FILED
May 16, 2019 07:34 AM(CT)
TENNESSEE COURT OF
CLAIMS
TENNESSEE BUREAU OF WORKERS’ COMPENSATION IN THE COURT OF WORKERS’ COMPENSATION CLAIMS
AT GRAY
KATELYN JONES, ) Docket No. 2018-02-0409 Employee, )
Vv. )
UPPER EAST TENNESSEE HUMAN __)
DEVELOPMENT AGENCY, ) State File No. 37058-2018 Employer, )
And )
PUBLIC ENTITY PARTNERS, ) Carrier. ) Judge Brian K. Addington
EXPEDITED HEARING ORDER DENYING REQUESTED BENEFITS
The Court held an Expedited Hearing on May 14, 2019, on Katelyn Jones’s entitlement to medical and temporary disability benefits. The issue is whether Ms. Jones is likely to establish at trial that she is entitled to these benefits for a knee injury she suffered from a fall at work. For the reasons below, the Court denies the requested relief.
History of Claim
Ms. Jones worked as a family resource specialist at Upper East Tennessee Human Development Agency (UETHDA). Her position included “engagement activities,” which are planned events where all students and their parents participate in social activities coordinated by teachers, their assistants, and the family resource specialists.
During an engagement activity in UETHDA’s gym on May 18, 2018, Ms. Jones ensured that the activities progressed, the children and parents stayed engaged, and the participants remained safe. After an activity ended, she walked across the gym floor and suddenly fell injuring her left knee. The floor was level and unobstructed. Ms. Jones did not observe anything that caused her to fall.
UETHDA provided a panel, and Ms. Jones chose Holston Medical Group. After two visits, UETHDA denied her claim on the basis she suffered an idiopathic injury. Ms.
WORKERS' COMPENSATION Jones continued limited treatment at her own expense and testified that she needs surgery to repair a ligament and bone spur.
Ms. Jones asserted her injury occurred at work and she never experienced knee complaints before the fall. She argued her work duties supervising children and interacting with the adults during the engagement activity presented a hazard that caused her injury. UETHDA argued Ms. Jones suffered an idiopathic injury; no work hazard caused her to fall. It asked the Court to deny Ms. Jones’s claim and moved to dismiss the case.
Findings of Fact and Conclusions of Law
To prevail at an expedited hearing, Ms. Jones must provide sufficient evidence to show she would likely to prevail at a hearing on the merits in proving her claim for medical and temporary disability benefits. See Tenn. Code Ann. § 50-6-239(d)(1) (2018). She failed to do so.
Since Ms. Jones does not know why she fell, UETHDA argued she suffered an idiopathic injury. An idiopathic injury is defined as “one that has an unexplained origin or cause, and generally does not arise out of the employment unless ‘some condition of the employment presents a peculiar or additional hazard.’” Veler v. Wackenhut Servs., No. E2010-00965-WC-R3-WC, 2011 Tenn. LEXIS 78, at *9 (Tenn. Workers’ Comp. Panel Jan. 28, 2011). Since Ms. Jones fell on a level, unobstructed surface, she must establish that her unexplained fall was due to a condition of the employment that presented a peculiar or additional hazard to her. Byrom v. Randstad N. Am., L.P., No. E2011-00367-WC-R3-WC, 2012 Tenn. LEXIS 152, at *13 (Tenn. Workers’ Comp. Panel Mar. 8, 2012).
Ms. Jones’s argument that her job duties presented a hazard that caused her injury is not persuasive. As the Workers’ Compensation Appeals Board explained in McCaffery v. Cardinal Logistics, 2015 TN Wrk. Comp. App. Bd. LEXIS 50, at *8-11 (Dec. 10, 2015), the relevant inquiry is not what caused the alleged idiopathic condition or event but what caused the injury. The Board noted that “cause” in the context of idiopathic injuries “means that the accident originated in the hazards to which the employee was exposed as a result of performing his job duties.” /d. at *10. Here, the important inquiry is not what caused Ms. Jones’s fall, but what caused her knee injury. Ms. Jones did not submit any evidence as to what caused her knee injury, and her mere presence at work is not a “hazard.” See Rogers v. Kroger Co., 832 S.W.2d 538, 541 (Tenn. 1992). Therefore, the Court holds Ms. Jones did not come forward with sufficient evidence to prevail at a hearing on the merits and she is not entitled to the requested benefits.
