TWCA reviews whether an employee suffered a compensable injury that left him partially disabled

STEPHEN D. GOOD v. SUNKOTE PLASTIC COATINGS CORPORATION ET AL. (TWCA December 19, 2012)

Pursuant to Tennessee Supreme Court Rule 51, this workers' compensation appeal has been referred to the Special Workers' Compensation Appeals Panel for a hearing and a report of findings of fact and conclusions of law.

The employee sought workers' compensation benefits, alleging that he injured his back at work on September 30, 2008, and is now totally and permanently disabled. The employer denied that the employee sustained a compensable work-related injury, but alternatively argued that the employee is not totally and permanently disabled.

The trial court concluded that the employee sustained a compensable work-related injury and awarded 80% permanent partial disability benefits. The employer has appealed, arguing that the evidence preponderates against the trial court's finding that the injury was compensable and that, even if the employee proved a compensable injury, the evidence preponderates against the award of 80% permanent partial disability benefits. We affirm the trial court's judgment.

Opinion available at:
https://www.tba.org/sites/default/files/goods_121912.pdf

Court reviews whether the trial court had proper jurisdiction to review an administrative order from the Labor Department

C.H. GUENTHER & SON, INC. v. SUE ANN HEAD ET AL. (Tenn. Ct. App. December 10, 2012)

An employee appeals the trial court’s decision to void a final administrative order by the Department of Labor awarding the employee attorney fees with respect to the employee’s actions to enforce a workers’ compensation settlement. We have determined that the applicable request for assistance process does not constitute a contested case under the Uniform Administrative Procedures Act and that the trial court therefore lacked subject matter jurisdiction to hear this matter. We reverse the decision of the trial court.

Opinion available at:
https://www.tba.org/sites/default/files/chguenther.pdf

TWCA reviews whether an employee's injury was compensable.

SCOTT D. STRAIN v. MR. BULT’S, INC. ET AL. (TWCA November 29, 2012)

An employee alleged that he sustained an injury to his back. His employer denied the claim. The trial court found the injury to be compensable and awarded the employee 30% permanent partial disability benefits. The employer has appealed contending that the evidence preponderates against the trial court’s finding that the injury is compensable. On appeal, the employee asserts that the award of benefits was inadequate. After review of the record, we affirm the trial court’s judgment.

Opinion available at:
https://www.tba.org/sites/default/files/strains_112912.pdf

TWCA reviews whether the right to reconsideration of a settlement is triggered by an across-the-board wage reduction

RON W. ROBINSON v. BRIDGESTONE AMERICAS TIRE OPERATIONS, LLC (TWCA November 21, 2012)

This workers’ compensation appeal has been referred to the Special Workers’ Compensation Appeals Panel for a hearing and a report of findings of fact and conclusions of law pursuant to Tenn. Sup. Ct. R. 51.

The employee injured his neck in the course of his employment in 2005. He returned to work for his pre-injury employer and settled his claim subject to the one and one-half times impairment cap.

In 2009, the employer entered into a new collective bargaining agreement in which the hourly wages of all production workers were reduced. Thereafter, the employee sought reconsideration on his earlier settlement pursuant to Tenn. Code Ann. § 50-6-241(d)(1)(B) (2008). The trial court held that the across-the-board wage reduction did not trigger the right to reconsideration and denied the employee’s claim. We affirm the judgment.

Opinion available at:
https://www.tba.org/sites/default/files/robinsonr_112112.pdf

TWCA reviews whether the reconsideration of a settlement was barred by the statute of limitations

JOHN FREEMAN v. GENERAL MOTORS COMPANY ET AL. (TWCA October 22, 2012)

The employee sought reconsideration of workers’ compensation settlements concerning a back injury in 2003 and a right knee injury in 2006. The trial court granted the petition and increased the previous permanent partial disability awards to 30% to the body as a whole for the back injury and 100% to the leg for the knee injury.

The employer has appealed, contending that reconsideration of the back injury was barred by the statute of limitations, that the awards for both injuries were excessive, that the trial court incorrectly awarded benefits in excess of six times the anatomical impairment for the knee injury, and that the trial court erred by awarding benefits in a lump sum.

