ÿWPCa  7# UN %k 0ûqU:l4¦º 0DÉ  w@ 0?[ 0Dš Þ 0JÞ 0T( 0^| 0hÚ 0rB 0|´ 0†0 0¶ 1uF 0d» AQÆp 06 0@M B D/ª BÙ D3öU>)U *gU*‘B)»DCä AM'Èt<½Sv~vÓŽ˜HP LaserJet 4 PlusHPPCL5MS,ð,,,,,ð0nLHÎ(ÈhH  Z ‹6Times New Roman RegularX(ÓH=$¡¡Ñ  ÑÒH°ÒÒ°ÒÑTR[  AØ'ÿ Legal[  AØ'ÿ Legal AØ'ÿ Legal AØ'ÿ LegalTÑÔ€XÎ_XXXÔÑ7€¾úXXdðXXdð7Ñ, øð AZ‹"Arial Regular]tÁ$øð 3|x´;($$””ò òÚ  Ú1Ú  Úó óH ¢;D£;e¤;g¥;D¦;D§;¨;e©;Ó€³;V´;î(ï(3"`$¤¤Ý ƒH=!ÝÑ  ÑÒH°ÒÒ°ÒÑTR[  AØ'ÿ Legal3Ø' AØ'ÿ Legalÿ3Ø'TÑÔ€XØ©XXXÔÑ7€å;XXdìdì7ÑÝ  Ýà ` àòòÚ  Ú0Ú  Úóó(%Ã$òòÚ  Ú1Ú  Úóó2 ÿÿ0Indent1Ô2ÔÔ3  Ô2" ÿÿ0Indent2à0 àÔ2ÔÔ3  Ô2, ÿÿ0Indent3à0 àà0 àÔ2ÔÔ3  Ô26 ÿÿ0Indent4à0 àà0 àà0 àÔ2ÔÔ3  Ô2@ ÿÿ0Indent5à0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô2J ÿÿ0Indent6à0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô2T ÿÿ0Indent7à0 àà0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô2^ ÿÿ0Indent8à0 àà0 àà0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô ÿÿ?AGMSYaioIndent0I.A.1.a.(1)(a)i)a)P ÿÿ8Mac DefaultMac DefaultÓ ` °šXÓ!"#&Cþÿ<< CÿÿƒLevel 1Level 2Level 3Level 4Level 5(ï3Ÿ­$¢¢Ý ƒH=!ÝÑ  ÑÒH°ÒÒ°ÒÑTR[  AØ'ÿ Legal3Ø' AØ'ÿ Legalÿ3Ø'TÑÔ€XØ©XXXÔÑ7€å;XXdìdì7ÑÝ  Ý("ÿÿ$££Ò  ÒÒ  Ò d(('÷ÿ dxdüÿP Pd$$$$'ÿÿdxd< Œ 9p`(&Times New Roman< Œ 9p`(Arial< Œ 9p`(Times% Line 7 d////7Border 1dd!#0Cþÿ << Gÿÿ ¾Ý ƒ!ÝÑ  ÑÑ#€d#ÑÔ€,ÔÑ  ÑÒ  ÒÒ H ÒÑ\R AØ'\ÑÔ€-ÔÑ#€d#ÑÝ  ÝÝ ƒ""ÝÝ  ÝÔ€-ÔÓ  Óò òÔ YYY ÔFILEDÔ€-XÔÌÌJuneÏ5,Ï1998ÌÌCecilÏW.ÏCrowsonÌAppellateÏCourtÏClerkÔ  Ôó ó Ý ƒ!ÝÑ#€d#ÑÔ€,ÔÑ  ÑÒ  ÒÒ H ÒÑ\R AØ'\ÑÔ€-ÔÑ#€d#ÑÝ  ÝÝ ƒ $Ýà àòòÚ  ÚÚ  ÚóóÝ  Ý€€The€plaintiff€did€not€appeal€the€decision€of€the€trial€court€with€respect€to€herÏsinus€injury.€€Therefore,€the€sinus€injury€will€only€be€discussed€for€a€clearÏunderstanding€of€her€back€injury.€€Ì ³Ý ƒ!ÝÑ#€d#ÑÔ€,ÔÑ  ÑÒ  ÒÒ H ÒÑ\R AØ'\ÑÔ€-ÔÑ#€d#ÑÝ  ÝÝ ƒ""ÝÝ  ÝÔ€-ÔÓ  Óò òÔ YYY ÔFILEDÔ€-XÔÌÌJuneÏ5,Ï1998ÌÌCecilÏW.ÏCrowsonÌAppellateÏCourtÏClerkÔ  Ôó óPtPtHHØ(ÿáÿâùFG(üHHØ(d'`Styl{WP}01•ÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃà Ãà Ãà Ãà Ãà ÃÃÃÃÃÃÃÃÃÃÃÐ ÐÐHHÐÐ  ÐÐ2ÐÐÿÿ¸æ$ÿÐÐHHÐÐÐÐÐÐÐÐ  ÐÐ ÐÐ ÐÑÑÑGenevaÑÑ ÑÑ € ÑÑ<Px–ÈÑÒÒÒ443!#4ÒÒ$ *$ÒÒ$*$ÒÒ ÿKK ÒÒ  Geneva ÒÒ  Geneva ÒÓ.,ÓÓÓÓ6ÓÓ ÓßßßßßßßßßßßßßßßßßßÑGenevaÑÑ ÑÒ  ellan Geneva ÒÒ  ellan Geneva ÒÝ ƒ!ÝÔ . ÔÔ€,ÔÑ  ÑÒ  ÒÒ H ÒÑ\R AØ'\ÑÔ€-ÔÑ#€..Xd#ÑÑ#€..Xd#ÑÝ  ÝÑ  ÑÓ  ÓÑ À ÑÑ X Ñò ò›Þ ÞÌ€Ìó óà@ àò òIN€THE€SUPREME€COURT€OF€TENNESSEEÌà@ àSPECIAL€WORKERS'€COMPENSATION€APPEALS€PANELÌÙ€!ÙœßR€120A1-j|` 81 `€€@ÿRß›à@ àAT€NASHVILLEó óÌÓ  ÓÌÌÌÌÌÌÌLINDA€LOU€SHANK,à àà àà à)Ìà àà àà àà àà àà à)à àÌà àPlaintiff/Appelleeà àà àà à)à àRUTHERFORD€CHANCERYà àà àà àà àà àà àà à)à àÌv.à àà àà àà àà àà à)à àNO.€€01S01„9709„CH„00189Ìà àà àà àà àà àà à)à àÌWAL„MART€STORES,€INC.,à àà à)à àHON.€ROBERT€E.€CORLEW,€III,€Ìà àà àà àà à€à àà à)à àCHANCELLORÌà àDefendant/Appellantà àà à)ÌÌÌÌÌÌÌò òòòÌFor€the€Appellant:à àà àà àà àFor€the€Appellee:ÌÌóóó óWesley€R.€Kliner,€Jr.à àà àà àD.€Russell€ThomasÌAllen€&€Kliner,€P.L.L.C.à àà àà à218€West€Main€Street,€Suite€OneÌP.O.€Box€23583à àà àà àà àMurfreesboro,€TN€€37130ÌChattanooga,€TN€€37422„3583ò òòòÌÌóóó óÌÌÌÓ  Óò òòòÌÌÌM€E€M€O€R€A€N€D€U€M€€€€O€P€I€N€I€O€Nóóó óÌÌò òòòMembers€of€Panel:ÌÌó óóóJustice€Frank€F.€Drowota,€IIIÌSenior€Judge€John€K.€ByersÌSpecial€Judge€William€S.€RussellÌÓ  ÓÌÌÌÌÌÔ% € ÔÌÌÌÌÌÌÌÌÌÌÌÌAFFIRMEDà àà àà àà àà àà àà àBYERS,€Senior€JudgeÌÌÓ  ÓÓÓòòò òOPINIONó óóóÌÓ  Óà àThis€workers'€compensation€appeal€has€been€referred€to€the€SpecialÏWorkers'€Compensation€Appeals€Panel€of€the€Supreme€Court€in€accordance€withÏTenn.€Code€Ann.€ðð€50„6„225(e)(3)€for€hearing€and€reporting€to€the€Supreme€CourtÏof€findings€of€fact€and€conclusions€of€law.€Ìà àReview€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€of€theÏfindings,€unless€the€preponderance€of€the€evidence€is€otherwise.€€Tenn.€Code€Ann.€Ïðð€50„6„225(e)(2);€òòStone€v.€City€of€McMinnville,€óó896€S.W.2d€548,€550€(Tenn.€1995).€ÌThe€application€of€this€standard€requires€this€Court€to€weigh€in€more€depth€theÏfactual€findings€and€conclusions€of€the€trial€court€in€a€workersðð€compensation€case.€ÏòòSee€Corcoran€v.€Foster€Auto€GMC,€Inc.,€óó746€S.W.2d€452,€456€(Tenn.€1988).