Gilbert, Thomas v. United Parsel Service, Inc.

2016 TN WC 163
CourtTennessee Court of Workers' Compensation Claims
DecidedJuly 15, 2016
Docket2016-06-0832
StatusPublished

This text of 2016 TN WC 163 (Gilbert, Thomas v. United Parsel Service, 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
Gilbert, Thomas v. United Parsel Service, Inc., 2016 TN WC 163 (Tenn. Super. Ct. 2016).

Opinion

TENNESSEE BUREAU OF WORKERS' COMPENSATION IN THE COURT OF WORKERS' COMPENSATION CLAIMS AT NASHVILLE

Thomas Gilbert, ) Docket No.: 2016-06-0832 Employee, ) v. ) United Parcel Service, Inc. ) State File No.: 33590-2016 Employer, ) And ) Liberty Mutual Insurance Company, ) Judge Kenneth M. Switzer Carrier. ) )

EXPEDITED HEARING ORDER

This case came before the undersigned workers' compensation judge on July 6, 2016, on the Request for Expedited Hearing filed by the employee, Thomas Gilbert, pursuant to Tennessee Code Annotated section 50-6-239 (20 15). The present focus of this case is whether Mr. Gilbert sustained a new, compensable aggravation of his preexisting condition or a continuation of his previous work injury.

For the reasons set forth below, the Court finds Mr. Gilbert has shown a likelihood of success in proving at a hearing on the merits that he sustained a new, gradually- occurring injury. He is entitled to medical benefits, but has not shown entitlement to temporary total disability benefits at this time. Further, while Mr. Gilbert has not shown entitlement to a statutory penalty regarding the employer's failure to provide timely temporary disability benefits, the Court refers the matter to the Bureau's Compliance Unit for consideration of whether penalties are appropriate for the Employer, United Parcel Service, and the carrier, Liberty Mutual, regarding delays in filing a First Report of Injury and Notice ofDenial. 1

History of Claim

Mr. Gilbert is a fifty-four-year-old resident of Maury County, Tennessee. He has 1 A complete listing of the technical record and exhibits admitted at the Expedited Hearing is attached to this Order as an appendix.

1 worked for UPS as a package car driver for approximately sixteen years. In that capacity, he is occasionally required to lift items weighing up to seventy pounds and to "stair climb." (Ex. 9.) Mr. Gilbert estimated he climbed into his work truck approximately 150 to 200 times per day, five days per week, stepping up approximately eighteen inches with his left leg first as the "normal motion" each time.

Mr. Gilbert sustained a work-related injury to his left knee on May 9, 2011, while working for UPS. Dr. David Moore, the authorized treating physician, performed an arthroscopic partial medial meniscectomy and chondroplasty and ultimately released him to work in October 2011, assigning a two-percent permanent partial impairment rating. (Ex. 1 at 16-17.) The parties entered into a settlement agreement, which the Circuit Court for Maury County approved on February 3, 2012, providing lifetime medical benefits for the injury. (Ex. 3, A-C.)

Pursuant to the agreement, Mr. Gilbert continued to receive authorized care from Dr. Moore. He administered injections in October and November 2011, as well as April, August and December 2012. (Ex. 1 at 17, 21, 26, 29, 31.) Mr. Gilbert testified the left- knee condition improved over time and he stopped seeing Dr. Moore in December 2012 "because the pain was gone and I could function normally." Regarding whether he felt "manageable discomfort" after ceasing treatment with Dr. Moore until returning to seek treatment in 2015, Mr. Gilbert explained, "You can ask just about any driver that drives a package car for UPS, there is some discomfort in the knees and back throughout the day, every day you work. So yes, there is, to some extent, manageable discomfort."

Mr. Gilbert testified he had no problems with his left knee in 2013 and 2014, but in approximately April or May 2015, he began experiencing pain in his left knee when climbing into the truck. Once the pain intensified, he returned to Dr. Moore. Notes from a July 23, 2015 visit document the onset of moderate medial compartment osteoarthritis. (Ex. 1 at 36.) The notes state:

Dr. Moore does think that he has simply aggravated that, which has caused the increase in pain and swelling to his knee. He does think the compression of his medial compartment osteoarthritis is directly related to his medial meniscus tear that was caused by his initial work-related injury in May of2011.

