ÿWPCØ .:?¶wYÖm”¢©:jÀì!~ïê(J†Õ«tDÇµ²ï~í_ÿÒâ—Bé_ƒeW¦áØ7Ý@ê–£C¦ãþ7&XÅ’ÿOFöÙ<Ö'!Äø:ÉƒuwYÕÜ©ãd5ìõx”¤ÉžÈŸ‡ÇÔ‰ÇŸ-;MüÒSv½ßxW\ôjäÿƒÚ›Ð^n°\{'tbÈnýú‰ ÈøÕ'os’{²¥§ý¾F«_£_ñj¡Ý¬ßæ”ìÁÚ5aû½‹¬á$aH¤xÞ½`^*Þ~;ÀqfIœeãÌ±w>T€VR UF~Ñ´Fs–^ÕWßg¾ÝªèUÎÂ“6Å†}Zv’Ó5®{m‰ ÛñÎ<9nO\›Â4”>û+ý>(Ð%õéM¨çu¼¥'\…5ØG.e!TY’e=ÊÃ£-<ñÚîTÜ|œ³k[rS¿;±Éœ‰ˆîgÂ†ºÝ'óCÉ^ÉÝ~ÉöH¤/«_›ì×ài8ßjb‹v‰•Pe¡Ë¦´û³ù¹#UN) %w 0û} U:x4²ÆtÕíIU:6pw‚x0?ú0D9U:}í·U:¤ÞUNÞÞ,,,,,,,,,,,,,,, B<<<<<< D3YYY0ŒŒŒŒŒŒŒŒŒŒŒŒŒ D+£££££££££££££££££££££££££££££££££££££££££££££££££££££££££££££££££££££ AOÎÆ0Dã D/' BVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV AYsÆÌ0F’˜HP LaserJet 4SiHPPCL5MS,ü,,,,,ü0nLhÎ(ÈhH Z‹6Times New Roman RegularX(ÓH=$¡¡Ñ ÑÒH°ÒÒ°ÒÑTR[ AØ'ÿ Legal[ AØ'ÿ Legal AØ'ÿ Legal AØ'ÿ LegalTÑÔ€XÎ_XXXÔÑ7€¾úXXdðXXdð7Ñ, øð AZ‹"Arial Regularyš&øð 3|xu jÝ ƒ Ny$ÝÒH°ÒÒ°ÒÔ€XèÔXXXÔà` àòòÚÚ1Ú ÚóóÝÝ€€The€trial€judge€entered€judgment€in€this€case€on€March€27,€1998€and€JuneÐ ° Ð11,€1998.€€On€October€30,€1998,€the€trial€judge€amended€the€judgment€to€provideÏthat€payments€be€made€until€the€plaintiff€reached€age€65.€€The€defendant€says€theÏtrial€court€had€no€authority€to€amend€the€order€after€30€days.€€We€find€no€need€to€goÏinto€this€because€the€amended€order€corrected€an€oversight€in€the€original€judgment.€ÏWe€would€have€entered€this€judgment€if€the€trial€judge€had€not. ãÔ€XèÔXXXÔÔ€èÝèXXèÔÔÔAdÔÓÓFILEDÔ€òèèÝÔÐ ÐÌòòAugust€19,€1999Ð ÐÌCecil€Crowson,€Jr.ÌAppellate€CourtÏClerkóó,c½¬AZ‹"Arial RegularñteòtÓ€ýtVþt8UÿtUu&UuDuDuDuDu Du Du Du u u‚uDuD uÓ€uVuî(ï(3Ny$¤¤Ý ƒH=!ÝÑ ÑÒH°ÒÒ°ÒÑTR[¤ AØ'ÿ Legal3Ø' AØ'ÿ Legalÿ3Ø'TÑÔ€XèÔXXXÔÑ7€oXXdìdì7ÑÝÝà` àòòÚÚ0Ú Úóó(%Ã$òòÚÚ1Ú Úóó,c½¬AZ‹"Arial Regular ãÔ€XèÔXXXÔÔ€èÝèXXèÔÔÔAdÔÓÓFILEDÔ€òèèÝÔÐ ÐÌòòAugust€19,€1999Ð ÐÌCecil€Crowson,€Jr.ÌAppellate€CourtÏClerkóó,c½¬AZ‹"Arial Regular(ÈhH Z6Times New Roman Regular Ô‡XèÔXXXÔÔ‡èÝèXXèÔÔÔAdÔÓÓFILEDÔ#†XèÔXèèÝ#ÔÔ‡òXXèÔÔÐ ÐÌòòAugust€19,€1999Ð ÐÌCecil€Crowson,€Jr.ÌAppellate€CourtÏClerkóód$$$$'ÿÿdxd(ï3¸Ø$££Ý ƒH=!ÝÑ ÑÒH°ÒÒ°ÒÑTR[¤ AØ'ÿ Legal3Ø' AØ'ÿ Legalÿ3Ø'TÑÔ€XèÔXXXÔÑ7€oXXdìdì7ÑÝÝ'ÈÈÈÈdxd€-‚ƒCþÿ<< CÿÿƒLevel 1Level 2Level 3Level 4Level 5($$””òòÚÚ1Ú Úóó„„'÷ÿdxdüÿPPd·-¸:Müÿ << deUU…Level 1Level 2Level 3Level 4Level 5(n$––òò(ÚÚ1Ú Ú)óóÝ ƒH=!ÝÑ ÑÒH°ÒÒ°ÒÑTR[¤ AØ'ÿ Legal3Ø' AØ'ÿ Legalÿ3Ø'TÑÔ€XèÔXXXÔÑ7€oXXdìdÈ7ÑÝÝññtñ›ññtñññtññëtñ›ñëtñññtñÑÑÔ€ XèÔXXXèÔÔÓÓœñuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññþtñÌñþtññuññuñ›ñuññuññÿtñÌÌÌñÿtññþtñÌñþtññuññÿtñ›ñÿtññuññþtñÌñþtññuññÿtñ›ñÿtññuññþtñÌñþtññuññÿtñ›ñÿtññuññþtñÌñþtññuññÿtñ›ñÿtññuññþtñÌñþtññuññÿtñ›ñÿtññuññþtñÌñþtññuññÿtñ›ñÿtññuññþtñÌñþtññuññÿtñ›ñÿtññuññþtñÌñþtññuññÿtñ›ñÿtññuññþtñÌñþtññuññÿtñ›ñÿtññuññþtñÌñþtññuññÿtñ›ñÿtññuññþtñÌñþtññuññÿtñ›ñÿtññuññþtñÌñþtññuññÿtñ›ñÿtññuññþtñÌñþtññuññÿtñ›ñÿtññuññþtñÌñþtññuññÿtñ›ñÿtññuññþtñÌñþtññuññÿtñ›ñÿtññuññþtñÌñþtññuññÿtñ›ñÿtññuññuñÌñuññuññuññuñÌÌÌñuññuññuññuñÌÌñuññuññuññþtñÌñþtññuññÿtñ›ñÿtññuññþtñÌñþtññuññÿtñ›ñÿtññuññþtñÌñþtññuññþtñ›ñþtññuññþtñÌñþtñ›à@@Ü