ÿWPCŠ ~Š¿MʹÄðS=÷Á@.éíÛW„9W³EOr/Þš#›[Ž«&Ö ÚG kRëŸÏCv;®ŽfðÔMeÇsß}n’ÙÓ‘û¨±šë¼A…:s¥¤{„¡5 :Ò3ŸZÜ¿³@áò[ëŲÎ{A¢Ï[†Ú±|×¿Ê ƒè˜¬$(IƒFÜŃ`Z¦_b(2Eˆq©HôÇmÀê‚GÞiáv¯æ;þÚ¿l3´™>À®çV…déUΉ0Ý€hYaMTx¹Åt/ sà7ë'¸„Fμoé+¡zoÇ›–ä© ;G3@%f!])ëØZƒþ$M™Ôu«›(…»Ok³=·ì¡yáÚ0•8`§a!\/ËaY¼VŒÓóìIP©ÍQNSš $$k‰™,÷ºhµ×lì÷r?Ÿ!›V·lÜuœWv³‰zâxЦ^§¨j¼0jzÓFÇ%»-¿›7ƒé gå.ë‹ “•í9Ù?}A‡¶!ŠöÚqìÏ1•÷k>Q0úÍ‚œðne–Ò¡œàÐé$@¬ײvz¶*B¤¾`Š0ëNÿ¡ca׿ztå^wP'ú@ôe+*Ù›2âÓ¹eCÎ:nªÝþÅ;¾-#!vUN— %å 0(ë4.=w@EUB…U:ÇUB7CU:z N´ ^ ¶  mÄ U<Û  U: ÆX Æ Æä ƪ pU:‹‹‹‹ AQÅÆ 0DÜ 0D  0Ddd D/¨ B× Bô D3 0FD˜HP LaserJet 8000 DN PSØÚØÚÚØØÚ0(ÖÃ9 Z ‹6Times New Roman RegularX($¡¡ ýÝ ƒ!¯"ÝÝ  ÝÔ€ X>TXXXÔÔ€ p€ X X>TÔÓ  Óò òÔ Ad ÔFILEDÔ€ X>TX  p€ÔÐ  ÐÌSeptember€22,€1999ÌÌCecil€Crowson,€Jr.ÌAppellate€Court€ClerkÔdAhÔó ó{Z='3|xX) ;)<)D=)>)Ó€H)K)VL)îM)Ó€W)X)¿4*NewsGoth BT Roman,–ûyAZ‹"Arial Regular+@FÐAZ‹*NewsGoth BT Roman -Ý ƒ!¯"ÝÝ  ÝÔ_ÔÔ€XXXXÔÔ€¸¢XXÔÓ  Óò òÔ Ad ÔFILEDÔ€XX¸¢ÔÐ  ÐÌSeptember€20,€1999ÌÌCecil€Ô_ÔCrowsonÔ_Ô,€Jr.ÌAppellate€Court€ClerkÔdAxÔó ó,–ûyAZ‹"Arial Regular*w1'L ÿU‹ÿÀÀÀ.èB' Z‹$Arrus BT Roman ýÝ ƒ!¯"ÝÝ  ÝÔ€X>TXXXÔÔ€p€ XX>TÔÓ  Óò òÔ Ad ÔFILEDÔ€X>TX p€ÔÐ  ÐÌSeptember€22,€1999ÌÌCecil€Crowson,€Jr.ÌAppellate€Court€ClerkÔdAhÔó ó,–ûyAZ‹"Arial RegularLevel 1Level 2Level 3Level 4Level 5‚Level 1Level 2Level 3Level 4Level 5„Level 1Level 2Level 3Level 4Level 5…Level 1Level 2Level 3Level 4Level 5 Ý ƒ!¯"ÝÝ  ÝÔ€XXXXÔÔ€¸¢XXÔÓ  Óò òÔ Ad ÔFILEDÔ€XX¸¢ÔÐ  ÐÌSeptember€20,€1999ÌÌCecil€Crowson,€Jr.Ð xx ÐAppellate€Court€ClerkÔdAhÔó ó,–ûyAZ‹"Arial Regular !"#(Cþÿ<<CÿÿƒLevel 1Level 2Level 3Level 4Level 5(3¯$¢¢Ý ƒ!ÝÝ  Ý(3¯$££Ý ƒ!ÝÝ  Ý($$””ò òÚ  Ú1Ú  Úó ó'''÷ÿ dxd düÿP Pd&&&&'ÿÿdxd6k¦$Triangleððà0  àÝ ƒ!ÝÝ  ÝÔ_ÔÑT°ÑÒ°ÒÒX°ÒÓ  ÓÑ  ÑÑ  ÑÔ  ÔÔ€ XlÖXXXÔÑ8€ ÄS %%dÜdÈ8Ññ>)ñ›ñ>)ñÑTR[° AØ'Pleading3Ø' AØ'ÿ Legalÿ3Ø'TÑñH)ññ>)ñßr€(<,(j 8` `€€@E Z` ttx0XTð ærßñ>)ññH)ññH)ñÔ_Ôßr€ (<,(j 8` `€€@E Z` 8ttxPXTð  rßÔ_ÔÔ_ÔñH)ññX)ñÔ€ XXX XlÖÔñX)ñÔ_Ô€à@PPDàò òIN€THE€SUPREME€COURT€OF€TENNESSEEˆÐ T Ðà@­ ­ DàSPECIAL€WORKERSðð€COMPENSATION€APPEALS€PANELˆÌà@ÀÀ*DàAT€JACKSONˆÌà@"Dà(February€12,€1999€Session)òòˆÐ  Ä ÐÌÌÌÌóóDANA€STORY,à@##/Dà)ˆÐ ´ ` Ðà@##/Dà)ˆÌà ` àPlaintiff/Appellee,à@##/Dà)ˆÐ Œ8  Ðà@##/Dà)ˆà p àà È àMADISON€COUNTY€CHANCERYÐ x$  Ðv.à@##/Dà)ˆÐ d  Ðà@##/Dà)ˆà p àà È àNO.€02S01„9807„CH„00075Ð Pü  ÐLEGION€INSURANCE€COMPANY,à@##/Dà)ˆÐ <è  Ðà@##/Dà)ˆà p àà È àHONORABLE€JOE€C.€MORRIS,Ð (Ô  Ðà ` àDefendant/Appellant.à@##/Dà)ˆà p àà È àCHANCELLORÐ À Ðà@##/Dà)ˆÌó óÌÌÌò òòòFor€the€Appellee:à  àà h àà À àà  àóó€€€€€òòFor€the€Appellant:ó óóóÐ žJ ÐÌMark€P.€Barnettà  àà h àà À à€€€€€à  à€€€€€Lee€Anne€MurrayÐ p ÐHILL€BORENà  àà h àà À à€€€€€à  àà p à€€€€€Cynthia€Ô_ÔDeBulaÔ_Ô€BainesÐ V Ð1269€North€Highland€Avenueà À àà  à€€€€€Ô_ÔFEENEYÔ_Ô€&€MURRAYÐ <è ÐP.O.€Box€3539à  àà h àà À àà  à€€€€€2040€First€American€CenterÐ "Î ÐJackson,€TN€38302„3539à h àà À àà  à€€€€€P.O.€Box€198685Ð ´ Ðà ` àà ¸ àà  àà h àà À àà  à€€€€€Nashville,€TN€37219„8685ÌÌÌÌÌÌÌÌÌÌà@ÂÂ&Dàòòò òÔ€ ¼äÜ »X XÔMEMORANDUM€OPINIONó óóóˆÐ ê(–"& ÐÔ€ XX » ¼äÜÔÌÌÌÌÌÌà@'Dàò òòòMEMBERS€OF€PANEL:óóó óˆÐ b/)- ÐÌà@ÈÈ#Dàò òJUSTICE€JANICE€M.€HOLDERˆÐ 41à*/ Ðà@CC"DàSENIOR€JUDGE€L.€T.€Ô_ÔLAFFERTYÔ_ÔˆÌà@ÊÊDàSPECIAL€JUDGE€J.€STEVEN€STAFFORDó óˆÐ  3¸,1 ÐÌÌÌÌÌò òÌAFFIRMEDà€ŽŽ9€%àSTAFFORD,€SPECIAL€JUDGEó óˆÐ  b938 ÐÔ_Ôà@,Dàò òòòOPINIONóóó óˆÐ T ÐÌÓ€Óà ` àThis€workerððs€compensation€appeal€has€been€referred€to€the€Special€WorkersððÏCompensation€Appeals€Panel€of€the€Supreme€Court€in€accordance€with€Tenn.€Code€Ann.