ÿWPCP \{xU‘Øå¦ ÃI€ÆÏ»IQ^¹Ïý‡W5°2‡?8ãSýAÚ„Qüõ($Ë^®S)Š/뎛ˌ »ÊOt<•X̼’³°8¯Úåñ¥8[™Åí( ZU HWŬ¤)Õ ö¿”^¿UûÖ“¤ Ï€@¬«†Ë0¶àس‚<…> Ì?DïŽèú™ù蜮{#Št`'¤ío¬z›÷ö×oátPh•  Ū},¤u(ÝÄ©KFï»/˜É×ØRü¿í¥¼[ɵ%€*LÉd›ÂR5Å]yfiM›Xk_d§Úƒ'$'ážÝžä.þ"ÚvDqeA¬w]Ãé5>=’#bóŽÅÃ…¼tûæ*‡À ¦D9~K&ĶØT¸!štF.èoüKmæò+™0Ja²×ê á Zð4Øùª(DC=»ñýÅ?ÛK{°£×6á,q—1&ÓéìŽ/Nðå+Z$û1}O<²[Ë “aho9'9WÝ´ƒ?þè/þȇé1 ••l½Vè7•#ªF,Ëóv~۶żë UNI %— 0ûUN˜w@æ4&:U:I Bƒ 0?  0Dß AQ# t O| Ë U:Ë U:Æ? 0D 0DI 0D D/ÑÑ B D3˜HP LaserJet 4 PlusHPPCL5MS,ð,,,,,ð0vLhÎ(ÈhH  Z 6Times New Roman RegularX(Ó3c$¡¡Ñ7€|ìXXdðXXdð7ÑÑ  ÑÒ°ÒÒH°ÒÔ€¼Tþ¼XXÔÑTR[¤ AØ'ÿ Legal[¤ AØ'ÿ Legal AØ'ÿ Legal AØ'ÿ LegalTÑ(¶ÍY Z ‹6Times New Roman Regular ëìíîïVð îñEòEóÓ€ýÓ€yk&v²3|x, øð AZ‹"Arial Regular d(ï(3ž$¤¤Ý ƒ3c!ÝÑ7€ÜÿXXdðdð7ÑÑ  ÑÒ°ÒÒH°ÒÔ€¼„ǼXXÔÑTR[  AØ'ÿ Legal3Ø' AØ'ÿ Legalÿ3Ø'TÑÝ  Ýà ` àòòÚ  Ú0Ú  Úóó(%Ã$òòÚ  Ú1Ú  Úóó !"#%Cþÿ<< Cÿÿ EÝ ƒ ž$ÝÒ°ÒÒH°ÒÔ€¼„ǼXXÔà ` àòòÚ  Ú1Ú  ÚóóÝ  Ý€Performed€to€treat€inflammation€where€the€muscle€is€attached€to€theÐ ° Ðbone.€òòThe€Sloane„Dorland›€Annotated€Medical„Legal€Dictionary,€óóWestÐ Æ ÐPublishing,€1987. öÝ ƒ!¯"ÝÝ  ÝÔ€XÔðXXXÔÔ€©wXXÔðÔÓ  Óò òÔ Ad ÔFILEDÔ€XÔðX©wÔÐ  ÐÌApril€9,€1999ÌÌCecil€W.€CrowsonÌAppellate€Court€ClerkÔdAhÔó ó,c½¬AZ‹"Arial Regular öÝ ƒ!¯"ÝÝ  ÝÔ€XÔðXXXÔÔ€©wXXÔðÔÓ  Óò òÔ Ad ÔFILEDÔ€XÔðX©wÔÐ  ÐÌApril€9,€1999ÌÌCecil€W.€CrowsonÌAppellate€Court€ClerkÔdAhÔó ó,c½¬AZ‹"Arial RegularƒLevel 1Level 2Level 3Level 4Level 5(3¯$¢¢Ý ƒ!ÝÝ  Ý(3¯$££Ý ƒ!ÝÝ  Ý($$””ò òÚ  Ú1Ú  Úó ó'''÷ÿ dxdüÿP Pd 'ÿÿdxdÝ ƒ3c!ÝÑ7€ÜÿXXdðdÈ7ÑÑ  ÑÒ°ÒÒH°ÒÔ€¼„ǼXXÔÑTR[  AØ'ÿ Legal3Ø' AØ'ÿ Legalÿ3Ø'TÑÝ  Ýñóñ›ñóñÑ  ÑÑ7€Üÿ»XdðXXdð7ÑÓÓñóñßr€ (<,(j 8` `€€@E0±` 8ttxPh°ð  rß›ñóñà@‘ ‘ Ìàò òIN€THE€SUPREME€COURT€OF€TENNESSEEˆÐ ° Ðà@w w ÌàSPECIAL€WORKERS'€COMPENSATION€APPEALS€PANELˆÌà@]](ÌàAT€NASHVILLEó óˆÐ  X ÐÓ<ÓÌÌÌÌDENISE€STAVROPOULOS,à À àà  à)à p àMAURY€CIRCUITÐ ŒÜ  Ðà ` àà ¸ àà  àà h àà À àà  à)à p àÐ ¢ò  Ðà ` àPlaintiff/Appelleeà h àà À àà  à)à p àNO.€01S01„9711„CV„00251Ð ¸  Ðà ` àà ¸ àà  àà h àà À àà  à)à p àÐ Î  Ðv.à ` àà ¸ àà  àà h àà À àà  à)à p àÐ ä4 Ðà ` àà ¸ àà  àà h àà À àà  à)à p àÐ úJ ÐSATURN€CORPORATION,à À àà  à)à p àHON.€JIM€T.€HAMILTON,€Ð ` Ðà ` àà ¸ àà  àà h àà À àà  à)à p àJUDGEÐ &v Ðà ` àà ¸ àà  àà h àà À àà  à)Ìà ` àDefendant/Appellantà À àà  à)Ð R¢ ÐÌÌòòò òà@ÌÌ.ÌàˆÌó óóóÌÌò òòòFor€the€Appellant:à h àà À àà  àFor€the€Appellee:Ð Ö& ÐÌó óóóThomas€H.€Peebles,€IVà h àà À àà  àJ.€Anthony€ArenaÐ "R ÐDana€C.€McLendon,€IIIà h àà À àà  àSchulman,€LeRoy€&€Bennett,€P.C.Ð #h ÐWaller€Landsen€Dortch€&€Davisà  à501€Union€Building,€7th€FloorÐ .$~ Ð809€South€Main€Street,€Suite€300à  àP.€O.€Box€190676Ð D%”  ÐPost€Office€Box€1035à h àà À àà  àNashville,€TN€37219„0676Ð Z&ª! ÐÌÌÌÌÌò òòòÓ  ÓM€E€M€O€R€A€N€D€U€M€€€€O€P€I€N€I€O€NÐ Þ,.(% ÐÌMembers€of€Panel:ÌÌó óóóÔ‡¼-#¼¼¼„ÇÔFrank€F.€Drowota,€III,€JusticeÔ#†¼„Ǽ¼¼-#c #ÔÐ 61†,) ÐWilliam€H.€Inman,€Senior€JudgeÌJoe€C.