Ü ÌàñuñòòIN›€THE€SUPREME€COURT€OF€TENNESSEEÐ ° Ðñ uñœßl€*6&"h 8 `€€Extt06°œ¨çlß›â °°$$âñ uñà@@BBÌàSPECIAL€WORKERS'€COMPENSATION€APPEALS€PANELÌñòtñœñòtññ uññòtñßl€ *6&"h 8 `€€ExŽtt06°ˆ¨ìlßñòtññ uññ uññ uñßn€ *8($hx' `€€EŸŽtt06×ˆ¨ìnßñ uññ uññuññýtñÐ ˆØO Ðñýtñ›à@@ˆˆÌàñuñAT›€KNOXVILLEóóÐ ˆØ ÐÓ9ÓÌÌÌœñuñÌ›Ìñuñ›ÌÌGLENDA€JOHNSON,àhààÀààà)àpàÐ òB Ðâ $$°°âà` àà¸ààààhààÀààà)àpàHAMILTON€CHANCERYÐ Ø( Ðà` àPlaintiff/AppelleeàhààÀààà)àpàÐ ¾ Ðà` àà¸ààààhààÀààà)àpàÐ ¤ô Ðv.à` àà¸ààààhààÀààà)àpàÔ‡XèÔXX XèÔÔNO.€03S01„9803„CH„00031Ô#† XèÔXXXèÔ.#ÔÐ ŠÚ Ðà` àà¸ààààhààÀààà)àpàÐ pÀ ÐÔ‡XèÔXX XèÔÔNORTH€PARK€HOSPITALàÀààà)Ð V¦ Ðà` àà¸ààààhààÀààà)àpàHON.€R.€ññtñœññtñVANNññtñ›ññtñ€OWENS,Ð <Œ Ðà` àDefendant/AppellantàÀà€àà)àpàÔ#† XèÔXXXèÔ#ÔÔ‡XèÔXX XèÔÔCHANCELLORÐ "r ÐÌÌÌÌÌòòòòÌÌFor€the€Appellant:àààhààÀàààFor€the€Appellee:Ð ^® ÐóóóóÌJoseph€C.€Wilson,€IIIàhààÀàààRonald€J.€BerkeÐ 0€ ÐSpears,€Moore,€Rebman€&€WilliamsààBerke,€Berke€&€BerkeÐ f ÐP.O.€Box€1749àààhààÀàààSuite€1230€Volunteer€BuildingÐ üL ÐChattanooga,€TN€€37401„1749àÀààà832€Georgia€AvenueÐ â2 Ðòòòòà` àà¸ààààhààÀàààóóóóChattanooga,€TN€€37402òòòòÐ È ÐÌÌÌÌÌÓÓÌÌM€E€M€O€R€A€N€D€U€M€€€€O€P€I€N€I€O€NóóóóÐ "'r"& ÐÌòòòòMembers€of€Panel:Ð ô(D$( ÐÌóóóóJustice€Frank€F.€Drowota,€IIIÐ Ì*&* ÐSenior€Judge€John€K.€ByersÌSpecial€Judge€Roger€E.€ThayerÌÓ ÓÌÌÌÌÌÌÌÌÌÌÌÌÌÌAFFIRMEDÔ#† XèÔXXXèÔa#ÔÔ‡XèÔXX XèÔÔà¸ààààhààÀààààpàBYERS,€Senior€JudgeÐ :b5; ÐÌòòòòÓÓÓÓOPINIONóóóóÐ Þ;.7=( ÐÓÓà` 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€of€factÏand€conclusions€of€law.€ÌÔ#† XèÔXXXèÔU#ÔÔ‡XèÔXX XèÔÔà` àReview€of€the€findings€of€fact€made€by€the€trial€court€is€òòde€novoóó€upon€the€recordÐ à0 Ðof€the€trial€court,€accompanied€by€a€presumption€of€the€correctness€of€the€findings,Ïunless€the€preponderance€of€the€evidence€is€otherwise.€€Tenn.€Code€Ann.€€ðð€50„6„¼225(e)(2);€òòStone€v.€City€of€McMinnville,€óó896€S.W.2d€548,€550€(Tenn.€1995).€€TheÐ H˜ Ðapplication€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 ä4 ÐCorcoran€v.€Foster€Auto€GMC,€Inc.,€óó746€S.W.2d€452,€456€(Tenn.€1988).Ô#† XèÔXXXèÔy#ÔÔ‡XèÔXX XèÔÔÐ ´ Ðà` àThe€trial€judge€found€the€plaintiff€to€be€permanently€disabled€and€orderedÏpayments€to€be€made€until€the€plaintiff€reaches€the€age€of€65€years.Ìà` àThis€case€has€some€convoluted€proceedings€in€the€trial€court,€as€well€as€in€theÏfiling€of€the€appeal.