Bragg, Robert v. Premium Services, LLC

2023 TN WC App. 34
CourtTennessee Workers' Compensation Appeals Board
DecidedAugust 1, 2023
Docket2020-07-0020
StatusPublished

This text of 2023 TN WC App. 34 (Bragg, Robert v. Premium Services, LLC) is published on Counsel Stack Legal Research, covering Tennessee Workers' Compensation Appeals Board primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Bragg, Robert v. Premium Services, LLC, 2023 TN WC App. 34 (Tenn. Super. Ct. 2023).

Opinion

FILED Aug 01, 2023 02:39 PM(CT) TENNESSEE WORKERS' COMPENSATION APPEALS BOARD

TENNESSEE BUREAU OF WORKERS’ COMPENSATION WORKERS’ COMPENSATION APPEALS BOARD

Robert Bragg ) Docket No. 2020-07-0020 ) v. ) State File No. 10723-2018 ) Premium Services, LLC, et al. ) ) ) Appeal from the Court of Workers’ ) Heard June 26, 2023 Compensation Claims ) via Microsoft Teams Allen Phillips, Judge )

Affirmed and Certified as Final

In this appeal, the employer asserts the trial court erred by failing to address in its compensation order the employer’s potential entitlement to an offset against permanent partial disability payments arising from the employee’s anticipated future social security benefits. The employee was not receiving social security benefits at the time of maximum medical improvement or as of the date of trial. In addition, the employee asserts the trial court erred by limiting the employer’s liability for unpaid medical expenses to the amounts mandated by Tennessee’s medical fee schedule and by not awarding attorneys’ fees on the amount of unpaid medical expenses to be paid by the employer. After careful consideration, we conclude the issue of a potential social security offset is not ripe for adjudication, and we affirm the trial court’s order in all other respects and certify it as final.

Judge Pele I. Godkin delivered the opinion of the Appeals Board in which Presiding Judge Timothy W. Conner and Judge Meredith B. Weaver joined.

Neil M. McIntire, Nashville, Tennessee, for the employer-appellant, Premium Services, LLC

Jeffrey P. Boyd, Jackson, Tennessee, for the employee-appellee, Robert Bragg

Factual and Procedural Background

The underlying facts of this case are largely undisputed for purposes of this appeal. On January 11, 2018, Robert Bragg (“Employee”) was injured while “using a vice [sic] to manually bend 3/4 [inch] steel into customer specifications” in the course

1 and scope of his employment with Premium Services, LLC (“Employer”). He complained of pain in his right elbow, right arm, and right shoulder and reported the incident to Employer. Employee received medical treatment for his right elbow with his authorized physician, Dr. Nicholas Vance, who performed a lateral epicondylitis release. He also received medical treatment for his right shoulder, including surgery, with his authorized physician, Dr. Adam Smith. Following his shoulder surgery, Employee began to complain of neck pain, and Dr. Smith recommended diagnostic testing, which Employer authorized to determine whether Employee’s cervical complaints were causally related to his 2018 work incident. Upon review of Employee’s diagnostic studies, Dr. Smith determined he could not conclude that Employee’s cervical symptoms were directly related to the January 2018 incident. He placed Employee at maximum medical improvement on October 15, 2019, assigned a 2% impairment rating to the whole body, and stated, “I do not believe I can directly attribute his arm and numbness and tingling and his cervical degenerative change to his elbow or his shoulder based on our findings.” Subsequently, Dr. Smith referred Employee to a pain specialist “outside of Worker’s Compensation.”

