ÿWPC> +‚ Itû=M/lmY—.´ÅtÛ¨Ìñš¿]†“¬<¡ŒVõ èËâñùxK£sL'1UÖ.6ÞÐ Žfw5&¨½Â"žþ¥'ðá&Æ@rKÖ,ªÌ˺ˆ Nµ1¿ô·Š¥ƒY³%ñ«—ÉÁ®àrõë._äz!ÿØÝ’%äAˆÕ€œŽ±s‡¯G³8K©ZZ"vó”dÞüY¦OÈhᤫQßÚ,‡è|hò:ÇÆEƈÝ:*­º¶h yê ø#óÏïu°ž6z«èxábÓøéºœö„w*aû}#ƒÏ]žaXP² yp%]å@™¯¤3æ ÷`îr­¤ª®§A›’ T†ÛDœr>'2ç÷ê‚NýlŒ÷z^ÌXµB*DŒá`±ûü ”‡ï¢lÏ…åÏð’©‹a¶T>;˜×&Ý–Ÿ)×6 kÿ>?qy«l¥¥° ªi$™{.úI^[kç³Î¿ü:–]úqvÞˆ£1Ë„/,º@P ‰~F)&¿¯dUÃâ² „øë,¥z#ŸùöÖQ/¼í<’»æ_úɺuTQ‹ ¡3¿’ŸlÐ`!á¨Î©äÕOžrì?³‹oÇŠÝ‚ÏäÚjÏhp9ŠÍdb#Á\ % ^ # 0ˆ/ U.N· w 4 z Ò— i x mz ‘ Æ™ Æ_ Æ% Æë V±N³Nµ z·E1Ò33      # +++++++++++b333333333333333333333333333333333333 0ë;;;; B && 0¤C D3ç D- 0KGG AS’Æå 0¤« 0DO A«“˜HP LaserJet 4050ÈÈÈÈÈÈÈÈ0»…‹+â (`£ª$¡¡Ñ€.ÑÑ8€½­»»d»»d8ÑÑ ý ÑÓ  Ó(í€"  Z6Times New Roman RegularyG*   ÀÅ£ ˜C:\PROGRA~1\COREL\WORDPE~1\TEMPLATE\CUSTOM~1\REVISE~1.WPTC:\Program Files\Corel\WordPerfect Office 2000\Template\Custom WP Templates\revised standard opinion.wpt3|xÿU‹ÿÀÀÀ Level 1Level 2Level 3Level 4Level 5‚Level 1Level 2Level 3Level 4Level 5„Level 1Level 2Level 3Level 4Level 5…Level 1Level 2Level 3Level 4Level 5˜C:\PROGRA~1\COREL\WORDPE~1\TEMPLATE\CUSTOM~1\REVISE~1.WPTC:\Program Files\Corel\WordPerfect Office 2000\Template\Custom WP Templates\revised standard opinion.wptH45678- ù-(|G2ÐØ$¤¤Ý ƒ£ª!ÝÑ€..ÑÑ8€]%»»dd8ÑÑ ý ÑÓ  ÓÝ  Ýà  àòòÚ  Ú0Ú  ÚóóÔ€XYX»»Ô d(|3Ç$££Ý ƒ£ª!ÝÑ€..ÑÑ8€]%»»dd8ÑÑ ý ÑÓ  ÓÝ  ÝVVVV'ÿÿdxd)!ÈÈÈÈdxdx( ±þ$’’ò òFigure€Ú  Ú1Ú  Úó ó^_X`YEþÿ<<CÿÿƒLevel 1Level 2Level 3Level 4Level 5(|3Ç$¢¢Ý ƒ£ª!ÝÑ€..ÑÑ8€]%»»dd8ÑÑ ý ÑÓ  ÓÝ  Ý($$””ò òÚ  Ú1Ú  Úó óX[Z&OLE 2.0 Box <=8ÿÿÿÿÿÿÿÿÿÿCÿÿ HKKKKÝ ƒ£ª!ÝÑ€.ÑÑ8€]%»»ddÈ8ÑÑ ý ÑÓ  ÓÝ  ÝÔ_ÔÔ€¼]%»»»ÔÑ8€YXXdì»»d8ÑÓ  ÓÔ‡îWô]%Ôà@@7 7 ìàIN€THE€SUPREME€COURT€OF€TENNESSEEÐ ° ÐSPECIAL€WORKERSðð€COMPENSATION€APPEALS€PANELÐ Ö& Ðà@@ƒƒìàAT€KNOXVILLEÔ#†¼]%»îîWôî#ÔÐ üL ÐSeptember€26,€2001€SessionÐ "r ÐÔ‡XYX»¼]%ÔÌò òÔ#†¼]%»XXY#ÔFIREFLY€INDUSTRIES,€INC.òòóó€v.€RHONDA€SEXTONòòóóÔ‡XYX»¼]%Ôó óÐ  p ÐÌà@@¼¼ìàò ò€Direct€Appeal€from€the€Circuit€Court€for€Scott€CountyÐ  p Ðà@@ôôìàNo.€4878€€€€€€Conrad€Ô_ÔTroutmanÔ_Ô,€Jr.,€Circuit€JudgeÐ  \ ÐÌÌà@@ìì*ìàßA€V) °°` d€÷E<Ï` AßÐ Ð  ÐÌNo.€E2001„00132„Ô_ÔWCÔ_Ô„R3„CV€„€Mailed€„€November€6,€2001Ð Ë  ÐÔ#†¼]%»XXY˜#ÔÔ‡XYX»¼]%ÔFILED:€DECEMBER€11,€2001Ð ·  ÐÌßA€V) °°` dE<Ž` AßÐ ß Ðó óÌÓ  ÓÓ  ÓThis€workersðð€compensation€appeal€has€been€referred€to€the€Special€Workersðð€CompensationÐ ŠÚ ÐAppeals€Panel€of€the€Supreme€Court€in€accordance€with€Tenn.€Code€Ann.ðð€50„6„225(e)(3)€forÐ vÆ Ðhearing€and€reporting€to€the€Supreme€Court€of€findings€of€fact€and€conclusions€of€law.€€The€trialÐ b² Ðcourt€awarded€the€employee€25€percent€disability€to€the€body€as€a€whole.€€The€employee€hasÐ Nž Ðappealed€insisting€the€award€is€inadequate€and€should€be€much€higher.€€The€employer€argues€certainÐ :Š Ðmedical€expenses€were€unauthorized€and€that€the€incident€in€question€caused€no€vocationalÐ &v Ðdisability.