ÿWPC! 3# ÚU:å % 0¸%4Ýñ 0ü 0Dw@H 0Jˆ 0TÒ 0^& 0h„ 0rì 0|^ 0†Ú 0` 1uð U,e 0d‘ U,õ U*! bK 0@S D3“ B)Æ D+ï DC B] AMz AOÇÆ‚Ü 0D^.¢v~ÐvÓN˜HP LaserJet 4 Plus/4M PlusHPPCL5E,,,,0 , øð AZ‹"Arial RegularX( 7$¡¡Ò°ÒÒ„°ÒÑ` ` ÑÓÓÑTR[  AØ'ÿ Legal[  AØ'ÿ Legal AØ'ÿ Legal AØ'ÿ LegalTÑdO˜ xxxxxx3|xæ (¬(3C6$¤¤Ý ƒ 7!ÝÒ°ÒÒ„°ÒÑ` °ÑÓÓÑTR[  AØ'ÿ Legal3Ø' AØ'ÿ Legalÿ3Ø'TÑÝ  Ýà ` àòòÚ  Ú0Ú  Úóó(#Ã$òòÚ  Ú0Ú  Úóó Ð Ñ DÒ Ó DÔ DÕ Ö D× Ó€â æ 2 ÿÿ0Indent1Ô2ÔÔ3  Ô2" ÿÿ0Indent2à0 àÔ2ÔÔ3  Ô2, ÿÿ0Indent3à0 àà0 àÔ2ÔÔ3  Ô26 ÿÿ0Indent4à0 àà0 àà0 àÔ2ÔÔ3  Ô2@ ÿÿ0Indent5à0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô2J ÿÿ0Indent6à0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô2T ÿÿ0Indent7à0 àà0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô2^ ÿÿ0Indent8à0 àà0 àà0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô ÿÿ?AGMSYaioIndent0I.A.1.a.(1)(a)i)a)< Œ 9p`(ModernP ÿÿ8Mac DefaultMac DefaultÓ ` °šXÓ< Œ 9p`(Monaco< Œ 9p`(Arial- ù-("ÿÿ$££Ò  ÒÒ  Ò****'ÿÿdxd% Line 7 d'ÈÈÈÈdxd''''7Border 1dd d-%)Cþÿ << Gÿÿ-%/(Cþÿ` << CÿÿƒLevel 1Level 2Level 3Level 4Level 5 xÝ ƒ!ÝÑ  ÑÑ#€d#ÑÔ€ÔÔ€#ÔÒ  ÒÒ „ ÒÑ ` ÑÑ\R AØ'\ÑÝ  ÝÔ€#ÔÔ YYY ÔÓ  ÓFILEDÔ€#XÔÌÌò òJuneÏ20,Ï1996ÌÌCecilÏCrowson,ÏJr.ÌAppellateÏCourtÏClerkó ó($$””ò òÚ  Ú1Ú  Úó ó $Ý ƒ!ÝÑ  ÑÑ#€d#ÑÔ€ÔÔ€#ÔÒ  ÒÒ „ ÒÑ ` ÑÑ\R AØ'\ÑÝ  ÝÝ ƒ%#ÝÒ  ÒÒ  ÒÝ  ÝPtPtHHÚ(ÿáÿâùFG(üHHØ(d'`Styl{WP}01•ÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃà Ãà Ãà Ãà Ãà ÃÃÃÃÃÃÃÃÃÃÃÐ ÐÐHHÐÐ  ÐÐ2ÐÐÿÿ¸æ$ÿÐÐHHÐÐÐÐÐÐÐÐ  ÐÐ ÐÐ ÐÑÑÑGenevaÑÑ ÑÑ € ÑÑ<Px–ÈÑÒÒÒ443!#4ÒÒ$ *$ÒÒ$*$ÒÒ ÿKK ÒÒ  Geneva ÒÒ  Geneva ÒÓ.,ÓÓÓÓ6ÓÓ ÓßßßßßßßßßßßßßßßßßßÑMonacoÑÑ ÑÒ  BA Op Monaco ÒÒ  BA Op Monaco ÒÝ ƒ!ÝÔ . ÔÔ€ÔÓ&€""X„d&ÓÑ#€""Xd#ÑÔ€#ÔÒ  ÒÒ „ ÒÑ ` ÑÑ\R AØ'\ÑÝ  ÝÑ p ћр$ÑÑ7€93XXdðdÈ7ÑÑ  ÑÓ  Óò òIN€THE€SUPREME€COURT€OF€TENNESSEEÌSPECIAL€WORKERS'€COMPENSATION€PANELÌœAT€NASHVILLE›ÌÓ  Óó óÌÌÌÌKATHY€SHRUM,à àà àà àà à)Ìà àà àà àà àà àà à)à àMACONÏCHANCERYÌÙ€-ÙœßW€+.0)D40x|½` à. `€À€Wß›à àPlaintiff/Appelleeà àà àà à)Ìà àà àà àà àà àà à)à àHon.€C.€K.ÏSmith,Ìv.à àà àà àà àà àà à)à àChancellorÌà àà àà àà àà àà à)à àÌINSURANCE€COMPANY€OF€THE€à à)à àNO.€€01S01„9511„CH„00205ÌSTATE€OF€PENNSYLVANIA,à àà à)à àÌà àà àà àà àà àà à)Ìà àDefendant/Appellantà àà à)ÌÌÌÌò òòòÌFor€the€Appellant:à àà àà àà àà àForÏthe€Appellees:Ìó óóóÌD.€Randall€Mantoothà àà àà àà àFrank€D.ÏFarrarÌLeitner,€Warner,€Moffitt,€Williams,à àà àWilliam€J.€ButlerÌà àDooley€&€Napolitan,€Attorneysà àà à102ÏScottsville€œHwy›.Ì2300€First€American€Centerà àà àà àP.O.€Box€280ÌNashville,€TN€€37238à àà àà àà àLafayette,€TN€Ï37083ÌÌÌÌÌÌÌÌÌ€ÌÌÌÌÓ  Óò òòòMEMORANDUM€OPINIONÌÌÌÌMembers€of€Panel:ó óóóÌÌJustice€Frank€F.€Drowota,€IIIÌSenior€Judge€John€K.€ByersÌSpecial€Judge€Roger€E.€ThayerÌÓ  Óò òÌÌÌÌÌMODIFIEDà àà àà àà àà àà àà à€€€€€€€THAYER,€SpecialÏJudgeÌAND€REMANDEDÌÓÓòòà àó óóóThis€workers'€compensation€appeal€has€been€referred€to€the€SpecialÏWorkers'ÌCompensation€Appeals€Panel€of€the€Supreme€Court€in€accordance€with€òòTenn.€CodeÏAnnóó.