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ÐFarris,€Mathews,€Ô_ÔBrananÔ_Ô€&€Ô_ÔHellenÔ_Ôà  àMemphis,€TN€€38103à x àÐ p"°" ÐOne€Commerce€Square,€Suite€2000à  àÐ V#–# ÐMemphis,€TN€€38103à h àà À àà  àÐ <$| $ Ðà ` àÌÌÌÌÌÌÌò òòòÓ  ÓM€E€M€O€R€A€N€D€U€M€€€€O€P€I€N€I€O€Nóóó óÐ l+¬', ÐÌò òòòMembers€of€Panel:Ð >-~). ÐÌó óóóJustice€Janice€Holderòòò òÐ /V+0 Ðó óóóSenior€Judge€John€K.€ByersÐ ü/<,1 ÐSenior€Judge€F.€Lloyd€Ô_ÔTatumÔ_ÔÌÓä ÓÌÌÌÌÌÔ% € ÔÌÌÌÌÌÌÌÌÌMODIFIED€AND€AFFIRMEDà À àà  àà p àà È àà  àBYERS,€Senior€JudgeÐ \>œ:A ÐÔ_Ô‡òòò òÓ  ÓÓÓOPINIONó óóóÐ À ÐÓ  Óà ` àThis€workers'€compensation€appeal€has€been€referred€to€the€Special€Workers'ÏCompensation€Appeals€Panel€of€the€Supreme€Court€in€accordance€with€Tenn.€CodeÏAnn.€ðð€50„6„225(e)(3)€for€hearing€and€reporting€to€the€Supreme€Court€of€findings€ofÏfact€and€conclusions€of€law.€Ìà ` àReview€of€the€findings€of€fact€made€by€the€trial€court€is€òòde€novoóó€upon€theÐ È   Ðrecord€of€the€trial€court,€accompanied€by€a€presumption€of€the€correctness€of€theÏfindings,€unless€the€preponderance€of€the€evidence€is€otherwise.€€Tenn.€Code€Ann.€Ïðð€50„6„225(e)(2);€òòStone€v.€City€of€McMinnville,€óó896€S.W.2d€548,€550€(Tenn.€1995).€Ð 0p ÐThe€application€of€this€standard€requires€this€Court€to€weigh€in€more€depth€the€factualÏfindings€and€conclusions€of€the€trial€court€in€a€workersðð€compensation€case.€€òòSeeÐ Ì  ÐCorcoran€v.€Foster€Auto€GMC,€Inc.,€óó746€S.W.2d€452,€456€(Tenn.€1988).Ð œÜ Ðà ` àThe€trial€court€found€that€the€plaintiff€sustained€compensable€injuries€in€JulyÏ1996€and€was€entitled€to€vocational€disability€awards€of€20€percent€to€the€body€as€aÏwhole€and€10€percent€to€each€arm.Ìà ` àThe€defendants€present€the€following€issue€on€appeal:€€ð ðDid€the€trial€court€errÏin€awarding€the€Plaintiff€20%€impairment€to€the€body€as€a€whole€and€a€10%Ïimpairment€to€the€right€arm€and€10%€impairment€to€the€left€arm?ððÌà ` àWe€modify€the€case€and€fix€the€Ô‡XH’XXXH’Ôpermanent€vocational€disability€based€on€theÐ 4$t $ ÐÔ#†XH’XXXH’»#Ôtotal€injuries€to€the€body€as€a€whole€in€accordance€with€Tenn.€Code€Ann.€ðð€50„6„Ð &@"& Ð207(3)(C)€at€30%.Ìò òÓ  ÓBACKGROUNDó óÐ ˜)Ø%* ÐÓ»Óà ` àAt€the€time€of€trial,€the€plaintiff€was€53€years€of€age€and€had€been€employedÏby€UPS€as€a€feeder€driver€for€the€past€29€years.€€Prior€to€that,€he€worked€at€OwensÏIllinois,€a€corrugated€box€company.€€He€attended€college€for€three€years€and€servedÏin€the€U.S.€Marine€Corps€for€six€years.€€Prior€to€the€injury€in€this€case,€he€was€in€goodÏhealth€and€had€no€pain€that€prevented€him€from€performing€any€activities.Ìà ` àAs€a€feeder€driver,€the€plaintiff€was€required€to€drive€and€deliver€packages€toÏvarious€destinations.€€His€job€specifically€involved€coupling€and€uncoupling€trailers.€ÏHe€explained€that€he€would€connect€or€disconnect€trailers€by€using€a€dolly€thatÏâ âweighed€between€1500„1700€pounds.