€€Judgment€of€the€trial€court€is€affirmed€as€to€the€award€of€disability€and€modified€as€to€theÐ b Ðallowance€of€medical€expenses.Ô#†¼]%»XXYŸ#ÔÔ‡XYX»¼]%ÔÐ þN ÐÓRÓÌò òÓ  ÓTenn.€Code€Ann.€ðð€50„6„225(e)€(1999)€Appeal€as€of€Right;€Judgment€of€the€Circuit€CourtÐ Ö& ÐModified€and€Affirmedó óÐ Â ÐÌòòÓ  ÓÓ  ÓThayer,€Sp.€J.,Ô#†¼]%»àXYË#ÔÔ‡XYX.¼]%Ôóó€delivered€the€opinion€of€the€court,€in€which€òòAnderson,€J.óó€and€òòByers,€Sr.€J.,óó€joined.Ð šê ÐÌCharles€B.€Sexton,€Oneida,€Tennessee,€for€the€Appellant,€Rhonda€Sexton.Ð r!  ÐÌLinda€J.€Hamilton€Ô_ÔMowlesÔ_Ô,€Knoxville,€Tennessee,€for€the€Appellee,€Firefly€Industries,€Inc.Ð J#š" ÐÌÓÊ ÓÓ  Óò òOPINIONó óÔ#†¼]%»XXY #ÔÔ‡XYX»¼]%ÔÐ "%r $ ÐÌÓ  ÓÔ#†¼]%»XXYÚ #ÔÔ‡XYX»¼]%Ôà  àIn€this€case€the€trial€court€awarded€the€employee,€Rhonda€Sexton,€25€percent€permanentÐ ú&J"& Ðpartial€disability€to€the€body€as€a€whole.€€Being€dissatisfied€with€the€amount€of€the€award,€theÐ æ'6#' Ðemployee€has€appealed.Ô#†¼]%»XXY> #ÔÔ€XYX»¼]%ÔÐ Ò("$( ÐÌòòò òÓ  ÓBasic€Factsóóó óÐ ª*ú%* ÐÓ½ Óà  àà ` àà ¸ àà  àà h àà À àà  àà p àà È àà  àà x àÌà  àThe€record€indicates€the€employee€was€49€years€of€age€and€lacked€one€and€one„half€creditsÐ ‚,Ò', Ðin€graduating€from€high€school.€She€never€obtained€a€Ô_ÔG.E.D.Ô_Ô€certificate€but€has€some€vocationalÐ n-¾(-ý~ Ðtraining€in€a€basic€computer€course.€€She€was€a€licensed€cosmetologist€and€had€15€years€experienceÐ ° Ðin€this€type€of€work.€€She€had€some€training€and€Ô_ÔexperienceÔ_Ô€as€an€insurance€sales€agent€and€five€yearsÐ œì Ðexperience€(part„time)€as€a€school€bus€driver.€€During€her€employment€career,€she€had€15€yearsÐ ˆØ Ðexperience€in€secretarial€work.Ð tÄ ÐÌà  àAt€the€time€in€question,€January€13,€1998,€she€was€employed€as€a€secretary€with€FireflyÐ L œ ÐIndustries,€Inc.,€a€company€involved€in€metal€fabrication.€€On€this€day€she€was€asked€to€go€down€inÐ 8 ˆ Ðthe€plant€and€work€with€a€box€of€metal€parts.€€€She€testified€the€box€of€parts€weighed€about€40„50Ð $ t Ðpounds€and€as€she€attempted€to€pull€it€off€the€table€to€move€the€box,€she€said€the€box€started€to€fallÐ  ` Ðand€she€felt€a€pop€in€her€back€with€pain€running€down€her€buttock€and€left€leg.€€She€called€for€helpÐ ü L  Ðand€supervisor€Gloria€Ô_ÔAdkinsÔ_Ô€came€over€and€assisted€her.€€She€told€Ô_ÔAdkinsÔ_Ô€she€had€hurt€herself€butÐ è 8  Ðdid€not€need€medical€treatment.Ð Ô$  ÐÌà  àOn€January€20òòóó,€she€decided€she€had€better€go€Ô_Ôsee€a€doctorÔ_Ô€and€went€to€Dr.€D.€Bruce€Coffey,Ð ¬ü  Ða€family€practice€physician,€who€treated€her€with€medicine€and€therapy€and€then€after€a€period€ofÐ ˜è  Ðtime€referred€her€to€several€other€doctors.€€She€eventually€returned€to€work€during€March€1998€butÐ „Ô  Ðonly€worked€a€light€duty€job€for€about€10€days.