ÿWPC©+ Æ# ä UNï %= 0ûC U:>4xŒ›w@£ 0?ã 0D"ÆfÆ,ÆòƸÆ~ 0DD 0Jˆ 0TÒ 0^& 0h„ Bì 0r  0|{ 0†÷ 0} 1u  D3‚ 0dµ 0@ 0KYU>¤U*âU* B)6DC_ AO¢ D+ñ¸°Ô­„ v~1"vÓ¯# AO‚) 0DÑ) D/* BD* AYa* 0Fº* A©+˜HP LaserJet 4SiHPPCL5MS,ü,,,,,ü0nLHÎ(ÈhH  Z ‹6Times New Roman RegularX(ÓH=$¡¡Ñ  ÑÒH°ÒÒ°ÒÑTR[  AØ'ÿ Legal[  AØ'ÿ Legal AØ'ÿ Legal AØ'ÿ LegalTÑÔ€XÎ_XXXÔÑ7€¾úXXdðXXdð7Ñ, øð AZ‹"Arial Regular­M³$3|xÎ0 ¯0°0D±0P²0P³0P´0Ó€À0UÁ0UÂ0PÃ0Ó€(ï(3Hù$¤¤Ý ƒH=!ÝÑ  ÑÒH°ÒÒ°ÒÑTR[  AØ'ÿ Legal3Ø' AØ'ÿ Legalÿ3Ø'TÑÔ€XXÿXXXÔÑ7€euXXdìdì7ÑÝ  Ýà ` àòòÚ  Ú0Ú  Úóó(#Ã$òòÚ  Ú0Ú  ÚóóLevel 1Level 2Level 3Level 4Level 5‚Level 1Level 2Level 3Level 4Level 5ƒLevel 1Level 2Level 3Level 4Level 5„Level 1Level 2Level 3Level 4Level 5…Level 1Level 2Level 3Level 4Level 5(3¯$©©Ý ƒ!ÝÝ  Ý2 ÿÿ0Indent1Ô2ÔÔ3  Ô2" ÿÿ0Indent2à0 àÔ2ÔÔ3  Ô2, ÿÿ0Indent3à0 àà0 àÔ2ÔÔ3  Ô26 ÿÿ0Indent4à0 àà0 àà0 àÔ2ÔÔ3  Ô d2@ 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)$$$$'ÿÿdxdP ÿÿ8Mac DefaultMac DefaultÓ ` °šXÓ("ÿÿ$££Ò  ÒÒ  Ò( ±þ$’’ò òFigure€Ú  Ú1Ú  Úó ó< Œ 9p`(&Times New Roman< Œ 9p`(Arial< Œ 9p`(Times% Line 7 d77777Border 1dd-.8Cþÿ << Gÿÿ'ÈÈÈÈdxd ®Ý ƒ!ÝÑ  ÑÑ#€d#ÑÔ€4ÔÑ  ÑÒ  ÒÒ H ÒÑ\R AØ'\ÑÔ€5ÔÑ#€d#ÑÝ  ÝÔ€5ÔÓ  ÓÔ YYY ÔFILEDÔ€5XÔÌÌò òMayÏ27,Ï1998ÌÌCecilÏCrowson,ÏJr.ÌÔ€5ôÔAppellateÏCourtÏClerkó ó ¦Ý ƒ!ÝÑ#€d#ÑÔ€4ÔÑ  ÑÒ  ÒÒ H ÒÑ\R AØ'\ÑÔ€5ÔÑ#€d#ÑÝ  ÝÝ ƒ $Ýà àòòÚ  ÚÚ  ÚóóÝ  ÝÔ€5ôÔÔ€4ÔWe€do€not€have€the€familiar€issue€of€accrediting€the€opinion€of€one€medical€expert€over€another€becauseÏthe€appellee,€who€was€aware€of€Dr.€Finelliððs€opinion,€never€presented€countervailing€expert€testimony€as€to€theÏextent€of€appellantððs€medical€impairment.Ô€5ÔÔ€5XÔ€€Ì £Ý ƒ!ÝÑ#€d#ÑÔ€4ÔÑ  ÑÒ  ÒÒ H ÒÑ\R AØ'\ÑÔ€5ÔÑ#€d#ÑÝ  ÝÔ€5ÔÓ  ÓÔ YYY ÔFILEDÔ€5XÔÌÌò òMayÏ27,Ï1998ÌÌCecilÏCrowson,ÏJr.ÌÔ€5ôÔAppellateÏCourtÏClerkó óPtPtHHØ(ÿáÿâùFG(üHHØ(d'`Styl{WP}01•ÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃà Ãà Ãà Ãà Ãà ÃÃÃÃÃÃÃÃÃÃÃÐ ÐÐHHÐÐ  ÐÐ2ÐÐÿÿ¸æ$ÿÐÐHHÐÐÐÐÐÐÐÐ  ÐÐ ÐÐ ÐÑÑÑGenevaÑÑ ÑÑ € ÑÑ<Px–ÈÑÒÒÒ443!#4ÒÒ$ *$ÒÒ$*$ÒÒ ÿKK ÒÒ  Geneva ÒÒ  Geneva ÒÓ.,ÓÓÓÓ6ÓÓ ÓßßßßßßßßßßßßßßßßßßÑGenevaÑÑ ÑÒ  ion-F Geneva ÒÒ  ion-F Geneva Ò-‚ƒCþÿ<< Cÿÿ($$””ò òÚ  Ú1Ú  Úó ó„„'÷ÿ dxdüÿP Pd-¸:Müÿ << deUU(n$––ò ò(Ú  Ú1Ú  Ú)ó ó-.:›&OLE 2.0 Box <=8ÿÿÿÿÿÿÿÿÿÿCÿÿ HKKKKÝ ƒ!ÝÔ . ÔÔ€4ÔÑ  ÑÒ  ÒÒ H ÒÑ\R AØ'\ÑÔ€5ÔÑ#€66Xd#ÑÑ#€66Xd#ÑÝ  ÝÓ  ÓÞ ÞÌà à›à@ àò òIN€THE€SUPREME€COURT€OF€TENNESSEEÌà@ àSPECIAL€WORKERS'€COMPENSATION€APPEALS€PANELÌÙ€ÙœßR€9;8A1-j|` à. `€€@ÿRß›à@ àAT€KNOXVILLEó óÓ  Ӝ̛œÌ›ÌœÌÌ›ÌÌELIZABETH€ANNE€FLICKNER,à àà àœà à)›à àÌ€à à€à àà àà àà àà àœà à)›à àKNOX€CHANCERYÌà àPlaintiff/Appellantà àà àà àœà à)›à àÌà àà àà àà àà àà àœà à)›à àNO.€03S01„9708„CH„00095Ìv.à àà àà àà àà àà àœà à)›à àÌà àà àà àà àà àà àœà à)›à àHON.€SHARON€BELL,ÌCRETE€CARRIER€CORPORATION,à àœà à)›à àCHANCELLORÌà àà àà àà àà àà àœà à)›Ìà àDefendant/Appelleeà àà àœà à)›ÌÌœÌÌò òòòFor€the€Appellant:à àà àà àà àFor€the€Appellee:ÌÌó óóóDavid€C.