€€Mr.€Carl€McVay,€the€plaintiffððs€manager,Ð Ð96< Ðtestified€that€the€dolly€is€calibrated€so€that€the€lifting€is€almost€automatic€after€youÏbegin€the€process.Ìâ  à ` àOn€July€8,€1996,€the€plaintiff€drove€a€Volvo€tractor„trailer€to€Nashville€for€UPS.€Ð X˜ ÐHe€testified€that€while€he€was€uncoupling€the€trailers€he€felt€a€pain€in€his€neck€thatÏran€down€into€his€arms,€wrists,€and€hands.€€On€the€trip€back€to€Memphis,€his€painÏbecame€worse€and€he€had€trouble€gripping€the€steering€wheel.€€The€plaintiff€alsoÏtestified€that€the€steering€was€difficult€and€the€seat€was€uncomfortable€on€the€VolvoÏtractor„trailer€but€that€he€never€filled€out€a€driver€vehicle€report€about€these€problems.€ÏWhen€he€returned€to€Memphis,€the€plaintiff€informed€Mr.€McVay€about€the€pain€in€hisÏneck,€arms,€and€hands.€€Mr.€McVay€testified€that€the€plaintiff€has€always€been€a€goodÏand€honest€worker.Ìà ` àThe€plaintiff€was€first€sent€by€UPS€to€Dr.€Debbie€OððCain,€who€saw€himÏperiodically€over€a€two€to€three€week€period€and€sent€him€to€physical€therapy€atÏHealthSouth.€€He€testified€that€his€pain€was€so€bad€and€his€blood€pressure€was€soÏhigh€that€HealthSouth€refused€to€treat€him€anymore.€€When€he€returned€to€Dr.ÏOððCain,€she€referred€him€to€Dr.€Arsen€Haig€Manugian,€an€orthopedic€surgeon.€€Dr.ÏManugian€eventually€diagnosed€the€plaintiff€with€carpal€tunnel€syndrome€andÏperformed€carpal€tunnel€release€surgeries€on€both€of€his€hands.€€The€plaintiff€testifiedÏthat€he€did€not€know€that€he€had€carpal€tunnel€syndrome€prior€to€Dr.€ManugianððsÏdiagnosis.Ìà ` àIn€February€1997,€shortly€after€the€surgeries,€the€plaintiff€returned€to€the€sameÏjob€at€UPS€with€no€restrictions€or€limitations,€but€he€continued€to€have€pain€andÏswelling€in€his€arms.€€The€plaintiff€testified€that€he€attempted€to€call€Dr.€Manugian€andÏMs.€Cindy€Kidd,€his€case€worker,€on€several€occasions€to€schedule€visits€about€hisÏcontinued€pain€but€that€neither€Dr.€Manugian€or€Ms.€Kidd€would€return€his€calls.€€AfterÏhis€lawyer€intervened,€the€plaintiff€had€one€last€appointment€with€Dr.€Manugian€inÏFebruary€1998.€€At€that€time,€the€plaintiff€was€sent€for€a€second€EMG,€but€heÏreported€that€he€never€received€the€results€despite€his€repeated€calls€to€Dr.ÏManugianððs€office.€€Ìà ` àSince€returning€to€UPS€in€February€1997,€the€plaintiff€has€not€missed€anyÏwork€for€pain€or€discomfort€and€has€not€complained€to€Mr.€McVay€of€any€additionalÏproblems.€€He€continues€to€work€approximately€50€hours€five€days€a€week€at€a€rateÐ t;´7> Ðof€$21.12€per€hour.€€Prior€to€his€injuries,€he€earned€$20.52€per€hour.€€Although€theÏplaintiff€can€do€other€jobs€at€UPS,€he€understood€that€he€would€have€to€take€a€payÏcut.€€Mr.€James€Kent€Hardy,€a€health€and€safety€manager€for€UPS,€testified€thatÏemployees€who€change€jobs€due€to€temporary€or€permanent€disability€stay€at€theÏsame€rate€of€pay.