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

Case No. 2015-05-0619
Regular Panel Decision
Jun 28, 2017

Baumgardner, William v. UPS

William Baumgardner, a delivery driver, sustained a left-knee injury while working for UPS in 2014. He sought permanent disability benefits, arguing the injury, including a medial meniscus tear, was compensable and that the employer's provided medical panel was invalid. The Workers' Compensation Judge denied the claim for permanent disability benefits, finding Mr. Baumgardner failed to prove the medial meniscus tear was primarily caused by the work injury and did not establish entitlement to PTD or PPD benefits under the AMA Guides. However, the court found the employer's initial medical panel invalid due to geographic limitations and ordered UPS to provide a new panel of orthopedic specialists for ongoing medical treatment.

Knee InjuryMedical Panel DisputePermanent Disability DenialCausation of InjuryAMA GuidesTreating Physician OpinionIME ReportVocational DisabilityTennessee LawWorkers' Compensation Judge
References
7
Case No. 534152
Regular Panel Decision
Jun 02, 2022

In the Matter of the Claim of Maurice Blue

Claimant Maurice Blue sustained a right leg injury in 2016, leading to a workers' compensation claim for his right knee. His physician diagnosed a medial meniscus tear and chondromalacia patella, initially recommending a 50% schedule loss of use (SLU) but later limiting it to 10% based on the 2018 Workers' Compensation Guidelines for Determining Impairment. The Workers' Compensation Law Judge (WCLJ) awarded 50% SLU, but the Workers' Compensation Board modified this to 10%, strictly applying a special consideration for chondromalacia patella and disregarding the meniscal tear. The Appellate Division found the Board's interpretation irrational, stating it leads to inequitable outcomes where greater injury results in lesser compensation. Consequently, the court modified the Board's decision, reversing the restrictive interpretation of the guidelines and remitting the matter for a proper assessment of the evidence.

Schedule Loss of UseKnee InjuryChondromalacia PatellaMeniscus TearMedical Impairment GuidelinesAppellate ReviewStatutory InterpretationEquity in CompensationRange of Motion DeficitsWorkers' Compensation Law
References
33
Case No. 2018-08-1537
Regular Panel Decision
Apr 30, 2019

Gammel, Loretta v. Bratton & O'Neal, P.C.

Loretta Gammel, a legal assistant for Bratton & O’Neal, P.C., sustained a compensable left-knee injury on February 6, 2018, while at work. Her authorized treating orthopedist, Dr. Timothy Micek, recommended surgery for an acute medial meniscus tear after conservative treatment failed, causally relating the injury to her work. Despite Dr. Micek's recommendations, utilization review denied the surgery. Ms. Gammel then sought an Expedited Hearing to compel approval of the surgery. The Court ruled in favor of Ms. Gammel, finding that she is likely to prevail at trial, as Dr. Micek's treatment recommendations are presumed medically necessary and the employer presented no rebutting medical evidence. Consequently, the Court ordered Bratton & O’Neal, P.C. to provide the necessary medical treatment, including the meniscus surgery.

Workers' CompensationMedical BenefitsKnee InjuryMeniscus TearExpedited HearingUtilization Review DenialTreating PhysicianCausationOrthopedicsPresumption of Medical Necessity
References
0
Case No. 2022-07-0577
Regular Panel Decision
Aug 14, 2023

Johnson, Carlos M. v. Corecivic, Inc.

Carlos M. Johnson, an employee, sought permanent impairment benefits for a left meniscus tear sustained at work, arguing that his pre-existing arthritis was aggravated by the injury and subsequent surgery, warranting a higher impairment rating. The Court of Workers' Compensation Claims at Jackson adopted Dr. Ferguson's one-percent impairment rating for the meniscus tear, rejecting Mr. Johnson's argument regarding the arthritis. The court found that Mr. Johnson failed to provide sufficient evidence to rebut the presumption that the authorized treating physician's (Dr. Ferguson) opinion was correct, which stated that the arthritis preexisted the injury and was not caused or aggravated by the work-related incident or surgery. Dr. Chung's opposing expert opinion was undermined by his mistaken belief about Mr. Johnson's age.

Permanent ImpairmentMeniscus TearArthritis AggravationMedical Expert OpinionCausationPresumption of CorrectnessChondroplastyIndependent Medical Evaluation (IME)Preexisting ConditionWeight as contributing factor
References
4
Case No. 2019-03-1017
Regular Panel Decision
Dec 20, 2019

Friend, Kenneth v. Staples

Kenneth Friend, a sales manager for Staples, alleged a right-knee injury sustained while working with planograms on June 19-20, 2019. He experienced increasing pain, swelling, and was later diagnosed with a medial meniscus tear by Dr. Todd Griffith, who recommended surgery. Staples denied the claim. Following an expedited hearing, the Court found Mr. Friend likely to prevail that his injury arose primarily out of employment. The Court awarded medical benefits, ordering Staples to approve the recommended surgery, but denied temporary disability benefits due to ongoing short-term disability payments from Staples and his work at a family business.