€€However,€the€essential€matters€for€us€to€determine€are€whether€theÏtrial€judgeððs€finding€that€the€plaintiff€suffered€permanent€vocational€disability€and€whetherÏthe€trial€court€properly€ordered€the€defendant€to€pay€a€medical€bill€in€the€amount€ofÏ$7,084.60.×ƒ×Ý ƒ%ÃÝòòÚÚ1Ú ÚóóÝÝ× ×Ð L#œ" Ðà` àWe€affirm€the€judgment€of€the€trial€court.ÌòòÓÓFACTSóóÐ ä&4"& ÐÓ6Óà` àThe€plaintiff,€age€55€at€the€time€of€trial,€received€her€LPN€licensure€in€1974€andÏher€RN€licensure€in€1989.€€She€also€took€nursing€courses€at€U.T.€towards€a€B.S.€degree.€ÏShe€held€nursing€positions€in€several€hospitals€throughout€the€years.Ìà` àOn€June€1,€1993,€she€began€working€for€the€defendant€as€a€home€health€careÏnurse.€€Her€job€required€her€to€keep€supplies€in€her€car€for€emergencies,€to€carry€a€largeÏbag€on€her€shoulders€into€the€patientsðð€homes,€and€to€roll€over€or€pull€patients.€€OnÏNovember€26,€1993,€she€was€traveling€from€a€patientððs€home€when€she€was€in€an€autoÐ „3Ô.4 Ðaccident.€€The€plaintiff€returned€to€work€on€December€13,€1993,€but€that€night€she€wasÏin€tremendous€pain.€€She€has€not€worked€since€that€time€because€she€does€not€feel€ableÏto€work.Ìà` àThe€plaintiff€saw€a€series€of€doctors€for€her€complaints€after€the€auto€accident.€ÏDr.€J.€Eugene€Huffstutter€diagnosed€her€with€fibromyalgia.€€Sometime€after€seeing€Dr.ÏññtñœññtñPeter€Boehm,ññtñ›ññtñ€the€plaintiff€had€to€go€to€the€ER€because€of€severe€chest€and€head€pains.€ÏThe€defendant€had€been€paying€her€medical€bills€prior€to€this€but€stopped€after€the€ERÏvisit.€€The€plaintiff€testified€that€she€had€to€get€loans€from€her€mother€and€ex„husbandÏin€order€to€live.Ìà` àPrior€to€the€auto€accident,€the€plaintiff€played€tennis,€cleaned€house,€worked€inÏthe€garden,€and€ran.€€The€plaintiff€and€several€other€witnesses,€including€relatives€andÏfriends,€testified€that€since€the€auto€accident€she€lacks€stamina,€has€sleep€problems,Ïcries€frequently,€feels€depressed,€and€is€less€outgoing.€€The€plaintiff€testified€that€sheÏstill€has€pain€in€her€muscles€in€her€knees,€feet,€hands,€shoulders,€hips,€neck,€and€spineÏand€that€she€still€has€migraines.€€€ÌÔ#† XèÔXXXèÔM#ÔÔ‡XèÔXX XèÔÔòòÓÓMEDICAL€EVIDENCEóóÐ ¤ô ÐÓ«#Óòòà` àóóDr.€David€B.€Dodson,€a€board€certified€internal€medicine€specialist,€testified€byÐ |!Ì Ðdeposition.€€Dr.€Dodson€has€been€the€plaintiffððs€doctor€since€1982.€€After€the€NovemberÏ26,€1993€auto€accident,€Dr.€Dodson€first€saw€the€plaintiff€on€December€3,€1993.€€At€thatÏtime,€she€was€suffering€from€neck€problems€and€muscle€spasms€between€her€shoulderÏblades€and€later€her€left€shoulder€and€right€hip€began€hurting.