Carolyn S. Todd v. St. Paul Fire and Marine Ins. Company

This workers' compensation appeal has been referred to the Special Workers' Compensation Appeals Panel of the Supreme Court in accordance with Tenn. Code Ann. section 5-6-225(e)(3) for hearing and reporting of findings of fact and conclusions of law. In this appeal, the employer's insurer contends (1) benefits should be denied because of a false application for employment, (2) the trial court erred in awarding medical expenses not authorized by it, (3) the trial court erred in awarding temporary total disability benefits from the date of the injury until September 13, 1993 and (4) the award of medical benefits based on ten percent permanent partial disability to the body as a whole is excessive. The employee contends the award of permanent partial disability benefits is inadequate. As discussed below, the panel has concluded the award of temporary total disability benefits should be modified and the judgment otherwise affirmed. The employee or claimant is thirty-four and has an eighth grade education. She first completed a job application on September 25, 1989 and was hired as a flagman at Ford Construction Company, but performed other jobs, including driving a truck and shoveling or sweeping asphalt. Because the work was seasonal, she signed three subsequent applications. In her applications, the claimant denied any previous back injury or workers' compensation claim. In both respects, the application was false. She had in fact received in the past benefits for a back injury, from another employer. On July 2, 1992, the claimant injured her back while shoveling asphalt at work. She continued working until July 16th, when she was referred to Dr. J. Canale. Dr. Canale diagnosed myositis and muscle inflammation, for which he treated her conservatively until August 27th, when he released her to return to work without restrictions, limitations or permanent impairment. The claimant informed the employer that she was dissatisfied with Dr. Canale and asked to be referred to another doctor. In her testimony, she said the insurance company failed to provide her with the name of another doctor or a list from whom she could have made a choice. The trial judge apparently believed her. On the advice of her attorney, she saw Dr. James McAfee on September 11, 1992. Dr. McAfee diagnosed cervical strain, for which he prescribed physical therapy and nerve blocks. The doctor opined the injury was related to the injury at work and estimated the claimant's permanent impairment at eight percent to the whole body, from appropriate guidelines. The claimant incurred medical expenses for care prescribed by Dr. McAfee totaling $5,974., which the trial court found to be reasonable and reasonably necessary. 2