Right-knee injuryMedial meniscus tearMCL sprainArthroscopic repairExpedited hearingMedical benefitsTemporary total disability benefitsCausationArising out of employmentCourse and scope of employment
References
2
Case No. MISSING
Regular Panel Decision

Continental Casualty Co. v. Baker

This workers' compensation case concerns James Baker's left knee injury sustained in 2000 and the subsequent dispute over whether a medial meniscus tear identified in a December 2005 MRI extended from the original workplace accident. Appellant Continental Casualty Company, the employer's insurer, sought judicial review of the Division of Workers' Compensation's decision in Baker's favor. The core of the appeal involves Continental's challenge to the trial court's jury instructions, particularly the definition of 'producing cause' which was deemed legally incorrect and confusing under newly established Texas Supreme Court precedent. The appellate court reversed the judgment and remanded the case for further proceedings, finding the erroneous jury instruction on causation to be harmful given the conflicting expert medical testimony.

Workers' CompensationJury InstructionProducing CauseMedical CausationMeniscus TearExpert TestimonyAttorney's FeesAppellate ReviewTexas LawEmployment Injury
References
23
Case No. 2015-08-0295
Regular Panel Decision
Apr 06, 2016

Anderson, Barry v. Aramark

Barry Anderson, an employee of Aramark, sustained a right-knee injury on May 26, 2015, while performing strenuous duties in the 'mats cell.' Despite reporting the injury and requesting medical attention, Aramark denied his workers' compensation claim, asserting it was not work-related or was pre-existing. Mr. Anderson sought treatment from Dr. Lloyd Robinson and later orthopedic specialist Dr. Anthony Mascioli, who diagnosed a right-knee medial meniscus tear. In an expedited hearing, the Court found Mr. Anderson credible and his injury compensable, ordering Aramark to provide a panel of physicians for his medical treatment. However, the Court denied his request for past medical expenses and temporary disability benefits without prejudice, allowing for future consideration.

Expedited HearingMedical Benefits ClaimRight Knee InjuryMedial Meniscus TearPanel of PhysiciansEmployer's Denial of ClaimInjury CausationTemporary Disability BenefitsMedical Treatment AuthorizationWorkplace Accident
References
2
Case No. 2015-06-0414
Regular Panel Decision
Dec 01, 2015

Cartee, Diana v. Schwan’s Food Service, Inc.

Diana Cartee, an employee of Schwan's Food Service, Inc., filed for an expedited hearing seeking medical benefits for a left knee injury sustained on June 3, 2015, while descending steps during a sales call. She claimed her knee twisted, resulting in a medial meniscus root tear. The employer, Schwan's, and its carrier, Hartford Insurance Company, argued the injury was idiopathic and not compensable. Chief Judge Kenneth M. Switzer found Ms. Cartee credible regarding the 'course of employment' but ultimately denied medical benefits, concluding she failed to prove the injury 'arose primarily out of' her employment due to the absence of a peculiar or additional hazard on the steps. The court also disregarded Dr. Allen Anderson's medical opinion on causation as an unqualified legal conclusion.

Workers' CompensationExpedited HearingMedical BenefitsKnee InjuryIdiopathic ConditionCourse of EmploymentArising Out of EmploymentCausationMedical EvidenceCredibility Assessment
References
13
Case No. 2016-03-0095
Regular Panel Decision
Dec 22, 2016

Babb, Willis Ray v. House Hasson Hardware Co., Inc.

Mr. Willis Ray Babb, an employee of House Hasson Hardware Co., Inc., sought an expedited hearing after sustaining a left-knee injury. This injury reportedly arose from an altered gait following a compensable left-foot injury in October 2015, which occurred when a pallet-jack fell on his foot. The employee experienced escalating knee pain, culminating in his knee buckling in January 2016, leading to an MRI revealing a medial meniscus tear and other degenerative changes. The employer's carrier denied the knee claim. The Workers' Compensation Judge, Pamela B. Johnson, ruled that Mr. Babb demonstrated a likelihood to prevail on the merits, establishing the injury's causation from his employment. Consequently, the Court granted his request for medical benefits for both his left foot and left knee, ordering House Hasson to provide a panel of orthopedic physicians.

Workers' CompensationLeft Knee InjuryFoot InjuryTruck DriverPallet-Jack IncidentMedical BenefitsExpedited HearingGait ChangeMeniscus TearChondromalacia
References
2
Case No. 2022 NY Slip Op 03565
Regular Panel Decision
Jun 02, 2022

Matter of Blue v. New York State Off. of Children & Family Servs.

Claimant Maurice Blue sustained a work-related right leg injury in December 2016, with his claim for workers' compensation benefits established for a right knee injury including a medial meniscus tear and chondromalacia patella. His physician initially assessed a 50% schedule loss of use (SLU) based on range of motion deficits but, applying a special consideration in the 2018 Workers' Compensation Guidelines for chondromalacia patella, limited his opinion to 10% SLU. The Workers' Compensation Board (WCB) adopted this 10% SLU, reversing a Workers' Compensation Law Judge's (WCLJ) award of 50%. On appeal, the Appellate Division, Third Department, found the WCB's interpretation of the guidelines irrational and inconsistent with the Workers' Compensation Law, as it resulted in claimants with more severe injuries receiving lesser compensation. The court reversed the WCB's decision regarding the preclusion of additional SLU for other knee impairments and remitted the matter for a proper assessment.

Workers' CompensationSchedule Loss of UseKnee InjuryChondromalacia PatellaMeniscus TearMedical Impairment GuidelinesAppellate ReviewStatutory InterpretationEquitable ApplicationJudicial Precedent
References
35
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