€€Dr.€Dodson€reviewed€x„¼rays€from€the€date€of€the€accident,€but€they€showed€no€evidence€of€acute€injury.€€HeÏordered€a€bone€scan€and€MRIs€of€the€cervical,€thoracic,€and€lumbar€spines.€€To€aÏreasonable€degree€of€medical€certainty,€Dr.€Dodson€testified€that€the€trauma€of€the€autoÏaccident€caused€the€plaintiff€to€have€fibromyalgia.€€He€explained€that€ð ðthe€relationshipÏof€her€injury€to€the€onset€of€her€symptoms€would€indicate€that€her€motor€vehicle€accidentÏwas€a€precipitating€factor€as€she€did€not€have€those€symptoms€before.ðð€€He€pointed€out,Ïhowever,€that€no€one€knows€exactly€what€causes€fibromyalgia.€€Ô#† XèÔXXXèÔ‰##ÔÔ‡XèÔXX XèÔÔAs€of€June€27,€1996,€Dr.Ð @506 Ðâ âDodson€testified€that€she€was€unable€to€work.€€He€offered€no€opinion€as€to€anyÐ 7\28 Ðimpairment€that€the€plaintiff€might€have,€but€he€did€feel€that€her€condition€is€permanent.€ÏDr.€Dodson€disclaimed€expertise€in€medical€impairment€ratings.Ô#† XèÔXXXèÔ6(#ÔÔ‡XèÔXX XèÔÔÐ |Ì Ðâ âà` àDr.€Richard€Pearce,€a€spine€specialist,€testified€by€deposition.€€Dr.€Pearce€firstÏsaw€the€plaintiff€on€January€10,€1994.€€Upon€review€of€the€bone€scan,€he€found€arthriticÏchanges€but€no€evidence€of€ð ðany€increased€abnormal€uptake€in€her€skeleton.ðð€€HeÏopined€that€these€changes€were€not€caused€by€the€auto€accident.€€His€review€of€the€MRIÏof€the€thoracic€spine€showed€no€abnormalities,€but€his€review€of€the€MRI€of€the€cervicalÏspine€showed€a€degenerative/arthritic€spur€and€small€disc€herniation€at€the€C4„C5€level.€ÏHe€stated€that€the€spur€would€have€been€developing€prior€to€the€auto€accident€and€thatÏthere€was€no€way€to€know€whether€the€herniation€was€present€prior€to€the€auto€accident.€ÏDr.€Pearceððs€clinical€examination€revealed€a€strain€of€her€thoracic€spine.€€He€believedÏthat€her€symptoms€from€the€auto€accident€related€to€strained€muscles€and€ligaments€inÏher€upper€back€and€the€base€of€her€neck.€€After€a€March€17,€1994€visit,€Dr.€PearceÏordered€an€MRI€of€her€shoulder.€€Although€the€MRI€was€normal,€he€referred€her€to€Dr.ÏPerkins€because€of€her€continuing€complaints.€€Dr.€Pearce€last€saw€the€plaintiff€onÏAugust€31,€1995€and€performed€a€repeat€examination€and€x„rays.€€At€this€time,€hisÏclinical€impression€was€ð ðdiffused€spinal€pain,€complaints€most€likely€related€to€soft€tissueÏinjury€versus€her€fibromyalgia.ðð€€He€recommended€that€she€be€seen€by€a€neurologist€andÏcontinue€her€treatment€by€Dr.€Huffstutter€for€fibromyalgia.€€Dr.€Pearce€found€that€theÏplaintiff€reached€maximum€medical€improvement€on€June€8,€1995€and€gave€her€a€5Ïpercent€permanent€partial€impairment€to€the€whole€person€based€on€the€muscle€andÏligament€strains.