Summary
The Tennessee Workers’ Compensation Appeals Board vacated and remanded an order requiring Dollar General Corporation to provide medical benefits to Patricia Johnson. The Board held that a motion seeking temporary disability or medical benefits may initiate the expedited-hearing process, but the trial court must apply the statutory standard requiring evidence that the employee is likely to prevail on the merits.
Topics
Practice areas
Questions Presented
- Whether the trial court could consider a motion to compel benefits, rather than a formally titled request for an expedited hearing, as a vehicle for seeking temporary disability or medical benefits.
- Whether the trial court was required to apply the evidentiary standard in Tennessee Code Annotated section 50-6-239(d)(1) before ordering initiation of medical benefits at an interlocutory stage.
- Whether the trial court's order granting medical benefits and referring the matter to the compliance program could stand without the required likelihood-of-success determination.
Holdings
- A properly filed pleading seeking temporary disability or medical benefits may initiate the expedited-benefits process regardless of whether it is titled a request for expedited hearing, motion to compel benefits, or another pleading, provided it satisfies applicable statutory, regulatory, and interpretive requirements.
- Before ordering the initiation of temporary disability or medical benefits at an interlocutory stage, the trial court must determine whether the injured employee has presented sufficient evidence to show that the employee will likely prevail at a hearing on the merits.
- The order granting medical benefits could not be affirmed because the trial court did not state that it applied the statutory likelihood-of-prevailing standard.
Key quotations
“In short, any properly-filed pleading that seeks temporary disability and/or medical benefits prior to a compensation hearing or final judgment, whether titled a “request for expedited hearing,” a “motion to compel benefits,” or some other pleading indicating that additional benefits are being sought, is subject to the evidentiary requirements of Tennessee Code Annotated section 50-6-239(d)(1).” (at 7)
“In any event, when ordering the initiation of medical or temporary disability benefits at an interlocutory stage of a case, the court must evaluate the evidence in light of the injured worker’s burden of proof, i.e., whether the employee has come forward with sufficient evidence to show a likelihood of prevailing at a hearing on the merits.” (at 7)
Factual background
Patricia Johnson fell at work on September 18, 2022, injuring her back and legs, and Dollar General accepted the compensability of the accident and initially provided medical treatment. After Johnson relocated to Mississippi, delays occurred in arranging authorized treatment, and her treating neurosurgeon recommended additional imaging, physical therapy, and surgery. Johnson filed a motion to compel additional medical benefits, and the trial court ordered the employer to provide physical therapy and a lumbar MRI without expressly determining whether Johnson was likely to prevail at a hearing on the merits.
Procedural history
Johnson was injured at work and sought additional medical treatment and related workers' compensation benefits. After the employer disputed the procedural vehicle for obtaining benefits and raised questions concerning medical causation, the trial court conducted a telephonic hearing on Johnson's motion to compel, ordered the employer to provide physical therapy and a lumbar MRI, denied attorney's fees, and referred the matter for compliance-program investigation and possible penalties. The Appeals Board vacated the order and remanded because the trial court did not apply the statutory requirement that the employee show a likelihood of prevailing at a hearing on the merits.
Remand instructions
The trial court must determine whether Johnson is likely to prevail at trial in establishing her entitlement to the requested medical benefits, applying the evidentiary requirements of Tennessee Code Annotated section 50-6-239(d)(1).