Ð pÀ ÐÌà  àAs€to€her€physical€condition€prior€to€the€incident€in€question,€she€told€the€court€she€had€neckÐ H˜ Ðand€shoulder€pain€that€had€been€diagnosed€as€Ô_ÔfibromyalgiaÔ_Ô;€she€suffered€from€endometriosis€whichÐ 4„ Ðcaused€some€back€pain;€she€had€upper€back€pain€for€which€she€took€pain€medication;€Ô_Ôand€sheÔ_Ô€hadÐ  p Ðsuffered€from€depression.€€She€also€testified€she€had€hurt€her€back€at€work€during€June€1997€whileÐ  \ Ðlifting€but€never€mentioned€the€event€to€her€employer.€€Medical€records€(Exhibit€#3)€from€a€doctorððsÐ øH Ðclinic€indicate€chronic€back€pain€dating€back€to€late€1996.Ð ä4 ÐÌà  àAt€the€trial€she€stated€she€could€not€do€housework€or€walk€very€far;€that€because€of€the€painÐ ¼  Ðshe€could€not€really€do€any€type€work€and€had€not€looked€for€work.€€She€said€she€was€very€depressedÐ ¨ø Ðand€had€gained€30„40€pounds€since€the€accident.Ð ”ä ÐÌà  àGloria€Ô_ÔAdkinsÔ_Ô,€a€supervisor€in€the€plant,€testified€that€before€the€January€13òòóó€incident,€sheÐ l¼ Ðcomplained€all€the€time€about€back€pain€and€she€quoted€the€employee€as€saying€she€hurt€her€backÐ X ¨ Ð(1)€at€home€scrubbing€carport€concrete,€(2)€at€a€family€reunion,€(3)€vacuuming€the€office,€and€(4)Ð D!” Ðmoving€stuff€in€the€office.€€She€said€the€box€of€metal€parts€weighed€about€20„30€pounds€and€that€theÐ 0"€  Ðbox€did€not€start€to€fall€but€was€still€resting€part€on€and€part€off€the€table€when€she€took€it€from€her.€Ð #l! ÐÔ_ÔAdkinsÔ_Ô€also€testified€that€before€the€incident€the€employee€said€she€was€taking€six€different€kindsÐ $X" Ðof€medicine€for€various€problems.Ð ô$D # ÐÌà  àLester€S.€Webster,€Sr.,€part€owner€and€president€of€the€company,€testified€she€told€him€shortlyÐ Ì&"% Ðafter€the€incident€she€had€hurt€her€back€but€she€did€not€need€to€see€a€doctor.€€The€incident€was€notÐ ¸'#& Ðreported€to€the€workersðð€compensation€carrier€as€an€injury.€€He€stated€the€first€he€realized€she€wasÐ ¤(ô#' Ðclaiming€any€injury€was€when€one€of€the€doctors€called€his€office€several€weeks€thereafter.€€He€saidÐ )à$( Ðshe€had€a€lot€of€complaints€about€back€pain€before€the€incident€and€she€said€she€was€taking€sixÐ |*Ì%) Ðdifferent€kinds€of€medicine.€€Mr.€Webster€also€told€the€court€that€when€she€stopped€working€Ô_ÔsheÔ_ÔÐ h+¸&* Ðnever€notified€the€company€why€she€was€not€coming€back.Ð ° ÐÌà  àTerri€Ô_ÔWestermanÔ_Ô,€the€workersðð€compensation€adjuster,€testified€the€incident€was€not€reportedÐ ˆØ Ðto€the€insurance€company€as€a€claim€or€injury€until€February€13,€1998,€and€that€by€that€time€she€hadÐ tÄ Ðalready€selected€and€seen€several€doctors€of€her€own€choice.€€She€said€soon€after€the€notice€of€injuryÐ `° Ðwas€received,€the€employee€Ô_Ôwas€furnishedÔ_Ô€a€list€of€doctors€and€she€chose€Dr.€Paul€Johnson,€anÐ L œ Ðorthopedic€surgeon.€Ð 8 ˆ ÐÌòòò òÓ  ÓExpert€Medical€Evidenceóóó óÐ  ` ÐÓ#ÓÌà  àAll€of€the€medical€evidence€was€presented€to€the€court€by€deposition€and€came€from€fiveÐ è 8  Ðdifferent€doctors.