€€This€impairment€rating€did€not€take€into€account€the€plaintiffððsÏfibromyalgia.€€He€offered€no€opinion€on€restrictions,€but€he€did€recommend€that€she€doÏoffice€or€desk€work.€€€€€€€Ìòòà` àóóThe€medical€records€of€Dr.€Thornton€Perkins,€an€orthopedic€surgeon,€wereÐ Ð/ +0 Ðintroduced€into€evidence.€€Upon€a€referral€from€Dr.€Dodson€and€Dr.€Pearce,€Dr.€PerkinsÏfirst€saw€the€plaintiff€on€May€9,€1994.€€In€his€examinations,€he€found€no€objectiveÏevidence€of€injury€but€felt€her€discomfort€was€genuine.€€Dr.€Perkins€indicated€that€sheÏhad€right€trochanteric€bursitis€secondary€to€direct€trauma,€bilateral€tendinitis€of€theÏshoulder,€worse€on€the€left.€€He€encouraged€her€to€return€to€work€even€on€a€half€dayÐ Ì84: Ðbasis.€€On€July€12,€1994,€he€ordered€a€repeat€of€her€bone€scan.€€He€recommended€thatÏshe€submit€to€psychological€testing€and€interviewing,€but€she€was€resistant€to€theÏsuggestion.€€Dr.€Perkins€also€recommended€treatment€for€fibromyositis.€€€Ìà` àDr.€J.€Eugene€Huffstutter,€a€rheumatologist,€testified€by€deposition.€€On€AugustÏ30,€1994,€Dr.€Huffstutter€diagnosed€the€plaintiff€as€having€ð ðfibrositis€or€soft€tissueÏrheumatism.ðð€€He€defined€fibromyalgia/€fibrositis€as€follows:€€ð ðIt€is€a€chronic€painfulÏcondition.€€It€is€a€collection€of€symptoms.€€A€syndrome€that€produces€pain.€€The€patientsÏwill€complain€of€weakness,€poor€sleep€habits.€€Many€of€these€patients€can€get€depressedÏbecause€they€hurt€and€it€interferes€with€their€activities€of€normal€living.ðð€€The€plaintiffððsÏtreatment€included€the€administration€of€muscle€relaxants€and€antidepressantÏmedication.€€Dr.€Huffstutter€last€saw€her€on€April€3,€1995€and€she€continued€to€be€quiteÏsymptomatic.€€AlthoughÔ#† XèÔXXXèÔ¬)#ÔÔ‡XèÔXX XèÔÔ€he€pointed€out€that€fibromyalgia€is€a€disease€of€unknownÐ tÄ Ðetiology,€heÔ#† XèÔXXXèÔ[7#ÔÔ‡XèÔXX XèÔÔ€testified€that€the€plaintiffððs€auto€accident€ð ðmay€have€caused€her€to€becomeÐ @ Ðsymptomatic€where€she€wasnððt€symptomatic€beforeðð€and€that€the€auto€accident€ð ðwas€aÏprecipitating€factor€which€unmasked€her€symptoms.ðð€€Regarding€impairment€forÏfibromyalgia,€Dr.€Huffstutter€stated€that€such€patients€ð ðhave€no€impairments€caused€byÏthe€fibromyalgia€syndrome.ðð€€With€respect€to€restrictions€secondary€to€fibromyalgia,€Dr.ÏHuffstutter€stated€that€he€does€not€give€formal€work€restrictions€but€allows€patients€to€doÏas€much€as€possible€while€setting€their€own€limits.€€Ìà` àThe€medical€records€of€Dr.€Peter€Boehm,€a€neurosurgeon,€were€introduced€intoÏevidence.€€Upon€a€referral€from€Dr.€Pearce,€Dr.