Finally, UETHDA’s motion to dismiss, presumably a motion for involuntary dismissal under Rule 41.02 of the Tennessee Rules of Civil Procedure, is denied. Ms.
2 Jones sought interlocutory relief at an expedited hearing, so this is a nonfinal order
subject to modification at any time before the final compensation hearing. See Tenn. Code Ann. § 50-6-239(d)(3).
IT IS, THEREFORE, ORDERED as follows: 1. Ms. Jones’s requested relief is denied at this time. 2. This matter is set for a Status Hearing on August 27, 2019 at 9:00 a.m. Eastern Time. The parties must call 855-543-5044 toll-free to participate in the hearing.
Failure to appear by telephone may result in a determination of the issues without your further participation.
ENTERED May 16, 2019. /s/ Brian K. Addington JUDGE BRIAN K. ADDINGTON Court of Workers’ Compensation Claims APPENDIX Exhibits
Ms. Jones’s Affidavit
Notice of Denial of Claim for Compensation
Medical records of HMG Urgent Care
Medical records of Family Physicians of Johnson City Franklin Woods’s radiology report
Medical records of Appalachian Orthopedics Collective-Medical bills and receipts
Pay Stubs from April and May 2018
Job Description
S98 SO ew Ne
Technical Record
1. Petition for Benefit Determination 2. Dispute Certification Notice 3. Request for Expedited Hearing 4. Motion to Dismiss 5. Agreed Order
6. Statement of Stipulated Facts 7. Ms. Jones’s Pre-Hearing Brief 8. Employer’s Pre-Hearing Brief CERTIFICATE OF SERVICE
I certify that a copy of the Order was sent to these recipients by the following methods of service on May 16, 2019.
Name Certified Mail Email Service sent to:
Josh Hoeppner, x josh@hoeppnerlaw.com Employee’s Attorney
Sam McPeak, xX sam@hbm-lawfirm.com Employer’s Attorney
Lio _ SO PENNY SHUM, COURT CLERK Court of Werkers’ Compensation Claims
Expedited Hearing Order Right to Appeal:
If you disagree with this Expedited Hearing Order, you may appeal to the Workers’ Compensation Appeals Board. To appeal an expedited hearing order, you must:
1. Complete the enclosed form entitled: “Expedited Hearing Notice of Appeal,” and file the form with the Clerk of the Court of Workers’ Compensation Claims within seven business days of the date the expedited hearing order was filed. When filing the Notice of Appeal, you must serve a copy upon all parties.
2. You must pay, via check, money order, or credit card, a $75.00 filing fee within ten calendar days after filing of the Notice of Appeal. Payments can be made in-person at any Bureau office or by U.S. mail, hand-delivery, or other delivery service. In the alternative, you may file an Affidavit of Indigency (form available on the Bureau’s website or any Bureau office) seeking a waiver of the fee. You must file the fully- completed Affidavit of Indigency within ten calendar days of filing the Notice of Appeal. Failure to timely pay the filing fee or file the Affidavit of Indigency will result in dismissal of the appeal.
3. You bear the responsibility of ensuring a complete record on appeal.
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FILED
May 16, 2019 07:34 AM(CT)
TENNESSEE COURT OF
CLAIMS
TENNESSEE BUREAU OF WORKERS’ COMPENSATION IN THE COURT OF WORKERS’ COMPENSATION CLAIMS
AT GRAY
KATELYN JONES, ) Docket No. 2018-02-0409 Employee, )
Vv. )
UPPER EAST TENNESSEE HUMAN __)
DEVELOPMENT AGENCY, ) State File No. 37058-2018 Employer, )
And )
PUBLIC ENTITY PARTNERS, ) Carrier. ) Judge Brian K. Addington
EXPEDITED HEARING ORDER DENYING REQUESTED BENEFITS
The Court held an Expedited Hearing on May 14, 2019, on Katelyn Jones’s entitlement to medical and temporary disability benefits. The issue is whether Ms. Jones is likely to establish at trial that she is entitled to these benefits for a knee injury she suffered from a fall at work. For the reasons below, the Court denies the requested relief.
