, 937 (Tenn. 1987); 3 Scott v. Integrity Staffing

Solutions, No. 2015-01-0055, 2015 TN Wrk. Comp. App. Bd. LEXIS 24, at *6 (Tenn.

Workers' Comp. App. Bd. Aug. 18, 2015). An employee need not prove every element

of his or her claim by a preponderance of the evidence in order to obtain relief at an

expedited hearing. McCord v. Advantage Human Resourcing, No. 2014-06-0063, 2015

TN Wrk. Comp. App. Bd. LEXIS 6, at *7-8, 9 (Tenn. Workers' Comp. App. Bd. Mar. 27,

20 15). At an expedited hearing, an employee has the burden to come forward with

sufficient evidence from which the trial court can determine that the employee is likely to

prevail at a hearing on the merits. !d.

Buffalo Wild Wings alleges Ms. Gumm delayed providing notice of a work-

related injury and seeking medical treatment. However, the First Report of Injury notes

3

The Tennessee Workers' Compensation Appeals Board allows reliance on precedent from the Tennessee Supreme

Court "unless it is evident that the Supreme Court's decision or rationale relied on a remedial interpretation of pre-

July I, 2014 statutes, that it relied on specific statutory language no longer contained in the Workers' Compensation

Law, and/or that it relied on an analysis that has since been addressed by the general assembly through statutory

amendments." McCord v. Advantage Human Resourcing, No. 2014-06-0063, 2015 TN Wrk. Comp. App. Bd.

LEXIS 6, at *13 n.4 (Tenn. Workers' Comp. App. Bd. Mar. 27, 2015).

3

that Ms. Gunn provided notice of her injury and sought medical treatment the day after

the injury. (Exs. 6, 3.) The Court finds Buffalo Wild Wings' allegations of delayed

notice and medical treatment without merit.

Buffalo Wild Wings further alleges that the medical records do not support

causation of a work-related injury. It provided the affidavit of General Manager, Kendra

Hawkins, which noted Ms. Hawkins saw Ms. Gumm bending, squatting, and walking

without any physical problem at the end of her shift on May 5, 2015. (Ex. 2.) Buffalo

Wild Wings asserts the discrepancies in Ms. Gumm's physical exams and her observable

movements point to some cause or worsening outside of her employment. (T.R. p. 10.)

However, Dr. Asbury opined, "I do believe that this is a new injury. She has no history

of patellar dislocation in the past so I do believe this is work-related." (Emphasis added.)

(Ex. 5.) Based on the foregoing, the Court finds that Ms. Gumm is likely to prevail at a

hearing on the merits that her left knee injury arose primarily out of and in the course of

her employment.

An employee is entitled to receive temporary total disability benefits pursuant to

Tennessee Code Annotated section 50-6-207(1) (2014) whenever the employee has

suffered a compensable, work-related injury that has rendered the employee unable to

work. See Simpson v. Satterfield, 564 S.W.2d 953 (Tenn. 1978). In order to establish a

prima facie case for temporary total disability benefits, the worker must show ( 1) that he

or she was totally disabled and unable to work due to a compensable injury, (2) that the

work injury and inability to work are causally connected, and (3) the duration of the

disability. Gray v. Cullom Mach., Tool & Die, Inc., 152 S.W.3d 439, 443 (Tenn. 2004).

On May 14, 2015, Dr. Thompson restricted Ms. Gumm from walking or standing

more than fifteen minutes per hour. Ms. Hawkins' affidavit asserts that Buffalo Wild

Wings was able to accommodate those restrictions. Ms. Gumm did not provide any

information or documentation to refute that assertion. On May 29, 2015, Dr. Asbury

opined that Ms. Gumm should be off work pending her follow-up visit, and on June 17,

2015, he opined that she should be off work until her follow-up visit on July 7, 2015.

(Ex. 5.) Ms. Gumm has established that she was unable to work as a result of the

compensable injury from May 29, 2015, until July 7, 2015. 4 As stated previously, Ms.

Gumm did not submit any post-June 17, 2015 medical records. Therefore, the Court is

unable to determine whether Ms. Gumm is entitled to any temporary disability benefits

beyond July 7, 2015.

Therefore, as a matter of law, Ms. Gumm has come forward with sufficient

evidence from which this Court concludes that she is likely to prevail at a hearing on the

merits. Her request for medical benefits and temporary disability benefits for the periods

4

Buffalo Wild Wings did not submit a wage statement but did reference in its response to the Expedited Hearing

that Ms. Gumm's wages qualify her for the minimum compensation rate of $127.20. Ms. Gumm did not provide

any evidence to the contrary.

4

set forth above is granted at this time.

IT IS, THEREFORE, ORDERED as follows:

1. Medical care for Ms. Gumm's injuries shall be paid, and Buffalo Wild Wings or

its workers' compensation carrier shall provide Ms. Gumm with medical treatment

for these injuries as required by Tennessee Code Annotated section 50-6-204

(2014).

2. The amount of temporary disability benefit is $127.20 per week.

3. Payment of past-due benefits in the amount of $672.34 shall be made for the

period from May 29, 2015, to July 7, 2015.

4. This matter is set for an Initial (Scheduling) Hearing on February I 0, 20 16 at 9:00

am CST/10:00 am EST.

