The Exception Proves the Rule 2014

Mar 1, 2017 | News, Workers' Compensation

By Courtney S. Paterson

The Tennessee Workers’ Compensation Appeals Board hands down several cases each month that expound upon and demonstrate the changes made to the Workers’ Compensation Laws in 2014. While certain cases may outline exceptions, the new law continues to be upheld by the Appeals Board.

In the case of Paula Dugger v. Home Health Care of Middle Tennessee, filed on January 31, 2017, the employee was employed as a home health nurse for her employer, Home Health Care of Middle Tennessee (HHC). While returning to her home from an attempt to travel to a patient’s residence, she was injured in a motor vehicle accident. The employer denied Ms. Dugger’s claim, contending that the injury did not occur in the course of her employment. The trial court dismissed the employee’s claim.

  • Ms. Dugger appealed directly to the Supreme Court, as permitted by Tennessee Code Annotated sections 50-6-225(a)(1) (2014) and 50-6- 239(c)(7) (2014). The Supreme Court reversed the holding of the trial court, holding that the unique facts of this case fall within the general exception to the coming and going and coming rule. Our Supreme Court has stated that, if the journey itself is a substantial part of the services for which the employee was employed and compensated, then an accident that occurs on that journey is compensable.
  • Finding that the injury, in this case, was compensable, the delivery of nursing services to patients in their homes is the most important feature of HHC’s business, and having employees traveling to its patients’ homes is an essential component of that service, secondary only to the actual health care which is provided. As such, the Court held that the employee was acting within the course of her employment with the employer at the time her injuries were sustained.

In Samuel Stallion v. TruGreen, L.P. filed on February 2, 2017, the employee sustained an injury to his back as a result of having to lift the rear gate of the landscaping truck provided to him by his employer when the cable-assist mechanism malfunctioned. He testified that, prior to this injury, he had not had pain in his back. He was referred to an orthopedic physician, and he selected Dr. Jolley from a panel of physicians.

  • His assessment was discogenic low back pain, L3-5 degenerative disc disease, and a “resolving” sprain. Dr. Jolley stated that, after looking at his films again, L3-L5 appeared degenerative enough to cause pain but that the degeneration was not work-related. He indicated that the employee may need a fusion of L3-L5 under private insurance.
  • Subsequently, Dr. Jolley completed a C-30A Final Medical Report and also responded to another letter from the employer, stating that the employee did not need any further medical treatment for his back sprain, and if any further medical treatment was needed, the treatment would be for degenerative disc disease that is not work-related. The trial court held that the employee was likely to prevail at a hearing on the merits based on a finding that he sustained a compensable aggravation of his degenerative condition.
  • The Appeals Board reversed the holding of the trial court on the basis that the medical proof from Dr. Jolley, the authorized treating physician, which is presumed correct, supported a finding that any further medical treatment needed by the employee for his back was not attributable to the work injury. Dr. Jolley’s opinion is entitled to a presumption of correctness pursuant to Tennessee Code Annotated section 50-6-102(14)(E) (2016).

In Reginald L. Watson v. Labor Smart, Inc., et al., filed on February 10, 2017, the appeals board affirmed the trial court’s decision to award temporary disability benefits.

  • Although an injured worker has the burden of proof on every element of his or her claim, at an expedited hearing, an employee need not prove every element by a preponderance of the evidence but must come forward with sufficient evidence from which the trial court can determine that the employee would likely prevail at trial consistent with Tennessee Code Annotated section 50-6-239(d)(1) (2015).
  • The burden of proof at an expedited hearing is a lesser evidentiary standard that “does not relieve an employee of the burden of producing evidence of an injury by accident that arose primarily out of and in the course and scope of employment . . ., but allows some relief to be granted if that evidence does not rise to the level of a ‘preponderance of the evidence.'” Buchanan v. Carlex Glass Co., No. 2015-01-0012, 2015 TN Wrk. Comp. App. Bd. LEXIS 39, at *6 (Tenn. Workers’ Comp. App. Bd. Sept. 29, 2015).

These cases are just three of many that are filed by the Appeals Board each month demonstrating the changes to the workers’ compensation laws enacted by the legislature that went into effect July 1, 2014. While there continue to be general exceptions, the legislative changes that went into effect more than two years ago continue to be upheld by the Court.

 

An associate with Spicer Rudstrom since 2009, Courtney focuses her practice on automobile liability, insurance coverage litigation, insurance defense litigation, insurance subrogation, premises liability, products liability, and workers’ compensation. She is admitted to practice in all trial and appellate state courts in Tennessee, as well as the U.S. District Court for the Middle District of Tennessee.