€Leeà àà àà àà àà àJames€T.€Shea,€IVÌÒ  ÒÒ î ÒJ.€D.€Leeà àà àà àà àà àà àBAKER,€McREYNOLDS,€BYRNEÌLEE,€LEE€&€LEEà àà àà àà àà àOððKANE,€SHEA€&€TOWNSENDÌ422€Gay€Streetà àà àà àà àà àP.€O.€Box€1708ÌKnoxville,€TN€37902à àà àà àà àKnoxville,€TN€37901ÌÌÌÌÌÌÌÌÓ  Óò òòòÔ€5 ÔM€E€M€O€R€A€N€D€U€M€€€O€P€I€N€I€O€NÌÔ€5¼ÔÌMembers€of€Panel:ÌÌó óóóJustice€Adolpho€A.€Birch,€Jr.ÌSenior€Judge€William€H.€InmanÌSpecial€Judge€Roger€E.€ThayerÌÓ  ÓÌÌÌÌÌÌÌÌMODIFIED€andÌAFFIRMEDà àà àà àà àà àà àINMAN,€Senior€JudgeÌÌÓÓÔ€4Ôà àThis€workers'€compensation€appeal€has€been€referred€to€the€SpecialÏWorkers'€Compensation€Appeals€Panel€of€the€Supreme€Court€in€accordanceÏwith€€T.C.A.€ðð€50„6„225(e)(3)€for€hearing€and€reporting€to€the€Supreme€CourtÏof€findings€of€fact€and€conclusions€of€law.Ìà àMs.€Flickner€is€55€years€old,€has€eight€years€of€formal€education,€and€hasÏworked€as€a€truck€driver€for€most€of€her€adult€life.€€She€testified€that€sheÏinjured€her€back€in€1975€in€a€work„related€accident€in€Florida,€that€sheÏunderwent€back€surgery€after€the€injury,€and€that€she€received€Florida€workersððÏcompensation€benefits€for€that€injury.€€Exhaustive€attempts€by€the€parties€failedÏto€discover€her€Florida€workersðð€compensation€records€owing€to€the€20„yearÏtime€lapse.€Ìà àMs.€Flickner€testified€that€after€the€1975€injury€she€recovered€and€wasÏable€to€work€full„time€at€various€jobs,€mostly€truck€driving,€for€the€next€20Ïyears.€On€June€16,€1995,€she€injured€her€lower€back€while€driving€a€truck€forÏCrete€Carrier€Corporation,€and€the€extent€of€her€vocational€disability€from€thatÏinjury€is€the€issue€before€us.Ìà àAfter€the€1995€injury,€Ms.€Flickner€was€treated€by€Dr.€Robert€E.€Finelli,Ïwho€diagnosed€lumbar€disk€defects€at€L3/4€and€L4/5,€and€scar€tissue€from€herÏprevious€surgery€at€L3/4€and€L5/S1.€€He€performed€extensive€lumbar€surgeryÏon€September€18,€1995.€€Ìà àVocational€Rehabilitation€Specialist€Dr.€Julian€Naldosky€testified€for€theÏemployee€that€she€could€no€longer€perform€her€truck€driving€job€and€had€noÏskills€which€would€transfer€to€a€semi„skilled,€light€or€sedentary€job.€€€He€opinedÏthat€jobs€available€to€her€in€her€disabled€condition,€in€light€of€her€employmentÏbackground,€abilities€and€education,€and€assuming€her€ability€to€tolerate€sittingÏand€standing€throughout€the€workday,€would€include€cashier€in€a€restaurant€orÏparking€lot,€ticket€seller,€retail€receiving€clerk,€automobile€self„serve€serviceÏstation€attendant,€gate€tender,€security€monitor,€hardware€assembler,€gasketÏinspector,€packager€of€small€parts€or€small€products,€and€a€bottling€lineÏattendant.€€These€jobs€enable€a€person€to€alternate€sitting€and€standing€but€do€notÏallow€the€person€to€sit€or€stand€at€will.€€If€she€is€limited€to€sitting€and€standingÏat€will,€she€would€be€100€percent€vocationally€disabled.