WPC+ ΢\;{ !bB²Q;3 ߞGteȱ`d6dвݨ']hPjԋ{w3n6@o|x%7"Sxr^F[f,&뉖`脮oՒ>xqk"~@Z4p:mv;R?.8Ӡ~O V#/3N;z'uZ݀/ @\fظ( 7B*o KC𬺝m-W3"\HCB0͒I] HwM~LFE3:X՛8+,a~/\2):tzxyLCnM~\ bPP6U *C KoK>8tBr})s0jqQqLmhK݈JZxˆaq2ͣ|wA.(zEGMSY_ekqAutoList21A.A.A.A.A.A.A.A.@A.(EGMSY_ekqAutoList22A.A.A.A.A.A.A.A.BA.(#$  0  (|3l$ !..88dd8     C:\OFFICE\WPWIN\TEMPLATE\STANDARD.WPT(|G2$ !..88dd8         0  XkdX d(|3l$ !..88dd8     VVVV'dxd)!dxdx( $ Figure  1  ^_X`YE<<CLevel 1Level 2Level 3Level 4Level 5(|3l$ !..88dd8     ($$   1  X[Z&OLE 2.0 Box <=8C HKKKKXy  <<= 8C(3uF$ !..88dd8      d !.88dd8     _88kdXXdd8  @@7 7 INTHESUPREMECOURTOFTENNESSEE  SPECIALWORKERSCOMPENSATIONAPPEALSPANEL  @@ATNASHVILLE  (April26,2000Session) * XkdX8 #8XXkd#TENNESSEEPROTECTIONANDADVOCACY,INC.,ETALv.JANIS   GREENEXkdX8   , @@ DirectAppealfromtheChanceryCourtforDavidsonCounty   @@No.973068IICarolMcCoy,Chancellor    @@*AV) ` dE<g` A h  No.M199900884_WC_ԄR3CVMailedJuly11,2000 ]  #8XXkd#XkdX8FiledOctober24,2000 C  AV) ` dE<` A _      Thisworkers'compensationappealhasbeenreferredtotheSpecialWorkers'CompensationAppeals T PaneloftheSupremeCourtinaccordancewithTenn.CodeAnn.506225(e)(3)forhearingand : reportingtotheSupremeCourtoffindingsoffactandconclusionsoflaw.      Tenn.CodeAnn.506225(e)(1999)AppealasofRight;JudgmentoftheChanceryCourt  ReversedinpartandAffirmedinpart;Remanded.       loser,sp.j.#8Xkda#XkdX.8,deliveredtheopinionofthecourt,inwhichbirch,j.,and_kurtz_,sp.j.,joined. N CarsonW.Beck,Nashville,Tennessee,fortheappellant,JanisGreene. j RichardE._Spicer_,Nashville,Tennessee,fortheappellees,TennesseeProtectionandAdvocacy,Inc., 6 etal.  U  MEMORANDUMOPINION #8XXkd#XkdX8        Bythisappeal,theemployeeorclaimant,JanisGreene,insiststheevidencepreponderates ~"" againstthetrialcourtsfindingthathercarpaltunnelsyndromedidnotariseoutofandinthecourse d## ofheremployment.Theemployer,TennesseeProtectionandAdvocacy,Inc.contendstheclaimis J$$ barredbytheemployeesfailuretogivetimelywrittennotice.Asdiscussedbelow,thepanelhas 0% % concludedthetrialcourtsorderdismissingtheclaimasnothavingarisenoutofandinthecourse &f!& ofemploymentshouldbereversed;andthepanelhasfurtherconcludedthetrialcourtsfindingswith &L"' respecttonoticeandtheextentoftheclaimantspermanentpartialdisabilityshouldbeaffirmed. '2#(   TheemployerinitiatedthisactiononSeptember15,1997,seekingadeclarationthatthe )$* employeesclaimedinjurydidnotariseoutofandinthecourseofemployment.Theemployee *%+ servedheranswerandacounterclaim.Construingthecounterclaimfairlyandconsistentlywiththe z+&,  F-(. evidenceandarguments,wehaveconcludedtheemployeewasandisseekingdisabilityandmedical  benefitsauthorizedbytheWorkersCompensationAct.Tenn.CodeAnn.506101etseq.    AfteratrialofalltheissuesonFebruary25,1999,thechancellormadeherfindings. b Paraphrased,thosefindingswerethat(1)theclaimantsuffered seriouscarpaltunnelsyndrome, H causeunknownbecauseofinsufficientmedicalproof,(2)timelywrittennoticeofherclaimedinjury . ~ wasgiven,(3)asaresultofhercarpaltunnelsyndrome,theclaimantretainedapermanentpartial  d vocationaldisabilityoftwentyfivepercenttotherighthandandtwelveandonehalfpercenttothe  J lefthand,(4)herclaimedmedicalexpenseswerereasonableandnecessaryand(5)theclaimantwas  0 acrediblewitness.      