Opinion

Johnson, Kyle v. Stanley Black & Decker, Inc.

  • 2015 TN WC 181
Court
Tennessee Court of Workers' Compensation Claims
Filed
Dec 11, 2015
Status
Published
On the bench
Audrey A. Headrick
Cited by
0 cases
Authority
More cited than 12.4%

The opinion

IN THE COURT OF WORKERS' COMPENSATION CLAIMS

AT CHATTANOOGA

Kyle Johnson ) Docket No.: 2015-01-0148

Employee, )

v. ) State File Number: 6636-2015

Stanley Black & Decker, Inc. )

Employer, ) Judge Audrey A. Headrick

And )

The Hartford )

Insurance Carrier. )

)

EXPEDITED HEARING ORDER DENYING

REQUESTED BENEFITS

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

Request for Expedited Hearing filed by the Employee, Kyle Johnson, on September 11,

2015. The central legal issue is whether Mr. Johnson sustained an injury arising

primarily out of and in the course and scope of employment. Based on the evidence

before it at this time, the Court finds Mr. Johnson is unlikely to prevail at a hearing on the

merits in proving compensability at a Compensation Hearing cmd denies his request for

temporary disability and medical benefits. 1

History of Claim

Mr. Johnson is a thirty-five-year-old resident of Whitfield County, Georgia. (T.R.

2

1.) He worked at Stanley as an installation technician and systems integrator. Id. Mr.

Johnson seeks medical and temporary disability benefits for a low back injury that

allegedly occurred on January 20, 2015, while loading a piece of equipment into a truck.

!d.

Mr. Johnson testified he drove a company van that he kept at home. He had a

company card to use for business expenditures and a Fleet card to purchase fuel. Mr.

Johnson began working for Stanley in February 2014. From October 2014 through

1

A complete listin'g of the technical record and exhibits is attached to this Order as an appendix.

2

Mr. Johnson testified he installed security systems on residential and commercial properties.

1

January 2015, Mr. Johnson testified his company van required repair approximately

seven to nine times by Mountain View Chevrolet. Stanley rented a Ford F350 one-ton

dually from Enterprise Rent-A-Car for Mr. ·Johnson's use during the times his company

van was in the shop. Mr. Johnson testified he facilitated getting the company van to

Mountain View and picking up the rental truck at Enterprise, which is located right down

the road from Mountain View.

Due to Mr. Johnson unloading his tools from the company van and loading his

tools onto the rental truck, Stanley purchased weatherproof job boxes for him to use to

make the transition easier. Mr. Johnson testified he initially transitioned his tools in the

parking lot at Mountain View. However, since it took him a little over three hours to

transfer his tools in the parking lot, Mr. Johnson testified someone at Mountain View

asked him to make other arrangements and do the transition elsewhere. (Ex. 1.) Mr.

Johnson testified Doug Welch, his supervisor, told him he could do the tool transition at

his home. !d. He stated doing the tool transition at his home took no more than an hour.

However, in Mr. Johnson's transcribed, recorded statement taken on or about January 29,

2015, he stated, in part, "it doesn't take more than ten minutes for me to load my tools up,

ifeventhat." (Ex.1, 1-Cat 16.)

On Friday, January 16, 2015, Mr. Johnson testified he did not work. He testified

he could not recall what he did on January 16, 2015, through January 18, 2015, when he

was off work. On Monday, January 19, 2015, Mr. Johnson testified he did not work

because he and his kids were sick. On Tuesday, January 20, 2015, Mr. Johnson testified

he got up that morning and went out to the rental truck to load the tools into his truck. As

he loaded the job boxes and picked one up at waist-height, he heard or felt a pop and

experienced severe pain in his back down into his right leg. He stated he dropped the box

and got his wife, Christina Johnson, who helped finish loading the truck. On cross-

examination, Mr. Johnson testified Mrs. Johnson could lift 100-pound storage boxes.

After loading the truck, Mr. Johnson testified he drove to his office. On his way,

Mr. Johnson spoke with his wife, who insisted he tell Mr. Welch about the incident. Mr.

Johnson testified he went to Mr. Welch's office and told him what happened to his back.

