Hall, Phyllis v. Fisher Installations, LLC

2015 TN WC 145
CourtTennessee Court of Workers' Compensation Claims
DecidedOctober 21, 2015
Docket2015-06-0518
StatusPublished

This text of 2015 TN WC 145 (Hall, Phyllis v. Fisher Installations, LLC) 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
Hall, Phyllis v. Fisher Installations, LLC, 2015 TN WC 145 (Tenn. Super. Ct. 2015).

Opinion

IN THE COURT OF WORKERS’ COMPENSATION CLAIMS AT NASHVILLE

Phyllis Hall ) Docket No.: 2015-06-0518 Employee, ) v. ) State File No.: 40578-2015 Fisher Installations, LLC ) Employer, ) Judge Joshua Davis Baker And ) Accident Fund Insurance ) Carrier. )

EXPEDITED HEARING ORDER GRANTING TEMPORARY DISABILITY AND MEDICAL BENEFITS

THIS CAUSE came to be heard before the undersigned upon the Request for Expedited Hearing filed by the employee pursuant to Tennessee Code Annotated section 50-6-239 (2014). The employee seeks medical care and temporary disability benefits related to a right rotator-cuff injury. The central dispute is whether the employer must provide treatment for the injury under workers’ compensation. The Court finds the employee carried her burden of proving entitlement to medical and temporary disability benefits.

History of Claim

Ms. Hall is a fifty-year-old resident of Davidson County, Tennessee who worked for Fisher Installations, LLC (Fisher) at the time of the incidents relevant to this claim. Fisher installs auditorium chairs.

On March 24, 2015, Ms. Hall worked for Fisher at Jefferson County High School. Workers recently poured concrete in the area where Ms. Hall worked, and left the concrete molds in place. Ms. Hall walked around the vertical pins supporting the concrete forms, caught her slacks on a pin, and fell to the ground, injuring her right shoulder. Ms. Hall testified she informed Katy Fisher, a co-owner of Fisher, of her injury. Ms. Fisher agreed that she knew Ms. Hall fell. Several days after the incident, Ms. Hall met with Ms. Fisher and Lisa Cunningham, Fisher’s director of operations. According to Ms. Hall, Ms. Fisher and Ms. Cunningham gave her the phone number for Tennessee Orthopedic Alliance (TOA) and instructed her to call for an appointment. Ms. Hall called the phone number and set up an appointment.

Ms. Hall treated with Dr. David Alexander at TOA. Dr. Alexander recommended x-rays and an MRI, which confirmed a “massive” right rotator-cuff tear. (Ex. 1 at 14.) Ms. Fisher gave Ms. Hall $120.00 toward her co-payments for two visits with Dr. Alexander. On her TOA Patient Questionnaire, Ms. Hall indicated her injury was not work-related. Id. at 26. Ms. Hall testified she indicated her injury was not work-related because Ms. Fisher asked her to get treatment under her private health insurance.

Ms. Hall testified that, when the MRI revealed a torn rotator cuff and Dr. Alexander recommended surgery, Ms. Fisher refused to provide further money for treatment and “basically” told her she was “on her own.” On examination, Ms. Fisher denied making this statement, but replied “no” when asked whether Fisher would continue paying Ms. Hall’s medical bills. Ms. Fisher stated she only offered to pay for Ms. Hall to undergo diagnostic treatment to ensure that continuing to work would not harm her.

Ms. Fisher admitted she did not report the injury under workers’ compensation, but claimed it was because Ms. Hall was concerned she would not pass a drug test, and she did not want Ms. Hall to lose her job.1 Ms. Cunningham affirmed that Ms. Hall expressed concern about her ability to pass a drug test.

Ms. Hall denied telling Ms. Fisher she could not pass a drug test and claimed Ms. Fisher did not want to report the injury because it could inhibit Fisher’s ability to procure work contracts by increasing its workers’ compensation “MOD rate.” Ms. Fisher denied this influenced her decision. Ms. Cunningham also denied telling Ms. Hall not to file a claim because it would affect Fisher’s MOD rate and ability to procure contracts.

