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

Case No. 2015-01-0281
Regular Panel Decision
Mar 19, 2018

Tucker, David E. v. Star Transportation

David Tucker, an employee of Star Transportation, sought to change his treating physician for a shoulder injury sustained on July 1, 2015. He expressed a loss of confidence in Dr. Mejia due to perceived ineffectual treatment, improper impairment assessment methodology, and the physician's refusal to complete a Physician Certification Form. The Court, citing precedents like Scott v. Integrity Staffing Solutions and Baker v. Electrolux, found no legal basis to compel the employer to provide a new panel of physicians. The Court ruled that Mr. Tucker's subjective dissatisfaction and the alleged inadequacies of Dr. Mejia did not warrant a change in treating physician.

Workers' CompensationShoulder InjuryTreating PhysicianMedical TreatmentImpairment RatingAMA GuidesTennessee LawRight to Control Medical TreatmentPhysician Certification FormMMI (Maximum Medical Improvement)
References
3
Case No. MISSING
Regular Panel Decision

Billy R. Phillips v. State of Tennessee v. Tennessee Technological University, State of Tennessee

This case addresses whether the State of Tennessee may be held liable for discretionary costs in workers' compensation claims. Plaintiff Billy R. Phillips, injured while employed by a state university, sought reimbursement for a treating physician's fee, court reporter costs, and a vocational disability expert's fee. The claims commission initially allowed only the physician's fee, a decision largely affirmed by the Tennessee Supreme Court. The Court held that the State's liability for costs is limited to those expressly permitted by the Tennessee claims commission statute or the Workers’ Compensation Act, specifically allowing the treating physician's fee under Tenn.Code Ann. § 50-6-226(c)(1) while denying other discretionary costs. The Court affirmed the claims commission's judgment on costs and upheld the Special Workers' Compensation Panel's modification of the plaintiff's disability award to thirty-seven percent.

Discretionary CostsWorkers' CompensationState LiabilityClaims CommissionStatutory InterpretationTreating Physician FeeCourt Reporter CostsVocational Disability ExpertRule 54.04Tennessee Code Annotated
References
5
Case No. 01-14-00767-CV
Regular Panel Decision

Shirley Lenoir, Individually and as Personal Representative of the Estate of Shana Lenoir and Christopher McKnight , Individually and as Next Friend of Nayla McKnight v. U.T. Physicians

This is a health care liability appeal where Shirley Lenoir and Christopher McKnight, individually and as representatives of the Estate of Shana Lenoir and Nayla McKnight, challenge the trial court's decision to grant U.T. Physicians' plea to the jurisdiction and motion to dismiss. The appellants allege that U.T. Physicians' negligence in treating Shana Lenoir’s twin pregnancy, specifically the administration of a medically unnecessary and contraindicated progesterone injection by Nurse Matthews, proximately caused her death. U.T. Physicians claimed sovereign immunity as a governmental unit. Appellants argue that U.T. Physicians is a private non-profit corporation and an independent contractor, not entitled to sovereign immunity, and that a waiver of immunity under the Texas Tort Claims Act was sufficiently pled due to the use of tangible physical property.

Sovereign ImmunityGovernmental UnitIndependent ContractorTexas Tort Claims ActHealth Care LiabilityMedical MalpracticeNegligenceProgesterone InjectionTwin PregnancyWrongful Death
References
16
Case No. MISSING
Regular Panel Decision

Billy Overstreet v. TRW Commercial Steering Division

This concurring opinion by Judge William C. Koch, Jr. addresses the legal basis for prohibiting ex parte communications between an employer's counsel and an employee's treating physician in a Workers' Compensation Act claim. While the Court's main conclusion relies on an implied-in-law contract theory, Judge Koch advocates for a fiduciary duty stemming from the physician-patient relationship. He clarifies that physicians have a duty of non-disclosure, subject to statutory exceptions for workers' compensation reports, but these exceptions do not permit ex parte communications. The opinion asserts that employees retain their medical privacy unless explicitly altered by law.

Physician-patient privilegeConfidentialityEx parte communicationWorkers' CompensationFiduciary dutyImplied contractMedical records disclosureHIPAALegal ethicsPatient rights
References
34
Case No. ADJ9725603
Regular
Nov 23, 2020

LUZ LOZA vs. GOLDBLATT GOLDBLATT/BAY AREA RESTAURANT MANAGEMENT, ARCH INSURANCE COMPANY, administered by YORK RISK SERVICES GROUP, INC.

The Workers' Compensation Appeals Board granted reconsideration of an administrative law judge's order finding the applicant entitled to pre-authorization for their treating physician to issue a PR-4 report at the medical-legal billing rate. While affirming the applicant's right to obtain the report, the Board clarified that the defendant retains the right to object to or raise defenses regarding the physician's billing. The Board reasoned that treating physicians are permitted to provide comprehensive medical-legal evaluations, and such reports are governed by specific medical-legal fee schedules, not the Official Medical Fee Schedule.