He stated Mr. Johnson kept talking about jobs in the forecast and acted as if he had not

said anything. Mr. Johnson. testified he took Aleve and worked that day and the

following day. He stated he took Thursday off due to his kids being sick.

Mr. Johnson testified a co-worker, Kevin Masticola, worked with him one to one

and a half days that week. He stated he did not make any complaints to Mr. Masticola

about his back. In the affidavit of Mr. Masticola, he stated he worked with Mr. Johnson

between January 20, 2015, and January 23, 2015. (Ex. 7.) Mr. Masticola testified Mr.

Johnson "performed strenuous work during that time and showed no signs of discomfort

while doing so."

2

Mrs. Johnson also testified on behalf of Mr. Johnson. She testified that on the

morning of January 20, 2015, Mr. Johnson came inside their house and complained of

pain from lifting boxes. Although Mrs. Johnson stated she does not remember lifting the

boxes, she testified she went outside and helped her husband load the truck. She also

testified she helped him up the steps on the way back into their house. Mrs. Johnson

stated that Mr. Johnson called her on his way to work, and she told him to report the

injury to Mr. Welch. She testified he called her as he went to a jobsite and was upset

because he felt like Mr. Welch did not care about his injury.

On cross-examination, Mrs. Johnson did not recall what Mr. Johnson did during

the four days he was off from work prior to January 20, 2015. Mrs. Johnson testified she

did not think Mr. Johnson worked on January 19, 2015, because either he or the kids

were sick. Mrs. Johnson also testified she did not remember why Mr. Johnson was off

from work on Thursday, January 22, 2015. She acknowledged she did not see the injury

happen. Mrs. Johnson testified she guided Mr. Johnson up the steps on the way into their

house. She also testified Mr. Johnson's injury was obvious to her because he had a hard

time getting around and limped some.

The parties stipulated that Friday, January 23, 2015, was Mr. Johnson's last day to

work for Stanley. At 4:05 p.m. on January 23, 2015, Mr. Johnson saw his personal

physician, Dr. John Harris. (See generally Ex. 3.) He gave a history of "lifting tool

boxes into his truck for work and felt acute pain in R lower back, associated with

shooting pain down the posterolateral R leg, all the way to the foot." Mr. Johnson stated

the incident occurred five days prior. He also advised he had no improvement, although

he took "muscle relaxers and anti-inflammator!es he had left over from previous injury."

Dr. Harris diagnosed Mr. Johnson with acute sciatica and lumbar muscle spasms. He

also prescribed medication for pain and inflammation and ordered physical therapy. Dr.

Johnson "instructed [Mr. Johnson] to check with his employer to determine his next step

for treatment under their workman's comp. policies. Specifically, if he needs to see their

work. comp. physician, or if his treatment will be left to me to complete." During cross-

examination, Mr. Johnson acknowledged he made a mistake when he told Dr. Harris that

his injury occurred five days prior since it was a Sunday.

On Saturday, January 24, 2015, Mr. Johnson sent an e-mail to Mr. Welch. (Ex. 1,

1-A.) In the e-mail, he stated the following:

I finally gave in yesterday afternoon and had to go see my doctor about my

back. I am hurting bad enough that it hurts to walk. After him seeing me

he has started treatment but has referred me to physical therapist to see how

extensive it is. Since this happened at work from lifting those dang tool

boxes in and out of this rental truck my doctor told me to go ahead and

inform you since there may be a process that I need to follow.

3

Approximately four-and-a-half hours later, Mr. Welch responded to Mr. Johnson's

e-mail. Id. Mr. Welch testified he first learned Mr. Johnson was alleging a work-related

back injury when he received Mr. Johnson's e-mail. In his response to Mr. Johnson's e-

mail, he stated, in pertinent part, as follows:

When and where did this happen?

Please plan on taking Monday off but call me around 9:00 a.m. so we can

call HR and see what the next steps are to document this and what the

appropriate actions are we need to follow. Given the situation, I think it

wise to have a release from your doctor before returning to work.