!d. Dr. Moore echoed that opinion at a visit in October 2015. !d. at 37. Mr. Gilbert received injections for pain at both visits.

In January 2016, Dr. Moore recommended a total knee replacement and referred Mr. Gilbert to Dr. Gregory Raab, an arthroplasty specialist. !d. at 44. Notes from that visit state, ""My impression is that his [need] for a total knee arthroplasty is directly related to his meniscal injury." !d. Dr. Raab saw Mr. Gilbert on April 22, 2016, noting

2 his history of surgery and opining:

[Mr. Gilbert] had been doing reasonably well until more recently, and over the last several months has had significant increase in his symptoms with pain worsening, both medially and anteriorly with stairs. He now describes the pain is constant. He has difficulty walking. He has difficulty with stairs, which is challenging given the patient' s job as a UPS driver, where he is constantly in and out of his vehicle loading and unloading.

!d. at 45. Dr. Raab agreed the knee replacement is necessary, reading x-rays and concluding: "Four views of the left knee from 01/07/2016 reveal a severe bone-on-bone medial compartment arthritis and moderate patellofemoral arthritis. This is a progression from x-rays both In [sic] July 2015, as well as significant progression since January 2012." !d. at48.

Mr. Gilbert's counsel sent a causation letter on April26, 2016, to Dr. Moore. (Ex. 7.) In relevant part, it reads as follows:

1. Has Mr. Gilbert sustained an aggravation of his specific !eft injury as a result of repetitive climbing into the truck during his job as a UPS driver? : ~ (&il_ .J-<:> 1 [41~ ~·_,.C#IJ ~ -:.t-L.... G J-.-,.. 0""-

No \'~<)~ of ~~ 6fr · 2. Is this aggravation at least S l percent cause of his current need for knee replacement? c~ ~(A~· bvJ No 3. Are the above opinions to a reasonable degree of medical certainty?

(Ex. 7 at 2.)

Mr. Gilbert learned of Dr. Moore's response on May 2, 2016. Records confirm he telephoned his supervisor, Richard Bonee, on that date. (Ex. 10.) According to Mr. Gilbert, he told Mr. Bonee he suffered a new, cumulative-trauma injury. Mr. Bonee acknowledged he characterized the injury in that manner, and that Mr. Gilbert telephoned him again on May 4, 2016, to report a new injury. Mr. Gilbert's counsel followed-up with a May 5, 2016 letter entitled "Notice of Injury" to Mr. Bonee. (Ex. 11.) Mr. Bonee admitted receiving the letter. He filed a First Report of Injury on June 22, 2016, only after the adjuster told him to do so.

Mr. Gilbert's last day worked was May 6, 2016, according to the Affidavit of Doug Grissom, his supervisor. (Ex. 5 at 2.) Mr. Grissom observed him limping that 3 morning and, after consulting with Mr. Bonee, sent him home. Mr. Gilbert testified he remains under UPS' employ, but UPS will not allow him to work until released by a physician after surgery. UPS paid no temporary disability benefits.

Liberty Mutual, UPS' carrier, sought utilization review regarding the knee replacement, which surgery was certified as medically necessary on May 5, 2016. (Ex. 3 at 2.) Liberty Mutual authorized the procedure and scheduled it to take place on July 12, 2016. !d. at 3. However, Mr. Gilbert cancelled the surgery on June 10, 2016, expressing concern that having surgery as authorized under the previous settlement would have a negative effect in his subsequent claim.

Mr. Gilbert filed a Petition for Benefit Determination (PBD) seeking medical and temporary disability benefits on May 5, 2016. The parties did not resolve the disputed issues through mediation, and the mediating specialist filed a Dispute Certification Notice (DCN) on June 2, 2016. Mr.

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2016 TN WC 163, Counsel Stack Legal Research, https://law.counselstack.com/opinion/gilbert-thomas-v-united-parsel-service-inc-tennworkcompcl-2016.