How is the New Court of Workers’ Compensation Claims Doing?

Kitty BoyteIt has been about 19 months since the COURT OF WORKERS’ COMPENSATION CLAIMS began hearing cases, and, while most of their hearings have been “expedited hearings” initiated by the filing of a Petition For Benefit Determination (meaning the parties can gather more information and present it to the Court in the Final Hearing), a review of the opinions it has rendered gives us a view of how the Court, as well as the Appeals Panel, is applying the changes to the statute.

The Court has adopted the “McCord standard” (named from the case of McCord v. Advantage Human Resourcing decided 02/27/15) that “The Employee is required to present evidence sufficient for the Court to conclude that the Employee would likely prevail at a hearing on the merits in according with the terms of TCA 50-6-239(D)(1)”.

In looking at the changes in the statute and seeing how the Court is interpreting those, we see:

  • An injury is “accidental” only if the injury is caused by a specific incident or set of incidents . . . identifiable by time and place of occurrence. TCA 50-6-102(13)(A).

The Court has demonstrated a strict interpretation of this new causation standard in: Cullum v. K-Mac/Taco Bell (12/23/14). Claimant’s petition for  benefits for knee problems denied because “the accident . . . “Must be caused by a specific incident… identifiable by time and place of occurrence.”

  • The opinion of the treating physician, selected by the employee from the employer’s designated panel of physicians… shall be presumed correct on the issue of causation. TCA 50-6-102(13) (E).

The Court gave the presumption of correctness to the authorized treating physician in: Sarah Brees v. Escape Day Spa (03/12/15).

Appeals Court overruled trial court saying “employee’s choice physician did not overcome the presumption of correctness afforded the causation opinion of the authorized treating physician.”, and in

Rosemary Boyd v. Hewlett Packard (07/24/15). Court dismissed the causation opinion of the evaluating physician because it did not address the discrepancy between his opinion and that of the authorized treating physician, and, therefore denied claimant’s request for benefits.

  • The eradication of the standard established in Legions v. Liberty Mutual Insurance Company 703 SW3d 620 Tenn. 1986, which “reasonable doubt as to whether an injury arose out of employment is to be resolved in favor of the employee” is demonstrated in each of these cases where the Employer’s denial of benefits was upheld based on the credibility of the Employee:

Luther Buchanan v. Carlex Glass (09/29/15).

Billy Vaughn v. Kenneth Parsons d/b/a Performance Mechanical (06/09/15)

William Sachs v. Johnson Controls (08/13/15)

Shawn Caskey v. Powers Pizza (10/07/15)

Stephen Seiferth v. Ingles Market (11/04/15)

Robin Moore v. Ingles Market (11/04/15)

Many of the expedited hearings involved pro se claimants, and we see that the Court is holding these claimants to that same standard even though they are not represented by counsel. For example:

 Sean East v. Heritage Hosiery Mill (12/12/14). Claimant’s petition was dismissed on appeal because he did not file a transcript of the proceedings or a statement of the evidence as required by the Appeals Court.

Admir Hadzic v. Averitt Express (05/18/15). Claimant’s petition was dismissed because he did not file the requisite Affidavit with his Motion for Expedited Hearing as required by the Court’s Practice and Procedures.

The one area where the Courts seem to be struggling is with claims involving ‘aggravations of pre-existing conditions’ [see Willis Bradshaw v. Jewell Mechanical (06/04/15) and John Miller v. Lowe’s Home Centers Inc. (10/21/15). While the Court has determined (as set forth in Miller) that the pre-reform case of Trosper v. Armstrong Wood Products, Inc. (273 S.W.3d 598 Tenn. 2008) is no longer the law in Tennessee, there still does not seem to be established case law as to how these aggravation cases are to be decided.

Remember, again, that these decisions are from “expedited hearings”, not final hearings, so a final determination of any of these cases could be different. However, as I said previously, it gives us an insight as to the thought processes that the Courts are going through in deciding whether or not to award benefits in these claims.

All of the decisions made by the Court of Workers’ Compensation and the Appeals Court can be found on

http://trace.tennessee.edu/utk_workerscomp/.

Article written by Kitty Boyte of Constangy, Brooks, Smith & Prophete, LLP.