Ìà àIn€this€case,€the€plaintiff€brought€suit€against€the€defendant€Wal„Mart,€allegingÏshe€was€entitled€to€workersðð€compensation€benefits€as€a€result€of€a€back€injury€andÏsinus€injury€sustained€in€the€course€of€her€employment.Ìà àThe€trial€court€found€the€plaintiffððs€sinus€injury€was€not€compensable× ƒ3 ××  ×€but€theÏplaintiffððs€back€injury€was€compensable,€awarding€her€38€percent€permanent€partialÏdisability€to€the€body€as€a€whole,€temporary€total€disability€benefits,€and€unpaidÏmedical€benefits€for€the€services€of€Dr.€Rex€Arendall.Ìòòà àóóThe€defendant€appeals€and€presents€the€following€issues:ÌÒ ` ÒÒ H ÒÓÓð ðI.à àPursuant€to€òòTennessee€Code€Annotatedóó€ðð€50„6„102(a)(5)€and€theÏfacts€à àof€thisà àcase,€the€proof€at€trial€preponderates€against€the€trial€courtððsÏà àfinding€that€the€plaintiffððs€back€injury€was€causally€related€to€theÏà àà àaccident€she€reported€of€April€26,€1994.ÌÌII.à àThe€trial€court€erred€in€finding€that€the€plaintiffððs€back€injury€wasÏà àà àsubject€to€the€six€(6)€times€multiplier€in€òòTennessee€CodeÏAnnotatedóó€€€€€€à àðð€50„6„241(b)€rather€than€the€two€and€one„half€(2€ðð)Ïtimes€multiplier€in€òòà àTennessee€Code€Annotatedóó€ðð€50„6„241(a)(1).ÌÌIII.à àThe€medical€care€of€Dr.€Rex€Arendall€was€unauthorized€and€shouldÏnot€à àhave€been€awarded€by€the€trial€court.ÌÌIV.à àThe€trial€court€erred€in€refusing€to€admit€into€evidence€release€fromÏà àwork€slips€provided€to€defendant€by€the€plaintiff€and€which€wereÏà àà àincluded€in€and€became€a€part€of€her€personnel€file.ððÌòòÌÒ  ÒÒ H ÒÓÓóóà àWe€affirm€the€judgment€of€the€trial€court.ÌÓ  Óò òFACTSó óÌÓ  Óà àThe€plaintiff,€age€39€at€the€time€of€trial,€has€a€GED€and€no€further€vocationalÏtraining.€€Before€moving€to€Tennessee,€the€plaintiff€lived€in€Michigan€and€performedÏa€variety€of€jobs,€all€of€which€involved€bending,€stooping,€twisting,€and€lifting€25€toÏ30€pounds€and€up€to€80€pounds.€Ìà àIn€May€1993,€the€plaintiff€went€to€work€for€the€defendant€Wal„Mart€as€aÏstocker€in€the€receiving€department€in€Smyrna,€Tennessee.€€As€a€stocker,€sheÏunloaded€trucks,€then€delivered€the€merchandise€to€the€pallets€for€the€differentÍdepartments,€and€then€put€the€freight€away.€€This€work€required€her€to€lift€up€to€80Ïpounds.Ìà àThe€plaintiff€testified€she€was€stocking€merchandise€for€the€defendant€onÏApril€26,€1994€when€a€boxed€chain€saw€fell€from€a€pallet€two€or€three€feet€above€herÏand€struck€her€on€the€left€side€of€the€face.€€She€said€her€head,€nose,€and€eye€all€hurtÏimmediately.€€The€plaintiff€attempted€to€avoid€the€box€by€turning€to€the€right,€but€sheÏtwisted€her€back€as€she€was€knocked€to€the€concrete€floor.€€She€testified€sheÏexperienced€immediate€back€pain.Ìà àA€co„worker,€who€took€the€plaintiff€to€the€emergency€room€at€Smyrna€MedicalÏCenter,€testified€the€plaintiffððs€only€complaints€of€pain€at€the€time€of€the€accidentÏwere€with€regard€to€her€head€and€face.€€The€plaintiff€testified€her€primary€concernÏwas€her€face€because€that€injury€was€obvious€and€because€her€head€and€eye€wereÏgiving€her€a€throbbing€headache.Ìà àAfter€the€accident,€the€plaintiff€took€off€work€for€four€or€five€days€but€returnedÏto€work€for€the€defendant€until€the€second€week€of€June€1994.€€In€June€1994,€theÏplaintiff€saw€Dr.€Gary€Schwartz€and€Dr.€Stephen€Patten€for€complaints€of€mid€to€lowÏback€pain.Ìà àWhen€the€plaintiff€resumed€her€work€as€a€stocker,€she€continued€toÏexperience€back€pain€which€radiated€into€her€legs.€€The€plaintiff€testified€she€wasÏworking€for€the€defendant€on€June€13,€1994€when,€as€she€carried€four€heavy€paintÏcans€up€a€ladder,€she€began€to€cough€and€feel€a€sharp€pain€in€her€back€so€severeÏthat€it€took€her€breath€away.€€She€further€testified€this€incident€exacerbated€her€backÏpain.€€In€August€1994,€the€plaintiff€saw€Dr.€J.€Wills€Oglesby€and€told€him€about€thisÏcoughing€spell€and€the€resulting€low€back€pain.€Ìà àMs.€Bronwen€Wiezenhut,€a€workersðð€compensation€rehabilitation€consultantÏemployed€by€the€defendantððs€insurance€carrier,€testified€her€job€is€to€make€sureÏinjured€workers€get€proper€medical€treatment€to€assist€them€in€returning€to€theirÏprevious€duties.€€In€managing€the€plaintiffððs€case,€Ms.