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GWGW Ad   FILEDR   June23,1999  CecilCrowson,Jr.AppellateCourtClerk ,kAZ"Arial Regular "GW""GW Ad   FILED#"GW"#"R"GW   June23,1999  CecilCrowson,Jr.AppellateCourtClerk ,cAZ"Arial Regular PED D!D"U#Ӏy&T d%%%%'dxd(f3f'$ !n!n!n!   'dxd-C<< CLevel 1Level 2Level 3Level 4Level 5($$   1  ' dxdP Pd-:M << deUULevel 1Level 2Level 3Level 4Level 5(n$ (  1  ) !222   TR[A'3'A' Legal3'TX  3 P p x (#X3XX2  #l*6&"h 8 `E tt06Hl HH(#(##INTHESUPREMECOURTOFTENNESSEE  SPECIALWORKERSXXXX!=!XXXXԀCOMPENSATIONAPPEALSPANEL  ATKNOXVILLE ""   (#(#HHERICK.MACK  ) p ANDERSONCOUNTYCIRCUIT   P   ) p  xp   P PlaintiffAppellee,  ) p  h`   P   ) p  XP  vs. P   ) p NO.03S019805CV00052 H@   P   ) p  80  CNAINSURANCECOMPANY  ) p THEHONORABLE (   P   ) p JAMESB.SCOTT,JR.,JUDGE   P   ) P DefendantAppellant.  )  &  FortheAppellant:   p FortheAppellee: ' xp LindaJ.HamiltonMowles   p BruceD.Fox X P Lewis,King,Krieg,Waldrop&   p Ridenour,Ridenour&Fox H!@ ЀCathron,P.C.   p P.O.Box530 8"0 OneCentreSquare,FifthFloor   p Clinton,Tennessee377170530 (#  620MarketStreetPOBox2425Knoxville,TN37901  MailedApril____,1999&  MEMORANDUMOPINION  h.`'*   '*  MembersofPanel:  810*- JusticeWilliamM.BarkerSpecialJudgeHowellN.PeoplesSpecialJudgeJoeC.Loser,Jr.   :37 Ї&  AFFIRMEDandREMANDED   p   PEOPLES,SpecialJudge    '  &      OPINION        '    P ThisworkersXXXX=XXXXԀcompensationappealhasbeenreferredtotheSpecialWorkersXXXX=XXXX  CompensationAppealsPaneloftheSupremeCourtinaccordancewithTennesseeCodeAnnotatedSection506225(e)(3)forhearingandreportingtotheSupremeCourtoffindingsoffactandconclusionsoflaw. P Thetrialcourtfoundthattheplaintiffsustainedaworkrelatedinjuryandawardedbenefitsforpermanentpartialdisabilityintheamountof85percenttotherightfoot.Theemployerhasappealedandassignsaserror(1)theamountoftheaward,(2)thefindingthattreatmentrenderedmorethanayearaftertheinjurywascausallyrelatedtotheaccident,and(3)theallowanceoftheexpenseoftreatmentbyDr.JamesA.Engblom.Forthereasonshereaftersetforth,weaffirmthejudgmentofthetrialcourt. P Theplaintiff,EricK.Mack,graduatedfromClintonHighSchoolin1987.Hehasworkedfor(1)MooreXXXX=XXXXsBuildingSupply,loadingtrucksandcarryingbuildingsupplies;(2) (#  HaroldBarnesConstruction,framinghouses;and(3)JamesRidenour,erectingsteelbuildings.Healsoworkedasameatcutterforafewmonths.HebeganworkingforClaytonHomesin1994wherehisjobinvolvedbuildingsidewallsofhouses.InJune1995,hetrippedonanIbeamwhichwasconcealedbyinsulationandinjuredhisrightfoot.Hereportedtheinjurytohisteamleader,MarkBradenandanothersupervisor,BobKeller.TheyassistedhimtothetoolroomandsenthimtoMcNeeleyXXXX=XXXXsMedicalClinictoseek h.