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

Case No. 2015-05-0037
Regular Panel Decision
Jun 30, 2016

Womack, Angela v. Yorozu Automotive TN

Angela Womack sustained a right shoulder injury on July 25, 2014, while working for Yorozu Automotive TN. Initial medical evaluations by authorized physicians did not identify a labral tear, leading to the cessation of benefits. Ms. Womack later sought treatment from Dr. Jeffrey Peterson, who diagnosed and surgically repaired a labral tear (SLAP repair), attributing it to the work injury. The court found Ms. Womack's injury compensable, overriding the presumption of correctness for the authorized physicians, and awarded medical, temporary total disability, and permanent partial disability benefits. However, the claim for enhanced permanent disability benefits was denied because her decision not to return to work was personal, not directly related to her work injury.

Workers' CompensationShoulder InjuryLabral TearSLAP RepairMedical CausationPresumption of CorrectnessTemporary Total DisabilityPermanent Partial DisabilityMedical BenefitsWork Injury
References
9
Case No. 2018-06-0453
Regular Panel Decision
Aug 15, 2018

Ingstrup, Jeffrey v. At Home Stores, LLC

Mr. Ingstrup, an employee, sustained a left shoulder injury diagnosed as a SLAP tear. His authorized treating physician, Dr. Todd Wurth, recommended surgery. However, the employer's carrier, Twin City Fire Insurance Co., denied the surgery based on a utilization review which found insufficient conservative treatment. After conservative treatments (injections and physical therapy) proved ineffective and worsened his condition, Dr. Wurth reaffirmed the need for surgery. The Court granted Mr. Ingstrup's request for an expedited hearing, ruling that circumstances had materially changed since the initial denial and that Dr. Wurth's renewed recommendation carried a presumption of medical necessity, which the employer failed to overcome. Consequently, the employer was ordered to provide the recommended surgical treatment.

Workers' CompensationMedical BenefitsExpedited HearingShoulder InjurySLAP TearSurgeryUtilization ReviewMedical NecessityConservative TreatmentTennessee Law
References
1
Case No. MISSING
Regular Panel Decision

Claim of Anderson v. New York City Department of Design & Construction

Claimant appealed a Workers' Compensation Board decision from April 25, 2013, which denied his application to include a partial right rotator cuff tear under his existing 2002 work-related injury claim. The Board found that claimant failed to establish a causal link between the 2002 automobile accident and the 2009 rotator cuff tear, despite the opinion of his orthopedist. The orthopedist acknowledged that age-related degeneration could cause such tears independently of trauma. The Appellate Division affirmed the Board's decision, concluding there was substantial evidence to support the finding that the orthopedist's testimony did not convincingly prove a causal relationship.

Rotator cuff tearCausal relationshipWorkers' CompensationMedical evidenceDisabilityWork-related injuryAutomobile accidentShoulder painOrthopedist opinionSubstantial evidence
References
4
Case No. 2016-05-0634
Regular Panel Decision
Aug 11, 2017

Clayton, Carolyn v. Speedway, LLC

This expedited hearing addresses Carolyn Clayton's claim for a work-related left knee injury at Speedway, LLC. The main issue was whether her employment caused an aggravation of her left meniscus tear, and a secondary issue concerned temporary disability benefits. The Court determined that Ms. Clayton is likely to prove her knee injury was exacerbated by a work accident on May 16, 2016, entitling her to medical treatment for the meniscal tear. However, her request for temporary disability benefits was denied due to insufficient expert medical testimony regarding the extent of her physical limitations and resulting disability.

Knee InjuryMeniscus TearAggravation of InjuryWork-Related AccidentMedical BenefitsTemporary DisabilityCausationExpert Medical TestimonyCredibilitySurveillance Video
References
4
Case No. 2020-06-0716
Regular Panel Decision
Sep 02, 2021

Dix, Jr., Jimmy v. Nyrstar Clarksville, Inc.

Jimmy Dix, Jr. alleged a right hamstring injury in April 2019 while employed by Nyrstar Clarksville, Inc. He claimed the authorized treating physician, Dr. Kurtis Kowalski, focused solely on his preexisting osteoarthritis, neglecting the hamstring tear. The Court, agreeing with Mr. Dix and supported by Dr. Philip Karpos's assessment of a significant hamstring tear, ruled that Nyrstar must authorize additional medical treatment for the hamstring injury with Dr. Kowalski. However, the request for temporary disability benefits was denied due to insufficient evidence regarding disability duration and work restrictions from Dr. Kowalski.