€€Ìà ` àThe€plaintiff€testified€that€he€continues€to€have€sharp€pain,€numbness,€tingling,Ïand€swelling€while€driving€for€UPS€and€that€he€has€difficulty€in€lifting€and€holding€ontoÏitems.€€Further,€he€has€not€been€able€to€use€tools€or€fish€because€of€trouble€with€hisÏgrip.€€Finally,€the€plaintiff€stated€his€opinion€that€he€is€60€percent€impaired€as€a€resultÏof€the€injuries€to€his€hands€and€neck.Ìò òÓ  ÓMEDICAL€EVIDENCEó ó€Ð ¸ø ÐÓ»#Óà ` àDr.€Arsen€Haig€Manugian,€a€board€certified€orthopedic€surgeon,€testified€byÏdeposition.€€Dr.€Manugian€first€saw€the€plaintiff€on€August€20,€1996€for€complaints€ofÏneck€pain,€bilateral€shoulder€and€arm€pain,€and€intermittent€numbness€in€both€hands.€ÏAfter€the€plaintiff€returned€several€times€with€continuing€complaints,€Dr.€ManugianÏsent€him€for€a€CT€scan€of€the€cervical€spine€and€an€EMG.€€Dr.€Steven€Landy,€aÏneurologist,€performed€the€plaintiffððs€EMG.€€Dr.€Landy€found€an€abnormal€studyÏconsistent€with€C„5€and€C„6€radiculopathy€and€evidence€of€bilateral€carpal€tunnelÏsyndrome,€worse€on€the€right.€€€€€€€€Ìà ` àThereafter,€Dr.€Manugian€diagnosed€the€plaintiff€with€bilateral€carpal€tunnelÏsyndrome€and€performed€surgery€on€his€right€wrist€in€December€1996€and€on€his€leftÏwrist€in€January€1997.€€After€therapy,€he€released€the€plaintiff€to€return€to€workÏwithout€restrictions€or€limitations,€except€to€drive€with€padded€gloves,€on€February€20,Ï1997.€€Dr.€Manugian€believed€that€the€plaintiff€made€an€excellent€recovery€from€theÏsurgeries€and€expected€no€impairment.€€Ìà ` àIn€February€1998,€the€plaintiff€returned€to€Dr.€Manugian€with€complaints€thatÏhe€had€increasing€pain€in€his€neck,€shoulders,€and€arms€and€that€he€had€weaknessÏand€numbness€in€his€arms€when€he€gripped€the€steering€wheel€for€long€periods.€€AtÏthis€time,€Dr.€Manugian€still€felt€that€the€plaintiff€had€no€permanent€impairment€as€aÏresult€of€the€carpal€tunnel€syndrome€and€surgeries.€€In€contrast€to€the€plaintiffððsÏtestimony,€Dr.€Manugian€testified€that€the€plaintiff€never€called€in€the€year€prior€to€hisÏFebruary€1998€visit€to€complain€about€continuing€pain.€€Ð €;À7> Ðà ` àDr.€Manugian€also€diagnosed€the€plaintiff€with€cervical€spondylosis€andÏdegenerative€arthritis€of€the€cervical€spine.€€He€opined€that€the€plaintiffððs€arthriticÏcondition€was€part€of€the€aging€process€and€not€caused€by€his€work.€€He€stated€thatÏthe€job€of€driving€a€truck€might€aggravate€the€plaintiffððs€pain€or€make€his€symptomsÏworse.€€Dr.€Manugian€testified€that€the€plaintiff€sustained€no€anatomical€impairmentÏas€a€result€of€the€arthritic€condition.Ìà ` àDr.€Joseph€C.€Boals,€a€board€certified€orthopedic€surgeon,€testified€byÏdeposition€after€seeing€the€plaintiff€one€time€for€an€independent€medical€evaluation.€ÏDr.