Opinion

Holloway, Patricia v. Herbalife International, Inc.

  • 2024 TN WC 14
Court
Tennessee Court of Workers' Compensation Claims
Filed
Mar 1, 2024
Status
Published
On the bench
Shaterra Reed Marion
Cited by
0 cases

The opinion

FILED

Mar 01, 2024

08:40 AM(CT)

TENNESSEE COURT OF

WORKERS' COMPENSATION

CLAIMS

TENNESSEE BUREAU OF WORKERS’ COMPENSATION

IN THE COURT OF WORKERS’ COMPENSATION CLAIMS

AT MEMPHIS

PATRICIA HOLLOWAY, ) Docket No.: 2022-08-1251

Employee, )

v. )

HERBALIFE INTERNATIONAL, )

INC., ) State File No.: 51646-2020

Employer, )

And )

TRUMBULL INSURANCE )

COMPANY, ) Judge Shaterra R. Marion

Carrier. )

________________________________________________________________________

EXPEDITED HEARING ORDER GRANTING BENEFITS

The Court held an Expedited Hearing on February 20, 2024, to determine Ms.

Holloway’s entitlement to medical benefits for her back and hip injuries. The Court holds

that she is entitled to these benefits, and that Dr. Ashley Park will be her authorized treating

physician. Additionally, the Court refers Herbalife to the Compliance Program for the

reasons below.

History of Claim

Ms. Holloway was first injured when a metal tray hit her above the right eye at work

on August 9, 2020. She testified that Herbalife did not offer her a panel. Instead, it directed

her to Baptist Hospital and then Nova Medical Centers. Nova referred Ms. Holloway to a

neurologist, and Ms. Holloway chose Dr. Mohammad Assaf from a panel.

Eight months after the injury, Ms. Holloway experienced dizziness at work and fell

to the floor, injuring her back. She testified that the medications prescribed by Dr. Assaf

caused dizziness, and Herbalife agreed to treat this fall as part of her initial injury. Herbalife

directed her to see Dr. Gregory Anderson at Nova and did not offer her a panel for her back

injury. Dr. Anderson diagnosed a lower-back contusion, recommended she take over-the-

counter medication as needed, and released her at maximum medical improvement.

1

After this, Ms. Holloway requested additional back treatment from her nurse case

manager and the adjuster, but they did not authorize a return visit.

Ms. Holloway then sought treatment for her back on her own with Dr. Ashley Park.

Dr. Park gave Ms. Holloway an injection and referred her to orthopedist Dr. Chad

Campion. Dr. Campion recommended surgery, but Ms. Holloway testified that she

declined it at that time because she exhausted her FMLA.

Dr. Park addressed causation for Ms. Holloway’s back symptoms. He stated her

back injury arose primarily out of her workplace accident and his treatment was reasonable

and necessary for her injury.

Ms. Holloway stated that after two years of Herbalife not granting her requests for

additional authorized treatment, they sent her back to Dr. Anderson in April of 2023.

Ultimately, he made a neurosurgical referral for the back injury. The referral did not list a

specific doctor, and Herbalife did not give her a panel for this referral.

Ms. Holloway testified that she specifically requested a panel from her nurse case

manager. She introduced emails into evidence confirming this. Ms. Holloway stated her

nurse case manager did not respond and instead made an appointment with neurosurgeon

Dr. Fereidoon Parsioon. In one email, Ms. Holloway stated she would go to Dr. Parsioon

because of her desperation to be treated and because she was “in so much pain.”

After examination and review of her medical records, Dr. Parisoon noted that Ms.

Holloway did not have any serious or surgical problems on her imaging. He further wrote

that she had a reasonable degree of conservative treatment for myofascial and muscular

back pain and did not need any additional treatment.

Additionally, Ms. Holloway testified that she suffered a hip injury during physical

therapy offered by Dr. Anderson when she was moving a chair with her legs. She stated

she experienced pain, numbness, and a muscle spasm in her left side.