Ìà àVocational€Consultant€Jane€Colvin€Roberson€testified€for€the€employerÏthat€with€her€current€restrictions,€the€employee€could€be€a€trucking€companyÏdispatcher,€recruiter,€log€clerk,€lay„away€clerk€in€a€retail€store,€sales€counterÏclerk€or€sales€position€in€which€she€could€sit€or€stand€at€will.€€She€opined€thatÏthe€employee€has€a€75€to€78€percent€vocational€loss€due€to€her€injury.€Ìà àMs.€Flickner€testified€that€after€the€surgery€she€tried€unsuccessfully€toÏfind€sedentary€work,€that€she€obtained€her€G.E.D.€[ððby€the€skin€of€my€teethðð]Ïand€that,€at€the€time€of€trial,€she€was€taking€an€adult€education€computer€classÏthrough€the€Department€of€Vocational€Rehabilitation€to€improve€herÏemployability.Ìà àThe€trial€court€found€that€her€medical€impairment€was€two€percent,Ïapplied€the€statutory€multiplier€of€six,€and€awarded€12€percent€permanentÏpartial€disability€to€the€body€as€a€whole€as€a€result€of€her€1995€injury.€€The€onlyÏissue€on€appeal€is€whether€the€trial€court€appropriately€applied€Dr.€FinelliððsÏexpert€testimony€in€finding€the€extent€of€vocational€disability.€€Ìà àThe€employee€[appellant]€contends€the€Chancellor€disregarded€the€medicalÏevidence€and€improperly€took€judicial€notice€of€and€interpreted€the€òòAMAÏGuidelines€to€Evaluation€of€Permanent€Impairment,€óóFourth€Edition,€withoutÏany€supporting€medical€testimony.€€Ìà àThe€employer€[appellee]€contends€the€Chancellor€appropriatelyÏinterpreted€and€applied€the€provisions€of€the€òòAMA€Guides€óóbecause€Dr.€FinelliððsÏtestimony€demonstrated€the€impairment€rating€he€gave€the€appellant€had€notÏbeen€determined€in€accordance€with€the€applicable€provision€of€the€òòAMAÏGuidelines.Ìà àóóReview€of€the€findings€of€fact€made€by€the€trial€court€is€òòde€novoóó€upon€theÏrecord€of€the€trial€court,€accompanied€by€a€presumption€of€the€correctness€ofÍthe€finding,€unless€the€preponderance€of€the€evidence€is€otherwise.€T.C.A.€ðð€50„6„225(e)(2);€òòStone€v.€City€of€McMinnville,€óó896€S.W.2d€548,€550€(Tenn.€1995).€€ÏThe€application€of€this€standard€requires€this€Court€to€weigh€in€more€depth€theÏfactual€findings€and€conclusions€of€the€trial€courts€in€workersðð€compensationÏcases.€€òòSee€Corcoran€v.€Foster€Auto€GMC,€Inc.,€óó746€S.W.2d€452,€456€(Tenn.Ï1988).Ô€5ÔÔ€5XÔÌÔ€4ÔÔ€4¼Ôà àAt€trial,€the€Chancellor€and€counsel€for€the€parties€agreed€that€Dr.ÏFinelliððs€January€6,1997€depositional€testimony€concerning€the€appellantððsÏmedical€impairment€rating€was€unclear.€€The€parties€were€directed€by€theÏChancellor€to€conduct€a€second€deposition,€at€which€time€Dr.€Finelliððs€opinionÏas€to€Ms.€Flicknerððs€medical€impairment€rating€as€a€result€of€her€1995€backÏinjury€was€to€be€clarified.€€Dr.€Finelliððs€testimony€on€February€17,€1997€isÏinstructive:ÌÓ  ÓÓÓÔ€4XÔDIRECT€EXAMINATION,€BY€MR.€LEE:Ô€4¼ÔÌÌà0 àÔ€4XÔQ:à8 àDoctor,€will€your€opinions€in€this€deposition€be€to€a€reasonable€degree€ofÏmedical€certainty?