PR-4 reportmedical-legal billing ratepre-authorizationprimary treating physician (PTP)Qualified Medical Evaluator (QME)comprehensive medical evaluationOfficial Medical Fee SchedulePetition for ReconsiderationFindings of Fact and Order (F&O)Labor Code
References
3
Case No. 2023-06-8627
Regular Panel Decision
Aug 09, 2024

ADKINS, RICHARD v. CODY ALLISON & ASSOCIATES

Mr. Adkins, an employee, requested the court designate Dr. Schmidt as his treating physician for pain management and order Hartford Fire Ins. Co. to reimburse him for all related pain management expenses. Hartford did not oppose the designation but argued against full reimbursement citing fee schedule limitations. The Court granted Mr. Adkins's requests, designating Dr. Schmidt as the authorized treating physician and ordering full reimbursement, finding the fee schedule inapplicable due to Hartford's noncompliance. Additionally, Hartford was referred to the Bureau of Workers’ Compensation Compliance Program for failing to cover treatment and provide a panel of physicians.

Pain Management TreatmentAuthorized Treating PhysicianMedical ReimbursementFee Schedule InapplicabilityEmployer NoncomplianceReferral AcceptanceMedical Necessity PresumptionWorkers' Compensation LawExpedited HearingCompliance Program Referral
References
6
Case No. 01S01-9708-BC-00173
Regular Panel Decision
Dec 07, 1998

Billy R. Phillips v. Tennessee Technological University, State of Tennessee

This case addresses whether the State of Tennessee may be held liable for discretionary costs in a workers' compensation claim. Plaintiff Billy R. Phillips sustained a work-related injury and sought to recover discretionary costs, including a treating physician's fee, court reporter costs, and a vocational disability expert's fee. The Supreme Court of Tennessee ruled that the State is only liable for costs expressly permitted by statute, specifically allowing the treating physician's fee under Tenn. Code Ann. § 50-6-226(c)(1) as an exception to the general prohibition against taxing discretionary costs against the State found in Tenn. Code Ann. § 9-8-307(d). The Court affirmed the claims commission's judgment denying other discretionary costs, while upholding the modified disability award of thirty-seven percent to the body as a whole.

Discretionary CostsState LiabilityWorkers' Compensation ActClaims Commission StatuteStatutory InterpretationCourt CostsTreating Physician FeesVocational Disability ExpertRule 54.04Tennessee Supreme Court
References
5
Case No. 2022-08-0687
Regular Panel Decision
Nov 18, 2025

McCool, Martha v. Professional Care Services

Martha McCool, a psychiatric nurse practitioner for Professional Care Services, was injured in 2019 after being attacked by a patient, leading to multiple surgeries and PTSD. A 2023 settlement agreement allowed for future medical expenses. In 2024, her authorized treating physician, Dr. Dan Shell, recommended reconstructive surgery. The employer authorized the surgery but denied McCool's request for a second surgical opinion. The trial court initially ordered the employer to authorize the second opinion and awarded attorney's fees, but later denied the fees. The Tennessee Workers' Compensation Appeals Board affirmed the order compelling the employer to authorize and pay for a second opinion, interpreting the relevant statute to mean an employee is entitled to a second opinion when surgery is recommended, regardless of whether the treating physician ordered it. The Board also reversed the denial of attorney's fees, modifying the trial court's judgment to award McCool's attorney $10,150.00.

Second OpinionSurgical RecommendationAttorney's FeesMedical ExpensesWorkers' Compensation LawStatutory InterpretationCompensable InjuryEmployer ObligationsEmployee RightsAppellate Review
References
15
Case No. E2019-00554-COA-R3-CV
Regular Panel Decision
Sep 25, 2020

Highlands Physicians, Inc. v. Wellmont Health System

This class action lawsuit involved Highlands Physicians, Inc. (HPI) alleging that Wellmont Health System breached an agreement and its fiduciary duties, leading to over $57 million in damages awarded by a jury. The trial court also awarded HPI over $5 million in attorney's fees, which Wellmont appealed. The Court of Appeals found that the trial court erred in not submitting the attorney's fee issue to the jury, thus vacating that award and remanding for a jury determination. However, the appellate court affirmed the trial court's judgment in all other respects, including the jury's findings on breach of contract and intentional interference with business relationships. The court also affirmed the trial court's summary judgment rulings regarding contract interpretation and third-party beneficiaries, as well as the denial of prejudgment interest.

Class ActionBreach of ContractFiduciary DutyIntentional InterferenceContract InterpretationThird-Party BeneficiaryAttorney's FeesDamages AwardSummary Judgment ProcedureExpert Witness Testimony
References
91
Case No. Docket No. 2022-03-0693; State File No. 35311-2022
Regular Panel Decision
Feb 07, 2024

Townsend, Timothy v. Universal Forest Products

Timothy Townsend sought attorney fees because Universal Forest Products delayed authorizing a recommended S1 joint arthrodesis surgery. The authorized treating physician, Dr. Paul Johnson, recommended the surgery in late June, but it was not performed until December. Universal Forest Products requested clarification on causation, especially given a recent normal MRI, which led to the delay. The Court determined that the employer's delay was not unreasonable under the circumstances, as they authorized the surgery soon after receiving a specific explanation from Dr. Johnson. Consequently, Mr. Townsend failed to prove entitlement to attorney fees by a preponderance of the evidence, and his request was denied.

Workers' Compensation ClaimsAttorney Fees DenialMedical Treatment AuthorizationSurgical Delay DisputeCausation in Workers' CompEmployer ResponsibilitiesPreponderance of EvidenceSettlement Agreement EnforcementLifetime Medical BenefitsMedical Examiner Opinion
References
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