`'* treatment.Dr.TrentMcNeeleytookxraysandreferredMr.MacktoDr.EdwardKahn,anorthopedicsurgeon.Dr.Kahnputawalkingcastontheinjuredfootandsenthimbacktoworkthenextday.Approximatelyonemonthlater,thecastwasremovedandwhenMr.Mackcomplainedofpain,Dr.Kahntoldhimhisfootwasjustsorefrombeinginthecastandreleasedhimfromfurthertreatment.InNovember1995,whileatwork,Mr.Macksteppedonapileofhosesandhadincreasedpaininhisfootatthesamelocationwherehehad 926 experiencedpainsincetheJune1995accident.HereportedthistohissupervisorandwasreferredtoDr.SearsatKnoxvilleOrthopedicClinic.Dr.Searstriedcustommoldedarchsupportsand,whenthatdidnotwork,referredhimtoDr.McPeakeatthesameclinic.Dr.McPeaketriedantiinflammatorymedicationandconservativetreatmentandthentoldhimthathehadarthritisinhisfootandthatnothingmorecouldbedonetohelp.Mr.Mackcontinuedtryingtowork.Hecouldnotputpressureonhisfootandturnedhisfootsidewaystowalkwhichcausedhimtobestiffleggedandhavepainuptowardhisknee.Hewasgivenalightdutyjobthatallowedhimtositinordertoalleviatethepaininhisfootandhedevelopedpaininhisback.InMay1997,Mr.MackwroteXXXXAXXXXIamnolongerabletoreturn  towork,becauseofthepainIsufferedatwork.XXXX@XXXXԀHe,subsequently,metDr.JamesA.  Engblom,apodiatrist. P Dr.EngblomtestifiedbydepositionthathefirstsawMr.MackonMay22,1997.Basedonhistoryandaphysicalexamination,Dr.Engblomthoughthehadaposteriortibialdysfunctionorrupture.AMRIandxraysrevealedbreachingorseparationofthenaviculocuneiformjointandlooseosteophyteatthebaseofthecuneiform.Healsohasflatfootdeformityofeachfootthathadbeenasymptomaticbeforetheinjurytotherightfoot.Dr.Engblomperformedasurgicalfusionatthenaviculocuneiformjoint.Sincethesurgery,Mr.MackXXXX=XXXXsgaithasbecomemorenormalandthepainhasdiminished.Hestillhastrouble &" comingdownstairsandtakesonestairatatime;hehasalittletroubleonunevensurfacesandhillyareas.Hisfoothurtsifhestandslongerthanthreehours.HereachedmaximummedicalimprovementonFebruary16,1998andwasreleasedtoreturntowork.Hehaslimitationsofstandingnomorethantwohourswithafifteenminutebreakandnoprolongedwalking.Dr.Engblomtestifiedthat,asaresultoftheinjurythatoccurredatworkinJune1995,Mr.Mackhas67percentimpairmenttotherightfootaccordingtotheAMAGuidesforEvaluationofPermanentImpairment,FourthEdition. P Thepartiesstipulated(1)therecordsofDr.EdwardKahn,(2)thathehaddeterminedthatMr.MackdidnotneedsurgeryorfurthermedicaltreatmentasofthelastvisitwithhimonAugust14,1995,and(3)thatDr.Kahnfoundnosignificantpathologyin 926 theMRIfilmsmadeduringDr.EngblomXXXX=XXXXstreatment.   P Dr.WilliamT.McPeaketestified,bydeposition,thatMr.MackwasfirstseenandtreatedbyDr.Sears,oneofhispartnersattheKnoxvilleOrthopedicCliniconNovember11,1995.Dr.McPeakefirstsawhimonMarch6,1996.Heobtainedabonescananddiagnosedarthriticordegenerativechangesinthemidfoot.HerecommendedIbuprofenorsomeothertypeofantiinflammatorymedication,suggestedaworkhardeningprogramandreleasedMr.Macktoreturntoworkactivitiesastolerated.Dr.McPeakesawhimfourmoretimes;thelasttimewasonFebruary19,1997whenheagainhadXXXXAXXXXchronicfootpainassociatedwith (  hisdeformities,hisflatfootdeformityandtheearlyarthriticchangesinthemidfoot.XXXX@XXXXԀDr.  