McDade, Michael v. IGC Protection

2016 TN WC 169
CourtTennessee Court of Workers' Compensation Claims
DecidedJuly 25, 2016
Docket2016-06-0432
StatusPublished

This text of 2016 TN WC 169 (McDade, Michael v. IGC Protection) 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
McDade, Michael v. IGC Protection, 2016 TN WC 169 (Tenn. Super. Ct. 2016).

Opinion

TENNESSEE BUREAU OF WORKERS’ COMPENSATION IN THE COURT OF WORKERS’ COMPENSATION CLAIMS AT NASHVILLE

Michael McDade, ) Docket No. 2016-06-0432 Employee, ) v. ) State File No. 25490-2016 ) IGC Protection, ) Judge Joshua Davis Baker Employer, ) ) and ) ) AmTrust North America, ) Insurance Carrier. )

EXPEDITED HEARING ORDER FOR MEDICAL BENEFITS

This matter came before the Court on July 5, 2016, on the Request for Expedited Hearing filed by the employee, Michael McDade, pursuant to Tennessee Code Annotated section 50-6-239 (2015). The present focus of this case is Mr. McDade’s entitlement to temporary disability and medical benefits. The central legal issue is his likelihood of success in proving he suffered an injury in the course and scope of his employment that completely prevented him from working while he healed. The employer, IGC Protection, claimed the injury did not occur while he was working for IGC. It also claimed Mr. McDade’s injury is idiopathic.1 For the reasons set forth below, the Court finds Mr. McDade would likely succeed at a hearing on the merits in proving his injury occurred in the course and scope of his employment but would likely fail to prove the injury prevented him working. The Court therefore holds IGC must provide Mr. McDade further reasonable and necessary medical care for treatment of his injury. 2

1 IGC attached a long list of defenses to the dispute certification notice. The majority concerns permanent rather than temporary benefits. 2 A complete listing of the technical record and exhibits admitted at the Expedited Hearing is attached to this Order as an appendix. Claim History

This case involves a shoulder injury from an unwitnessed fall. Mr. McDade worked for IGC in motor-vehicle traffic control. In addition to this job, Mr. McDade also worked for Ingram Barge Company. According to his Petition for Benefit Determination, on March 15, 2016, Mr. McDade fell on top of some poles inside an IGC box truck and dislocated his shoulder. No one witnessed the fall, but some coworkers saw him immediately after. The first report of injury stated, “EE was walking and tripped on flag stands causing unknown injury to unknown shoulder.” (Ex. 3.)

Mr. McDade went to the emergency room and was diagnosed with an anterior left shoulder dislocation. (Ex. 1.) ER workers performed a shoulder reduction to return Mr. McDade’s shoulder to the socket and then x-rayed it. The x-ray showed no fracture, and the hospital released him that same day.

Mr. McDade received follow-up care from Dr. James Rubright at Premier Orthopaedics & Sports Medicine. The patient intake information form Mr. McDade completed at the initial visit listed his employer as Ingram Barge and stated he worked as a chef. (Ex. 1 at 9.) Mr. McDade indicated on the form his injury resulted from an accident but left blank the section concerning whether the accident occurred on the job.

Dr. Rubright diagnosed Mr. McDade with left shoulder pain and recommended medication. He released Mr. McDade to return to work with restrictions that prohibited him from using his left arm. (Ex. 1 at 15.) Dr. Rubright also ordered an MRI. The MRI revealed a fracture, and Dr. Rubright recommended surgery to repair it. He noted Mr. McDade would likely be out of work for three to four months for surgery and recovery. (Ex. 1 at 19.) On April 27, 2016, the same day Dr. Rubright recommended surgery, IGC denied Mr. McDade’s claim. The denial notice stated the “injury did not arise out of the course and scope of employment.” (Ex. 4.)

After IGC denied his claim, Mr. McDade filed a Petition for Benefit Determination (PBD) seeking temporary disability and medical benefits. The parties did not resolve the disputed issues through mediation, and the Mediating Specialist filed a Dispute Certification Notice (DCN). Mr. McDade filed a Request for Expedited Hearing and this Court set the matter for an evidentiary hearing.

At the hearing, with regard to the mechanism of injury, Mr. McDade testified that, on the morning of March 15, 2016, while en route to work, he spoke on the telephone to Jacob Austin, the owner of IGC, about retrieving car keys from the back of a box truck so that Mr. McDade could use a vehicle for work that day. He stated the keys hung from a hook or nail in the back of the box truck.

At approximately 6:20 a.m., while it was still dark outside, Mr. McDade entered

2 the box truck. He said the interior was dark, so he used his cell phone to light the area and search for the keys. After he retrieved the keys and turned to leave, Mr. McDade testified he tripped on some poles lying on the floor of the truck. He attempted to catch himself as he fell but was unable to do so. He heard a “snap” and experienced intense left shoulder pain. Mr. McDade exited the box truck, and his coworkers took him to the hospital where he received emergency treatment detailed in the medical records.

IGC questioned Mr. McDade about whether he tripped over the poles in the truck and fell or simply fell on top of them. Mr. McDade admitted he did not state he tripped in his affidavit or Petition for Benefit Determination. It is his testimony, however, that he tripped and fell. IGC also asked Mr. McDade why he failed to indicate his injury was work-related on the patient initial intake form at Dr. Rubright’s office. Mr. McDade said he overlooked the question.

As for his post-injury ability to work, Mr. McDade testified he could not return to his job with Ingram following the March 15, 2016 accident because Ingram would not allow him to resume working on a boat due to the condition of his arm. He, however, admitted no doctor took him off work completely following his injury and stated he returned to work for IGC on a couple of occasions. He testified he could not do his work at IGC to full capacity because of his pain medication, but admitted IGC allowed him to work within the restrictions that prohibited use of his left arm. Text messages between Mr. McDade and Mr. Austin showed Mr. Austin offered him work.

Mr. McDade further testified, despite being released to return to work with restrictions, he could not work while taking pain medication because his head was “in a fog.” He also stated he could do few things at work, such as lifting cones or signs, and testified he essentially served as a “warm body” on the worksite.

Mr. McDade argued his claim is work-related because the accident occurred while retrieving keys inside the box truck in the course of his employment for IGC. He claimed he mistakenly listed Ingram as his employer because he believed he had to use his private insurance to get treatment.

IGC argued Mr. McDade’s injury did not occur during his employment for IGC. Instead, it claimed the injury occurred during his work for Ingram. It further argued that, even if the injury occurred in the course and scope of his work for IGC, the injury is idiopathic because Mr. McDade did not trip on the poles in the truck but simply fell on top of them. IGC claims the distinction is important as Mr. McDade presented no proof that falling on top of the poles was more injurious than simply falling on the ground. Finally, IGC argued Mr. McDade failed to prove his injury prevented him working, so he cannot recover temporary disability benefits.

3 Findings of Fact and Conclusions of Law

In order to grant the relief Mr. McDade seeks, the Court must apply the following legal principles. Mr. McDade bears the burden of proof on all elements of his workers’ compensation claim. Tenn. Code Ann. § 50-6-239(c)(6) (2015); see also Buchanan v. Carlex Glass Co., No. 2015-01-0012, 2015 TN Wrk. Comp. App. Bd. LEXIS 39, at *5 (Tenn. Workers’ Comp. App. Bd. Sept. 29, 2015).

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Bluebook (online)
2016 TN WC 169, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mcdade-michael-v-igc-protection-tennworkcompcl-2016.