Mueller-Rice, Meagan v. MEDATAG, Inc. d/b/a Poblanos Mexican Cuisine

2022 TN WC 9
CourtTennessee Court of Workers' Compensation Claims
DecidedFebruary 4, 2022
Docket2017-01-0750
StatusPublished

This text of 2022 TN WC 9 (Mueller-Rice, Meagan v. MEDATAG, Inc. d/b/a Poblanos Mexican Cuisine) 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
Mueller-Rice, Meagan v. MEDATAG, Inc. d/b/a Poblanos Mexican Cuisine, 2022 TN WC 9 (Tenn. Super. Ct. 2022).

Opinion

FILED Feb 04, 2022 02:12 PM(ET)

TENNESSEE COURT OF WORKERS' COMPENSATION CLAIMS

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

AT CHATTANOOGA Meagan Mueller-Rice, ) Docket No.: 2017-01-0750 Employee, ) Vv. ) State File No.: 82287-2017 MEDATAG,, Inc. d/b/a Poblanos ) Mexican Cuisine, ) Judge Audrey Headrick Uninsured Employer. ) COMPENSATION ORDER

The Court held a Compensation Hearing on Ms. Mueller-Rice’s claim to determine whether she is entitled to medical, temporary disability, and permanent disability benefits. The employer, Poblanos, did not attend the hearing. After considering the proof, the Court holds Ms. Mueller-Rice is entitled to medical and temporary disability benefits but not permanent disability benefits.

History of Claim

Ms. Mueller-Rice, a Tennessee resident, injured her left knee on September 30, 2017, when she tripped over a dog leash while serving customers.! She reported her injury to Sabrina Holbrook, the manager on duty. Because her leg was bleeding and swelling, Ms. Mueller-Rice left work to seek emergency treatment. The provider took her off work for four days, gave her a leg immobilizer and crutches, and referred her to Dr. Thomas Brown, III, an orthopedic surgeon.

Before seeing Dr. Brown, Ms. Mueller-Rice texted Ms. Holbrook and asked her to file a claim and provide the carrier’s contact information. Instead, Ms. Holbrook referred Ms. Mueller-Rice to Irma Hyde, a Poblanos shareholder. Ms. Hyde failed to provide the requested information and advised that Ms. Mueller-Rice did not work enough hours to qualify for workers’ compensation benefits. After that exchange, Ms. Mueller-Rice returned to the emergency room on October 9 and was taken off work until seen by an orthopedist.

' Poblanos, a restaurant, allowed dogs on the premises. Ms. Mueller-Rice saw Dr. Brown for left-knee pain on November 29, 2017. He ordered x-rays, an MRI, and physical therapy. Dr. Brown released Ms. Mueller-Rice in February 2018 to follow up as needed. Later, Dr. Brown prepared a C-32 Medical Report.” He noted he did not take Ms. Mueller-Rice off work for the injury or assign any restrictions. Further, Dr. Brown placed her at maximum medical improvement in March 2018 and assigned no permanent impairment.

Before seeing an orthopedist, Ms. Mueller-Rice filed a Petition for Benefit Determination, and a Bureau compliance specialist investigated the case. Poblanos admitted to the investigator that it was uninsured when Ms. Mueller-Rice became injured and did not dispute her injury was related to her work.?

During the hearing, Ms. Mueller-Rice presented medical bills, which she said were incurred for her injury. Those providers and amounts owed are:

e Dr. Brown, $525.00;

e Benchmark PT, $0 ($280.00 paid by Ms. Mueller-Rice);

e Chattanooga Outpatient Center, $580.00 ($558 paid by Ms. Mueller-Rice);

e CHI Memorial, $1,053.86 for September 30, 2017 date of service;

e CHI Memorial, $258.06 for October 9, 2017 date of service;

e Chattanooga Emergency Med, PLLC, $329.00 for September 30, 2017 date of service;

e Chattanooga Emergency Med, PLLC, $329.00 for October 9, 2017 date of service; and

e Diagnostic Imaging Consultants, $31.00.

These charges include emergency room care, diagnostic images, physical therapy, and office visits. Except for paying $758.00 in medical expenses, Poblanos did not provide Ms. Mueller-Rice any workers’ compensation benefits.