ÌÌà0 àA:à8 àYes.ÌÌà0 àQ:à8 àAnd€would€you€describe€to€the€Court€„€„€weððre€taking€this€by€videotape€„€„Ïwhat€Elizabeth€Flicknerððs€impairment€rating€is€as€a€result€of€yourÏSeptember€18,€1995€surgery?ÌÌà0 àA:à8 àBefore€I€answer€that,€can€we€go€back€to€the€original€injury€of€twenty€yearsÏago€and€then€we€can€just€kind€of€walk€through€this?ÌÌà0 àQ:à0 àCertainly.ÌÌà0 àA:à8 àMs.€Flickner€had€a€surgical€procedure€at€her€lower€interspace€of€L5„S1Ïand€the€interspace€above€it€at€L4„5.€€And€just€based€on€that€type€of€historyÍin€which€sheððs€told€us,€and€if€you€go€to€the€òòAMA€Guidelines,óó€this€wouldÏbe€rated€as€a€pre„existing€impairment€rating€of€ten€percent€for€the€first€levelÏand€one€percent€for€the€second€level,€for€a€total€of€eleven€percent.€€SheÏhad€a€history€of€twenty€years€of€having€no€problems€until€a€new€injuryÏoccurred.€€And€here€she€was€found€to€have€a€ruptured€disc€at€the€third€discÏcalled€L3„4.€€And€this€was€a€bona€fide€disc,€brand€new,€which€wasÏdocumented€by€additional€x„rays.€€There€was€a€question€of€having€aÏrecurrent€disc€down€below€at€L4„5.€€Because€of€the€twenty€year€hiatus,Ïthe€fact€that€she€had€been€working€during€this€time,€and€a€new€injuryÏoccurred€essentially€twenty€years€later,€her€rating€would€be€ten€percentÏagain€to€the€virgin€interspace€of€L3„4.€€The€òòAMA€Guidelinesóó€add€anÏadditional€two€percent€when€exploring€a€previously€operated€interspace.€ÏHer€impairment€rating€for€the€second€surgery€would€be€twelve€percent.ÌÌà0 àQ:à8 àIs€that€to€a€reasonable€degree€of€medical€certainty?ÌÌà0 àA:à8 àYes.ÌÌà àà àMR.€LEE:€You€may€ask.ÌÌCROSS€EXAMINATION€BY€MR.€SHEA:ÌÌà0 àQ:à8 àDoctor,€impairment€ratings,€as€you€understand,€are€to€be€given€inÏaccordance€with€the€òòAMA€Guidelines,€óóFourth€Edition?òòÌÌà0 àóóA:à8 àThatððs€correct.ÌÌà0 àQ:à8 àAnd€in€this€case,€youððre€relying€upon€Table€75€of€the€musculoskeletalÏprovision€of€the€òòAMA€Guidelines,€óóFourth€Edition?ÌÌà àA:à àThatððs€correct.ÌÌà0 àQ:à8 àI€understand€that€in€accordance€with€the€òòAMA€Guidelines,€óóFourth€Edition,Ïthat€in€regard€to€an€intervertebral€disc€or€soft€tissue€lesion,€in€Table€75,ÏSection€II„F,€if€you€have€multiple€level€surgical€procedures€with€orÏwithout€operations€and€with€or€without€residual€signs€or€symptoms,€thatÏwould€amount€to€a€ten€percent€impairment€rating?ÌÌà0 àA:à8 àThatððs€correct.ÌÌà0 àQ:à8 àI€understand€that€itððs€your€opinion,€based€upon€the€òòAMA€Guidelines,óó€thatÏin€regard€to€this€first€surgery€back€in€1975,€which€was€located€at€L5„S1Ïand€L4„5,€that€Ms.€Flickner€would€have€an€eleven€percent€rating.€€ThatÏwould€be€ten€percent€plus€the€one€percent?ÌÌà0 àA:à8 àThatððs€correct.ÌÌà0 àQ:à8 àItððs€true€also€that€in€accordance€with€Table€75€of€the€òòAMA€Guidelines,óóÏSection€G,€that€if€a€person€has€multiple€operations€with€or€withoutÏresidual€symptoms,€that€for€the€second€surgery€to€the€lumbar€area,€that€theÏplaintiff€would€have€an€additional€two€percent?