History of Claim
Ms. Jones worked as a family resource specialist at Upper East Tennessee Human Development Agency (UETHDA). Her position included “engagement activities,” which are planned events where all students and their parents participate in social activities coordinated by teachers, their assistants, and the family resource specialists.
During an engagement activity in UETHDA’s gym on May 18, 2018, Ms. Jones ensured that the activities progressed, the children and parents stayed engaged, and the participants remained safe. After an activity ended, she walked across the gym floor and suddenly fell injuring her left knee. The floor was level and unobstructed. Ms. Jones did not observe anything that caused her to fall.
UETHDA provided a panel, and Ms. Jones chose Holston Medical Group. After two visits, UETHDA denied her claim on the basis she suffered an idiopathic injury. Ms.
WORKERS' COMPENSATION Jones continued limited treatment at her own expense and testified that she needs surgery to repair a ligament and bone spur.
Ms. Jones asserted her injury occurred at work and she never experienced knee complaints before the fall. She argued her work duties supervising children and interacting with the adults during the engagement activity presented a hazard that caused her injury. UETHDA argued Ms. Jones suffered an idiopathic injury; no work hazard caused her to fall. It asked the Court to deny Ms. Jones’s claim and moved to dismiss the case.
Findings of Fact and Conclusions of Law
To prevail at an expedited hearing, Ms. Jones must provide sufficient evidence to show she would likely to prevail at a hearing on the merits in proving her claim for medical and temporary disability benefits. See Tenn. Code Ann. § 50-6-239(d)(1) (2018). She failed to do so.
Since Ms. Jones does not know why she fell, UETHDA argued she suffered an idiopathic injury. An idiopathic injury is defined as “one that has an unexplained origin or cause, and generally does not arise out of the employment unless ‘some condition of the employment presents a peculiar or additional hazard.’” Veler v. Wackenhut Servs., No. E2010-00965-WC-R3-WC, 2011 Tenn. LEXIS 78, at *9 (Tenn. Workers’ Comp. Panel Jan. 28, 2011). Since Ms. Jones fell on a level, unobstructed surface, she must establish that her unexplained fall was due to a condition of the employment that presented a peculiar or additional hazard to her. Byrom v. Randstad N. Am., L.P., No. E2011-00367-WC-R3-WC, 2012 Tenn. LEXIS 152, at *13 (Tenn. Workers’ Comp. Panel Mar. 8, 2012).
Ms. Jones’s argument that her job duties presented a hazard that caused her injury is not persuasive. As the Workers’ Compensation Appeals Board explained in McCaffery v. Cardinal Logistics, 2015 TN Wrk. Comp. App. Bd. LEXIS 50, at *8-11 (Dec. 10, 2015), the relevant inquiry is not what caused the alleged idiopathic condition or event but what caused the injury. The Board noted that “cause” in the context of idiopathic injuries “means that the accident originated in the hazards to which the employee was exposed as a result of performing his job duties.” /d. at *10. Here, the important inquiry is not what caused Ms. Jones’s fall, but what caused her knee injury. Ms. Jones did not submit any evidence as to what caused her knee injury, and her mere presence at work is not a “hazard.” See Rogers v. Kroger Co., 832 S.W.2d 538, 541 (Tenn. 1992). Therefore, the Court holds Ms. Jones did not come forward with sufficient evidence to prevail at a hearing on the merits and she is not entitled to the requested benefits.
Finally, UETHDA’s motion to dismiss, presumably a motion for involuntary dismissal under Rule 41.02 of the Tennessee Rules of Civil Procedure, is denied. Ms.
