Opinion

Travis, Fred v. Carter Express, Inc.

  • 2019 TN WC 43
Court
Tennessee Court of Workers' Compensation Claims
Filed
Mar 13, 2019
Status
Published
On the bench
Pamela Johnson
Cited by
0 cases

The opinion

FILED

Mar 13, 2019

01:53 PM(ET)

TENNESSEE COURT OF

WORKERS' COMPENSATION

CLAIMS

TENNESSEE BUREAU OF WORKERS’ COMPENSATION

IN THE COURT OF WORKERS’ COMPENSATION CLAIMS

AT KNOXVILLE

FRED TRAVIS, II, ) Docket No. 2018-03-0237

Employee, )

V. )

CARTER EXPRESS, INC., ) State File No. 14934-2018

Employer, )

And )

PROTECTIVE INSURANCE ) Judge Pamela B. Johnson

COMPANY, )

Carrier. )

REMAND EXPEDITED HEARING ORDER GRANTING ATTORNEY’S FEES

UNDER TENNESSEE CODE ANNOTATED SECTION 50-6-226(d)(1)(B)

This matter came before the Court on February 28, 2019, on remand from the

Workers’ Compensation Appeals Board. Following an Expedited Hearing, this Court

concluded that Mr. Travis was entitled to recover attorney’s fees under Tennessee Code

Annotated section 50-6-226(d)(1)(b) (2018). Carter appealed, and the Workers’

Compensation Appeals Board vacated the award of attorney’s fees and remanded the case

for consideration of this issue within the framework in Thompson v. Comcast Corp. The

Court grants Mr. Travis’s request.

History of Claim

The relevant facts are contained in the Expedited Hearing Order’ and Appeals Board

Opinion” and are incorporated as if set forth below. For context, Mr. Travis, a Tennessee

resident, injured his right shoulder while working for Carter. He testified that he first

injured his left shoulder on the evening of November 2, 2017, while cranking the tractor’s

landing gear. At his first delivery stop on the morning of November 3, he experienced a

sharp pain in his right shoulder when he pushed on the trailer’s swing doors and while

' Travis v. Carter Express, Inc., No. 2018-03-0237, 2018 TN Wrk. Comp. LEXIS (Sept. 6, 2018).

? Travis v. Carter Express, Inc., 2018 TN Wrk. Comp. App. Bd. LEXIS 67 (Dec. 21, 2018).

]

strapping/unstrapping the cargo. At the next stop, he felt increased pain with pinning the

swing door back and while climbing into the tractor.

The next day, Mr. Travis informed his driver manager that he hurt his shoulder at

work and needed medical treatment. That same day, he went to Fast Pace Urgent Care

Clinic and stated that he was “not sure what he has done, yesterday notice[d] tightness in

[right] shoulder.” He reported that he drove an eighteen-wheeler and related his

complaints to getting in and out of the truck or loading it. In his injury report, he noted

his injury occurred on November 3 at 10:00 a.m. and caused by “normal job duty” such

as “climbing into truck or trailer,” “entering or exiting truck or trailer,” or “tightening

straps.”

He ultimately came under the care of Dr. Sean Grace, who noted, “[D]uring the

course of his work as a truck driver he was lifting the trailer door in the back and felt

sharp pain his upper arm and shoulder area.” Dr. Grace recommended an MR

arthrogram, but Carter denied the claim before it was administered. Despite Carter’s

denial of treatment, Mr. Travis returned to Dr. Grace, who confirmed that his right-

shoulder injury was directly related to the work incident and indicated he would likely

benefit from surgery.

Carter denied Mr. Travis’s claim, arguing his description of injury varied between

his injury reports, medical records, affidavit, and testimony. It also asserted that

Tennessee has no jurisdiction, introducing an agreement signed by Mr. Travis at the time

of hire in which he agreed that all claims would be governed by the Indiana Workers’

Compensation Act.