€ðð€50„¼6„225(e)€for€hearing€and€reporting€to€the€Supreme€Court€of€findings€of€fact€and€conclusionsÏof€law.Ìà ` àReview€of€the€findings€of€fact€made€by€the€trial€court€is€òòde€novoóó€upon€the€record,Ð Ô €  Ðaccompanied€by€a€presumption€of€the€correctness€of€the€findings,€unless€the€preponderanceÏof€the€evidence€is€otherwise.€€Tenn.€Code€Ann.€ðð€50„6„225(e)(2);€òòòòò òStone€v.€City€ofÐ ¤P  ÐMcMinnvilleó óóó,€óó896€S.W.2d€548,€550€(Tenn.€1995).€€The€application€of€this€standard€requiresÐ  ¸  Ðthis€Court€to€weigh€in€more€depth€the€factual€findings€and€conclusions€of€the€trial€court€in€aÏworkerððs€compensation€case.€€òòSeeò ò€òòCorcoran€v.€Foster€Auto€GMC,€Inc.ó óóóóó,€746€S.W.2d€452,€456Р܈ Ð(Tenn.€1988).€€However,€considerable€deference€must€be€given€to€the€trial€judge,€who€hasÏseen€and€heard€witnesses€especially€where€issues€of€credibility€and€weight€of€oral€testimonyÏare€involved.€€òòòòò òJones€v.€Hartford€Accident€&€Indem.€Co.ó óóó,€óó811€S.W.2d€516,€521€(Tenn.€1991).Ð À Ðà ` àThe€defendant€asserts€that€the€trial€court€erred€when€it€found€that€the€plaintiff€sufferedÏa€35%€permanent€partial€disability€to€each€arm€and€submits€the€following€issues€for€ourÏreview:ÌÓ€Óà ` àI.à0 ¸ àThe€plaintiff€did€not€suffer€an€injury€as€defined€by€the€Tennessee€WorkersððÐ ´`" ÐCompensation€Act;Ð ¸ €%¸ €% ÐÌà ` àII.à0 ¸ àThe€trial€court€failed€to€give€greater€weight€to€the€testimony€of€the€treatingÐ „!0% Ðphysician€rather€than€the€evaluating€physician;€andÐ ¸ €%¸ €% ÐÌà ` àIII.à0 ¸ àThe€plaintiff€did€not€suffer€a€vocational€disability€pursuant€to€the€TennesseeÐ T$( ÐWorkersðð€Compensation€Act.Ð ¸ €%¸ €% ÐÌÓÓà ` àFor€the€following€reasons,€we€affirm€the€judgment€of€the€trial€court.ÌÓÓÌÓÓà@-Dàò òòòFACTSóóˆÐ ô) #. ÐÓ€Óà ` àó óThe€plaintiff€is€a€twenty„eight„year„old€female.€€She€is€a€high€school€graduate€whoÐ Ô+€%0 Ðattended€college€at€both€Memphis€State€University€and€Lambuth€University.€€She€subsequentlyÏenrolled€at€Jackson€State€Community€College€where€she€received€a€nursing€degree€in€1994.Ìà ` àWhile€attending€nursing€school,€she€was€employed€at€the€Jackson„Madison€CountyÏGeneral€Hospital.€€After€attaining€her€nursing€degree,€she€was€employed€by€WorkcareÏResources.€€She€was€subsequently€hired€as€director€of€professional€services€at€Housecall€HomeÏHealthcare.€€In€August€1996,€she€went€to€work€for€the€Chester€County€Nursing€HomeÏ(hereinafter€known€as€the€ð ðnursing€home.ðð)€as€the€assistant€director€of€nursing.€€Her€jobÏrequired€her€to€assist€the€director€of€nursing€as€needed.€€Her€primary€objective€was€to€be€theÏâ âcare€plan€team€coordinator€with€her€emphasis€being€on€updating€all€the€care€plans€for€theÐ |8(2B Ðnursing€home€patients.€€Since€the€plaintiff€was€the€only€person€with€any€computer€background,Ïshe€was€also€required€to€enter€the€care€plan€data€into€the€computer.Ìâ âà ` àThe€plaintiff€testified€that€the€nursing€home€was€at€full€capacity€when€she€began€workÏand€that€care€plans€were€required€to€be€prepared€for€each€patient.€€The€care€plans€were€anÏevaluation€of€each€patient€and€were€required€by€state€guidelines.€€They€were€used€to€verify€thatÏthe€patients€needed€to€be€in€the€nursing€home€thereby€allowing€the€nursing€home€to€receiveÏpayment€for€their€care.Ìà ` àAt€the€time€the€plaintiff€was€employed,€the€nursing€home€was€several€months€behindÏon€the€care€plans.€€The€preparation€of€the€care€plans€was€a€team€effort€involving€everyone€whoÏcared€for€the€patient.