Opinion

Cole, Mason v. R & L Carriers

  • 2022 TN WC 54
Court
Tennessee Court of Workers' Compensation Claims
Filed
Jul 28, 2022
Status
Published
On the bench
Deana C. Seymour
Cited by
0 cases
Authority
More cited than 24.2%

The opinion

FILED

Jul 28, 2022

07:00 AM(CT)

TENNESSEE COURT OF

WORKERS' COMPENSATION

CLAIMS

TENNESSEE BUREAU OF WORKERS’ COMPENSATION

IN THE COURT OF WORKERS’ COMPENSATION CLAIMS

AT MEMPHIS

MASON COLE, ) Docket No. 2021-08-0425

Employee, )

v. )

R&L CARRIERS, ) State File No. 60977-2020

Employer, )

And )

HARTFORD INSURANCE CO., ) Judge Deana C. Seymour

Carrier. )

)

____________________________________________________________________________

EXPEDITED HEARING ORDER

The Court held an Expedited Hearing on July 6, 2022, to determine Mason Cole’s

entitlement to medical and temporary disability benefits for a low-back injury. R&L

Carriers contended that Mr. Cole was not entitled to the requested benefits because he was

noncompliant with treatment, failed to obtain medical proof of causation, and worked in a

light-duty position that met his restrictions until his termination for cause. Based on the

proof presented, the Court holds Mr. Cole is likely to prevail at trial on his claim for

medical benefits but is not likely to prevail on his claim for temporary disability benefits

at this time.

History of Claim

On September 11, 2020, Mr. Cole claimed a work-related back injury after his

forklift ran off the dock due to faulty brakes. R&L accepted the claim and authorized

treatment. After a referral to a specialist, Mr. Cole selected Dr. Sam Murrell from a panel.

Mr. Cole presented to Dr. Murrell in December 2020, complaining of low-back and

left-leg pain. X-rays showed disc degeneration at L5-S1. Dr. Murrell diagnosed Mr. Cole

with “low back pain/strain with left sciatica” and “underlying degenerative disc disease.”

He ordered physical therapy and an MRI. However, Mr. Cole did not return for follow up,

and in April 2021, R&L terminated treatment for noncompliance and terminated his

employment for violating its attendance policy.

1

At the hearing, Mr. Cole testified he continues to have problems with his back. He

claimed he attended physical therapy until February 2021 but never received the MRI. His

therapist ultimately discontinued therapy until he obtained the diagnostic testing, which

according to Mr. Cole, R&L had denied. He noted that he had difficulty reaching his initial

adjuster. 1 He also testified that he tried contacting Dr. Murrell’s office to get an

appointment under workers’ compensation without success.

Mr. Cole admitted to working in a light-duty position until his termination.

However, he argued that his termination was based on absences related to treatment for his

work injury. He asked the Court to order R&L to provide additional treatment and

temporary disability benefits.

R&L refused to offer any additional medical benefits, arguing that Mr. Cole was

noncompliant with treatment and offered no medical proof of causation. It further

contended he was not entitled to temporary disability benefits, as no physician took him

completely off work and he worked in a light-duty capacity until he was terminated for

violating the company’s attendance policy.

R&L introduced the affidavits of adjuster John Hewitt and Service Center Manager

Doug Martindale. 2 It also introduced the Rule 72 Declaration of Injury Recovery Specialist

Monica Holbrook.

Mr. Hewitt’s affidavit discussed how Mr. Cole missed at least two visits with Dr.

Murrell after he sent letters, advising him of the rescheduled appointments. According to

Mr. Hewitt, Dr. Murrell closed Mr. Cole’s file due to the missed visits.

Ms. Holbrook’s declaration addressed Mr. Cole’s missed appointments with Dr.

Murrell and a March 2021 letter sent to him regarding his medical noncompliance. The

declaration also discussed Mr. Cole’s termination for violating company policy, R&L’s

accommodation of Mr. Cole’s restrictions, and the transitional work he performed until his

termination.