€Wiezenhut€was€responsibleÏfor€scheduling€her€appointments€with€doctors€and€overseeing€her€medical€care.Ìà àHowever,€the€plaintiff€and€her€husband€testified€Ms.€Wiezenhut€would€cancelÏappointments€and€schedule€them€with€another€doctor;€she€would€be€late€forÏappointments€or€go€to€the€doctor€without€the€plaintiff;€she€would€forget€importantÏdocuments,€as€she€did€when€she€failed€to€take€the€MRI€report€to€Dr.€M.€RobertÏWeiss;€and€she€did€not€offer€alternative€health€care€to€the€plaintiff€when€she€foundÏout€that€Dr.€Patten€had€referred€her€to€Dr.€Rex€Arendall,€informing€the€plaintiffÏinstead€that€Dr.€Arendallððs€care€would€not€be€covered€by€workersðð€compensation.Ì€€à àFurthermore,€the€plaintiff€testified€Ms.€Wiezenhut€did€not€offer€her€a€panel€ofÏthree€physicians€for€her€back€injury.€€Instead,€the€plaintiff€said€Ms.€WiezenhutÏreferred€her€to€Dr.€Oglesby€for€her€back€injury€without€mentioning€she€could€selectÏfrom€a€panel€of€two€other€physicians.€€On€the€other€hand,€Ms.€Wiezenhut€testifiedÏshe€faxed€a€list€of€three€physicians€to€the€insurance€company,€which€then€offeredÏthe€plaintiff€a€panel€of€physicians€for€her€back€injury.€€Ms.€Wiezenhut€lacked€anyÏpersonal€knowledge€that€the€plaintiff€was€given€a€list€of€physicians€and€herÏtestimony€about€this€was€based€on€inadmissible€hearsay€evidence,€which€the€trialÏjudge€did€not€consider.Ìà àBeginning€October€17,€1994,€the€plaintiff€returned€to€work€for€the€defendantÏwhere€she€sat€on€a€stool€and€answered€the€telephone€all€day.€€The€plaintiff€testifiedÏshe€could€not€sit€for€prolonged€periods€because€her€back€pain€would€radiate€acrossÏher€hip€and€down€the€back€of€her€legs.€€She€said€she€asked€the€defendant€for€aÍchair€with€back€support€but€was€told€the€stool€was€the€only€chair€available.€€The€lastÏday€the€plaintiff€worked€for€the€defendant€was€October€19,€1994,€staying€only€half€ofÏthat€day€because€the€pain€in€her€back€was€too€severe.Ìà àThe€plaintiffððs€husband€went€to€Wal„Mart€on€October€19,€1994€to€voice€hisÏdissatisfaction€with€the€physicians€the€defendant€had€provided€to€his€wife€becauseÏshe€was€not€getting€any€relief€from€her€constant€pain.€€Cynthia€Avent,€theÏdefendantððs€personnel€manager€who€is€responsible€for€keeping€the€workersððÏcompensation€files,€confirmed€through€a€note€in€the€plaintiffððs€file€that€Mr.€Shank€hadÏcomplained€about€the€provided€physicians.€€Ms.€Avent€further€testified€thatÏsubsequent€to€this€note€neither€Wal„Mart€nor€Ms.€Wiezenhut€offered€the€plaintiff€anyÏadditional€health€care.Ìà àUpon€a€referral€from€Dr.€Patten,€the€plaintiff€went€to€see€Dr.€Arendall€onÏOctober€19,€1994€with€complaints€of€low€back€pain.€€At€Dr.€Arendallððs€office,€theÏplaintiff€filled€out€a€history€of€injury€form€on€which€she€indicated€that€her€injury€wasÏnot€job€or€accident€related.€€She€testified€she€did€this€because€Ms.€Wiezenhut€hadÏtold€her€workersðð€compensation€would€not€pay€any€more€of€her€medical€bills.€€TheÏplaintiff€and€her€husband€testified€they€knew€Dr.€Arendallððs€care€would€not€beÏcovered€by€workersðð€compensation.€€They€also€testified€Dr.€Arendall€knew€her€injuryÏwas€work€related€from€the€very€beginning.Ìà àIn€November€1994,€Dr.€Arendall€performed€back€surgery€on€the€plaintiff,€andÏhe€took€her€off€work€for€the€next€11€months€while€she€recuperated.€€ThroughÏDecember€1995,€the€plaintiff€had€follow„up€visits€with€Dr.€Patten€and€Dr.€DevyaniÏSanders€and€continued€to€obtain€work€release€slips.€Ìà àThe€plaintiff€testified€that€since€these€injuries€she€cannot€clean€her€house,Ïmow€her€lawn,€enjoy€the€athletic€and€outdoor€activities€she€did€before€the€accident,Íor€sit€for€prolonged€periods€of€time.€€The€plaintiff€testified€and€the€defendantÏconfirmed€she€is€still€employed€by€Wal„Mart,€but€she€has€not€worked€since€OctoberÏ19,€1994.Ìà àIn€addition,€the€plaintiff€testified€she€had€never€suffered€from€low€back€painÏprior€to€the€accident€at€work.€€The€plaintiff€testified€she€saw€a€chiropractor€for€neckÏadjustments€and€obtained€work€release€slips€from€him€while€working€in€Michigan€inÏ1990€and€1991,€but€she€said€she€never€saw€him€for€back€pain.