€€This€initially€resulted€in€a€written€report€that€the€plaintiff€wouldÏsubsequently€enter€into€the€computer.€€The€plaintiff€was€the€team€leader€and€spent€theÏmajority€of€her€time€working€on€the€care€plans€and€entering€data€into€the€computer.Ìà ` àDuring€the€last€part€of€October€1996,€the€plaintiff€began€experiencing€numbness€andÏtingling€in€her€right€hand.€€This€gradually€began€to€occur€in€both€hands.€€She€reported€this€toÏher€employer€the€first€part€of€November€but€did€not€request€to€see€a€physician€until€the€middleÏof€November€because€she€was€hopeful€that€the€symptoms€would€go€away.€€In€an€effort€toÏalleviate€the€symptoms,€she€personally€bought€splints€and€began€to€wear€them.Ìà ` àAfter€her€condition€did€not€improve,€she€saw€Dr.€Lowell€Stonecipher€in€December€1996.€ÏAt€this€time,€the€plaintiff€was€spending€approximately€six€hours€per€day€writing€and€enteringÏdata€into€the€computer.€€She€testified€that€once€the€care€plans€were€caught€up,€she€believedÏthat€she€would€only€be€required€to€spend€approximately€two€hours€per€day€on€the€plans.€€WhenÏshe€saw€Dr.€Stonecipher,€she€did€not€request€to€be€taken€off€work€because€she€did€not€wantÏto€get€any€further€behind.Ìà ` àAfter€seeing€Dr.€Stonecipher€the€first€time,€the€plaintiffððs€hands€grew€worse.€€Her€wrists€Ïached€and€she€had€numbness€and€tingling€in€her€thumb€and€first€two€fingers.Ìà ` àThe€plaintiff€returned€to€see€Dr.€Stonecipher€on€January€6,€1997.€€On€her€return€to€work€Ïthat€day,€she€was€informed€by€the€nursing€home€that€her€position€was€being€eliminated.€€AtÏthe€time€of€her€termination,€the€care€plans€were€virtually€up„to„date.Ìà ` àThe€plaintiff€was€off€work€for€a€month€and€then€was€employed€as€a€medical€careÏmanager€for€Crawford€and€Company.€€She€was€not€required€to€do€any€computer€work€in€thisÏjob.€€The€plaintiff€left€Crawford€and€Company€in€November€1997€and€obtained€employmentÏwith€Corvel€Corporation€in€the€same€capacity.Ìà ` àThe€plaintiff€testified€that€while€working€for€the€€nursing€home,€her€strength€decreasedÏby€approximately€75%.€€She€also€testified€that€the€pain€in€her€hands€peaked€in€January€1997Ïand€that€it€has€remained€constant€since€that€time.€€She€suffers€pain€on€a€daily€basis€and€is€veryÏweak.€€The€pain€in€her€hand€wakes€her€up€at€least€once€each€night.€€Because€of€her€problem,Ïshe€is€very€careful€about€how€she€picks€things€up.€€Her€husband€is€required€to€do€most€of€theÏhousework€including€vacuuming€and€mopping.Ð \:4J Ðà ` àThe€only€time€the€plaintiff€drives€is€when€she€is€required€to€do€so€with€her€job.€€She€Ïexperiences€great€pain€while€driving€because€of€the€vibration€of€the€steering€wheel€and€theÏrequired€gripping.€€In€her€job,€she€is€sometimes€required€to€drive€as€far€as€Memphis.€€SheÏtestified€that€she€has€modified€her€driving€technique€so€that€she€now€drives€with€her€knees€onÏoccasion€or€drives€under€handed€and€alternates€her€hands.Ìà ` àBefore€beginning€work€for€the€nursing€home,€the€plaintiff€was€required€to€take€a€pre„¼employment€physical.€€No€problems€were€noted€on€the€physical€examination.€€The€plaintiffÏtestified€that€she€had€never€had€any€problems€with€her€hands,€experienced€joint€pain€orÏsuffered€from€a€serious€illness€before€she€began€work€at€the€nursing€home.€€She€has€never€beenÏdiagnosed€with€lupus€or€rheumatoid€arthritis.€€Before€her€injury,€she€was€able€to€water€ski€andÏrode€a€jet€ski€most€weekends€that€the€weather€permitted.