Findings of Fact and Conclusions of Law

At a Compensation Hearing, Ms. Mueller-Rice must prove by a preponderance of the evidence that she is entitled to benefits. Tenn. Code Ann. § 50-6-239(c)(6) (2021).

* The Dispute Certification Notice reflects compensability was undisputed. The Court notes that Form C- 32 asked whether “the employment activity, more likely than not, [was] primarily responsible for the injury or primarily responsible for the need for treatment.” Dr. Brown marked “yes.”

* The investigative report states counsel previously represented Ms. Mueller-Rice and Poblanos. However, no attorney for either party either filed a notice of appearance or filed a signed document with the Clerk. Medical Benefits

Poblanos did not offer any medical treatment as required by Tennessee Code Annotated section 50-6-204(a)(1)(A), so Ms. Mueller-Rice sought treatment on her own. Whether an employee is justified in seeking payment for unauthorized medical expenses from an employer depends upon the circumstances of each case. Buchanan v. Mission Ins. Co., 713 8.W.2d 654, 656 (Tenn. 1986). By failing to give Ms. Mueller-Rice a panel, Poblanos risked losing control of the course of her medical treatment and being required to pay for treatment it never authorized. See Berdnik v. Fairfield Glade Cmty. Club, 2017 TN Wrk. Comp. App. Bd. LEXIS 32, at *17 (May 18, 2017).

The Court holds that Ms. Mueller-Rice was justified in seeking emergency and follow-up treatment for her injury. She sought emergency treatment due to left-knee bleeding and swelling and was discharged with a leg immobilizer and crutches. The Court also holds the emergency and orthopedic treatment, diagnostic tests, and crutches and immobilizer were reasonable and necessary for treatment of Ms. Mueller-Rice’s injury.

Ms. Mueller-Rice testified that the medical expenses were incurred for treatment of her work injury. Based on the undisputed evidence, the Court holds Poblanos liable for the bills associated with the treatment that Ms. Mueller-Rice received for the work injury. The Court holds that Poblanos must reimburse Ms. Mueller-Rice $838.00 for services received from the providers identified in the medical bills, which she proved by uncontroverted evidence. The Court also holds that Poblanos must pay the outstanding balances to those providers in the amount of $3,105.92. See Russell v. Genesco, Inc., 651 S.W.2d 206, 211 (Tenn. 1983). Further, Dr. Brown is designated as Ms. Mueller-Rice’s authorized physician for future medical care.

Temporary Disability Benefits

To receive temporary total disability benefits, Ms. Mueller-Rice must show: (1) a disability from working as the result of a compensable injury; (2) a causal connection between the injury and the inability to work; and (3) the duration of the period of disability. Shepherd v. Haren Const. Co., Inc., 2016 TN Wrk. Comp. App. Bd. LEXIS 15, at *13 (Mar. 30, 2016).

Ms. Mueller-Rice asserted entitlement to temporary total disability benefits. The medical records state that the emergency provider initially took Ms. Mueller-Rice off work on September 30, 2017, for four days and again on October 9, 2017, until she saw Dr. Brown. Based on this evidence, the Court holds that Ms. Mueller-Rice has proven entitlement to temporary total disability benefits from September 30 through October 4, 2017, and from October 9 through November 29, 2017. Thus, the Court holds that Poblanos must pay Ms. Mueller-Rice temporary total disability benefits at the undisputed weekly compensation rate of $200.00 for eight weeks, or $1,600.00 in benefits.

Permanent Partial Disability Benefits

Ms. Mueller-Rice also claimed entitlement to permanent partial disability benefits under Tennessee Code Annotated section 50-6-207(3)(A). To receive these benefits, Ms. Mueller-Rice must prove she has a permanent impairment. Dr. Brown did not assign a permanent impairment, so she is not entitled to these benefits.

Uninsured Employers Fund

Finally, although this Court holds Poblanos must provide Ms.

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Related

Russell v. Genesco, Inc.
651 S.W.2d 206 (Tennessee Supreme Court, 1983)

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Bluebook (online)
2022 TN WC 9, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mueller-rice-meagan-v-medatag-inc-dba-poblanos-mexican-cuisine-tennworkcompcl-2022.