Reviewoffindingsoffactbythetrialcourtisdenovoupontherecordofthetrialcourt,   accompaniedbyapresumptionofcorrectnessofthefindings,unlessthepreponderanceofthe x  evidenceisotherwise.Tenn.CodeAnn.506225(e)(2).Thisstandardrequiresthepanelto ^  examineindepthatrialcourtsfactualfindingsandconclusions.Thereviewingcourtisnotbound D  byatrialcourtsfactualfindingsbutinsteadconductsanindependentexaminationtodetermine *z  wherethepreponderanceoftheevidencelies._Galloway_Ԁv.MemphisDrumServ.,822S.W.2d584 ` (Tenn.1991).Conclusionsoflawarerevieweddenovowithoutanypresumptionofcorrectness. F Presleyv.Bennett,860S.W.2d857(Tenn.1993).#8XXkd #XkdX8 ,   Wherethetrialjudgehasseenandheardthewitnesses,considerabledeferenceshouldbe  accordedthosecircumstancesonreview,_Kellerman_Ԁv.FoodLion,Inc.,929S.W.2d333(Tenn.  1996),becauseitisthetrialcourtwhichhadtheopportunitytoobservethewitnesssdemeanorand t toheartheincourttestimony.Longv.TriConInd.,Ltd.,996S.W.2d173(Tenn.1999).The Z appellatetribunal,however,isaswellsituatedtogaugetheweight,worthandsignificanceof @ _depositional_Ԁtestimonyasthetrialjudge.Ormanv.Williams_Sonoma_,Inc.,803S.W.2d672,67677 &v (Tenn.1991).  \   Theclaimantisafortyeightyearoldcollegegraduate,whobeganworkingfortheemployer ( in1993asanadvocate.Herdutiesincludeassistingpersonswithneedsineducationalandother  settingsandspeakingatseminars.Thosedutiesrequiredrepetitiveuseofthehandstooperatea  computerterminal,usethetelephone,preparecasenotes,setupcasefiles,filloutformsanddrive   acar.Shetestifiedthatshewouldspendfivetosevenhoursadaytalkingonthephoneandwriting p!  notesatthesametime.Inthespringof1997,shebegantonoticeburningpain,numbnessand V"! tinglinginherhands,wristsandforearms,especiallywhileusingthetelephoneandwritingnotes. <#" Afamilypractitionerprescribedasplintwhichsheregularlyworewhileatrest.Shecontinued "$r# working.ShewasalsoreferredtoDr.W.Cooper_Beazley_,anorthopedicsurgeon. %X $   Dr._Beazley_Ԁordereddiagnostictesting,fromtheresultsofwhichhediagnosedbilateral &$"& carpaltunnelsyndrome.TheclaimantcontinuedtoworkuntilJanuary21,1998,whencorrective ' #' surgerywasperformedbyDr._Beazley_.ShereturnedtoworkwithrestrictionsonFebruary2,1998. (#( Evenbeforethat,onJuly14,1997,theclaimantsrepresentativeprovidedtheemployerwithwritten )$) noticethathehadbeen consultedbyJanisGreeneonaWorkersCompensationmatterinvolving l*%* bilateralcarpaltunnel.Wefirstaddresstheissueofnotice. R+&+    `     h      p  8,',   Immediatelyupontheoccurrenceofaninjury,orassoonthereafterasisreasonableand  practicable,aninjuredemployeemust,unlesstheemployerhasactualknowledgeoftheaccident,  givewrittennoticeoftheinjurytoheremployer.Nobenefitsarerecoverableunlesssuchwritten | noticeisgivenwithinthirtydaysaftertheinjuriousoccurrence,unlesstheinjuredworkerhasa b reasonableexcuseforthefailuretogivetherequirednotice.Thenoticemaybegivenbythe H employeeorherrepresentative.Tenn.CodeAnn.506201.