€Loser,€Special€JudgeÌÓ ÓÌÌÌÌÌAFFIRMED€asÌMODIFIEDà ¸ àà  àà h àà À àà  àà p àINMAN,€Senior€JudgeÐ ö:F62 Їò òòòÓ  Óà@¿¿(ÌàÔ‡ tT ¼¼„ÇÔO€P€I€N€I€O€NÔ#†¼„Ǽ  tTÕ #ԈР° ÐÌóóó óÓÓà ` àThis€workers'€compensation€appeal€has€been€referred€to€the€Special€Workers'Ð V ÐCompensation€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€findingsÏof€fact€and€conclusions€of€law.Ìà ` àDenise€Stavropoulos€(employee),€suffered€bilateral€hand€numbness€and€later€Ïsevere€neck€pain€with€no€identifiable€precipitating€event.€€Massive€cervical€discÏherniation€was€diagnosed€and€corrective€surgery€was€performed.€€The€trial€courtÏfound€the€condition€to€be€work„related€and€awarded€90€percent€permanent€partialÏvocational€disability,€in€lump€sum,€and€temporary€total€disability€benefits,€set€off€Ïby€group€disability€benefits€which€had€been€òòpaid€as€of€the€date€of€trial.óó€Ð ’â Ðà ` àEmployee€is€42€years€old€and€has€a€€high€school€education.€€€After€14€yearsððÏwork€as€a€sewing€machine€operator€and€press€operator€for€General€Motors€inÏMichigan,€she€began€working€for€Saturn€Corporation€(employer)€in€1992€as€anÏInventory€Management€team€member.€€€Her€duties€included€operating€a€forkliftÏtruck€with€an€overhead€computer€screen€and€reaching€up€to€the€computer€to€enterÏdata€about€the€work€that€was€being€performed.Ìà ` àShe€had€been€treated€by€a€therapeutic€masseuse€on€two€occasions€inÏNovember€1995,€for€tension,€headaches,€and€mild€€thoracic€stiffness.€€OnÏNovember€15,€1995,€the€masseuse€found€tight€levator,€rhomboid€and€supraspinousÏmuscles,€i.e.,€the€muscles€surrounding€the€shoulder€blades€and€cervical€spine.€€SheÏperformed€an€hour„long€ð ðœmyofacial›€release€techniqueðð€to€the€shoulder€blades€andÏcervical€spine,€with€good€results.œ×ƒ×Ý ƒ %ÃÝòòÚ  Ú1Ú  ÚóóÝ  Ý×  ×›€Ð ¢4ò/, Ðà ` àThe€employee€first€noticed€numbness€in€her€hands€during€the€second€weekÏof€July,€1996,€and€does€not€recall€any€precipitating€event.€€She€testified€that€theÏnumbness€occurred€at€work€or€at€home,€and€that€no€particular€kind€of€activity€madeÏit€better€or€worse.Ìà ` à€€On€July€30,€1996,€the€employee€returned€to€the€masseuse,€who€performedÏanother€hour„long€treatment€for€moderate€neck€stiffness€and€numbness€in€the€armsÏand€hands.€€When€the€massage€failed€to€relieve€the€employeeððs€symptoms,€theÏmasseuse€recommended€she€see€her€doctor.€€Ìà ` àThe€employee€went€to€her€family€physician,€Dr.€Paul€Perryman,€who€orderedÏnerve€conduction€tests€and€ruled€out€carpal€tunnel€syndrome.€€He€referred€her€toÏDr.€Michael€Muha,€a€hand€specialist,€after€which€she€filed€an€injury€report.€€SheÏtestified€that€she€remembered€the€onset€of€numbness€the€week€of€July€9,€1996,Ïbecause€it€was€her€auntððs€birthday.€€Ìà ` àOn€August€30,€1996,€when€Dr.€Muha€first€examined€the€employee,€he€notedÏthat€ð ðetiology€of€symptoms€are€unclear.