Opinion

Lane Sr., Antonio v. Securemedy, Inc.

  • 2020 TN WC App. 26
Court
Tennessee Workers' Compensation Appeals Board
Filed
Jul 7, 2020
Status
Published
On the bench
David F. Hensley, Timothy W. Conner, Pele I. Godkin
Cited by
0 cases

The opinion

FILED

Jul 07, 2020

01:41 PM(CT)

TENNESSEE

WORKERS' COMPENSATION

APPEALS BOARD

TENNESSEE BUREAU OF WORKERS’ COMPENSATION

WORKERS’ COMPENSATION APPEALS BOARD

Antonio Lane, Sr. ) Docket No. 2018-08-1503

)

v. ) State File No. 45081-2017

)

Securemedy, Inc., et al )

)

)

Appeal from the Court of Workers’ )

Compensation Claims )

Deana C. Seymour, Judge )

Vacated and Remanded

Following a court-approved settlement of the employee’s claim for workers’ compensation

benefits, the employee sought additional medical treatment for lumbar complaints that he

contended should be provided as a result of the settlement agreement. The employer

declined to authorize the treatment, and the employee filed a petition for benefits seeking

additional medical care. Following a hearing, the trial court concluded that the parties’

settlement agreement did not exclude future medical care for any of the employee’s work

injuries and ordered the employer to provide future medical treatment for the employee’s

low back complaints. The employer has appealed. Tennessee Code Annotated section 50-

6-240(d) mandates that settlement agreements “compromising and settling the issue of

future medical benefits” include a provision confirming that the employee has been

informed of the potential consequences of the settlement, if any, with respect to Medicare

and TennCare benefits and liabilities. Here, the parties’ settlement agreement did not

include such a provision, and neither the parties nor the trial court addressed the

applicability of section 50-6-240(d) to the parties’ settlement agreement. Without

addressing the merits of the issues raised by the employer, we vacate the trial court’s order

and remand the case for the trial court’s consideration of the applicability of section 50-6-

240(d) to the parties’ settlement agreement and the impact on this case, if any, of the

absence of the statutory language from that agreement.

Judge Pele I. Godkin delivered the opinion of the Appeals Board in which Presiding Judge

Timothy W. Conner and Judge David F. Hensley joined.

Charlie Patrick, Memphis, Tennessee, for the employer-appellant, Securemedy, Inc.

1

Antonio Lane, Sr., Memphis, Tennessee, employee-appellee, pro se

Memorandum Opinion 1

Antonio Lane, Sr. (“Employee”), was involved in a motor vehicle accident and

suffered injuries to his neck and low back on May 28, 2017, while in the course of his

employment as a security guard with Securemedy, Inc. (“Employer”). Employer accepted

the claim as compensable and authorized medical treatment with Dr. Samuel Murrell, who

diagnosed Employee with a low back strain and a disc herniation at the C3-4 level of the

cervical spine. On May 23, 2018, Dr. Murrell opined that Employee had reached maximum

medical improvement for his injury and assigned a permanent medical impairment rating

of 6%. The parties entered into a settlement agreement that was approved by the trial court

on December 20, 2018. Thereafter, Employee requested medical treatment for his lumbar

spine, which was denied by Employer based upon certain language in the settlement

agreement that it contended limited Employee’s future medical benefits to treatment related

to Employee’s cervical spine. 2

Employee filed a petition for benefits requesting medical care for his lumbar spine.

Following an unsuccessful mediation, Employee filed a request for an expedited hearing.

The trial court determined that an expedited hearing would be improper and concluded that

Tennessee Code Annotated section 50-6-204(g)(2)(B) (2019) governs a hearing for post-

settlement medical benefits, noting that Employee “must prove all essential elements of his

claim by a preponderance of the evidence.”

Following the hearing, the trial court concluded that the parties’ settlement

agreement entitled Employee to future medical care for his lumbar spine. In reaching its

conclusion, the trial court noted that the settlement agreement “did not exclude any injury

from the provision of open future medical benefits.” As a result, the court “default[ed] to

the interpretation most consistent with the statutory intent of providing benefits to injured

workers.” The trial court further concluded that the settlement agreement contained no

language limiting future medical benefits and no language documenting any consideration

for an agreement to limit medical benefits. The court determined that the “four corners”

of the settlement agreement provided future medical benefits for work injuries sustained

1

“The Appeals Board may, in an effort to secure a just and speedy determination of matters on appeal and

with the concurrence of all judges, decide an appeal by an abbreviated order or by memorandum opinion,

whichever the Appeals Board deems appropriate, in cases that are not legally and/or factually novel or

complex.” Appeals Bd. Prac. & Proc. § 1.3.

