     FILED
    Jan 25, 2019
   10:31 AM(ET)
 TENNESSEE COURT OF
WORKERS' COMPENSATION
       CLAIMS
                                      History of Claim

        Mr. Huffaker's work injury occurred when he fell while exiting his bus. After
some initial treatment, orthopedist Dr. William R. Fly provided conservative treatment
including a boot walker and physical therapy from February to June 2016. Due to Mr.
Huffaker's persistent left-ankle swelling, Dr. Fly referred him to fellow orthopedist and
foot specialist Dr. Mary Testerman. Dr. Testerman treated him from June to November
2016 with medications and physical therapy then released him with permanent
restrictions and an impairment rating.

        Following the first Expedited Hearing, the Court held that Mr. Huffaker presented
sufficient evidence entitling him to a panel of physicians for evaluation and treatment of
any work-related back or knee injury but not evaluations of his elbows or shoulders. As a
result of that order, CAC provided two panels of orthopedic physicians, and Mr. Huffaker
selected Dr. Michael Casey for evaluation of his knee and Dr. Colin Booth for his back.

       Dr. Casey evaluated Mr. Huffaker and noted:

       I do not feel that over two years later that this is truly an event from his fall.
       My diagnosis today is more patellofemoral pain with some early
       patellofemoral wear. I see no other evidence of internal derangement. I do
       not feel that this is directly related to his workers' compensation injury
       back in February 2016.

       Dr. Booth evaluated Mr. Huffaker and wrote "the patient's issues are due to
degenerative disc disease, which is long standing. His injury may have aggravated these
symptoms but at two years out, I cannot say his current symptoms are due to any work
injury."

       Having received the above opinions, Mr. Huffaker requested MRis of his neck,
shoulders, elbows, arms, and left leg. Additionally, he was not satisfied with the ankle
treatment received from Drs. Fly and Testerman and requested a second opinion under
Tennessee Code Annotated section 50-6-204(3)(C) (2018).

        CAC argued it provided Mr. Huffaker medical treatment related to his work injury
and he is not entitled to a second opinion of his ankle injury. Further, neither Dr. Casey
nor Dr. Booth related Mr. Huffaker's current complaints to the work injury, and no
treating physician recommended the requested MRis. Finally, CAC argued Mr.
Huffaker's request for additional treatment should be denied because he offered no
medical proof establishing a connection between his current need for treatment and the
work injury.



                                               2
                        Findings of Fact and Conclusions of Law

       Mr. Huffaker need not prove every element by a preponderance of the evidence to
receive relief at an expedited hearing. Instead, he must present sufficient evidence
showing he would likely prevail at a hearing on the merits. McCord v. Advantage
Human Resourcing, 2015 TN Wrk. Comp. App. Bd. LEXIS 6, at *7-8, 9 (Mar. 27, 2015).

       To prove a compensable injury, Mr. Huffaker must establish that the injury arose
primarily out of and in the course and scope of employment. To establish that the injury
arose primarily out of the employment, he must show "to a reasonable degree of medical
certainty that [the injury] contributed more than fifty percent (50%) in causing the death,
disablement or need for medical treatment, considering all causes." The term "reasonable
degree of medical certainty" means that "in the opinion of the physician, it is more likely
than not considering all causes, as opposed to speculation or possibility." See Tenn.
Code Ann. §50-6-102(14)(C)-(D). Thus, causation must be established by expert medical
testimony.

       First, Mr. Huffaker seeks MRis, which no physician recommended, for multiple
body parts. Although the Court is aware of Mr. Huffaker's sincerely held belief that his
current conditions and need for treatment arose primarily out of his work injury, his lay
opinion alone is legally insufficient to establish the essential element of medical
causation. Thus, the Court holds Mr. Huffaker failed to establish he is likely to prevail at
a hearing on the merits that he is entitled to the requested MRis.

        Second, Mr. Huffaker seeks a second opinion for his ankle under Tennessee Code
Annotated section 50-6-204(3)(C), which affords an employee a second opinion on the
issue of surgery and diagnosis. Petty v. Convention Prod. Rigging, 2016 TN Wrk. Comp.
App. Bd. LEXIS 95, at * 19-21 (Dec. 29, 2016). None of the treating physicians
recommended surgery. Therefore, the Court holds Mr. Huffaker failed to establish he is
likely to prevail at a hearing on the merits that he is entitled to a second opinion.

      IT IS, THEREFORE, ORDERED as follows:

   1. CAC is not obligated to provide the requested MRis or a second opinion on his
      ankle injury. However, Mr. Huffaker may return to Dr. Testerman for ongoing
      reasonable, necessary, and related medical treatment for his work-related left ankle
      mJury.

   2. This matter is set for a Status Hearing/Scheduling Conference on March 28,
      2019, at 2:30 p.m. Eastern Time. The parties must call 865-594-0109 or 855-
      383-0003 toll-free to participate in the Status Hearing. Failure to appear by
      telephone may result in a determination of the issues without the party's
      participation.

                                             3
ENTERED on January 25, 2019.



                              LISA A. LOWE, JUDGE
                              Court of Workers' Compensation Claims

                                 APPENDIX

Technical Record:
      1. Petition for Benefit Determination
      2. Dispute Certification Notice
      3. Motion for Extension of Time
      4. Order Granting Motion for Extension of Time
      5. Order Granting Employee's Second Motion for Extension of Time
      6. Request for Expedited Hearing
      7. Expedited Hearing Order Granting Medical Benefits
      8. Motion for Further Diagnostic Testing with photographs
      9. Employer's Response and Memorandum in Opposition to Employee's Motion
          for Further Diagnostic Tes ting
      10. Mr. Huffaker's position statement (email dated January 13, 2019)

Exhibits:
       1. Affidavit of Jack T. Huffaker
       2. Hand-written Statement of Jack T. Huffaker
       3. First Report of Work Injury
      4. MRI of Outpatient Diagnostic Center at Knoxville, dated March 7, 2016
       5. Panel of Physicians, Form C-42, Selection Date of February 19, 2016
      6. Medical Report of Dr. M. Chris Testerman, dated November 8, 2016
      7. Medical Records of Knoxville Orthopedic Clinic
       8. Photographs of Lower Extremities
      9. Text Message to Susan Dowling, dated August 29, 2016
       10. Email of Kellie Earls, dated October 12, 2016
       11. Affidavit of Kellie Earls
       12. Executed Panel of Physicians for Back Injury
       13. Executed Panel of Physicians for Knee Injury
       14.August 30, 2018 letter from The Poole to Mr. Huffaker
      15. September 26, 2018 Medical Record of Dr. Michael Casey and causation
           response
      16. October 3, 2018 Medical Record of Dr. Colin Booth



                                      4
                             CERTIFICATE OF SERVICE

        I hereby certify that a true and correct copy of the Expedited Hearing Order was
sent to the following recipients by the following methods of service on January 25, 2019.

Name                     Certified Fax      Email    Service sent to:
                         Mail
Jack T. Huffaker,        x                  x        Jack T. Huffaker
Self-Represented                                     516 Kay Drive
Employee                                             Strawberry Plains, TN 37871
                                                     debandj ackc@comcast.net
Hanson R. Tipton,                           x        htrigton@watsonroach.com
Employer's Attorney




                                                   sg,,,.,.._J) ft<~Ot'-
                                         QL.k-vSiIRUM,
                                         PENNY             Court Cler           ~
                                         WC.CourtClerk@tn.gov




                                           5