€€She€is€now€unable€to€participate€inÏany€of€these€activities.Ìà ` àThe€plaintiff€testified€that€she€would€now€be€unable€to€work€as€a€staff€nurse€due€to€herÏinability€to€lift€patients.€€She€could€not€work€in€a€hospital€nursery€because€of€her€inability€toÏperform€repetitive€lifting.€€Because€of€her€inability€to€lift,€she€also€could€not€work€in€the€homeÏhealth€field.Ìà ` àSince€she€left€Dr.€Stonecipherððs€care,€her€condition€has€not€improved.Ìà ` àThe€plaintiff€never€took€any€time€off€work€because€of€her€problems€nor€did€she€everÏrequest€any€time€off€work.€€She€continued€to€do€her€job€at€the€nursing€home€at€all€times.Ìà ` àThe€plaintiff€testified€that€she€did€not€want€to€miss€work€because€she€did€not€want€toÏbecome€further€behind.€€She€stated€that€no€one€else€could€operate€the€computer€and€she€feltÏresponsible€for€getting€the€job€done.Ìà ` àArchie€Story,€the€plaintiffððs€husband,€testified€that€the€plaintiff€had€no€physical€problemsÏbefore€working€at€the€nursing€home.€€He€stated€that€he€is€now€required€to€do€almost€all€of€theÏhousework€and€that€they€have€had€to€change€their€lifestyle€because€of€the€plaintiffððs€condition.€ÏWhen€they€buy€groceries€or€cleaning€supplies,€they€must€buy€smaller€sizes€so€that€the€plaintiffÏwill€be€able€to€lift€and€handle€the€containers.ÌÓ€ÓÌà@ŸŸ'Dàò òòòMEDICAL€EVIDENCEóóó óˆÐ <-è&7 ÐÌÓ€Óà ` àThe€plaintiff€was€first€seen€by€Dr.€Lowell€Stonecipher,€an€orthopaedic€surgeon,€onÏDecember€13,€1996.€€He€diagnosed€the€plaintiff€as€being€in€the€early€stages€of€carpal€tunnelÏsyndrome,€placed€her€on€medication€and€prescribed€splints€for€her€to€wear€at€night.Ìà ` àThe€plaintiff€returned€to€see€Dr.€Stonecipher€on€January€6,€1997,€and€advised€him€thatÏshe€was€worse.€€Dr.€Stonecipher€ordered€a€nerve€conduction€test€which€was€normal.Ìà ` àWhen€Dr.€Stonecipher€saw€the€plaintiff€on€January€17,€1997,€she€was€still€havingÏsymptoms€so€he€changed€her€medication€and€gave€her€a€cortisone€injection.€€The€plaintiffÏreturned€three€weeks€later€at€which€time€he€changed€her€medication€again€and€ordered€labÏwork.Ð \:4I Ðà ` àDr.€Stonecipher€last€saw€the€plaintiff€on€May€7,€1997.€€He€did€not€believe€that€theÏplaintiff€had€suffered€any€permanent€anatomical€impairment.€€He€also€testified€that€he€did€notÏtake€the€plaintiff€off€work€or€place€any€job€restrictions€on€her.Ìà ` àOn€July€14,€1997,€the€plaintiff€saw€Dr.€Joseph€Boals,€an€orthopaedic€surgeon,€forÏpurposes€of€an€evaluation.€€His€examination€revealed€a€positive€Phalenððs€test€bilaterally,Ïgeneralized€tenderness€to€touch€over€the€wrist€and€very€inadequate€grip€strength€bilaterally.€ÏDr.€Boals€diagnosed€the€plaintiff€as€suffering€from€overuse€syndrome€to€both€upper€extremitiesÏand€possible€carpal€tunnel€syndrome€bilaterally.€Ìà ` àDr.€Boals€testified€that€the€plaintiff€was€a€very€difficult€person€to€evaluate€due€to€theÏplaintiffððs€symptomatology€and€marked€loss€of€grip€strength.€€He€opined€that€the€work€that€theÏplaintiff€had€performed€for€the€nursing€home€for€six€months€was€the€cause€of€her€problems.Ìà ` àDr.€Boals€testified€that€the€plaintiff€had€suffered€a€25%€permanent€anatomicalÏimpairment€to€each€upper€extremity.€He€equated€10%€of€the€disability€rating€to€a€mild€carpalÏtunnel€syndrome€with€the€remaining€anatomical€disability€being€given€for€the€loss€of€strength.€ÏHe€testified€that€his€rating€was€a€combination€of€loss€of€strength€from€overuse€€syndrome€andÏthe€presence€of€carpal€tunnel€syndrome.