Findings of Fact and Conclusions of Law

To obtain the requested relief, Mr. Cole must show that he is likely to prevail at a

hearing on the merits. Tenn. Code Ann. § 50-6-239(d)(1) (2020); McCord v. Advantage

Human Resourcing, 2015 TN Wrk. Comp. App. Bd. LEXIS 6, at *7-8, 9 (Mar. 27, 2015).

1

R&L changed third-party administrators in November 2021.

2

Mr. Martindale’s affidavit testimony concerned issues addressed in R & L Carrier’s Motion to Dismiss,

which the Court denied by separate order.

2

Initially, Mr. Cole seeks continued medical care for his back. Tennessee Code

Annotated section 50-6-204(a)(1)(A) requires the employer to furnish medical treatment

made reasonably necessary by a work accident. Moreover, Tennessee law has long held

that medical proof is not to be “read and evaluated in a vacuum” but instead “must be

considered in conjunction with the lay testimony of the employee as to how the injury

occurred and the employee’s subsequent condition.” Thompson v. Aetna Life & Cas. Co.,

812 S.W.2d 278, 283 (Tenn. 1991).

R&L accepted Mr. Cole’s claim after his forklift ran off the dock and authorized

treatment with two providers. Panel-selected physician Dr Murrell ordered physical

therapy and an MRI. While Mr. Cole did attend some therapy, he testified that R&L never

authorized the MRI.

R&L relied on Mr. Cole’s medical noncompliance to support its contention that he

is not entitled to further treatment. According to R&L, Mr. Cole stopped attending

appointments with Dr. Murrell after his first visit.

In Tennessee, when an employee “refuses to comply with any reasonable request

for examination or to accept the medical or specialized medical services that the employer

is required to furnish . . ., the injured employee’s right to compensation shall be suspended

and no compensation shall be due and payable while the injured employee continues to

refuse.” Tenn. Code Ann. § 50-6-204(d)(8). Our Supreme Court has long interpreted this

provision to mean that “in circumstances where an employee is noncompliant with medical

treatment, ‘compensation shall be held in abeyance, not terminated.’” Newell v. Metro

Carpets, LLC, 2016 TN Wrk. Comp. App. Bd. LEXIS 57, at *4-5 (Sept. 28, 2016). In

addition, where an employee misses medical appointments but credibly testifies that she

was unaware that they had been scheduled, this does not constitute medical noncompliance.

Bailey v. Amazon, 2022 TN Wrk. Comp. App. Bd. LEXIS 16, at *6-7 (May 3, 2022).

The evidence presented does not convince the Court that Mr. Cole was

noncompliant with treatment. The record is unclear whether Mr. Cole received notice of

the rescheduled appointments with Dr. Murrell. While Mr. Hewitt’s affidavit and Ms.

Holbert’s declaration mentioned that letters were sent to Mr. Cole about these

appointments, the letters were not introduced, and Mr. Cole did not testify to receiving

these letters.

Moreover, even if Mr. Cole were initially noncompliant with treatment, he has

attempted to become compliant so that he can receive additional treatment for his back.

Based on Mr. Cole’s credible testimony, he had difficulty communicating with his initial

adjuster and obtaining treatment since the beginning of his claim. He stated he tried to see

the doctor under workers’ compensation with no success and discussed the current

problems he continues to have with his back. Therefore, any past noncompliance on Mr.

Cole’s part would not affect his present entitlement to medical benefits.

3

R&L also claimed that Mr. Cole’s failure to introduce medical proof of causation

supported its contention that he is not entitled to further treatment. It points to Dr. Murrell’s

diagnosis of degenerative disc disease to infer that his condition may be pre-existing.

The only medical proof introduced was Dr. Murrell’s December 2020 record. While

Dr. Murrell did not provide a causation opinion, his records suggest that Mr. Cole’s need

for treatment arose from an incident at work involving a forklift with faulty brakes. In

addition, Dr. Murrell ordered an MRI to assist with diagnosis, which was never authorized

by R&L despite Dr. Murrell’s status as an authorized treating physician. This testing could

also prove helpful in addressing causation. Based on the foregoing, Mr. Cole appears likely

to prevail on his claim for continued treatment with Dr. Murrell for any condition found to

arise primarily out of his employment.

