Opinion

TOLEDO, FRANCISCO BELLO v. SAFETY NATIONAL CASUALTY CO.

  • 2024 TN WC 33
Court
Tennessee Court of Workers' Compensation Claims
Filed
Apr 17, 2024
Status
Published
On the bench
Joshua Davis Baker
Cited by
0 cases

The opinion

FILED

Apr 17, 2024

09:16 AM(CT)

TENNESSEE COURT OF

WORKERS' COMPENSATION

CLAIMS

TENNESSEE BUREAU OF WORKERS’ COMPENSATION CLAIMS

IN THE COURT OF WORKERS’ COMPENSATION CLAIMS

AT NASHVILLE

FRANCISCO BELLO TOLEDO, ) Docket No. 2023-06-1942

Employee, )

v. )

)

GENUINE PARTS CO., ) State File No. 5274-2023

Employer, )

And )

)

SAFETY NATIONAL CASUALTY ) Judge Joshua D. Baker

CO., )

Carrier. )

EXPEDITED HEARING ORDER

At an April 4, 2024 expedited hearing, Mr. Bello Toledo sought benefits for “pain

and suffering,” lost wages, and money to treat a back injury allegedly arising from a

collision between two cherry pickers at work. For the reasons below, the Court denies his

request.

Claim History

Mr. Bello Toledo was operating a cherry picker at Genuine Parts on January 16,

2023, when another cherry picker collided with his, jarring his back. When he complained

of back and neck pain, the safety manager scheduled an appointment with a nurse

practitioner, who ordered x-rays. The x-rays were normal except for an “area of concern

along the base of his thoracic spine,” deemed “likely chronic” rather than from acute

trauma.

Ten days after the injury, the safety manager scheduled an appointment for Mr.

Bello Toledo directly with orthopedist Dr. Joseph Blythe. Dr. Blythe recommended

physical therapy, offered an injection that Mr. Bello Toledo declined, and set a follow-up

appointment.

However, when Mr. Bello Toledo returned for his follow-up, he said Dr. Blythe’s

staff rescheduled his appointment for being late. Because he felt his treatment could not

wait, he went to the emergency room, where he received medication and a referral to an

orthopedist.

Mr. Bello Toledo went to see Dr. Eric Neff, who also recommended physical

therapy, which Mr. Bello Toledo completed. Genuine Parts paid for all medical treatment,

including the unauthorized emergency room visit, physical therapy, and treatment with Dr.

Neff.

Two months after the injury, Genuine Parts offered a panel of physicians, and Mr.

Bello Toledo chose a spine specialist even though he wished to only continue seeing Dr.

Neff. So Genuine Parts did not schedule an appointment and declined to pay for any further

medical care.

Two months later, Dr. Neff signed a Final Medical Report stating Mr. Bello Toledo

had zero impairment, and he anticipated the injury would not require additional medical

care.

At the expedited hearing, Mr. Bello Toledo complained he had received only about

60% of his pay when unable to work. He requested the remainder of his lost wages, money

to treat on his own, and compensation for “pain and suffering.”

Findings of Fact and Conclusions of Law

To receive benefits at an expedited hearing, Mr. Bello Toledo must prove he would

likely prevail at a final hearing. McCord v. Advantage Human Resourcing, 2015 TN Wrk.

Comp. App. Bd. LEXIS 6, at *7-8, 9 (Mar. 27, 2015). Genuine Parts contended that Mr.

Bello Toledo is unlikely to prevail at a final hearing in proving a compensable injury.1

To prove a compensable injury, an employee must show “to a reasonable degree of

medical certainty that [the work accident] contributed more than fifty percent (50%) in

causing the . . . disablement or need for medical treatment, considering all causes.” Tenn.

Code Ann. § 50-6-102(12)(A)-(D) (2023). Unless a cause is obvious, an “employee must

present expert medical proof that the alleged injury is causally related to the employment.”

Berdnik v. Fairfield Glade Com’ty Club, 2017 TN Wrk. Comp. App. Bd. LEXIS 32, at *11

(May 18, 2017).