2

Employer cites the following language from the settlement agreement in support of its position: “Employer

agrees to pay for reasonable and necessary authorized future medical expenses which are directly related to

the subject injury, specifically Employee’s only permanent diagnosis of small disc herniation at the C3-4

level of the cervical spine pursuant to Tenn. Code Ann. § 50-6-204.” There was no language in the

settlement agreement expressly limiting or terminating Employee’s right to future medical treatment for

the compensable lumbar spine condition.

2

by Employee, although Employee must still “prove that the treatment he seeks is causally-

related to the accident.” Employer has appealed.

In its brief, Employer asserts the trial court erred in ordering it to provide medical

care for Employee’s lumbar spine complaints “based on an ambiguity in the parties’

settlement agreement.” Further, Employer asserts that “[n]otwithstanding this challenge

to the trial court’s ruling, the trial court also erred in ordering [Employer] to provide

medical care for [Employee’s] current lumbar spine complaints” because Employee failed

to prove that his “current need for treatment is causally related to the work-related injury.”

Finally, Employer asserts that the trial court erred by failing to address its res judicata

defense.

While we do not address the merits of Employer’s issues in this opinion, we note

that Employer’s first issue assumes that the trial court found the language in the parties’

settlement agreement concerning future medical care to be ambiguous. However, neither

the parties nor the trial court addressed the applicability of Tennessee Code Annotated

section 50-6-240(d) to the parties’ settlement agreement, which provides, in part, as

follows:

Nothing in this section shall be construed to prohibit the parties from

compromising and settling the issue of future medical benefits at any time;

provided, that the settlement agreement is approved by a judge of the court

of workers’ compensation claims, and includes a provision confirming that

the employee has been informed of the potential consequences of the

settlement, if any, with respect to [M]edicare and TennCare benefits and

liabilities.

Tenn. Code Ann. § 50-6-240(d) (2019) (emphasis added).

Here, the parties’ settlement agreement did not include a provision “confirming that

the employee [was] informed of the potential consequences of the settlement, if any, with

respect to [M]edicare and TennCare benefits and liabilities” as provided in section 50-6-

240(d). Citing section 50-6-240, the trial court noted that “the issue of future medical

treatment may be resolved by agreement,” but the court did not address the absence of a

provision “confirming that the [E]mployee [was] informed of the potential consequences

of the settlement, if any,” as contemplated in section 50-6-240(d). Consequently, we are

compelled to vacate the trial court’s order and remand the case. The trial court’s order

compelling Employer to provide future medical treatment for Employee’s low back

complaints is vacated, and the case is remanded for the trial court’s consideration of the

applicability of section 50-6-240(d) to the parties’ settlement agreement and the impact on

this case, if any, of the absence of the statutory language from that agreement. Costs on

appeal are taxed to Employer.

3

TENNESSEE BUREAU OF WORKERS’ COMPENSATION

WORKERS’ COMPENSATION APPEALS BOARD

Antonio Lane, Sr. ) Docket No. 2018-08-1503

)

v. ) State File No. 45081-2017

)

Securemedy, Inc., et al. )

)

)

Appeal from the Court of Workers’ )

Compensation Claims )

Deana C. Seymour, Judge )

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 7th day

of July, 2020.

Name Certified First Class Via Via Sent to:

Mail Mail Fax Email

Antonio Lane, Sr. X ablanesr@gmail.com

Charles R. Patrick X charlie.patrick@leitnerfirm.com

Yonishka Voorhees yonishka.voorhees@letinerfirm.com

Deana C. Seymour, Judge X Via Electronic Mail

Kenneth M. Switzer, Chief Judge X Via Electronic Mail

Penny Shrum, Clerk, Court of X penny.patterson-shrum@tn.gov

Workers’ Compensation Claims

Olivia Yearwood

Clerk, Workers’ Compensation Appeals Board

220 French Landing Dr., Ste. 1-B

Nashville, TN 37243

Telephone: 615-253-1606

Electronic Mail: WCAppeals.Clerk@tn.gov

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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