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BlU*‰B)³DCÜ AM D3lŸv~¢ 0@ vÓ` 03 0ŠÂ 0 L 0´ì 0Ç  0Ûg 0ïB AO1Æ€ 0DF D/Š B¹˜HP LaserJet 4Si/4SiMX PS 600dpiPSCRIPTÀÌÀääÀÀÌ0 (ÖÃ9 Z ‹6Times New Roman RegularX($¡¡ NDOUSUTUV{WXYÓ€ez!3|xe tuvwxyz#,37=CIQYag­­1.a.i.(1)(a)(i)1)a)(<1$´´Ô2Ô6.Ú  Ú0Ú  ÚÔ3  Ôà0  à`"Arial RegularC:\WPWIN60\TEMPLATE\STANDARD.WPT2 ÿÿ0Indent1Ô2ÔÔ3  Ô2" ÿÿ0Indent2à0 àÔ2ÔÔ3  Ô2, ÿÿ0Indent3à0 àà0 àÔ2ÔÔ3  Ô26 ÿÿ0Indent4à0 àà0 àà0 àÔ2ÔÔ3  Ô2@ ÿÿ0Indent5à0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô2J ÿÿ0Indent6à0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô2T ÿÿ0Indent7à0 àà0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô2^ ÿÿ0Indent8à0 àà0 àà0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô ÿÿ?AGMSYaioIndent0I.A.1.a.(1)(a)i)a)< Œ 9p`(ModernP ÿÿ8Mac DefaultMac DefaultÓ ` °šXÓ< Œ 9p`(Monaco< Œ 9p`(&Times New Roman d< Œ 9p`(Arial% Line 7 d''''7Border 1dd€-(Cþÿ << Gÿÿ%%%%'ÿÿdxd ùÝ ƒ!ÝÔ€ÔÔ€$ÔÝ  ÝÔ€&ÔÔ€&ÔÓ  ÓÔ YYY ÔFILEDÔ€&XÔÌÌò òSeptember€13,€1996ÌÌCecil€Crowson,€Jr.ÌÔ€&ôÔAppellate€Court€Clerkó óPtPtHHÚ(ÿáÿâùFG(üHHÚ(d'@("ÿÿ$££Ò  ÒÒ  ÒStyl{WP}01•ÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃà Ãà Ãà Ãà Ãà ÃÃÃÃÃÃÃÃÃÃÃÐ ÐÐHHÐÐ  ÐÐ2ÐÐÿÿ¸æ$ÿÐÐHHÐÐÐÐÐÐÐÐ  ÐÐ ÐÐ ÐÑÑÑGenevaÑÑ ÑÑ € ÑÑ<Px–ÈÑÒÒÒ443!#4ÒÒ$ *$ÒÒ$*$ÒÒ ÿKK ÒÒ  Geneva ÒÒ  Geneva ÒÓ.,ÓÓÓÓ6ÓÓ ÓßßßßßßßßßßßßßßßßßßÑMonacoÑÑ ÑÒ  BA Op Monaco ÒÒ  BA Op Monaco Ò(gfi$µµà0  àÔ2(ÆÔ6.Ú  Ú0Ú  Ú.Ú  Ú0Ú  ÚÔ3  Ôà0` (#(#à(bÕä$¶¶à0  àà0` (#(#àÔ2ˆAÔÚ  ÚÚ  Ú.Ô3  Ôà0¸ ` (#` (#à(xâr$··à0  àà0` (#(#àà0¸ ` (#` (#àÔ2ˆAÔ(Ú  Ú0Ú  Ú)Ô3  Ôà0¸ (#¸ (#à(ŒU$¸¸à0  àà0` (#(#àà0¸ ` (#` (#àà0¸ (#¸ (#àÔ2ˆAÔ(Ú  ÚaÚ  Ú)Ô3  Ôà0h(#(#à(Ÿ@Æ$¹¹à0  àà0` (#(#àà0¸ ` (#` (#àà0¸ (#¸ (#àà0h(#(#àÔ2ˆAÔ(Ú  ÚÚ  Ú)Ô3  Ôà0Àh(#h(#à(³ýt$ººà0  àà0` (#(#àà0¸ ` (#` (#àà0¸ (#¸ (#àà0h(#(#àà0Àh(#h(#àÔ2ˆAÔÚ  Ú0Ú  Ú)Ô3  Ôà0À(#À(#à(Çñû$»»à0  àà0` (#(#àà0¸ ` (#` (#àà0¸ (#¸ (#àà0h(#(#àà0Àh(#h(#àà0À(#À(#àÔ2ˆAÔÚ  ÚaÚ  Ú)Ô3  Ôà0p(#(#à€-‚ƒCþÿ<< CÿÿƒLevel 1Level 2Level 3Level 4Level 5($$””ò òÚ  Ú1Ú  Úó ó„„'÷ÿ dxdüÿP PdÝ ƒ!ÝÔ . ÔÔ€ÔÓ&€##X„d&ÓÑ#€##Xd#ÑÔ€$ÔÝ  ÝÑ\R AØ'\ÑÓ  ÓÔ€&ÔÑ\R AØ'\ÑÑ7€ ]œ XXdædÈ7Ñà@ àò òIN€THE€COURT€OF€APPEALS€OF€TENNESSEEÌà@ àWESTERN€SECTION€AT€JACKSONÌÌÌMICHELLE€QUINN,à àà àà à)€€Ìà àà àà àà àà àà à)Ìà àà àó óPlaintiff/Appellee,à àà àò ò)€€Shelby€Circuit€No.€59519€T.D.Ìà àà àà àà àà àà à)ÌÙ€€ÙÙ€€ÙßL€)+(;+'h|ÎÂ` Å `€€LßVS.à àà àà àà àà àà à)€€Appeal€No.€02A01„9504„CV„00068Ìà àà àà àà àà àà à)ÌSHELBY€COUNTY,à àà àà à)Ìà àà àà àà àà àà à)Ìà àà àó óDefendant/Appellant.à àò ò)ó óÌÌÌà@ àAPPEAL€FROM€THE€CIRCUIT€COURT€OF€SHELBYÏCOUNTYÌà@ àAT€MEMPHIS,€TENNESSEEÌà@ àTHE€HONORABLE€JAMES€T.€ALLISON,€SPECIAL€JUDGEÌÌÌÌÌÌÌò òCARROLL€C.€JOHNSONÌó óMemphis,€TennesseeÌAttorney€for€Defendant/AppellantÌÌÌÌÌÌÌÌÌò òREVERSED€AND€DISMISSEDÌÌÌÌÌÌÌÌó óà àà àà àà àà àà àà àà àà àò òALAN€E.€HIGHERS,€J.ÌÌÌÌCONCUR:ÌÌW.€FRANK€CRAWFORD,€P.J.,€W.S.ÌÌHOLLY€KIRBY€LILLARD,€J.ÌÌó óà àÌÌÌÌÌÌÌÓÓà àIn€this€action€for€personal€injury,€Shelby€County€appeals€from€the€trial€courtððsÏÑ7€ ]œ XXdæ XXdæ7Ñjudgment€awarding€compensation€for€permanent€partial€disability€and€chiropractic€feesÏto€plaintiff.