ÌÓ  Óò òMEDICAL€PROOF€AND€TESTIMONYó óÌÓ  Óòòà àóóThe€medical€records€indicate€that€Dr.€Gary€Schwartz€saw€the€plaintiff€severalÏtimes€in€June€for€complaints€of€mid„back€pain.€€Dr.€Schwartz€could€not€find€anythingÏwrong€with€the€plaintiffððs€back,€so€he€referred€her€to€Dr.€Stephen€Patten.€€Ìà àDr.€Patten€became€the€plaintiffððs€treating€physician,€seeing€her€for€the€firstÏtime€on€June€10,€1994€for€complaints€of€mid€to€low€back€pain€which€radiated€intoÏher€legs.€€He€ordered€an€MRI,€performed€on€July€11,€1994,€which€indicated€a€mildÏdiffuse€disc€bulge€at€L4„5€with€apparent€small€herniation.€€Dr.€Patten€continued€toÏtreat€the€plaintiff€after€her€back€surgery€in€November€1991€until€he€moved€toÏGeorgia.€€Then,€Dr.€Devyani€Sanders€took€over€Dr.€Pattenððs€treatment€of€the€plaintiff.òòÌà àóóDr.€J.€Wills€Oglesby,€an€orthopedist,€saw€the€plaintiff€on€August€8,€1994€andÏrecorded€a€history€from€her€that€she€had€a€coughing€spell€on€June€13,€1994€andÏthereafter€developed€severe€left€side€low€back€pain.€€Dr.€Oglesby€placed€her€in€aÏphysical€therapy€and€work€hardening€program,€but€he€later€noted€this€activityÏaggravated€her€back€pain.€€Ìòòà àóóDr.€M.€Robert€Weiss,€a€neurosurgeon,€performed€an€independent€medicalÏexamination€of€the€plaintiff€on€September€20,€1994.€€He€also€recorded€a€history€ofÏthe€coughing€spell€leading€to€her€back€pain.€€Dr.€Weiss€noted€he€needed€to€reviewÍthe€plaintiffððs€MRI,€which€he€termed€ð ðreportedly€negative.ðð€€He€opined€she€mayÏreturn€to€work€without€restrictions.€€€€€€€Ìà àDr.€Rex€Arendall,€a€board€certified€neurosurgeon,€testified€by€deposition.€€Dr.ÏArendall€first€saw€the€plaintiff€on€October€19,€1994€for€complaints€of€low€back€painÏwith€radiation€into€the€left€leg.€€At€this€time,€Dr.€Arendall€said€he€was€not€given€anyÏhistory€of€the€plaintiffððs€work€accident€on€April€26,€1994.€€But,€he€also€said€theÏplaintiff€told€him€that€she€wrote€workersðð€compensation€was€not€applicable€on€theÏhistory€of€injury€form€because€she€thought€her€coverage€had€been€cut€off.Ìà àDr.€Arendall€diagnosed€her€with€degenerative€disc€disease€and€performed€aÏmicroscopic€lumbar€laminectomy€on€November€3,€1994.€€Dr.€Arendall€recognizedÏan€MRI,€which€indicated€a€herniated€disc€at€L4„5,€had€been€done€as€early€as€JulyÏ11,€1994.€€His€notes€and€post„surgery€tests€indicated€the€plaintiff€was€continuing€toÏhave€pain€because€of€a€lasting€nerve€impingement.€€He€found€she€should€beÏpermanently€restricted€from€repetitive€bending,€stooping,€lifting€over€25€pounds,€orÏstanding/sitting€in€one€static€position€for€prolonged€periods.€€Dr.€Arendall€testifiedÏthe€plaintiff€was€off€work€for€11€months€under€his€care€and€her€condition€would€carryÏa€medical€impairment€of€ten€percent€to€the€body€as€a€whole€under€the€òòAMA€Guides.óó€€Ìà àBased€on€her€counselððs€request,€Dr.€Arendall€released€copies€of€the€plaintiffððsÏfile€and€the€history€of€injury€form€dated€October€19,€1994.€€Counsel€then€asked€Dr.ÏArendall€to€give€an€opinion€on€causation.€€In€a€responsive€letter€dated€February€16,Ï1995,€Dr.€Arendall€stated€based€upon€the€history€given€by€the€plaintiff,€as€well€as€theÏprior€history€given€to€the€other€treating€physicians,€he€could€not€say€the€lumbarÏinjury€was€related€to€the€alleged€incident€with€any€degree€of€medical€certainty.Ìà àOn€February€5,€1996,€the€plaintiff€submitted€a€revised€history€of€injury€form€toÏDr.€Arendall.€€In€his€medical€deposition,€Dr.€Arendall€opined€on€direct€examinationÍthe€plaintiffððs€injury€was€causally€related€to€the€April€26,€1994€incident€if€he€basedÏhis€€opinion€on€the€revised€history€of€injury€form€rather€than€the€initial€history€givenÏby€the€patient.€€He€further€testified€both€the€episode€of€the€chain€saw€box€falling€onÏher€and€the€coughing€spell€while€holding€heavy€paint€cans€could€cause€a€disc€toÏrupture.Ìà àOn€cross„examination,€Dr.€Arendall€stated€based€upon€the€initial€historyÏgiven€by€the€plaintiff€he€could€not€say€with€any€degree€of€medical€certainty€her€discÏherniation€was€caused€by€her€work€accident€on€April€26,€1994.€€When€posed€withÏthe€hypothetical€of€her€work€accident€with€the€boxed€chain€saw,€he€testified€onÏredirect€examination€this€was€the€most€likely€cause€of€her€disc€injury.