ÌÌà àA:à àThatððs€correct.ÌÌà0 àQ:à8 àAnd€in€this€case€there€was€an€additional€surgery€in€this€case€to€a€new€areaÏof€the€lumbar€portion€of€the€body€at€L4„5?ÌÌà0 àA:à8 àThatððs€correct.ÌÌà0 àQ:à8 àAnd€itððs€true€therefore€that€under€Section€„€„€ÌÌà0 àA:à8 àIððm€sorry.€€L3„4.ÌÌà0 àQ:à8 àIððm€sorry.€€L3„4,€and€some€additional€work€at€L4„5?ÌÌà àA:à àThatððs€correct.ÌÌà0 àQ:à8 àAnd€that€pursuant€to€Table€75,€Sections€II„G„1€that€plaintiff€wouldÏtherefore€be€entitled€to€an€additional€two€percent€in€accordance€with€theÏòòAMA€Guidelinesóó€for€that€new€surgery€in€the€lumbar€level;€isnððt€thatÏcorrect?ÌÌà0 àA:à8 àòòThatððs€your€interpretation€of€that.€[emphasis€added]ÌÌóóà àQ:à8 àIs€there€„€„€ÌÌà àà àMR.€LEE:€Well,€let€him€finish€his€answer.ÌÌà àà àMR.€SHEA:€Okay.€€I€didnððt€realize€that€he€had€not.ÌÌà àA:à àYeah.€€Thatððs€your€interpretation€of€that.ÌÌà àQ:à àOkay,€Doctor.ÌÌà àA:à8 àThis€is€the€way€I€interpret€it.€€And€you€have€to€remember,€youððreÏdealing€with€the€òòAMA€Guidelinesóó€which€are€guidelines.€€LetððsÏtake,€for€example,€this€lady€twenty€years€ago€had€three€operations,Ïone,€two€and€three.€€It€would€be€ten,€eleven,€twelve.€€And€thenÏbecause€this€had€already€been€a€violated€interspace,€that€was€takenÏinto€consideration€for€her€workmansðð€comp€injury,€the€secondÏoperation€at€these€two€levels€would€have€been€four€percent.ÌÌà0 àà8 àThe€real€issue€is€this€new€interspace€at€L3„4€after€twenty€years€is€a€newÏdisc.€€Itððs€a€new€disc.€€Itððs€not€an€old€disc.€€You€still€have€to€open€the€skinÏhigher€than€where€the€previous€interspace€operation€was.€€You€have€to€doÏthe€bone€work€and€violate€the€foramina€which€is€what€the€impairmentÏrating€is€given€for.€€So€the€actual€work€at€the€L3„4€interspace€level€is€tenÏpercent.€€The€second€„€„€when€you€go€down€to€the€previous€operatedÏinterspace€„€„€you€might€disagree€with€this,€but€this€is€the€way€„€„€youððveÏgot€to€have€some€sanity€„€„€they€assume€that€because€the€bone€work€hasÏbeen€done,€itððs€easier€to€operate€on€a€second€interspace.€€Well,€thatððs€notÏtrue.€€You€have€a€lot€of€scar€tissue.€€And€thatððs€probably€where€theÍfailings€of€the€impairment€rating€system€for€the€òòAMA€Guidelinesóó€are,€butÏyou€have€to€add€some€consistency€to€the€rating.€€And€the€way€I€interpret€itÏis,€a€brand€new€interspace€is€ten€percent,€because€other€work€has€beenÏdone€at€4„5,€there€is€scar€tissue,€there€is€arthritis€thatððs€been€taken€intoÏconsideration€with€the€original€rating€of€twenty€years€ago.€€And€all€weððreÏdoing€is€going€in€there€and€removing€the€scar€tissue€and€going€down€andÏinspecting€the€disc,€and€that€gives€an€additional€two€percent€impairment.