The employee contends that the trial court erred by failing to award permanent total disability benefits. We conclude that the employee’s petition for reconsideration of the settlement of his back injury was not timely filed and reverse that part of the judgment. We affirm the judgment in all other respects.

Opinion available at:
https://www.tba.org/sites/default/files/freemanj_102212.pdf

Court reviews a worker's compensation case involving a fraud upon the court

CHEYENNE DUFFER v. KEYSTOPS, LLC. (Tenn. Ct. App. August 1, 2012)

This appeal arises out of a personal injury suit, wherein the plaintiff and Dewayne Duffer filed suit against a trucking company for injuries suffered in an accident and for loss of consortium as a result of the accident. Plaintiff’s employer intervened to recover worker’s compensation benefits paid to plaintiff.

Soon thereafter, the trucking company discovered that plaintiff was male, had filed the action using an assumed female identity, and had lied throughout the discovery process. The trucking company filed a motion for summary judgment.

The court granted the motion and dismissed plaintiff’s and employer’s complaints, finding that plaintiff had committed a fraud upon the court and that employer had failed to file suit within the applicable statute of limitations because plaintiff’s complaint was rendered void ab initio. Plaintiff and employer appeal. We affirm the dismissal of plaintiff’s complaint but reverse the dismissal of employer’s complaint.

Opinion available at:
https://www.tba.org/sites/default/files/dufferc_080112.pdf

TWCA reviews the voluntariness of an employee's retirement and the extend of his disability for the purposes of awarding benefits

DANA AUTOMOTIVE SYSTEMS GROUP, LLC ET AL. v. LARRY EVANS (TWCA August 2, 2012)

An employee developed carpal tunnel syndrome. Before receiving medical treatment for that condition, he accepted an offer from his employer to resign in exchange for a lump sum payment of his retirement benefits. The offer was unrelated to the work injury.

The trial court granted the employer’s motion for partial summary judgment, finding that Tennessee Code Annotated section 50-6-241(d)(1)(A) (2008) limited the employee’s award of benefits to one and one-half times the anatomical impairment in light of his voluntary retirement.

On the date scheduled for trial, the trial court declined to hear evidence or permit an offer of proof concerning the voluntariness of his retirement and the extent of his vocational disability. Judgment was entered awarding permanent partial disability of one and one-half times the medical impairment. The employee has appealed. We vacate the judgment and remand the case to the trial court for a determination on the merits of the case.

Opinion available at:
https://www.tba.org/sites/default/files/danaautomotive_080212.pdf

Court reviews whether a medical expert's testimony was properly entered into evidence

BETTY FRANKLIN v. DURO STANDARD PRODUCTS CO., INC. (Tenn. Ct. App. August 1, 2012)

In this claim for workers’ compensation benefits, the trial court awarded permanent partial disability benefits to the employee for hearing loss. Her employer has appealed, contending that the trial court erred by admitting the testimony of the employee’s medical expert into evidence and by finding that her hearing loss was caused by her employment. We affirm the judgment of the trial court.

Opinion available at:
https://www.tba.org/sites/default/files/franklinb_080112.pdf

Court reviews a dispute between an insurance company and a trucking company involving over-the-road drivers

AMERICAN ZURICH INSURANCE COMPANY v. MVT SERVICES, INC., D/B/A MESILLA VALLEY TRANSPORTATION (Tenn. Ct. App. July 30, 2012)

This appeal involves retrospective insurance premiums on a workers’ compensation insurance policy. The defendant trucking company operates in several states, including Texas and Tennessee. Tennessee requires employers to maintain worker’s compensation insurance for certain employees, but Texas does not.

The defendant trucking company purchased workers’ compensation insurance for its Tennessee employees from the plaintiff insurance company. The trucking company employed over-the-road truck drivers who were Tennessee residents. The trucking company decided to classify its Tennessee-resident over- the-road drivers as Texas employees whose on-the-job injuries would not be covered by the Tennessee workers’ compensation insurance policy. Consequently, the trucking company did not pay insurance premiums to cover those employees.

