Spencer, Gerald v. National State Park Concession d/b/a Cades Cove Riding Stables , 2016 TN WC 156 ( 2016 )


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  •                                                                                                                F~ED
    July 6 , 2016
    1N COURT OF
    WORKERS' CO!\IPENSATION
    CLAIMS
    TilDe 2: 50 Pl\1
    TENNESSEE BUREAU OF WORKERS' COMPENSATION
    IN THE COURT OF WORKERS' COMPENSATION CLAIMS
    AT KNOXVILLE
    GERALD SPENCER,                                             )   Docket No.: 2015-03-0899
    Employee,                                          )
    v.                                                         )    State File Number: 100267-2015
    NATIONAL STATE PARK                                        )
    CONCESSION d/b/a CADES COVE                                )    Judge Lisa Lowe Knott
    RIDING STABLE,                                             )
    Employer,                                         )
    and                                                        )
    LIBERTY MUTUAL INSURANCE                                   )
    COMPANY,                                                   )
    Carrier.                                          )
    EXPEDITED HEARING ORDER DENYING
    TEMPORARY DISABILITY AND MEDICAL BENEFITS
    This matter came before the undersigned workers' compensation judge on June
    28, 2016, on the Request for Expedited Hearing filed by the employee, Gerald Spencer,
    pursuant to Tennessee Code Annotated section 50-6-239 (20 15). The central legal issues
    are: (1) whether Mr. Spencer sustained an injury to his right knee and/or his right
    hip/back arising primarily out of and in the course and scope of his employment with the
    Employer, National State Park Concession d/b/a Cades Cove Riding Stables; (2) the date
    of and notice of alleged injuries; and (3) whether Mr. Spencer is entitled to medical and
    temporary disability benefits. For the reasons set forth below, the Court finds that Mr.
    Spencer's request for medical and temporary disability benefits related to his right knee
    injury is denied and his request for medical treatment related to his right
    hip/back/my fascial pain is granted, but his request for temporary disability benefits for
    same is denied. 1
    1
    A complete listing of the technical record and exhibits admitted at the Expedited Hearing is attached to this Order
    as an appendix.
    1
    History of Claim
    Mr. Spencer is a forty-seven-year-old resident of Knox County, Tennessee.
    National State Park Concession d/b/a Cades Cove Riding Stables (CCRS) employed Mr.
    Spencer initially as a cashier and then later as a horse wrangler. Mr. Spencer held
    seasonal positions with CCRS from 2012 through 2015. CCRS currently lists Mr.
    Spencer as an inactive employee. His last date as an active employee was August 17,
    2015.
    Mr. Spencer acknowledges pre-existing bi-lateral knee conditions. He previously
    obtained diagnostic testing and injections in both knees. Dr. Edwin Holt, Ortho
    Tennessee, performed right knee surgery on May 15, 2015. Due to the physical aspect of
    Mr. Spencer's job duties, Dr. Holt did not release him to return to work without
    restrictions until July 1, 2015. (Ex. 8.)
    Mr. Spencer alleged that on August 1, 2015, he was removing the saddle from his
    assigned horse, when a co-worker named Nick Coppenger let his horse loose in the barn.
    This action spooked Mr. Spencer's horse, which threw him against a wall and knocked
    him to the gr und. Mr. Spencer alleged he sustained injuries to his right kne and hip. 2
    Mr. Ronald Lee, General Manager of CCRS, stated in his affidavit that he did not receive
    written or oral notification of the injury from Mr. Spencer. CCRS disputed that the
    alleged incident occurred on August 1, 2015, as records reflect Mr. Spencer and Mr.
    Coppenger last worked together in July 2015.
    Mr. Spencer filed a Petition for Benefit Determination (PBD) seeking temporary
    disability and medical benefits. The parties did not resolve the disputed issues through
    mediation, and the Mediating Specialist filed a Dispute Certification Notice (DCN). Mr.
    Spencer filed a Request for Expedited Hearing.
    At the Expedited Hearing, Mr. Spencer did not dispute his pre-existing right knee
    condition. Mr. Spencer claimed he spoke with Mr. Lee about his prior right knee
    surgery; that he did six weeks of physical therapy; and Dr. Holt released him to return to
    work with no restrictions on July 1, 2015. Mr. Spencer testified he knew the alleged
    incident at work occurred on a Sunday. He was not sure of the exact date but believed it
    to be August 1 or August 2, 2015.