€€€€€Ìà àDr.€Lloyd€A.€Walwyn,€a€board€certified€orthopedic€surgeon,€also€testified€byÏdeposition.€€Dr.€Walwyn€saw€the€plaintiff€for€an€independent€medical€evaluation€onÏNovember€28,€1995€at€the€request€of€her€counsel.€€He€reviewed€her€medicalÏrecords;€took€a€medical€history€from€her,€which€included€a€description€of€her€workÏrelated€accident€and€resulting€symptoms;€and€examined€her.€€To€a€reasonableÏdegree€of€medical€certainty,€Dr.€Walwyn€diagnosed€her€with€a€surgically€treatedÏlumbar€disc€herniation€with€post€surgical€residual€symptoms,€which€was€consistentÏwith€her€work€injury€on€April€26,€1994.Ìà àDr.€Walwyn€stated€the€plaintiff€was€at€maximum€medical€improvement€andÏher€back€condition€would€restrict€her€ability€to€lift,€carry,€push,€or€pull,€to€performÏrepetitious€squatting,€twisting,€bending,€or€stooping,€and€to€sit,€stand,€climb,€or€walkÏfor€prolonged€periods.€€He€opined€the€plaintiff€would€have€a€ten€percent€wholeÏperson€permanent€impairment€based€on€her€back€injury,€which€was€caused€by€herÏwork€accident.€Ìà àDr.€Richard€E.€Fishbein€submitted€a€C„32€form€and€later€testified€byÏdeposition.€€He€performed€an€independent€medical€evaluation€of€the€plaintiff€andÏagreed€with€Dr.€Arendall€and€Dr.€Walwyn€in€their€impairment€rating€of€ten€percent€forÏher€back€injury.€€Based€on€a€reasonable€degree€of€medical€certainty,€Dr.€FishbeinÏopined€the€most€probable€cause€of€the€plaintiffððs€ruptured€disc€was€when€sheÏtwisted€to€avoid€the€boxed€chain€saw€from€striking€her.€ÌÓ  Óò òANALYSISÌThe€Back€InjuryÌÓ  Óó óà àThe€first€issue€raised€by€the€defendant€is€whether€the€proof€at€trialÏpreponderates€against€the€trial€courtððs€finding€that€the€plaintiffððs€back€injury€wasÏcausally€related€to€the€work€accident€she€reported€of€April€26,€1994.òòÌà àóóIn€order€to€be€eligible€for€workersðð€compensation€benefits,€an€employee€mustÏsuffer€ð ðan€injury€by€accident€arising€out€of€and€in€the€course€of€employment€whichÏcauses€either€disablement€or€death.ðð€€Tenn.€Code€Ann.€ðð€50„6„102(a)(5).€€TheÏphrase€ððarising€out€ofðð€refers€to€causation.€€The€causation€requirement€is€satisfied€ifÏthe€injury€has€a€rational,€causal€connection€to€the€work.€€òòReeser€v.€Yellow€FreightÏSys.,€Inc.,€óó938€S.W.2d€690,€692€(Tenn.€1997)€(citations€omitted).òòÌóóà àAlthough€causation€cannot€be€based€upon€merely€speculative€or€conjecturalÏproof,€absolute€certainty€is€not€required.€€Any€reasonable€doubt€in€this€regard€is€toÏbe€construed€in€favor€of€the€employee.€€We€have€thus€consistently€held€that€anÏaward€may€properly€be€based€upon€medical€testimony€to€the€effect€that€a€givenÏincident€ð ðcould€beðð€the€cause€of€the€employeeððs€injury,€when€there€is€also€layÏtestimony€from€which€it€may€be€reasonably€inferred€that€the€incident€was€in€fact€theÏcause€of€the€injury.€€òòId.óó€Ìà àWhere€the€trial€judge€has€made€a€determination€based€upon€the€testimony€ofÏwitnesses€whom€he€has€seen€and€heard,€great€deference€must€be€given€to€thatÏfinding€in€determining€whether€the€evidence€preponderates€against€the€trial€judgeððsÏdetermination.€€òòSeeóó€òòHumphrey€v.€David€Witherspoon,€Inc.,€óó734€S.W.2d€315€(Tenn.Ï1987).€€In€this€case,€as€in€all€workersðð€compensation€cases,€the€claimant's€ownÏassessment€of€his€physical€condition€and€resulting€disabilities€is€competentÏtestimony€and€cannot€be€disregarded.€òò€Tom€Still€Transfer€Co.€v.€Way,óó€482€S.W.2dÏ775,€777€(Tenn.€1972).Ìà àThe€defendant€submits€causation€in€this€case€is€highly€speculative€andÏcontroverted€based€on€the€medical€proof.€€The€defendant€says€the€plaintiffððs€firstÏcomplaint€of€back€pain€after€the€April€26,€1994€accident€was€not€until€June€1994€toÏDr.€Schwartz€and€other€medical€reports€showed€the€plaintiffððs€back€pain€began€afterÏa€coughing€spell.Ìà àFurther,€the€defendant€points€out€that€Dr.€Arendall€opined€the€plaintiffððs€injuryÏwas€causally€related€to€the€April€26,€1994€incident€only€if€he€based€his€opinion€onÏthe€revised€history€of€injury€form,€which€was€written€by€the€plaintiffððs€counsel.€€OnÏcross„€examination,€Dr.