Simmons, Patrick v. RHA/Trenton, Inc.

2016 TN WC 295
CourtTennessee Court of Workers' Compensation Claims
DecidedDecember 8, 2016
Docket2016-07-0249
StatusPublished

This text of 2016 TN WC 295 (Simmons, Patrick v. RHA/Trenton, 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
Simmons, Patrick v. RHA/Trenton, Inc., 2016 TN WC 295 (Tenn. Super. Ct. 2016).

Opinion

FILED

December 8, 2016

TN COURT OF WORKERS’ COMPENSATION CLAIMS

Time: 3:10 PM

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

AT JACKSON

PATRICK SIMMONS, ) Docket No. 2016-07-0249 Employee, )

V. )

RHA/TRENTON, INC., ) State File No. 83151-2015 Employer, )

And )

PMA INS. CO., ) Judge Allen Phillips Insurance Carrier. )

EXPEDITED HEARING ORDER FOR MEDICAL BENEFITS

This matter came before the undersigned Workers’ Compensation Judge on November 22, 2016, upon the Request for Expedited Hearing filed by Patrick Simmons pursuant to Tennessee Code Annotated section 50-6-239 (2016). Mr. Simmons requested medical and temporary disability benefits for an alleged back injury on August 5, 2015. RHA contended he failed to provide adequate notice of his alleged injury and failed to prove causation. Accordingly, the central legal issues are whether Mr. Simmons provided proper notice of his alleged injury and whether he came forward with sufficient causation evidence at this interlocutory stage of the case. For the following reasons, the Court holds Mr. Simmons provided proper notice and that he came forward with sufficient evidence for entitlement to certain medical benefits. Mr. Simmons, however, did not come forward with sufficient evidence, at this time, of any entitlement to temporary disability benefits.’

' The Court provides a complete listing of the Technical Record and Exhibits admitted at the Expedited Hearing in an Appendix attached to this Order. History of Claim

Mr. Simmons worked for RHA, a residential facility for mentally- challenged adults. Mr. Simmons was a “direct services provider,” or “DSP.” His job required him to tend to the personal needs of residents, including feeding, bathing, and assisting them to the restroom. On August 5, 2015, at approximately 7:45 p.m., Mr. Simmons was assisting a resident from the restroom back to his chair when the resident began falling. When the resident fell, he pulled and twisted Mr. Simmons’ back. There were no witnesses.

Mary Crayton, a co-employee, testified by deposition that she saw Mr. Simmons when she reported to relieve him at 11:45 p.m. (Ex. 7 at 10-11.) Mr. Simmons was leaning against a “dresser” and Ms. Crayton recognized he was “hurt.” Jd. at 11. However, Mr. Simmons did not tell her why he was in pain. Jd. at 12. Thinking he was suffering from “his diabetes,” Ms. Crayton admonished Mr. Simmons to call his wife rather than attempt to drive himself home. Jd.

After returning home, Mr. Simmons’ condition worsened to the point that, on the afternoon of August 6, his wife summoned an ambulance. After transport to Jackson Madison County General Hospital, Mr. Simmons, “told [the] nurse that he was walking a patient yesterday and the patient fell to one side and he had to twist his back a little.” (Ex. 1 at 1.) Mr. Simmons added he “didn’t start hurting until he got home.” /d. His pain “start[ed] in right lower back and radiat[ed] to [his] right hip and right knee.” Jd. at 2. The “active” diagnosis was “back pain.” Jd. The record contained no details of an examination.

On that same date, Mr. Simmons’ wife sent his supervisor, Eric Yarbrough, a text message to advise Mr. Simmons was to be off work per a physician’s orders.” (Ex. 6.) A series of subsequent text messages between August 6 and September 24 discussed the provision of FMLA leave papers and inquiries as to Mr. Simmons’ condition. There is no mention of a work injury.

Mr. Simmons testified Mr. Yarbrough called to “check on him” on August 6. Mr. Simmons stated he reported the injury to Mr. Yarbrough at that time; Mr. Yarbrough testified he did not.

