Chavez, Raul Morelos v. Jesus Morelos Chavez

2024 TN WC App. 17
CourtTennessee Workers' Compensation Appeals Board
DecidedApril 11, 2024
Docket2020-05-0797
StatusPublished

This text of 2024 TN WC App. 17 (Chavez, Raul Morelos v. Jesus Morelos Chavez) 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
Chavez, Raul Morelos v. Jesus Morelos Chavez, 2024 TN WC App. 17 (Tenn. Super. Ct. 2024).

Opinion

FILED Apr 11, 2024 01:20 PM(CT) TENNESSEE WORKERS' COMPENSATION APPEALS BOARD

TENNESSEE BUREAU OF WORKERS’ COMPENSATION WORKERS’ COMPENSATION APPEALS BOARD

Raul Morelos Chavez ) Docket No. 2020-05-0797 ) v. ) State File No. 11082-2020 ) Jesus Morelos Chavez, et al. ) ) ) Appeal from the Court of Workers’ ) Compensation Claims ) Dale A. Tipps, Judge )

Affirmed and Certified as Final

The employee fell at work and sustained a left clavicle fracture. The employer accepted the claim as compensable and provided authorized treatment for his condition, including surgery, physical therapy, and referrals to other specialists for evaluation of complaints of dizziness and back pain. After being placed at maximum medical improvement, the employee sought additional medical treatment on his own and requested that he be given a new authorized physician. Following an expedited hearing, the trial court concluded that the employee failed to identify a legal basis that would justify changing his authorized physician and that he failed to prove he is likely to prevail at trial on his claim for additional medical benefits. The employee appealed, and we affirmed the trial court’s interlocutory order. Thereafter, a compensation hearing was held. The trial court concluded that the employee was entitled to permanent disability and lifetime medical benefits with his authorized treating physicians but was not entitled to additional temporary disability benefits. The employee has appealed. Having carefully reviewed the record, we affirm the trial court’s order 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.

Raul Morelos Chavez, La Vergne, Tennessee, employee-appellant, pro se

Neil McIntire, Nashville, Tennessee, for the employer-appellee, Jesus Morelos Chavez

1 Factual and Procedural Background

This is the second appeal in this matter. Raul Chavez (“Employee”) was injured on December 20, 2019, after he lost his balance and fell while working for his brother, Jesus Morelos Chavez (“Employer”). He was evaluated at Stonecrest Medical Center the same day and diagnosed with a fractured left clavicle. The claim was accepted as compensable, and Employee saw Dr. William Mayfield, an orthopedic surgeon, who performed reparative surgery. Dr. Mayfield placed Employee at maximum medical improvement and released him to full duty on June 25, 2020. 1 Employer paid temporary disability benefits from December 20, 2019, through June 29, 2020. Dr. Mayfield did not assign any permanent medical impairment for Employee’s condition and noted that he did not need follow-up care. Employee did not return to work for Employer.

While receiving treatment for his clavicle injury, Dr. Mayfield made two referrals: one to a neurologist for complaints of dizziness and another to an orthopedist for complaints of back pain. With respect to the first referral, Employee selected Dr. Richard Rubinowicz from an Employer-provided panel of neurologists. On March 2, Dr. Rubinowicz evaluated Employee and provided an assessment of dizziness and mild closed head injury. He noted Employee presented with “posttraumatic dizziness following a head injury that has resolved.” Dr. Rubinowicz discussed Employee’s symptoms and “ongoing management” noting that, “[n]o additional intervention [is] required at this time.”

Dr. Mayfield also referred Employee to Dr. Christopher Kauffman, an orthopedic surgeon specializing in the spine, who evaluated Employee’s complaints of cervical, thoracic, and lumbar pain. Dr. Kauffman diagnosed an acute cervical sprain, lumbar sprain, and thoracic sprain. He ordered MRIs and, upon review, noted the studies revealed “no evidence of acute injury and minimal degenerative changes,” which Dr. Kauffman determined to be “consistent with a pre-existing condition.” Dr. Kauffman placed Employee at maximum medical improvement on June 17, released him to full duty work, and assigned zero permanent impairment.

Employee was not satisfied with the medical care he had received and sought unauthorized treatment on his own with additional medical providers who treated him for depression and anxiety. He also received medical care from Dr. Darian Reddick, a neurologist who diagnosed Employee with chronic low back pain and spasm.

At a February 2, 2023 expedited hearing, Employee testified that he was released from medical care by his providers even though he believed he still needed treatment. Employee stated that he continued to have severe pain that limited his ability to work and caused severe depression. He requested another doctor who could provide treatment for

1 Although Employee was seen by Dr. Mayfield again in November, no additional issues were noted. 2 his condition so that he could return to work. Conversely, Employer argued that Employee was provided medical treatment with three authorized treating physicians and had received all workers’ compensation benefits to which he was entitled. In addition, Employer asserted that all treating doctors had released Employee from their care. After the hearing, the trial court determined Employee had not identified any legal basis that would justify changing his authorized treating physician and had therefore not established he would likely prevail at trial on his claim for additional medical benefits. Employee appealed, and we affirmed, noting Employee provided no proof that he had been denied reasonable and necessary medical care or that an authorized provider had refused to see him. Employee also did not file a brief or offer any legal argument as to how he believed the trial court erred.

Following our remand, the court issued a scheduling order setting deadlines for completing discovery, filing motions, filing pre-trial submissions, and setting the matter for trial on December 12, 2023. The parties were unable to reach a resolution via mediation, and a dispute certification notice (“DCN”) was issued on December 5. Compensability, medical benefits, temporary disability benefits, and permanent disability benefits were all marked as disputed issues on the DCN. In addition, in the section of the DCN where defenses are identified, Employer asserted that “all benefits have been paid and will be provided pursuant to the workers’ compensation laws” and that Employer “[d]isputed causation for some alleged complaints.” In a pre-compensation hearing statement filed with the court, the only issue identified was “[w]hether Employee is entitled to any further benefits of any kind, including temporary total disability [benefits], permanent partial disability [benefits], or medical benefits in addition to those already paid or offered[.]”

A compensation hearing was held on December 12. The trial court noted that the two percent impairment rating assigned by Dr. Mayfield for Employee’s clavicle fracture and the zero percent impairment rating assigned by Dr. Kauffman for Employee’s back complaints were unrebutted; as a result, Employee was entitled to an original award of permanent partial disability benefits in the amount of $3,840.21. The court also concluded that although Employee did not return to work, he was not entitled to receive increased permanent partial disability benefits pursuant to Tennessee Code Annotated section 50-6-207(3)(F). Finally, the court once again determined that Employer had authorized treatment for Employee’s work injury and that Employee “offered no proof” that Employer refused to authorize additional treatment with any approved physician. In addition, Employee’s unauthorized providers did not provide an opinion as to whether his current problems were primarily caused by the work accident. As a result, the court concluded there was no legal basis for a change in medical providers.

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Cite This Page — Counsel Stack

Bluebook (online)
2024 TN WC App. 17, Counsel Stack Legal Research, https://law.counselstack.com/opinion/chavez-raul-morelos-v-jesus-morelos-chavez-tennworkcompapp-2024.