Given the e-mail, I'm assuming you haven't called the number on our

Clinical Infonnation Wallcard? (attached) Copies ofthese are on the front

table in the conference room. At this point, not sure if it's necessary to call

them today since you've seen your own doctor but in the future we need to

call these folks when any incident happens that you may need medical

attention for.

Mr. Johnson replied to Mr. Welch's question by e-mail. He stated:

It happened when I was loading the tool boxes back into the truck Tuesday

morning from where they thought my van was ready again lol. Doug I'm

really sorry I'm not trying to cause any issues or complications and

definitely don't want to jeopardize my job (lol I'm wanting my new van

lol), honestly though it's all I can do to walk around at this point.

Mr. Johnson testified he called the number on the poster Mr. Welch attached to his e-

mail. He stated he spoke to a nurse, who advised him to follow his doctor's orders.

On Monday, January 26, 2015, Mr. Johnson testified he spoke with Mr. Welch on

the telephone about needing to start a claim. He stated Mr. Welch told him he wanted

Mr. Johnson's tools back, his rental truck returned, and his laptop. Mr. Johnson stated he

had the call on speakerphone, and his wife heard Mr. Welch tell him his job was most

likely over.

On Thursday, January 29, 2015, Mr. Johnson provided a recorded statement to

Rita Reeder, an adjuster for Stanley's insurer, the Hmtford. (Ex. 1, 1-B.) In his

statement, Mr. Johnson described the incident as happening between 7:30 and 8:00 a.m.

on January 20, 2015. Jd. at 6. Mr. Johnson provided the following description of the

incident to Ms. Reeder:

4

And I was lifting, I was loading my tools into the pickup truck to get ready

to head to the office because the week before previously they said that my

van was ready for repair, re-, ready and done with the repairs. So I had off-

loaded all of those tools, and then on, needless to say when I got my, went

to get my van they didn't have it properly fixed. It's, the blinkers didn't

work and stuff so we left it at the dealership. Well, Tuesday morning when

I was loading up my tools, because I was off Monday 'cuz I had a sick

child. Uh, I was loading my tools up and I lifted, I was lifting, what we

have is called portable job boxes. They're roughly 48 inches long by 36

inches wide by 36 inches deep, square, and I was lifting one of those up to

put it into the back of the truck so that I would have all my equipment and

tools with me to head to the office to start the job that day, and when I

picked it up, I, uh, set it in the back of the truck, and I don't know if I, like,

as far as a pop or anything, I don't know, I just know instantly I had sharp

pain running down my leg and up into my back. And it, at that p-, it, I

mean, it hurt. I, when I went to turn around to take a step and everything I

was just, every time I would put weight on my leg, at that very instant I

started having sharp pains running down my leg really bad. And that's

when it, that's when it, it had occurred.

!d. at 7.

Additionally, Mr. Johnson told Ms. Reeder he had never injured his back prior to January

20, 2015. !d. at 9-10. When the initial recorded statement concluded, Ms. Reeder

advised Mr. Johnson she would contact him after she spoke with his employer. !d. at 22.

When Ms. Reeder contacted Mr. Johnson to complete his recorded statement, Mr.

Johnson volunteered to her that he had "CCTV evidence of when [the accident]

happened." 3 (Ex. 1, 1-C at 1.) Mr. Johnson told Ms. Reeder he had cameras ·on his house

to watch his children outside. !d. at 3. He stated if he could not download the video

footage he would "shut the whole DVR down just to save the hard drive, to where ifl end

up in court, I have it" !d. at 2-3. However, during cross-examination, Mr. Johnson

acknowledged he was unable to download the video footage.

In his second recorded statement, Ms. Reeder asked Mr. Johnson if he reported to

Mr. Welch a week and a half prior to January 20, 2015, that his back was hurting after he

stepped off a ladder. !d. at 10. Mr. Johnson stated Mr. Welch asked him if he needed to

go to a doctor, and he told him he would go if his back kept hurting. !d. Ms. Reeder

stated Mr. Welch told her Mr. Johnson "declined medical treatment; that [he] indicated ..

. that, that [Mr. Johnson had] lived with this for a long time." !d. at 11. Mr. Johnson

3

The date Ms. Reeder took the second recorded statement is unclear. However, it appears she took the second

statement either the following day or one day shmtly thereafter.