ðð€€Cervical€spine€€x„rays€revealed:ÌÓÓà8 ` àsome€degenerative€disc€disease€at€C5„6€level€with€mild€interspaceÏnarrowing€with€some€associated€proliferative€change€but€with€noÏsignificant€œneuroforaminal›€encroachment€evident.Ð ` 8"` 8" Ѐ€ÌÓ¨ÓHe€prescribed€pain€medication€and€physical€therapy€and€told€her€to€temporarilyÏavoid€work€at€or€above€shoulder€level€and€use€of€any€power€or€vibratingÏequipment,€and€to€return€in€two€weeks.Ìà ` àAfter€the€employee€had€physical€therapy€three€times€a€week€for€two€weeks,Ïshe€returned€to€Dr.€Muha€with€no€improvement€in€her€symptoms;€in€fact€herÏsymptoms€had€deteriorated€to€ð ðintenseðð€pain€in€her€neck€and€the€back€of€herÏshoulders.€€Her€right€hand€numbness€and€tingling€had€become€constant.€€BecauseÏof€severe€pain,€she€had€been€unable€to€work€for€six€days.€€He€ordered€an€MRI.Ð Ð8 40 Ðà ` àResults€of€the€September€13,€1996€MRI€revealed€a€ð ðmassiveðð€central€œC4›„5Ïcervical€disc€herniation€with€spinal€cord€compression,€osteophyte€formation€andÏdegenerative€changes,€with€left€C5„6€œforaminal›€stenosis.€€Dr.€Muha€referred€her€toÏhis€partner,€Dr.€Joseph€Wade,€who€performed€a€œdiskectomy›€and€fusion€of€œC4›„5€andÏC5„6,€and€placed€a€cervical€locking€plate€in€her€neck.€€Ìà ` àPost„surgically,€the€employee€was€released€to€light€duty€œon€January€24,€1997Ïwith›€no€lifting€more€than€20€pounds€and€no€exposure€to€vibratory€œstimuli.›€€€ThoseÏrestrictions€were€made€permanent€on€March€6,€1997.€€Ìà ` àOn€May€1,€1997,€she€returned€to€see€Dr.€Wade€with€fairly€severe€posteriorÏneck€pain€and€radial€œlucency›€between€œC4›€and€the€bone€graft,€but€solid€fusionÏeverywhere€else€and€no€evidence€of€instability.€€Permanent€restrictions€includedÏthose€mentioned€above,€plus€no€repetitive€rotation€or€flexion€extension€of€her€neckÏand€no€work€above€the€level€of€the€shoulders.€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€Ìà ` àThe€evidence€on€the€issue€of€causation€consists€of€the€depositions€of€theÏemployee€and€Dr.€Joseph€Wade€and€the€employeeððs€trial€testimony.Ìò òòòà@TT$ÌàEmployeeððs€DepositionˆÐ D%”  Ðà ` àó óóóWhen€deposed,€the€employee€testified:Ð p'À"  ÐÓÓà ` àQ:€à8 ¸ àTell€me€what€you€remember€about€having€pain€or€problems€onÐ œ)ì$" Ðthat€particular€day.Ð ¸ 8"¸ 8" ÐÌà ` àA:à8 ¸ àIt€was€the€numbness€that€Iððm€still€telling€„€„€you€know,€that€stillÐ Þ,.(% Ðoccurs.Ð ¸ 8"¸ 8" ÐÌà ` àQ:à8 ¸ àOkay.€€And€what€were€you€doing€when€you€were€having€thatÐ  0p+( Ðnumbness?Ð ¸ 8"¸ 8" ÐÌà ` àA:à8 ¸ àI€donððt€recall.Ðb3².+¸ 8"¸ 8" ÐÌà ` àQ:à8 ¸ àDo€you€remember€what€you€were€„€„€ÐŽ5Þ0-¸ 8"¸ 8" ÐÌà ` àA:à8 ¸ àI€donððt€have€to€be€doing€anything.€€Iððm€sitting€here€right€now.к7 3/¸ 8"¸ 8" ÐÌà ` àQ:à8 ¸ àIððm€talking€about€July€„€„€Ðæ9651¸ 8"¸ 8" Їà ` àA:à8 ¸ àBack€then€the€same€thing,€the€same€thing€was€happening.€€IÐ ° Ðcould€be€sitting€and€the€numbness€was€there€just€as€it€is€hereÏright€now,€as€Iððm€sitting€here.