    Mr. Spencer testified he reported the injury to his managing supervisor, Edward
    Kirkland, on the day it happened. At the Expedited Hearing, Mr. Kirkland testified he
    was present in the tacking room when the incident occurred. He "heard a ruckus" and
    saw a horse go running through the hallway where Mr. Spencer was working. Mr.
    2
    In his closing argument, Mr. Spencer referenced additional injuries to his foot and ankle. However, his PBD only
    referenced right knee and hip injuries.
    2
    Kirkland testified he entered the stall area and saw Mr. Spencer on the ground. He
    helped Mr. Spencer get up. Mr. Kirkland stated Mr. Spencer said at that time he was not
    feeling well. Mr. Kirkland did not remember the exact date of the incident. Mr. Kirkland
    testified that after Mr. Spencer's right knee surgery, he returned to work and was doing a
    good job, but after this incident, Mr. Spencer was limping or "walking funny" and having
    difficulties doing his job.
    Mr. Spencer testified he attempted to return to Dr. Holt but was unable to schedule
    an appointment because he owed Dr. Holt money for past treatment. He underwent an
    MRI at the VA hospital, which revealed a small meniscal tear. (Ex. 11.) CCRS
    ultimately authorized Dr. John Harrison to evaluate Mr. Spencer's right knee and right
    hip. (Ex. 14.)
    CCRS countered that: Mr. Spencer did not give proper written notice of his
    alleged injury; the injury did not occur on August 1, 2015; and there is no medical proof
    establishing Mr. Spencer's right knee injury arose primarily out of and in the course and
    scope of his employment.
    Findings of Fact and Conclusions of Law
    Because this case is in a posture of an Expedited Hearing, Mr. Spencer need not
    prove every element of his claim by a preponderance of the evidence in order to obtain
    relief at an expedited hearing. McCord v. Advantage Human Resourcing, No. 2014-06-
    0063, 2015 TN Wrk. Comp. App. Bd. LEXIS 6, at *7-8, 9 (Tenn. Workers' Comp. App.
    Bd. Mar. 27, 2015). Instead, he must come forward with sufficient evidence from which
    the court can determine that he is likely to prevail at a hearing on the merits. !d.; Tenn.
    Code Ann. § 50-6-239(d)(1) (2015).
    To be compensable under Workers' Compensation Law, an injury must arise
    primarily out of and occur in the course and scope of the employment. Tenn. Code Ann.
    § 50-6-102(14) (2015). The term "injury" is defined as "an injury by accident ... arising
    primarily out of and in the course and scope of employment, that causes death,
    disablement or the need for medical treatment of the employee." !d. For an injury to be
    accidental, it must be "caused by a specific incident, or set of incidents, arising primarily
    out of and in the course and scope of employment, and is identifiable by time and place
    of occurrence." Tenn. Code Ann.§ 50-6-102(14)(A) (2015).
    Date of and Notice ofInjury
    Mr. Spencer testified the injury occurred on a Sunday but could not recall the
    exact date. He explained with specificity that he was removing the saddle from his
    assigned horse when Mr. Coppenger spooked his horse. His horse threw him against a
    wall and he fell. There is a dispute as to the exact date of injury, since Mr. Spencer
    3
    alleged it occurred on August 1, 2015, and Mr. Lee testified Mr. Spencer and Mr.
    Coppenger last work together in July 2015. Under Tennessee Code Annotated section
    50-6-201(a)(l) (2015), an injured employee shall give written notice of the injury to an
    employer who has no actual notice. Regardless of whether the incident occurred in July
    or August 2015, Mr. Kirkland's testimony established he was Mr. Spencer's managing
    supervisor at the time of the incident and he had actual knowledge of the incident on the
    day it occurred. CCRS's actual knowledge of the incident relieved Mr. Spencer of the
    obligation to provide written notice.