The plaintiff insurance company conducted a retrospective premium audit; in the audit, it determined that the Tennessee- resident over-the-road drivers presented a risk of loss to the insurance company. Consequently, the insurance company notified the trucking company that it owed retrospective premiums based on those drivers. The trucking company refused to pay, so the insurance company canceled the insurance policy and filed this lawsuit for the retrospective premiums. The trial court granted summary judgment in favor of the insurance company, and the trucking company now appeals.

We affirm, finding under the undisputed facts that the Tennessee-resident over-the-road employees presented a risk of loss to the insurer under the workers’ compensation insurance policy during the relevant policy periods.

Opinion available at:
https://www.tba.org/sites/default/files/americanzurich_073012.pdf

TWCA reviews the award of workers' compensation benefits based on whether an employee had a meaningful return to work

JEFF KING v. GERDAU AMERISTEEL US, INC. (TWCA July 30, 2012)

An injured employee returned to work for his pre-injury employer. The employee was moved to a different area and worked fewer overtime hours because of his medical restrictions. The trial court held that the employee did not have a meaningful return to work pursuant to Tennessee Code Annotated section 50-6-241(d)(1)(A) (2008) and awarded permanent partial disability benefits in excess of one and one-half times the anatomical impairment. The employer appealed.

We hold that the employee had a meaningful return to work and that Tennessee Code Annotated section 50-6-241(d)(1)(A) limits the employee’s recovery to one and one-half times the anatomical impairment. We therefore modify the judgment of the trial court.

Opinion available at:
https://www.tba.org/sites/default/files/kingj_073012.pdf

TN Supreme Court reviews whether an employee's claim for workers' compensation benefits was barred by the statute of limitations

GERDAU AMERISTEEL, INC. v. STEVEN RATLIFF (Tenn. June 7, 2012)

An employee viewed the bodies of co-workers who had died as a result of work accidents on two separate occasions in February and April 2008. On June 23, 2008, the employee was diagnosed with post-traumatic stress disorder caused by the two incidents. On June 23, 2009, the employee requested a benefit review conference. The employer filed a complaint to determine the amount of workers’ compensation benefits due.

The employer subsequently filed a motion for summary judgment contending that the statute of limitations commenced on the date of the second accident and that the claim was therefore barred. The employee contended that the statute did not begin to run until the date of his diagnosis and that his claim was timely.

The trial court granted the employer’s motion. The employee appealed. We reverse the judgment of the trial court and remand the case for entry of a judgment consistent with the trial court’s alternative findings.

Opinion available at:
https://www.tba.org/sites/default/files/gerdau_060712.pdf

TN Supreme Court reviews whether an employee's injuries were compensable based on whether he refused to follow a safety rule

TROY MITCHELL v. FAYETTEVILLE PUBLIC UTILITIES (Tenn. May 8, 2012)

The trial court awarded workers’ compensation benefits to an injured lineman who had violated a rule requiring the use of protective gloves while in a bucket lift. The employer appealed, contending that the statutory defenses of willful misconduct and, more particularly, the willful failure or refusal to use a safety appliance or device precluded recovery.

The appeal was referred to the Special Workers’ Compensation Appeals Panel for a hearing and a report of findings of fact and conclusions of law in accordance with Tennessee Code Annotated section 50-6-225(e)(3) (2008). After oral argument before the Panel, but before the Panel filed its opinion, the case was transferred to the full Court.

Because the evidence establishes that the employee admitted his knowledge of a regularly enforced safety rule, understood the rationale for the rule, and willfully (rather than negligently or recklessly) failed to comply, the injuries he suffered because of the rule violation are not compensable. The judgment of the trial court is, therefore, reversed and the case is dismissed.

