WPC9  fQҞZ5,71fU`|?:U2 "SܛJ.b{KE߹iѝ35]aJNc <6ZD4ViKaPLé3pNkL ־$jA^6Xׯ;ۥU'v5"5"Tb^HIpo$.'kW4 (Yq}^)0Naagm }nҁ|װU=_Eeع bJ3YBnfDL2ي δ(% ImSjMsNH!ݿ>x r'.\Hd$椘YݜNjm![_Ÿ.Ը}ͳxxJ~0F]jc392r"ݞГha/9m( }Vr}*# LUNW % 0U Nw@44HoW B 0? 0D" f ==@U:HU:K AQ( 0D 0D2 0Dvv D/ B D3HP LaserJet 4 PlusHPPCL5MS,,,,,,0nLH(hH  Z 6Times New Roman RegularX(3c$7|XXdXXd7  HTXXTR[A' Legal[A' LegalA' LegalA' LegalT(Y Z 6Times New Roman Regular UVӀ ӀDLL%Y3|x e  $HXX `   1    X<X"OutcomeofNonsurgicalTreatmentforPlantarFasciitis,Gill,LowellH.,M.D.and  Kiebzak,GaryM.,Ph.D.,FootandAnkleInternational,Vol.17,No.9,September1996. d((3$ 3c!7<XXdd7  HXXTR[A' Legal3'A' Legal3'T   `   0  ('$  2     $HXX `   2    X<XThetrialcourtreferredtoRileyv.AetnaCasualtyandSuretyCo.,Inc.,729S.W.2d  81(Tenn.1987);wenotethatinRiley,thetrialcourtfoundworkrelatedcausationofplantar  fasciitis,andthatfindingwasnotappealedtotheSupremeCourt. ""  XVn XXXI XXVn   Ad FILEDXVn XI  October12,1998CecilW.CrowsonAppellateCourtClerkdAh ,cAZ"Arial Regular ""  XVn XXXI XXVn   Ad FILEDXVn XI  October12,1998CecilW.CrowsonAppellateCourtClerkdAh ,cAZ"Arial RegularLevel 1Level 2Level 3Level 4Level 5Level 1Level 2Level 3Level 4Level 5Level 1Level 2Level 3Level 4Level 5Level 1Level 2Level 3Level 4Level 5!"#$&C<< CLevel 1Level 2Level 3Level 4Level 5(3$ !  (3$ !  ($$   1  ((' dxdP Pd 'dxd 3c!7<XXdd7  HXXTR[A' Legal3'A' Legal3'T    7<XdXXd7r )<,(j 8` `@E0` 8ttxPh  rߛ   INTHESUPREMECOURTOFTENNESSEE  SPECIALWORKERSCOMPENSATIONAPPEALSPANELATNASHVILLEm @#(July20,1998Session)  H SANDRAGAILHOLMES,    ) p NO.01S019710CH00237 H   `     h     ) ` Plaintiff/Appellee h     ) p RUTHERFORDCHANCERY h   `     h     )v. `     h     )   `     h     ) p HON.ROBERTE.CORLEW,III  МBRIDGESTONE/FIRESTONE,  ) p CHANCELLOR  INC., `     h     ) p    `     h     ) ` Defendants/Appellants    ) (  FortheAppellant: h     FortheAppellee: (x  KittyBoyte    h     SusanK.Bradley F  МGRACEY,RUTH,HOWARD,    WILSON&BRADLEY V!  ` TATE&SOWELL    6PublicSquareNorth f" 150SecondAvenueNorth,    Murfreesboro,TN37130 v# Suite201Nashville,TN37201   MEMORANDUMOPINION: *6&$ MembersofPanel: JudgeBenH.Cantrell /n*( SeniorJudgeWilliamH.InmanSpecialJudgeJoeC.Loser,Jr.   AFFIRMED   h      p   INMAN,SeniorJudge :63   ` Thisworkers'compensationappealhasbeenreferredtotheSpecial Workers'CompensationAppealsPaneloftheSupremeCourtinaccordancewithTenn.CodeAnn.506225(e)(3)forhearingandreportingtotheSupremeCourtoffindingsoffactandconclusionsoflaw.## # 4   ` Theplaintiffsoughtworkerscompensationbenefitsforplantarfasciitis, `  whichsheallegedwascausedbystandingonaconcreteflooratworkfortwelvehoursshifts.Thedefendantarguedthatplantarfasciitisisnotcausedbystandingforlongperiodsandthereforeplaintiffsjobdidnotcausehercondition. ` Thetrialcourt,inacomprehensiveandwellreasonedopinion,foundthepreponderanceoftheevidenceprovedtheconditiontobeworkrelatedandϜawardedbenefits,whichthedefendantappeals. ` Weaffirmthejudgmentofthetrialcourt.