    Causation
    An injury "arises primarily out of and in the course and scope of employment only
    if it has been shown by a preponderance of the evidence that the employment contributed
    more than fifty percent (50%) in causing the injury, considering all causes." Tenn. Code
    Ann. § 50-6-102(14)(B) (2015).
    CCRS authorized Dr. John Harrison to evaluate Mr. Spencer's alleged right knee
    and hip injuries. Regarding Mr. Spencer's knee injury, Dr. Harrison stated, "Based on
    today's assessment, I cannot state with any medical certainty that [Mr. Spencer's] alleged
    work injury of 8/01/2015 contributed to more than 50% of [his] ongoing knee problems.
    Review of prior medical records indicates that this patient's knee problems have been
    longstanding and preceded his alleged work injury." (Ex. 14.)
    Regarding Mr. Spencer's hip injury, Dr. Harrison stated the following:
    He is advised that his accident did not cause any significant hip pathology.
    It is likely to persist. His ongoing symptoms in my opinion maybe more
    related to a gluteal contusion or some underlying back problem. The
    patient is reassured that he will require no surgery on his hip. The patient
    reports that he is done with trail riding and does not wish to risk trying to
    get back into this. It is my opinion that the patient's current complaints do
    not appear to be related in any way to any type of significant hip pathology.
    His current complaints are more myofascial in nature. In the absence of
    any history of such complaints prior to his accident and assuming his
    history to be truthful and accurate, I would conclude that his current
    myofascial complaints are likely than not to be related to his work injury of
    August 1, 2015. The patient on repeat questioning states he had had no
    prior problems with pain in the gluteal area or lower back or hip region
    prior to his accident of 8/0 1/20 15. He is reassured that the hip joint itself
    on the left greater than right is in no need of surgical intervention at this
    time. It appears more likely than not that his gluteal pain may be more
    back related than anything related to his his joints themselves. The patient
    will continue with a home exercise program. He is released again to be
    4
    seen [as needed].
    (Emphasis added.)
    Id. Mr. Spencer provided
    evidence that Dr. Holt released him without restrictions
    from his prior knee surgery and he returned to work. However, he did not introduce a
    medical opinion to refute Dr. Harrison's opinion that the work injury did not contribute
    more than fifty percent to his right knee problem. Therefore, as a matter of law, Mr.
    Spencer has not come forward with sufficient evidence from which this Court concludes
    that he is likely to prevail at a hearing on the merits with regard to his alleged right knee
    injury. As a result, it is not necessary for the Court to address Mr. Spencer's claim for
    temporary disability benefits related to his alleged right knee injury.
    In contrast, CCRS did not introduce a medical opinion to refute Dr. Harrison's
    opinion that Mr. Spencer's current myofascial complaints are more likely than not related
    to the work injury. Therefore, Mr. Spencer has come forward with sufficient evidence
    from which this Court concludes that he is likely to prevail at a hearing on the merits with
    regard to his hip/back/myofascial pain. Dr. Harrison did not recommend any treatment
    (other than a home exercise program) for Mr. Spencer's myofascial pain and released him
    to return as needed. With regard to his claim for temporary disability benefits, Mr.
    Spencer did not provide a medical opinion to establish he was unable to work as a result
    of his myofascial pain. Therefore, he has not established that he is entitled to temporary
    disability benefits due to his hip/back/myofascial injury.
    IT IS, THEREFORE, ORDERED as follows:
    1. Mr. Spencer's claim against Cades Cove Riding Stable and its workers'
    compensation carrier for the requested medical and temporary disability benefits
    related to his alleged right knee injury is denied at this time.
    2. Cades Cove Riding Stable shall allow Mr. Spencer to return as needed to Dr.
    Harrison for reasonable, necessary, and related treatment for his
    hip/back/myofascial pain. Mr. Spencer's claim for temporary disability benefits
    related to his hip/back/myofascial pain is denied at this time.
    3. This matter is set for an Initial (Scheduling) Hearing on Wednesday, September
    7, 2016, at 9:00A.M. Eastern Time.
    5
    ENTERED this the 6th day of July, 2016.
    Judge Lisa Lowe Knott
    Court of Workers' Compensation Claims
    Initial (Scheduling) Hearing:
    An Initial (Scheduling) Hearing has been set with Judge Lisa Lowe Knott, Court
    of Workers' Compensation Claims. You must call 865-594-0109 or toll-free at 855-
    383-0003 to participate in the Initial Hearing.