€Boehm€evaluated€the€plaintiff€on€MarchÏ21,€1995.€€He€detected€no€reflex€changes,€no€atrophy,€and€no€motor€deficit,€but€he€didÏfind€subjective€symptoms.€€His€impression€was€that€the€plaintiff€had€ð ðmid€thoracic€painÏrepresenting€probable€€thoracic€strainðð€and€ð ðcervical€disc€and€joint€disease€withÏsuperimposed€recent€cervical€strain.ððÌà` àThe€medical€records€of€Dr.€Bruce€Kaplan,€a€neurologist,€were€also€introduced€intoÏevidence.€€Dr.€Kaplan€saw€the€plaintiff€on€October€9,€1995€and€found€that€she€wasÏð ðneurologically€normal.ðð€€He€recommended€a€yoga€program€and€ð ðurged€patience€andÏemphasized€that€there€is€no€evidence€of€any€serious€underlying€pathology.ðð€€He€alsoÏmade€the€following€findings:€€ð ðThere€is€no€indication€of€cervical€radiculopathy€at€any€levelÐ Ì84: Ðnor€of€mid„thoracic€paraspinal€denervation€in€her€area€of€maximum€discomfort.€€ThereÏis€no€indication€of€carpal€tunnel€syndrome€or€other€median€neuropathy€as€alternativeÏexplanations€for€the€numbness€she€experiences€in€her€hand.ððÌà` àDr.€Walter€King€testified€by€deposition.€€Dr.€King€saw€the€plaintiff€for€anÏindependent€medical€evaluation€on€June€19,€1997€at€the€request€of€her€attorney.€€WithÏrespect€to€medical€impairment€and€disability,€Dr.€King€made€the€following€opinion:ÌÒ` ÒÓÓI€thought€she€had€cervical€and€lumbar€strain,€strain€of€the€right€lower€extremity.€ÏNoted€there€was€fibromyalgia€that€was€brought€on€by€this€accident€andÏosteoporosis€secondarily.€€At€the€time,€I€thought€she€had€a€21€percent€wholeÏbody€impairment€secondary€to€injuries€received€in€the€stated€accident.€€TheseÏwere€according€to€the€AMA€Guidelines€and€felt€to€be€permanent.€€There€is€aÏfunctional€capacity€evaluation,€states€she€might€be€able€to€return€to€some€kindÏof€administrative€position.€€I€didnððt€feel€that€she€could€return€to€her€originalÏposition.€€I€released€her€to€light„duty€work€per€the€functional€capacity€evaluation.€Ï€ÌÒ` @ÒÓ @ÓDr.€King€explained€that€fÔ#† XèÔXXXèÔ÷7#ÔÔ‡XèÔXX XèÔÔibromyalgia€is€not€specifically€covered€by€the€òòAMA€Guidesóó,€soÐ ŽÞ Ðhis€€impairment€rating€refers€to€the€pain€and€loss€of€range€of€motion€sections€of€the€òòAMAÐ ^® ÐGuides.óóÔ#† XèÔXXXèÔC#ÔÔ‡XèÔXX XèÔÔ€€To€a€reasonable€degree€of€medical€certainty,€Dr.€King€testified€that€the€autoÐ .~ Ðaccident€either€caused€the€plaintiffððs€problems€or€aggravated€a€preexisting€conditionÏcausing€those€problems.€€Ìà` àÔ#† XèÔXXXèÔ'D#ÔÔ‡XèÔXX XèÔÔAndrew€L.€Marini,€a€physical€therapist,€did€a€functional€capacity€evaluation.€€TheÐ – æ ÐOctober€29,€1996€evaluation€stated€the€following€about€the€plaintiff:€€ÌÒ` ÒÓÓthe€patient€should€be€able€to€sit€between€eight€and€ten€hours€an€day€withÏpositional€changes€every€two€to€four€hours.