򀀀 @  ` SandraGailHolmes[ Employee]beganworkingforBridgestone ` [ Employer]in1987.Herjobasatirebuilderconsistedoftwelvehourshifts   duringwhichshestoodonaconcretefloorona1/4"rubbermatwhilebuildingtires.Shewasnotpermittedtositunlessshewasonbreak. ` In1994shebegancomplainingofherfeet,andonAugust22,1994,requestedmedicaltreatmentatworkowingtoburningpainshootingthroughherheelandarcofherleftfoot,upthroughthecalfmuscle,andlessersymptomsinherrightfoot.Theemployersonsitephysician,Dr.Flynn,senthertoDr.MarkChristofersen,anorthopedicsurgeon,whomemployeetestifiedshesawonce,forϜtenor15minutes,onSeptember1,1994. ` Dr.Christofersenexaminedemployeeandfoundexcellentjointmotionandnoswellingbutwithtendernesstopalpationattheoriginoftheplantarfasciaandarchontheleftandtoalesserextentontheright.ShehadbeenonacourseofNaprosyn,whichwasineffective,andthenToradol,10mg.,overtheprevious :P52 weekwhichalsowasofnobenefit.Dr.ChristiansendiscussedplantarfasciitisϜwithher,discoursingthelistofremedies,includingstretching,shoemodification,antiinflammatory,heelinsertsandinjections.ShewasnoteagerϜforinjections,andbecausemostofthefirstmeasureswereineffective,heprescribedapairofnightsplints.Hewasnotoptimisticaboutthistreatment,sincenightsplintsaremostlybeneficialforpatientswhohavepainuponarisinginthemorning,whereasemployeespainwasnotsosevereinthemorningbutϜworsenedduringtheday.Hispessimismabouthiscourseoftreatmentappearsjustified,sinceafteronevisittohisoffice,shedidnotreturnforfurthertreatment. ` Dr.Christiansenwasdeposedandopined:  8 ` Plantarfasciitisisaninflammationofaconnectivetissuestructureunderthearch...andforsomereasoninpeopleslives,particularly  p betweentheagesof30and60,inflammationcanoccurinthatplantarfascia.Anditmostcommonlyoccursneartheoriginofthatconnectivetissueattheheel. ` 8"` 8"  @%..... p"   8 ` Weseeheelpaininsecretarieswhoalternatesittingandstanding $ duringtheday.Weseeheelpaininsedentarypeople,peoplewhostandalldayandpeoplewhostandforextremelylongshiftsoftime.Andsobecauseofthatheterogeneitywehesitatetoblamecertain ' #! Мsettingsforheelpain.($"` 8"` 8" 0 ` Q:8 ` $` $Isthatjusttypicalofyourpractice,Dr.Christofersen,oris *<&$ thatopinionsharedbythecolleaguesinyourfieldofexpertise? -\(& 8" 8" 0 ` A:8 ` $` $Imconfidentthatthereisthatthereareavarietyof ,/|*( opinions,andIprobablyshouldntcommentonthat.<0+) 8" 8"  ` Dr.ChristofersenalsotestifiedthathispositionaschiefoforthopedicsatBaptistHospitalplaceshim incharge,ifyouwill,ofthepodiatryservice,and thatheiscurrentlynotgrantingprivilegesfor[surgical]releaseoftheplantar 61/ fasciaforheelpainbecauseofagrowingincidenceofpeoplewhohaveintractableheelpainfollowingendoscopicsurgeryforheelpain.  ` Whenaskedwhattreatmenthewouldrecommendforanemployeewhocontinuedtohavesymptomsdespiteconservativetreatmenthereplied:8 ` Iftheytoldmethattheyhadintractablepainwhilestanding,thenImighttrytoworkwiththeemployerandgetthemamoresedentaryjob. ` 8"` 8"  ` EmployeethensawpodiatristDr.FredMarinoonMarch16,1995withsharppainandburningintheleftfootwhichworsenedasherworkshiftϜprogressed.Shehadmildercomplaintsabouttherightfoot.Heperformedxrayandexaminationanddiagnosed plantarfasciitisheelspursyndrome.HetreatedemployeeconservativelywithoutsubstantialimprovementuntilOctober,1995,whenheperformedsurgeryonherleftfoot. ` Dr.Marinoappearedattrialandtestified:  8 ` Inmyexperienceandeducation,andreviewoftheliterature,myoverwhelmingimpressionisthatthisisaconditionrelatedtolongperiodsofstandingandperiodsofshortwalking. ` 8"` 8"  ` WhenaskedthebasisforhisdisagreementwithDr.Christiansen,whohadopinedthatplantarfasciitiscannotbeattributedtostandingforlongperiodsatwork,hereplied:8 `  Myexperienceandanumberofpodiatricarticlesandarecentarticle *@&$ intheFootandAnkleInternational,whichisapublicationorjournaloftheFootandAnkleSocietyoftheAmericanOrthopedicAssociation. ` 8"` 8"    ` ThejournalarticletowhichDr.Marinoreferredwasthereuponintroducedintoevidenceastrialexhibit#3,fromwhichwequote:  8 ` Thereisacorrelationintheincidenceofplantarfasciitiswiththetypeofflooronwhichapatientworks.Mostpatientswithplantarfasciitisworkedonhardfloors.   '  1      כ61/` 8"` 8" Ї   ` Dr.Marinofurthertestifiedthathehaspracticedpodiatryfor  approximatelytenyears,duringwhichtimehehastreated1,951patientswiththediagnosisofplantarfasciitis,andthatasubstantialnumberofthem[ probably85or90percent]areinproductionworkorserviceworksuchascashiersandcafeteriaworkers.Heopinedthatthebasisforthehighnumberoffactorytypeworkershavingplantarfasciitiswas inmyopinion,withoutadoubt, P  Мprolong[ed]standing.Ofhis1,951suchpatients,37haveundergonesurgery,whichheperformswhenapatientis nonresponsivetoconservativecarewithcontinuingdisablingsymptoms. ` Thetrialjudgefound:  8 ` Thebasicdifferencebetweenthetestimoniesofthetwodoctorsappearstobethattheyhaveopposingphilosophiesastothecompensabilityofaninjurydiagnosedasplantarfasciitis.TheparticularsofthePlaintiffsconditionaside,itappearsthatDr.Marinofirmlybelievesthatplantarfasciitiscanbeandoftenorgenerallyiscausedbyrepetitivemotionsintheworkplace,whileDr.Christofersenhastheopinionthattheinjuryiseithercongenital,orcausedbyfactorsoutsidetheworkplace,andthusisrarelyifevercompensable...TheCourtmustrecognizethattheSupremeCourthaspreviouslyfoundtheconditionknownasplantarfasciitistobecompensableundertheworkerscompensationlawwheretheproofjustifiessuchafinding.   '  2      כ$` 8"` 8" ) ` ThetrialcourtacknowledgedtheunpublishedopinionofaSpecialWorkersCompensationPanelinGerdesv.DistributionandAutoServices,Inc., ( $" No.01S019409CH00100(Nashville,May31,1995)inwhichthePanelheld *@&$ thatplantarfasciitiswasnotcompensableinthatcasebecausethecontradictorymedicalevidencesupportedaconclusionthattheplaintiffsconditionwasidiopathic.TheCourtfounditsignificantthatinGerdes,thePaneldidnotfind P1,*  plantarfasciitistobeanoncompensableconditionperse,butmerelythatthe p3., plaintiffinthatparticularcasehadfailedtosatisfytheburdenofestablishingthathehadsustainedaninjury.  ` Theplaintiffinaworkerscompensationsuithastheburdenofprovingeveryelementofhercasebyapreponderanceoftheevidence.Tindallv.Waring  ` ParkAssn.,725S.W.2d935(Tenn.1987).Causationandpermanencymustbe 0  showninmostcasesbyexpertmedicalevidence.Id.Althoughabsolute P  certaintyisnotrequiredforproofofcausation,medicalproofthattheinjurywascausedinthecourseoftheemployeesworkmustnotbespeculativeorsouncertainregardingthecauseoftheinjurythatattributingittotheplaintiffsemploymentwouldbeanarbitrarydeterminationoramerepossibility.If,uponundisputedproof,itisconjecturalwhetherdisabilityresultedfromacauseoperatingwithinpetitionersemployment,oracauseoperatingwithoutemployment,therecanbenoaward.If,however,equivocalmedicalevidencecombinedwithotherevidencesupportsafindingofcausation,suchaninferencemayneverthelessbedrawnbythetrialcourtunderthecaselaw.Livingstonv. p" МShelbyWilliamsIndus.,Inc.,811w511(Tenn.1991).