Said, Medhat v. Communications Test Design, Inc

2020 TN WC 134
CourtTennessee Court of Workers' Compensation Claims
DecidedDecember 22, 2020
Docket2018-06-0433
StatusPublished

This text of 2020 TN WC 134 (Said, Medhat v. Communications Test Design, Inc) 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
Said, Medhat v. Communications Test Design, Inc, 2020 TN WC 134 (Tenn. Super. Ct. 2020).

Opinion

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

AT NASHVILLE

Medhat Said, ) Docket No. 2018-06-0433 Employee, )

Vv. )

Communications Test Design, Inc., ) State File No. 60229-2019 Employer, )

And )

Zurich American Insurance Company, ) Judge Kenneth M. Switzer Carrier. )

COMPENSATION ORDER

The threshold issue in this case is the compensability of Medhat Said’s claim regarding a gradual injury he suffered while working for Communications Test Design, Inc. Two well-qualified experts, both of whom treated Mr. Said, have reached vastly different opinions on this complex question of medical causation. After a December 16, 2020, compensation hearing, the Court accepts the opinion of Mr. Said’s unauthorized physician and holds that he suffered a compensable injury.

As to his requested relief, it flows from that conclusion that Mr. Said is entitled to future medical benefits. The Court awards permanent partial disability benefits but denies increased benefits. Also, Mr. Said is entitled to past temporary disability benefits and reimbursement from CTDI for some of the medical bills relative to the work injury. But the Court denies his request for attorney’s fees from an alleged wrongful denial of the claim and declines to refer the case for consideration of a penalty.

Claim History Employee Testimony and Treatment Mr. Said worked for CTDI as a materials handler, scanning boxes. He testified that the work was fast-paced and high-volume. On August 7, 2017, he reported pain in his left

shoulder from working. CTDI authorized treatment, and he later chose Dr. Malcolm Baxter from a panel. At the first visit in early October, Dr. Baxter wrote that Mr. Said’s pain “started after scanning a lot of boxes,” and “sharp pain with repetitive motions involved with his job.” Dr. Baxter concluded, “This does appear to be work related more than 50% based on his history.” He provided conservative treatment.

At the next visit on October 31, Dr. Baxter placed restrictions and ordered a shoulder MRI. The MRI report found “[nJo threshold evidence for rotator cuff or glenoid labral tear.” At the next visit on December 11, Dr. Baxter noted, “MRI really does not show any evidence of rotator cuff tearing or significant tendinitis.” He removed the restrictions, released Mr. Said from treatment, and assigned a zero-percent impairment rating. CTDI could not accommodate the restrictions, and it did not pay temporary disability benefits from October 31 through the date of maximum medical improvement designated by Dr. Baxter.

Mr. Said returned to Dr. Baxter in February 2018, stating that his shoulder still hurt. At that time, Dr. Baxter wrote that the work incident “really wasn’t an injury, more just using the arm,” and he altered his causation opinion by noting, “I don’t see any evidence of a work related injury.” After receiving the revised causation opinion, CTDI denied further treatment.

Mr. Said then sought treatment on his own from Dr. Jason Jones. In March, Dr. Jones performed surgery. The operative report states that he found “fraying and tearing” on the anterior labrum and a “fairly large tear” to the subscapularis, and he performed an open biceps tenodesis. Mr. Said continued to treat with Dr. Jones afterward and participated in physical therapy.

Dr. Jones took him off work while he rehabilitated from surgery. However, in June, Mr. Said opened a restaurant and began working there as the manager. He did not offer evidence about how much he earned in the new position but simply said he needed to support his family.

On October 9, 2018, Dr. Jones placed Mr. Said at maximum medical improvement and restricted him from performing any repetitive motion with the left arm. Afterward, CTDI terminated him.

Mr. Said’s personal insurance covered treatment with Dr. Jones. However, he testified that he paid Dr. Jones $210.00 and $910.00 for physical therapy out-of-pocket. He also paid $271.71 to the surgery center, which is documented in bills attached to an affidavit signed by Dr. Jones. Dr. Jones wrote that Mr. Said’s bills for treatment, the surgery center and physical therapy were reasonable and necessary, and CTDI stipulated to this at a previous hearing.’

' Several bills are attached to Dr. Jones’s affidavit. The affidavit does not show how much Mr. Said paid him. However, Mr. Said’s testimony was undisputed on this point. The affidavit contains an explanation of benefits for anesthesia but not a bill. The affidavit also has a bill from Southern Hills, which Dr. Jones

2 Dr. Jones’s Testimony

Dr. Jones testified that he is an orthopedic surgeon who specializes in shoulders and received training abroad from a world-renowned expert.” Ex. 7 at 6-7. He reviewed the records from Dr. Baxter’s December 2017 encounter with Mr. Said. /d. at 44. Dr. Jones based his initial diagnosis on the “presenting complaint” of shoulder pain with repetitive motion and his clinical examination. /d. at 11. Specifically, he performed an O’Brien test suggesting either biceps pain or labral tearing; Mr. Said exhibited signs on the test and also had “very specific anterior shoulder pain.” /d. at 12-13.

Dr. Jones explained his surgery recommendation as follows:

He had very point-specific physical examination findings. He had this rather profound complaint of inability to work and anterior shoulder pain and this was affecting his life in multiple ways. He tried conservative treatment. And everything lined up fairly well with biceps and labral complex tearing. So that’s where the decision came to discuss surgery, because nothing else was working. This was affecting his life. And he certainly had signs and symptoms compatible with that.

Td. at 14.

Dr. Jones performed both arthroscopic and open surgery. /d. at 17. During surgery, Dr. Jones discovered a superior border subscapularis tear and a biceps tendon tear. /d. at 16-17. He repaired the biceps tendon tear but did not repair the subscapularis tear because “the tissue quality in this case [was]n’t good enough to repair.” Jd. at 17. Instead, he debrided the subscapularis, which is “a very standard way to treat subscapularis, you know, small tears.” Jd. at 18. Dr. Jones said, “[H]e had significant pathology on his arthroscopic exam, which is certainly the most sensitive and specific way to look at any kind of injury.” Id. at 18 (Emphasis added).

Before the procedure, Dr. Jones excused Mr. Said from work beginning February 23, 2018, and he released him to return to work with restrictions on October 9, 2018. Jd. at 24. On that date, Dr. Jones assigned maximum medical improvement. /d. at 25. He placed a three-percent upper extremity impairment and one-percent whole body permanent impairment. /d. at 39-40. Dr. Jones found a class one injury and used a grade one modifier. Id. at 38. According to the causation letter mentioned below, he used the diagnosis-based impairment chart on page 402 of the AMA Guides. During the deposition, he clarified that the upper-extremity impairment rating should be three percent. /d. at 40.

did not mention in the affidavit. Mr. Said testified regarding these sums, but the Court did not admit the bills into evidence and denies the request that CTDI pay them.

? Dr. Jones’s resume was not made an exhibit to his deposition testimony.

3 At the deposition, Dr. Jones additionally reviewed a causation letter that he signed from Mr. Said’s attorney, stating that he stood by his responses. /d. at 31. In that letter, Mr. Said’s attorney asked Dr. Jones whether he could state within a reasonable degree of medical certainty that Mr. Said’s employment contributed more than fifty percent in causing his injury, considering all causes, and whether repetitive movement is a common cause of tendonitis. Dr.

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Moore v. Town of Collierville
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2020 TN WC 134, Counsel Stack Legal Research, https://law.counselstack.com/opinion/said-medhat-v-communications-test-design-inc-tennworkcompcl-2020.