                                                                                  FILED
                                                                                Dec 18, 2019
                                                                                11:33 AM(CT)
                                                                              TENNESSEE COURT OF
                                                                             WORKERS' COMPENSATION
                                                                                    CLAIMS




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

SONIA PURVIS,                                )   Docket No. 2019-06-1189
         Employee,                           )
v.                                           )
                                             )
CLARKSVILLE MONTGOMERY                       )
COUNTY CAA,                                  )   State File No. 58922-2018
        Employer,                            )
                                             )
ACCIDENT FUND INSURANCE CO.                  )
OF AMERICA,                                  )
         Carrier.                            )   Judge Joshua Davis Baker



                          EXPEDITED HEARING ORDER
                              DENYING BENEFITS


       The Court held an expedited hearing on December 12, 2019, to consider Ms.
Purvis’s request for temporary disability benefits and reinstatement of medical benefits.
Clarksville Montgomery County Community Action Agency (CMCCAA) terminated her
medical benefits when she refused to sign releases for medical records from providers
who treated her for previous work-related accidents and other conditions. CMCCAA
asked that the Court deny her requests. For the reasons below, the Court denies Ms.
Purvis’s request for temporary disability and reinstatement of her medical benefits.

                                    History of Claim

       The crux of the parties’ disagreement concerns the cause of Ms. Purvis’s current
need for treatment. Before her most recent injury, she injured her right shoulder and neck
at work in 2011. She settled that claim with Auto-Owners Insurance for benefits that
included lifetime future medical treatment. Additionally, Ms. Purvis suffers from lupus;
a condition she testified regularly causes her considerable pain.

       Ms. Purvis suffered her most recent workplace accident on August 8, 2018, when
she fell while walking up a wheelchair ramp. She claimed she injured her hip, back,
neck, right shoulder and right arm in the accident. CMCCAA accepted the claim and
offered a panel of physicians from which she chose Doctor’s Care.1

       Ms. Purvis saw providers at Doctor’s Care three times. While she agreed that
none of the physicians took her off work, Ms. Purvis said she could not work because of
severe pain. She testified that the physicians were essentially prohibited from taking her
off from work but introduced no proof to support her testimony.

      Following the 2018 accident, Auto-Owners canceled Ms. Purvis’s treatment
provided through her 2011 workers’ compensation settlement. It asserted that the 2018
accident was an “intervening cause” of her current need for treatment.

       CMCCAA also suspended Ms. Purvis’s medical benefits, claiming that it could
not determine if the 2018 accident caused her need for treatment, considering her lupus
and the prior injury. It asked Ms. Purvis to provide releases so it could submit her
records to the authorized treating physician for a causation opinion.

       Ms. Purvis gave a release for one doctor but failed to do so for other doctors who
treated her for the 2011 accident. She also refused to sign releases for providers treating
her for lupus, arguing that her lupus had no relevance to her workers’ compensation
claim.

                             Findings of Fact and Conclusions of Law

       Ms. Purvis has the burden of proving entitlement to the requested benefits. To
carry that burden, she must present sufficient evidence to prove she 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). The Court finds she failed to carry
that burden.

        While the parties agree that Ms. Purvis had an accident at work and CMCCAA
initially provided treatment for her injuries, CMCCAA terminated those benefits when
questions arose about the medical cause of her need for treatment. Thus, the parties
dispute medical causation.

        Ms. Purvis must prove medical causation through a doctor’s opinion to prevail at
this hearing; she cannot prove her claim through lay testimony alone. See Berdnik v.
Fairfield Glade Cmty. Club, 2017 TN Wrk. Comp. App. Bd. LEXIS 32, at *11 (Mar. 31,
2017); Scott v. Integrity Staffing Solutions, 2015 TN Wrk. Comp. App. Bd. LEXIS 24, at
*12 (Aug. 18, 2015). Ms. Purvis provided no medical opinion to prove her current need
for treatment arose primarily from her 2018 accident, so she failed to establish she would


1
    Neither party introduced any medical records.
                                                    2
likely prevail on this issue at trial.   Accordingly, the Court denies her claim for
reinstatement of her medical benefits.

       The Court’s denial does not prevent Ms. Purvis from getting medical proof of
causation. CMCCAA terminated benefits because it questioned whether her need for
treatment arose from other conditions, but it did so only after asking Ms. Purvis several
times to sign releases so the authorized treating physician could review her records. The
Court finds CMCCAA’s decision to suspend her benefits reasonable under the
circumstances, and this hearing may have been avoided if Ms. Purvis had signed the
requested releases.

       Given that Ms. Purvis did not establish the likelihood of proving medical
causation, the Court also denies her request for temporary disability benefits. See Jewell
v. Cobble Constr. and Arcus Restoration, 2015 TN Wrk. Comp. App. Bd. LEXIS 1, at
*21 (Jan. 12, 2015).

      It is ORDERED as follows:


   1. Ms. Purvis’s request for temporary disability and reinstatement of her medical
      benefits is denied.

   2. This matter is set for a status conference on Monday, March 9, 2020, at 9:00
      a.m. (CDT). You must call 615-741-2113 or toll-free 855-874-0474 to
      participate in the Hearing. Failure to call might result in a determination of
      issues without your participation.


ENTERED DECEMBER 18, 2019.



                                  ___________________________________
                                  Joshua Davis Baker, Judge
                                  Court of Workers’ Compensation Claims




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                                      APPENDIX


Exhibits:

   1. Ms. Purvis’s Affidavit
   2. HIPAA Medical Release

Technical Record:

   1. Petition for Benefit Determination
   2. Dispute Certification Notice
   3. Request for Expedited Hearing


                            CERTIFICATE OF SERVICE


        I certify that a correct copy of this Order was sent as indicated on December 18,
2019.

 Name                       Regular    Via    Via Service sent to:
                             Mail      Fax   Email
 Sonia Purvis                 X                X   804 Parkview Ct.
                                                   Clarksville, TN 37042
                                                   epurvis496@aol.com

 Gordon Aulgur                                   X   gordon.aulgur@accidentfund.com
                                                     rosemary.marlatt@accidentfund.com



                                   ____________________________________________
                                   Penny Shrum, Court Clerk
                                   Court of Workers’ Compensation Claims
                                   Wc.courtclerk@tn.gov




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