ԀAnyreasonabledoubtin $ thisregardistobeconstruedinfavoroftheemployee.Wehavethusconsistentlyheldthatanawardmayproperlybebaseduponmedicaltestimonytotheeffectthatagivenincident couldbethecauseoftheemployeesinjury,whenthereisalsolaytestimonyfromwhichitreasonablymaybeinferredthattheincidentwasinfactthecauseoftheinjury.Reeserv.YellowFreightSys., /*( Inc.,938S.W.2d690,692(Tenn.1997). 1-*  ` Employeetestifiedthatshehadneverhadproblemswithherfeetbeforeshebeganworkingforthisemployer.Sheengagedinnostrenuousphysicalactivitiesorprolongedstandingoutsideofherworkenvironment.Shesaidher <830 symptomswerelesswhensheawakenedinthemorningbutbecamesevereasthedayprogressedatworkwhereshestoodonaconcretefloor.#05#Ԁ ,  ` Wherethetrialjudgehasmadeadeterminationbaseduponthetestimonyofwitnesseswhomhehasseenandheard,greatdeferencemustbegiventothatfindingindeterminingwhethertheevidencepreponderatesagainstthetrialjudgesdetermination.SeeHumphreyv.DavidWitherspoon,Inc.,734S.W.2d   315(Tenn.1987).#9# (   ` ThetrialcourtacceptedtheopinionofDr.Marino,whotestifiedattrial,overthatofDr.Christiansen,whotestifiedbydeposition,andhehehadԛthe $t discretiontodo.Johnsonv.Midwesco,Inc.,801S.W.2d804,806(Tenn. p 1990).#߷;#Whenԛthemedicaltestimonyispresentedbydeposition,asitwasinthe  caseofDr.Christiansen,thisCourtisabletomakeitsownindependentassessment.C#߆<#ooperv.INA,884S.W.2d446,451(Tenn.1994);Landersv. d FiremansFundIns.Co.,775S.W.2d355,356(Tenn.1989).#|=#Wehavecarefully @! reviewedDr.Christiansensdepositionaltestimonyaboutcausation:  8 ` ...[W]ehesitatetoblamecertainsettingsforheelpain...thereareavarietyofopinions...itscommonforustosee,tohearourstrongestcomplaintsfrompeoplewhosejobsrequirethemtostandbecausethatmakesthemhurtinanaggravatedfashion...probablyourdifficultyinsayingwithconfidencethatprolongedstandingisadirectcauseofplantarfasciitisisthefactthattherearesomanypeople *L&# whoarenotrequiredtodoprolongedstandingatworkwhodevelopplantarfasciitis.[emphasisadded]-l(%` 8"` 8" >Ӝ> ` Underthefactsofthisparticularcase,weagreewiththetrialcourtsfindingthatfindDr. .*jx` `@E` 8ttxP t@ INTHESUPREMECOURTOFTENNESSEE   r )<,(j 8` `@E` 8ttxP  r @  )ATNASHVILLESANDRAGAILHOLMES,    } p RUTHERFORDCHANCERY  `  `     h     } p No.95WC957Below  p  ` Plaintiff/Appellee h     } 0   `     h     } p Hon.RobertE.Corlew,III @  vs. `     h     } p Chancellor P   `     h     }BRIDGESTONE/FIRESTONE,INC. `     h     } p No.01S019710CH00237    `     h     } ` Defendant/Appellant    } p AFFIRMED  @(JUDGMENTORDER `  ThiscaseisbeforetheCourtupontheentirerecord,includingtheorderofreferraltotheSpecialWorkers'CompensationAppealsPanel,andthePanel'sMemorandumOpinionsettingforthitsfindingsoffactandconclusionsoflaw,whichareincorporatedhereinbyreference. `  Whereupon,itappearstotheCourtthattheMemorandumOpinionofthePanelshouldbeacceptedandapproved;and `  Itis,therefore,orderedthatthePanel'sfindingsoffactandconclusionsoflawareadoptedandaffirmed,andthedecisionofthePanelismadethejudgmentoftheCourt. XX `  CostswillbepaidbyDefendant/AppellantandSurety,forwhichexecutionmayissueifnecessary. `  ITISSOORDEREDon"*US , US , *October12,1998. `     h      p PERCURIAM H947 # = E#