In its Expedited Hearing Order, the Court held Mr. Travis presented sufficient

evidence that he would likely to prevail at a hearing on the merits in proving that:

* Carter filed Mr. Travis’s claim with the Workers’ Compensation Board of Indiana. It gave notice to

Indiana of its inability to determine liability and requested additional time on two separate occasions. On

November 17, 2017, Carter noted it was “trying to determine compensability, claimant does not know

how he strained his shoulder.” On December 4, 2017, Carter explained it was “REQUESTING

MEDICAL INFORMATION FROM THE PROVIDER SO WE CAN_ DETERMINE

COMPENSABILITY.” (Emphasis in original).

‘ The parties introduced three reports of injury. The Indiana First Report of Employee Injury, prepared by

Carter Safety Director Rick Wisener, noted a November 3, 2017 injury date at 10:00 a.m. and an

unknown cause of injury to the right shoulder. The IAIBC First Report of Injury, prepared by Claims

Adjuster Amy Miller, noted a November 3, 2017 injury date at 10:00 a.m. and indicated, “CLMT WAS

EITHER ENTERING AND EXITING TRUCK AN SPRAINED RIGHT SHOULDER. UNKN

DETAILS.” (Emphasis in original). The Employee’s Report of Injury, prepared by Mr. Travis, also

noted a November 3, 2017 injury date at 10:00 a.m. and indicated injury caused by “normal job duty”

while he was “climbing into truck or trailer,” or “entering or exiting truck or trailer, or tightening straps.”

2

1) Carter’s forum-selection clause was unenforceable and he was entitled to seek

benefits under Tennessee law.

2) He suffered an injury caused by a specific incident, or set of incidents, identifiable

by time and place of occurrence.

3) His injury arose primarily out of and in the course and scope of his employment

and caused the need for medical treatment.

4) He is entitled to medical and temporary partial disability benefits.

5) Carter wrongfully failed to timely initiate benefits that it owed, and its failure to

timely initiate benefits justified an award of attorney’s fees and costs at this

interlocutory stage under section 50-6-226(d)(b)(1).

On appeal, the Appeals Board affirmed this Court’s conclusions on all counts

except as to the award of attorney’s fees and costs. The Appeals Board concluded this

Court failed to consider whether this case falls within the limited circumstances

supporting an award of attorneys’ fees and costs at an interlocutory stage. It therefore

vacated that part of the Expedited Hearing Order and remanded for further consideration.

On remand, the parties appeared before the Court on January 4, 2019. Upon their

agreement, the Court set Mr. Travis’ deadline to file his fee petition and brief on January

25, Carter’s deadline to file its responsive brief on February 22, and the hearing date on

February 28. Before the deadline to file and again during the hearing, Carter moved for a

continuance, which the Court denied.

Mr. Travis’s Request for Attorney’s Fees

Mr. Travis argued that this is an appropriate case for awarding attorney’s fees and

costs at the interlocutory stage. Following an Expedited Hearing, this Court ruled that

Carter’s failure and refusal to timely initiate benefits was incorrect. The Appeals Board

affirmed. He asserted this case falls within the extremely limited circumstances

identified by the Appeals Board.

Concerning the uncertainties inherent in litigation, Mr. Travis argued no

uncertainties exist in this case concerning the Indiana forum-selection clause, as it was

not enforceable when signed and that will not change with the passage of time.

Addressing the limited issues typically addressed at Expedited Hearings, section

50-6-239(d)(1) authorizes the Court to determine issues concerning the provision of

temporary disability and medical benefits, and section 50-6-226(d)(1)(B) authorizes the

Court to award costs and fees on finding that these benefits were owed.

Considering that discovery and medical proof is often incomplete, Mr. Travis

submitted proof from Fast Pace and Dr. Grace that substantiated a right-shoulder injury

caused by work. Carter focused on Mr. Travis’s purported inability to identify a specific

3

incident, but it ignored section 50-6-102(14), which defines accidental injury as one

caused by a specific incident, or set of incidents, arising primarily out of and in the course

and scope of employment. These findings are unlikely to change with additional

discovery or medical proof.