ÌÓ€ÓÌà@.Dàò òI.ó óˆà p àÐ Äp! ÐÌÓ€Óà ` àThe€defendant€asserts€that€the€plaintiff€has€not€suffered€a€compensable€injury€as€definedÏby€the€Workersðð€Compensation€Act€because€she€did€not€miss€any€time€from€work€prior€to€herÏtermination.€€The€Workers'€Compensation€Act€defines€a€compensable€injury€in€pertinent€partÏas€ð ð€.€.€.€an€injury€by€accident€arising€out€of€and€in€the€course€of€employment€which€causesÏeither€disablement€or€death€of€the€employee€.€.€.ðð€T.C.A.€€ðð€50„6„102(a)(5).€€€If€all€threeÏelements€are€present,€the€injury€is€compensable.€€òòòòò òFink€v.€Caudleóó,ó óóó€856€S.W.2d€952,€958Ð ¬&X - Ð(Tenn.€1993).€Ìà ` àIn€support€of€this€argument,€the€defendant€relies€uponò òòò€òòLawson€v.€Lear€Seating€Corpóó.Ð |)(#1 Ðó óóó944€S.W.2d€340€(Tenn.€1997),€and€òòòòò òBarker€v.€Home„Crest€Corp.óó,ó óóó€805€S.W.2d€373€(Tenn.Ð ä*$3 Ð1991).€€The€defendant€argues€that€òòòòò òLawsonó óóóóó€and€òòò òòòBarkeróóó óóó€hñ:)ñeñ:)ññ;)ñoñ;)ñld€that€a€plaintiff€is€not€entitled€toÐ L,ø%5 Ðdisability€benefits€until€the€plaintiff€suffers€a€compensable€injury€and€misses€work.€€TheÏdefendantððs€reliance€on€these€cases,€however,€is€misplaced.€€In€òòò òòòLawsonóó,ó óóó€the€Supreme€CourtÐ /È(9 Ðreversed€a€trial€court€ruling€that€the€plaintiff,€who€suffered€from€carpal€tunnel€syndrome,€failedÏto€commence€her€action€within€one€year€of€the€accident€causing€her€injury.€€ò òòòòòLawsonóóóóó ó,€944Ð ì1˜+= ÐS.W.2d€at€340.€€The€Court€noted€that€in€the€case€of€repetitive€stress€injuries€identifying€theÏð ðaccident€resulting€in€injuryðð€is€problematic€because€the€symptoms€appear€and€worsen€overÏan€extended€period€of€time€and€may€subside€when€the€employeeððs€job€is€altered.òòò ò€€òòId.óó€ó óóóat€341.€Ð $6Ð/C ÐAfter€reviewing€the€approaches€taken€by€other€jurisdictions,€the€Court€adopted€ð ðthe€last€dayÏâ âworkedðð€rule€for€determining€when€the€statute€of€limitations€period€is€triggered.€€òòò òòòId.óóó óóó€at€342.€Ð ô8 2G ÐÓ€Óà0 ` àà8¸ ` €%` €%àð ðEach€day€Lawson€worked€contributed€to€her€injury.€Because€there€is€noÏâ âone€particular€incident€or€evidence€identifiable€as€an€ð ðaccident€resultingÏin€the€injuryðð€and€because€Lawson€suffered€new€trauma€to€her€hand€eachÏday€she€worked,€we€hold€that€the€date€of€the€accidental€injury€is€the€dateÏthat€Lawson€was€no€longer€able€to€work€because€of€her€€injury.€€TheÏrecord€establishes€that€June€17,€1993,€was€the€first€day€that€LawsonÏwas€unable€to€perform€her€job;€therefore€the€statute€of€limitationsÏcommenced€at€that€time.ððÐ ¸ (#¸ (# ÐÌòòòòò òId.ó óóóóó€at€342„343.€€Ð Äp  ÐÌÓ€Óà ` àòòòòò òBarkeróó€ó óóóalso€involved€a€claim€for€carpal€tunnel€syndrome.€€The€Supreme€Court€used€theÐ ¤P  Ðð ðlast€day€workedðð€rule€to€determine€that€the€insurer€providing€coverage€on€the€date€when€theÏconditionððs€severity€prevented€the€employee€from€working€would€be€responsible€forÏcompensation.€€805€S.W.2d€at€376.Ìà ` àThe€defendant€misreads€these€cases€to€hold€that€a€plaintiff€is€not€entitled€to€disabilityÏbenefits€until€the€plaintiff€suffers€a€compensable€injury€òòandóó€misses€work.€€€Neitheròòò ò€òòLawsonó óóóóó€norÐ ¬X Ðòòòòò òBarkeró óóóóó€addressed€the€issue€of€causation;€neither€case€held€that€a€worker€has€not€been€injuredÐ À Ðuntil€the€worker€has€missed€work.€€òòò òòòLawsonóóó óóó€was€limited€to€identifying€a€date€to€trigger€theÐ |( Ðrunning€of€the€statute€of€limitations.