McCool, Martha v. Professional Care Services

2025 TN WC App. 57
Tennessee Workers' Compensation Appeals Board·Decided November 18, 2025·No. 2022-08-0687·Published

Opinion

FILED Nov 18, 2025 11:57 AM(CT) TENNESSEE WORKERS' COMPENSATION APPEALS BOARD

TENNESSEE BUREAU OF WORKERS’ COMPENSATION WORKERS’ COMPENSATION APPEALS BOARD

Martha McCool Docket No. 2022-08-0687

v. State File No. 99553-2019

Professional Care Services, et al.

Appeal from the Court of Workers’ Heard October 23, 2025 Compensation Claims Via Microsoft Teams Shaterra R. Marion, Judge

Affirmed in Part, Reversed in Part, Modified in Part, and Certified as Final

In this compensation appeal, the employer challenges the trial court’s order requiring it to authorize a second opinion examination on the issue of surgery, and the employee challenges the trial court’s order denying her claim for attorney’s fees. The employee was injured when she was attacked by a patient in the employer’s parking lot in 2019, necessitating several surgeries. In 2023, the parties entered into a court-approved settlement agreement that left open the employee’s entitlement to reasonable and necessary future medical expenses as provided in the statute. In 2024, the employee’s authorized treating physician recommended additional reconstructive surgery, which the employer authorized. However, prior to agreeing to undergo this surgery, the employee asked for a second surgical opinion, which the employer declined to provide. The employee filed a petition asking the court to order the employer to authorize a second opinion examination and seeking an award of attorney’s fees. Following a hearing, the trial court ordered the employer to authorize the second opinion examination and determined the employee was entitled to attorney’s fees pursuant to Tennessee Code Annotated section 50-6- 226(d)(1)(B) but reserved ruling on the amount of any such award. The employer appealed that order. Before addressing the merits of the employer’s appeal, we vacated, in part, the trial court’s order and remanded the case for the court to consider and resolve all remaining issues, including the employee’s claim for attorney’s fees. Thereafter, the trial court issued an order denying the claim for attorney’s fees under section 50-6-226(d)(1)(A), which the employee appealed. Upon careful review of the record, relevant statutes, and arguments of counsel, we affirm the trial court’s orders in part, reverse them in part, modify them in part, and certify as final the modified orders for purposes of further appeal.

Presiding Judge Timothy W. Conner delivered the opinion of the Appeals Board in which Judge Pele I. Godkin and Judge Meredith B. Weaver joined.

Gregory H. Fuller and Brayden R. Hunter, Brentwood, Tennessee, for the employer, Professional Care Services

Jonathan L. May, Memphis, Tennessee, for the employee, Martha McCool

Factual and Procedural Background

Martha McCool (“Employee”) worked for Professional Care Services (“Employer”)

as a psychiatric nurse practitioner. On October 7, 2019, Employee was attacked by a patient in Employer’s parking lot and stabbed multiple times, suffering injuries to her abdomen, torso, upper extremities, head, and face. She was also diagnosed with posttraumatic stress disorder. In August 2023, the parties entered into a settlement agreement acknowledging the compensability of her claim. As part of the settlement, the parties agreed to leave open Employee’s entitlement to “reasonable and necessary future medical expenses for the work injury” as ordered by her authorized treating physicians, including Dr. Dan Shell. The trial court approved that agreement on August 11, 2023.

In April 2024, Dr. Shell recommended additional surgery to reconstruct Employee’s abdominal wall, and in May 2024, Employer authorized the additional surgery. However, prior to agreeing to undergo this additional surgery, Employee requested a second surgical opinion pursuant to Tennessee Code Annotated section 50-6-204(a)(3)(C). Employer declined to authorize the second opinion examination, asserting it had authorized the surgery recommended by the treating physician, and the physician had not submitted a written order for a second opinion examination. As a result, Employee filed a request to resume mediation with respect to several issues, including her entitlement to a second opinion examination under the terms of the settlement agreement. Following unsuccessful mediation, Employee filed a request for a hearing.

In preparation for the hearing, the parties filed stipulations of fact and submitted certain exhibits for the court’s consideration, including an email exchange between Employee, Dr. Shell’s office, and Employer’s insurer in which Dr. Shell’s office stated that “Dr. Shell will be fine with her getting a second opinion from another plastic surgeon.” In addition, Employee filed an email exchange between Employee and the insurer indicating that Employee was willing to select another plastic surgeon from the original panel of specialists Employer had provided for the second opinion examination. In response, the insurer declined to authorize a second opinion. In its pre-hearing brief, Employer argued that “there has not been a referral for a second opinion provided by . . . Dr. Shell.” It further asserted that “Employee is the reason for the delay as [she] has refused to adhere to the treatment plan provided by the authorized treating physician.” During oral argument, Employer further argued that it is up to authorized treating physicians to direct medical care and prescribe or order treatment that is reasonable and necessary under the circumstances of the case, including a second opinion examination, which it acknowledged falls within the meaning of “treatment” as described in section 50-6-204(a)(1)(A).

In response, Employee asserted that the relevant statutes express only one prerequisite to an employee’s entitlement to a second opinion examination: a surgical recommendation from an authorized treating physician. Relying on Tennessee Code Annotated section 50-6-204(a)(3)(C), Employee argued that, under such circumstances, if an employee has already received a panel of specialists, he or she can select one of the remaining specialists on that panel for a second opinion examination. If no panel of specialists was ever given, the employer can provide a panel of two specialists for selection of a physician to provide a second opinion as to the issue of surgery and diagnosis. See Tenn. Code Ann. § 50-6-204(a)(3)(C). Employee also sought reasonable attorney’s fees and expenses pursuant to Tennessee Code Annotated section 50-6-226(d)(1).

Following the hearing, the court issued an order on April 23, 2025, compelling Employer to authorize a second opinion examination regarding Dr. Shell’s recommendation for additional surgery. Moreover, the court determined that Employee was entitled to an award of attorney’s fees under Tennessee Code Annotated section 50-6- 226(d)(1)(B), and it directed Employee’s counsel to “file a motion for fees,” after which Employer would have five days to respond.

On May 5, Employee’s counsel filed a motion for attorney’s fees as directed by the trial court. On May 15, Employer filed a notice of appeal as to the trial court’s April 23 compensation order. Because the trial court’s compensation order did not resolve all pending issues in the case, we remanded the case on July 10 for the court to address all unresolved issues, and we held Employer’s appeal of the April 23 compensation order in abeyance until such time as the court issued an order resolving all remaining issues. 1

On August 13, the trial court issued a supplemental order denying Employee’s claim for attorney’s fees under section 226(d)(1)(A). The court reasoned that a second opinion examination is not “treatment or care” as that term is used in section 226(d)(1)(A) and, therefore, Employee is not entitled to a fee under that subsection. 2 Employee filed her notice of appeal on August 19.

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McCool, Martha v. Professional Care Services, 2025 TN WC App. 57 (Tenn. Super. Ct. 2025).

2025 TN WC App. 57 (McCool, Martha v. Professional Care Services) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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