McPeaketestifiedthathedidnotfindanyobjectiveevidenceofatearofthetibialtendonwhenheexaminedandtreatedMr.Mack.XXXXAXXXX(H)istearcouldhavebeenthereandbecame  symptomaticafterwardsoritcouldhavedevelopedafterhewasexaminedbyme.XXXX@XXXXԀHealso  admittedthat,throughouttreatmentbyDr.Searsandhimself,Mr.Mackhadcomplainedofposteriortibialtendonpain. P FredColvin,associateprofessorintherehabilitationcounselortrainingprogramattheUniversityofTennesseetestifiedthatMr.Mackhadanoccupationaldisabilityof40to50percent. P PursuanttoT.C.A.Section506225(e),thiscaseisrevieweddenovouponthe &" recordwithapresumptionofthecorrectnessofthetrialcourtXXXX=XXXXsfinding.Spencerv.Towson (!$ Moving&Storage,Inc.,922S.W.2d508,509(Tenn.1996). *#&  P TheemployerasksthiscourttoweighthetestimonyofthephysicianswhotestifiedandtofindthattheconditiondiagnosedbyDr.EngblomandthesurgeryperformedbyhimarenotcausallyrelatedtotheinjuryMr.MacksustainedatworkinJune1995.Wherethemedicalevidencediffers,thetrialjudgemayaccepttheopinionofoneexpertovertheopinionsofothers.Johnsonv.Midwesco,Inc.,801S.W.2d804,806(Tenn.1990). 4-0 Wherethemedicaltestimonyispresentedbydepositionormedicalreports,thisCourtcanmakeitsownindependentassessmentofthemedicalprooftodeterminewherethepreponderancelies.Cooperv.INA,884S.W.2d446,451(Tenn.1994);Landersv. 926 FiremanXXXX=XXXXsFundIns.Co.,775S.W.2d335,336(Tenn.1989).Thetestimonyofexpert  witnessesmustbeconsideredinlightofalltheotherevidenceinthecase.Thomasv.Aetna  LifeIns.Co.,812S.W.2d278(Tenn.1991).Therecordestablishesaconsistentpatternof   complaintsbyMr.MackabouttheinjurytohisrightfootfromJune1,1995andthroughhistreatmentandsurgerybyDr.EngblominAugust1997.Dr.McPeaketestifiedthattheconditiondiagnosedbyDr.EngblomcouldhavebeenpresentallalongandnotsymptomaticatthetimeMr.MackwasseenbyDr.McPeake.HeadmitsthatthecomplaintstohimwereconsistentwiththeultimatediagnosisbyDr.Engblom.Dr.KahnreleasedMr.MacktoreturntoworkwithoutfurthertreatmentinAugust1995,andneversawhimagain.WeconcurwiththetrialjudgeinfindingDr.EngblomXXXX=XXXXstestimonyconcerningcausationtobe  themostcompelling. P TheemployernowconteststhechargesofDr.EngblomarguingthatMr.Mackhadnoreasonableexcusefornotconsultingwiththeemployerbeforeincurringexpensesoftreatment.XXXXAXXXXTheliabilityoftheemployerturnsontheissueofwhether,underthe h` circumstances,theemployeewasjustifiedinobtainingfurthermedicalservice,withoutfirstconsultingtheemployer.XXXX@XXXXԀPickettvChattanoogaConval.&NursingHome,627S.W.2d (#  941,944(Tenn.1982)(citingBurlingtonIndustries,Inc.v.Clark,571S.W.2d816(Tenn. %  1978);TomStillTransferv.Way,482S.W.2d775(Tenn.1972):andHolstonValley &" CommunityHospitalv.Dykes,205Tenn.336,326S.W.2d486(1959)).Theemployerdid (!