Ð ¸ 8"¸ 8" ÐÌà ` àQ:à8 ¸ àSo€it€wasnððt€particularly€you€being€at€work?Ð X¸ 8"¸ 8" ÐÌà ` àA:à8 ¸ àAnything,€it€was€just€this€happening€to€your€„€„€tinglingÐ 4 „ Ðhappening€to€your€hands€and€your€arms€all€the€way€around.Ð ¸ 8"¸ 8" ÐÌà ` àQ:à8 ¸ àAnd€was€that€true€whether€you€were€at€home€or€at€work;€youÐ vÆ  Ðwere€just€having€numbness€that€you€didnððt€understand?Ð ¸ 8"¸ 8" ÐÌà ` àA:à8 ¸ àYes.и ¸ 8"¸ 8" ÐÌà ` àQ:à8 ¸ àDid€you€associate€it€with€work?Ðä4¸ 8"¸ 8" ÐÌà ` àA:à ¸ àNo.Ð ` ÐÌà ` àQ:à8 ¸ àWhy€was€that,€because€it€was€happening€at€any€point€in€time?Ð<Œ¸ 8"¸ 8" ÐÌà ` àA:à8 ¸ àExactly,€it€didnððt€make€a€difference€if€I€was€at€work€or€if€I€wasÐ h¸ Ðat€home,€it€was€doing€it.€€But€I€did€find€later€on€the€pain€startedÏcoming€onto€it,€and€that€was€while€I€was€at€work.€€TheÏnumbness€was€one€thing€but€the€pain€afterwards€was€going€onÏthe€more€I€did€my€job.Ð ¸ 8"¸ 8" ÐÌÓ  Óà0 @` àò òòòEmployeeððs€Trial€TestimonyÐ ì < ÐÓÛ(ÓÓ  Óà ` àÌà ` àó óóóQ:à8 ¸ àAnd€you€said€that€it€[œnumbness]€›started€in€the€week€of€JulyÐ #h Ðthe€œ9th›,€right?Ð ¸ 8"¸ 8" ÐÌà ` àA:à8 ¸ àYes.ÐZ&ª!¸ 8"¸ 8" ÐÌÓ  Óà ` àQ:à8 ¸ àAnd€during€that€time€period€you€had€gone€to€both€a€therapeuticÐ †(Ö#! Ðmasseuse€and€a€Dr.€Perryman€and€you€didnððt€ask€workerððsÏcompensation€to€pay€for€that?Ð ¸ 8"¸ 8" ÐÓ-*ÓÌà ` àA:à8 ¸ àNo.ÐÞ,.(%¸ 8"¸ 8" ÐÌà ` àQ:à8 ¸ àThatððs€because€you€didnððt€associate€it€with€the€work?Ð /Z*'¸ 8"¸ 8" ÐÌà ` àA:à8 ¸ àI€didnððt€know€what€it€was€at€the€time.€€It€was€numbness.Ð61†,)¸ 8"¸ 8" ÐÌà ` àQ:à8 ¸ àAnd€it€happened€at€any€point€in€time;€you€didnððt€know?Ðb3².+¸ 8"¸ 8" ÐÌà ` àA:à ¸ àYes.Ð Ž5Þ0- ÐÌà ` àQ:à ¸ àOff€work,€on€work?Ð º7 3/ ÐÌà ` àA:à ¸ àRight.Ð æ9651 Їà ` àQ:à8 ¸ àAnd€you€didnððt€know€what€you€were€doing€when€you€firstÐ ° Ðstarted€having€that€numbness;€right?Ð ¸ 8"¸ 8" ÐÌà ` àA:à8 ¸ àRight.ÐòB¸ 8"¸ 8" ÐÌà ` àQ:à8 ¸ àStill€donððt€know?Ð n¸ 8"¸ 8" ÐÌà ` àA:à8 ¸ àRight.ÐJ š¸ 8"¸ 8" ÐÌò òòòà@::ÌàDeposition€of€Dr.€Joseph€F.€WadeˆÐ vÆ  ÐÌó óóóÓ  Óà ` àQ:à8 ¸ àDr.€Wade,€did€you€ultimately€form€an€opinion€as€to€the€likelyÐ ¢ò  Ðcause€of€the€disc€herniation€at€œC4›„5€in€Ms.€Stavropoulosðð€case?Ð ¸ 8"¸ 8" ÐÌà ` àA:à8 ¸ àYes,€I€did.Ðä4¸ 8"¸ 8" ÐÌà ` àQ:à8 ¸ àAnd€what€is€your€opinion?Ð`¸ 8"¸ 8" ÐÌà ` àA:à8 ¸ àWell,€certainly€the€history€that€I€took€from€her€was€that€she€hadÐ <Œ Ðthe€onset€of€numbness€in€her€hands€òòat€work,óó€and€that€she€hadÐ R¢ Ða€job€that€allowed€frequent€extension€and€rotation€of€the€neck,Ïand€this€seemed€like€a€consistent€and€likely€cause€of€herÏherniation.€€(emphasis€added)Ð ¸ 8"¸ 8" ÐÓ6/ÓÌòòò òÓ  Óà ` àóóó óQ:à8 ¸ àAnd€is€that€opinion€based€upon€a€reasonable€degree€of€medicalÐ À Ðprobability?Ð ¸ 8"¸ 8" ÐÓ.2ÓÌòòò òà ` àó óóóA:à8 ¸ àYes,€it€is.Ð"R¸ 8"¸ 8" ÐÌòòò òÓ  Óà ` àó óóóQ:à8 ¸ àOkay.€€For€the€5„6€disc,€do€you€have€an€opinion€as€to€the€causeÐ .