€Arendall€stated€based€upon€the€initial€history€given€by€theÏplaintiff€he€could€not€say€with€any€degree€of€medical€certainty€there€was€a€causalÏconnection€between€the€work€accident€and€her€back€injury.Ìà àIn€addition,€the€defendant€says€the€opinions€on€causation€of€Dr.€Walwyn€andÏDr.€Fishbein,€who€only€saw€the€plaintiff€once€for€an€independent€medical€evaluation,Ïdepended€upon€the€reliability€of€the€history€they€received€from€the€plaintiff.€€TheÏdefendant€urges€this€Court€to€give€more€weight€to€Dr.€Arendallððs€opinion€becauseÏhe€was€one€of€the€plaintiffððs€treating€physicians.€Ìà àAfter€a€careful€review€of€the€record,€we€note€the€medical€testimony€shows€thatÏDr.€Arendall,€Dr.€Walwyn,€and€Dr.€Fishbein€all€testified€there€was€a€causalÏrelationship€between€the€work€accident€on€April€26,€1994€and€her€back€injury.€ÏAlthough€Dr.€Arendallððs€opinion€on€causation€was€based€upon€a€revised€history€ofÏinjury€form€submitted€by€the€plaintiff,€we€find€two€uncontroverted€facts€in€hisÏtestimony€to€be€significant:€(1)€he€testified€the€plaintiff€told€him€that€she€wroteÏworkersðð€compensation€was€not€applicable€on€the€history€of€injury€form€because€sheÏthought€her€coverage€had€been€cut€off,€and€(2)€he€reviewed€an€MRI€which€indicatedÏa€herniated€disc€at€L4„5€as€early€as€July€11,€1994.Ìà àFinally,€the€plaintiffððs€own€assessment€of€her€physical€condition€and€resultingÏdisabilities€is€competent€testimony€which€we€cannot€disregard.€€We€find€theÏevidence€does€not€preponderate€against€the€finding€of€the€trial€court€that€theÏplaintiffððs€back€injury€was€causally€related€to€her€work€accident€on€April€26,€1994.ÌÓ  Óò òThe€Multiplier€Capó óÌÓ  Óà àThe€second€issue€raised€by€the€defendant€is€whether€the€trial€court€erred€inÏfinding€that€the€plaintiffððs€back€injury€was€subject€to€the€six€(6)€times€multiplier€inÏTenn.€Code€Ann.€ðð€50„6„241(b)€rather€than€the€two€and€one„half€(2€ðð)€timesÏmultiplier€in€Tenn.€Code€Ann.€ðð€50„6„241(a)(1).Ìà àUnder€the€provisions€of€Tenn.€Code€Ann.€ðð€50„6„241(a)(1),€an€injuredÏemployee€who€returns€to€her€employment€at€a€wage€equal€to€or€greater€than€theÏwage€she€was€receiving€at€the€time€of€injury€cannot€recover€an€award€more€than€2Ïðð€times€the€medical€impairment€rating€found€by€the€medical€experts.€€TheÏlanguage€of€Tenn.€Code€Ann.€ðð€50„6„241(b)€provides€that€an€injured€employee€whoÏdoes€not€return€to€her€employment€at€a€wage€equal€to€or€greater€than€the€wage€sheÍwas€receiving€at€the€time€of€injury€can€recover€an€award€up€to€6€times€the€medicalÏimpairment€rating.Ìà àTo€determine€which€statutory€cap€applies,€we€must€decide€whether€theÏplaintiff€made€a€ð ðmeaningful€return€to€work.ðð€€òòBailey€v.€Krueger€Ringier,€Inc.,óó€No.Ï02S01„9409„CH„00061,€Weakley€County€(Tenn.€May€17,€1995).€€What€constitutes€aÏmeaningful€return€to€work€is€a€highly€fact€specific€analysis:ÌÒ ` ÒÒ H ÒÓÓà àIf€the€offer€from€the€employer€is€not€reasonable€in€light€of€theÏcircumstances€of€the€employeeððs€physical€ability€to€perform€the€offeredÏemployment,€then€the€offer€of€employment€is€not€meaningful€and€the€injuredÏemployee€may€receive€disability€benefits€up€to€six€times€the€amount€of€theÏmedical€impairment.€€On€the€other€hand,€an€employee€will€be€limited€toÏdisability€of€two€and€one„half€times€the€medical€impairment€if€his€refusal€toÏreturn€to€offered€work€is€unreasonable.€€The€resolution€of€what€is€reasonableÏmust€rest€upon€the€facts€of€each€case€and€be€determined€thereby.ÌÒ  ÒÒ H ÒÌÓÓòòNewton€v.€Scott€Health€Care€Ctr.,óó€914€S.W.2d€884,€886€(Tenn.€1995).òòÌà àóóAfter€reviewing€all€the€relevant€facts€in€this€case,€we€conclude€the€plaintiff€didÏnot€make€a€meaningful€return€to€work.€€The€testimony€of€the€plaintiff€indicates€sheÏreturned€to€work€for€the€defendant€four€or€five€days€after€the€work€accident€on€AprilÏ26,€1994€and€left€work€the€second€week€of€June€1994€after€a€coughing€spell€whichÏexacerbated€her€back€pain.Ìà àThereafter,€the€plaintiff€received€reasonable€and€necessary€medicalÏtreatment€and€tried€to€return€to€work€for€the€defendant€on€October€17,€1994€whereÏshe€sat€on€a€stool€and€answered€the€telephone€all€day.