WPC # VUNa % 0U: 4  0J W w@_  0T 0^ 0hW 0r 0|1 0 03 1uU,8 0ddU,U>U*2U*\B) BDC AM\v~, D3v 0@ AO? 0D D/I BxHP LaserJet 4Si/4SiMX PS 600dpiPSCRIPT0 (hH  Z 6Times New Roman RegularX(H=$  HTR[A' Legal[A' LegalA' LegalA' LegalTX_XXX7XXdXXd7,  AZ"Arial Regularz!3|x 2 0Indent123    D   D    Ӏ HR2" 0Indent20 23  2, 0Indent30 0 23  26 0Indent40 0 0 23  2@ 0Indent50 0 0 0 23  2J 0Indent60 0 0 0 0 23  2T 0Indent70 0 0 0 0 0 23  2^ 0Indent80 0 0 0 0 0 0 23    ?AGMSYaioIndent0I.A.1.a.(1)(a)i)a)<  9p`(ModernP 8Mac DefaultMac Default ` X<  9p`(Monaco<  9p`(&Times New Roman<  9p`(Arial<  9p`(Times% Line 7 d d$$$$7Border 1dd-&C << G  !  #d#!    H \RA'\"#d#  "   YYY FILED"X August30,1996CecilCrowson,Jr."AppellateCourtClerk PtPtHH(FG(HH(d'@%%%%'dxdStyl{WP}01  HH  2$HH  Geneva  <Px443!#4$*$$*$ KK  Geneva  Geneva .,6 Monaco   BA Op Monaco  BA Op Monaco ("$    -C<< CLevel 1Level 2Level 3Level 4Level 5($$   1  ' dxdP Pd ! . &  Xd&#  Xd#!    H \RA'\"###Xd####Xd#    X   ̛  @ INTHESUPREMECOURTOFTENNESSEE@ SPECIALWORKERS'COMPENSATIONAPPEALSPANEL@ ATJACKSON,APRIL1996SESSION ̜BLANCHERENESMITH,   ) MADISONCHANCERY      )  Plaintiff/Appellee   ) NO.Ϝ02S019511CV00112      ) v.      ) HON.JOEC.MORRIS      ) CHANCELLOR ̜L'(&;+'h|B` 81 `LߛBRUCEHARDWOODFLOORS,  )      ) Defendant/Appellant  )       FortheAppellant:    FortheAppellee: WilliamF.Kendall,III   MaryDeeϜPerkinsRobertB.Vandiver,Jr.   GeorgeL.Morrison,III̜WALDROP&HALL,P.A.   201E.Baltimore106SouthLibertyStreet   Jackson,TN38301Jackson,TN38301   MEMORANDUMOPINIONMembersofPanel: JusticeLyleReidSeniorJudgeJohnK.ByersSpecialJudgeJoeC.Loser  ̜ REVERSEDandDISMISSED.   BYERS,SeniorJudge  Thisworkers'compensationappealhasbeenreferredtotheSpecialWorkers'CompensationAppealsPaneloftheSupremeCourtinaccordancewithTenn.CodeAnn.506225(e)(3)forhearingandreportingtotheSupremeCourtoffindingsoffactandconclusionsoflaw. PlaintiffwasworkingatBruceHardwoodFloorswhensheinjuredherrightshoulderinOctoberof1991whileliftingpiecesofwoodfromaconveyorbelt.InMayof1992,shecomplainedtohertreatingphysicianofpaininherhandsandwrists.Sheallegedworkrelatedpermanentdisabilityasaresultoftheseconditions.Thetrialcourtawardedplaintiff33percentpermanentpartialdisabilitytoeacharm. Wefindtheplaintiffhasfailedtomeetherburdenofprovingpermanentpartialdisabilityandthereforereversethedecisionofthetrialcourtanddismissthecomplaint. Plaintifftestifiedthatshewasremovingthinorshortwoodfromaconveyorbeltandlifting40to50poundsfrequentlywhenherrightshoulderstartedbotheringher,sometimeinOctoberorbeforeOctober.TheemployerreferredhertoConvenientCareClinic,thenreferredhertoDr.AlanPechacek,boardcertifiedorthopedicsurgeon,atJacksonClinic. Dr.PechaceksexaminationandxrayonNovember11,1991gavehimtheimpressionthatplaintiffsrightshoulderpainwasduetosomeirritationorinflammationoftherotatorcufftendons.Heprescribedphysicaltherapy,exercises,painmedicationandworkrestrictions,whichimprovedplaintiffscondition. InJanuaryof1992,Dr.Pechacektoldplaintiffshecouldreturntofullworkwithnorestrictions.Hecontinuedtoseeherforrenewalofprescriptionsbutfeltshewas basicallyfunctional,asfarasbeingabletodoherjob. InMayof1992,plaintiffreturnedtoDr.Pechacekcomplainingofshoulderpainandalsobilateralwristandhandpainandnumbness.Shesaidthisbotheredherbothatworkandathomeatnight.AtherJune,1992officevisit,Dr.Pechacekstatedthatplaintiffssymptomswere mildandvague,andhegavehersplintstowearonherwrists.Shewasnolongerworkingbecauseofsomedisputewithheremployer,andhethoughtshecouldcontrolherhandactivityathome.