$~ Ðof€what€was€wrong€with€that€disc?Ð ¸ 8"¸ 8" ÐÌòòò òà ` àó óóóA:à8 ¸ àI€think€that€it€was€predominately€degenerative€and€probably€noÐ p'À"  Ðmore€related€to€work€than€it€was€to€outside€activities.€€I€felt€thatÏit€was€bad€enough,€however,€that€if€it€had€a€fused€disc€above€it,Ïthat€its€degeneration€would€quickly€worsen€and€probably€leadÏto€problems,€so€I€didnððt€think€that€it€could€be€left€alone.Ð ¸ 8"¸ 8" ÐÓ73ÓÌòòò òÓ  Óà @` ààH@` àóóó ó*€€€€€*€€€€€*Ð ô-D)& ÐÓ™5ÓÌòòCROSS„EXAMINATION:Ð  0p+( ÐÌóó(Counsel€for€employer€read€extensively€from€employeeððs€deposition,€as€quotedÐ L2œ-* Ðabove,€and€further,€wherein€she€testified€that€she€did€not€associate€herÏsymptoms€with€her€job€òòuntil€she€first€saw€Dr.€Wadeóó€on€the€day€of€her€MRI,€andÐ x4È/, Ðhe€said€something€to€her€that€indicated€to€her€for€the€first€time€that€it€might€beÏwork„related.)ÌÌÓ  Óà ` àQ:à8 ¸ àNow,€having€read€that€testimony€to€you,€my€question€to€you€is:ÐÐ8 40¸ 8"¸ 8" ÐÐ æ9651 Ðà8 ` àà8¸ ` 8"` 8"à€I€want€you€to€assume€œthat€that›€is€the€history€of€the€onsetÏof€these€problems€as€she€testified€to€in€that€deposition.Ð ¸ ภà Ðà8 ` àà8¸ ` 8"` 8"àBased€upon€that€history€as€opposed€to€any€history€sheÏgave€to€you€when€you€treated€her,€can€you€state€with€aÏreasonable€degree€of€medical€certainty€that€the€rupturedÏdisc€that€you€treated€her€for€was€caused€by€her€work?Ð ¸ ภà ÐÓ¢7ÓÌà ` àA:à8 ¸ àNo,€I€cannot.ÐJ š¸ 8"¸ 8" ÐÌÓ  Óà ` àQ:à8 ¸ àCan€you€state€with€a€reasonable€degree€of€medical€certaintyÐ vÆ  Ðthat€the€disc€problem€was€aggravated€or€was€advanced€„€„€theÏseverity€of€it€was€„€„€the€severity€of€the€disc€rupture€was€causedÏby€her€work?Ð ¸ 8"¸ 8" ÐÌà ` àA:à8 ¸ àNo,€I€cannot.Ðä4¸ 8"¸ 8" ÐÌòòRE„DIRECT:Ð ` ÐóóÌà ` àQ:à8 ¸ àBut€again,€if,€as€she€stated,€she€really€wasnððt€looking€up€aÐ <Œ Ðwhole€lot€at€home€more€than€just€normal€everyday€householdÏchores,€yet€at€work€a€good€part€of€her€shift€involved€repetitiveÏbending€and€flexing€of€her€neck,€do€you€think€that€the€workÏthen€is€most€likely€a€cause€of€this€condition?Ð ¸ 8"¸ 8" ÐÌà ` àA:à8 ¸ àI€donððt€think€you€can€say€that,€no.ÐÀ¸ 8"¸ 8" ÐÌÓÓà ` àReview€of€the€findings€of€fact€made€by€the€trial€court€is€òòde€novoóó€upon€theÐ ì < Ðrecord€of€the€trial€court,€accompanied€by€a€presumption€of€the€correctness€of€theÏfinding,€unless€the€preponderance€of€the€evidence€is€otherwise.€€Tenn.€Code€Ann.òòÐ D%”  Ðððóó€50„6„225(e)(2);€€òòStone€v.€City€of€McMinnville,€óó896€S.W.2d€548,€550€(Tenn.Ð p'À"  Ð1995).Ìà ` àThe€application€of€this€standard€requires€this€Court€to€weigh€in€more€depthÏthe€factual€findings€and€conclusions€of€the€trial€courts€in€workersðð€compensationÏcases.€€òòSee€Corcoran€v.€Foster€Auto€GMC,€Inc.,€óó746€S.W.2d€452,€456€(Tenn.Ð  0p+( Ð1988).