FlLED .January 13. 2015
WORKERS• CO).lPE~SATlO~ CL~I\1~
Time: 7:15 .\\1
COURT OF WORKERS' COMPENSATION CLAIMS DIVISION OF,¥0RKERS• COMPENSATION
EMPLOYEE: Deborah Little DOCKET#: 2014-06-0021
STATE FILE#: 70979-2014
EMPLOYER: Sweet T' sand DATE OF INJURY: August 17,2014 Andy Patel
CARRIER: Indemnity Insurance of N o11h America
EXPEDITED HEARING ORDER
THIS CAUSE came before the undersigned Workers' Compensation Judge upon the Request for Expedited Heruing filed on October 30, 2014, by Deborah Little (Employee) against Sweet T's and Andy Patel (Employer). The Request for Expedited Heru·ing was filed pursuant to Tennessee Code Annotated section 50-6-239(d) to consider whether Employee is entitled to temporruy disability and medical benefits.
The undersigned Workers' Compensation Judge conducted a heru-ing via teleconference on December 4 2014. Employee acted prose. Employer did not apperu·. After considering the arguments, the applicable law, the testimony and all the evidence introduced at the Expedited Hearing, the Court finds that Employee is entitled to medical benefits.
ANALYSIS
Issue
1. Whether Employer shall be required to provide Employee temporru·y disability benefits, and, if so, the amount of those benefits and the pe1iod of time for which they are owed.
2. Whether Employer shall be required to provide medical benefits to Employee. Evidence Submitted
Employee was the only party that attended the hearing. In addition to her testimony, Employee entered the following exhibits into evidence:
Ex. 1 -Medical Bills Ex. 2 -Medical Records Ex. 3 -USPS Tracking Information
After the conclusion of the hearing, Employee submitted the following proof with leave of the Court:
Ex. 4 - Statement of Jennifer Davis
Any other documents submitted to the clerk prior to the hearing that were not introduced as an exhibit during the hearing were not considered.
History of Claim
At the time of the events giving rise to this claim, Employer operated two restaurants in Tennessee. Employee worked as a server at Employer's Westmoreland location. She earned $320 per week at the time of her injury.
On August 17, 2014, Employee entered the kitchen during her shift and slipped on some water that had pooled on the floor in the area around the dishwashing station. Employee does not remember the fall but her co-worker, Jennifer Davis, witnessed the accident and provided a notarized statement. In that statement, Ms. Davis said she saw Employee slip in the area around the dishwashing station. Employee's head bounced twice and she lost consciousness.
After Employee regained consciousness, one of her co-employees called an ambulance. She was transported to Sumner Regional Medical Center (Sumner Regional) and stayed overnight. Employee underwent a CT scan of her head and neck which revealed no acute fractures. Employee also had stitches and suffered significant bruising of her face and left eye.
Employee was released from Sumner Regional on August 18, 2014. The providers at Sumner Regional did not impose any work place restrictions on Employee. Employee owes $2,676.58 for medical treatment associated with the accident. Employer told Employee that it had workers' compensation insurance. However, the insurer refused to pay the Employee's hospital bills.
Employee returned to work for Employer approximately two (2) weeks after she was released from the hospital. Employer, however, closed its Westmoreland location shortly after Employee returned to work so Employee no longer works for Employer.
2 Employee's Contentions
Employee alleges that she slipped in water that had pooled on the floor in the area around the dishwashing station in the restaurant kitchen. Employee claims that she could not work for two (2) weeks following the incident, and that she still suffers from headaches. Beyond the emergency treatment she received immediately after the accident, Employee has not received any medical care.
Employee requests that the Court order Employer to pay the medical expenses associated with the accident. Employee also requests that the Court order Employer to pay her for the wages she lost during the two (2) weeks Employee was unable to work.
Employer's Contentions
Employer did not appear at the hearing.
Findings of Fact and Conclusions of Law
Standard Applied
When determining whether to award or deny benefits, a workers' compensation judge must decide whether, based on the evidence introduced at the expedited hearing, the moving party is likely to succeed on the merits at the compensation hearing. See generally. McCall v. Nat"l Health Care Corp., 100 S.W. 3d 209, 214 (Tenn. 2003). In a workers' compensation action, Employee shall bear the burden of proving each and every element of the claim by a preponderance of the evidence. Tenn. Code Ann. § 50-6-239(c)(6). Employee must show that the injury arose primarily out of and in the course and scope of employment. Tenn. Code Ann. § 50-6-102(13).
Expedited hearings are governed by Tennessee Code Annotated section 50-6-239(d) which provides the following in pertinent part:
(1) Upon motion of either party made at any time after a dispute certification notice has been issued by a workers' compensation mediator, a workers' compensation judge may, at the judge's discretion, hear disputes over issues provided in the dispute certification notice concerning the provision of temporary disability or medical benefits on an expedited basis and enter an interlocutory order upon determining that the injured employee would likely prevail at a hearing on the merits.