#8XXkd#XkdX8Thenoticemaybegivenbymail, . ~ WilliamH.ColemanCo.v._Isbell_,159Tenn.459,19S.W.2d243(1929),andcomplieswiththe  d statutoryrequirementsifitnotifiestheemployeroftheaccidentandthefactthattheemployeehas  J sufferedaninjury.QuakerOatsCo.v.Smith,574S.W.2d45(Tenn.1978).  0   Thereasonsfortherequirementare(1)togivetheemployeranopportunitytomakean    investigationwhilethefactsareaccessible,and(2)toenabletheemployertoprovidetimelyand   propertreatmentfortheinjuredemployee.Jonesv.SterlingLastCorp.,962S.W.2d469(Tenn. x  1998).Indeterminingwhetheranemployeehasshownareasonableexcuseforfailuretogivesuch ^  notice,courtswillconsiderthefollowingcriteriainlightoftheabovereasonsfortherule:(1)the D  employersactualknowledgeoftheemployeesinjury,(2)lackofprejudicetotheemployerbyan *z  _excusal_Ԁofthenoticerequirement,and(3)theexcuseorinabilityoftheemployeetotimelynotify ` theemployer._McCaleb_Ԁv.SaturnCorp.,910S.W.2d412(Tenn.1995).Itissignificantthatwritten F noticeisunnecessaryinthosesituationswheretheemployerhasactualknowledgeoftheinjury. , _Raines_Ԁv.ShelbyWilliamsIndustries,Inc.,814S.W.2d346(Tenn.1991).    Where,ashere,theinjuryisagraduallyoccurringone,thebeginningdateforgivingthe  writtennoticeisthedateonwhichtheemployeeisforcedtoquitworkbecauseoftheinjury. t Lawsonv.LearSeatingCorp.,944S.W.2d340(Tenn.1997).Inthepresentcase,thatdatewas Z January21,1998. @   Whileitmaybereasonablyarguedthatthewrittennoticegivenbytheclaimants  \ representativeinthepresentcasewasnottimely,sinceitwasgivenbeforethedateonwhichthe B employeewasforcedtoquitworking,itcannotbesaidthattheemployerdidnothaveatleastas ( muchknowledgeastheemployeethatshehadaworkrelatedinjury.Theuntimelynoticeis  evidenceoftheemployersactualknowledge.Moreover,thefactthattheemployerracedtothe  courthouseafterreceivingnotice,ratherthanofferingtoprovidemedicalcare,isevidenceofthelack   ofprejudicetotheemployer.Thechancellorsfindingwithrespecttonoticeisaffirmed. p!    Next,theemployeecontendstheinjuryiscompensablebecausetheevidencepreponderates <#" againstthetrialcourtsfindingofinsufficientmedicalproofofcausation.Ithaslongbeenthelaw "$r# ofthisstatethataninjuryarisesoutoftheemploymentifthereisarationalcausalconnection %X $ betweenthedutiesofemploymentandtheinjury.Inthiscase,thechancellorsfindingsincluded %>!% thefollowingexcerpt: &$"& 0  Withregardtowhetherthisinjuryaroseoutofandinthecourseofemployment,andwith ' #' regardtotheissueofcausation,theCourtisnotinapositiontomakeadeterminationbased (#( ontheproofbeforeit.Itisessentialtomakingsuchaconclusionthatthereissufficient )$) medicaltestimonytosupportsuchafinding.Dr._Beazley_,forwhateverreason,wouldnot l*%* rendersuchanopinion.TheCourtisnotinapositiontomakethatdeterminationbasedon R+&+ laytestimonysolely.Caselawrequiresthatthephysician,thisoneorperhapsanother 8,', _physician,renderanopinionthattheinjurywascausedbytheworkthattheywere  performing....