A back injury’s cause is not obvious, as they occur in numerous ways and for

diverse, complicated reasons. Yet Mr. Bello Toledo produced no expert evidence showing

his back condition is causally related to his work accident or even that further treatment is

required. For this reason, the Court denies his request for benefits.

1

Genuine Parts moved for dismissal under Tennessee Rule of Civil Procedure 41.02(2) (2023). However,

this decision makes that motion moot. At an interlocutory stage, granting a Rule 41.02 motion operates only

to deny interlocutory benefits without dismissing the claim. Carrillo v. Hurtado, 2023 TN Wrk. Comp.

App. Bd. LEXIS 40, at *10 (Aug. 16, 2023). Because benefits are denied, the outcome is the same.

Even if Mr. Bello Toledo had produced expert proof that he his injury arose

primarily from his employment and requires additional treatment, the Court has no

authority to award the relief he requested, including compensation for “pain and suffering,”

money for more treatment, or his full pay as opposed to temporary disability benefits,

which is “sixty-six and two-thirds percent (66 ⅔%) of [his] average weekly wages[.]”

Tenn. Code Ann. § 50-6-207.

Rather, the Workers’ Compensation Law requires an employer to “furnish, free of

charge to the employee, such medical and surgical treatment . . . made reasonably necessary

by accident[.]” Id. at -204(a)(1)(A).

To a degree, Genuine Parts satisfied this requirement, as it paid for medical

treatment. On the other hand, Genuine Parts ignored its legal obligation to offer Mr. Bello

Toledo a choice of physicians within three days from when he notified his safety manager

of his injury and expressed a need for medical care. Tenn. Comp. R. & Regs. 0800-02-01-

.06(1) (2018). Instead, it directed him to a nurse practitioner and then to Dr. Blythe, leaving

him without a choice of physician. Although permissible, directing an injured worker to

“employer-sponsored medical providers . . . does not satisfy nor alleviate the requirement

for providing an appropriate panel within the three (3) business days.” Id. at -.06(4).

Genuine Parts offered a panel only after two months and did so disingenuously, as

Mr. Bello Toledo testified that he never received an appointment with his panel-selected

physician. Therefore, the Court refers Genuine Parts to the Compliance Program of the

Bureau of Workers’ Compensation for appropriate action based on its failure to timely

offer a panel of physicians, as required by the Workers’ Compensation Law.

It is ORDERED as follows:

1. Mr. Bello Toledo’s request for benefits is denied at this time for lack of proof.

2. The Court refers Genuine Parts to the Compliance Program of the Bureau of

Workers’ Compensation for appropriate action, if any, based on its failure to provide

a panel of physicians within three days as required by Tennessee Compilation Rules

and Regulations 0800-02-01-.06(1).

3. The Court sets a status hearing for Monday, June 3, 2024, at 10:30 a.m. Central

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

result in a determination of the issues without the party’s participation.

ENTERED April 17, 2024.

______________________________________

JOSHUA D. BAKER, JUDGE

Court of Workers’ Compensation Claims

APPENDIX

Exhibits:

1. Medical Records

2. Rule 72 Declaration of Francisco Bell Toledo (excluding hearsay statements

concerning diagnosis and treatment)

3. GPC Return to Work form dated May 1, 2023

4. Final Medical Report

5. List of Claim Payments

6. Panel

Technical Record:

1. Petition for Benefit Determination

2. Dispute Certification Notice

3. Request for Expedited Hearing

4. Show Cause Order entered October 10, 2023

5. Show Cause Order entered November 7, 2023

CERTIFICATE OF SERVICE

I certify that a copy of this Order was sent as shown on April 17, 2024.

Name Certified Email Service sent to:

Mail

Francisco Bello X bello2373@yahoo.com

Toledo,

Self-represented

Employee

Nick Lastra, X nalastra@mijs.com

Employer’s Attorney nowens@mijs.com

______________________________________

PENNY SHRUM, COURT CLERK

wc.courtclerk@tn.gov

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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