€Boals€diagnosed€the€plaintiff€with€residuals€from€bilateral€carpal€tunnel€releaseÏsurgeries.€€He€opined€that€the€plaintiff€has€a€five€percent€anatomical€impairment€toÏeach€extremity.€€In€addition,€Dr.€Boals€diagnosed€the€plaintiff€with€severe€preexistingÏcervical€spondylosis€with€C5„C6€radiculopathy.€€He€opined€that€the€plaintiff€has€a€10Ïpercent€permanent€partial€impairment€to€the€body€as€a€whole€based€on€theÏradiculopathy.€€Dr.€Boals€stated€that€the€job€of€driving€a€truck€could€cause€orÏaggravate€the€plaintiffððs€problems€with€his€neck€and€hands.Ìò òÓ  ÓANALYSISó óà @¸ àÐ ´ô ÐÓP/Óà ` àThe€defendants€raise€the€issue€of€whether€the€trial€court€erred€in€awarding€theÏplaintiff€20€percent€impairment€to€the€body€as€a€whole€and€10€percent€impairment€toÏeach€arm.Ìà ` àThe€extent€of€vocational€disability€is€a€question€of€fact€to€be€determined€fromÏall€of€the€evidence,€including€lay€and€expert€testimony.€€òòWorthington€v.€Modine€Mfg.Ð ¼'ü#( ÐCo.,óó€798€S.W.2d€232,€234€(Tenn.€1990).€€Where€the€trial€judge€has€made€aÐ Œ)Ì%* Ðdetermination€based€upon€the€testimony€of€witnesses€whom€he€has€seen€and€heard,Ïgreat€deference€must€be€given€to€that€finding€in€determining€whether€the€evidenceÏpreponderates€against€the€trial€judgeððs€determination.€€òòSeeóó€òòHumphrey€v.€DavidÐ ô.4+0 ÐWitherspoon,€Inc.,€óó734€S.W.2d€315€(Tenn.€1987).Ð Ä0-2 Ðà ` àOur€review€of€the€expert€testimony€reveals€the€following.€€Dr.€Manugian€foundÏthat€the€plaintiff€had€no€permanent€impairment€from€his€arthritic€condition€or€carpalÏtunnel€syndrome.€€However,€Dr.€Manguian€did€state€that€the€job€of€driving€a€truckÏmight€aggravate€the€plaintiffððs€pain€or€make€his€symptoms€worse.€€Dr.€Boals€foundÏthat€he€sustained€a€10€percent€impairment€to€the€body€as€a€whole€as€a€result€of€hisÏarthritic€condition€and€a€five€percent€impairment€to€each€arm€as€a€result€of€his€carpalÐ ;Ð7> Ðtunnel€syndrome.€€Dr.€Boals€also€stated€that€the€job€of€driving€a€truck€could€cause€orÏaggravate€the€plaintiffððs€problems€with€his€neck€and€hands.€€Ìà ` àThe€defendants€argue€that€the€opinion€of€Dr.€Manugian,€the€treating€physician,Ïshould€be€accorded€greater€weight€than€the€opinion€of€Dr.€Boals,€who€only€saw€theÏplaintiff€one€time€for€an€independent€medical€evaluation.€€We€note€the€trial€court€hasÏthe€discretion€to€accept€the€opinion€of€one€medical€expert€over€another€medicalÏexpert.€€òòJohnson€v.€Midwesco,€Inc.,€óó801€S.W.2d€804,€806€(Tenn.€1990).Ð ˆÈ  Ðà ` àRegarding€the€lay€testimony,€the€plaintiff€testified€that€prior€to€the€July€8,€1996Ïwork€injury€to€his€neck,€arms,€and€hands€he€had€no€pain€or€difficulty€in€performing€hisÏwork.€€However,€since€being€diagnosed€with€carpal€tunnel€syndrome€and€an€arthriticÏcondition€and€undergoing€two€surgeries,€the€plaintiffððs€pain€has€increased€to€the€pointÏof€making€it€difficult€for€him€to€drive€and€grip€the€steering€wheel€in€his€job.