John Ellis v. Dallas Area Rapid Transit

Court of Appeals of Texas·Decided January 14, 2021·No. 02-19-00224-CV·Published

Opinion

In the Court of Appeals Second Appellate District of Texas at Fort Worth ___________________________ No. 02-19-00224-CV ___________________________

JOHN ELLIS, Appellant

V.

DALLAS AREA RAPID TRANSIT, Appellee

On Appeal from the 48th District Court Tarrant County, Texas Trial Court No. 048-280578-15

Before Sudderth, C.J.; Kerr and Wallach, JJ. Memorandum Opinion by Justice Kerr MEMORANDUM OPINION

In this workers’ compensation case, John Ellis appeals the trial court’s

judgment affirming the Texas Department of Insurance’s decision regarding the

extent of Ellis’s compensable injury. Ellis argues that the trial court erred by requiring

expert medical evidence causally linking his alleged injuries to his on-the-job accident,

and he claims that this error resulted in a legally insufficient judgment. We affirm.

I. Background

In May 2014, Ellis was involved in a motor-vehicle accident while driving a bus

for Dallas Area Rapid Transit (DART). DART provided workers’ compensation

coverage for employees, so Ellis filed a claim with the Texas Department of

Insurance’s Division of Workers’ Compensation (TDI).

In the year that followed, Ellis visited more than seven doctors for pain in his

neck, shoulder, arm, hand, and wrist. Ellis claimed that the 2014 collision aggravated

preexisting injuries to his rotator cuff and wrist, both of which he traced to a prior on-

the-job accident in 2013. Although the medical records presented at trial showed that

Ellis reported a right-shoulder rotator-cuff tear and a right-wrist ganglion cyst as

preexisting conditions, none of the medical records causally linked the aggravation of

his shoulder or wrist conditions to the 2014 collision.

A. Medical History

Ellis visited the emergency room the night of his on-the-job accident but was

discharged with “no significant acute injuries” other than cervical strain, right-

2 shoulder strain, and right-wrist strain. The following day, Dr. Lawus-Scurry examined

Ellis and took x-rays of his shoulder and wrist. The doctor found “no significant acute

injuries” diagnosing only a cervical-spine muscle spasm and a sprained or strained

neck, elbow, forearm, and shoulder.

Ellis sought a second opinion from Dr. Powell, who concluded that Ellis had

shoulder strain, cervical strain, wrist sprain, and trapezius strain. Approximately one

month later, Dr. Powell examined Ellis again and found that Ellis had regained full

range of motion in his shoulder, wrist, neck, and spine.

Dr. Ford then conducted a peer review of Ellis’s file. In his report, Dr. Ford

aggregated and summarized Ellis’s then-current diagnoses: “a cervical strain, a

ganglion cyst of the wrist, a shoulder strain, a trapezius strain, a wrist and forearm

sprain/strain, multilevel cervical stenosis, shoulder impingement, and a rotator cuff

tear.” Dr. Ford noted that MRIs conducted in 2013—before the 2014 collision,

obviously—found “a partial tear of the supraspinatus tendon” in Ellis’s right shoulder

and “questionable tenosynovitis within the carpal tunnel” in his right wrist. Of Ellis’s

diagnoses, Dr. Ford concluded that “the alleged work-related [incident] was a

substantial factor in bringing about . . .a cervical strain, a shoulder strain, a trapezius

strain, and a wrist and forearm strain/sprain” but that the “ganglion cyst, cervical

stenosis, and a partial rotator cuff tear with impingement are clearly

documented . . . as pre[]existing conditions which are not a direct result of the original

3 work-related event of May 18, 2014.” Notably, Dr. Ford did not mention a tendinitis

diagnosis; Ellis’s medical records did not contain such a diagnosis at the time.

Dr. Powell served as Ellis’s treating doctor and continued seeing Ellis and

reviewing his condition every two to four weeks. See Tex. Lab. Code Ann.

§ 401.011(42) (defining “treating doctor” as “the doctor who is primarily responsible

for the employee’s health care for an injury”). Although Ellis’s shoulder and wrist had

recovered full range of motion one month after the accident, Dr. Powell later noted

new limitations in Ellis’s range of motion. But an MRI of Ellis’s shoulder revealed

that his right-shoulder rotator cuff—which was allegedly torn due to a preexisting

injury—was fully intact. Moreover, the new range-of-motion limitations in Ellis’s wrist

were inconsistent with the 2014 injury. Dr. Powell thus referred Ellis to a specialist for

his wrist, but her overall assessment of Ellis’s condition remained unchanged.

The wrist specialist Ellis visited was Dr. Zehr, a hand surgeon. Dr. Zehr

diagnosed Ellis with “[t]endinitis right wrist mainly first dorsal compartment” and

concluded that the tendinitis—rather than the ganglion cyst—was the primary cause

of Ellis’s wrist pain. Dr. Zehr recommended cortisone injections and a thumb splint

but noted that surgery was an option if necessary. When Ellis continued to experience

pain, Dr. Zehr scheduled Ellis for surgery for the tendinitis. But Ellis canceled the

surgery after learning that it would not be covered by workers’ compensation.

4 TDI then appointed a designated doctor1—Dr. Clenney—to examine Ellis and

impartially determine the extent of his compensable injury. Id. § 401.011(10) (defining

“compensable injury”). Dr. Clenney noted significant limitations in the range of

motion of Ellis’s right wrist and right shoulder “far in excess of that based on the

injury and the MRI.” Dr. Clenney identified five potentially compensable conditions:

(1) cervical sprain/strain; (2) right shoulder sprain/strain; (3) right wrist sprain/strain;

(4) right trapezial strain; and (5) right forearm strain. But Dr. Clenney indicated that

Ellis had not yet reached his date of maximum medical improvement (MMI).2

Meanwhile, Ellis visited yet another hand surgeon: Dr. Montejo. Although Dr.

Montejo noted many of the same sprains and strains diagnosed by Ellis’s other

A designated doctor is “a doctor appointed by mutual agreement of the parties 1

or by the division to recommend a resolution of a dispute as to the medical condition of an injured employee.” Tex. Lab. Code Ann. § 401.011(15); see also 28 Tex. Admin. Code ch. 127 (2020) (Tex. Dep’t of Ins., Designated Dr. Procedures & Requirements). The employer, the employee, or TDI may order a medical examination by the designated doctor to determine the extent of the employee’s compensable injury, among other issues. See Tex. Lab. Code Ann. § 408.0041(a). TDI gives the designated doctor’s report “presumptive weight unless the preponderance of the evidence is to the contrary.” Id. § 408.0041(e).

The date of “maximum medical improvement” in a case not involving spinal 2

surgery is “the earlier of (A) the earliest date after which, based on reasonable medical probability, further material recovery from or lasting improvement to an injury can no longer reasonably be anticipated; [or] (B) the expiration of 104 weeks from the date on which income benefits begin to accrue.” Id. § 401.011(30).

5 doctors, he attributed Ellis’s wrist pain to de Quervain’s tenosynovitis and

epicondylitis.3 Dr. Montejo did not opine about the cause of these new diagnoses.

TDI then referred Ellis to Dr.

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