(#(#   Wearepersuadedthattheabovequotedexcerptmisstatesthedegreeofcertaintyofproof b ofmedicalcausationrequiredbythecaselaw,wherethereisalsocrediblelayproofofcausation. H Dr.Beazleysdeposition,whichcontainedtheonlymedicalproof,includedthefollowingquestions . ~ andanswersconcerningcausation:  d  (83! !""    72  Q  .3  0 `   DoyouhaveanopinionastowhatcausedthecarpaltunnelthatMs.Greene  0 experienced?7)8݌  ` (#` (# Ќ    ! ! (88""    92  A  .3  0 `   Well,hercomplaintswerefromherjobactivitieswhereshewasusingthecomputer.9:݌ ` (#` (# Ќ   (88! !""    ;2  Q  .3  0 `   Okay.IsthereanythinginMs.Greeneshistorythatwouldnotbeconsistentwith ^  aworkrelatedinjury?;;݌D ` (#` (# Ќ  ! ! (88""    =2  A  .3  0 `   Itcouldbe.Imean,Icantsay100percentwhetheritisorisnt.Shehassomeareas ` inherhistory,useofaterminalanddrivingalot,thathavebeenshowninthepast F tocausecarpaltunnel.==݌,` (#` (# Ќ   (ʽ88! !  ....    ""    B@2ʽ  Q  .3  0 `   Okay.Haveyoutreatedpeople,inthepast,whodevelopedcarpaltunnelsyndrome t fromkeyboarduse?B@{@݌Z` (#` (# Ќ  ! ! !(ڽ88""    2B2ڽ  A  .3  0 `   Yes.2BkB݌&v` (#` (# Ќ   #(88!! !""    C2  Q  .3  0 `   Theseactivitiescouldbeconsistentwith(or)relatedtocarpaltunnel....?CC݌B` (#` (# Ќ  ! ! %(88#""    rE2  A  .3  0 `   Couldbe.rEE݌` (#` (# Ќ    ....    '( 88%! !""    G2   Q  .3  0 `   Isthereanyevidence!isthereanynotationsinyourrecordsastoanyotheractivities V"! thatmightcausecarpaltunnel,suchasplayingaguitar,oranyotheractivitiesthat <#" shemighthavedone?GRG݌"$r#` (#` (# Ќ  ! ! )(*88'""    I2*  A  .3  0 `   No,sir.II݌%>!%` (#` (# Ќ   +(:88)! !""    K2:  Q  .3  0 `   DidMs.Greenerelatetoyouthatshefeltthatitwascausedbyherwork?K:K݌' #'` (#` (# Ќ  ! ! -(J88+""    L2J  A  .3  0 `   Shethoughtitwas,yes,sir.LL݌)$)` (#` (# Ќ    .... l*%*  0(Z88-! !""    |N2Z  Q  .3  0 `   Dr.Beazley,isityourpractice!aswespokeearlier!nottocommentonawork R+&+ relatedinjuryunlessitsaspecificincidentatwork?|NN݌8,',` (#` (# Ќ  _! ! 2(j880""    P2j  A  .3  0 `   Itsmypracticetoallowtheemployerandemployeetodeterminethat.Yes,Itryto  stayawayfromitifatallpossible.PP݌|` (#` (# Ќ   4(z882! !""    R2z  Q  .3  0 `   Soinacaselikethisyouwouldnotformanopinionastowhetheritwaswork H relatedornotworkrelated,isthatcorrect?RR݌. ~` (#` (# Ќ  ! ! 6(884""    T2  A  .3  0 `   Thatscorrect.TT݌ J` (#` (# Ќ     8(886! !Oncrossexamination:    ""    }V2  Q  .3  0 `   ...Ifyouthoughtthatapersonsinjurywas,withinareasonabledegreeofmedical   certainty,incurredinthescopeofonesemployment,youwouldtestify,wouldnt x  you?}VV݌^ ` (#` (# Ќ  ! ! :(888""    X2  A  .3  0 `   Yeah.Imean,ifits!asanexample,ifsomeonehastheirfingercutofforhadan *z  acuteinjuryanditwasveryblackandwhite!Imean,itwasobviousthatthiswas ` thepointintimeithappened,thatscommonsense,yes,sir.X Y݌F` (#` (# Ќ  Onredirectexamination:   <(88:! !""    [2  Q  .3  0 `   Dr._Beazley_,haveyou!youtestifiedinthepastthatcarpaltunnelisworkrelated?[[݌` (#` (# Ќ  ! ! >(j88<""    ]2j  A  .3  0 `   Icantrememberanytimeinthenearpast,no,sir.Notunlessitwasrelatedto,like, Z someonehadadistalradiusfractureanditwasfromdirecttraumafromthat.ButI @ dontrememberthelasttimethatIsaidthat,no.]]