    Please Note: You must call in on the scheduled date/time to
    participate. Failure to call in may result in a determination of the issues without
    your further participation.
    Right to Appeal:
    Tennessee Law allows any party who disagrees with this Expedited Hearing Order
    to appeal the decision to the Workers' Compensation Appeals Board. To file a Notice of
    Appeal, you must:
    1. Complete the enclosed form entitled: "Expedited Hearing Notice of Appeal."
    2. File the completed form with the Court Clerk within seven business days of the
    date the Workers' Compensation Judge entered the Expedited Hearing Order.
    3. Serve a copy of the Expedited Hearing Notice of Appeal upon the opposing party.
    4. The appealing party is responsible for payment of a filing fee in the amount of
    $75.00. Within ten calendar days after the filing of a notice of appeal, payment
    must be received by check, money order, or credit card payment. Payments can be
    made in person at any Bureau office or by United States mail, hand-delivery, or
    other delivery service. In the alternative, the appealing party may file an Affidavit
    of Indigency, on a form prescribed by the Bureau, seeking a waiver of the filing
    fee. The Affidavit of Indigency may be filed contemporaneously with the Notice
    6
    of Appeal or must be filed within ten calendar days thereafter. The Appeals Board
    will consider the Affidavit of Indigency and issue an Order granting or denying
    the request for a waiver of the filing fee as soon thereafter as is
    practicable. Failure to timely pay the filing fee or file the Affidavit of
    lndigency in accordance with this section shall result in dismissal of the
    appeal.
    5. The parties, having the responsibility of ensuring a complete record on appeal,
    may request, from the Court Clerk, the audio recording of the hearing for the
    purpose of having a transcript prepared by a licensed court reporter and filing it
    with the Court Clerk within ten calendar days of the filing of the Expedited
    Hearing Notice of Appeal. Alternatively, the parties may file a joint statement of
    the evidence within ten calendar days of the filing of the Expedited Hearing
    Notice of Appeal. The statement of the evidence must convey a complete and
    accurate account of what transpired in the Court of Workers' Compensation
    Claims and must be approved by the workers' compensation judge before the
    record is submitted to the Clerk of the Appeals Board.
    6. If the appellant elects to file a position statement in support of the interlocutory
    appeal, the appellant shall file such position statement with the Court Clerk within
    five business days of the expiration of the time to file a transcript or statement of
    the evidence, specifying the issues presented for review and including any
    argument in support thereof. A party opposing the appeal shall file a response, if
    any, with the Court Clerk within five business days of the filing of the appellant's
    position statement. All position statements pertaining to an appeal of an
    interlocutory order should include: ( 1) a statement summarizing the facts of the
    case from the evidence admitted during the expedited hearing; (2) a statement
    summarizing the disposition of the case as a result of the expedited hearing; (3) a
    statement of the issue(s) presented for review; and (4) an argument, citing
    appropriate statutes, case law, or other authority.