ÌÌà0 àQ:à8 àWell,€Doctor,€in€regard€to€this€provision€of€Table€75€of€the€òòAMAÏGuidelines,óó€however,€it€does€seem€to€indicate,€does€it€not,€that€in€regardÏto€a€second€operation€to€the€lumbar€area€of€the€spine€that€the€addedÏimpairment€rating€pursuant€to€these€guidelines€would€be€two€percent?ÌÌà0 àA:à8 àNo.€€òòYouððre€misreading€it.€[emphasis€added]ÌÌà àóóQ:à0 àAll€right.€€Thatððs€„€„€ÌÌà0 àA:à8 àMultiple€operations€with€or€without€residual€surgery,€second€operation€atÏthe€same€interspace.€€òòThatððs€the€way€I€interpret€that.óó€òò[emphasis€added]ÌÌóóà0 àQ:à8 àDoes€it€say€that,€though,€Doctor?ÌÌà0 àA:à8 àNo,€it€does€not.ÌÌà0 àQ:à8 àAnd€does€it€not€seem€to€indicate€in€the€three€columns,€multiple€levels€ofÏthe€spine,€that€is,€cervical,€lumbar,€thoracic?ÌÌà0 àA:à8 àIt€does.€€But,€again,€a€second€operation€at€a€new€interspace€is€a€newÏproblem.ÌÌà0 àQ:à8 àThatððs€true.€€No€question€about€that.ÌÌà0 àA:à8 àAnd,€again,€whether€you€call€the€area€cervical,€thoracic,€or€lumbar,€thereððsÏstill€spinal€segments.ÌÌà0 àQ:à8 àI€see.€€òòThe€issue€for€us€in€this€lawsuit,€Doctor,€is€what€the€rating€would€beÏin€accordance€with€the€AMA€Guidelines.[emphasis€added]ÌÌóóà0 àA:à8 àòòThe€way€I€interpret€it€is€twelve€percent.óó€òò[emphasis€added]óóÌÌà0 àQ:à8 àAnd€it€would€be€twelve€percent€for€the€new€injury?ÌÌà0 àA:à8 àThatððs€right.€€It€would€be€ten€percent€for€the€new€virgin€interspace€at€L3„4Ïand€two€percent€for€the€second€previously€operated€interspace.ÌÌà0 àQ:à0 àAnd€you€and€I€have€discussed€this€and€youððre€saying€that€I€interpret€theÏòòGuidelinesóó€differently€from€you,€but€are€they€subject€to€interpretation€on€thatÏissue?€€That€is€„€Ìà0 àA:à8 àòòThe€Guidelines€are€vague€here,€but€I€try€to€use€common€sense.€[emphasisÏadded]óó€I€mean,€youððve€got€a€period€of€twenty€years€where€the€patient€wasÏpain€free,€and€then€a€new€problem€occurs.€€This€was€not€addressed.€€ÌÌà@ à„€€€„€€€„€€€„€€€„€€€ÌÌà0 àQ:à8 àIn€regard€to€the€actual€wording,€though,€of€new€level€or€new€operation,Ïunder€Table€75,€Section€II€that€would€just€indicate€an€additional€twoÏpercent€for€each€level€after€the€original€ten€percent€in€1975?ÌÌà0 àA:à8 àòòMaybe€this€is€the€difference€between€a€lay€person€like€yourself€and€aÏmedical€doctor€.€.€.€[emphasis€added]ÌóóÌÓ  ÓÓÓà àÔ€4¼ÔAfter€reviewing€Dr.€Finelliððs€deposition€and€hearing€further€argument€byÏcounsel,€the€Chancellor€held€that€the€appellant€had€sustained€two€percentÏmedical€impairment,€applied€the€multiplier€of€six,€and€awarded€a€judgment€ofÏ12€percent€permanent€partial€disability€to€the€body€as€a€whole.Ìà àThe€employee€appeals,€insisting€essentially€that€the€trial€court€disregardedÏDr.€Finelliððs€depositions,€which€are€the€only€medical€evidence€of€the€extent€ofÏher€permanent€partial€disability,€in€finding€two€percent€medical€impairment€andÏawarding€12€percent€permanent€partial€disability€based€on€the€multiplier€of€sixÏas€provided€in€T.C.A.€ðð€50„6„241.