€€The€plaintiff€testified€sheÏcould€not€sit€for€prolonged€periods€because€her€back€pain€would€radiate€across€herÏhip€and€down€the€back€of€her€legs.€€She€said€she€asked€the€defendant€for€a€chairÏwith€back€support€but€was€told€the€stool€was€the€only€chair€available.€€The€plaintiffÏworked€under€these€conditions€until€October€19,€1994,€leaving€in€the€middle€of€theÏday€because€the€pain€was€too€severe.Ìà àWe€find€the€trial€court€did€not€err€by€finding€that€the€plaintiff€did€not€make€aÏmeaningful€return€to€work€and€therefore€the€application€of€the€6€times€cap€wasÏproper.òòÌÓ  Óóóò òThe€Medical€Services€of€Dr.€Arendalló óÌÓ  Óà àThe€third€issue€raised€by€the€defendant€is€whether€the€medical€care€of€Dr.ÏArendall€was€unauthorized€and€should€not€have€been€awarded€by€the€trial€court.Ìà àTenn.€Code€Ann.€ðð€50„6„204(a)(4)€provides:ÌÒ ` ÒÒ H ÒÓÓà àThe€injured€employee€shall€accept€the€medical€benefits€affordedÏhereunder;€provided,€that€the€employer€shall€designate€a€group€of€three€(3)Ïor€more€reputable€physicians€or€surgeons€not€associated€together€inÏpractice,€if€available€in€that€community,€from€which€the€injured€employeeÏshall€have€the€privilege€of€selecting€the€operating€surgeon€or€the€attendingÏphysician;€and,€provided€further,€that€the€liability€of€the€employer€for€suchÏservices€rendered€the€employee€shall€be€limited€to€such€charges€as€prevailÏfor€similar€treatment€in€the€community€where€the€injured€employee€resides.€ÏThe€above€listing€of€physicians€or€surgeons€may€include€doctors€ofÏchiropractic€within€the€scope€of€their€licenses.ÌÒ  ÒÒ H ÒÌÓÓà àIn€reviewing€this€statute,€our€Supreme€Court€has€held:ÌÒ ` ÒÒ H ÒÓÓà àWhere€the€employer€fails€to€give€the€employee€the€opportunity€toÏchoose€the€ultimate€treating€physician€from€a€panel€of€at€least€threeÏphysicians,€he€runs€the€risk€of€having€to€pay€the€reasonable€cost€for€treatmentÏof€the€employeeððs€injuries€by€a€physician€of€the€employeeððs€choice.€.€.€.€€TheÏdecision€turns€on€the€issue€of€whether,€under€the€circumstances,€theÏemployee€was€justified€in€obtaining€further€medical€services,€without€firstÏconsulting€the€employer€or€its€insurer.ÌÒ  ÒÒ H ÒÌÓÓòòUnited€States€Fidelity€&€Guar.€Co.€v.€Morgan,óó€795€S.W.2d€653,€655€(Tenn.€1990)Ï(citations€omitted).Ìà àThe€defendant€submits€Dr.€Arendallððs€medical€treatment€was€unauthorizedÏand€the€testimony€of€the€plaintiff€and€her€husband€proves€they€were€well€aware€ofÏthis€fact.€€The€defendant€contends€it€provided€medical€care€to€the€plaintiff€and€evenÏstood€ready€to€provide€additional€medical€care,€but€the€defendant€says€it€did€notÍreceive€notice€of€the€plaintiffððs€dissatisfaction€with€the€provided€physicians€until€theÏvery€day€she€sought€treatment€from€Dr.€Arendall.€Ìà àThe€record€in€this€case€reveals€the€plaintiff€testified€Ms.€Wiezenhut€did€notÏoffer€her€a€panel€of€three€physicians€for€her€back€injury.€€Instead,€the€plaintiff€saidÏMs.€Wiezenhut€referred€her€to€Dr.€Oglesby€for€her€back€injury€without€mentioningÏshe€could€select€from€a€panel€of€two€other€physicians.€€Ms.€Wiezenhut€testified€sheÏfaxed€a€list€of€three€physicians€to€the€insurance€company,€but€she€could€not€say€theÏinsurance€company€presented€the€list€to€the€plaintiff.€Ìà àIn€addition,€the€record€shows€the€plaintiffððs€husband€went€to€Wal„Mart€onÏOctober€19,€1994€to€voice€his€dissatisfaction€with€the€physicians€the€defendant€hadÏprovided€to€his€wife€because€she€was€not€getting€any€relief€from€her€constant€pain.€ÏCynthia€Avent,€the€defendantððs€personnel€manager,€testified€that€subsequent€to€thisÏdate€neither€Wal„Mart€nor€Ms.€Wiezenhut€offered€the€plaintiff€any€additional€healthÏcare.Ìà àUnder€these€circumstances,€we€find€the€plaintiff€acted€in€good€faith€and€wasÏjustified€in€seeking€medical€treatment€on€her€own.€€òòSee€United€States€Fidelity€&ÏGuar.€Co.€v.€Morgan,óó€795€S.W.2d€653,€655€(Tenn.€1990)€(citations€omitted).€€EvenÏthough€the€plaintiff€went€to€see€Dr.€Arendall€on€October€19,€1994,€the€same€day€herÏhusband€complained€to€Wal„Mart,€the€record€reveals€the€plaintiff€was€experiencingÏso€much€back€pain€that€she€reasonably€thought€she€was€not€getting€necessaryÏmedical€care€from€the€provided€physicians€who€failed€to€acknowledge€her€herniatedÏdisc€in€the€MRI€report.