Ð Ô$  ÐÌà  àDr.€D.€Bruce€Coffey€testified€he€initially€felt€the€employee€had€a€muscle€Ô_Ôstrain€and€prescribedÐ ¬ü  ÐmedicineÔ_Ô€and€therapy€treatments.€€Later€Ô_ÔM.R.I.Ô_Ô€findings€indicated€degenerative€disc€disease€and€aÐ ˜è  Ðsmall€ruptured€area€in€her€low€back.€€Since€his€treatment€did€not€substantially€help€her,€he€referredÐ „Ô  Ðher€to€an€orthopedic€surgeon,€Dr.€Hyde.€€Later€she€appeared€to€be€depressed€and€he€referred€her€toÐ pÀ Ða€psychiatrist.€€Dr.€Coffey€told€the€court€he€related€the€rupture€to€her€last€work€activity€ð ðsince€I€haveÐ \¬ Ðno€history€of€her€having€back€problems€prior€to€that.ðð€€He€felt€she€had€impairment€but€left€theÐ H˜ Ðdetermination€of€that€to€the€orthopedic€surgeon.ò òó óÐ 4„ ÐÌà  àDr.€Gilbert€L.€Hyde,€the€orthopedic€surgeon,€examined€the€employee€on€February€13,€1998Ð  \ Ðand€took€a€history€that€she€had€injured€her€back€at€work€during€June€1997,€which€was€about€sevenÐ øH Ðmonths€before€the€date€in€question,€and€had€Ô_ÔreinjuredÔ_Ô€herself€on€January€13,€1998€while€working.€Ð ä4 ÐHe€testified€the€Ô_ÔM.R.I.Ô_Ô€study€showed€degenerative€disc€disease€and€a€small€disc€Ô_ÔherniationÔ_Ô€at€L5„S1.€Ð Ð  ÐDuring€his€testimony€he€originally€said€he€attributed€the€cause€of€the€problem€to€the€June€1997€workÐ ¼  Ðincident€and€the€1998€work€incident€but€later€testified€her€condition€was€probably€more€related€toÐ ¨ø Ðthe€last€incident.€€He€said€his€diagnosis€was€given€on€the€assumption€she€had€no€significant€priorÐ ”ä Ðback€problems€before€these€dates.€€He€opined€she€had€a€10€percent€medical€impairment€and€was€notÐ €Ð Ðemployable.€€He€recommended€she€have€a€caudal€block€which€was€performed.Ð l¼ ÐÌà  àDr.€William€E.€Kennedy,€a€retired€orthopedic€surgeon€who€is€now€engaged€in€only€doingÐ D!” Ðindependent€medical€examinations,€examined€the€employee€during€November€1998€and€took€aÐ 0"€  Ðhistory€that€she€had€no€significant€low€back€pain€prior€to€the€January€13,€1998€work€Ô_ÔactivityÔ_Ô;€he€feltÐ #l! Ðher€symptoms€were€exaggerated;€he€said€the€Ô_ÔM.R.I.Ô_Ô€showed€broad„based€disc€bulge€which€wasÐ $X" Ðconsistent€with€degenerative€disc€disease€but€not€indicative€of€any€disc€injury;€that€the€main€causeÐ ô$D # Ðof€her€condition€was€the€aging€process€but€the€1998€work€incident€aggravated€her€condition;€Ô_ÔandÔ_Ô€thatÐ à%0!$ Ðshe€had€13€percent€impairment.Ð Ì&"% ÐÌà  àDr.€Laraine€Lieberman,€a€psychiatrist,€examined€Mr.€Sexton€during€May€1998€and€testifiedÐ ¤(ô#' Ðshe€was€extremely€depressed€apparently€due€to€the€fact€she€was€not€able€to€work,€had€no€earningsÐ )à$( Ðand€her€employer€had€instituted€this€proceeding€against€her.€€She€classified€her€condition€as€majorÐ |*Ì%) Ðdepression,€chronic€and€recurrent,€with€55€„€60€percent€impairment€which€is€referred€to€in€theÐ h+¸&* ÐÔ_Ôguidelines€as€marked€to€extreme€impairment.