€€ÌÔ€5Ôà àÔ€4ÔIn€making€its€determination€of€vocational€impairment,€the€trial€court€shallÏconsider€all€pertinent€factors,€including€lay€and€expert€testimony,€employeeððsÏage,€education,€skills€and€training,€local€job€opportunities,€and€capacity€to€workÏat€types€of€employment€available€in€claimantððs€disabled€condition.€òò€óóT.C.A.€ðð€€Ï50„6„241(a)(1);€òòRoberson€v.€Loretto€Casket€Co.,€óó722€S.W.2d€380,€384€(Tenn.Ï1986).Ô€5ÔÔ€5XÔÌÔ€5¼ÔÔ€4Ôà àExpert€medical€testimony€must€be€given€in€accordance€with€the€standardsÏset€out€in€T.C.A.€ðð€€50„6„204(d0(3),€which€provides:ÌÓ  ÓÓÓÔ€4XÔò òà àà8 àà à(3)€ó óTo€provide€uniformity€and€fairness€for€all€parties,€anyÏmedical€report€prepared€by€a€physician€furnishing€medicalÏtreatment€to€a€claimant€shall€use€the€òòAmerican€Medical€AssociationÏGuides€to€the€Evaluation€of€Permanent€Impairment,€óóor€the€òòManualÏfor€Orthopedic€Surgeons€in€Evaluation€Permanent€PhysicalÏImpairment.óó€€A€physician€shall€utilize€the€most€recent€edition€ofÏeither€publication€in€determining€the€degree€of€anatomicalÏimpairment.€€A€practitioner€shall€be€required€to€give€an€impairmentÏrating€based€on€one€of€the€two€publications€noted€above.Ô€4¼ÔÌÓ  ÓÌÓÓà 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.ÏINA,€óó884€S.W.2d€446,€451€(Tenn.€1994);€òòLanders€v.€Firemanððs€Fund€Ins.€Co.,Ïóó775€S.W.2d€355,€356€(Tenn.€1989).Ìà àWe€have€reviewed€the€depositions€of€Dr.€Finelli€and€find€that€he€utilizedÏthe€most€recent€edition€of€the€òòAMA€Guidelinesóó€in€assessing€medical€impairment,Ïas€indicated€by€his€testimony€(1)€that€his€opinion€was€based€upon€the€òòAMAÏGuidelines,€óó(2)€that€he€was€relying€upon€Table€75,€(3)€that€in€assessing€12Ïpercent€impairment€he€was€interpreting€the€òòAMA€Guidelines,óó€and€(4)€that€ð ðtheÏòòGuidelinesóó€are€vague€here,€but€I€try€to€use€common€sense.ðð€€€Dr.€FinelliððsÏassessment€of€twelve€percent€medical€impairment€is€fully€documented€andÏsupported€by€his€expert€medical€interpretation€of€the€òòAMA€Guidelines€óóand€theÏpreponderance€of€the€medical€evidence.× ƒ< ××  ×€€Ìà àThe€trial€court€determined€that€appellant€was€entitled€to€the€multiplier€ofÏsix€times€the€medical€impairment.€€The€six„times€multliplier€is€not€to€be€appliedÏautomatically,€but€should€be€reserved€for€the€most€severe€of€all€unscheduledÏpermanent€partial€disabilities.€The€evidence€indicates€that€there€were€many€jobsÏMs.€Flickner€could€do€with€her€medical€restrictions,€and€that€she€has€had€theÏbenefit€of€vocational€rehabilitation€re„training€for€sedentary€work.€€We€find€theÏapplication€of€the€multiplier€of€six€is€not€supported€by€the€preponderance€of€theÏevidence€and€that€the€evidence€supports€a€multiplier€of€four.€€Applying€theÏmultiplier€of€four€to€the€medical€impairment€of€twelve€percent,€we€find€theÏpreponderance€of€the€evidence€supports€a€finding€of€48€percent€vocationalÏdisability.