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ÔÔ€#ÔÝ  ÝÒ  ÒÒ X ÒÓ  ÓÔ€#¼ÔÑ\R AØ'\ÑÌà@ àIN€THE€SUPREME€COURT€OF€TENNESSEEÌÌà@ àSPECIAL€WORKERSðð€COMPENSATION€APPEALS€PANELÌÌà@ àAT€JACKSONÌà@ à(February€6,€1997€Session)ÌÌÌÓ ` Ü›XÓPAMELA€SUE€HIGGINS,à àà à)à àHARDIN€CIRCUITÌà àà àà àà àà àà à)Ìà àPlaintiff„Appellee,à àà àà à)à àHon.€C.€Creed€McGinleyÌà àà àà àà àà àà à)à àJudgeÌà àà àà àà àà àà à)ÌVs.à àà àà àà àà àà à)à àNo.€02S01„9605„CV„00050ÌÙ€€ÙßL€')&;+'h|3` Å `€€Lßà àà àà àà àà àà à)ÌANGELICA€CORPORATION,à à)Ì€€€€a/k/a€ANGELICA€UNIFORMà à)à àÌ€€€€GROUP,€INC.,€a/k/a€ANGELICAà à)Ì€€€€MANUFACTURING€PLANT,à à)Ìà àà àà àà àà àà à)Ìà àDefendant„Appellant.à àà à)Ìà àà àà àà àà àà àÌÌÌÌÌòòFor€Appellantóó:à àà àà àà àà àòòFor€Appelleeóó:ÌÌMr.€David€L.€Kleinfelterà àà àà àà àMs.€Lisa€June€CoxÌDale,€Rosenberg€&€McLeanà àà àà àAttorney„at„LawÌP.€O.€Box€198258à àà àà àà àà à64€Lynoak€CoveÌ221€Fourth€Ave.,€North,€5th€Floorà àà àJackson,€Tennessee€38305ÌNashville,€Tennessee€37219„7443ÌÌÌÌà@ àòòM€E€M€O€R€A€N€D€U€M€€€€€O€P€I€N€I€O€NÌÌà@ àMembers€of€Panelóó:ÌÌà@ àLyle€Reid,€Associate€Justice,€Supreme€CourtÌà@ àJoe€C.€Loser,€Jr.,€Special€JudgeÌà@ àLeonard€W.€Martin,€Special€JudgeÌÌÌÌAFFIRMED€à àà àà àà àà àà àà à€€€€€€€€€€€€Martin,€JudgeÌÌÔ€#XÔÇÔ€#¼ÔÑ7€ebXdìXXdì7Ñà@ àòòMEMORANDUM€OPINIONóóÌÌÌÌÓ€Óà àà àThis€workersðð€compensation€appeal€has€been€referred€to€the€SpecialÏWorkersðð€Compensation€Appeals€Panel€of€the€Supreme€Court€in€accordance€withÏTenn.€Code€Ann.€section€50„6„225(e)(3)€for€hearing€and€reporting€to€theÏSupreme€Court€of€findings€of€fact€and€conclusions€of€law.€ÌÌà àà àDefendant€appeals€from€the€trial€courtððs€award€of€45€per€cent€(45%)Ïpermanent€partial€vocational€disability€of€each€arm,€following€surgery€on€eachÏwrist€for€carpal€tunnel€syndrome.€€Defendant€raises€three€(3)€issues,€that€theÏplaintiffððs€injuries€are€not€causually€related€to€her€employment€and€therefore,€notÏcompensable;€that€the€plaintiff€did€not€give€proper€notice€as€required€by€Tenn.ÏCode€Ann.€section€50„6„201;€and€that€the€preponderance€of€the€evidence€does€notÏsupport€the€trial€judgeððs€finding€that€the€plaintiff€suffered€a€45€per€cent€(45%)Ïpermanent€partial€vocational€disability€to€each€arm.€€The€panel€has€concluded€thatÏthe€judgment€of€the€trial€court€should€be€affirmed.ÌÌà àà àThe€employee,€Ms.€Pamela€Sue€Higgins,€is€thirty„eight€(38)€yearsÏold,€quit€school€in€the€eighth€(8th)€grade,€and€she€has€performed€sewing€work€forÏdifferent€manufacturers€for€twenty€(20)€years.€€Ms.€Higgins€began€herÏemployment€with€Angelica€on€January€14,€1991.€€Shortly€after€going€to€work€forÏAngelica€she€was€seen€by€Doctor€James€H.€Thomas,€a€family€practitioner,€withÏthe€specific€complaint€that€her€right€wrist€had€hurt€for€five€(5)€days.€ÏApproximately€two€and€one„half€(2€l/2)€months€later€she€returned€to€DoctorÏThomas€with€the€same€complaint.