€ðð€50„6„225(e)(3)€for€hearing€and€reporting€to€the€Supreme€Court€of€findings€ofÏfact€and€conclusions€of€law.Ìà àThis€appeal€by€Defendant,€Insurance€Company€of€the€State€of€Pennsylvania,Ïhas€resulted€from€the€action€of€the€trial€court€in€authorizing€the€employee€to€seekÏtreatment€from€a€physician€not€designated€by€the€employer.€€The€dispute€has€arisenÏafter€the€parties€reached€a€settlement€of€all€issues,€and€it€relates€to€post„judgmentÍtreatment€of€plaintiff,€Kathy€Shrum.Ìà àDuring€February,€1995,€an€order€of€compromise€and€settlement€was€enteredÏstating€the€employee€was€to€receive€an€award€of€permanent€disability€benefitsÏbased€on€a€40.17%€disability€to€the€body€as€a€whole.€€The€order€recited€plaintiffÏwas€to€remain€under€the€care€of€Dr.€Dave€A.€Alexander,€an€orthopedic€surgeon,Ïwho€had€performed€surgery€on€plaintiff€and€who€was€her€treating€physician€forÏcarpal€tunnel€syndrome€injuries.€€Dr.€Alexander€had€been€designated€along€withÏtwo€other€surgeons€by€the€Defendant€as€medical€care€providers€pursuant€to€ourÏstatute.Ìà àAfter€providing€for€the€furnishing€of€future€medical€expenses,€the€orderÏrecitedÌÓÓÌà0 àThe€parties€specifically€recognize€that€defendant€has€not€accepted€asÏcompensable€and€will€not€pay€medical€benefits€related€to€any€conditionÏother€than€plaintiffððs€alleged€bilateral€carpal€tunnel€syndrome€in€light€of€theÏfact€that€there€is€medical€proof€which€suggests€that€plaintiff€suffers€from€aÏcongenital€condition€known€as€cervical€ribs€which€might€be€responsible€forÏsome€of€plaintiffððs€current€symptomatology.ÌÓÓÌà àOn€May€19,€1995,€plaintiff€filed€a€motion€reciting€she€had€not€been€receivingÏsatisfactory€medical€attention€and€requested€the€court€to€choose€an€independentÏphysician€to€treat€her€œor›€to€allow€plaintiff€to€choose€her€own€treating€physician.€ÏDefendant€filed€a€response€opposing€the€request€and€alleged€there€was€noÏevidence€to€support€her€claim€as€she€had€not€been€treated€since€April€4,€1994.Ìà àOn€June€19,€1995,€an€order€was€entered€by€the€trial€court,€stating€ð ð€.€.€.ÏPlaintiff€is€not€satisfied€with€the€doctors€submitted€to€treat€plaintiff€by€defendant€.€.€.ððÏand€the€order€provided€for€the€appointment€of€Dr.€Stephen€Neeley,€an€orthopedicÏsurgeon,€to€treat€her€for€injuries€which€were€the€subject€of€the€workersððÏcompensation€proceeding.Ìà àDefendant€filed€a€motion€to€alter€or€amend€the€order€which€was€supported€byÏtwo€affidavits.€€One€affidavit€was€executed€by€an€insurance€adjuster€stating€neitherÏplaintiff€nor€her€attorney€had€expressed€any€dissatisfaction€with€the€medicalÏtreatment€of€Dr.€Alexander.€€It€also€stated€she€had€not€requested€to€see€either€of€theÏother€two€physicians€the€company€was€providing.€€The€other€affidavit€was€executedÏby€the€records€custodian€of€Dr.€Alexanderððs€office€and€all€of€the€doctorððs€notesÏrelating€to€his€treatment€of€plaintiff€was€made€an€exhibit€to€the€affidavit.Ìà àThe€doctorððs€office€records€indicate€on€Tuesday,€March€14,€1995,€plaintiffÏwas€complaining€of€symptoms€on€both€sides€on€both€hands.