$ notinitiallyfurnishhimapanelofthreephysiciansfromwhichtochoose,butdirectedhimtoMcNeeleyXXXX=XXXXsMedicalClinic.Hewas,subsequently,seenbyanumberofotherphysicians ,%( providedbytheemployer,eachofwhombrieflytreatedandreleasedhimtoreturntoworkwithoutfurthertreatment.Hecontinuedtohavepainandtobeseverelylimitedintheuseofhisrightfootforalmosttwoyears.WeareunabletofindMr.Mackwasunreasonableinseekingtreatmentfromaphysicianofhischoosing.ThefindingofthetrialcourtthattheemployershouldpayforthetreatmentbyDr.Engblomisaffirmed. P Finally,theemployerarguesthatnophysicianotherthanDr.Engblomfoundanypermanentimpairmentanditwaserrortoawarddisabilitybenefits.OnlyDr.Kahnsaidhe 926 foundnopermanentimpairment.ThemedicalrecordsofthevariousphysicianswerestipulatedbythepartiesandarefilledwithreferencestoMr.MackXXXX=XXXXsabnormalgait,swelling  andpain.TheCourthasalreadyaddressedthereliancebythetrialjudgeontheopinionofDr.Engblom.InassessingtheextentoftheMr.MackXXXX=XXXXsdisability,histestimony,the   testimonyofhiswife,andavocationalexpertwerealsoavailable.Inlightofthesubstantialmedicalimpairmentandthelackofworkexperienceinoccupationsthatdonotrequireprolongedstandingand/orwalking,theawardof85percenttothefootwasnotunreasonable.SeeRobersonv.LorettoCasketCo.,722S.W.2d380(Tenn.1986). (     P Thefindingsofthetrialcourtareaffirmedandthecaseisremandedfortheenforcementofthejudgmentwithinterestasprovidedbylaw.CostsoftheappealaretaxedtoCNAInsuranceCompany.E+ ` hp x (#P XE0p x (#X0  _____________________________  HowellN.Peoples,SpecialJudge  6 P p x (#X6Ӏ Concur:  X P Ѐ̀___________________________̀WilliamM.Barker,Justicè̀̀___________________________̀JoeC.Loser,SpecialJudge  &" ` TR[A' Legal[A'A' LegalA' LegalTn!*8($hx  `E tt06Q n ` Q` Q` (#` (#@E E INTHESUPREMECOURTOFTENNESSEE@"ATKNOXVILLE  p       p         p      ` (#` (#` Q` Q  p  XP   , @,  `  `   p      x    p ERICK.MACK)0 p ANDERSONCIRCUIT( p(#p(#   񀀀) p No.96LA0224  Ҁ PlaintiffAppellee񀀀) p      x   $ XP X$ 0  0h8"8"0h8"h8"08"8")0p8"8"No.03S019805CV00052 p8"p8" v.    h   0  )8"8"     h     ) p HonJamesB.Scott,Jr.  CNAINSURANCECOMPANY  )0 p      x   @ p8"p8"     h     ) Defendant/Appellant,    )   )      h      p  xp     p      x   X P @FF'JUDGMENTORDER ThiscaseisbeforetheCourtupontheentirerecord,includingtheorderofreferraltotheSpecialWorkers'CompensationAppealsPanel,andthePanel'smemorandumOpinionsettingforthitsfindingsoffactandconclusionsoflaw,whichareincorporatedhereinbyreference; Whereupon,itappearstotheCourtthatthememorandumOpinionofthePanelshouldbeacceptedandapproved;and Itis,therefore,orderedthatthePanel'sfindingsoffactsandconclusionsoflawareadoptedandaffirmed,andthedecisionofthePanelismadetheJudgmentoftheCourt. CostsonappealaretaxedtotheAppellant,CNAInsuranceCompanyandLindaJ.HamiltonMowles,surety,forwhichexecutionmayissueifnecessary.̀06/23/99