€€Doctor€Thomas€soon€concluded€that€herÏproblem€was€carpal€tunnel€syndrome€in€nature€and€referred€her€to€Doctor€L.ÏDavid€Johnson,€an€orthopaedic€surgeon,€for€treatment.€€After€treating€herÍconservatively,€excluding€other€possible€causes€of€her€symptoms,€and€based€uponÏelectrodiagnostic€studies€performed€by€Doctor€Ron€Bingham,€on€May€13,€1991,ÏDoctor€Johnson€diagnosed€her€as€having€moderate€carpal€tunnel€syndrome€on€theÏright,€and€severe€carpal€tunnel€syndrome€on€the€left.€€Doctor€JohnsonÏsubsequently€performed€carpal€tunnel€surgeries€on€both€right€and€left€wrists.€€SheÏwas€also€seen€by€Doctors€Cohn€and€Cramer,€and€Pechacek,€in€consultation,€in€theÏprocess€of€eliminating€other€causes€for€her€symptoms€and€confirming€herÏdiagnosis.€€Doctor€Johnson€also€testified€that€it€was€July€of€1992€before€he€cameÏto€a€conclusion€as€to€the€causation€of€her€problems.€€When€asked€the€question,Ïð ðUp€to€that€point€in€time,€would€a€lay€person€have€any€way€of€knowing€orÏdiagnosing€the€nature€or€cause€of€her€problems?ðð,€he€answered,€ð ðNoðð.€ÏSubsequent€to€her€surgeries,€Doctor€Johnson€evaluated€her€as€having€a€15€perÏcent€(15%)€anatomical€impairment€to€each€upper€extremity.€€It€should€also€beÏnoted€that€she€had€a€trigger€release€surgery€on€her€thumb€which€completelyÏresolved€her€thumb€problem.€€Another€significant€point€with€regard€to€the€noticeÏissue,€is€that€in€Doctor€Johnsonððs€deposition,€it€was€revealed€that€on€October€4,Ï1991,€he€signed€a€health€insurance€claim€form€on€which€it€was€checked€orÏindicated€that€Ms.€Higgins€injuries/symptoms€were€not€work€related.ÌÌà àà àAppellate€review€of€the€award€of€disability€benefits€is€ò òde€novoó ó€uponÏthe€record€of€the€trial€court,€accompanied€by€a€presumption€of€correctness€of€theÏfindings€of€fact€unless€the€preponderance€of€the€evidence€is€otherwise.€€Tenn.ÏCode€Ann.€section€50„6„225(e)(2).€€This€tribunal€is€required€to€conduct€anÏindependent€examination€of€the€evidence€to€determine€where€the€preponderanceÏof€the€evidence€lies.€€ò òòòWingert€v.€Government€of€Sumner€Countyóó,€908ÏS.W.2d€921,€(Tenn.€1995).ó ó€€Because€the€standard€of€review€is€more€rigorousÏthan€its€predecessor,€the€material€evidence€rule,€we€are€required€to€weight€inÍmore€depth€all€of€the€relevant€evidence.€€ò òòòCorcoran€v.€Foster€Auto€GMC,ÏInc.óó,€746€S.W.2d€452,€458€(€Tenn.€1988).€€ó óWhere€the€trial€judge€has€seenÏand€heard€the€witnesses,€especially€if€issues€of€credibility€and€weight€to€be€givenÏoral€testimony€are€involved,€considerable€difference€must€be€accorded€thoseÏcircumstances€on€review.€€òòò òHumphrey€v.€David€Witherspoonóó,€734€S.W.2dÏ315€(Tenn.€1987).ó ó€€ÌÌà àà àWhen€medical€testimony€is€presented€by€deposition,€this€court€is€ableÏto€make€its€own€independent€assessment€of€the€medical€proof€to€determine€whereÏthe€preponderance€of€the€evidence€lies.€€ò òòòLanders€v.