Regarding the standard of proof, Mr. Travis asserted Carter denied his claim on an

election of remedies/forum-selection clause and inability to identify a specific incident,

ignoring that he reported a set of incidents. The Court’s findings on these issues were

based on an interpretation of the law, not on how changing facts could apply to the law.

Finally, analyzing the Court’s ability to make different determinations at a

Compensation Hearing, Mr. Travis argued that the Court’s and Appeals Board’s opinions

on compensability were based on an interpretation of the law and the law is unlikely to

change between the Expedited and Compensation Hearings.

Mr. Travis argued that the Court should give meaning to section 50-6-

226(d)(1)(B) by awarding costs and fees. To deny his request will encourage Carter to

continue to erroneously, incorrectly, and inconsistently fail to timely initiate benefits and

further limits attorney involvement on behalf of injured employees.

Mr. Travis’s attorney, Brad C. Burnette, submitted an affidavit addressing his

experience, the time required and work involved, and nature of the fee arrangement with

Mr. Travis. Attorney Burnette asserted he entered into a contingency fee agreement with

Mr. Travis and charged an hourly fee under section 50-6-226(d)(1)(B) of $350 for

himself and $90 for his paralegal. Attorney Burnette submitted detailed fee entries

totaling 78.10 in attorney hours and 10.10 in paralegal time, for a total of $28,244.

Mr. Travis also submitted the affidavit of Attorney Jonathan Doolan, who stated,

within a reasonable degree of professional certainty, that the time dedicated by Attorney

Burnette was reasonable, necessary, within the common and customary practice of

competent attorneys practicing in workers’ compensation, and consistent with the

Supreme Court Rules regarding fees.

Carter opposed Mr. Travis’s fee petition on grounds that its failure to initiate

benefits was not erroneous, incorrect, or otherwise inconsistent with the law or facts at

the time the decision was made. Carter argued that Mr. Travis repeatedly indicated

uncertainty in what caused his alleged injury and failed to identify a specific incident, or

set of incidents, identifiable by time and place of occurrence. Carter further argued that

Dr. Grace based his causation opinion on an unreported description of injury. It also

argued that Indiana law governed this claim. It concluded that its failure to initiate

benefits was reasonable.

Carter further asserted that an award of attorney’s fees is premature, given that

medical treatment remains incomplete. It argued that diagnostic testing has not been

completed and Mr. Travis “may have a SLAP tear or rotator cuff tear or he may have a

non-work-related tumor, or some other non-work-related condition.” It asserted that

considering attorney’s fees before a confirmed diagnosis is premature and presents a

great risk to employers. It asked the Court to deny the request, or in the alternative to

delay its decision until the case is more fully developed.

Finally, although Carter offered no specific objections to the Attorney Burnette’s

affidavit and fee entries, it asked the Court to limit the fees to a reasonable hourly rate

and reasonable time.

Findings of Fact and Conclusion of Law

The General Assembly amended the Workers’ Compensation Law in 2016 to

authorize trial courts to award attorneys’ fees and costs under section 50-6-226(d)(1)(B)

when an employer wrongfully denies benefits or fails to timely provide benefits.

The 2016 version of this subsection provided in part:

[T]he court of workers’ compensation claims may award reasonable

attorneys’ fees and reasonable costs ... when the employer:

Wrongfully denies a claim by filing a timely notice of denial, or fails to

timely initiate any of the benefits to which the employee is entitled under

this chapter, including medical benefits under § 50-6-204 or temporary or

permanent disability benefits under § 50-6-207, if the workers’

compensation judge makes a finding that such benefits were owed at an

expedited hearing or compensation hearing.

(Emphasis added). The 2016 amendment to subdivision (d)(1)(B) applied to injuries

occurring on or after July 1, 2016.

In Thompson v. Comcast Corp., 2018 TN Wrk. Comp. App. Bd. LEXIS 1, at *26

(Jan. 30, 2018), the Appeals Board determined that the word “wrongfully” as used in the

statute above applied only to the denial of a claim but not to the failure to timely initiate

benefits.