5

stated there was "no medical evidence of any back injuries at all." !d. at 12. He stated he

saw his doctor on the same day he stepped off the ladder, and the doctor diagnosed him

with a pulled muscle. !d.

Mr. Welch testified Mr. Johnson did not actually report a work-related injury

involving the ladder. Instead, he testified he questioned Mr. Johnson after seeing him

leaning back with his hand on his back. He testified Mr. Johnson told him he "tweaked"

his back when he stepped off a ladder. However, although Mr. Welch stated he asked

Mr. Johnson twice if he needed to go to the doctor, Mr. Johnson told him he dealt with a

back injury from a long time ago. Since Mr. Johnson related his back pain to an old

injury, Mr. Welch testified he did not tum in a claim.

The medical records reflect that Mr. Johnson continued to treat with Dr. Harris.

(Ex. 3.) Mr. Johnson underwent a lumbar MRI on February 25, 2015. !d. After

receiving the MRI results, Dr. Harris referred Mr. Johnson to see an orthopedic

physician. !d. Mr. Johnson saw Dr. Scott Hodges on March 24, 2015, for treatment of

his "moderate to large right paracentral disc extrusion at L4 L5 causing moderate right

paracentral canal stenosis and right L5 nerve root impingement." (Ex. 4.) Dr. Hodges

recommended an urgent, right lumbar microdiscectomy. !d. On March 24, 2015, Dr.

Hodges stated that Mr. Johnson stated his employer terminated him on March 23, 2015.

!d. As of the hearing date, Mr. Johnson has not had surgery performed.

During the hearing, Mr. Johnson testified about his termination from Stanley due

to expenses on his business card. He stated that Stanley's corporate office performed an

audit of his expenses one to two months after his injury. The auditors contacted Mr.

Johnson by telephone and told him they were looking at his credit card usage. Mr.

Johnson testified he disclosed to the auditors one expense that was not work-related that

occurred on January 26, 2015. He stated he and his wife went to Harbor Freight to buy

an engine hoist because he works on cars at home, and his wife took his wallet into the

store and used his company credit card. Mr. Johnson stated his personal credit card looks

similar to his company credit card. He testified he did not think he made any other

personal purchases on the company credit card.

Mr. Welch, Mr. Johnson's supervisor, testified Mr. Johnson also charged a

backpack that came with a free accessory grill kit to his company credit card on January

23, 2015, which was not work-related. He also testified there were two to three

purchases made at Walmart by Mr. Johnson on the company credit card over the

weekend. Mr. Welch stated the company credit card is not for personal use. He also

stated the only reimbursement mechanism in place at Stanley is for when an employee

makes an out-of-pocket business expenditure and submits the receipt.

When asked during cross-examination if he ever used the Fleet card for personal

use, Mr. Johnson testified he had not. However, Mr. Welch testified Mr. Johnson drove a

6

diesel rental truck in December 20 14 and January 2015. During that time, Mr. Johnson

made seven purchases of gasoline on the Fleet card. Mr. Welch testified Mr. Johnson

made some of the gasoline charges on the same day, and some ofthe charges were on the

weekend.

Regarding the toolbox purchased by Stanley, Mr. Welch testified he authorized the

purchase of one toolbox. He did not know Mr. Johnson was unloading the tools or

leaving them at his house. Instead, Mr. Welch testified it is a common practice to load

and unload from a company van to a rental truck because the dealership has plenty of

room in its parking lot. Regarding Mr. Johnson's company van being in the shop, Mr.

Welch testified the service manager at Mountain View told him the plug wire had been

ripped off, and it look like it had been manually ripped out.

Mr. Welch also testified regarding the company tools that Mr. Johnson provided to

him. During March 2014 through January 2015, Mr. Johnson spent $13,178 on the

company credit card. However, Mr. Johnson only returned a minimal amount of

equipment, as demonstrated by the photograph he took of the equipment. (Ex. 11.)

Although Mr. Welch testified Mr. Johnson also shipped a few pipe benders to Nicole

Ringrose with Stanley, he testified he previously authorized Mr. Johnson to purchase

many more items.