€€In€thisÏcase,€as€in€all€workersðð€compensation€cases,€the€claimant's€own€assessment€of€herÏphysical€condition€and€resulting€disabilities€is€competent€testimony€and€cannot€beÏdisregarded.€òò€Tom€Still€Transfer€Co.€v.€Way,óó€482€S.W.2d€775,€777€(Tenn.€1972).Ð ì, Ðà ` àIn€making€determinations€of€vocational€disability,€the€court€shall€consider€allÏpertinent€factors,€including€lay€and€expert€testimony,€employeeððs€age,€education,Ïskills€and€training,€local€job€opportunities,€and€capacity€to€work€at€types€ofÏemployment€available€in€claimantððs€disabled€condition.€€Tenn.€Code€Ann.òò€ððóó€50„6„Ð  $` $ Ð241(a)(1);€òòRoberson€v.€Loretto€Casket€Co.,€óó722€S.W.2d€380,€384€(Tenn.€1986).€€OurÐ ì%,"& Ðreview€of€these€relevant€factors€shows€that€the€plaintiff€is€53€years€old,€has€someÏcollege€education,€and€has€worked€as€a€truck€driver€for€UPS€for€the€past€29€years.Ìà ` àWe€find€the€evidence€does€not€preponderate€against€the€findings€of€the€trialÏcourt€that€the€plaintiff€sustained€a€vocational€disability€of€20€percent€to€the€body€as€aÏwhole€because€of€the€neck€injury€and€a€vocational€disability€of€10€percent€to€eachÏarm€because€of€the€carpal€tunnel€syndrome.Ìà ` àRegarding€the€plaintiffððs€arthritic€condition,€the€defendants€contend€that€hisÏinjury€of€July€8,€1996€does€not€constitute€an€ð ðinjury€by€accidentðð€because€it€producedÏonly€an€increase€in€pain.Ìà ` àIn€our€view,€the€following€rules€of€law€settle€this€point:€€(1)€an€employer€isÏresponsible€for€workersðð€compensation€benefits,€even€though€the€employee€mayÏhave€been€suffering€from€a€serious€preexisting€condition€or€disability,€if€theÐ €;À7> Ðemployment€causes€an€actual€progression€or€aggravation€of€the€prior€disablingÏcondition€or€disease€which€produces€pain€that€is€disabling,€and€(2)€an€employer€takesÏan€employee€as€he€is€and€assumes€the€responsibility€of€him€having€a€preexistingÏcondition€aggravated€by€a€work€related€injury€which€might€not€affect€a€normal€person.€ÏòòHill€v.€Eagle€Bend€Mfg.,€Inc.,óó€942€S.W.2d€483,€488€(Tenn.€1997)€(citations€omitted).Ð ð 0 Ðà ` àIn€this€case,€the€plaintiff€suffered€a€work€related€injury€on€July€8,€1996€whichÏcaused€an€aggravation€of€his€preexisting€arthritic€condition€which€produced€disablingÏpain.€€Therefore,€we€find€that€the€preponderance€of€the€evidence€supports€the€trialÏcourtððs€finding€that€the€plaintiff€suffered€a€compensable€injury€by€accident.ÌÔ‡XH’XXXH’ÔÓÓÓÓà ` àÔ#†XH’XXXH’­B#ÔTenn.€Code€Ann.€ðð€50„6„207(3)(C)€limits€the€plaintiffððs€recovery€to€one€totalÐ ð0 Ðaward.€€This€section€states€in€pertinent€part:€€ð ðWhen€an€employee€sustainsÏconcurrent€injuries€resulting€in€concurrent€disabilities,€such€employee€shall€receiveÏcompensation€only€for€the€injury€which€produced€the€longest€period€of€disability.