Turning to Mr. Cole’s request for temporary total disability benefits, he must show

(1) he became disabled from working due to a compensable injury; (2) there is a causal

connection between the injury and the inability to work; and (3) the duration of the period

of disability. Jones v. Crencor Leasing and Sales, 2015 TN Wrk. Comp. App. Bd. LEXIS

48, at *7 (Dec. 11, 2015). Since no doctor took Mr. Cole completely off work, he would

not be entitled to temporary total disability benefits.

However, temporary partial disability benefits are due when the treating physician

has released the injured employee to return to work with restrictions before maximum

medical improvement, and the employer either (1) cannot return the employee to work

within the restrictions or (2) cannot provide restricted work for a sufficient number of hours

and/or at a rate of pay equal to or greater than the employee’s average weekly wage on the

date of injury. Id. at *7-8. Mr. Cole admitted that R&L accommodated his restrictions until

he was terminated in April 2021. However, he did not introduce any medical proof that he

remained under restrictions after his termination. Thus, he is unlikely to prevail at a hearing

on his claim for temporary disability benefits at this time.

IT IS, THEREFORE, ORDERED as follows:

1. R&L shall provide treatment with Dr. Sam Murrell for any condition related to his

September 11, 2020 work injury under Tennessee Code Annotated section 50-6-

204. Should Dr. Murrell refuse to treat Mr. Cole, R&L shall provide a panel of

orthopedic physicians, and Mr. Cole shall select his authorized treating physician.

2. Mr. Cole’s request for temporary disability benefits is denied at this time.

3. This case is set for a Status Conference on September 19, 2022, at 10:00 a.m.

Central Time. The parties must call 615-532-9550 or toll-free at 866-943-0014 to

4

participate in the hearing. Failure to call might result in a determination of the issues

without the party’s participation.

ENTERED July 28, 2022.

____________________________________

Judge Deana C. Seymour

Court of Workers’ Compensation Claims

APPENDIX

Technical Record

1. Petition for Benefit Determination (with attachments)

2. Dispute Certification Notice

3. Order on Show Cause Hearing, dated December 2, 2021

4. Order on Show Cause Hearing, dated January 12, 2022

5. Hearing Request, filed January 12, 2022

6. Rule 72 Declaration of Mason Cole, filed January 18, 2022

7. Notice of Appearance

8. Notice of Filing Wage Statement

9. Motion to Dismiss for Inappropriate Service of Process

10. Notice of Hearing

11. Order on Status Hearing and Setting Expedited Hearing

12. Hearing Request, along with Rule 72 Declaration of Mason Cole, filed April 18,

2022

13. Employer’s Position Statement

14. Employer’s Exhibit List

15. Employer’s Witness List

16. Rule 72 Declaration of Monica Holbrook

17. Affidavit of John Hewitt

18. Affidavit of Doug Martindale

19. Employer’s Notice of Filing Medical Records

20. Order Denying Motion to Dismiss, dated July 21, 2022

Exhibits

1. Dr. Murrell’s December 18, 2020 medical record

2. Original Petition for Benefit Determination

3. Hearing Request, dated October 1, 2021

4. Affidavit of John Hewitt

5. Affidavit of Doug Martindale

6. Rule 72 Declaration of Monica Holbrook

5

CERTIFICATE OF SERVICE

I certify that a copy of this order was sent as indicated on July 28, 2022.

Name Certified U.S. Email Service sent to:

Mail Mail

Mason Cole, X X X 5618 Sycamore Ridge

Self-Represented Memphis, TN 38134

Employee maolova2@icloud.com

Leslie Bishop, X lbishop@lewisthomason.com

Employer’s Attorney

_____________________________________

Penny Shrum, Court Clerk

Court of Workers’ Compensation Claims

WC.CourtClerk@tn.gov

6

Expedited Hearing Order Right to Appeal:

If you disagree with this Expedited Hearing Order, you may appeal to the Workers’

Compensation Appeals Board. To appeal an expedited hearing order, you must:

1. Complete the enclosed form entitled: “Notice of Appeal,” and file the form with the

Clerk of the Court of Workers’ Compensation Claims within seven business days of the

date the expedited hearing order was filed. When filing the Notice of Appeal, you must

serve a copy upon all parties.