€€Ìà ` àIn€order€to€be€eligible€for€workersðð€compensation€benefits,€an€employeeÏmust€suffer€ð ðan€injury€by€accident€arising€out€of€and€in€the€course€of€employmentÏwhich€causes€either€disablement€or€death.ðð€€Tenn.€Code€Ann.€ðð€50„6„102(a)(5).€Ð Ð8 40 ÐThe€phrase€ð ðarising€out€ofðð€refers€to€causation.€€The€causation€requirement€isÏsatisfied€if€the€injury€has€a€rational,€causal€connection€to€the€work.€€òòReeser€v.Ð Ü, ÐYellow€Freight€Sys.,€Inc.,€óó938€S.W.2d€690,€692€(Tenn.€1997)€(citations€omitted).€Ð  X Ðà ` àAlthough€causation€cannot€be€based€upon€merely€speculative€or€conjecturalÏproof,€absolute€certainty€is€not€required.€€Any€reasonable€doubt€in€this€regard€is€toÏbe€construed€in€favor€of€the€employee.€€An€award€may€properly€be€based€uponÏmedical€testimony€to€the€effect€that€a€given€incident€ð ðcould€beðð€the€cause€of€theÏemployeeððs€injury,€when€there€is€also€lay€testimony€from€which€it€reasonably€mayÏbe€inferred€that€the€incident€was€in€fact€the€cause€of€the€injury.€€òòReeser€v.€YellowÐ ` ÐFreight€Sys.,€Inc.,€óó938€S.W.2d€690,€692€(Tenn.€1997)€(citations€omitted).Ð <Œ Ðà ` àWhen€the€medical€testimony€is€presented€by€deposition,€as€it€was€in€thisÏcase,€this€Court€is€able€to€make€its€own€independent€assessment€of€the€medicalÏproof€to€determine€where€the€preponderance€of€the€evidence€lies.€€€òòCooper€v.€INA,Ð À Ðóó884€S.W.2d€446,€451€(Tenn.€1994);€òòLanders€v.€Firemanððs€Fund€Ins.€Co.,€óó775Ð ì < ÐS.W.2d€355,€356€(Tenn.€1989).Ìà ` àThe€material€elements€of€a€workersðð€compensation€case€must€be€proved,€asÏin€all€other€civil€cases,€by€a€preponderance€of€all€the€evidence.€€But€a€workersððÏcompensation€case€enjoys€a€distinction€not€otherwise€shared:€because€it€is€remedialÏin€nature,€ð ðany€reasonable€doubt€as€to€whether€an€injury€arose€out€of€and€in€theÏcourse€of€employment€is€to€be€resolved€in€favor€of€the€employee.ðð€€òòParker€v.€RyderÐ ô-D)& ÐTruck€Lines,€óó591€S.W.2d€755€(Tenn.€1979).€€Absent€this€statutorily€mandatedÐ  0p+( Ðprinciple,€òòsee:€óóT.C.A.€ðð€50„6„116,€the€argument€of€the€appellant€would€prevail.Ð L2œ-* Ðà ` àThe€issue€is€closer€than€we€like,€but€we€cannot€say€that€the€evidenceÏpreponderates€against€the€finding€of€the€trial€judge,€and€his€finding€of€90€percentÏimpairment€is€affirmed.Ð Ð8 40 Ðò òòòà@ŸŸ%ÌàThe€Lump€Sum€IssueˆÐ ° Ðó óóóà ` àThe€award€of€benefits€(360€weeks)€was€commuted€to€a€lump€sum.€€TheÐ Ü, Ðappellant€complains€of€this€action,€arguing€that€T.C.A.€ðð€50„6„114(b)€allows€suchÏcommutations€if€(1)€it€is€established€that€a€lump€sum€is€in€the€best€interest€of€theÏemployee,€and€(2)€œshe›€is€capable€of€wisely€managing€and€controlling€theÏcommuted€award.€€Our€Supreme€Court€has€held€in€the€clearest€of€language€that€aÏcommutation€should€not€be€ordered€perfunctorily,€as€was€done€in€this€case.€€òòNo.Ð ¸  ÐAmer.€Ray.,€Inc.€v.€Thrasher,€óó817€S.W.2d€508€(Tenn.€1991).