At a separate session, a therapist made her do an exercise that made her hip worse.

She informed her nurse case manager and Herbalife of her hip injury through emails that

were introduced into evidence. She testified that Herbalife never offered treatment or a

panel for her hip.

Ms. Holloway testified that although she told Dr. Parsioon about her hip, he never

treated her for her hip pain, so she returned on her own to Dr. Park for hip treatment. Dr.

Park ordered an MRI and did an epidural, which Ms. Holloway said did not help much. He

currently recommends more injections.

2

Herbalife stated that it did not deny Ms. Holloway’s back or hip injury. It argued

that Dr. Anderson and Dr. Parsioon were her authorized treating physicians, they supplied

the necessary treatment for her injuries, and then released her at maximum medical

improvement. Herbalife also argued that emails show Dr. Anderson intended to directly

refer Ms. Holloway to Dr. Parsioon, but no evidence of those emails exists in the record.

Ms. Holloway argued that due to Herbalife’s failure to offer treatment and panels,

Dr. Park should be declared her authorized treating physician.

Findings of Fact and Conclusions of Law

Ms. Holloway has the burden of proving she is likely to prevail at trial in

establishing that she is entitled to medical benefits for her back and hip injuries. Tenn.

Code Ann. § 50-6-102(12) (2023); McCord v. Advantage Human Resourcing, 2015 TN

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

Tennessee Code Annotated section 50-6-204(3)(A) requires employers to give a

panel of physicians when the employee has suffered an injury and expressed a need for

medical care.

Under Rule 0800-02-01-.06(4) (2018) of the Tennessee Compilation Rules and

Regulations, an employer may direct an injured worker to an employer-sponsored medical

provider. However, the Appeals Board held that this employer-directed provider does not

replace a panel or relieve that employer of its obligation to provide a panel of physicians.

Hawes v. McLane Co., 2021 TN Wrk. Comp. App. Bd. LEXIS 30, at *9 (Aug. 25, 2021).

Further, “[a]n employer who fails to provide a panel of physicians runs the risk of

having to pay for unauthorized medical care in the event the trial court determines that a

panel should have been provided.” Id. (citing Young v. Young. Elec. Co., TN Wrk. Comp.

App. Bd. LEXIS 24, at *16 (May 25, 2016).

In Young, the employer learned of the employee’s accident eight days after the

incident at the latest but did not provide a panel until “several weeks” after the injury.

Young, at *1. The employee selected a panel physician, but the employer denied the claim

instead of scheduling an appointment with the physician. Id.

Additionally, the employee sought his own treatment before the employer offered

this panel, and after the deadline for employers to either deny a claim or provide a panel.

Id. at *18. The Appeals Board found that the employee “justifiably sought treatment on his

own” and was entitled to continue treating with his own doctor as his authorized physician.

Id. at *18-19.

3

Here, Herbalife only offered one panel in the three and a half years since Ms.

Holloway’s initial injury. Herbalife did not provide a panel either time it sent Ms. Holloway

to Nova; it did not give a panel when Dr. Anderson made a general neurosurgical referral;

and it did not provide a panel after Ms. Holloway injured her hip and informed Herbalife

of that injury.

Ms. Holloway repeatedly asked Herbalife for additional treatment and sent multiple

emails to her nurse case manager requesting a panel for her neurosurgical referral. At the

hearing, Ms. Holloway asked that she be allowed to continue treating with Dr. Park as her

authorized physician.

The Court finds that, as in Young, Ms. Holloway justifiably sought treatment on her

own with Dr. Park for both her back and hip injuries. The Court also finds that Herbalife’s

repeated failure to panel Ms. Holloway entitles her to treat with Dr. Park. The Court thus

designates Dr. Park as Ms. Holloway’s authorized treating physician for her back and hip

injuries going forward.