Tenn. Code Ann. § 50-6-239(d)(l), (4). In addition, the "Mediation and Hearing Procedures" governing practice in the Court of Workers' Compensation Claims provides the following:
3 After a case is placed on the docket, if there is a dispute over temporary disability or medical benefits, either party may request an expediting hearing of the issue of temporary disability or medical benefits by indicating its desire for an expedited hearing on the request for hearing form or by a filing a separate motion. The indication of the desire for an expedited hearing on the request for hearing form shall serve as the motion for expedited hearing.
Tenn. Comp. R. & Regs., 0800-02-21-.14(1).
Dispositive Factual Finding
The Court finds that Employee slipped and fell in standing water in the kitchen at work. Employee hit her head on the floor when she fell. As a result of the fall, Employee lost consciousness and suffered a cut to her head. Employee was transported to the hospital and stayed there overnight. The physician treating Employee did not order that she be taken off from work or impose any workplace restrictions. Employee incurred significant medical expenses for treatment related to her injury. Employer's alleged workers' compensation insurance carrier did not cover the cost of her treatment and the bills remain unpaid. Employer closed its restaurant in Westmoreland. Employee no longer works for Employer. Employee still suffers from headaches as a result of the accident.
Application ofLaw to Facts
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FlLED .January 13. 2015
WORKERS• CO).lPE~SATlO~ CL~I\1~
Time: 7:15 .\\1
COURT OF WORKERS' COMPENSATION CLAIMS DIVISION OF,¥0RKERS• COMPENSATION
EMPLOYEE: Deborah Little DOCKET#: 2014-06-0021
STATE FILE#: 70979-2014
EMPLOYER: Sweet T' sand DATE OF INJURY: August 17,2014 Andy Patel
CARRIER: Indemnity Insurance of N o11h America
EXPEDITED HEARING ORDER
THIS CAUSE came before the undersigned Workers' Compensation Judge upon the Request for Expedited Heruing filed on October 30, 2014, by Deborah Little (Employee) against Sweet T's and Andy Patel (Employer). The Request for Expedited Heru·ing was filed pursuant to Tennessee Code Annotated section 50-6-239(d) to consider whether Employee is entitled to temporruy disability and medical benefits.
The undersigned Workers' Compensation Judge conducted a heru-ing via teleconference on December 4 2014. Employee acted prose. Employer did not apperu·. After considering the arguments, the applicable law, the testimony and all the evidence introduced at the Expedited Hearing, the Court finds that Employee is entitled to medical benefits.
ANALYSIS
Issue
1. Whether Employer shall be required to provide Employee temporru·y disability benefits, and, if so, the amount of those benefits and the pe1iod of time for which they are owed.
2. Whether Employer shall be required to provide medical benefits to Employee. Evidence Submitted
Employee was the only party that attended the hearing. In addition to her testimony, Employee entered the following exhibits into evidence:
Ex. 1 -Medical Bills Ex. 2 -Medical Records Ex. 3 -USPS Tracking Information
After the conclusion of the hearing, Employee submitted the following proof with leave of the Court:
Ex. 4 - Statement of Jennifer Davis
Any other documents submitted to the clerk prior to the hearing that were not introduced as an exhibit during the hearing were not considered.
History of Claim
At the time of the events giving rise to this claim, Employer operated two restaurants in Tennessee. Employee worked as a server at Employer's Westmoreland location. She earned $320 per week at the time of her injury.
On August 17, 2014, Employee entered the kitchen during her shift and slipped on some water that had pooled on the floor in the area around the dishwashing station. Employee does not remember the fall but her co-worker, Jennifer Davis, witnessed the accident and provided a notarized statement. In that statement, Ms. Davis said she saw Employee slip in the area around the dishwashing station. Employee's head bounced twice and she lost consciousness.
After Employee regained consciousness, one of her co-employees called an ambulance. She was transported to Sumner Regional Medical Center (Sumner Regional) and stayed overnight. Employee underwent a CT scan of her head and neck which revealed no acute fractures. Employee also had stitches and suffered significant bruising of her face and left eye.
Employee was released from Sumner Regional on August 18, 2014. The providers at Sumner Regional did not impose any work place restrictions on Employee. Employee owes $2,676.58 for medical treatment associated with the accident. Employer told Employee that it had workers' compensation insurance. However, the insurer refused to pay the Employee's hospital bills.
Employee returned to work for Employer approximately two (2) weeks after she was released from the hospital. Employer, however, closed its Westmoreland location shortly after Employee returned to work so Employee no longer works for Employer.