Majority opinion available at:
https://www.tba.org/sites/default/files/mitchellt_050812.pdf

Justice Holder's dissenting opinion is available at:
https://www.tba.org/sites/default/files/mitchellt_DIS_050812.pdf

TWCA reviews whether an employee exhausted his administrative remedies after his employer denied approval for a surgical procedure

SAMMY T. ROBERTSON v. ROADWAY EXPRESS, INC. (TWCA June 8, 2012)

Pursuant to Tennessee Supreme Court Rule 51, this workers’ compensation appeal has been referred to the Special Workers’ Compensation Appeals Panel for a hearing and a report of findings of fact and conclusions of law.

The employee injured his lower back on August 22, 2005. The trial court approved a settlement of his workers’ compensation claim in 2008. The order approving the workers’ compensation settlement provided for future authorized medical treatment in accordance with Tennessee Code Annotated section 50-6- 204.

In January 2011, the employee’s treating physician recommended a surgical procedure. The employer’s medical utilization review provider determined that the medical necessity of the procedure was not documented, and the employer denied approval for the procedure. The employee appealed the decision to the Department of Labor and Workforce Development (“the Department”), and the Department’s medical director did not overturn the utilization review decision.

The employee then filed a petition in the trial court, seeking an order requiring the employer to authorize the surgery. The trial court granted the petition but denied the employee’s application for attorney’s fees. The employer has appealed, contending that the trial court erred by granting the petition, that the employee failed to exhaust his administrative remedy, and that the petition is barred by res judicata and collateral estoppel. The employee has appealed from the denial of an award of attorney’s fees. We vacate the judgment of the trial court and dismiss the case without reaching the merits of the appeal.

TWCA reviews whether an employee was eligible for reconsideration of a workers' compensation settlement

MARVIN WINDOWS OF TENNESSEE, INC. v. JAMES GARDNER (TWCA June 8, 2012)

The employee was injured in 2007 and returned to work for his pre-injury employer. The employee’s claim was settled in November 2007 and was subject to the one and one-half times impairment cap set out in Tennessee Code Annotated section 50-6-241(d)(1)(A). In July 2009, the employee was diagnosed with cancer, and he took a medical leave of absence.

The employee remained on leave for over one year. The employer’s policy permitted one year of medical leave. When the employee was unable to return to work in July 2010, he was terminated pursuant to that policy. The employee then sought reconsideration of the November 2007 settlement.

The trial court found that the employee was not eligible for reconsideration. The employee has appealed, contending that the trial court’s ruling was erroneous. We affirm the judgment of the trial court.

Opinion available at:
https://www.tba.org/sites/default/files/marvinwindows_060812.pdf

TWCA reviews an employee's motion for post-judgment medical treatment

CYNTHIA SIMMONS v. KEN-KEL MANAGEMENT, INC. ET AL. (TWCA June 1, 2012)

An employee filed a motion requesting that a former employer be ordered to provide postjudgment medical treatment. After a hearing, the trial court granted the employee’s motion. The former employer has appealed, contending that the trial court erred in granting the employee’s motion. We affirm the trial court’s judgment.

Opinion available at:
https://www.tba.org/sites/default/files/simmonsc_060112.pdf

Court reviews whether an Employer was entitled to use Tennessee's worker's compensation law in order to recover subrogation benefits

JANICE LACROIX, et al., v. L.W. MATTESON, INC., et al. (Tenn. Ct. App. May 29, 2012)

Deceased, a resident of Iowa, an employee of plaintiff, delivered materials to the State of Tennessee, and while the materials were being unloaded sustained injuries which resulted in his death, which arose out of the course and scope of his employment.

His widow could claim benefits either under the Iowa worker's compensation laws or the State of Tennessee worker's compensation laws, which contain essentially similar provisions. The widow claimed benefits under the Iowa worker's compensation law, and the employer under both laws was entitled to seek subrogation recovery for benefits paid from the alleged third party tort feasors. The State of Iowa would not have jurisdiction over some of the alleged tort feasors, and the employer brought his subrogation action in the State of Tennessee under the Tennessee worker's compensation statutes.

Defendants moved for summary judgment and the Trial Court concluded that since the claimant elected to sue under the Iowa worker's compensation statutory scheme, that the employer could not rely on the Tennessee worker's compensation statutes to maintain its action in Tennessee, and dismissed plaintiffs' action. On appeal, we hold that the employer was entitled to employ the Tennessee worker's compensation statute in an effort to recover subrogation benefits against the third party tort feasors.