Mr. Johnson also testified regarding his application and receipt of short-term and

long-term disability benefits through Stanley's employer-funded disability plan. He

stated he applied on the Cigna website. ·Mr. Stanley initially testified he answered "no''

on the disability form regarding whether the condition was work-related. However, he

then testified he applied, checked it was work-related, disability benefits were declined,

and appealed to Cigna. Mr. Stanley acknowledged he made a mistake in his previous

testimony.

Mr. Johnson filed a Petition for Benefit Determination seeking temporary

disability benefits. (T.R. 1.) The parties did not resolve the disputed issues through

mediation, and the Mediating Specialist filed a Dispute Certification Notice on July 30,

2015. (T.R. 2.) Mr. Johnson filed a Request for Expedited Hearing on September 11,

2015. (T.R. 3.) This Court heard the matter on November 10, 2015.

Mr. Johnson asks the Court to order medical benefits and temporary disability

benefits. Stanley asks the Court to deny Mr. Johnson's claim based upon Mr. Johnson's

lack of credibility. The parties stipulate that Tennessee has jurisdiction over Mr.

Johnson's claim for his alleged injury of January 20, 2015.

7

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); 4 Scott v. Integrity Staffing

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

Workers' Camp. 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. Camp. App. Bd. LEXIS 6, at *7-8, 9 (Tenn. Workers' Camp. 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.

Mr. Johnson Failed to Demonstrate a Likelihood of Success on the Merits at Trial

The Court finds that Mr. Johnson failed to demonstrate a likelihood of success on

the merits at trial. The pivotal issue of whether Mr. Johnson sustained a compensable

injury turns on his credibility. Mr. Johnson's expedited hearing lasted approximately

four hours. The Court had ample time and opportunity to observe Mr. Johnson's manner

and demeanor. As recited above, there were multiple inconsistencies in Mr. Johnson's

testimony. The inconsistencies ranged from matters of importance to matters that would

otherwise be inconsequential. For example, there were inconsistencies regarding Mr.

Johnson's testimony of how long it took him to perform the tool transitions. During his

transcribed, recorded statement taken on or about January 29, 2015, Mr. Johnson stated,

"it doesn't take more than ten minutes for me to load my tools up, if even that." (Ex. 1,

1-C, 16.) At the expedited hearing, Mr. Johnson testified it took him no more than an

hour to load up his tools.

More importantly, the unrebutted testimony of Mr. Welch, Mr. Johnson's

supervisor, was that Mr. Johnson made multiple, unauthorized expenditures on the

company credit card and Fleet card between December 2014 and January 2015. During

the months of December 2014 and January 2015, Mr. Johnson purchased gas numerous

times with his Fleet card during the period of time he drove a diesel rental truck. Mr.

4

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).

g.

Johnson made some of the gas purchases on the same day. Once auditors with Stanley's

corporate office contacted him, Mr. Johnson acknowledged he purchased an engine hoist

on his company credit card sometime after January 20, 2015. Mr. Welch also testified

Mr. Johnson used the company credit card on January 23, 2015, to purchase a backpack

that came with a free accessory grill kit. He further testified Mr. Johnson made two to

three purchases at Walmart using the company credit card.

When considering the totality of all of the evidence introduced at the expedited

hearing in this matter, the Court finds substantial doubt exists regarding whether Mr.

Johnson sustained a work-related back injury on Tuesday, January 20, 2015. The

testimony showed that Mr. Johnson did not work from Friday, January 16, 2015, through

Monday, January 19, 2015. Neither Mr. Johnson nor his wife could recall what Mr.

Johnson did during that time. Mr. Johnson alleged he injured his back at home on

Tuesday, January 20, 2015, while loading toolboxes into his rental truck at home and

reported the incident to Mr. Welch that morning. He worked on January 21, 2015. Mr.

Johnson did not work on Thursday, January 22, 2015.

On Friday, January 23, 2015, Mr. Johnson saw Dr. Harris and alleged he injured

his back while lifting toolboxes into his truck for work five days prior. If Mr. Johnson

injured his back five days prior, it happened on Sunday, January 18, 2015, when he was

off work. Given the many discrepancies in Mr. Johnson's testimony, as well as the

unrebutted testimony of his supervisor, Mr. Welch, the Court does not believe that Mr.