€€The€doctor€noted€heÏwas€not€sure€what€to€make€of€her€symptoms€but€they€did€not€sound€like€carpalÏtunnel€syndrome€symptoms.€€The€office€note€further€stated€she€had€been€evaluatedÏfor€thoracic€outlet€syndrome,€and€the€doctor€thought€she€should€see€another€doctorÏwhom€she€had€seen€before€regarding€her€problem.Ìà àThe€doctorððs€records€also€contain€a€copy€of€a€letter€dated€May€2,€1995,€fromÏDr.€Alexander€to€Plaintiffððs€attorney€stating€it€was€his€clinical€opinion€that€plaintiffÏwas€not€suffering€from€carpal€tunnel€syndrome.Ìà àThe€motion€to€alter€or€amend€the€order€was€overruled,€resulting€in€thisÏappeal.€€The€appellate€record€does€not€contain€a€transcript€of€evidence€at€anyÏhearing€which€the€trial€court€conducted,€and€our€review€of€the€issue€is€confined€toÏthe€technical€record.Ìà àIt€is€often€stated€that€the€appellate€review€of€findings€of€fact€by€the€trial€courtÏshall€be€de€novo€upon€the€record€of€the€trial€court,€accompanied€by€a€presumptionÏof€the€correctness€of€the€findings,€unless€the€preponderance€of€the€evidence€isÏotherwise.€€òòTenn.€Code€Ann.óó€ðð€50„6„225(e)(2).€€However,€the€appellate€court€cannotÏreview€the€facts€òòde€novoóó€without€an€appellate€record€containing€the€facts€and,Ïtherefore,€in€the€œabsence›€of€a€transcript€of€a€statement€of€the€evidence,€theÏappellate€court€must€assume€that€the€record,€had€it€been€preserved,€would€haveÏcontained€sufficient€evidence€to€support€the€trial€courtððs€factual€findings.€€òòSherrod€v.ÏWixóó,€849€S.W.2d€780€(Tenn.€App.€1992).€€The€òòde€novoóó€review€does€not€carry€aÏpresumption€of€correctness€to€a€trial€courtððs€conclusions€of€law€but€is€confined€toÏfactual€findings.€€òòUnion€Carbide€Corp.€V.€Huddlestonóó,€854€S.W.2d€87€(Tenn.€1993).€ÏThus,€a€question€of€law€is€reviewed€without€the€presumption€of€correctness.Ìà àThe€only€factual€finding€by€the€trial€court,€which€we€must€accept€as€beingÏsupported€by€the€evidence€since€a€transcript€of€evidence€is€lacking,€is€that€plaintiffÏwas€dissatisfied€with€Dr.€Alexander.€€A€review€of€the€record€leads€us€to€concludeÏher€dissatisfaction€has€resulted€from€Dr.€Alexanderððs€opinion€that€her€currentÏproblem€was€not€connected€to€her€work„related€injuries.€€We€are€to€decide€whether,Ías€a€matter€of€law,€the€trial€court€may€order€a€new€physician€to€treat€the€employeeÏmerely€because€the€employee€is€not€satisfied€with€the€physicianððs€opinion€as€to€theÏcausation€of€her€current€problems.Ìà àòòTenn.€Code€óóAnn.€ðð€50„6„204€imposes€responsibility€on€the€employer€toÏprovide€free€medical€care€to€the€employee€and€the€employee€is€generally€requiredÏto€accept€such€services.€€There€are€many€cases€supporting€the€payment€of€medicalÏexpenses€of€doctors€seeing€and€treating€employees€who€were€not€designated€byÏthe€employer,€but€these€exceptions€are€grounded€on€peculiar€factual€situations€andÏcontain€legitimate€reasons€to€depart€from€the€statutory€rules.