Mr. Simmons sought care from his primary physician, who referred him for an MRI. The MRI, performed on August 11, was interpreted as showing a right L4-L5 paracentral disc herniation and possible “free fragment.” (Ex. 2.) Several

* The Court notes the first text message was sent at 9:51 a.m. on August 6. This indicates Mr. Simmons sought medical attention at a facility on the night of August 5. There is no medical record of that visit in evidence. days later, Mr. Simmons again spoke with Mr. Yarbrough, who advised Mr. Simmons would have to use vacation and sick time while off from work. In line with the text messages, Mr. Yarbrough provided FMLA paperwork. Mr. Simmons believed the FMLA paperwork was the paperwork for workers’ compensation. (Ex. 11 at 8.)

In early October 2015, Mr. Simmons consulted his attorney. Thereafter, on October 7, he specifically reported his injury of August 5 to RHA. His intent was to “get the correct papers for workers’ comp.” RHA completed an “Unusual Occurrence Initial Report Form” that noted an accident on August 5 at 7:00 p.m. and that Mr. Simmons reported the injury on October 7. (Ex. 12.) The description of injury was that Mr. Simmons transferred a resident who “sat down abruptly.” Id. RHA’s carrier completed a First Report of Injury on October 13 and noted the same date and description of injury. (Ex. 3.) The First Report included: “[Mr. Simmons] did not report to his supervisor and requested FMLA on 8/11 without telling HR it was due to work related injury. EE has been out of work for almost 2 months; please assign . . . for investigation.” Jd.

On October 16, RHA’s carrier filed a “Notice of Denial of Claim for Compensation” and listed as the basis: “Failure to timely report a work incident/injury to the employer.” (Ex. 4.) Since that time, Mr. Simmons has not worked.

RHA offered the testimony of Mr. Yarbrough, who denied receiving any notice of an injury until October 7. On that day, Gina Horner, RHA’s Human Resources manager, summoned him from a staff meeting to advise him Mr. Simmons had reported an injury. Mr. Yarbrough testified he was “surprised” because Mr. Simmons had been off work on FMLA leave. He noted he had no reason to keep Mr. Simmons from reporting a claim and convincingly testified he would like to “have him back” as an employee. During his two years as a manager, no one had reported an injury to him, but he noted RHA taught employees to report all injuries to their supervisor.

Ms. Horner testified Mr. Simmons appeared on October 7 to request “workers’ comp papers.” She did not know what he was talking about, to which he replied that “Eric [Yarbrough] knew.” She then contacted Mr. Yarbrough, who told her that Mr. Simmons had not reported any injury to him. Ms. Horner knew Mr. Simmons had been off work but did not know of any injury. She confirmed all employees are to immediately report any injury to their supervisor. Ms. Horner described Mr. Simmons as a “good employee” and that RHA would “like to have him back.” RHA offered the depositions of three co-employees, who either did not know of Mr. Simmons’ injury or learned of it several weeks later. (Exs. 7, 8 and 9.) Mary Crayton did testify that, when she called to “check on [Mr. Simmons]” three days after the alleged incident, he told her he was “hurt at work.” (Ex. 7 at 12.) Ms. Crayton did not “have any conversations with anybody else” at RHA regarding this discussion. /d. at 14. She heard “nothing” from her supervisor, Mr. Yarbrough, as to why Mr. Simmons did not return to work. /d. at 15.

Based upon this proof, Mr. Simmons contended he provided proper notice to Mr. Yarbrough within two or three days of the injury. He argued this case was a “classic example” of a misunderstanding of which benefits were being requested: Mr. Simmons believed he was requesting workers’ compensation, and Mr. Yarbrough believed it was FMLA. However, even if he did not timely report, Mr. Simmons argued RHA suffered no prejudice from his reporting approximately sixty days later on October 7. He pointed to the recent case of Buckner v. Eaton Corp., No. 2016-01-0303, 2016 TN Wrk. Comp.

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Cite This Page — Counsel Stack

Bluebook (online)
2016 TN WC 295, Counsel Stack Legal Research, https://law.counselstack.com/opinion/simmons-patrick-v-rhatrenton-inc-tennworkcompcl-2016.