Penalty Referral

Section 50-6-118(9) authorizes penalties for an employer’s failure to timely offer a

panel of physicians. Tennessee Compilation Rules and Regulations 0800-02-01-.06(1)

states that after “receipt of notice of a workplace injury and the employee expressing a need

for medical care, an employer shall, as soon as practicable but no later than three (3)

business days after receipt of such request, provide the employee a panel of physicians[.]”

Subsection (2) of the rule states, “In the absence of evidence establishing a defense,

where the employer fails to provide an appropriate initial panel of physicians to the

employee within three (3) business days from the date the employer has notice of a work-

related injury and the employee expressed a need for medical care, . . . the employer may

be assessed a civil penalty[.]” Id.

Here, Herbalife did not provide a panel before sending Ms. Holloway to Nova after

her visit to Baptist Hospital. When Ms. Holloway fell eight months later, Herbalife did not

provide a panel and directed Ms. Holloway to Dr. Anderson. Dr. Anderson, in his later

treatment of Ms. Holloway, referred her to a neurosurgeon and did not list a doctor on this

referral. Herbalife did not provide a panel for this referral, and instead directed her to Dr.

Parsioon. And finally, after Ms. Holloway injured her hip in physical therapy, Herbalife

did not offer a panel.

Of note, Herbalife failed at four different points throughout the case to provide a

panel for Ms. Holloway, though it did not deny her back or hip injuries. The Court therefore

refers Herbalife to the Compliance Program for potential assessment of penalties under 50-

6-118(9).

4

IT IS THEREFORE ORDERED as follows:

1. Ms. Holloway’s request for Dr. Park to be her authorized treating physician for her

back and hip injuries is granted.

2. Herbalife is referred for penalties for violations of Tennessee Code Annotated

section 50-6-118(9).

3. The Court sets a status conference for May 6, 2024, 1:30 p.m. Central Time. The

parties must call (866) 943-0014. Failure to call might result in a determination of

the issues without the party’s participation.

4. Unless an 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

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 confirmation within seven business days

may result in a penalty assessment for non-compliance. For questions regarding

compliance, contact the Workers’ Compensation Compliance Unit via email at

WCCompliance.Program@tn.gov.

ENTERED March 1, 2024.

________________________________________

Judge Shaterra R. Marion

Court of Workers’ Compensation Claims

APPENDIX

Exhibits:

1. Dr. Parsioon’s Medical Records

2. Dr. Anderson’s Medical Records

5

3. Dr. Park’s and Dr. Campion’s Medical Records

4. First Report of Injury

5. Notice of Denial for Dr. Parks’s Treatment

6. Emails relating to Ms. Holloway’s hip injury in physical therapy

7. Emails relating to Ms. Holloway’s back claim being treated under her initial head

injury claim

8. Emails relating to Ms. Holloway’s requests for a neurosurgery panel

9. Audio Recordings relating to Ms. Holloway’s physical therapy

Technical Record:

1. Petition for Benefit Determination

2. Dispute Certification Notice with email to mediator

3. Hearing Request, along with Affidavit of Patricia Holloway

4. Order on Pre-trial Conference filed February 15, 2024

5. Employee’s Revised Exhibit List filed January 29, 2024

6. Employee’s Exhibit List filed September 19, 2024

7. Employer’s Prehearing Brief

8. Employer’s Witness and Exhibit List

CERTIFICATE OF SERVICE

I certify that a copy of this Order was sent as indicated on March 1, 2024.

Name Service sent to:

Email

Rhoberta Orsland, X rorsland@forthepeople.com

Employee’s Attorney lwaite@forthepeople.com

John Barringer, X jbarringer@manierherod.com

Employer’s Attorney hsantilli@manierherod.com

Bureau of Workers’ X WCCompliance.Program@tn.gov

Compensation

Compliance Program

_____________________________________

Penny Shrum, Court Clerk

Court of Workers’ Compensation Claims

WC.CourtClerk@tn.gov

6

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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