Lopez, Alexandra v. Team Health

2016 TN WC 122
CourtTennessee Court of Workers' Compensation Claims
DecidedMay 18, 2016
Docket2015-03-0668
StatusPublished

This text of 2016 TN WC 122 (Lopez, Alexandra v. Team Health) 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
Lopez, Alexandra v. Team Health, 2016 TN WC 122 (Tenn. Super. Ct. 2016).

Opinion

FIT__ED 1\llay 18, 2016

1N cornu oF \\ ORKERS' COMPE NSATION CLAIMS

Time: 7:15AM TENNESSEE BUREAU OF WORKERS' COMPENSATION IN THE COURT OF WORKERS' COMPENSATION CLAIMS AT KNOXVILLE

ALEXANDRA LOPEZ ) Docket No.: 2015-03-0668 Employee, ) v. ) State File No.: 76726-2015 TEAM HEALTH, ) Employer, ) Judge Pamela B. Johnson And ) TRUMBULL INSURANCE CO., ) Carrier. ) )

EXPEDITED HEARING ORDER GRANTING MEDICAL BENEFITS

This matter came before the undersigned Workers' Compensation Judge on the Request for Expedited Hearing filed by the Employee, Alexandra Lopez, pursuant to Tennessee Code Annotated section 50-6-239 (2015). The central legal issues are (1) whether Ms. Lopez sustained an injury 1 arising primarily out of and in the course and scope of her employment with the Employer, Team Health; (2) whether Ms. Lopez is entitled to past or future medical benefits; and (3) whether Ms. Lopez is entitled to past or future temporary disability benefits. For the reasons set forth below, the Court finds Ms. Lopez demonstrated she is likely to prevail at a hearing on the merits on the issue of entitl ement to a panel of orthopedic physicians for evaluation of her right knee. 2

History of Claim

Ms. Lopez is a forty-nine-year-old resident of Knox County, Tennessee. Team Health employed Ms. Lopez as an Administrative Assistant. On September 14, 2015, Ms. Lopez slipped in liquid while collecting mail. (T.R. 1.) Ms. Lopez caught herself

1 Team Health announced at the Expedited Hearing that it accepted Ms. Lopez's left ankle claim as compensable, but denied the right-knee claim. 2 A complete listing of the technical record and exhibits admitted at the Expedited Hearing is attached to this Order as an appendix. but struck her left ankle on the mail cart. The following day, Ms. Lopez contacted Jason Price at Team Health by email and text to report the incident. (Exs. 4 and 5.)

On September 21, 2015, she went to her primary care physician (PCP), Dr. Michael West, at Norwood Family Medicine. (Ex. 3.) Dr. West diagnosed Ms. Lopez with an avulsion fracture of the medial malleolus and left-ankle sprain. !d. Dr. West also placed Ms. Lopez off work and referred her for an orthopedic consult. !d. Team Health did not pay Ms. Lopez temporary total disability benefits during this period because her treatment was not with an authorized provider. (Ex. 5.)

Ms. Lopez testified Team Health provided her with a panel of orthopedic physicians and she selected Dr. William McPeake at Knoxville Orthopedic Clinic, whom she saw on September 29, 2015. Dr. McPeake diagnosed strain to the left-anterior tibial tendon, placed Ms. Lopez in a walking boot, and _released her to return to work with restrictions of minimal walking and standing. (Ex. 6.)

Ms. Lopez testified Team Health did not comply with Dr. McPeake's restrictions, which she stated included staying off her foot with her foot elevated and removing her boot every two hours for fifteen minutes. She indicated she worked her same job, performing computer work. She acknowledged Team Health offered to move her closer to the bathroom, but she turned this offer down because it moved her further away from the breakroom. Team Health additionally offered to have her coworkers come to her, instead of her walking to them.