€òòò ò€òòBarkeróóó óóóapplied€the€"last€day€worked"€rule€to€determineÐ ä Ðwhich€insurer€would€pay€benefits.€€Ìà ` àThe€ð ðlast€date€workedðð€rule€was€adopted€in€this€state€to€prevent€workers€with€gradualÏand€repetitive€injuries€from€losing€the€opportunity€to€bring€claims€due€to€the€statute€ofÏlimitations.€€Applying€this€narrow€rule€to€questions€of€causation€would€create€a€precedentÏwhich€would€make€any€worker€injured€by€repetitive€stress€ineligible€for€compensation€unlessÏthat€worker€misses€work.€€This€application€is€inconsistent€with€the€nature€of€the€TennesseeÏWorkers€Compensation€Act€which€is€designed€to€protect€workers€from€economic€devastationÏfollowing€job„related€injuries.òòò ò€€òòBetts€v.€Tom€Wade€Ginóó,ó óóó€810€S.W.2d€140,€142€(Tenn.€1991).€Ð $'Ð + ÐÓ€Ó€à8 ` àà8¸ ` (#` (#àð ðTennesseeððs€workersðð€compensation€laws€must€be€construed€soÐ Œ(8"- Ðas€to€ensure€that€injured€employees€are€justly€and€appropriatelyÏreimbursed€for€debilitating€injuries€suffered€in€the€course€ofÏservice€to€the€employer.ððÐ ¸ Ð ¸ Ð  ÐÌòòò òòòId.óó€ó óóóat€142„43.€€€Ð <-è&2 ÐÌÓÀÓà ` àThe€medical€evidence€and€the€lay€evidence€in€this€case€support€a€causal€connectionÏbetween€ñ<)ñStoryñ<)ññ=)ñthe€plaintiffñ=)ñððs€injury€and€her€employment€at€the€nursing€home.€€€We€hold€that€herÏfailure€to€miss€work€is€not€fatal€to€her€claim.€€ÌÓÀÓÌà@ää.Dàò òII.ˆÐ ø4¤.; Ðó óÌÓ€Óà ` àThe€defendant€asserts€that€the€trial€court€erred€in€failing€to€give€greater€weight€to€theÏâ âtestimony€of€the€treating€physician€than€the€evaluating€physician.Ð @8ì1? Ðà ` àThe€treating€physician,€Dr.€Stonecipher,€treated€the€plaintiff€from€December€13,€1996,Ïâ âuntil€May€7,€1997.€According€to€his€records,€he€saw€the€plaintiff€six€times€during€this€period.€ÏHe€believed€that€the€plaintiff€had€an€early€carpal€tunnel€that€would€get€worse€over€time.€ÏHowever,€he€did€not€take€her€off€work€nor€did€he€restrict€her€in€any€way.€€He€did€not€find€thatÏthe€plaintiff€had€suffered€any€permanent€anatomical€impairment.Ìà ` àDr.€Boals€saw€the€plaintiff€only€once€for€purposes€of€an€evaluation.€€He€found€theÏplaintiff€to€have€a€positive€Phalenððs€test€bilaterally,€tenderness€to€touch€over€her€wrists€and€veryÏinadequate€grip€strength€bilaterally.€€He€diagnosed€the€plaintiff€with€severe€overuse€syndrome€Ïand€possible€carpal€tunnel€syndrome.€€He€opined€that€the€cause€of€the€plaintiffððs€problem€wasÏthe€work€she€had€performed€for€the€nursing€home.€€He€testified€that€she€suffered€a€25%Ïpermanent€anatomical€impairment€to€both€arms€with€10%€of€the€impairment€relating€to€theÏcarpal€tunnel€syndrome€and€the€remainder€attributed€to€her€loss€of€strength.Ìà ` à€Both€Dr.€Stonecipher€and€Dr.€Boals€testified€by€deposition.€€In€making€his€ruling,€theÏtrial€judge€noted€that€he€had€the€responsibility€of€reconciling€the€conflicting€medical€evidence.ÌWhen€medical€testimony€differs,€it€is€within€the€discretion€of€the€trial€judge€to€determine€whichÏexpert€testimony€to€accept.€€òòòòò òKellerman€v.€Food€Lion,€Inc.ó óóóóó,€929€S.W.2d€333,€335€(Tenn.Ð l Ð1996);€òòòòò òJohnson€v.€Midwesco,€Incóó.ó óóó,€801€S.W.2d€804€(Tenn.€1990).Ð Ô€  ÐÓ€Óà8 ` àà8¸ ` (#` (#àð ð[W]here€the€issues€involve€expert€medical€testimony€and€all€theÏmedical€proof€is€contained€in€the€record€by€deposition,€as€it€is€inÏthis€case,€then€this€Court€may€draw€its€own€conclusions€aboutÏthe€weight€and€credibility€of€that€testimony,€since€we€are€in€theÏsame€position€as€the€trial€judge€.