In 2018, the Generally Assembly revised this subsection, which now reads:

In addition to attorneys’ fees provided for in this section, the court of

workers’ compensation claims may award reasonable attorneys’ fees and

reasonable costs ... when the employer:

5

Wrongfully denies a claim or wrongfully fails to timely initiate any of the

benefits to which the employee or dependent is entitled under this chapter,

including medical benefits under § 50-6-204, temporary or permanent

disability benefits under § 50-6-207, or death benefits under § 50-6-210 if

the workers’ compensation judge makes a finding that the benefits were

owed at an expedited hearing or compensation hearing. For purposes of

this subdivision (d)(1)(B), “wrongfully” means erroneous, incorrect, or

otherwise inconsistent with the law or facts.

(Emphasis added).

In Andrews v. Yates Services, LLC, 2018 TN Wrk. Comp. App. Bd. LEXIS 22, at

*8-9 (May 8, 2018), the Appeals Board noted that the recently-enacted amendment

applied only to injuries occurring on or after April 18, 2018.

While the 2018 version is not applicable to the present case—Mr. Travis’s injury

date is November 2-3, 2017—the 2018 version is informative. In Yates, the Appeals

Board found the 2018 version instructive when determining the definition of “wrongfully

denies” as used in the 2016 version of section 50-6-226(d)(1)(B). Jd. at *9. The Appeals

Board concluded that “wrongfully denies” in the earlier version requires a finding that an

employer’s denial was erroneous, incorrect, or otherwise inconsistent with the law or

facts to support a claim for reasonable attorneys’ fees and expenses at the time the

decision was made. Jd. at *10, 13. However, the Appeals Board cautioned, “[A]

decision to award attorneys’ fees and expenses at an interlocutory state of a case should

be made only in extremely limited circumstances.” See Thompson, at *28-29.

Here, using the 2016 version, the Court must determine whether, at the time the

decision was made, Carter “wrongfully denie[d] a claim by filing a timely notice of

denial, or fail[ed] to timely initiate any of the benefits to which [Mr. Travis] is entitled

under this chapter, including medical benefits under § 50-6-204.” Carter gave notice to

Indiana of its inability to determine liability and requested additional time on two

separate occasions and noted it was “trying to determine compensability.” However,

there is no evidence that Carter filed a notice of denial under either Indiana or Tennessee

law, so the first part of section 50-6-226(d)(1)(B) is inapplicable.

The Court is therefore left with determining whether, at the time the decision was

made, Carter failed to timely initiate any of the benefits to which Mr. Travis was entitled.

The Court considers the information available to Carter at the time it failed to provide

medical and temporary disability benefits. The Court holds that Carter’s failure to timely

initiate benefits was incorrect, erroneous, and inconsistent with the law or facts for

several reasons.

First, section 50-6-114 states no contract or agreement shall in any manner operate

to relieve any employer of any obligation created by the Tennessee Workers’

Compensation Law. The forum-selection clause, standing on its own, was therefore void

from the outset.

Second, even if the forum-selection clause were enforceable, Mr. Travis did not

make an election of remedies to recover under Indiana law. Signing the agreement at the

time of hire was a condition of employment. After his work injury, he neither actively

pursued nor knowingly or voluntarily received benefits under Indiana law.

Third, Mr. Travis timely reported a work injury, but Carter failed to timely initiate

treatment without sufficient reason. Ms. Riley suggested he seek treatment at an urgent-

care clinic, which he did. Fast Pace referred Mr. Travis to an orthopedic physician, who

determined that his right-shoulder injury was directly related to the work incident.

However, Carter failed to authorize care at Fast Pace or with Dr. Grace, nor did it provide

a panel of physicians. Carter offered no countervailing testimony to refute Mr. Travis’s

testimony or Dr. Grace’s opinions.