€The€county€contends€that€the€trial€court€erred€in€finding€that€plaintiff€sufferedÏpermanent€partial€disability€as€a€result€of€the€accident€and€in€permitting€plaintiff€toÏrecover€her€chiropractic€fees.€€We€find€these€allegations€of€error€to€be€well„taken;Ïtherefore,€we€reverse€the€trial€courtððs€judgment.€€ÌÌà àPlaintiff,€Michelle€Quinn,€was€employed€as€a€secretary€in€the€dietary€departmentÏof€the€Shelby€County€Health€Care€Center.€Plaintiff€had€been€a€patient€of€Dr.€Finn,€anÏinternist,€since€September€1992.€Two€weeks€prior€to€the€date€of€the€subject€accident,Ïplaintiff€had€seen€Dr.€Finn€and€had€complained€of€lower€back€pain€and€numbness€inÏboth€legs.€€At€this€visit,€she€also€reported€a€history€of€scoliosis,€which€is€a€curvature€ofÏthe€spine.€ÌÌà àOn€October€26,€1992,€plaintiff€fell€from€a€stool€at€her€place€of€employment€andÍcomplained€of€injury€to€her€back.€The€night€of€the€accident,€she€went€to€the€hospitalÏemergency€room,€where€x„rays€were€taken€of€her€neck€and€back.€ÌÌà àThe€day€following€the€accident,€plaintiff€went€to€see€Dr.€Knight,€an€orthopedicÏsurgeon.€€She€complained€of€lower€back€pain€that€was€allegedly€caused€by€the€fallÏfrom€the€stool.€Dr.€Knight€reviewed€the€x„rays€that€had€been€taken€at€the€hospital€and,Ïaside€from€evidence€of€mild€scoliosis,€found€them€to€be€normal.€Ìà àÌà àOver€the€course€of€the€next€few€weeks,€plaintiff€continued€to€complain€to€Dr.ÏKnight€about€back€pain.€Consequently,€on€November€24,€1992,€Dr.€Knight€ordered€aÏCT€scan€and€a€bone€scan€to€be€performed€on€the€plaintiff.€€The€CT€scan€came€backÏnegative,€while€the€bone€scan€only€indicated€only€mild€scoliosis.€ÌÌà àIn€December€1992,€plaintiff€was€examined€by€Dr.€Harriman,€an€orthopedicÏsurgeon€who€practiced€in€the€same€group€as€Dr.€Knight.€€Harriman€reviewed€plaintiffððsÏCT€and€bone€scans€and€had€plaintiff€perform€certain€physical€activities€in€order€to€testÏher€range€of€motion.€€At€the€conclusion€of€the€exam,€Harriman€explained€the€nature€ofÏscoliosis€to€the€plaintiff€and€told€her€that€the€scoliosis€was€not€caused€by€her€fall€fromÏthe€stool.€ÌÌà àDr.€Harriman€next€saw€plaintiff€on€December€16,€1992.€€His€examinationÏrevealed€that€her€strength€tests€were€normal,€and€that€there€were€no€other€significantÏproblems.€€In€Dr.€Harrimanððs€opinion,€there€were€no€orthopedic€problems€with€plaintiff.€ÍHe€suggested€that€she€undergo€psychological€evaluation.€On€January€15,€1993,€Dr.ÏHarriman€again€examined€plaintiff€and€observed€that€she€had€a€full€range€of€motion€inÏher€back,€her€EMG€test€was€normal,€another€CT€scan€was€normal,€and€there€were€noÏother€apparent€problems.€€Dr.€Harrimanððs€opinion€was€that€plaintiff€suffered€noÏimpairment.ÌÌà à€In€October€1993,€plaintiff€was€injured€in€a€car€accident€when€her€vehicle€wasÏstruck€in€the€rear.€€After€the€accident,€plaintiff€saw€Dr.€Finn€for€neck€and€back€pain.€InÏJanuary€1994,€Dr.€Finn€ordered€a€CT€scan,€which€indicated€that€there€was€a€mild€diskÏbulge€in€her€back.