Ð ° ÐÌà  àDr.€Paul€H.€Johnson,€an€orthopedic€surgeon,€examined€Mrs.€Sexton€on€March€3,€1998€andÐ ˆØ Ðsaw€her€again€on€March€16òòóó,€and€concluded€the€diminished€disc€height€on€the€M.R.I.€at€L5„S1€wasÐ tÄ Ða€long„standing€condition€and€that€surgery€would€not€be€recommended.€€He€stated€she€did€not€haveÐ `° Ðany€impairment€and€he€released€her€to€return€to€work.€€He€also€added€that€he€felt€the€M.R.I.€studyÐ L œ Ðwas€of€marginal€quality.Ð 8 ˆ ÐÌòòò òÓ  ÓVocational€Evidenceóóó óÐ  ` ÐÓÚ3ÓÌà  àDr.€Norman€E.€Hankins,€a€vocational€consultant,€reviewed€medical€records€and/orÐ è 8  Ðdepositions€of€the€various€doctors€and€administered€certain€tests€to€the€employee€in€order€to€helpÐ Ô$  Ðdetermine€her€vocational€disability.€€He€testified€by€deposition€and€stated€even€though€Mrs.€SextonÐ À  Ðdid€not€graduate€from€high€school,€she€had€performed€at€the€level€of€a€high€school€graduate.€€HeÐ ¬ü  Ðadministered€a€test€to€determine€her€general€learning€ability€and€found€she€had€an€I.Q.€of€122.€€Dr.Ð ˜è  ÐHankins€opined€that€if€one€accepted€the€opinions€and€restrictions€of€Drs.€Hyde€and€Lieberman,€theÐ „Ô  Ðvocation€disability€would€be€100€percent.€€Also,€if€the€restrictions€of€Drs.€Hyde€and€Kennedy€wereÐ pÀ Ðaccepted,€the€vocational€disability€would€still€be€100€percent.€€However,€without€any€psychologicalÐ \¬ Ðproblems,€vocational€disability€would€be€about€68€percent.€€Also,€under€Dr.€Johnsonððs€assessmentÐ H˜ Ðof€her€condition,€there€would€be€no€vocational€disability.Ð 4„ ÐÌà  àDr.€Rodney€Caldwell,€also€a€vocational€consultant,€testified€orally€at€the€trial€and€foundÐ  \ Ðvocational€disability€to€be€20€„€25€percent€if€Drs.€Hyde€and€Kennedyððs€restrictions€were€imposed.€Ð øH ÐHe€agreed€that€no€vocational€disability€would€exist€under€Dr.€Johnsonððs€testimony.Ð ä4 ÐÌòòò òÓ  ÓIssues€on€Appealóóó óÐ ¼  ÐÓ:ÓÌà  àOn€appeal€the€employee€contends€the€evidence€preponderates€against€the€award€of€25€percentÐ ”ä Ðdisability€to€the€extent€it€should€be€fixed€at€a€higher€amount.€€The€employer€argues€a€preponderanceÐ €Ð Ðof€the€evidence€shows€the€employee€has€no€disability€resulting€from€the€January€13,€1998€incident.€Ð l¼ ÐAlso,€the€employer€contends€if€the€claim€is€compensable,€it€should€not€be€liable€for€certain€medicalÐ X ¨ Ðexpenses€as€they€were€unauthorized€expenses.Ð D!” ÐÌòòò òÓ  ÓStandard€of€Reviewóóó óÐ #l! ÐÓz<ÓÌà  àThe€review€of€the€issues€on€appeal€is€òòde€novoóó€accompanied€by€a€presumption€of€theÐ ô$D # Ðcorrectness€of€the€findings€of€the€trial€court€unless€the€preponderance€of€the€evidence€is€otherwise.€Ð à%0!$ ÐTenn.€Code€Ann.€ðð€50„6„225(e)(2).