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Case Law Database

Access over workers' compensation decisions, including En Banc, Significant Panel Decisions, and writ-denied cases.

Case No. 2015-02-0128
Regular Panel Decision
Oct 06, 2015

Karig, Monica v. Oddello Industries

Monica Karig, an employee of Oddello Industries, sought additional medical benefits for bilateral carpal tunnel syndrome, alleging it was a result of repetitive arm movements at work. She requested an additional panel of physicians after being dissatisfied with the initial panel and a causation letter from Dr. Freeman, which did not confirm work-related causation. The employer, Oddello Industries, denied compensability and requested a signed medical release. The Court denied Ms. Karig's request for an additional panel of physicians, finding she failed to prove entitlement and did not provide expert medical evidence to rebut Dr. Freeman's opinion. The Court granted Oddello's request for a signed medical release for Ms. Karig's medical records.

Workers' CompensationCarpal Tunnel SyndromeMedical BenefitsExpedited HearingPanel of PhysiciansMedical ReleaseCausationPre-existing ConditionRepetitive Strain InjuryTennessee Law
References
5
Case No. 2016-06-0081
Regular Panel Decision
Jun 01, 2016

Scott, William v. Air Now

William Scott, an employee of Air Now, filed a Request for Expedited Hearing seeking additional medical benefits, specifically a new panel of physicians, and past temporary disability benefits. The court found Air Now's initial panel of physicians legally insufficient due to non-compliance with statutory requirements and ordered the employer to provide a new panel. Furthermore, the court determined Mr. Scott was entitled to temporary partial disability benefits from January 7 through January 28, 2016. This was because, despite a previous maximum medical improvement designation, temporary work restrictions were reinstated during this period, indicating he was no longer at MMI and unable to perform full duties. The court declined to rule on the 'unavailability' of physicians or the quality of care.

Workers' CompensationExpedited HearingMedical BenefitsTemporary DisabilityPhysician PanelMaximum Medical ImprovementWork RestrictionsShoulder InjuryMotor Vehicle AccidentStatutory Compliance
References
5
Case No. ADJ11629744
Regular
Apr 24, 2023

ROCHELLE BOYD vs. VISSER, NATIONAL INTERSTATE RICHFIELD

The applicant sought reconsideration after the WCJ denied injury claims to the brain, internal system, psyche, and sexual dysfunction, as well as the issuance of additional QME panels. The Appeals Board granted reconsideration, finding good cause existed for additional QME panels in internal medicine and psychiatry. The original findings of fact were rescinded, and the issue of further QME panels in urology and neurology was deferred. The Board concluded that additional QME evaluations were necessary for a full adjudication of the claimed injuries outside of the admitted orthopedic injuries.

Workers' Compensation Appeals BoardPetition for ReconsiderationQualified Medical EvaluatorQME panelsinternal medicinepsychiatryneurologyurologysexual dysfunctionpsyche
References
3
Case No. 2020-01-0376
Regular Panel Decision
Mar 02, 2023

Melton, Jeannette v. Amazon.com Services, LLC

Ms. Melton, an employee, sought an order for a panel of physicians in New Orleans, Louisiana, after relocating, following a work-related head injury on June 3, 2020. The employer, Amazon.com Services, LLC, denied the panel, citing a records review and issues with providing a neurologist in the requested locale. Judge Audrey Headrick found the treating physician's opinion more persuasive than the defense's record review, ruling that Ms. Melton is entitled to additional medical benefits and a panel of neurologists in her new community. The Court ordered Amazon to provide the panel by March 31, 2023. Additionally, the case was referred to the Compliance Program for consideration of penalty assessments against Amazon for its failure to provide a compliant panel and continue medical benefits.

Workers' CompensationConcussionTraumatic Brain InjuryPanel of PhysiciansMedical TreatmentOut-of-State RelocationNeurologist ReferralEmployer ObligationUtilization ReviewPenalty Assessment
References
1
Case No. ADJ10917207
Regular
Aug 13, 2019

CARMEN ROJO vs. K & M MEAT COMPANY, STARR INDEMNITY & LIABILITY COMPANY

This case involves a dispute over the necessity of an additional Qualified Medical Evaluator (QME) panel in orthopedic surgery. The Applicant sought reconsideration of an administrative law judge's (ALJ) order for a new orthopedic QME panel, arguing it was an abuse of discretion and prejudicial. The Appeals Board granted reconsideration, finding the original QME's referral for an orthopedic evaluation was for treatment, not a recommendation for a new medical-legal evaluation. Consequently, the Board amended the ALJ's findings, holding there was no good cause for an additional orthopedic QME panel and denying the defendant's request.

QME panelorthopedic surgeryreconsiderationremovalFindings & Orderchiropractic QMEmedical-legal evaluationgood causesupplemental pleadingmedical dispute
References
9
Case No. 2019-03-1132
Regular Panel Decision
Aug 13, 2020

Sauber, Sarah v. Harbor Freight Tools USA, Inc.