€.€.€.€With€these€principles€inÏmind,€we€review€the€record€to€determine€whether€the€evidenceÏpreponderates€against€the€findings€of€the€trial€court.ððÐ ¸ Ð ¸ Ð  ÐÌòòòòò òÓ€ÓKrick€v.€City€of€Lawrenceburgó óóóóó,€945€S.W.2d€709,€712€(Tenn.€1997);€òòseeóó€òòalsoóó€òòòòò òElmore€v.Ð ¼%h* ÐTravelers€Ins.ó óóóóó,€824€S.W.2d€541,€544€(Tenn.€1992)€(when€testimony€is€presented€byÐ $'Ð , Ðdeposition,€this€Court€is€in€just€as€good€a€position€as€the€trial€court€to€judge€the€credibility€ofÏthose€witnesses.)Ìà ` àThe€trial€court€accredited€the€medical€testimony€of€Dr.€Boals.€€We€find€no€compellingÏreason€to€disagree€with€the€finding€of€the€trial€court.ÌÓ€ÓÌà@ÃÃ-Dàò òIII.ˆÐ /È(7 Ðó óÌÓ€Óà ` àThe€defendant€asserts€that€the€plaintiff€has€not€suffered€a€vocational€disability€accordingÏto€the€Tennessee€Workersðð€Compensation€Act.Ìà ` àThe€plaintiff€is€a€twenty„eight„year„old€female€who€is€a€certified€registered€nurse.€€PriorÏto€her€injury,€she€worked€as€a€nurse€and€in€the€home€health€field.€€She€currently€is€employedÏas€a€medical€case€manager.Ìà ` àThe€plaintiff€candidly€testified€about€the€effects€this€injury€has€had€on€her€life.€€SinceÏthe€injury,€her€strength€has€decreased€by€approximately€75%.€€She€experiences€daily€pain€inÐ l93E Ðher€hands.€€She€cannot€lift€things€as€she€could€before€the€injury€and€has€been€required€toÏmodify€her€behavior€and€lifestyle€to€complete€the€simplest€of€tasks.€€Driving€a€car€causes€herÏpain€and€she€is€no€longer€able€to€water€ski€or€ride€a€jet€ski.€€The€plaintiff€testified€that€she€didÏnot€believe€that€she€could€work€in€any€of€her€prior€jobs€due€to€the€her€lack€of€strength€and€herÏinability€to€lift€repetitively.Ìà ` àThe€extent€of€an€injured€workerððs€disability€is€an€issue€of€fact.€€ò òòòòòJaske€v.€Murray€OhioÐ \   ÐMfg€Co.ó óóóóó,€750€S.W.2d€150,€151€(Tenn.€1988).€€The€Supreme€Court€recently€discussed€whatÐ Äp  Ðshould€be€considered€in€determining€vocational€disability€in€ò òòòòòWalker€v.€Saturn€Corpó óóóóó,€986Ð ,Ø  ÐS.W.2d€204€(Tenn.€1998).€€The€Court€stated€that:ÌÓ€Óà8 ` àà8¸ ` (#` (#àð ðAn€anatomical€impairment€rating€is€not€always€indispensable€toÏa€trial€courtððs€finding€of€a€permanent€vocational€impairment.€€InÏfact,€anatomical€impairment€is€distinct€from€the€ultimate€issue€ofÏvocational€disability€that€the€trial€court€must€assess.€€AnÏemployee€should€not€be€denied€compensation€solely€because€sheÏis€unable€to€present€a€witness€who€will€testify€to€the€exactÏpercentage€of€her€medical€impairment.€(Citations€omitted.)Ð ¸ Ð ¸ Ð  ÐÌÓ  Ó*€*€*€*€ÌÓ{_ÓÌà8 ` àà8¸ ` (#` (#àThe€Panel€correctly€held€that€a€vocational€impairment€isÏmeasured€not€by€whether€the€employee€can€return€to€her€formerÏjob,€but€whether€she€has€suffered€a€decrease€in€her€ability€to€earnÏa€living.€€òòSeeóó€òòò òCorcoranó óóó,€746€S.W.2d€at€458.€€This€Court€statedÐ ,Ø Ðin€òòò òCorcoranóóó ó€that€a€vocational€disability€results€when€ð ðtheÐ  È  Ðemployeeððs€ability€to€earn€wages€in€any€form€of€employment€thatÏwould€have€been€available€to€him€in€an€uninjured€condition€isÏdiminished€by€an€injury.ðð€òòIdóó.€at€459.€€Ðì"˜#¸ Ð ¸ Ð  ÐÌà8 ` àà8¸ ` (#` (#àIn€assessing€the€extent€of€an€employeeððs€vocational€disability,€theÏtrial€court€may€consider€the€employeeððs€skills€and€training,Ïeducation,€age,€local€job€opportunities,€anatomical€impairmentÏrating,€and€her€capacity€to€work€at€the€kinds€of€employmentÏavailable€in€her€disabled€condition.