Fourth, Mr. Travis unequivocally testified that he provided his restrictions to Ms.

Riley, and Carter failed to accommodate his restrictions or return him to work. Thus, the

Court finds Carter wrongfully failed to timely initiate medical and temporary disability

benefits that it owed.

The Court must now address whether this case falls within the “extremely limited

circumstances” under Thompson. In Thompson, the Appeals Board cautioned trial courts

to consider:

The uncertainties inherent in litigation, the limited issues typically

addressed at expedited hearing, the fact that discovery and medical proof

often incomplete at an interlocutory stage of a case, the standard of proof

that applies at expedited hearings, and the fact that a trial judge’s

determination at an interlocutory hearing are subject to change at any time

prior to the entry of a final compensation hearing order.

Id. at *26. The Appeals Board affirmed the award of attorney’s fees in Thompson

because the employer declined to authorize treatment based solely on its own

interpretation of the medical records and without seeking an expert opinion to support its

denial.

Considering the Thompson factors, the Court concludes Carter’s failure to timely

initiate benefits justifies an award of attorney’s fees and costs at this interlocutory stage

and in these extremely limited circumstances. Here, just as in Thompson, Carter declined

to authorize treatment or provide temporary disability benefits based on its own

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interpretation that Mr. Travis’s reports of injury were inconsistent and without seeking an

expert opinion to rebut Dr. Grace’s causation opinion and support its denial.

Mr. Travis and the medical records consistently demonstrated that he injured his

right shoulder at work. Carter offered no evidence to rebut Mr. Travis’s description of

his injury. Mr. Travis credibly offered reasonable explanations for any inconsistencies in

the medical records or his injury report. Carter also did not offer any expert medical

opinion to support its refusal to authorize medical treatment despite receiving timely

notice of an injury and its driver manager instructing Mr. Travis to seek medical

attention.

Carter also failed to initiate benefits under Tennessee law claiming Indiana law

governed. Moreover, Carter did not provide benefits under Indiana law. The forum-

selection clause was not enforceable when it was signed, and this Court, affirmed by the

Appeals Board, concluded that Tennessee has jurisdiction.

Instead, Carter delayed took steps at every stage to delay Mr. Travis’s claim.

Twice, it sought extensions under Indiana law to provide benefits, and twice it was

denied. Despite no evidence to rebut Mr. Travis’s testimony or Dr. Grace’s causation

opinion, Carter continued to deny the claim and failed to initiate benefits, forcing Mr.

Travis to file a Petition for Benefit Determination and Request for Expedited Hearing.

Even after agreeing to the deadlines regarding the fee petition, Carter twice sought

extensions from this Court seeking additional delay.

As the Appeals Board noted, uncertainties exist in litigation. Issues at an

Expedited Hearing often differ from those at a Compensation Hearing, and different

burdens of proof apply. However, while discovery and medical proof continue to

develop after an Expedited Hearing, an employer cannot be allowed to deny benefits and

delay recovery without cause, relying solely only upon its own interpretation of the

employee’s description of injury and medical records. Additional discovery and medical

proof, a higher burden of proof, and the passage of time will not change the fact that

Carter’s failure to initiate benefits was erroneous, incorrect, and inconsistent with the law

and facts at the time the decision was made.

The Workers’ Compensation Law requires an employer to provide an injured

employee with medical treatment upon timely notice of a work injury. When an

employer fails to timely initiate the benefits to which the employee is entitled, the

General Assembly has determined that an employer may be held liable for the injured

employee’s attorney’s fees following an Expedited Hearing. The General Assembly

made no change to the attorney’s fees provision when it revised section 50-6-

226(d)(1)(B) in 2018. The purpose of the statute is defeated if an injured employee must

wait until a Compensation Hearing to recover attorney’s fees incurred for recovering

temporary disability and medical benefits. Accordingly, the Court concludes Mr. Travis

8

is entitled to recover attorney’s fees and costs under section 50-6-226(d)(b)(1) at this

interlocutory stage and in these extremely limited circumstances.