5. Unless interlocutory appeal of the Expedited Hearing Order is filed, 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)

(2014). The Insurer or Self-Insured Employer must submit confirmation of

compliance with this Order to the Bureau by email to

WCCompliance.Program@tn .gov no later than the seventh business day after

entry of this Order. Failure to submit the necessary confirmation within the period

of compliance may result in a penalty assessment for non-compliance.

6. For questions regarding compliance, please contact the Workers' Compensation

Compliance Unit via email WCCompliance.Program@tn.gov or by calling (615)

253-1471 or (615) 532-1309.

ENTERED this the 4th day of December, 2015.

Judge Lisa A. Knott

Court of Workers' Compensation Claims

Initial (Scheduling) Hearing:

An Initial (Scheduling) Hearing has been set with Judge Lisa A. Knott, Court of

Workers' Compensation Claims. You must call 865-594-0109 or toll-free at 855-

383-0003 to participate in the Initial Hearing.

5

Please Note: You must call in on the scheduled date/time to

participate. Failure to call in may result in a determination of the issues without

your further participation.

Right to App al:

Tennessee Law allows any party who disagrees with this Expedited Hearing Order

to appeal the decision to the Workers' Compensation Appeals Board. To file a Notice of

Appeal, you must:

1. Complete the enclosed form entitled: "Expedited Hearing Notice of Appeal."

2. File the completed form with the Court Clerk within seven business days of the

date the Workers' Compensation Judge entered the Expedited Hearing Order.

3. Serve a copy of the Expedited Hearing Notice of Appeal upon the opposing party.

4. The appealing party is responsible for payment of a filing fee in the amount of

$75.00. Within ten calendar days after the filing of a notice of appeal, payment

must be received by check, money order, or credit card payment. Payments can be

made in person at any Bureau office or by United States mail, hand-delivery, or

other delivery service. In the alternative, the appealing party may file an Affidavit

of Indigency, on a form prescribed by the Bureau, seeking a waiver of the filing

fee. The Affidavit of Indigency may be filed contemporaneously with the Notice

of Appeal or must be filed within ten calendar days thereafter. The Appeals Board

will consider the Affidavit of lndigency and issue an Order granting or denying

the request for a waiver of the filing fee as soon thereafter as is

practicable. Failure to timely pay the filing fee or file the Affidavit of

lndigency in accordance with this section shall result in dismissal of the

appeal.

5. The parties, having the responsibility of ensuring a complete record on appeal,

may request, from the Court Clerk, the audio recording of the hearing for the

purpose of having a transcript prepared by a licensed court reporter and filing it

with the Court Clerk within ten calendar days of the filing of the Expedited

Hearing Notice of Appeal. Alternatively, the parties may file a joint statement of

the evidence within ten calendar days of the filing of the Expedited Hearing

Notice of Appeal. The statement of the evidence must convey a complete and

accurate account of what transpired in the Court of Workers' Compensation

Claims and must be approved by the workers' compensation judge before the

record is submitted to the Clerk of the Appeals Board.

6

6. If the appellant elects to file a position statement in support of the interlocutory

appeal, the appellant shall file such position statement with the Court Clerk within

five business days of the expiration of the time to file a transcript or statement of

the evidence, specifying the issues presented for review and including any

argument in support thereof. A party opposing the appeal shall file a response, if

any, with the Court Clerk within three business days of the filing ofthe appellant's

position statement. All position statements pertaining to an appeal of an

interlocutory order should include: (1) a statement summarizing the facts of the

case from the evidence admitted during the expedited hearing; (2) a statement

summarizing the disposition of the case as a result of the expedited hearing; (3) a

statement of the issue(s) presented for review; and (4) an argument, citing

appropriate statutes, case law, or other authority.

7

APPENDIX

Exhibits:

• EXHIBIT 1: Affidavit of Sara Gumm

• EXHIBIT 2: Affidavit of Kendra Hawkins

• EXHIBIT 3: Medical Records of Blount Memorial Hospital

• EXHIBIT 4: Medical Record ofBMH Occupational Health Center

• EXHIBIT 5: Medical Records ofOrthoTennessee

• EXHIBIT 6: First Report of Work Injury, for date of injury of May 5, 2015

• EXHIBIT 7: Sedgwick Correspondence to Dr. Asbury regarding Causation, dated

June 5, 2015

• EXHIBIT 8: Panel ofPhysicians, Form C42, for date of injury of May 5, 2015

Technical record: 5

Petition for Benefit Determination

Dispute Certification Notice

Show Cause Order

Request for Expedited Hearing

Response of Employer & Insurer to Employee's Request for Expedited Hearing

5

The Court did not consider attachments to Technical Record filings unless admitted into evidence during the

Expedited Hearing. The Court considered factual statements in these filings or any attachments to them as

allegations unless established by the evidence.

8

CERTIFICATE OF SERVICE

I hereby certify that a true and correct copy of the Expedited Hearing Order was

sent to the following recipients by the following methods of service on this the 4th day of

December, 2015.

Name Certified Via Via Service sent to:

Mail Fax Email

Sara M. Gumm, X X 3488 Pearly Smith Road

Employee Louisville, TN 3 7777

Jaimawb ite 1024(li2gmaiI. com

James V. Thompson, X jthomQson@raineykizer .com

Esq.

Employer's Counsel

Penny Shrum, Clerk of Court

Court of Workers' Compensation Claims

WC.CourtCierk@tn.gov

9

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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