2 Employee's Contentions
Employee alleges that she slipped in water that had pooled on the floor in the area around the dishwashing station in the restaurant kitchen. Employee claims that she could not work for two (2) weeks following the incident, and that she still suffers from headaches. Beyond the emergency treatment she received immediately after the accident, Employee has not received any medical care.
Employee requests that the Court order Employer to pay the medical expenses associated with the accident. Employee also requests that the Court order Employer to pay her for the wages she lost during the two (2) weeks Employee was unable to work.
Employer's Contentions
Employer did not appear at the hearing.
Findings of Fact and Conclusions of Law
Standard Applied
When determining whether to award or deny benefits, a workers' compensation judge must decide whether, based on the evidence introduced at the expedited hearing, the moving party is likely to succeed on the merits at the compensation hearing. See generally. McCall v. Nat"l Health Care Corp., 100 S.W. 3d 209, 214 (Tenn. 2003). In a workers' compensation action, Employee shall bear the burden of proving each and every element of the claim by a preponderance of the evidence. Tenn. Code Ann. § 50-6-239(c)(6). Employee must show that the injury arose primarily out of and in the course and scope of employment. Tenn. Code Ann. § 50-6-102(13).
Expedited hearings are governed by Tennessee Code Annotated section 50-6-239(d) which provides the following in pertinent part:
(1) Upon motion of either party made at any time after a dispute certification notice has been issued by a workers' compensation mediator, a workers' compensation judge may, at the judge's discretion, hear disputes over issues provided in the dispute certification notice concerning the provision of temporary disability or medical benefits on an expedited basis and enter an interlocutory order upon determining that the injured employee would likely prevail at a hearing on the merits.
Tenn. Code Ann. § 50-6-239(d)(l), (4). In addition, the "Mediation and Hearing Procedures" governing practice in the Court of Workers' Compensation Claims provides the following:
3 After a case is placed on the docket, if there is a dispute over temporary disability or medical benefits, either party may request an expediting hearing of the issue of temporary disability or medical benefits by indicating its desire for an expedited hearing on the request for hearing form or by a filing a separate motion. The indication of the desire for an expedited hearing on the request for hearing form shall serve as the motion for expedited hearing.
Tenn. Comp. R. & Regs., 0800-02-21-.14(1).
Dispositive Factual Finding
The Court finds that Employee slipped and fell in standing water in the kitchen at work. Employee hit her head on the floor when she fell. As a result of the fall, Employee lost consciousness and suffered a cut to her head. Employee was transported to the hospital and stayed there overnight. The physician treating Employee did not order that she be taken off from work or impose any workplace restrictions. Employee incurred significant medical expenses for treatment related to her injury. Employer's alleged workers' compensation insurance carrier did not cover the cost of her treatment and the bills remain unpaid. Employer closed its restaurant in Westmoreland. Employee no longer works for Employer. Employee still suffers from headaches as a result of the accident.
Application ofLaw to Facts
Under the Tennessee Workers' Compensation law, an "injury" or "personal injury" by accident is compensable whenever "the injury is caused by a specific incident, or set of incidents, arising primarily out of and in the course and scope of employment." Tenn. Code Ann. § 50-6- 102(13) (2014). "An injury arises primarily out of and in the course and scope of employment only if it has been shown by a preponderance of the evidence that the employment contributed more than fifty percent (50%) in causing the injury, considering all causes[.]" Jd. (internal quotations omitted).
Employee has alleged that she slipped and fell in some standing water at work. Employee suffered a laceration to her head and was hospitalized overnight for treatment and observation. The Court finds that Employee has alleged a prima facie case for a compensable workers' compensation injury and is likely to prevail at trial. The Court, therefore, finds that Employee is entitled to recover temporary workers' compensation benefits. Tennessee Code Annotated section 50-6-204(a)(l) requires an employer to provide an injured employee reasonable and necessary medical care for treatment of a compensable injury. Employee presented evidence showing that she incurred $2,676.58 in medical bills that remain unpaid for treatment of her injury. The Court orders Employer to cover the costs of Employee's treatment. Employee shall furnish copies of the bills to Employer for payment.
Employee claims that she still suffers from headaches as a result of the accident. The Court finds that Employee is entitled to continued care for her headaches and any other injuries related to the workplace accident. Employer is hereby ordered to provide Employee a panel of
4 three physicians pracbcmg in Employee's community from which Employee shall select an authorized treating physician. See Tenn. Code Ann. § 50-6-204(a)(3)(A)(i). Employee shall pay the costs of all reasonable and necessary care provided by the authorized treating physician.