€€She€should€be€able€to€stand€four€toÏfive€hours€per€day,€and€continuously€for€20€minutes.€€She€is€able€to€ambulate€forÏten€minutes€at€1.2€miles€per€hour€continuously€and€should€be€able€to€ambulateÏshort€distances€over€a€four„€to€five„hour€time€frame.€€Alternating€sit€to€standÏappears€to€be€her€most€compatible€position€in€an€eight„€to€ten„hour€work€day.ÌÌÒ` FÒÓ(FÓThe€evaluation€also€stated€that€ð ðshe€does€qualify€for€an€occupational€categorization€ofÏððlightðð.ððÔ#† XèÔXXXèÔLE#ÔÔ‡XèÔXX XèÔÔ€Ð D,”', ÐòòÓÓCAUSATION€AND€DISABILITY€AWARDóóÐ .`). ÐÓIÓà` àThe€trial€judge€had€before€him€the€testimony€and€medical€records€of€theÏphysicians,€as€well€as€a€report€of€a€physical€therapist.€€The€findings€of€the€experts€areÏset€out€above€and€they€encompass€opinions€about€the€cause€of€the€plaintiffððs€condition,Ïwhich€appears€most€obviously€to€be€fibromyalgia,€and€its€relationship€to€the€injury.Ìà` àThere€were€various€views€expressed€concerning€the€medical€impairment€rating.€ÏDr.€Pearce€found€the€plaintiff€had€a€5€percent€partial€permanent€impairment€to€the€bodyÐ ä844: Ðas€a€whole.€€He€did€not,€however,€relate€any€impairment€for€the€fibromyalgia.€€Dr.€KingÏfound€the€plaintiff€suffered€a€21€percent€medical€impairment€to€the€body€as€a€whole.Ìà` àThe€trial€judge€may€accept€the€testimony€of€one€or€more€expert€witnesses€overÏthat€of€others.€€òòKellerman€v.€Food€ññtñœññtñLion,ññtñ›ññtñ€Inc.,óó€929€S.W.2d€333€(Tenn.€1996).€€Obviously,Ð d Ðthe€trial€judge€accepted€the€opinion€of€Dr.€King€as€to€the€amount€of€impairment.€€Further,ÏDr.€Huffstutter€testified€the€auto€accident€ð ðmay€have€caused€[the€plaintiff]€to€becomeÏsymptomatic€where€she€wasnððt€symptomatic€beforeðð€and€ð ðwas€a€precipitating€factorÏwhich€unmasked€her€symptoms.ðð€€Ô#† XèÔXXXèÔÌH#ÔÔ‡XèÔXX XèÔÔHe€further€testified€there€is€no€impairment€fromÐ H˜ Ðfibromyalgia€syndrome.Ìà` àIn€addition€to€the€expert€witnesses,€the€trial€judge€heard€testimony€from€theÏplaintiff€and€other€lay€witnesses,€who€described€the€lack€of€ability€the€plaintiff€now€suffersÏin€doing€tasks€and€hobbies€she€did€before.Ìà` àWe€find€the€record€supports€the€findings€of€the€trial€judge€on€the€matter€ofÏcausation€and€on€the€award€of€total€permanent€disability.€€Further,€the€order€of€the€trialÏjudge€on€October€30,€1998,€which€orders€the€defendant€to€pay€compensation€until€ageÏ65€is€in€accordance€with€Tenn.€Code€Ann.€ðð€50„6„207(4)(A)(I).€€And€if€the€trial€judge€hadÏno€authority€to€make€such€amendment,€we€approve€the€order€and€would€have€amendedÏthe€order€to€conform€to€the€statute.