By Courtney S. Paterson
Tim Venable v. Superior Essex, Inc., et al.
Docket No. 2015-05-0582
State File No. 78398-2014
Filed November 2, 2016
This is a case before the Appeals Board on an interlocutory appeal filed by the employer, and the dispute was whether the employer should be required to provide the employee medical benefits.
The employee alleged a left knee injury on September 18, 2014, when he twisted his left knee stepping off a forklift. His employer accepted the claim as compensable and provided authorized medical treatment with Dr. Randall Davidson. Dr. Davidson diagnosed a tear of the medial meniscus and performed an arthroscopic repair of the meniscus.
After continued complaints, the employee was referred to Dr. Scott McCall, who recommended a second surgery that he opined was related to the original workers’ compensation injury. In response, the employer sought a utilization review with Dr. Glenn Smith, who concluded the recommended second surgery was not medically necessary.
The employer then denied authorization for the surgery recommended by Dr. McCall. Dr. McCall revised his request for the recommended surgery. The employer again submitted the request for utilization review, this time with Dr. Bart Goldman, who concluded that while the recommended surgery was likely reasonable, he nonetheless opined it was unrelated to the work injury.
The trial court determined that the employee was likely to succeed at a hearing on the merits and ordered the employer to provide ongoing medical care, including surgery recommended by the authorized treating physician, Dr. McCall. The trial court held that the utilization review physicians did not overcome the statutory presumption of correctness applicable to the opinion of the authorized physician.
The appeals board affirmed the trial court’s decision and remanded the case.
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.
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