€Firemanððs€Fund€Ins.ÏCo.óó,€775€S.W.2d€355,€356€(Tenn.€1989);€òòHenson€v.€City€ofÏLawrenceburgóó,€851€S.W.2d€809,Ì812€(Tenn.€1993).€€ó óIt€should€be€noted€that€this€panel€has€no€hesitancy€aboutÏdelving€into€the€intracicies€of€Ms.€Higginsðð€medical€history€and€has€carefully€readÏthe€medical€depositions€and€related€exhibits.ÌÌà àà àWith€regard€to€the€issue€of€whether€or€not€Ms.€Higginsðð€injuries€areÏcausally€related€to€her€employment,€the€preponderance€of€the€evidence€clearlyÏestablishes€that€Ms.€Higgins€has€bi„lateral€carpal€tunnel€syndrome€which€wasÏcaused€by€€twenty€(20)€years€of€working€in€sewing€factories,€and€that€it€becameÏdisabling€while€she€was€employed€by€Angelica.€€In€ò òòòBrown€Shoe€Company€v.ÏReedóó,€357€S.W.2d,€65€(Tenn.€1961)ó ó,€an€early€gradual€injury€case,€the€courtÏquoted€with€approval€from€ò òLarson,€Section€39.5ó ó,€the€following:ÌÌÓ  ÓÓÓà àà àð ðThe€date€of€accident€for€gradual€loss€of€use€of€the€handsÌà àà àwas€held€to€be€the€date€on€which€this€development€finallyÌà àà àprevented€claimant€from€performing€his€work.€€The€problemÌà àà àis€thus€solved€in€a€manner€which€is€familiar€in€a€comparableÌÓ€Óà àà àarea€of€occupational€diseases.ððÌÌÓ  Óà àà àIt€has€long€been€the€law€that€in€gradual€occurring€injury€cases,€suchÏas€carpal€tunnel€syndrome€cases,€you€do€not€go€back€and€try€to€apportion€theÏinjury€out€amongst€all€previous€employers,€but€rather€the€employer€for€whom€theÏemployee€is€working€at€the€time€the€injury€becomes€disabling€is€the€one€that€hasÏto€pay.€€This€is€too€clearly€established€to€require€the€citation€of€authorities.€ÏClearly,€Ms.€Higgins€was€working€for€Angelica€when€her€carpal€tunnel€syndromeÏproblem€became€disabling.ÌÌà àà àThe€second€issue€is€whether€the€plaintiff€gave€proper€notice€of€herÏwork€related€injury€as€required€by€Tenn.€Code€Ann.€section€ò ò50„6„201.× ƒ+ ××  ×€ó óIn€theÏcase€of€ò òòòCentral€Motor€Express€Company,€Inc.,€v.€Richard€M.€Burneyóó,Ï377€S.W.2d€947,€(Tenn.€1964),€ó ó€the€Supreme€Court€held€as€follows:ÌÓÓà àà àð ðUnder€the€doctrine€of€ò òòòBrown€Shoe€Company€v.€Reedóó,€supra,Ìà àà àó ówhich€we€have€held€to€be€applicable€in€the€present€case,€theÌà àà àbeginning€date€for€computing€notice€is€the€date€on€which€theÌà àà àdisability€manifests€itself€to€such€an€extent€that€petitioner€wasÌà àà àforced€to€leave€work.ððÌÌÓ€ÓÌà àà àIt€took€Doctor€Johnson€a€while€to€ascertain€for€sure€that€Ms.€HigginsððÏproblem€was€carpal€tunnel€syndrome€and€that€it€was€work€related.€€Ms.€HigginsÏhas€an€eighth€(8th)€grade€education€and€in€her€trial€she€testified,€ð ðI€honestly€didnððtÍknow€what€was€causing€my€problem.ðð€€She€also€testified€that€she€told€AngelicaÏeverything€that€the€doctors€told€her.ÌÌà àà àThe€third€and€final€isssue€is€whether€the€trial€judgeððs€finding€that€theÏplaintiff€suffered€a€45€per€cent€(45%)€permanent€partial€vocational€disability€toÏeach€arm€is€supported€by€the€preponderance€of€the€evidence.