Ìà àOur€workersðð€compensation€statutes€do€not€specifically€address€the€issueÏinvolved€but€òòTenn.€Code€Ann.óó€ðð€50„6„204(a)(5)€provides:ÌÓÓÌà0 àœIn›€case€of€dispute€as€to€the€injury,€the€court€may,€at€the€instance€of€eitherÏparty,€or€on€its€own€motion,€appoint€a€neutral€physician€of€good€standing€andÏability€to€make€an€examination€of€the€injured€person€and€report€suchÏphysicianððs€findings€to€the€court,€the€expense€of€which€examination€shall€beÏborne€equally€by€the€parties.ÌÓÓÌà àIt€could€be€argued€this€section€of€the€statute€only€applies€prior€to€theÏadjudication€of€a€workersðð€compensation€claim€but€the€language€of€the€statute€doesÏnot€limit€the€application€to€that€narrow€of€a€scope.€€We€recognize€there€are€manyÏtimes€when€hotly€contested€issues€develop€after€final€adjudication€of€a€claim€inÏregard€to€the€payment€of€future€medical€expenses,€and€we€believe€this€language€isÏsufficient€to€authorize€the€trial€court€to€proceed€when€unusual€and€exceptionalÍcircumstances€arise€in€post„trial€hearings.€€We€note€this€provision€authorizes€aÏphysician€to€make€an€examination€and€report€his€findings€not€to€treat€the€injuredÏparty.Ìà àPlaintiff€cites€òòTenn.€R.€œCiv›.€P.óó€35€as€justifying€the€courtððs€action.€€This€rule,€ifÏapplicable,€only€authorizes€an€examination€and€not€treatment€of€the€injured€party.Ìà àConsidering€all€of€the€circumstances€in€our€review€of€the€record,€we€are€ofÏthe€opinion€the€trial€court€was€in€error€in€authorizing€a€new€and€different€physicianÏto€treat€the€plaintiff€solely€under€the€finding€she€was€dissatisfied€with€Dr.ÏAlexanderððs€opinion.€€We€find€that€since€there€is€a€dispute€regarding€the€question€ofÏpayment€of€medical€expenses,€the€trial€courtððs€order€should€be€modified€to€provideÏthat€plaintiff€is€authorized€to€see€Dr.€Stephen€Neeley€for€the€purpose€of€examinationÏand€determination€of€whether€her€present€problems€are€related€to€herÏcompensable€injury€or€to€other€causes.€€After€this€report€is€filed€with€the€trial€court,Ïthen€a€decision€could€be€made€whether€to€continue€with€Dr.€Alexander,€or€with€oneÏof€the€other€two€designated€surgeons€or€Dr.€Neeley.€€Costs€of€the€new€examinationÏand€report€should€be€shared€equally€by€the€parties.Ìà àOur€caution€here€is€also€to€avoid€providing€an€injured€employee€with€aÏtreating€physician€who€only€tells€the€employee€what€he€or€she€desires€to€hearÏconcerning€causation€of€symptoms€or€current€problems.Ìà àIt€results€that€the€action€of€the€Chancellor€is€modified€as€indicated€and€theÏcase€is€remanded€to€the€trial€court€for€such€further€orders€as€may€be€necessary.€ÍCosts€of€the€appeal€are€taxed€to€Defendant€and€sureties.ÌÌÓÓÌà àà àà àà àà àà àà àòò€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€óóÌà àà àà àà àà àà àà àRoger€E.€Thayer,€Special€JudgeÌÌÌCONCUR:ÌÌÌÌÌòò€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€óóÌFrank€F.€Drowota,€III,€JusticeÌÌÌÌÌòò€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€ÌóóJohn€K.€Byers,€Senior€Judge