Duncan, Danya v. Houchens Food Group, Inc.

2015 TN WC 47
CourtTennessee Court of Workers' Compensation Claims
DecidedMay 12, 2015
Docket2015-06-0043
StatusPublished

This text of 2015 TN WC 47 (Duncan, Danya v. Houchens Food Group, Inc.) is published on Counsel Stack Legal Research, covering Tennessee Court of Workers' Compensation Claims primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Duncan, Danya v. Houchens Food Group, Inc., 2015 TN WC 47 (Tenn. Super. Ct. 2015).

Opinion

FILED May 12,20 15

T~COURTOF WORKERS ' C0:\1PENSATION CLAn1 S

Time: 7: 15 A:\1

COURT OF WORKERS' COMPENSATION CLAIMS DIVISION OF WORKERS' COMPENSATION

Danya Duncan, ) DOCKET #: 2015-06-0043 Employee, ) STATE FILE #: 2642-2015 v. ) DATE OF INJURY: December 8, 2014 Houchens Food Group, Inc., ) Chief Judge Switzer Employer, ) and ) Chubb Group, ) Insurance CarrierffP A. )

EXPEDITED HEARING ORDER

THIS CAUSE came before the undersigned Workers' Compensation Judge on April 28, 2015, upon the Request for Expedited Hearing filed by the Employee Danya Duncan (Mr. Duncan), on March 31, 2015, pursuant to Tennessee Code Annotated section 50-6-239 to determine if the Employer, Houchens Food Group, Inc. (Houchens), is obligated to provide medical and temporary disability benefits. Considering the positions of the parties, the applicable law, and all of the evidence submitted, the Court concludes that Mr. Duncan is entitled to additional medical benefits in the form of a panel of physicians for evaluation of his injury, but he is not entitled to the requested arthroscopic procedure or additional temporary disability benefits at this time.

ANALYSIS

Issues

Whether Mr. Duncan sustained an injury that arose primarily out of and in the course and scope of his employment with Houchens.

Whether Mr. Duncan is entitled to additional medical care as recommended by a physician.

Whether Mr. Duncan is entitled to past or future disability benefits.

1 Evidence Submitted

The Court admitted into evidence the exhibits below:

1. Medical Records of Danya Duncan (26 pages) • Gateway Medical Center/Riverside Medical Associates (Dr. Tsambassis ); • Tennessee Orthopaedic Alliance and Surgery Center of Clarksville (Dr. DeVries); and, • Clarksville Imaging Center 2. Form C-20, First Report of Injury, December 8, 2014 3. Form C-42, Choice of Physician (undated) 4. Form C-41, Wage Statement, February 20, 2015 5. Form C-23, Notice ofDenial, January 15, 2015 6. U.S. Department of Labor FMLA Notice, January 15, 2015 7. Carrier's "Payment Summary" forms, five (5) payments: December 18, 22 and 31, 2014, and January 7 and 14, 2015.

The Court designated the following as the technical record:

• Petition for Benefit Determination, January 30, 2015 • Employer's position statement, March 9, 2015 • Dispute Certification Notice, March 10, 2015 • Request for Expedited Hearing, March 31, 2015.

The Court did not consider attachments to the above filings unless admitted into evidence during the Expedited Hearing. The Court considered factual statements in the above filings or any attachments to them as allegations unless established by the evidence.

The parties agreed that:

• Mr. Duncan's compensation rate is $127.20 per week; • The date of injury is December 8, 2014; and, • Mr. Duncan provided timely notice of the injury to Houchens.

The following witnesses provided in-person testimony: Mr. Duncan and Robert Duncan.

2 History of Claim

Summary ofAlleged Incident

Mr. Duncan is a thirty-seven (37) year-old resident of Montgomery County, Tennessee. On direct examination, he testified that he worked at Houchens as a cashier for approximately one year prior to the date of injury. His duties included ringing up the customers' orders, placing the items in bags held by a carousel, placing the bags in the customers' shopping carts and occasional cleaning. He said that, before the date of injury, nothing was wrong with his left knee.