Johnson simply made a mistake regarding his date of injury when he saw Dr. Harris on

Friday, January 23, 2015. Further, the Court finds Mr. Johnson's testimony that he

cannot recall what he did between Friday, January 16, 2015, and Monday, January 19,

2015, to be a self-serving explanation.

When considering Mr. Johnson's credibility, the Court also finds it disturbing that

during the time he alleged he sustained a work-related injury and e-mailed notice of his

alleged injury to Mr. Welch, he was simultaneously acting in a dishonest manner by

using his company credit card to make personal expenditures. On the same day that he

saw Dr. Harris, Mr. Johnson purchased a backpack that came with a free accessory grill

kit with the company credit card. On Monday, January 26, 2015, Mr. Johnson purchased

an engine hoist at Harbor Freight to work on cars at his home.

Simply put, the evidence introduced at the expedited hearing convinces the Court

that Mr. Johnson did not injure his back on January 20, 2015, while loading toolboxes

into his rental truck for work. Even prior to the Refonn Act of 2013, the liberal

construction mandate for the Workers' Compensation Law did not require a court to

disregard "discrepancies in an employee's testimony and other evidence which tends to

disprove an employee's claim." Kenney v. Shiroki North America, Inc., No. M2009-

02484-WC-R3-WC, 2011 Tenn. LEXIS 182, at *13-*14 (Tenn. Workers' Comp. Panel

Feb. 28, 2011). The Reform Act of 2013 removed the liberal construction previously

9

given to employees. After considering all of the testimony in this case, the Court finds

Mr. Johnson did not sustain a compensable injury on January 20, 2015. Therefore, Mr.

Johnson has not demonstrated that he is likely to prevail at a hearing on the merits.

IT IS, THEREFORE ORDERED:

1. Mr. Johnson's requested relief is denied.

2. This matter is set for an Initial (Scheduling) Hearing on January 12, 2016, at 10:00

a.m. Eastern Time.

ENTERED this the 11th day of December, 2015.

~ i.Headrick

Court of Workers' Compensation Claims

Initial (Scheduling) Hearing:

A Scheduling Hearing has been set on January 12, 2016, at 10:00 a.m. Eastern

Time, with Judge Audrey A. Headrick, Court of Workers' Compensation Claims.

You must call 423-634-0164 or toll free at 855-383:.0001 to participate in the Initial

Hearing.

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 Appeal:

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.

10

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 Indigency 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

Indigency in acco-rdance 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. 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 five business days of the filing of the 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.

11

APPENDIX

Exhibits:

1. Affidavit of Kyle Johnson

2. Affidavit of Kristina Johnson

3. Medical records of Dr. John Harris

4. Medical records of Dr. Scott Hodges

5. Dr. Hodges' responses dated April24, 2015

6. Affidavit of Doug Welch

7. Affidavit of Kevin Masticola

8. Time card ofMr. Johnson, January 11, 2015, through January 24,2015

9. Wage Statement

10. Clinical consultation form

11. Photographs of tools

Technical record: 5

1. Petition for Benefit Determination, June 19, 2015

2. Dispute Certification Notice, July 30, 2015

3. Request for Expedited Hearing, September 11, 2015

4. Response to Request for Expedited Hearing and Request for Evidentiary Hearing,

September 18, 2015

5. Notice of Scheduled Hearing, October 7, 2015

6. Memorandum in Suppm1 of Employee's Petition for Medical and Temporary

Disability Benefits, October 26; 2015

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.

12

CERTIFICATE OF SERVICE

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

Denying the Requested Benefits was sent to th~ following recipients by the following

methods of service on this the 11th day of December, 2015.

Name Certified First Via Fax Via EmaiVMail Address

Mail Class Fax Number Email

Mail

Josh Ward, Esq. X _iosh(ti.}massevattornevs.com

David Riley, Esq. X drilev(a)!!Wtclaw .com

Penny Shrum, Clerk of Court

Court of Workers' Compensation Claims

WC.CourtClerk@tn. gov

13

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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