2 Jones sought interlocutory relief at an expedited hearing, so this is a nonfinal order
subject to modification at any time before the final compensation hearing. See Tenn. Code Ann. § 50-6-239(d)(3).
IT IS, THEREFORE, ORDERED as follows: 1. Ms. Jones’s requested relief is denied at this time. 2. This matter is set for a Status Hearing on August 27, 2019 at 9:00 a.m. Eastern Time. The parties must call 855-543-5044 toll-free to participate in the hearing.
Failure to appear by telephone may result in a determination of the issues without your further participation.
ENTERED May 16, 2019. /s/ Brian K. Addington JUDGE BRIAN K. ADDINGTON Court of Workers’ Compensation Claims APPENDIX Exhibits
Ms. Jones’s Affidavit
Notice of Denial of Claim for Compensation
Medical records of HMG Urgent Care
Medical records of Family Physicians of Johnson City Franklin Woods’s radiology report
Medical records of Appalachian Orthopedics Collective-Medical bills and receipts
Pay Stubs from April and May 2018
Job Description
S98 SO ew Ne
Technical Record
1. Petition for Benefit Determination 2. Dispute Certification Notice 3. Request for Expedited Hearing 4. Motion to Dismiss 5. Agreed Order
6. Statement of Stipulated Facts 7. Ms. Jones’s Pre-Hearing Brief 8. Employer’s Pre-Hearing Brief CERTIFICATE OF SERVICE
I certify that a copy of the Order was sent to these recipients by the following methods of service on May 16, 2019.
Name Certified Mail Email Service sent to:
Josh Hoeppner, x josh@hoeppnerlaw.com Employee’s Attorney
Sam McPeak, xX sam@hbm-lawfirm.com Employer’s Attorney
Lio _ SO PENNY SHUM, COURT CLERK Court of Werkers’ Compensation Claims
Expedited Hearing Order Right to Appeal:
If you disagree with this Expedited Hearing Order, you may appeal to the Workers’ Compensation Appeals Board. To appeal an expedited hearing order, you must:
1. Complete the enclosed form entitled: “Expedited Hearing Notice of Appeal,” and file the form with the Clerk of the Court of Workers’ Compensation Claims within seven business days of the date the expedited hearing order was filed. When filing the Notice of Appeal, you must serve a copy upon all parties.
2. You must pay, via check, money order, or credit card, a $75.00 filing fee within ten calendar days after filing of the Notice of Appeal. Payments can be made in-person at any Bureau office or by U.S. mail, hand-delivery, or other delivery service. In the alternative, you may file an Affidavit of Indigency (form available on the Bureau’s website or any Bureau office) seeking a waiver of the fee. You must file the fully- completed Affidavit of Indigency within ten calendar days of filing the Notice of Appeal. Failure to timely pay the filing fee or file the Affidavit of Indigency will result in dismissal of the appeal.
3. You bear the responsibility of ensuring a complete record on appeal. You may request from the court clerk the audio recording of the hearing for a $25.00 fee. If a transcript of the proceedings is to be filed, a licensed court reporter must prepare the transcript and file it with the court clerk within ten business days of the filing the Notice of Appeal. Alternatively, you may file a statement of the evidence prepared jointly by both parties within ten business days of the filing of the Notice of Appeal. The statement of the evidence must convey a complete and accurate account of the hearing. The Workers’ Compensation Judge must approve the statement before the record is submitted to the Appeals Board. If the Appeals Board is called upon to review testimony or other proof concerning factual matters, the absence of a transcript or statement of the evidence can be a significant obstacle to meaningful appellate review.
4. If you wish to file a position statement, you must file it with the court clerk within ten business days after the deadline to file a transcript or statement of the evidence. The party opposing the appeal may file a response with the court clerk within ten business days after you file your position statement. All position statements should include: (1) a statement summarizing the facts of the case from the evidence admitted during the expedited hearing; (2) a statement summarizing the disposition of the case as a result of the expedited hearing; (3) a statement of the issue(s) presented for review; and (4) an argument, citing appropriate statutes, case law, or other authority.
