Opinion

Harris, Shunekari v. American International Group, Inc., d/b/a American Home Assurance

  • 2024 TN WC 20
Court
Tennessee Court of Workers' Compensation Claims
Filed
Mar 13, 2024
Status
Published
On the bench
Joshua Davis Baker
Cited by
0 cases

The opinion

FILED

Mar 13, 2024

03:12 PM(CT)

TENNESSEE COURT OF

WORKERS' COMPENSATION

CLAIMS

TENNESSEE BUREAU OF WORKERS’ COMPENSATION CLAIMS

IN THE COURT OF WORKERS’ COMPENSATION CLAIMS

AT NASHVILLE

SHUNEKARI HARRIS, ) Docket No. 2022-06-0698

Employee, )

v. )

)

AMERICAN INTERNATIONAL ) State File No. 800860-2022

GROUP, INC., d/b/a AMERICAN )

HOME ASSURANCE, )

Employer, )

)

AMERICAN CASUALTY CO. OF ) Judge Joshua Davis Baker

READING, PA, )

Carrier. )

EXPEDITED HEARING ORDER

At an expedited hearing, Ms. Harris asked for medical and temporary disability

benefits, and reimbursement for medical costs, for alleged work-related bilateral

tenosynovitis. American Home Assurance (AIG) opposes her requests, asserting she did

not give timely notice of her claim and lacks medical proof relating her injuries to her

employment. The Court holds Ms. Harris is unlikely to prevail at a hearing on the merits

in proving a causal connection between her employment and her injury and denies her

request for benefits. In addition, AIG’s notice defense is rejected.

Claim History

Ms. Harris worked at AIG for approximately eight years until October 6, 2021. At

that time, she took leave to get treatment for her right hand. Dr. Christopher Jones

completed her short-term disability form and took her off work from that day until

December 16, 2021. Ms. Harris, however, never returned to work for AIG.

Two days before her leave began, Ms. Harris said she contacted Kevin Polk, her

supervisor, to let him know she was “having problems with my right hand and needed to

1

see the doctor.” Ms. Harris did not mention that her right-hand problems resulted from her

work, and the short-term disability paperwork did not mention this either.

While on leave, Ms. Harris saw Dr. Jones several times and attended physical

therapy. None of the medical notes states that her condition arose from work.

On March 7, 2022, Ms. Harris received an email from Jamie Hafer, a human

resources representative, telling her that her short-term disability payments stopped

because Dr. Jones had not provided additional records to show entitlement to further

benefits. Ms. Hafer told her to contact Guardian, the vendor who oversees disability leave

payments, and reapply.

Ms. Harris did so and said someone at Guardian advised her to start a workers’

compensation claim. According to Ms. Harris, this conversation happened on April 1 and

was the first time she associated her claim to her work. That same day, she emailed Ms.

Hafer and requested information on filing a claim. She filed a Petition for Benefit

Determination on April 7.

In her Petition, Ms. Harris complained that AIG failed to report her workers’

compensation hand injuries. She recounted that she told Mr. Polk about her injury on

October 4, 2021. Mr. Polk admitted knowing Ms. Harris was taking leave for hand

treatment, but he denied she said it was due to a work injury. At the hearing, AIG

maintained that it first knew Ms. Harris was asserting a workers’ compensation claim on

April 1.

After the Petition was filed, the parties mediated, and their versions of what occurred

somewhat differ but are not incongruent. In an affidavit, Anthony Grunkmeyer, an

insurance adjuster, said he offered Ms. Harris a panel of physicians on May 6 and May 26,

but Ms. Harris refused to choose a doctor. Ms. Harris did not deny that AIG offered her a

panel but said she never received it and continued treating with her own doctors after the

mediator said she could.

On May 9, 2022, while mediation was still ongoing, Ms. Harris saw Dr. Todd Rubin,

who diagnosed bilateral tenosynovitis. He offered either surgery or conservative treatment.

Ms. Harris selected conservative treatment and continued physical therapy. Dr. Rubin’s

medical notes did not reference a work injury.

While the events beginning in the fall of 2021 were happening, Ms. Harris was also

receiving treatment from Dr. Steven Koester, a chiropractor, for back pain stemming from

an earlier automobile accident. Ms. Harris sent Dr. Koester a questionnaire seeking his

causation opinion. He responded that he was treating her for “cervical radiculopathy,

thoracic radiculopathy, and upper extremity subluxations.” He checked boxes on the

2

questionnaire stating that her need for medical treatment was more than 50% caused by her

work and recommended ongoing chiropractic care.1

After receiving the questionnaire, Ms. Harris requested an expedited hearing, and

one was scheduled. The Court continued the hearing to allow the parties time to depose

Dr. Koester about his responses. He ended up sitting for a deposition three times.