Ms. Fisher did not ask Ms. Hall to take a drug test, but stated testing would have been required if she asked for medical treatment. Ms. Fisher, however, did not suspect Ms. Hall was under the influence of drugs when she suffered her injury. Ms. Hall admitted using marijuana in the past, but denied using marijuana near the time of the accident.

Ms. Hall continued to work for Fisher until May 22, 2015. Ms. Fisher did not know Dr. Alexander imposed work restrictions on Ms. Hall that prevented her from working. She maintained, however, that Fisher had light-duty work available, and that

1 The general contractor with whom Fisher contracted required drug testing for anyone injured on the jobsite.

2 Ms. Fisher performed light-duty work until her termination on May 22. Fisher was unwilling to offer Ms. Hall modified duty at the time of the trial because she “abandoned her job” when she failed to show up for work without reporting the reason for her absence. At trial, Ms. Hall stated she was being treated by the doctor and “under doctor’s orders.”

Ms. Hall underwent surgery to repair her torn right rotator cuff on June 5, 2015. (Ex. 1 at 6-8.) Ms. Hall testified Dr. Alexander had yet to release her to return to work. Ms. Hall’s medical records contain three memos taking her off work from the date of surgery until August 27, 2015. Id. at 61-64. The records also indicate Ms. Hall had a follow-up appointment scheduled for August 27. Id. at 1. The records from this appointment are not before the Court.

Ms. Hall filed a Petition for Benefit Determination. (T.R. 1.) The parties did not resolve the disputed issues through mediation, and the Mediation Specialist filed a Dispute Certification Notice. (T.R. 2.) Ms. Hall filed a Request for Expedited Hearing seeking medical and temporary disability benefits. (T.R. 3.) This Court heard both Requests on September 22, 2015.

Findings of Fact and Conclusions of Law

The General Rules of the Workers’ Compensation Program provide the following concerning reporting a workplace injury:

Each employer, self-insured employer, and/or insurer shall file a Form C-20 (Tennessee Employer’s First Report of Work Injury or Illness) in accordance with the following:

(1) The Form C-20 shall be filed with the [Bureau] in all cases where the injury or illness results in the receipt of medical treatment outside of the employer’s premises, absence from work, retention of a permanent impairment, or death[.]

(2) Employers, other than self-insured employers, shall report the injuries or illnesses described in paragraph (1) of this Rule to their insurer within one (1) business day of knowledge of the injury or illness. Insurers, and self-insured employers, shall file the Form C-20 with the [Bureau] as soon as possible, but not later than fourteen (14) days after knowledge of an injury or illness of a nature that an employee does not return to his or her employment within seven (7) days after the occurrence of the injury or illness. Reports of injuries or illnesses in which an employee returns to his or her employment within seven (7) days or fewer shall be filed as soon as possible, but not later than the fifteenth (15th) day of the

3 month following the month in which the injury or illness occurred.

Tenn. Comp. R. & Regs. 0800-02-01-.06(1)-(2) (2015) (emphasis added.).

This claim presents the hazards and difficulties associated with employers and employees failing to properly report a workers’ compensation injury. The following facts are not disputed:

 Ms. Hall suffered an injury to her right shoulder in the course and scope of her work with Fisher.  Ms. Hall reported her workplace accident to Fisher in a timely manner.  Ms. Hall received off-premises medical care for her shoulder injury from Dr. Alexander at TOA, who performed corrective shoulder surgery.  Ms. Hall told TOA her injury did not result from a workplace accident.  Ms. Hall paid for the surgery, her initial care and any follow-up care by using her private insurance.  Fisher acquiesced in this course of action and even provided money to cover the cost of some of the associated copays.

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Bluebook (online)
2015 TN WC 145, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hall-phyllis-v-fisher-installations-llc-tennworkcompcl-2015.