Ð Ì&"% ÐÌà  àWhere€the€trial€court€has€seen€and€heard€witnesses€and€issues€of€credibility€and€the€weightÐ ¤(ô#' Ðof€oral€testimony€are€involved,€the€trial€court€is€usually€in€a€better€position€to€judge€credibility€andÐ )à$( Ðweigh€evidence€but€where€evidence€is€introduced€by€deposition,€the€appellate€court€is€in€as€good€aÐ |*Ì%) Ðposition€as€the€trial€court€in€reviewing€and€weighing€testimony.€€òòò òLanders€v.€Firemanððs€Fund,€Inc.óóó ó,Ð h+¸&* Ð775€S.W.2d€355,€356€(Tenn.€1989).Ð ° ÐÌòòò òÓ  ÓAnalysisóóó óÐ ˆØ ÐÓ$@ÓÌà  àOn€the€question€regarding€the€award€of€25€percent€disability€to€the€body€as€a€whole,€we€findÐ `° Ðthe€evidence€is€somewhat€equivocal€with€reference€to€the€cause€of€the€employeeððs€present€condition.€Ð L œ ÐDrs.€Coffey€and€Hyde€gave€opinion€the€January€13€incident€probably€caused€her€present€physicalÐ 8 ˆ Ðcondition€but€based€their€opinions€on€the€assumption€she€had€no€prior€back€complaints€or€problems.€Ð $ t ÐThere€is€considerable€evidence€pre„existing€back€problems€did€exist€and€this€reduces€the€completeÐ  ` Ðacceptability€of€these€expert€opinions.€€If€these€opinions€on€causation€are€eliminated,€it€only€leavesÐ ü L  Ðthe€opinion€of€Dr.€Kennedy€to€support€an€award€based€on€physical€disability€as€the€only€other€doctor,Ð è 8  ÐDr.€Johnson,€found€no€disability.Ð Ô$  ÐÌà  àDr.€Kennedy€was€of€the€opinion€the€employee€was€exaggerating€her€complaints€and€her€mainÐ ¬ü  Ðproblem€was€due€to€degenerative€disc€disease€but€that€this€prior€condition€had€been€aggravated€byÐ ˜è  Ðthe€lifting€incident€she€described€on€the€January€13òòóó€date€and€that€this€resulted€in€permanentÐ „Ô  Ðimpairment.Ð pÀ ÐÌà  àThe€psychiatrist,€Dr.€Lieberman€found€extensive€depression€but€other€evidence€indicated€sheÐ H˜ Ðhad€been€treated€for€depression€prior€to€the€1998€work€activity.Ð 4„ ÐÌà  àDespite€all€of€this€conflicting€evidence€on€causation€of€the€injury,€the€record€is€clear€thatÐ  \ Ðwhatever€her€condition€was€she€had€continued€to€work€until€after€the€January€13€date.€€In€renderingÐ øH Ða€decision,€the€trial€court€apparently€concluded€that€some€but€not€all€of€her€problems€were€work„Ð ä4 Ðrelated.Ð Ð  ÐÌà  àWe€must€observe€that€when€evidence€of€this€nature€exists,€it€is€difficult€for€medical€expertsÐ ¨ø Ðand€courts€to€separate€an€old€injury€or€condition€from€a€recent€injury€or€condition€in€reaching€aÐ ”ä Ðdecision€on€permanent€disability€of€a€worker.€€However,€in€a€workersðð€compensation€case,€the€burdenÐ €Ð Ðof€proof€is€on€the€employee€to€establish€by€a€preponderance€of€the€evidence€the€injury€upon€whichÐ l¼ Ðthe€award€is€sought.€€In€our€final€analysis,€we€conclude€that€the€evidence€does€not€preponderateÐ X ¨ Ðagainst€the€award€of€disability€fixed€by€the€trial€court.Ð D!” ÐÌà  àThe€only€other€issue€relates€to€the€allowance€of€all€medical€expenses€claimed€by€theÐ #l! Ðemployee.