The first two times were on June 6 and 12, 2023. Throughout the depositions, AIG

presented Dr. Jones’s records. Dr. Koester agreed that, despite his questionnaire answers,

he could not say that the conditions he treated Ms. Harris for were more than 50% caused

by her work. Further, he could not say that her bilateral tenosynovitis was more than 50%

caused by work.

After the deposition, the Court reset the expedited hearing. Before the hearing,

however, Ms. Harris contacted Dr. Koester and secured an affidavit where he changed

directions and causally-related her bilateral tenosynovitis to her work. He cited

presentation of new information for changing his opinion, stating “the prior doctors whose

medical notes were provided by Mrs. Harris give a clear picture of her work injury, and I

stand firmly by [my] opinion in my causation letter.”

After this turn of events, the Court again continued the expedited hearing, and the

parties deposed Dr. Koester for the third time. At that time, Dr. Koester walked back his

affidavit statement that he received new information after the first deposition. He admitted

that AIG’s counsel had in fact shown him the same information in the earlier depositions.

In the end, Dr. Koester retreated to his causation opinion from his first deposition, where

he said that Ms. Harris’s bilateral tenosynovitis is not more than 50% related to her work.

At the hearing, Ms. Harris asked that AIG pay for medical bills in treating her

alleged workplace injuries. She also asked for temporary disability benefits from her last

day worked to the present, and for additional medical treatment.

AIG argued that Ms. Harris failed to timely report her injury, so the claim should be

denied. It further argued that she failed to carry her burden of proving she would likely

succeed at a hearing on the merits because of Dr. Koester’s causation opinion.2

Findings of Fact and Conclusions of Law

To receive benefits, Ms. Harris must present sufficient evidence that she would

likely prevail at a final hearing in proving her entitlement to them. See Tenn. Code Ann.

1

Although Dr. Koester’s questionnaire response suggests back treatment, the parties agreed that Ms. Harris

is not seeking workers’ compensation benefits for a back injury.

2

Despite these defenses, AIG has not denied Ms. Harris’s claim.

3

§ 50-6-239(d)(1) (2023); McCord v. Advantage Human Resourcing, 2015 TN Wrk. Comp.

App. Bd. LEXIS 6, at *9 (Mar. 27, 2015). The Court holds she did not carry her burden of

proving a likelihood of success on the merits due to Dr. Koester’s negative causation

opinion.

Ms. Harris must prove medical causation to prevail at a final hearing, which requires

an expert’s testimony to a “reasonable degree of medical certainty” that the employment

“contributed more than fifty percent (50%) in causing the . . . need for medical treatment,

considering all causes.” Tenn. Code Ann. § 50-6-102(12)(C). She did not do so.

Dr. Koester gave many varying opinions throughout this litigation. He first

answered a questionnaire causally relating Ms. Harris’s back condition to her work despite

having treated her for several years before October 2021. Then, he retracted that opinion

and said that neither Ms. Harris’s back condition nor her bilateral tenosynovitis was caused

by her work. After that deposition, he signed an affidavit reversing his deposition

testimony, based on supposed new information, and he related her bilateral tenosynovitis

to her employment. Finally, at the last deposition, Dr. Koester reversed course again and

confirmed the negative causation opinion from his first deposition.

So, when the dust settles, the Court is left with the whipping winds of multiple

opinions all converging to form a steady breeze of nothingness. These crosswinds of

opinions make it difficult for the Court to have confidence in any of Dr. Koester’s opinions

and rejects them all. Thus, Ms. Harris is left with no medical opinion relating her injuries

to her employment and cannot prove that she would likely prevail at a final hearing. Her

claim for medical and temporary disability benefits, and reimbursement of medical costs,

is denied.

The Court acknowledges that an employee is not always required to have a positive

causation opinion to prevail at an expedited hearing. Indeed, in most circumstances when

an employee reports a workplace injury, the Workers’ Compensation Law requires the

employer to give a panel of physicians. Tenn. Code Ann. § 50-6-204(a)(3)(A)(i). As seen

in the Appeals Board’s opinion in Hawes v. McLane Company, Inc., 2021 TN Wrk. Comp.

App. Bd. LEXIS 30 (Aug. 25, 2021), failure to offer a panel is perilous, as the employer

cannot rely on a negative causation opinion to deny treatment at an expedited hearing when

it neglected its legal duty to provide a panel.