Hamstring TearOsteoarthritisMedical Treatment DisputeTemporary Disability BenefitsAuthorized Treating PhysicianEmployer's ResponsibilityCausation of InjuryMaximum Medical Improvement (MMI)Expedited HearingTennessee Workers' Compensation
References
5
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. 518426
Regular Panel Decision
Oct 02, 2014

MatterofAndersonvNewYorkCityDepartmentofDesign&Construction

Donald Anderson, the claimant, sought workers' compensation benefits for injuries sustained in a 2002 work-related automobile accident. Initially, his claim was established for neck and back injuries, but in 2005, the Workers' Compensation Board determined he had no continuing disability, noting he was magnifying symptoms. In 2009, Anderson was diagnosed with a partial right rotator cuff tear, which he sought to include under his existing claim, alleging a causal link to the 2002 accident. The Board denied this application, finding a lack of established causal relationship. The Appellate Division affirmed the Board's decision, concluding that Anderson failed to present convincing evidence from his orthopedist or any other proof to establish the necessary causal connection between the 2002 accident and his right rotator cuff tear.

Workers' CompensationCausally Related InjuryRotator Cuff TearAutomobile AccidentMedical EvidenceDisability BenefitsAppellate ReviewShoulder InjurySubstantial EvidenceCausation
References
4
Case No. 02-19-00224-CV
Regular Panel Decision
Jan 14, 2021

John Ellis v. Dallas Area Rapid Transit

John Ellis appealed a trial court's judgment affirming a Texas Department of Insurance (TDI) decision in his workers' compensation case against Dallas Area Rapid Transit (DART). Ellis claimed a 2014 motor-vehicle accident aggravated preexisting injuries, including a right-shoulder rotator-cuff tear and right-wrist tendinitis. However, medical examiners, including a designated doctor, concluded that only cervical, shoulder, and wrist sprains/strains were compensable, while the disputed conditions were preexisting or inconsistent with the 2014 injury. The trial court upheld TDI's finding that the compensable injury did not extend to the rotator-cuff tear and tendinitis, and the appellate court affirmed the trial court's judgment, finding sufficient evidence to support its conclusion.

Workers' CompensationMedical CausationPreexisting InjuryAppellate ReviewLegal SufficiencyExpert Medical EvidenceTexas LawOn-the-Job InjuryRotator Cuff TearWrist Tendinitis
References
34
Case No. MISSING
Regular Panel Decision
Jan 15, 2008

Taylor v. American Radio Dispatcher, Inc.

The Supreme Court, Bronx County, granted defendants’ motion for summary judgment, dismissing the complaint on the ground that plaintiff did not suffer a “serious injury” within the meaning of Insurance Law § 5102 (d). The defendants established their prima facie case by submitting reports of independent medical examinations. The plaintiff failed to raise a triable issue of fact, as her experts’ reports, opining on a tear of the anterior talo-fibular ligament and a tear of the meniscus of the right knee, lacked objective, contemporaneous evidence of the extent and duration of alleged physical limitations. Additionally, there was no contemporaneous medical proof for her claim that her injury prevented her from performing substantially all of her usual activities for 90 of the 180 days following the accident. The Appellate Division unanimously affirmed the lower court's decision.

Serious injuryInsurance Lawsummary judgmentmedical examinationanterior talo-fibular ligamentmeniscus tearobjective evidencephysical limitationscustomary activitiesappellate division
References
3
Case No. 2023-07-2338
Regular Panel Decision
Jan 29, 2024

Holloway, Christopher v. Natchez Trace Youth Academy

Christopher Holloway, a 47-year-old employee, sustained a left-knee injury at work while breaking up a fight. He sought increased benefits, contending his permanent disability rating should include left-knee arthritis in addition to a meniscal tear. The Court, however, upheld a one percent impairment rating based solely on the meniscal tear, concluding that while the work injury aggravated his preexisting arthritis symptoms, it did not primarily cause the arthritis or his current disablement. Despite this, the Court found Holloway reasonably resigned from his pre-injury job due to his knee condition, thus entitling him to increased benefits. The employer was ordered to pay $6,449.24 in permanent partial disability and increased benefits, plus medical treatment and court costs.

Knee InjuryMeniscal Tear RepairPreexisting ArthritisAggravation of InjuryPermanent Partial DisabilityImpairment Rating DisputeIncreased Benefits AwardReturn-to-Work SuitabilityVoluntary Resignation JustificationMedical Expert Opinions
References
5
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