€€In€this€connection,€the€employer€contends€the€court€was€in€error€in€allowing€recovery€ofÐ $X" Ðcertain€charges€of€Drs.€Coffey,€Hyde€and€Lieberman.Ð ô$D # ÐÌà  àAlthough€the€employee€initially€reported€she€had€hurt€her€back,€she€declined€medicalÐ Ì&"% Ðtreatment€thinking€she€would€be€all€right€in€a€few€days€and€the€employer€did€not€report€the€matterÐ ¸'#& Ðto€the€insurance€carrier.€€She€later€decided€she€needed€to€see€a€doctor€and€went€to€see€Dr.€Coffey€andÐ ¤(ô#' Ðthen€came€under€the€care€of€Dr.€Hyde.€€The€employer€was€not€aware€that€she€was€being€treated€forÐ )à$( Ðany€injury€until€on€about€February€13òòóó€when€one€of€the€doctors€called€concerning€her€treatment.€€Ô_ÔUpÐ |*Ì%) Ðuntil€that€time,€she€was€being€treated€under€her€general€health€and€medical€insurance€policy€throughÐ h+¸&* Ðher€employment.Ð ° ÐÌà  àThe€adjuster€for€Ô_ÔSafecoÔ_Ô€Insurance€Company€personally€appeared€at€the€trial€and€testified€sheÐ ˆØ Ðimmediately€notified€the€employee€and€two€doctors€that€the€workersðð€compensation€carrier€wouldÐ tÄ Ðpay€for€their€treatment€up€until€that€point€in€time€but€not€thereafter€because€they€were€not€on€theÐ `° Ðapproved€list€of€physicians€being€furnished€to€the€employee.€€The€record€indicates€several€chargesÐ L œ Ðof€Dr.€Coffey€occurred€after€this€February€13òòóó€date€up€until€March€11,€1998,€and€that€numerousÐ 8 ˆ Ðcharges€of€Dr.€Hyde€were€incurred€after€this€time€up€until€August€11,€1998.Ð $ t ÐÌà  àUpon€receiving€the€list€of€physicians,€the€employee€chose€Dr.€Johnson,€an€orthopedicÐ ü L  Ðsurgeon,€who€saw€her€on€March€3€and€16,€1998;€determined€she€had€no€impairment€and€released€herÐ è 8  Ðto€return€to€work€without€any€restrictions.Ð Ô$  ÐÌà  àOn€March€9,€1998,€the€employeeððs€attorney€wrote€a€letter€to€the€adjuster€notifying€that€Mrs.Ð ¬ü  ÐSexton€needed€to€see€a€psychiatrist€and€requested€a€list€of€doctors€from€which€she€could€make€aÐ ˜è  Ðchoice.€€A€reply€dated€March€19,€1998€from€the€carrierððs€attorney€declined€the€request€and€stated€thatÐ „Ô  Ða€psychiatrist€would€not€be€furnished€unless€the€treating€doctor€(Dr.€Johnson)€requested€same.€Ð pÀ ÐDuring€May€1998€the€employee€came€under€the€care€of€a€psychiatrist,€Dr.€Lieberman.Ð \¬ ÐÌà  àOur€statute,€Tenn.€Code€Ann.€ðð€50„6„204,€requires€the€employer€to€furnish€medical€servicesÐ 4„ Ðfree€to€the€employee€and€the€employee€is€also€generally€bound€to€accept€the€medical€services.€Ð  p ÐGenerally,€if€the€employee€is€dissatisfied€with€the€treating€doctorððs€services,€the€employee€may€(1)Ð  \ Ðmove€the€court€to€appoint€a€neutral€physician,€(2)€consult€with€the€employer€and€make€otherÐ øH Ðarrangements,€or€(3)€go€to€a€physician€of€his€or€her€own€choice,€without€consulting€the€employer,€andÐ ä4 Ðthus€be€liable€for€such€services.€€òòò ò€Consolidated€Coal€Co.€v.