€€Further,€the€claimantððs€ownÏassessment€of€her€physical€condition€and€resulting€disabilitiesÏcannot€be€disregarded.€€The€trial€court€is€not€bound€to€acceptÏphysiciansðð€opinions€regarding€the€extent€of€the€plaintiffððsÏdisability,€but€should€consider€all€the€evidence,€both€expert€andÏlay€testimony,€to€decide€the€extent€of€an€employeeððs€disability.ððÏ(Citations€omitted.)Ð ¸ Ð ¸ Ð  ÐÌòòòòò òWalkeró óóóóó,€at€207„08.Ð  0¸)1 ÐÌÓ€Óà ` àWe€find€that€the€trial€court€correctly€determined€that€the€plaintiff€suffered€aÏcompensable€injury€to€each€arm€and€correctly€applied€the€relevant€factors€in€determining€theÏamount€of€vocational€disability€suffered€by€the€plaintiff.€€This€issue€is€without€merit.ÌÓ€ÓÌÌÌÌÐ ä93= Ðà@ØØ*Dàò òòòCONCLUSIONˆÐ T ÐÌó óóóÓ€Óà ` àThe€defendant€asserts€that€the€trial€court€erred€when€it€found€that€the€plaintiff€sufferedÐ 4à Ða€35%€permanent€partial€disability€to€each€arm.€€We€disagree.€€The€judgment€of€the€trial€courtÏis€affirmed€with€the€costs€of€this€appeal€being€taxed€to€the€defendant.ÌÌÌÌÓ€ÓÌà ` àà ¸ àà  àà h àà À àà  àòòà p à€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€Ð ”@  Ðóóà ` àà ¸ àà  àà h àà À àà  àà p àò òJ.€STEVEN€STAFFORD,€SPECIAL€JUDGEÐ „0  ÐÌÌÌÌCONCUR:ó óÐ 4à ÐòòÌÌÌÌ€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€óó€Ð ä Ðò òJANICE€M.€HOLDER,€JUSTICEÐ Ô€ Ðó óòòÌÌÌÌ€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€óóÐ „!0  Ðò òL.T.€LAFFERTY,€SENIOR€JUDGEó óñK)ñÐ  t" ! ÐñK)ññL)ñÑ, TÑÒ€ÒÒÀXÒÔ‡Xu XX XlÖÔÑTR[° AØ'ÿ Legal[° AØ'Pleading AØ'ÿ Legal AØ'ÿ LegalTÑñL)ññW)ññM)ñßr€(<,(j 8` `€€@E»- ` ttx0ó, ð árßñM)ññW)ññL)ñà@\ \ ÌàIN€THE€SUPREME€COURT€OF€TENNESSEEˆÐ ,  Ðà@66)ÌàAT€JACKSONˆÌÌÌñL)ññL)ñÌÌDANA€STORY,à0 ˆ àà à àà08ˆ$ˆ$àà  à)à è àMADISON€CHANCERYÐ,8$8$ Ðà Ø àà 0 àà ˆ àà à àà 8 àà  à)à è àNo.€53580€T.D.€BelowÐ , Ðà Ø àPlaintiff/Appellee,à à àà 8 àà  à)Ð , Ðà Ø àà 0 àà ˆ àà à àà 8 àà  à)à è àHon.€Joe€C.€Morris,Ð ,  Ðv.à Ø àà 0 àà ˆ àà à àà 8 àà  à)à è àChancellorÐ ,  Ðà Ø àà 0 àà ˆ àà à àà 8 àà  à)ÌñL)ññW)ñßw€(A1-j|Tã`  `€€@E ` ttxdDGº ° wßñW)ññL)ñà Ø àà 0 àà ˆ àà à àà 8 àà  à)€à è àNo.€€02S01„9807„CH„00075Ð ,  ÐLEGION€INSURANCE€COMPANY,à  à)Ð ,  Ðà Ø àà 0 àà ˆ àà à àà 8 àà  à)Ìà Ø àDefendant/Appellant.à 8 àà  àà0 è à)à @ àAffirmed.à0ðè$è$àÐ,ð$ð$ ÐÌÌà@ÑÑ'ÌàòòJUDGMENT€ORDERóóˆÐ , ÐÌÌÔ#† XlÖX XXu±j#ÔñL)ññM)ññL)ñÔ‡XâôXX XzÁÔÔ#† XzÁXXXâôq#ÔñL)ññM)ññL)ñÔ‡ XXX XlÖÔÓÓà Ø àà 0 àThis€case€is€before€the€Court€upon€motion€for€review€pursuant€to€Tenn.Ð , ÐCode€Ann.€ðð€50„6„225(e)(5)(B),€the€entire€record,€including€the€order€of€referral€to€theÏSpecial€Workers'€Compensation€Appeals€Panel,€and€the€Panel's€MemorandumÏOpinion€setting€forth€its€findings€of€fact€and€conclusions€of€law,€which€areÏincorporated€herein€by€reference;Ìà Ø àà 0 àWhereupon,€it€appears€to€the€Court€that€the€motion€for€review€is€notÏwell„taken€and€should€be€denied;€andÌà Ø àà 0 àIt€is,€therefore,€ordered€that€the€Panel's€findings€of€fact€and€conclusionsÏof€law€are€adopted€and€affirmed,€and€the€decision€of€the€Panel€is€made€the€judgmentÏof€the€Court.€€ò òÐ X/,%' Ðó óà Ø àà 0 àCosts€on€appeal€are€taxed€to€the€appellant.Ð $1ø&) Ðà Ø àà 0 àIT€IS€SO€ORDERED€this€____€day€of€______,€1999.Ô#† XlÖXX XŸr#ÔñL)ññM)ññL)ñÔ‡XâôXX XzÁÔÔ#† XzÁXXXâô$u#ÔñL)ññM)ññL)ñÔ‡ XXX XlÖÔÐ ð2Ä(+ Ðà Ø àà 0 àà ˆ àà à àà 8 àà  àPER€CURIAMÌHolder,€J..€„€Not€participating.Ô#† XlÖXX XÜv#ÔñL)ñ