Sarah Sauber, an employee, sought additional medical treatment for her right hand and elbow, and temporary partial disability benefits after sustaining a work injury. The Court granted her request for a hand-specialist panel, acknowledging a referral from a panel-selected physiatrist, Dr. Steven Musick. However, the Court denied her requests for a new orthopedic panel or a second opinion for her elbow, finding no refusal to treat by her authorized physician, Dr. David Hovis, and no recommendation for surgery. Additionally, her claim for temporary partial disability benefits was denied as she continued to work comparable hours and pay post-injury.

Worker's CompensationExpedited HearingMedical TreatmentHand Specialist ReferralElbow InjuryTemporary Partial DisabilityMaximum Medical ImprovementPhysician ReferralSecond OpinionTennessee Law
References
5
Case No. 2014-08-0058
Regular Panel Decision
Sep 18, 2015

Marzette, Shelton v. Pat Salmon and Sons, Inc.

This is an interlocutory appeal where the employee, Shelton Marzette, alleges work-related hearing loss and vertigo while driving a truck. The employer, Pat Salmon and Sons, Inc., denied the claim after a physician selected from their initial panel opined that the condition was not work-related. The trial court determined that the employer's provided panel of medical providers did not meet statutory requirements and awarded additional medical benefits, requiring the employer to provide a new panel of physicians specializing in hearing loss injuries for a causation opinion. The Appeals Board affirmed the trial court's decision, concluding that the issue of additional medical benefits was properly considered and that the evidence did not preponderate against the trial court's findings.

Workers' Compensation AppealsMedical BenefitsHearing LossVertigoPanel of PhysiciansCausation OpinionExpedited HearingDispute Certification NoticeStatutory ComplianceMedical Care Entitlement
References
1
Case No. WCB No. G0699039
Regular Panel Decision
Sep 23, 2011

HARRIS, JEFFREY T. v. SCHMIDT, ASHLEY E.

Leo P. DiLuzio sustained work-related injuries to his neck, back, and left knee on July 19, 2005. He was classified with a permanent partial disability and received an additional 25 weeks of Schedule Loss of Use (SLU) for his left knee, making it a 50% SLU. The self-insured employer argued that the 525-week cap on indemnity benefits for concurrent SLU and PPD awards under Workers' Compensation Law § 15(3)(w) should apply, despite the pre-July 26, 2010 accident date. The Workers' Compensation Law Judge (WCLJ) ruled that the claimant was entitled to both SLU and PPD awards without the 525-week cap. The Board Panel affirmed the WCLJ's decision, referencing Matter of Sanchez and clarifying that the 525-week cap in § 15(3)(w) is applicable only to accidents occurring on or after July 26, 2010.

Workers' CompensationPermanent Partial DisabilitySchedule Loss of UseIndemnity BenefitsConcurrent AwardsStatutory InterpretationAccident DateLegislative AmendmentSection 15(3)(w)Section 15(3)(v)
References
1
Case No. 2020-06-0216
Regular Panel Decision
Sep 21, 2020

De Rosa, Debra v. I & MJ Gross Co.

Debra De Rosa, an employee of I & MJ Gross Co., injured her wrist and subsequently sought additional treatment with a new doctor. She contended that the carrier, Nationwide Mutual Ins. Co., failed to offer a panel of physicians or inform her of her right to choose from a list of three doctors. However, I & MJ Gross Co. denied these allegations, asserting that it had twice fulfilled its statutory obligation to offer a physician panel. The Court found the employer's testimony credible regarding the panel offer and noted that Ms. De Rosa accepted treatment from Dr. John Weaver. Dr. Weaver ultimately placed her at maximum medical improvement and stated no further treatment was necessary, leading the Court to deny Ms. De Rosa’s request for additional medical care.

Workers' CompensationMedical TreatmentPhysician PanelCredibility DeterminationWrist InjuryMaximum Medical ImprovementStatutory ObligationEmployee RightsEmployer ResponsibilityMedical Benefits
References
1
Case No. 2016-07-0772
Regular Panel Decision
May 25, 2017

Jacks, Bonnie v. Camden Healthcare/Northpoint Senior Services, LLC

Bonnie Jacks, an employee of Northpoint, sustained a left shoulder injury in 2015. She requested an expedited hearing for additional medical benefits and approval of physician referrals to orthopedic and pain management specialists, as well as payment of outstanding medical bills. The employer, Northpoint, failed to provide a panel of physicians as required by law, instead offering Dr. Berry and later accepting a referral to Dr. Chandler. The Court found Ms. Jacks entitled to a panel of physicians for an orthopedic evaluation and ordered Northpoint to approve Dr. Berry’s referral to Tennessee Orthopedic Alliance. Additionally, Northpoint was ordered to pay Dr. Berry's outstanding bills totaling $340.00. The Court denied Ms. Jacks' counsel's request for attorney's fees but referred the case to the Penalty Unit for consideration of a penalty against Northpoint for failing to timely provide a panel of physicians.

Workers' CompensationMedical BenefitsExpedited HearingPhysician PanelOrthopedic ReferralPain ManagementAttorney's Fees DeniedPenalty Unit ReferralRotator Cuff TearShoulder Injury
References
3
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