€Prideóóó ó,€452€S.W.2d€349,€354€(Tenn.Ð Ð  Ð1970).Ð ¼  ÐÌà  àWhether€an€employee€is€justified€in€seeking€additional€medical€services€without€consultingÐ ”ä Ðthe€employer€usually€depends€on€the€circumstances€of€each€case.€€In€order€to€bind€the€employer€toÐ €Ð Ðpay€for€such€expenses,€there€must€be€some€reasonable€excuse€or€justification€for€the€employee€toÐ l¼ Ðunilaterally€seek€additional€medical€services.€€òòò òÔ_ÔDorrisÔ_Ô€v.€Ô_ÔINAÔ_Ô€Ins.€Co.óóó ó,€764€S.W.2d€538€(Tenn.€1989).Ð X ¨ ÐÌà  àThe€trial€court€found€the€employee€was€justified€in€seeking€treatment€from€all€doctors.€€WeÐ 0"€  Ðare€inclined€to€agree€with€most€of€this€ruling.€€The€insurance€carrier€agreed€to€pay€for€theÐ #l! Ðunauthorized€expenses€up€to€February€13,€1998,€when€the€injury€was€reported€and€a€list€of€physiciansÐ $X" Ðwas€being€furnished.€€The€employee€chose€Dr.€Johnson€from€the€list€and€he€saw€her€on€two€visitsÐ ô$D # Ðduring€March€and€discharged€her€on€March€16òòóó.€€Several€days€later€her€request€for€permission€to€seeÐ à%0!$ Ða€psychiatrist€was€denied€so€she€was€without€a€designated€orthopedic€doctor€an/or€psychiatrist.€Ð Ì&"% ÐUnder€these€circumstances,€we€find€it€reasonable€for€her€to€seek€medical€attention€of€her€ownÐ ¸'#& Ðchoosing€since€she€claimed€she€was€still€in€need€of€treatment.€€However,€we€modify€the€trial€courtððsÐ ¤(ô#' Ðruling€to€disallow€medical€expenses€of€Dr.€Coffey€and€Dr.€Hyde€which€were€incurred€from€FebruaryÐ )à$( Ð13,€1998€to€March€16,€1998,€the€period€of€time€between€furnishing€the€list€of€designated€physiciansÐ |*Ì%) Ðand€the€discharge€of€the€employee€by€that€physician.€€We€hold€that€the€employer€is€liable€for€allÐ h+¸&* Ðmedical€expenses€of€these€doctors€and€the€psychiatrist€which€were€incurred€after€this€period€of€time.€Ð ° ÐòòÔ_ÔSee€ò òU.S.€Fidelity€&€Guar.Ô_Ô€Co.€v.€Morganóóó ó,€795€S.W.2d€653€(Tenn.€1990)€where€the€employer€wasÐ œì Ðheld€responsible€for€unauthorized€medical€expenses€after€employerððs€doctor€discharged€the€employeeÐ ˆØ Ðunder€circumstances€similar€to€the€present€case.Ð tÄ ÐÌà  àThe€judgment€of€the€trial€court€is€affirmed€as€to€the€award€of€disability€and€is€modified€as€toÐ L œ Ðthe€allowance€of€medical€expense.€€€Costs€of€appeal€are€taxed€to€the€employee.Ð 8 ˆ Ðà  àÌÌÌÌà  àà ` àà ¸ àà  àà h àà À àà  à___________________________________€Ð Ô$  Ðà  àà ` àà ¸ àà  àà h àà À àà  àROGER€E.€THAYER,€SPECIAL€JUDGEÐ  À  ÐÔ‡¼]%»XXYÔÔ#†XYX»¼]% c#ÔÔ‡¼]%»XXYÔà@7 7 ìàÔ#†XYX»¼]%bc#ÔÔ‡¼]%»XXYÔIN€THE€SUPREME€COURT€OF€TENNESSEEˆÐ ° Ðà@° ° ìàAT€KNOXVILLE,€TENNESSEE€Ô#†XYX»¼]%¶c#ԈР ÐÌÌÌò òÔ‡¼]%»XXYÔÔ#†XYX»¼]%ud#ÔÔ‡¼]%»XXYÔÓ  Ó€FIREFLY€INDUSTRIES,€INC.€€V.€€RHONDA€€SEXTONÐ ˜ è ÐScott€€County€Circuit€€CourtÔ#†XYX»¼]%·d#ÔÔ‡¼]%»XXYÔÔ#†XYX»¼]%ce#Ôó óÐ ¬ ü ÐÓÖdÓà@__&ìàò òÔ% ‡ ÔÔ%†âeÔÔ% ‡ ÔÔ%† fÔÔ% ‡! ÔÔ%†!fÔÔ% ‡" ÔÔ%†"