Ms. Lopez further testified, within one month of walking in the boot, she developed extreme pain in her right knee. She explained the boot "was higher," "tilted to one side," and "heavy." Ms. Lopez contacted Hartford adjusters, Faith Bailey and Andrea Nicolle, on October 14, 2015, to report pain and swelling in her right knee. (Ex. 4.) Ms. Lopez sought approval from The Hartford for evaluation of her right-knee pain by Dr. McPeake. She advised further she was unable to drive and missed work due to the pain and swelling. Later the same day, Andrea Nicolle advised Ms. Lopez that, upon review of the file and medical notes, The Hartford determined it appropriate to issue a Form C-27 denying compensability of the right-knee injury.

Ms. Lopez returned to see her PCP, Dr. West, on October 16, 2015, for right-knee pain. (Ex. 3.) Dr. West obtained an x-ray of the right knee and referred Ms. Lopez to an orthopedic physician. !d.

Several days later, on October 20, 2015, Ms. Lopez returned to see Dr. McPeake for her left ankle. (Ex. 6.) Dr. McPeake placed Ms. Lopez off work until after an MRI of her left ankle, which occurred on October 29, 2015. !d.

On October 23, 2015, Ms. Lopez saw Dr. Robert Smith at Ortho Tennessee for

2 right-knee pain, which she stated began three weeks ago and as the result of overuse. (Ex. 6.) Dr. Smith injected the right knee and prescribed crutches. !d. Dr. Smith noted, "I do think she has aggravated some of her arthritis in this knee because she is having to use the boot and having to walk differently." !d. Following the injection, Ms. Lopez testified she treated with prescription therapy of Prednisone and Hydrocodone and used a cane as a walking aid. (See also Ex. 3.)

Ms. Lopez then went back to Dr. McPeake on November 9, 2015, with continued left-ankle pain. (Ex. 6.) Dr. McPeake ordered physical therapy and removed Ms. Lopez from work again on November 9, 2015. He also requested that Team Health excuse her from work for three weeks. He released her to return to work on December 7, 2015. !d.

Ms. Lopez testified she no longer worked for Team Health, stating she quit for personal reasons unrelated to the work injury. On cross-examination, she admitted she reported for jury duty on a Monday, but was excused on Tuesday and told she was not required to return. Later in the week, she told Team Health she was returning to jury duty. She testified, "I lied ... and my employer stated that he wanted to come talk to me and instead I quit."

Ms. Lopez filed a Petition for Benefit Determination seeking medical and temporary disability benefits. The parties did not resolve the disputed issues through mediation, and the Mediating Specialist filed a Dispute Certification Notice. Ms. Lopez filed a Request for Expedited Hearing, and this Court heard the matter on April 26, 2016. 3

At the Expedited Hearing, the parties focused on the disputed right-knee injury. Ms. Lopez admitted she received treatment for her knees prior to the September 14, 2015 work injury, including undergoing arthroscopic surgery on her right knee twenty years ago. However, she denied daily problems with her knees, explaining she only experienced sporadic pain prior to the work injury. She further admitted she took Prednisone and Hydrocodone and used a cane before the work injury. However, when a ked about specific dates of ·ervice with her PCP for knee pain, leg pain, or pain in her hips knees, and ankles, Ms. Lopez was unabl e to recall the specific vi sits. 4 She testified a difference existed between her prior pain and the excruciating pain behind her right kneecap that developed after wearing the walking boot on her left ankle.

Ms. Lopez additionally testified she did not receive temporary total disability

3 The parties stipulated that Ms. Lopez's average weekly wage was $593. I 5, which correlates to a workers' compensation rate of$395.43 per week. 4 The medical records show Ms. Lopez treated for arthralgia of multiple sites, myalgia and myositis, and peripheral neuropathy among other medical conditions, and used a cane, in the months leading up to the work injury. Her treatment included prescription therapy of Prednisone and Hydrocodone. (See generally Ex. 3.)

3 benefits from September 14 through September 29, 2015, when she saw Dr. McPeake. She additionally indicated she did not receive temporary disability benefits for the four days she was off work in October 2015, when she saw Dr. Smith for her right-knee pain.

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2016 TN WC 122, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lopez-alexandra-v-team-health-tennworkcompcl-2016.