݌&v` (#` (# Ќ   @(z88>! !""     `2z  Q  .3  0 `   Okay.Soyourpositionis,youdonot! `B`݌B` (#` (# Ќ  ! ! B(88@""    a2  A  .3  0 `   Itrynottodoitunlessitsjustreally!itssoobviousthatitsnotapointof  contentioninadeposition.aa݌` (#` (# Ќ  ̀Dr._Beazley_Ԁdidnottestify,withanydegreeofcertainty,thattheinjurywasworkrelated,buthe p!  clearlydidtestifythattheinjury couldbeconsistentwithorrelatedtotheclaimantsactivitiesat V"! work.Ourunderstandingoftheruleisthatbecausemedicalwitnessesarerarely,ifever,ableto <#" statetheiropinionsonmedicalcausationwithreasonablecertainty,medicaltestimonythatthe "$r# employmentcouldhavecausedaninjuryissufficienttomakeoutaprimafaciecasethattheinjury %X $ aroseoutoftheemployment,andthat,iftheemployerintroducesnoevidencetothecontrary,the %>!% preponderanceoftheevidencesupportsanawardofworkerscompensationbenefits.See_Downen_ &$"& v.AllstateIns.Co.,811S.W.2d523(Tenn.1991)andauthoritycitedtherein.Moreover,wherethe ' #' injuryoccursinthecourseoftheemployment,astheclaimanttestifiedwithoutcontradictionthat (#( herinjurydid,anyreasonabledoubtastowhethersuchaninjuryarisesoutoftheemployment )$) shouldberesolvedinfavoroftheemployee._Reeser_Ԁv.YellowFreightSystems,Inc.,938S.W.2d l*%* 690(Tenn.1997).Fromthoseauthorities,weconcludethatDr._Beazley_stestimony,while R+&+ insufficientbyitselftoprovemedicalcausation,establishesaprimafaciecase,whenconsideredin 8,', contextwiththecredibletestimonyoftheclaimant.Inadditiontotestifyingthattheinjurycould  beworkrelated,thedoctorseemedtoruleoutotherpossiblecauses.Becausetheemployerchose  nottoofferanycountervailingmedicalproof,theevidencethuspreponderatesagainstthetrial | courtsfindingofinsufficientproofofcausation. b   Fortheabovereasons,thejudgmentofthetrialcourtdisallowingtheclaimisreversed.In . ~ allotherrespects,thejudgmentisaffirmed.ThecaseisremandedtotheChanceryCourtfor  d DavidsonCounty.Costsonappealaretaxedtotheappellees.  J   ̀̀ x  #8XXkdt$#XkdX8  D  8XXkd@7 7 INTHESUPREMECOURTOFTENNESSEE  @$ATNASHVILLE  #XkdX88m# 8XXkd  TENNESSEEPROTECTIONANDADVOCACY,INC.andTRAVELERS  INSURANCECOMPANYv.JANISGREENE#XkdX8m#   n@  ChanceryCourtforDavidsonCounty   @#No.973068II   @*AV) ` dE<K` A߈ L  @= = No.M199900884_WC_ԄWCMCVFiledOctober24,2000 A  AV) ` dE< ` A  ]   8XXkd#XkdX8p#@( ORDER 8XXkd#XkdX8q#Ԉ R  8XXkd#XkdX8aq#8XXkd#XkdX8q#  ThiscaseisbeforetheCourtuponmotionforreviewpursuanttoTenn.CodeAnn.506  225(e)(5)(B),theentirerecord,includingtheorderofreferraltotheSpecialWorkers'Compensation  AppealsPanel,andthePanel'sMemorandumOpinionsettingforthitsfindingsoffactand  conclusionsoflaw,whichareincorporatedhereinbyreference; f   Whereupon,itappearstotheCourtthatthemotionforreviewisnotwelltakenandshould 2 bedenied;and h   Itis,therefore,orderedthatthePanel'sfindingsoffactandconclusionsoflawareadopted 4 andaffirmed,andthedecisionofthePanelismadethejudgmentoftheCourt.    CostswillbepaidbyTennesseeProtectionandAdvocacy,Inc.andTravelersInsurance  Company,forwhichexecutionmayissueifnecessary. |   ITISSOORDERED. H!! 8XXkd#XkdX8v#   `     h     PER_CURIAM_ %!&   &!'