For self-represented litigants: Help from an Ombudsman is available at 800-332-2667. LB-1099
EXPEDITED HEARING NOTICE OF APPEAL Tennessee Division of Workers’ Compensation www. tn.gov/labor-wid/weomp.shtml wce.courtclerk@tn.gov 1-800-332-2667
Docket #: State File #/YR:
Employee
Vv.
Employer Notice Notice is given that
[List name(s) of all appealing party(ies) on separate sheet if necessary]
appeals the order(s) of the Court of Workers’ Compensation Claims at
to the Workers’ Compensation Appeals
Board. [List the date(s) the order(s) was filed in the court clerk’s office]
Judge
Statement of the Issues Provide a short and plain statement of the issues on appeal or basis for relief on appeal:
Additional Information Type of Case [Check the most appropriate item]
L] Temporary disability benefits L] Medical benefits for current injury LC Medical benefits under prior order issued by the Court
List of Parties Appellant (Requesting Party): At Hearing: LJEmployer LJEmployee
Address:
Party’s Phone: Email: Attorney's Name: BPR#: Attorney’s Address: Phone:
Attorney's City, State & Zip code:
Attorney’s Email:
* Attach an additional sheet for each additional Appellant *
rev. 10/18 Page 1 of 2 RDA 11082 Employee Name: SF#: DOI:
Appellee(s)
Appellee (Opposing Party): At Hearing: L]JEmployer LJEmployee
Appellee’s Address:
Appellee’s Phone: Email: Attorney’s Name: BPR#: Attorney’s Address: Phone:
Attorney’s City, State & Zip code:
* Attach an additional sheet for each additional Appellee *
CERTIFICATE OF SERVICE
I, Expedited Hearing Notice of Appeal by First Class, United States Mail, postage prepaid, to all parties
and/or their attorneys in this case in accordance with Rule 0800-02-22.01(2) of the Tennessee Rules of Board of Workers’ Compensation Appeals on this the day of , 20
, certify that | have forwarded a true and exact copy of this
[Signature of appellant or attorney for appellant]
LB-1099 rev. 10/18 Page 2 of 2 RDA 11082
Tennessee Bureau of Workers’ Compensation 220 French Landing Drive, I-B Nashville, TN 37243-1002 800-332-2667
AFFIDAVIT OF INDIGENCY
I, , having been duly sworn according to law, make oath that because of my poverty, | am unable to bear the costs of this appeal and request that the filing fee to appeal be waived. The following facts support my poverty.
1. Full Name: 2. Address:
3. Telephone Number: 4. Date of Birth: 5. Names and Ages of Ail Dependents:
Relationship:
6. lam employed by:
My employer’s address is:
My employer’s phone number is:
7. My present monthly household income, after federal income and social security taxes are deducted, is:
$
8. | receive or expect to receive money from the following sources:
AFDC $ per month beginning ssl $ per month beginning Retirement $ per month beginning Disability $ per month beginning Unemployment $ per month beginning Worker's Comp.$ per month beginning Other $ per month beginning
LB-1108 (REV 11/15) RDA 11082 9. My expenses are:
Rent/House Payment $ permonth Medical/Dental $ per month
Groceries $ per month Telephone $ per month
Electricity $ per month School Supplies $ per month
Water $ per month Clothing $ per month
Gas $ per month Child Care $ per month
Transportation $ per month Child Support $ per month
Car $ per month
Other $ per month (describe: ) 10. Assets:
Automobile $ (FMV)
Checking/Savings Acct. $
House $ __ (FMV)
Other $ Describe:
11. My debts are:
Amount Owed To Whom
| hereby declare under the penalty of perjury that the foregoing answers are true, correct, and complete and that I am financially unable to pay the costs of this appeal.
APPELLANT
Sworn and subscribed before me, a notary public, this
day of , 20
NOTARY PUBLIC
My Commission Expires:
LB-1108 (REV 11/15) RDA 11082