Next, the Court must determine whether Mr. Travis’s attorney’s fees are

reasonable, considering the factors in Tennessee Supreme Court Rules 8, Rules of

Professional Conduct 1.5(a).

Mr. Travis’s attorney attested that the time, labor, and skill required to prepare and

try this matter are supported by the time entries. He argued that, through his

representation, Mr. Travis was finally paid back temporary disability benefits that he was

owed, and Carter paid his outstanding medical bills related to his limited treatment. The

time required with these efforts was significant and precluded or delayed other work

available. Further, he and his staff are experienced in workers’ compensation. Attorney

Doolan’s affidavit provides that the time dedicated by Attorney Burnette was reasonable,

necessary, within the common and customary practice of competent attorneys practicing

in workers’ compensation, and consistent with the Supreme Court Rules regarding fees.

Other than Carter’s counsel’s argument, it offered no countervailing evidence to

support its contention that Mr. Travis’s fees were unreasonable under the Rules of

Professional Conduct.

Therefore, considering the affidavits of Attorneys Burnette and Doolan, the

detailed fee entries, and the claim as a whole, the Court concludes Mr. Travis

demonstrated by a preponderance of the evidence that his attorney’s fee is reasonable.

Thus, he shall receive fees totaling $28,244 under subsection 226(d)(1)(B).

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). 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.

It is so ORDERED.

ENTERED March 13, 2019. oO)

OM

PAMELA B. JOHNSON, JUDGE

Court of Workers’ Compensation Claims

APPENDIX

9

Technical Record:

1. Petition for Benefit Determination

2. Dispute Certification Notice

3. Additional Issues, Objections, and/or Defenses submitted by Employee

4. Additional Issues, Objections, and/or Defenses submitted by Employer

5. Request for Expedited Hearing

6. Affidavit of Fred Travis, III

7. Notice of Objection to Expedited Hearing on the Record

8. Employer’s Response to Request for Expedited Hearing

9. Expedited Hearing Order

10. Expedited Hearing Transcript

11. WCAB Opinion

12. Order Setting Deadlines to File Briefs and Oral Argument

13. Employee’s Brief Supporting Request for Attorney’s Fees and Affidavits of

Attorneys Burnette and Doolan

14. Employer’s Motion to Compel and for Continue

15. Employee’s Response to Motion to Compel and for Continue

16. Order Denying Motion to Continue

17. Employer’s Brief on the Attorney Fee Issue

Exhibits:

1. Affidavit of Fred Travis, III

2. Indiana Workers’ Compensation First Report of Work Injury

3. JAIABC Release 1 First Report of Injury Form

4. Third Coast Underwriters Employee’s Report of Injury

5. Notice of Inability to Determine Liability/Request for Additional Time — filed

November 20, 2017 — Rejected

6. Notice of Inability to Determine Liability/Request for Additional Time — filed

December 4, 2017

7. Agreement as to Jurisdiction and Notice as to Indiana Workers’ Compensation

Law

8. GPS Log of November 2-3, 2017

9. Cellular Phone Record of Injury Report, dated November 4, 2017

10. Weather History for November 3, 2017

11. Medical Records of Fast Pace Medical Clinic, PLLC

12. Medical Records of Dr. Sean Grace, Tennessee Orthopaedic Clinic

13. Medical Expense of DJO Global

14. Affidavit of Brad C. Burnette

15. Detailed Time Entries

16. Affidavit of Jonathan Doolan

10

CERTIFICATE OF SERVICE

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

sent to the following recipients by the following methods of service on March 13, 2019.

Employer’s Attorney

Name Certified | Fax | Email | Service sent to:

Mail

Brad C. Burnette, X | bradburnette@foxandfarleylaw.com

Employee’s Attorney

J. Allen Brown, X | allen@jallenbrownpllc.com

-.

IP. i, Li tpt soil Pin sat >

PENNY/SHRUM, Court Clerk (2

WC.CourtClerk@tn.gov

11

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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