Employee has also requested reimbursement of wages she lost while off from work following her injury. Employee testified that she missed two (2) weeks of work because of her injury. The Tennessee Workers' Compensation law does not provide direct reimbursement for lost wages. Instead, an injured employee is entitled to receive temporary total disability benefits pursuant to Tennessee Code Annotated § 50-6-207(1) whenever the employee has suffered a compensable, work-related injury that has rendered the employee unable to work. See Simpson v. Satterfield, 564 S.W.2d 953 (Tenn. 1978). Entitlement to temporary total disability benefits ends whenever an employee is able to return to work or reaches maximum medical improvement (MMI). See id.; Cleek v. Wal-Mart Stores, Inc., 19 S.W.3d 770, 776 (Tenn. 2000).
Employee has not provided an opinion from a physician stating that she could not resume working following her injury. The medical records provided by Employee show that the hospital released her from care the day after her injury without imposing any restrictions on her activities. Because Employee has not, at this time, submitted any medical proof to show that she was totally disabled from working due to her injury, the Court finds that Employee is not entitled to recover temporary disability benefits.
IT IS, THEREFORE, ORDERED as follows:
1. Employer shall pay Employee's medical bills in the amount of $2,676.58 associated with treatment rendered to her to date for the workplace injury;
2. Employer shall provide Employee continuing treatment for her injury to be initiated by providing Employee a panel of treating physicians, in accordance with the requirements ofTennessee Code Annotated section 50-6-204(a)(3)(A)(i), from which Employee shall select an authorized treating physician;
3. Employer shall pay the cost of all reasonable and necessary medical care provided by the authorized treating physician for the subject injury; and
4. Employee is not entitled to temporary disability benefits.
5. Unless interlocutory appeal of the Expedited Hearing Order is filed, compliance with this Order must occur no later than seven (7) business days from the date of entry of this Order as required by Tennessee Code Annotated section 50-6- 239(d)(3). The Insurer or Self-Insured Employer must submit confirmation of compliance with this Order to the Division by email to WCCompliance.Program@tn.gov no later than the seventh (7th) business day after entry of this Order. Failure to submit the necessary confirmation within the pe1iod of compliance may result in a penalty assessment for non-compliance.
5 6. For questions regarding compliance, please contact the Workers' Compensation Compliance Unit via email WCCompliance.Program@tn.gov or by calling (615) 253- 1471 or (615) 532-1309.
Initial Hearing:
An Initial Hearing has been set with Judge Joshua Davis Baker, Court of Workers Compensation Claims, on March 2, 2015, at 9:00 a.m. Central Standard Time. You must call 615-741-2113 or toll free at 855-874-0474to participate in the Initial Hearing. Please Note: You must call in on the scheduled date and time to participate. Failure to call in may result in a determination of the issues without your further participation.
ISSUED AND FILED WITH THE COURT OF WORKERS' COMPENSATION CLAIMS ON THE 13th DAY OF JANUARY, 2015.
Judge Joshua Davis Baker Tennessee Court of Workers' Compensation Claims 220 French Landing Drive Nashville, TN 37243
6 Right to Appeal:
Tennessee Law allows any party who disagrees with this Expedited Hearing Order to appeal the decision to the Workers' Compensation Appeals Board. To file a Notice of Appeal, you must:
1. Complete the enclosed form entitled: "Expedited Hearing Notice of Appeal".
2. File the completed form with the Court Clerk within seven (7) business days of the date the Expedited Hearing Order was entered by the Workers' Compensation Judge.
3. Serve a copy of the Request for Appeal upon the opposing party.
4. The parties, having the responsibility of ensuring a complete record on appeal, may request from the Court Clerk the audio recording of the hearing for the purpose of having a transcript prepared by a licensed court reporter and filing it with the Court Clerk within ten (10) calendar days of the filing of the Expedited Hearing Notice of Appeal. Alternatively, the parties may file a statement of the evidence within ten (1 0) calendar days of the filing of the Expedited Hearing Notice of Appeal. The statement of the evidence must be approved by the Judge before the record is submitted to the Clerk of the Appeals Board.
5. If the appellant elects to file a position statement in support of the interlocutory appeal, the appealing party shall file such position statement with the Court Clerk within three (3) business days of the filing of the Expedited Hearing Notice of Appeal, specifying the issues presented for review and including any argument in support thereof. If the appellee elects to file a response in opposition to the interlocutory appeal, appellee shall do so within three (3) business days ofthe filing of the appellant's position statement.
7 CERTIFICATE OF SERVICE
I hereby cettify that a true and cotTect copy of the Expedited Hearing Order was sent to the following recipients by the following methods of se!Vice on this the 13th day of January, 2015.
Name Certified First Via Fax Via Email Address Mail Class Fax Number Email Mail Deborah Little X Littlechic54@hotmail.com Sweet T's and X 1555 btterstate Dl'ive, Cookeville, Andy Patel TN38501
Joshua Davis Baker Workers' Compensation Judge