Opinion available at:
https://www.tba.org/sites/default/files/lacroixj_052912.pdf

The Tennessean: Workers' Comp Changes Likely on Horizon

Tennessee companies could see a reduction in workers' compensation premiums later this year according to The Tennessean, depending on the outcome of complex negotiations over the rates doctors receive for treating workers' comp patients. Several business groups support the measure, saying that an overall rate reduction would help make Tennessee more competitive with neighboring states, but many in the health care community say cuts would hurt medical providers and even force some of them to stop treating patients. Gov. Bill Haslam chose not to tackle workers' compensation reform this year, but is exploring major changes. Many observers expect this will be a major issue for the legislature in 2013.

Read the full story at the Tennessean's website.

TWCA determines the apportionment of liability between an employer and the Second Injury Fund

VICKI MARSH v. FARRAR HOLLIMAN AND MEDLEY ET AL. (TWCA May 12, 2012)

The only issue before the trial court was the apportionment of liability between the employer and the Second Injury Fund. The employee had two compensable injuries prior to the injury that rendered her permanently and totally disabled. The trial court found that those injuries had caused 85% permanent partial disability. Based on that finding, it held the employer liable for 15% of the award and the Second Injury Fund liable for 85% of the award. We find that the trial court incorrectly applied Tennessee Code Annotated section 50-6- 208(a)(1)(2008), and modify the award accordingly.

Opinion available at:
https://www.tba.org/sites/default/files/marshv_051212.pdf

TWCA reviews whether an employer was permitted to file a reconsideration action in a case in which an employee returned to his pre-injury position

LOJAC ENTERPRISES ET AL. v. LEONARD J. KANIPE (TWCA May 10, 2012)

Pursuant to Tennessee Supreme Court Rule 51, this workers’ compensation appeal has been referred to the Special Workers’ Compensation Appeals Panel for a hearing and a report of findings of fact and conclusions of law.

The employee was injured on the job and was able to return to his pre-injury position. His initial workers’ compensation claim was settled after a benefit review conference. As a part of his settlement he retained a right of reconsideration pursuant to Tennessee Code Annotated section 50-6-241(d)(1) (2008). Subsequently, he lost his employment.

After an impasse at the benefit review conference, his employer filed this action to reconsider the employee’s benefits in the county where the injury occurred. The employee then filed a similar suit in the county of his residence.

The employee filed a motion to dismiss the employer’s action, contending that Tennessee Code Annotated section 50-6-241(d)(1)(B)(iv) does not permit an employer to file a reconsideration action. The employer contended that the statute did permit filing of a reconsideration action by an employer or in the alternative, the statute was unconstitutional. The trial court in the employer’s case granted the motion to dismiss and found the statute constitutional. The employer has appealed. We affirm the judgment.

Opinion available at:
https://www.tba.org/sites/default/files/lojac_051012.pdf

TWCA reviews the credibility of an employee's testimony and whether the injury arose out of the course of employment

KIEWIT-ACT, A JOINT VENTURE v. CHRIS JONES and CHRISTOPHER BRYON JONES v. KIEWIT-ACT, A JOINT VENTURE and ZURICH AMERICAN INSURANCE COMPANY (TWCA May 20, 2012)

Pursuant to Tennessee Supreme Court Rule 51, this workers’ compensation appeal has been referred to the Special Workers’ Compensation Appeals Panel for a hearing and a report of findings of fact and conclusions of law.

The employee has appealed the trial court’s denial of benefits for injuries to his right shoulder purportedly caused by a fall at work. The trial court denied the claim based on a finding that the employee’s testimony was not credible and that he failed to establish that his injury arose out of and in the course of his employment. The employee has also challenged the trial court’s award of $3,245.25 in discretionary costs to the employer. We affirm the trial court’s judgment.

Opinion available at:
https://www.tba.org/sites/default/files/kiewitact_051012.pdf