€€Ð ä4 Ðà ` àWe€find€no€sufficient€evidence€to€justify€the€commutation,€and€the€orderÏdirecting€a€lump€sum€award€is€accordingly€vacated.€€òòSee:€Bailey€v.€ColonialÐ <Œ ÐFreight€Systems,€óó836€S.W.2d€534€(Tenn.€1992).Ð h¸ Ðò òòòà@««&ÌàThe€œSetñêñ„ñêñoff›€IssueˆÐ ”ä Ðà ` àó óóóT.C.A.€ðð€50„6„114€provides:Ð À ÐÓÓà8 ` àò òSupremacy€of€chapter€„€Setoffs€for€payments€by€disability€plan.Ðì <` 8"` 8" Ðà8 ` àó ó(a)€No€contract€or€agreement,€written€or€implied,€or€rule,€regulationÐ "R Ðor€other€device,€shall€in€any€manner€operate€to€relieve€any€employerÏin€whole€or€in€part€of€any€obligation€created€by€this€chapter€except€asÏherein€provided.Ð ` 8"` 8" Ðà8 ` à(b)€However,€any€employer€may€set€off€from€temporary€total,Ïtemporary€partial,€and€permanent€partial€and€permanent€totalÏdisability€benefits€any€payment€made€to€an€employee€under€anÏemployer€funded€disability€plan€for€the€same€injury,€provided€that€theÏdisability€plan€permits€such€an€offset.€€Such€an€offset€from€a€disabilityÏplan€may€not€result€in€an€employee€receiving€less€than€the€employeeÏwould€otherwise€receive€under€the€Workersðð€Compensation€Law.€€InÏthe€event€that€a€collective€bargaining€agreement€is€in€effect,€thisÏprovision€shall€be€subject€to€the€agreement€of€both€parties.Ð ` 8"` 8" ÐÌÓÓà ` àThere€was€in€effect€at€the€time€of€the€injury€an€employer€funded€disabilityÏplan€which€was€approved€by€a€collective€bargaining€agreement.€€Under€this€plan,Ïthe€employee€made€disability€payments€to€the€plaintiff.€€The€trial€judge€properlyÏordered€such€payments€off„set€against€the€workersðð€compensation€award,€butÏlimited€the€off„set€to€disability€payments€made€ð ðas€of€the€time€of€trial.ððÐ æ9651 Ðà ` àThere€òòprima€facieóó€appears€to€be€no€language€in€the€statute€limiting€the€off„Ð ° Ðset€to€payments€made€ð ðas€of€the€time€of€trial.ððÌà ` àThe€language€of€the€statute€is€clear.€€òòAny€paymentóó€to€an€employee€under€anÐ  X Ðemployer€funded€plan€which€permits€an€offset€and€which€involves€the€same€injury,Ïand€is€approved€by€the€parties€to€any€collective€bargaining€agreement,€may€be€off„¼set€from€œworkersðð€›compensation€benefits.€€There€is€no€de„limiting€language.Ìà ` àThe€intent€of€the€statute€is€to€guarantee€that€employees€receive€the€fullÏbenefit€of€the€workersðð€compensation€statute,€and€to€relieve€employers€from€theÏburden€of€twice€compensating€its€employees€by€paying€both€disability€andÏworkersðð€compensation€benefits€for€the€same€injury€and€at€the€same€time.€€It€isÏundisputed€that€Plaintiff€received€such€disability€benefit€payments€during€the€timeÏthat€she€was€not€able€to€work€as€a€result€of€her€cervical€disc€condition.€€It€is€alsoÏclear€that€the€collective€bargaining€agreement€in€place€between€its€representedÏemployees€allows€such€a€œsetoff›€to€be€coordinated€between€disability€payments€andÏworkersðð€compensation€benefits.Ìà ` àThe€record€reveals€no€reason€why€the€statute€should€not€be€enforced.