Ms. Harris’s requests here, however, arose from dissimilar circumstances. Unlike

Hawes, where the employer relied on a negative causation opinion from a doctor without

offering a panel, the Court finds AIG did not fail in its duty to offer a panel. Indeed, Mr.

Grunkmeyer’s affidavit and Ms. Harris’s own testimony support the conclusion she had

the option to receive treatment from a panel physician, but she instead chose to continue

treating with Dr. Koester.

4

With this proof, the Court finds Ms. Harris’s actions, or inactions, are the catalysts

that resulted in the need for litigation. Had Ms. Harris chosen a doctor, her claim likely

would have been resolved long ago. The Court declines to let her go back now and select

a physician almost two years after AIG offered her a panel.

Lastly, the Court denies AIG’s notice defense.3 Ms. Harris credibly testified she first

learned her claim could fall under workers’ compensation after speaking with a Guardian

representative on April 1, 2022. She emailed Ms. Hafer that same day requesting

documents to file a claim. The Court finds this email served as timely, sufficient notice of

a repetitive stress injury under Tennessee Code Annotated 50-6-201(b)(2).

While AIG argued Ms. Harris should have connected her condition to her work

when she first learned she had bilateral tenosynovitis, the Court cannot credit this

argument. Ms. Harris is not a doctor, and the condition she suffers from is not one

obviously arising from work. Further, her decision to file for short-term disability rather

than workers’ compensation at the onset of her symptoms casts doubt on AIG’s argument

that she knew or should have known her condition resulted from her work.

It is ORDERED as follows:

1. Ms. Harris’s request for medical and temporary disability benefits, as well as

reimbursement for medical costs, is denied at this time for lack of proof.

2. The Court sets a status hearing for Monday, June 3, 2024, at 10:00 a.m. Central

Time. The parties must call (615) 741-2113 or (855) 874-0474 to participate.

Failure to call might result in a determination of the issues without the party’s

participation.

Entered on March 13, 2024.

______________________________________

Joshua Davis Baker, Judge

Court of Workers’ Compensation Claims

3

AIG also moved the Court to deny benefits under Tennessee Rule of Civil Procedure 41.02 at the close of

Ms. Harris’s proof because she failed to meet her evidentiary burden. The Court took the request under

advisement and now finds the motion moot. As determined by the Appeals Board in Garcia Carrillo v.

Hurtado, 2023 TN Wrk. Comp. App. Bd. LEXIS 40 (Augst 16, 2023), these motions are only useful in an

interlocutory hearing to deny benefits in that context with no effect on the continued viability of the

employee’s workers’ compensation claim. Because this Court denied Ms. Harris’s requests for benefits, the

outcome is the same.