2. You must pay, via check, money order, or credit card, a $75.00 filing fee within ten

calendar days after filing of the Notice of Appeal. Payments can be made in-person at

any Bureau office or by U.S. mail, hand-delivery, or other delivery service. In the

alternative, you may file an Affidavit of Indigency (form available on the Bureau’s

website or any Bureau office) seeking a waiver of the fee. You must file the fully-

completed Affidavit of Indigency within ten calendar days of filing the Notice of

Appeal. Failure to timely pay the filing fee or file the Affidavit of Indigency will

result in dismissal of the appeal.

3. You bear the responsibility of ensuring a complete record on appeal. You may request

from the court clerk the audio recording of the hearing for a $25.00 fee. If a transcript of

the proceedings is to be filed, a licensed court reporter must prepare the transcript and file

it with the court clerk within ten business days of the filing the Notice of

Appeal. Alternatively, you may file a statement of the evidence prepared jointly by both

parties within ten business days of the filing of the Notice of Appeal. The statement of

the evidence must convey a complete and accurate account of the hearing. The Workers’

Compensation Judge must approve the statement before the record is submitted to the

Appeals Board. If the Appeals Board is called upon to review testimony or other proof

concerning factual matters, the absence of a transcript or statement of the evidence can be

a significant obstacle to meaningful appellate review.

4. If you wish to file a position statement, you must file it with the court clerk within ten

business days after the deadline to file a transcript or statement of the evidence. The

party opposing the appeal may file a response with the court clerk within ten business

days after you file your position statement. All position statements 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.

For self-represented litigants: Help from an Ombudsman is available at 800-332-2667.

NOTICE OF APPEAL

Tennessee Bureau of Workers’ Compensation

www.tn.gov/workforce/injuries-at-work/

wc.courtclerk@tn.gov | 1-800-332-2667

Docket No.: ________________________

State File No.: ______________________

Date of Injury: _____________________

___________________________________________________________________________

Employee

v.

___________________________________________________________________________

Employer

Notice is given that ____________________________________________________________________

[List name(s) of all appealing party(ies). Use separate sheet if necessary.]

appeals the following order(s) of the Tennessee Court of Workers’ Compensation Claims to the

Workers’ Compensation Appeals Board (check one or more applicable boxes and include the date file-

stamped on the first page of the order(s) being appealed):

□ Expedited Hearing Order filed on _______________ □ Motion Order filed on ___________________

□ Compensation Order filed on__________________ □ Other Order filed on_____________________

issued by Judge _________________________________________________________________________.

Statement of the Issues on Appeal

Provide a short and plain statement of the issues on appeal or basis for relief on appeal:

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

Parties

Appellant(s) (Requesting Party): _________________________________________ ☐Employer ☐Employee

Address: ________________________________________________________ Phone: ___________________

Email: __________________________________________________________

Attorney’s Name: ______________________________________________ BPR#: _______________________

Attorney’s Email: ______________________________________________ Phone: _______________________

Attorney’s Address: _________________________________________________________________________

* Attach an additional sheet for each additional Appellant *

LB-1099 rev. 01/20 Page 1 of 2 RDA 11082

Employee Name: _______________________________________ Docket No.: _____________________ Date of Inj.: _______________

Appellee(s) (Opposing Party): ___________________________________________ ☐Employer ☐Employee

Appellee’s Address: ______________________________________________ Phone: ____________________

Email: _________________________________________________________

Attorney’s Name: _____________________________________________ BPR#: ________________________

Attorney’s Email: _____________________________________________ Phone: _______________________

Attorney’s Address: _________________________________________________________________________

* Attach an additional sheet for each additional Appellee *

CERTIFICATE OF SERVICE

I, _____________________________________________________________, certify that I have forwarded a

true and exact copy of this Notice of Appeal by First Class mail, postage prepaid, or in any manner as described

in Tennessee Compilation Rules & Regulations, Chapter 0800-02-21, to all parties and/or their attorneys in this

case on this the __________ day of ___________________________________, 20 ____.

______________________________________________

[Signature of appellant or attorney for appellant]

LB-1099 rev. 01/20 Page 2 of 2 RDA 11082

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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