In December 2019, Dr. Smith responded to an inquiry from Employee’s counsel in which he opined that Employee’s cervical symptoms were related to his January 2018 work incident. Employee filed a petition for benefit determination on January 9, 2020, requesting medical treatment for his neck. Employer provided a panel from which Employee selected neurosurgeon Dr. Fereidoon Parsioon. Prior to his appointment with Dr. Parsioon, Employee chose to see orthopedic surgeon Dr. Patrick Curlee on his own. In his records, Dr. Curlee noted that he was seeing Employee based on a referral from Dr. Smith and documented a “two-year history” of neck and arm pain with some numbness and tingling in his arms and hands. Based upon his review of the cervical MRI, Dr. Curlee diagnosed Employee with severe degenerative disc disease. He recommended a cervical spine fusion at three levels and opined that Employee’s work injury had aggravated or exacerbated his cervical pathology, resulting in the need for surgery. In June 2020, Employee saw Dr. Parsioon, who agreed that Employee had degenerative disc disease but did not agree that the condition or the need for surgery were work related. Dr. Parsioon offered to perform the surgery under Employee’s personal insurance, and Employer denied Employee’s neck claim based on Dr. Parsioon’s opinion. Eventually, Dr. Curlee performed the cervical spine surgery under Employee’s private insurance.

At the March 2, 2023 trial, all four doctors’ depositions were entered into evidence, and Employee testified live. On March 14, the trial court issued an order finding by a preponderance of the evidence that Employee injured his neck while turning the vise at work. In doing so, the court attached greater weight to Dr. Curlee’s opinions. 1

1 Employer argued that Dr. Parsioon’s opinion should be presumed correct because he was chosen from a panel. The trial court determined that even if Dr. Parsioon had been entitled to a presumption of correctness, Dr. Curlee’s opinion was sufficient to rebut any presumption that would have attached. 2 Thus, the court determined that Employee had sustained a twenty-three percent permanent partial disability and applied enhancement factors of 1.35 for Employee’s not having returned to work, 1.2 for his being over the age of 40, and 1.45 for his lacking a high school diploma or its equivalent. Based on a compensation rate of $419.19 per week, Employee’s award of permanent partial disability benefits totaled $101,914.09.

The parties agreed that Employee reached maximum medical improvement on January 21, 2021, and that the accrued benefits from that date to March 2, 2023, the date of trial, were payable in a lump sum. The court noted that Employee’s counsel was entitled to a fee of twenty percent of the recovery, payable in lump sum, and that the remainder of Employee’s permanent partial disability award was payable to Employee in periodic payments until paid in full. The trial court also ordered Employer to “pay the medical bills for treatment of [Employee’s] neck injury pursuant to the fee schedule.” It further noted that, pursuant to Tennessee Code Annotated section 50-6-226(a)(1), Employee’s attorneys’ fees are to be paid by Employee as a percentage of his recovery, as he was the party who employed the attorney. The court concluded that Employee was entitled to reasonable and necessary future medical treatment for his elbow, shoulder, and neck under Tennessee Code Annotated section 50-6-204(a)(1)(A) and designated Dr. Vance as the treating physician for the elbow, Dr. Smith for the shoulder, and Dr. Curlee for the neck.

On March 16, Employee filed a Rule 59 Motion to Alter or Amend the Judgment or in the Alternative Rule 60.04 Motion to Clarify Clerical Mistake. In its motion, Employee requested that the court clarify the procedure by which it had ordered the reimbursement of the medical expenses already paid by BlueCross/BlueShield (“BCBS”) and attorneys’ fees to be paid based on those medical expenses. On April 18, the trial court issued an order denying Employee’s motion to alter or amend, referencing its March 14 order instructing Employer to pay the disputed medical bills pursuant to the applicable fee schedule. In doing so, the court noted that Tennessee Code Annotated section 50-6-204(a)(3)(A)(iii) provides that “[t]he liability of the employer for the services provided to the employee shall be limited to the maximum allowable fees” under the fee schedule. The court also relied on Tenn. Comp. R. and Regs.

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Cite This Page — Counsel Stack

Bluebook (online)
2023 TN WC App. 34, Counsel Stack Legal Research, https://law.counselstack.com/opinion/bragg-robert-v-premium-services-llc-tennworkcompapp-2023.