€Dr.€Finn€referred€plaintiff€to€Dr.€Joe€Hudson,€a€neurosurgeon,€whoÏconcluded€that€plaintiffððs€symptoms€were€attributable€to€scoliosis.€He€noted€that€theÏJanuary€1994€CT€scan€showed€that€there€was€a€questionable€disk€herniation.€AfterÏexamining€plaintiff€and€reviewing€MRI€results,€Dr.€Hudson€concluded€that€plaintiff€hadÏa€small€disk€protrusion€in€her€back.€€However,€his€opinion€was€that€the€protrusion€wasÏinsignificant€and€would€not€cause€her€any€clinical€problems.€ÌÌà àPursuant€to€the€suggestion€of€her€attorney,€plaintiff€submitted€to€examination€byÏDr.€Joseph€Lipkowitz,€a€chiropractor,€in€April€1994.€€After€performing€a€range€of€motionÏtests€and€taking€x„rays,€Lipkowitz€concluded€that€plaintiff€had€a€28%€impairment€of€theÏwhole€person€due€to€her€fall€from€the€stool.€€€ÌÌÓ ` p‚XN ˜X Óà àIn€July€1994,€Dr.€Harriman€again€examined€the€plaintiff€and€observed€thatÏplaintiff€had€a€full€range€of€motion,€and€did€not€experience€pain€when€pressure€wasÍapplied€to€her€back.€€Dr.€Harriman€concluded€that€plaintiff€had€no€permanentÏimpairment.€ÌÌà àThe€county€has€an€on„the„job€injury€policy,€which€provides€for€payment€ofÏmedical€expenses€and€disability€in€the€event€that€an€employee€suffers€an€injury€on€theÏjob€as€a€result€of€his€or€her€employment.€€With€the€exception€of€$4,005.00€inÏchiropractic€fees,€the€county€paid€all€of€plaintiffððs€medical€bills.€The€county€declined€toÏpay€the€chiropractic€bill€because€the€countyððs€policy€expressly€provides€thatÏchiropractic€fees€are€not€compensable.€€€Ìà àà àThe€trial€court€assigned€10%€permanent€partial€disability€to€plaintiff€andÏawarded€damages€to€her€in€the€amount€of€$9,396.40.€The€trial€court€further€held€thatÏthe€county€was€responsible€for€payment€of€plaintiffððs€chiropractic€fees€in€the€amount€ofÏ$4,005.00.€Ìà àÌà àThe€county€argues€on€appeal€that€plaintiff€failed€to€prove€that€any€injury€sheÏsuffered€was€caused€by€the€fall€from€the€stool.€€According€to€the€county,€any€injury€toÏplaintiffððs€neck€and€back€was€either€preexisting€due€to€scoliosis€or€was€sustained€in€theÏautomobile€accident.€€In€addition,€the€county€argues€that€the€medical€testimonyÏadduced€at€trial€proves€that€plaintiff€suffered€no€permanent€impairment.€€Finally,€theÏcounty€contests€the€trial€courtððs€award€of€chiropractorððs€fees€on€the€basis€that€theÏcountyððs€on„the„job€injury€policy€provides€that€the€county€will€neither€recognize€nor€payÏfor€treatment€rendered€by€chiropractors.€€This€section€states:ÌÓÓà8 àà8 à#10.€€The€County€will€not€accept€responsibility€for€payment€of€anyÍexpenses€incurred€as€a€result€of€visit€to€a€chiropractor.€€Furthermore,€aÏstatement€from€a€chiropractor€will€not€meet€the€requirement€of€aÏphysician€evaluation€validating€the€injury€or€any€absence€from€workÏdue€to€the€injury.ÌÌÓÓà àÌà àIn€the€case€òòsub€judiceóó,€plaintiff€has€the€burden€of€proving€causation€by€aÏpreponderance€of€the€evidence.€€òòTindall€v.€Waring€Park€Assoc.óó,€725€S.W.2d€935Ï(Tenn.€1987).