ÌÌà àà àThe€extent€of€vocational€disability€is€a€question€of€fact€to€beÏdetermined€from€all€of€the€evidence,€including€lay€and€expert€testimony.€Ïòòò òWorthington€v.€Modine€Mfg.€Co.óó,€798€S.W.2d€232,€234€(Tenn.€1990).ó ó€ÏA€medical€expertððs€rating€of€anatomical€disability€is€one€of€the€relevant€factors,Ïbut€the€vocational€disability€is€not€restricted€to€the€precise€estimate€of€theÏanatomical€disability€made€by€a€medical€witness.€€ò òòòCorcoran€v.€Foster€AutoÏGMC,€Inc.óó,€746€S.W.2d€452,€458€(Tenn.€1988).ó ó€€Once€the€causation€andÏpermanency€of€an€injury€have€been€established€by€expert€testimony,€the€trialÏjudge€may€consider€many€pertinent€factors,€including€age,€job€skills,€education,Ïtraining,€duration€of€disability,€and€job€opportunities€for€the€disabled,€in€additionÏto€anatomical€impairment,€for€the€purpose€of€evaluating€the€extent€of€a€claimantððsÏpermanent€disability.€€Tenn.€Code€Ann.€section€50„6„241(a)(2).ÌÌà àà àAfter€careful€consideration€of€all€the€relevant€factors€in€this€case,€theÏpanel€finds€that€the€evidence€fails€to€preponderate€against€the€judgment€of€theÏtrial€court.ÌÌà àà àThe€judgment€of€the€trial€court€is€therefore€affirmed.€€Costs€areÏtaxed€to€the€defendant„appellant.ÌÌÌà àà àòòà àà àà àà à€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€Ìà àà àà àà àà àà ààHMM*àóó€€€€€€€à àLeonard€W.€Martin,€JudgeÌÌÌÓÓCONCUR:ÌÌÌòò€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€ÌóóLyle€Reid,€Associate€JusticeÌÌÌòò€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€ÌóóJoe€C.€Loser,€Jr.,€JudgeÌÌÌà àà àÌ€€€ÌÌà àà àÌÌà àÇÑ ` ÑÔ€(Ôà@ àIN€THE€SUPREME€COURT€OF€TENNESSEEÌÌà@ àAT€JACKSONÔ€(XÔÌÌÌÓ#` p…X LÐ X#ÓPAMELA€SUE€HIGGINS,à àà à)à àHARDIN€CIRCUITÌÓ#` p` LÐ X#Óà à)à àNO.€2184ÌÓ` p` ¸ ’XÓà àPlaintiff/Appellee,à à)à àÌÓ#` p` ¸ LÐ X#Óà àà à)à àHon.€C.€Creed€McGinley,Ìvs.à àà à)à àJudgeÌà àà à)ÌANGELICA€CORPORATION,€a/k/a€ANGELICA,à à)à àNO.€02S01„9605„CV„00050ÌßJ€',;+'b|vX` Å `€@ÿJßUNIFORM€GROUP,€INC.,€a/k/a€ANGELICAà à)ÌMANUFACTURING€PLANT,à à)Ìà àà à)Ìà àDefendant/Appellant.à à)à àAFFIRMED.ÌÌÌÌà@ àÔ€(¼ÔJUDGMENT€ORDERÔ€(XÔÌÌÓÓÌÓ` p`  ’XÓà àThis€case€is€before€the€Court€upon€the€entire€record,€including€the€orderÏof€referral€to€the€Special€Workers'€Compensation€Appeals€Panel,€and€the€Panel'sÏMemorandum€Opinion€setting€forth€its€findings€of€fact€and€conclusions€of€law,€whichÏare€incorporated€herein€by€reference.Ìà àWhereupon,€it€appears€to€the€Court€that€the€Memorandum€Opinion€of€theÏPanel€should€be€accepted€and€approved;€andÌà 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€ofÍthe€Court.Ìà àCosts€will€be€paid€by€Appellant,€and€surety,€for€which€execution€mayÏissue€if€necessary.Ìà àIT€IS€SO€ORDERED€this€17th€day€of€April,€1997.ÌÌà àà àà àà àà àà àà àà àPER€CURIAMÌ(Reid,€J.,€not€participating)ÌÌÌÌÔ€#ÔÔ€#¼Ô