€ItsÏprovisions€are€clear€and€unequivocal,€and€the€judgment€will€be€modified€to€provideÏthat€the€employer€may€off„set€all€disability€payments€made€to€the€plaintiff€at€anyÏtime€for€the€same€injury,€from€the€compensation€award.Ìà ` àAs€modified,€the€judgment€is€affirmed,€with€the€costs€taxes€equally€to€theÏparties.€€The€case€is€remanded€for€all€appropriate€purposes.ÌÓÓ€Ô‡¼-#¼¼¼„ÇÔà ` àà ¸ àà  àà h àà À àà  àÐ L2œ-* Ðà ` àà ¸ àà  àà h àà À àà  àà p à_______________________________Ìà ` àà ¸ àà  àà h àà À àà  àà p àWilliam€H.€Inman,€Senior€JudgeÔ#†¼„Ǽ¼¼-#´Z#ÔÐ r4Â/, ÐÌÌÌÌÐ Ú9*51 ЇCONCUR:ÌÌà ` àÔ‡¼-#¼¼¼„ÇÔÌÌÌ_______________________________ÌFrank€F.€Drowota,€III,€JusticeÔ#†¼„Ǽ¼¼-#}\#ÔÐ  l Ðà ` àÔ‡¼-#¼¼¼„ÇÔÌÌÌ_______________________________ÌJoe€C.€Loser,€Jr.,€Special€JudgeÔ#†¼„Ǽ¼¼-#!]#ÔÐ l¼  ÐÔ‡¼-#¼¼¼„ÇÔà ` àà ¸ àà  àà h àà À àà  àœñìñ_______________________________ñìñ›Ìà ` àà ¸ àà  àà h àà À àà  àœñëñWilliam€H.€Inman,€Senior€JudgeñëñÔ#†¼„Ǽ¼¼-#»]#Ô›ÌÌÌÌÌÌœñíñCONCUR:ñíññîñÌÔ‡¼d¼¼¼$êÔÌÌÌ_______________________________ÌFrank€F.€Drowota,€III,€JusticeÔ#†¼$ê¼¼¼d`#ÔÐ f¶ ÐÔ‡¼d¼¼¼$êÔÌÌÌ_______________________________ÌJoe€C.€Loser,€Jr.,€Special€JudgeÔ#†¼$ê¼¼¼d­`#Ôñîññðñ›ñðññïñÐ  ` Ðñïññðñ›ñðññðñÑX°ÑÒXHÒÔ‡ ¼½G ¼¼¼„ÇÔà@  DàIN€THE€SUPREME€COURT€OF€TENNESSEEˆÐ ° ÐÌà@)DàAT€NASHVILLEˆÌÌÌÌDENISE€STAVROPOULOS,€ñðñññññðñà  àñðñññññðñà  à)€à p àMaury€CircuitÐ ø H Ðà ` àà ¸ àà  àà h àà À àà  à)à p àNo.€€7515Ð  T Ðà ` àPlaintiff„Appellee,€ñðññòññðñà À àñðññòññðñà À àà  à)Ð  ` Ðñðññýññýññðññðññýñßr€ (<,(j 8` `€€@E ` 8ttxPXð  rßñýññðñà ` àà ¸ àà  àà h àà À àà  à)à p àHon.€Jim€T.€Hamilton,€Judgeà (# àÐ l  Ðvs.à ` àà ¸ àà  àà h àà À àà  à)Ð (x  Ðà ` àà ¸ àà  àà h àà À àà  à)ÌSATURN€CORPORATION,à À àà  à)à p àNO.€01S01„9711„CV„00251Ð @  Ðà ` àà ¸ àà  àà h àà À àà  à)Ìà ` àDefendant„Appellant.à À àà  à)à p àAffirmed€as€Modified€Ð X¨ ÐÌÔ‡ 5] 5 ¼ ¼½GÔÌÌà@ŽŽ(Dàò òòòÔ#† ¼½G ¼ 5 5]_e#ÔÔ‡ XÔðX ¼ ¼½GÔJUDGMENT€ORDERóóó óˆÐ l ÐÌÌÓÖÓà ` àà ¸ àThis€case€is€before€the€Court€upon€motion€for€review€pursuant€to€Tenn.€CodeÏAnn.€ðð€50„6„225(e)(5)(B),€the€entire€record,€including€the€order€of€referral€to€the€SpecialÏWorkers'€Compensation€Appeals€Panel,€and€the€Panel's€Memorandum€Opinion€settingÏforth€its€findings€of€fact€and€conclusions€of€law,€which€are€incorporated€herein€by€reference;ÌÌà ` àà ¸ àWhereupon,€it€appears€to€the€Court€that€the€motion€for€review€is€not€well„¼taken€and€should€be€denied;€andÌÌà ` àà ¸ àIt€is,€therefore,€ordered€that€the€Panel's€findings€of€fact€and€conclusions€ofÏlaw€are€adopted€and€affirmed,€and€the€decision€of€the€Panel€is€made€the€judgment€of€theÏCourt.ÌÌà ` àà ¸ àCosts€are€taxed€equally€to€the€parties.ÌÌà ` àà ¸ àIt€is€so€ordered.ÌÌà ` àà ¸ àà  àà h àà À àà  àà p àPER€CURIAMÌDrowota,€J.,€not€participatingÌÔ#†XÜÿXX XÔðy`#ÔÔ#†¼„ǼXXÜÿ»e#Ôñðñ›