€€Therefore,€we€believe€the€plaintiff€was€properly€awarded€theÏmedical€services€of€Dr.€Arendall,€whose€treatment€and€surgery€were€reasonableÏand€necessary.€€€€Ìà àThe€trial€court€found€the€defendant€failed€to€provide€the€plaintiff€with€a€panelÏof€three€physicians€for€her€back€injury.€€Ms.€Wiezenhut€lacked€any€personalÏknowledge€that€the€plaintiff€was€given€any€list€of€physicians€and€her€testimony€wasÏbased€on€inadmissible€hearsay€evidence.€€Based€on€the€trial€judgeððs€determinationÏof€credibility,€we€cannot€say€the€evidence€preponderates€against€the€decision€of€theÏtrial€court€to€award€the€plaintiff€the€medical€services€of€Dr.€Arendall.€ÌÓ  Óò òThe€Work€Release€Slipsó óÌÓ  Óà àThe€final€issue€raised€by€the€defendant€is€whether€the€trial€court€erred€inÏrefusing€to€admit€into€evidence€release€from€work€slips€provided€to€the€defendant€byÏthe€plaintiff€and€which€were€included€in€and€became€a€part€of€her€personnel€file.Ìà àRegarding€evidentiary€issues,€our€Supreme€Court€has€held:ÌÒ ` ÒÒ H ÒÓÓà àIn€Tennessee€admissibility€of€evidence€is€within€the€sound€discretionÏof€the€trial€judge.€€When€arriving€at€a€determination€to€admit€or€exclude€evenÏthat€evidence€which€is€considered€relevant€trial€courts€are€generallyÏaccorded€a€wide€degree€of€latitude€and€will€only€be€overruled€on€appealÏwhere€there€is€a€showing€of€abuse€of€discretion.ÌÌÒ  ÒÒ H ÒÓÓòòOtis€v.€Cambridge€Mut.€Fire€Ins.€Co.,óó€850€S.W.2d€439,€442€(Tenn.€1992)€(citationsÏomitted).€€Ìà àThe€defendant€sought€to€introduce€work€release€slips€which€indicated€theÏplaintiff€saw€a€chiropractor€and€missed€work€for€both€lumbar€spinal€syndrome€andÏheadaches€during€the€time€she€lived€in€Michigan.€€Counsel€for€the€plaintiff€objectedÏto€the€admissibility€of€the€work€release€slips€on€the€basis€of€double€hearsay.€€TheÏtrial€judge€stated€the€work€release€slips€contained€hearsay€within€hearsay€but€theÏfirst€hurdle€could€be€met€as€a€business€record€exception.€€The€trial€judge€allowedÏthe€work€release€slips€to€be€marked€for€identification€and€to€be€used€to€cross„examine€the€plaintiff,€who€testified€she€could€not€remember€what€she€had€missedÏwork€for€but€she€never€saw€the€chiropractor€for€back€pain.€€€€€€Ìà àWe€conclude€the€trial€judge€did€not€abuse€his€discretion€by€refusing€to€admitÏthe€work€release€slips€into€evidence€and€only€allowing€them€to€be€used€for€theirÏimpeachment€value.ÌÓ  Óò òCONCLUSIONó óÌÓ  Óà àWe€affirm€the€judgment€of€the€trial€court.€€The€cost€of€this€appeal€is€taxed€toÏthe€defendant.€€à àà àÌÌÓÓà àà àà àà àà àà à_____________________________Ìà àà àà àà àà àà àJohn€K.€Byers,€Senior€JudgeÌÌCONCUR:ÌÌÌÌ________________________________ÌFrank€F.€Drowota,€III,€JusticeÌÌÌÌ________________________________ÌWilliam€S.€Russell,€Special€Judge€œÇÒ  ÒÒ £ ÒòòÔ€-¼Ôà@ àIN€THE€SUPREME€COURT€OF€TENNESSEEÌÌà@ àAT€NASHVILLEÌÌÌÌLINDA€LOU€SHANK,à àà àà à}à àRUTHERFORD€CHANCERYÌà àà àà àà àà àà à}à àNo.€95WC„553€BelowÌà àPlaintiff/Appelleeà àà àà à}Ìà àà àà àà àà àà à}à àHon.€Robert€E.€Corlew,€III,Ìvs.à àà àà àà àà àà à}à àChancellorÌà àà àà àà àà àà à}ÌßJ€14;+'b|@²` ‚- `€@ÿJßWAL„MART€STORES,€INC.,à àà à}à àNo.€01S01„9709„CH„00189Ìà àà àà àà àà àà à}Ìà àDefendant/Appellantà àà à}à àAFFIRMED.ÌÌÌà@ àJUDGMENT€ORDERÌÌÌÓ€Óà àà àThis€case€is€before€the€Court€upon€the€entire€record,€includingÏthe€order€of€referral€to€the€Special€Workers'€Compensation€Appeals€Panel,Ïand€the€Panel's€Memorandum€Opinion€setting€forth€its€findings€of€fact€andÏconclusions€of€law,€which€are€incorporated€herein€by€reference.Ìà àà àWhereupon,€it€appears€to€the€Court€that€the€MemorandumÏOpinion€of€the€Panel€should€be€accepted€and€approved;€andÌà àà àIt€is,€therefore,€ordered€that€the€Panel's€findings€of€fact€andÏconclusions€of€law€are€adopted€and€affirmed,€and€the€decision€of€the€PanelÏis€made€the€judgment€of€the€Court.ÌÓ ` ` šXÓà àà àCosts€will€be€paid€by€Defendant/Appellant,€€for€which€executionÏmay€issue€if€necessary.ÌÓÓà àà àIT€IS€SO€ORDERED€on€June€5,€1998.ÌÌÌÌà àà àà àà àà àà àà àPER€CURIAMÌóóÌÌÌÌÌÌÌÌÔ€-XÔ›