ÌòòÓÓMEDICAL€BILLSóóÐ %\ $ ÐÓšQÓà` àThe€defendant€raises€questions€about€the€manner€in€which€the€Clerk€and€MasterÏfiled€a€report€on€medical€bills€in€response€to€a€referral€from€the€trial€court.€€As€we€readÏthe€record,€counsel€for€the€plaintiff€and€the€defendant€agreed€to€the€manner€ofÏestablishing€the€amount€of€medical€bills€incurred€by€the€plaintiff€for€treatment€of€herÏinjuries.Ìà` àThe€defendant€further€complains€that€the€treatment€encompassed€in€the€medicalÏbill€of€$7,084.60€was€for€treatment€of€angina.€€Dr.€Dodson€testified€that€the€treatment€forÏthe€heart€problem€was€a€result€of€a€not€unexpected€side€effect€to€the€medication€givenÏthe€plaintiff€to€treat€her€injuries€from€the€accident.€€Based€upon€this,€we€find€the€trialÏjudge€properly€ordered€the€defendant€to€pay€the€bill.Ìà` àThe€cost€of€this€appeal€is€taxed€to€the€defendant.€Ð Ü8,4: Ð‡à` àà¸ààààhàÓÓàÀààààpà_____________________________Ìà` àà¸ààààhààÀààààpàJohn€K.€Byers,€Senior€JudgeÌÌÌÌCONCUR:ÌÌÌÌ________________________________ÌFrank€F.€Drowota,€III,€JusticeÌÌÌÌ________________________________ÌRoger€E.€Thayer,€Special€œJudgeñuñÐ *z ÐñuññuñÒ` ÒÔ#† XèÔXXXèÔ]N#ÔÔ‡Xmþ XX XèÔÔÌßn€*8($hxóR `€€Ekòtt06£ ¨8nßâ ` £` £` $` $âÌà@nnàIN€THE€SUPREME€COURT€OF€TENNESSEE€ˆÌà@##$àAT€KNOXVILLEˆÌà¸ààààhààÀààààpààÈàà ààxàÌÌà¸ààààhààÀààà€€€àpàÐ P Ðààà°àààà` àààà` àà¸ààààhààÀààààpààÈàÌGLENDA€JOHNSONàÀà€€€€€€€€€€€€€€€€€)€€€€€HAMILTONÐ 0€ Ðâ ` $` $` £` £âCHANCERY€àààhààÀààààpà€€€€€àÈà€€€€€)à àNo.€95„697Ð p ÐÒ HÒ€€à¸àPlaintiff„Appellee,àÀà€€€€€€€àà€€€€€)àpààÈàà ààxààÐ àÐ ` ÐÓ àœX°œXÓà¸ààààhààÀààà€€€€€)àpàNo.€03S01„9803„CH„00031àÐ àÐ P Ðv.à¸ààààhààÀàà0à€€€€€)Ðð@8"8" Ðà¸ààààhààÀààà€€€€€)àpààÈàà ààxà€€€€€€€€€€€€€€€€€Ð à0 ÐNORTH€PARK€HOSPITALàÀààà€€€€€)Ð Ð Ðà¸ààààhààÀààà€€€€€)àpà€€€Ð À Ðà¸àDefendant„Appellant€àÀà€€€€€€€€€€€€€€€€€)Ð ° Ðà¸àÌà¸ààà€€€€€àhààÀààààpààÈà€€€€€Ð à Ð€€€€à¸ààààhà€€€€€€€€€àÀà€€€€€€€€€€Ð €Ð ÐÌà¸ààààhà€€€€€€€€JUDGMENT€ORDERÌÌÓ€Óà¸à€This€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,Ïwhich€are€incorporated€herein€by€reference;ÌÌà¸àWhereupon,€it€appears€to€the€Court€that€the€memorandum€Opinion€of€theÏPanel€should€be€accepted€and€approved;€andÌÌà¸àIt€is,€therefore,€ordered€that€the€Panel's€findings€of€facts€and€conclusionsÏof€law€are€adopted€and€affirmed€and€the€decision€of€the€Panel€is€made€theÏJudgment€of€the€Court.ÌÌà¸àCosts€on€appeal€are€taxed€to€the€defendant,€North€Park€Hospital€andÏJoseph€C.€Wilson,€III,€surety,€for€which€execution€may€issue€if€necessary.€Ì€€€€€€08/19/99Ô#† XèÔX XXmþW#ÔñuññuñÔ#† XèÔXXXèÔjN#Ôñuñ›Ð ð-@)3 Ðà¸à€