    7
    APPENDIX
    Exhibits:
    •     EXHIBIT 1: Affidavit of Gerald Spencer;
    •     EXHIBIT 2: Affidavit of Ronald Lee;
    •     EXHIBIT 3: Affidavit of Jessica Parker;
    •     EXHIBIT 4: NSPC Riding Stables at Cades Cove August 2015 Accident
    Report Log;
    •      EXHIBIT 5: NSPC Employee Work Schedule;
    •     EXHIBIT 6: Gerald Spencer's Work Schedule, as prepared by Ronald Lee;
    •     EXHIBIT 7: Wage Statement, Form C-41 (for identification only);
    •     EXHIBIT 8: Medical Records of Dr. Edwin Holt, Ortho Tennessee (bate-
    stamped 0 1-17);
    •     EXHIBIT 9: Medical Records of University of Tennessee Medical Center
    (bates-stamped 18-20)
    •     EXHIBIT 10: Medical Records of University Orthopaedic Surgeons (bates-
    stamped 21-23);
    •     EXHIBIT 11: Medical Records from Department of Veterans Affairs;
    •     EXHIBIT 12: Tennessee Department of Labor and Workforce Development,
    Division of Employment Security, Time Sensitive Request for Separation
    Information;
    •     EXHIBIT 13: Tennessee Department of Labor and Workforce Development,
    Employment Security Division, Decision of Appeals Tribunal;
    •     EXHIBIT 14: Medical Records of Dr. John E. Harrison, Tennessee Orthopedic
    Clinics;
    •     EXHIBIT 15: Written Accident Report, Incident on November 6, 2013;
    •     EXHIBIT 16: Letter from Dr. Edwin Holt, June 3, 2016;
    •     EXHIBIT 17: Discharge Summary from Ortho Tennessee, August 6, 2015;
    •     EXHIBIT 18: Form I-9, Employment Eligibility Verification;
    •     EXHIBIT 19: Gerald Spencer's Pay Stub, July 18, 2016;
    •     EXHIBIT 20: Gerald Spencer's Work Scheduled, as prepared by Ronald Lee
    (duplicate of Exhibit 6);
    •     EXHIBIT 21: Gerald Spencer and Nicholas Coppenger's Coinciding Work
    Schedule from March 2015 through November 2015, as prepared by Ronald
    Lee;
    •     EXHIBIT 22: ·Cades Cover Riding Stables Accident Report Log, August 2015;
    and
    •     EXHIBIT 23: Telephone Statement of Edward Kirkland, as prepared by
    Ronald Lee.
    8
    Technical record: 3
    1. Petition for Benefit Determination;
    2. Dispute Certification Notice;
    3. Request for Expedited Hearing;
    4. Employer's Motion for Continuance;
    5. Employer's Position Statement;
    6. Employee's Response to Motion for Continuance;
    7. Order Denying CCRS's Motion for Continuance;
    8. Employee's Request for Statements;
    9. Employer's Motion to Quash Gerald Spencer's Subpoena for Witness
    Statements;
    10. Subpoena for Edward Kirkland;
    11. Subpoena for Cades Cove Riding Stables;
    12. Subpoena for Liberty Mutual Insurance Company;
    13. Order Granting Employer's Motion to Quash;
    14. Employee Motion to Quash Employer's Request for All Medical Records from
    the Department of Veteran's Affairs;
    15. Employer's Response to Employee's Motion to Quash Employer's Request for
    all Medical Records from the Department of Veteran Affairs;
    16. Notice of Filing Affidavit of Jessica Parker;
    17. Employer's Motion to quash Subpoena for Joe Lane to Testify at Expedited
    Hearing;
    18. Medical Records Exhibit List;
    19. Employee's Motion for a Hearing before the Judge Sooner than Later;
    20. Order;
    21. Employee's Filing of Doctor Notes;
    22. Response to Employee's Motion for Hearing;
    23. Employee's Response to Employer's Response to Motion for a Hearing;
    24. Order Denying Mr. Spencer's Motion for Hearing Sooner Rather than Later;
    and
    25. Order Setting Expedited Hearing.
    3
    The Court did not consider attachments to Technical Record filings unless admitted into evidence during the
    Expedited Hearing. The Court considered factual statements in these filings or any attachments to them as
    allegations unless established by the evidence.
    9
    CERTIFICATE OF SERVICE
    I hereby certify that a true and correct copy of the Expedited Hearing Order was
    sent to the following recipients by the following methods of service on this the 6th day of
    July, 2016.
    Name                        Certified Via       Via      Service sent to:
    Mail      Fax       Email
    Gerald Spencer,                X                  X      Gerald Spencer
    Self-Represented                                         9003 C. Grayland Drive
    Employee                                                 Knoxville, TN 3 7923
    GerrvsoenceTI 23 02vahoo.com
    Eric Shen, Esq.,                                   X     Eric.shen@libertymutual.com
    Employer' s Attorney
    P nny Shr , Clerk of Court
    Court of  rkers' Compensation Claims
    WC.CourtCierk@tn.gov
    10
    

Document Info

Docket Number: 2015-03-0899

Citation Numbers: 2016 TN WC 156

Judges: Lisa Lowe Knott

Filed Date: 7/6/2016

Precedential Status: Precedential

Modified Date: 1/10/2021