VESTAL, COLTON v. TBDN TENNESSEE CO.

CourtTennessee Court of Workers' Compensation Claims
DecidedJune 18, 2026
Docket2024-70-6741
StatusPublished

This text of VESTAL, COLTON v. TBDN TENNESSEE CO. (VESTAL, COLTON v. TBDN TENNESSEE CO.) 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
VESTAL, COLTON v. TBDN TENNESSEE CO., (Tenn. Super. Ct. 2026).

Opinion

FILED Jun 18, 2026 07:00 AM(CT) TENNESSEE COURT OF WORKERS' COMPENSATION CLAIMS

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

COLTON VESTAL, Docket No. 2024-70-6741 Employee, v. State File No. 16621-2023 TBDN TENNESSEE CO., Employer, Judge Robert Durham And GREAT AMER. ALLIANCE INS. CO., Insurer.

COMPENSATION HEARING ORDER GRANTING BENEFITS

The Court held a Compensation Hearing on May 28, 2026, to determine Mr. Vestal’s anatomic impairment from his work-related asthma. The Court finds that his impairment is 60% and awards benefits accordingly.

History of Claim

In this accepted claim, Mr. Vestal was burning plastic at work when the fumes caused uncontrollable coughing so severe that his right lung collapsed. Over the next several weeks, he suffered multiple collapsed-lung episodes from uncontrolled coughing and ultimately had surgery to prevent further episodes. He also injured his shoulder during these coughing spells, resulting in a 1% impairment from his treating orthopedist, Dr. Kenneth Nord.

Mr. Vestal received authorized treatment for occupational asthma from Dr. Carla Burke initially and then pulmonologist Linda Sevin.

He testified about how the condition affects and limits him. He uses a steroid inhaler every morning, as well as an Albuterol rescue inhaler for flare-ups, which he uses two to four times a day. He never goes a day without using Albuterol at least once. After walking about 100 feet, he is out of breath and must take a break. He is always tired and lacks stamina. His hands tingle from low oxygen levels. He is very careful about his environment and potential irritants that might trigger a flare-up. Dust, humidity, fragrances, candles, and cleaning supplies are some of the common irritants that can start a coughing spell. He stays at home most of the time.

Mr. Vestal tried to go back to work at TBDN but was constantly exposed to fumes. He also had an asthma attack when he tried to work for TBDN’s sister company, TBTN. Although he has applied for some jobs, he has not attempted work since.

As for his asthma impairment, the pulmonology experts disagreed dramatically about his rating. After Dr. Sevin assigned a 60% rating, TBDN sent Mr. Vestal’s records to pulmonologist Clair McGroder, who assigned 6%.

While both experts are pulmonologists, Dr. Sevin treated Mr. Vestal for over two years, administered testing to determine his lung function, and diagnosed his occupational asthma. She is a “pulmonary and critical care specialist” at Vanderbilt with a focus on occupational lung diseases, including asthma. She said Mr. Vestal’s pulmonary function tests revealed a normal FEV1/FVC ratio. His “diffusing capacity,” or how well oxygen was getting from his lungs to his blood stream, was also in the normal range. Dr. Sevin diagnosed Mr. Vestal with occupational asthma, with complications from his recurrent pneumothoraxes.

By contrast, Dr. McGroder, although board-certified in pulmonary and critical care, only reviewed Mr. Vestal’s records and has limited experience using the AMA Guides. She specializes in patients with interstitial lung disease and is head of the interstitial lung disease program at Columbia University, where she also teaches. She routinely treats general pulmonary patients but has no formal training in using the AMA Guides, 6th edition and estimated she has only used the AMA Guides in rating impairment 10 to 12 times before.

The significant difference in the pulmonologists’ ratings centered around which table from the AMA Guides to use and the import of results from two methacholine challenge tests, one administered by Dr. Sevin while Mr. Vestal was off of medication and one administered by Dr. Burke while medication was still in his system.

In calculating impairment, Dr. Sevin testified by deposition that she considered various circumstances, including that Mr. Vestal required surgery when most patients do not, his lasting chest pain with decreased mobility, and his youth. She said his age could make his lung function look “normal” given his age and height, since the parameters set by the Guides are based on a small population that do not include a “lot of, you know, young, active 29-year-olds.”

But she relied mostly on results from a methacholine challenge test she administered after Mr. Vestal was off medication for several weeks. She said it was “pretty common” for patients to have significant, uncontrolled asthma in their workplace that is not reproduced outside that environment. Thus, she needed “more specific measurements of airway hyperresponsiveness,” like the methacholine challenge test, to make her assessment. The test revealed moderate airway hyperreactivity, showing a positive reaction on his second increased dose.

For her part, Dr. McGroder testified by deposition that she focused on Dr. Burke’s November 2023 evaluation of Mr. Vestal, pulmonary function tests that were within normal limits, and Dr. Burke’s methacholine challenge test that was negative. Notably, Mr. Vestal had been using an inhaled steroid only five days before the test. When used to diagnose asthma, test protocol requires the patient to be off steroids for two weeks.

However, Dr. McGroder explained that because she used Dr. Burke’s result to determine impairment, not causation, the fact that Mr. Vestal was still under the influence of steroids at the time of the methacholine test was relevant to her determination that since he had normal lung function tests while receiving treatment, she could not use Table 5-5 to assess impairment.

As for the appropriate table to use, Dr. Sevin said that under Table 5-5, Mr. Vestal’s impairment was “pretty straightforward,” based on the “key factor” of his methacholine challenge test and because treatment did not control his symptoms. She gave him a “Class 4 impairment, which would be 60 percent whole person.”

Conversely, Dr. McGroder discounted Table 5-5 based on her interpretation of section 5.6(b) of the Guides. Specifically, that passage tells the rater to “[n]ote that in the absence of airflow limitation with asthma treatment, Table 5-5 may not be used to determine impairment for airway hyperresponsiveness (specific or non- specific) alone.” It then says that “the individual with airway hyperresponsiveness may have no measurable impairment (solely determined on the basis of lung function test values) but may still have disability for specific jobs.”

Dr. McGroder interpreted this to mean that if there is no “overt obstructive ventilatory defect as in a decreased FEV1 over FVC ratio, you cannot use a test for bronchial hyperreactivity, like the methacholine challenge test when the patient is not receiving treatment, to determine impairment. It should be used for diagnosis only.” Thus, she did not use Table 5-5 to assess Mr. Vestal’s impairment because his objective tests, including Dr. McGroder’s methacholine challenge test showed normal lung function with treatment.

She observed that the pulmonary system chapter of the AMA Guides has two tables: Table 5-5, which is specifically for asthma, and Table 5-4, which covers “pulmonary dysfunction.” She said that in both tables, “pulmonary disfunction or dyspnea” is the “key factor” used as the “objective measure” of lung function.

Using Table 5-4, Dr. McGroder found that Mr. Vestal’s lack of objective airflow limitations placed him in Class 0 in the objective tests section. Further, she placed him in Class 0 in the physical findings section because records did not describe a wheeze or any airflow symptoms during doctor’s visits. However, he qualified for Class 3 in the history section. Considered together, Dr. McGroder felt that the most accurate impairment for Mr. Vestal was 6%, as described in Class 1.

Dr. Sevin disagreed with Dr.

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Related

Orman v. Williams Sonoma, Inc.
803 S.W.2d 672 (Tennessee Supreme Court, 1991)

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Bluebook (online)
VESTAL, COLTON v. TBDN TENNESSEE CO., Counsel Stack Legal Research, https://law.counselstack.com/opinion/vestal-colton-v-tbdn-tennessee-co-tennworkcompcl-2026.