€.€.€.ððÌà ` àIn€òòCrump€v.€B€&€P€Const.€Co.,óó€703€S.W.2d€140€(Tenn.€1986),€the€SupremeÐ  ` ÐCourt€dealt€with€the€concurrent€injury€rule€established€by€Tenn.€Code€Ann.€ðð€50„6„¼207(3)(C)€and€held€that€concurrent€injuries€to€a€plaintiffððs€arm,€which€led€to€aÏpsychiatric€disability,€should€be€compensated€on€the€basis€of€the€injury€to€the€bodyÏas€a€whole€because€the€disabilities€arose€from€one€injury.Ìà ` àTenn.€Code€Ann.€ðð€50„6„207(3)(C)€applies€to€this€case€because€the€injury€toÏthe€plaintiffððs€neck€is€to€the€body€as€a€whole€and€the€injury€to€his€arms€should€be€toÏthe€body€as€a€whole€when€superimposed€on€his€neck€injury.ÌÓÞBÓÓÓà ` àThe€10%€disability€to€the€arm€and€the€20%€disability€to€the€body€as€a€whole,Ïwhen€combined€as€required€by€the€statute,€amount€to€30%€vocational€disability€to€theÏbody€as€a€whole.€€We,€therefore,€fix€this€as€the€award€in€the€case.Ìà ` àThe€cost€of€this€appeal€is€taxed€to€the€defendants.à  àÐ è.(+0 ÐÌÓÓà ` àà ¸ àà  àà h àà À àà  à_____________________________Ìà ` àà ¸ àà  àà h àà À àà  àJohn€K.€Byers,€Senior€JudgeÌÌCONCUR:ÌÌÌ________________________________ÌJanice€Holder,€JusticeÌÌÌ________________________________ÌF.€Lloyd€Tatum,€Senior€JudgeÐ  b<¢8? ÐÑ` ÀÑà@… … ÌàÔ‡»? »XXH’ÔIN€THE€SUPREME€COURT€OF€TENNESSEEˆÐ `  ÐÌà@îî)ÌàAT€JACKSONÔ#†XH’X »»?+J#ԈР|  ÐÌÌÓ-°,X…XDp X°œX-ÓWADDELL€GRAY,à  àà0 h àà0œh$h$à)à0Èœ$œ$àSHELBY€CIRCUITà Ð àÐVöÈ$È$ ÐÓ<°,X°D‚, X°,X…XDp X<Óà œ à)à È àNO.€€90431„5€T.D.€Ð <Ü ÐÓ<°,°Dp X°,X°D‚, X<Óà ` àPlaintiff/Appellee,à œ à)à È àÐ " Ðà ` àà œ à)à È àHon.€Kay€S.€Robilio,Ð ¨ Ðvs.à ` àà œ à)à È àJudgeÐ îŽ  Ðà ` àà œ à)ÌUNITED€PARCEL€SERVICE,€INC.,à0 œ à)à È àà x àкZ œ$œ$ ÐOHIO€d/b/a€UNITED€PARCEL€SERVICE€andà0 œ à)Р@ œ$œ$ ÐLIBERTY€MUTUAL€FIRE€INSURANCE€à0 œ à)І& œ$œ$ ÐCOMPANY,à œ à)à È àNO.€02S01„9808„CV„00081Ð l  Ðà ` àà œ à)Ìßx€Y_B2.jzÏI`  `€€@ÿEÿ` 8ttxP78Ç I xßà ` àDefendants/Appellants.à œ à)à È àMODIFIED€AND€AFFIRMEDÐ 8Ø ÐÌÌÌà@~~'ÌàÔ‡»? »XXH’ÔJUDGMENT€ORDERÔ#†XH’X »»?O#ԈРÐp ÐÌÓÓÓ  ÓÌÓ6°À°` p’X°,°Dp X6Óà ¸ àThis€case€is€before€the€Court€upon€the€entire€record,€including€the€orderÏof€referral€to€the€Special€Workers'€Compensation€Appeals€Panel,€and€the€Panel'sÏMemorandum€Opinion€setting€forth€its€findings€of€fact€and€conclusions€of€law,€which€areÏincorporated€herein€by€reference.Ìà ¸ àWhereupon,€it€appears€to€the€Court€that€the€Memorandum€Opinion€of€theÏPanel€should€be€accepted€and€approved;€andÌà ¸ àIt€is,€therefore,€ordered€that€the€Panel's€findings€of€fact€and€conclusionsÏof€law€are€adopted€and€affirmed,€and€the€decision€of€the€Panel€is€made€the€judgmentÏof€the€Court.Ìà ¸ àCosts€will€be€paid€by€Defendants/Appellants,€for€which€execution€mayÏissue€if€necessary.Ìà ¸ àIT€IS€SO€ORDERED€this€12th€day€of€October,€1999.ÌÌà ¸ àà È àà  àà x àà Ð àà (# à¼à ¸ àà È àPER€CURIAMÌÌÐ P<ð28 ЇÌ