5

APPENDIX

Exhibits

1. Rule 72 Declaration of Shunekari Harris

2. Questionnaire responses of Dr. Steven Koester signed 11/8/22

3. Return to work note from Dr. Christopher Jones, 2/22/22

4. Letter from Nurse Practitioner Keith Holley, 8/7/23

5. Medical records (excluding records from Dr. Paul Leavitt, pages 24-68)

6. Rule 72 Declaration of Anthony Grunkemeyer

7. Panel of Physicians form, unsigned

8. Depositions of Dr. Steven Koester, 6/6/23 and 7/12/23

9. Wage Statement

10. Hughston Clinic Fax

11. Email exchange with Jamie Hafer

12. Email correspondence with Kevin Polk dated 10/3/21

13. UNUM denial of short-term disability

14. Ciox Health invoice dated 8/8/23

15. Hughston Clinic authorization to disclose dated 8/24/23

16. Cigna Explanation of Benefits for medical and pharmacy claims

17. VUMC printout and Ms. Harris’s accounting of medical bills, excluding

Dr. Leavitt’s bills

18. UNUM FMLA medical certification

19. Dr. Steven Koester’s records excluding Ms. Harris’s handwritten notes

20. Rule 72 Declaration of Dr. Steven Koester

21. Transcript of Dr. Steven Koester’s 1/26/24 deposition

22. Video of Dr. Steven Koester’s 1/26/24 deposition

23. Settlement from Davidson County Chancery Court

6

Technical Record

1. Dispute Certification Notice

2. Request for Expedited Hearing

3. Motion to Dismiss filed by Fortitude

4. Employee’s Motion to Continue Status Conference,10/14/22

5. Order Granting Dismissal of Fortitude and Continuing Status Conference

6. Notice of Appearance filed by Counsel for American Home Assurance

7. Order on Status Conference entered 1/24/23

8. Employer’s Motion to Compel

9. Employer’s Notice to Strike Motion to Compel

10. Status Conference Order entered 3/8/23

11. Status Conference Order entered 4/13/23

12. Order Setting Expedited Hearing entered 5/22/23

13. Employee’s Motion to Strike June 6 Deposition of Dr. Steven Koester

14. Employee’s Motion for Sanctions filed June 6

15. Employer’s Motion to Continue Expedited Hearing

16. Employer’s Response to Motion to Strike Deposition and Motion for Sanctions

17. Order Denying Motion to Strike and Motion for Sanctions and Granting Motion for

Continuance entered 6/21/23

18. Employer’s Notice of Deposition filed J7/10/23

19. Order Setting Expedited Hearing entered 7/19/23

20. Employer’s Pre-hearing Brief filed 8/2/23

21. Employer’s Motion to Present Testimony of Anthony Grunkemeyer and Kevin Polk

by Teleconference filed 8/2/23

22. Employer’s Witness and Exhibit List

23. Employer’s Notice of Filing 6/6 Deposition of Dr. Steven Koester

24. Employer’s Notice of Filing 7/12 Deposition of Dr. Steven Koester

25. Employer’s Amended Witness and Exhibit List filed 8/9/23

26. Employer’s Amended Motion to Present Testimony of Joanne Jenkins and Kevin

Polk by Teleconference

27. Order Granting in Part and Denying in Part Motion for Testimony By Phone

28. Employer’s Amended Motion to Present Testimony of Kevin Polk by

Teleconference or Alternatively to Continue the 8/16/23 Expedited Hearing

29. Order Denying Amended Motion for Testimony by Phone and Resetting Expedited

Hearing

30. Order Granting Continuance of Expedited Hearing entered 8/28/23

31. Employer’s Motion to Appear by Telephone for Joanne Jenkins and Kevin Polk

32. Employer’s Motion to Appear by Telephone for Tifani Campbell

33. Employee’s “Motion to Dismiss question number 10”

34. Order on Motions for Testimony by Phone

35. Order Continuing Expedited Hearing and Setting Status Conference entered

7

12/11/23

36. Employee’s Motion

37. Order Setting Expedited Hearing entered January 29, 2024

38. Employer’s Response to Employee’s Motion and Motion for Sanctions to Quash

CERTIFICATE OF SERVICE

I certify that a copy of this Order was sent as indicated on March 13, 2024.

Name Mail Fax Email Service sent to:

Shunekari Harris, X shunekariharris@gmail.com

Employee

Allen Grant, X Agrant@eraclides.com

David Ward, dward@eraclides.com

Employer’s Attorneys adolan@eraclides.com

______________________________________

Penny Shrum, Court Clerk

Court of Workers’ Compensation Claims

wc.courtclerk@tn.gov

8

Right to Appeal:

If you disagree with the Court’s Order, you may appeal to the Workers’ Compensation

Appeals Board. To do so, you must:

1. Complete the enclosed form entitled “Notice of Appeal” and file it with the Clerk of the

Court of Workers’ Compensation Claims before the expiration of the deadline.

 If the order being appealed is “expedited” (also called “interlocutory”), or if the

order does not dispose of the case in its entirety, the notice of appeal must be filed

within seven (7) business days of the date the order was filed.

 If the order being appealed is a “Compensation Order,” or if it resolves all issues

in the case, the notice of appeal must be filed within thirty (30) calendar days of

the date the Compensation Order was filed.

When filing the Notice of Appeal, you must serve a copy on the opposing party (or attorney,

if represented).

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

days after filing 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 filing 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 your appeal.

3. You are responsible for ensuring a complete record is presented on appeal. If no court

reporter was present at the hearing, you may request from the Court Clerk the audio

recording of the hearing for a $25.00 fee. If you choose to submit a transcript as part of your

appeal, which the Appeals Board has emphasized is important for a meaningful review of

the case, a licensed court reporter must prepare the transcript, and you must file it with the

Court Clerk. The Court Clerk will prepare the record for submission to the Appeals Board,

and you will receive notice once it has been submitted. For deadlines related to the filing of

transcripts, statements of the evidence, and briefs on appeal, see the applicable rules on the

Bureau’s website at https://www.tn.gov/wcappealsboard. (Click the “Read Rules” button.)

4. After the Workers’ Compensation Judge approves the record and the Court Clerk transmits

it to the Appeals Board, a docketing notice will be sent to the parties.

If neither party timely files an appeal with the Appeals Board, the Court Order

becomes enforceable. See Tenn. Code Ann. § 50-6-239(d)(3) (expedited/interlocutory

orders) and Tenn. Code Ann. § 50-6-239(c)(7) (compensation orders).

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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