Mr. Duncan testified that, on December 8, 2014, while "ringing out" a customer and placing items in bags, he lifted a turkey, weighing approximately twenty-five (25) pounds, to bag it. He struck his left knee on the register, losing his balance. He said that he then "hyperflexed" his knee, which he later clarified to mean that while the knee remained against the register, his body fell forward, causing his knee to hyperextend so that it bent in an unusual direction. He then struck his left knee against the bagging carousel, which stands near the register on the floor and revolves as items are placed in bags. Mr. Duncan said that, after the knee made contact with the bagging carousel, he immediately experienced pain. He conceded that Dr. William DeVries subsequently characterized his reported pain as greater than the physician would have expected, but stated, "I understand that. But I'm the one experiencing the pain; I'm the one dealing with this."

The First Report of Injury form states, "EE turned to put groceries in cart and hit his left knee on bagging stand. Knee contusion stationary object" (Ex. 2).

On cross-examination, Mr. Duncan testified that the injury occurred at approximately 10:00 a.m. Before the date of injury, he never hit his left knee on the carousel, nor did he ever seek medical treatment for his left knee.

Robert Duncan, Mr. Duncan's father, also testified. Robert Duncan said that, although Mr. Duncan does not live with him, he sees him often, and that to the best of his knowledge, Mr. Duncan never experienced a problem with his left knee before the date of InJUry.

Medical History

Dr. Nicholas Tsambassis examined Mr. Duncan on the date of injury. Dr. Tsambassis is the only doctor listed on Form C-42, Agreement Between Employer/Employee Choice of Physician (Ex. 3). Although the form lists the date of injury and was signed by Mr. Duncan, it does not contain a date of selection.

3 At the first visit, Dr. Tsambassis ordered an x-ray of the knee (Ex. I, p. 6). Dr. Tsambassis ordered an MRI on December II, 20I4 (Ex. I, p. 7, p. 9). On December I5, 20I4, Dr. Tsambassis excused Mr. Duncan from work (Ex. I, p. II). After reviewing the MRI results (Ex. I, p. 26), Dr. Tsambassis referred Mr. Duncan to Tennessee Orthopaedic Alliance on December 29, 20I4 (Ex. I, p. I2). The referral was general in nature so that no specific physician was designated.

Mr. Duncan saw Dr. DeVries at Tennessee Orthopaedic Alliance on January 8, 20I5 (Ex. I, pp. I7-23). Under "History of Illness," Dr. DeVries noted, "He injured his knee on December 8 when he was at work and struck his left knee against a cash register and hyper.flexed his knee. Ever since he has had pain and difficulty walking and weightbearing" (Ex. I, p. I7; emphasis added). Under "Impression," Dr. DeVries wrote, "Left knee pain with medial meniscal tear" (Ex. I, p. I8). He additionally wrote, "I discussed with him that clearly his pain is out of portion (sic.) to what I am seeing on the MRI scan. . . . I did recommend arthroscopic evaluation of the meniscus to remove the tearing .... " !d. Dr. DeVries placed Mr. Duncan on limited duty, to include "sitting job only," and, "no squatting, kneeling or climbing" (Ex. I, p. I8, p. 22).

Carrier's adjuster faxed a letter to Dr. DeVries on January I2, 20I5 (Ex. I, p. 24). In the introductory paragraphs, Carrier wrote:

On I2/8/I4, he was bagging groceries for a customer and struck the left knee at the end of the counter. The left knee began swelling right away. He had instant pain under the left kneecap. The new Workers' Compensation law, (sic) requires that all injuries must arise primarily out of and in the course and scope of employment in order for the claim to be compensable. This threshold can only be met if the employee can show by a preponderance of the evidence that the employment was at least 50. I percent of the cause of the lllJUry.

The adjuster asked, "In your medical opmwn, did Mr. Duncan's left knee pain and possible small posterior hom medial meniscal tear arise primarily out of and in the course of his employment and did the employment cause at least 50. I percent ofthe condition?" In his January I4, 20I4 response, Dr.

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Bluebook (online)
2015 TN WC 47, Counsel Stack Legal Research, https://law.counselstack.com/opinion/duncan-danya-v-houchens-food-group-inc-tennworkcompcl-2015.