€€In€òòTindallóó,€the€Court€explained:ÌÓÓà8 àà8 àThis€Court€has€consistently€held€that€causation€and€permanency€of€aÏwork„related€injury€must€be€shown€in€most€cases€by€expert€medicalÏevidence.€€Furthermore,€ððby€ð ðcausal€connectionðð€is€meant€notÏproximate€cause€as€used€in€the€law€of€negligence,€but€cause€in€theÏsense€that€the€accident€had€its€origin€in€the€hazards€to€which€theÏemployment€exposed€the€employee€while€doing€his€work.ðð€€€AlthoughÏabsolute€certainty€is€not€required€for€proof€of€causation,€medical€proofÏthat€the€injury€was€caused€in€the€course€of€the€employee's€work€mustÏnot€be€speculative€or€so€uncertain€regarding€the€cause€of€the€injuryÏthat€attributing€it€to€the€plaintiff's€employment€would€be€an€arbitraryÏdetermination€or€a€mere€possibility.€€ððIf,€upon€undisputed€proof,€it€isÏconjectural€whether€disability€resulted€from€a€cause€operating€withinÏpetitioner's€employment,€or€a€cause€operating€without€employment,Ïthere€can€be€no€award.ðð€€€If,€however,€equivocal€medical€evidenceÏcombined€with€other€evidence€supports€a€finding€of€causation,€suchÏan€inference€may€nevertheless€be€drawn€by€the€trial€court€under€theÏcase€law.€€ÌÌòòId.óó€at€937€(internal€citations€omitted).ÌÌà àÌÌÓÓà àAt€the€trial€in€this€matter,€plaintiff€relied€almost€exclusively€on€the€testimony€ofÏher€chiropractor,€Dr.€Lipkowitz,€in€attempting€to€establish€causation€and€permanentÏimpairment.€€However,€we€find€that€the€testimony€of€plaintiffððs€chiropractor€attributingÏthe€cause€of€plaintiffððs€injury€to€the€fall€from€the€stool€was€both€speculative€andÏuncertain.ÌÌà àIt€is€uncontroverted€that€plaintiff€complained€of€neck€and€back€pain€prior€to€herÏfall€from€the€stool.€€In€addition,€plaintiff€suffered€from€scoliosis,€a€condition€to€which€twoÏhighly€qualified€medical€specialists€attributed€her€back€pain.€€The€x„rays€and€CT€scansÏshowed€no€physical€abnormality€other€than€scoliosis€prior€to€the€car€wreck.€Moreover,Ïplaintiff€was€not€examined€by€her€chiropractor€prior€to€the€car€wreck.€€€It€is€thereforeÏspeculative€what,€if€any,€portion€of€her€alleged€back€injury€was€due€to€the€fall€from€theÏstool.€€In€light€of€the€foregoing€evidence,€we€find€that€plaintiff€failed€to€carry€her€burdenÏof€proof€as€to€causation.ÌÌà àWe€hold€that€the€evidence€preponderates€against€the€trial€courtððs€conclusionÏthat€plaintiffððs€alleged€disability€arose€from€an€accident€that€occurred€within€the€scopeÏof€her€employment.€€In€addition,€we€find€that€the€trial€court€erred€in€requiring€the€countyÏto€payÌÌÌÌÌÌÌÌÌ€plaintiffððs€chiropractic€fees€in€contravention€of€its€on„the„job€injury€policy.€€Accordingly,Íthe€judgment€below€is€reversed€and€the€suit€is€dismissed.€€Costs€incident€to€this€appealÏare€taxed€to€plaintiff.ÌÌÓÓà àà àà àà àà àà àà àà àà àòò€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€Ïóóà àà àà àà àà àà àà àà àà àHIGHERS,€J.ÌÌÌCONCUR:ÌÌÌÌòò€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€óóÌCRAWFORD,€P.J.,€W.S.ÌÌÌÌòò€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€óóÌLILLARD,€J.