̛̜ InJuly1992,shereturnedstillcomplainingofdiscomfort,soDr.Pechacekorderednerveconductionstudies,whichshowedmildchangesinthemediannerveoftherightwristandminimalchangesinthemediannerveoftheleftwrist. PlaintiffwenttoworkinAugust1992asacashier,andworkedforvariousemployersincludingKrystal,WendysPopeyes,FuelMartandSavingsOilwhilecontinuingtobetreatedbyDr.Pechacek. InJanuary1993,plaintiffunderwentbilateralcarpaltunnelreleasesurgery,afterwhichshehadalmostnocomplaintsofnumbnessortingling,norealresidualproblemsasaresultofthesurgery,noneedforfurtheractivetreatmentandnorestrictions.Dr.PechacekopinedshehadnoresidualpermanentimpairmentundertheAMAGuidelinesasaresultofhershoulderinjuryorherwristconditionandsurgery.HetestifiedthathewasveryfamiliarwiththerequirementsoftheAMAGuidelines,havingusedthemformanyyearsinhiswork.Heopinedthatagripstrengthtestisnotdefinitiveincarpaltunnelcasesbecausetherecouldbemanycausesforlossofgripstrengththatareunrelatedtocarpaltunnelsyndrome.PlaintiffpointedouttoDr.PechacekthatanexampleintheAMAGuidelinesseemsverysimilartoplaintiffsconditionandassessed10%permanentpartialdisabilitytothearm.Dr.Pechacek,unpersuaded,opinedthattheexampledoesnotlimithisevaluationofthisparticularpatient,whodidnothavethedemonstrated60%lossofgripstrengthinonehand,aswasthecaseintheexample. PlaintiffreturnedtoworkatPopeyes,thenlaterworkedatPonyExpressandatNOMAasapickerfillingorders.Dr.Pechacektestifiedthatherconditiondidnotseemtoworsenwithwork,butworkseemedtoaggravatehersymptomsaccordingtothepatient. Dr.JosephC.Boals,boardcertifiedorthopedicsurgeon,evaluatedplaintiffattherequestofhercounselonSeptember14,1994.Hisexaminationshowedsometendernessovertherotatorcuffsbutfullrangeofmotion.Bothhandsshowedhealedsurgicalincisionsandnonumbnessineitherhand.TinelandPhalentestswerenegative.Jamardynamometergripstrengthtestshowed35poundsofgripstrengthbilaterally.Hediagnosedresidualsfrombilateralcarpaltunnelreleaseandchronictendinitisofbothshoulders.Heopinedshehadnopermanentdisabilityastohershouldersbutdidhavechronictendinitisandcouldneedsomekindofsurgicalprocedureifthisproceededtogetworse,butatthepresenthermotionwasfullandtherewasnodisabilitytoberated.Astoherwrists,heopinedtheyweremarkedlyweakonbothsidesandassessed20percentpermanentphysicalimpairmentofbothupperextremities.Headvisedhertoavoidrepetitiveworkorjobsrequiringheavylifting.   Ourreviewisdenovoontherecordaccompaniedwithapresumptionofthecorrectnessoffindingsoffactofthetrialjudgeunlessthepreponderanceoftheevidenceisotherwise.Tenn.CodeAnn.506225(e)(2).Inassessingtheextentofpermanentimpairment,thepermanencyofaworkrelatedinjurymustfirstbeestablishedbycompetentmedicalevidence.Corcoranv.FosterAutoGMS,Inc.,746S.W.2d452,458(Tenn.1988).Thetrialjudgemay,whenthereisadifferenceinopinionbetweentheexperts,accepttheopinionofoneormoreovertheopinionofanotherorothers.Johnsonv.Midwesco,Inc.,801S.W.2d804(Tenn.1990).Wheremedicaltestimonyisdocumentaryorbydeposition,thereviewingtribunalisasabletopassontheweightandvalueoftheevidenceasthetrialjudge.Humphreyv.DavidWitherspoon,Inc.,734S.W.2d315,316(Tenn.1987). OurreviewofthemedicalevidencebyDrs.PechacekandBoalspersuadesusthattheopinionofDr.PechacekastothepermanencyofplaintiffsconditionsshouldbegivenmoreweightthanthatofDr.Boals.Dr.Pechacekwastheattendingphysicianandinthatcapacity,sawandtreatedtheplaintiffforanumberofyearsforthesecomplaints.HewasverywellversedastoAMAGuidelines,and,althoughorthopedicsurgeonsmayofcoursediffer,ourreviewoftheGuidelinessupportshispracticeofnotusinggripstrengthtestingasexclusivelydefinitiveinassessingpermanentdisability. Wefindtheplaintiffhasfailedtomeetherburdenofprovingpermanentdisabilityasaresultofworkrelatedinjury.Weneednotdeterminewhetherthelastinjuriousinjuryruleshouldapply. Theplaintiffscomplaintisdismissedwithcostsassessedtotheplaintiff.      __________________________________      JohnK.Byers,SeniorJudge̜CONCUR:__________________________________̜LyleReid,Justice%  ԛ__________________________________JoeC.Loser,SpecialJudge