€We€so€modify€the€holding€of€the€trial€court,€and€as€modified,€theÏjudgment€is€affirmed,€with€costs€assessed€to€the€appellee.€ÌÓÓà àÌà àÌà àà àà àà àà àà à________________________________Ìà àà àà àà àà àà àWilliam€H.€Inman,€Senior€JudgeÌÌÌÌÌÌÌÌCONCUR:ÌÌÌÌ_____________________________ÌAdolpho€A.€Birch,€Jr.,€JusticeÌÌÌÌ_____________________________ÌRoger€E.€Thayer,€Special€JudgeÌà àÇÒ  ÒÒ î ÒÌà à€€€€€€€€€€€€€€€€€IN€THE€SUPREME€COURT€OF€TENNESSEEÌßJ€9=;+'b|` à. `€@ÿJßà àà àà àà àà àà àà àà à€€€€€€€€€€€€€Ìà à€à à€€€€€€€€€€€€€à àAT€KNOXVILLEà àà àÌÌÌÌÌÌÒ Ê ÒÒ î Òà àà àà àà àà àà àà àà àÌÒ S ÒÒ î Òà àà àELIZABETH€ANNE€FLICKNERà àà à)à àà àà àà àà àà àà àà àà àà àà àà à)à àà àà à€€€€à àÏà àà àPlaintiff/€Appellantà àà àà à)€€€KNOX€CHANCERYÌ€€€€à à€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€à àà à)Ìà àà àà àà àà àà àà à)Ìà àà àà àà àà àà àà à)€€€€No.€€128871„3à àà àà à.à à€à àà àà àà àà àà à)€€€ÏHon€Sharon€Bellà àà àà àà à€€€€€€€€€€à àà àà àà à)€€€€ÏChancellorà àà àà àà àà à€€€€à àà àà à€€€€€€€à àà à)à àà àà àà àà àà àà àà àà àà àà àà à)€€€€€ÏNo.€03S01„9708„CV„00095Ìà àà àà àà àà àà àà à)ÌCRETE€CARRIER€CORPORATIONà àà à)Ì€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€à àà àà à)€€€€€€Ìà àDefendant/Appellee.à àà àà à)à àÌà àà àà à€€€€€€€€€€€€à àÌà àÌÌà àà àà àà àà àJUDGMENT€ORDERÌà àà àà àÌà à€€€€€€€€€€€ÓfæÓÓ ø ÓÓ` Ü…X ì–XÓThis€case€is€before€the€Court€upon€the€entire€record,€includingÏthe€order€of€referral€to€the€Special€Workersðð€Compensation€Panel,€and€theÏPanelððs€Memorandum€Opinion€setting€forth€its€findings€of€fact€and€conclusionsÏof€law,€which€are€incorporated€herein€by€reference;Ìà àà àWhereupon,€it€appears€to€the€Court€that€the€Memorandum€Opinion€ofÏthe€Panel€should€be€accepted€and€approved;€andÌà àà àIt€is,€therefore,€ordered€that€the€Panelððs€findings€of€fact€andÍconclusions€of€law€are€adopted€and€affirmed,€and€the€decision€of€the€Panel€isÏmade€the€Judgment€of€the€Court.€€à àà àÌÒ  ÒÒ î Òà à€€€€€Costs€on€appeal€are€taxed€to€the€defendant/appellee,€Crete€CarrierÏCorporation,€for€which€execution€may€issue€if€necessary.ÌÌ05/27/98Ì€ÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌà àà àÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌÌal€to€the€Special€Workerðð€Compensation€Panel,€and€the€PanelððsÏMemorandum€Opinion€setting€forth€its€findings€of€fact€and€conclusions€ofÏlaw,€which€are€incorporated€herein€by€reference;Ìà àÌà àWhereupon,€it€appears€to€the€Court€that€the€Memorandum€Opinion€ofÏthe€Panel€should€be€accepted€and€approved;€andÌÌà àIt€is,€therefore,€ordered€that€the€Panelððs€findings€of€act€and€conclusionsÏof€law€are€adopted€and€affirmed,€and€the€decision€of€the€Panel€is€made€theÏJudgment€of€the€Court.ÌÌà àCosts€on€appeal€are€taxed€€to€the€plaintiff„appellant,€Vernon€Harris€andÌGilbert€and€Faulkner.€surety,€for€which€execution€may€issue€if€necessary.€€ÌÌ06/03//97à àà àà àà àà àà àÌÌÌÌà à