Summary
The Tennessee Workers’ Compensation Appeals Board affirmed an interlocutory order requiring FirstFleet, Inc. to provide Larnell Moon with a panel of neuro-ophthalmologists. The Board held that a treatment recommendation by an authorized treating physician is presumed medically necessary under Tennessee Code Annotated section 50-6-204(a)(3)(H), and that the employer had not rebutted the presumption. The case was remanded, with appellate costs taxed to the employer.
Topics
Practice areas
Questions Presented
- Whether the trial court erred by ordering FirstFleet to provide Moon with a panel of neuro-ophthalmologists.
- Whether Moon was required at the interlocutory stage to establish a causal link between his vision complaints and the work injury, or whether the authorized physician’s referral was presumed medically necessary under Tennessee Code Annotated section 50-6-204(a)(3)(H).
Holdings
- An authorized treating physician’s recommendation for treatment by referral is presumed medically necessary under Tennessee Code Annotated section 50-6-204(a)(3)(H). Once Moon presented suitable proof that Dr. Manalo made the referral, FirstFleet bore the burden of rebutting the presumption by a preponderance of the evidence. FirstFleet failed to rebut the presumption, so the trial court properly ordered it to provide the panel.
Key quotations
“Thus, when medical proof is presented by deposition, “the reviewing court may draw its own conclusions about the weight and credibility of the expert testimony.”” (at 2)
“Employee is not required to show that he is likely to succeed in proving that his vision issues are primarily caused by the accident or that any pre-existing vision issues are not the primary cause of his current complaints.” (at 3)
Factual background
Larnell Moon was involved in a single-vehicle accident in the course and scope of his employment as a commercial truck driver for FirstFleet on December 28, 2022. He sustained multiple injuries, including a traumatic brain injury, and treated with Dr. Erwin Manalo, an authorized treating physician. After Moon reported blurred vision, Dr. Manalo recommended evaluation by a neuro-ophthalmologist, but FirstFleet declined to provide a panel, citing insufficient information linking the vision complaints to the work injury. The trial court ordered FirstFleet to provide the panel.
Procedural history
Moon, an employee of FirstFleet, was injured in a work-related vehicle accident and later sought a panel of neuro-ophthalmologists based on a recommendation from his authorized treating physician. The trial court ordered FirstFleet to provide the panel and referred the employer to the Bureau’s Compliance Program for failing to do so. FirstFleet appealed, and the Appeals Board affirmed the order and remanded the case.
Remand instructions
The case was remanded after affirmance of the trial court’s order requiring FirstFleet to provide a panel of neuro-ophthalmologists. Costs on appeal were taxed to FirstFleet.