By: Duane Willis

In a case handled by B. Duane Willis of Morgan & Akins, Joseph Kolby Willis v. All Staff, 2017 Tenn. LEXIS 455 (August 7, 2017), the Tennessee Supreme Court Special Workers Compensation Panel affirmed the dismissal of a claim as not work related, and restated again the burden of proof the employee must carry when trying to prove causation on a claim.

The claim arose from an alleged incident on July 30, 2014, when the employee was working for All Staff. He was taking a break between tasks, and then standing from a squatting position when he displaced his kneecap. It was noteworthy that the employee had preexisting knee problems, and a condition called patella alta, which predisposed him to knee dislocations.

The employee filed a petition for benefits, and at an Expedited Hearing, after the employee presented his proof and his version of the facts, the trial court found the injury to be idiopathic in nature, stating that the employee “simply stood up, twisted the wrong way, and the knee dislocated.” Even in light of the denial, the employee proceeded to trial, which necessitated the deposition of the treating physician, Dr. David Moore. Dr. Moore testified that it was “possible” the activity done before the dislocation had caused Employee’s legs to become fatigued, stating that such fatigue “would have helped contribute to his injury.” Dr. Moore further testified that it would be “speculation” for him to render an opinion on the question because Employee had not provided a history of having fatigue in his legs. Dr. Moore also testified that Employee had “patella alta,” which predisposed him to kneecap dislocation. On cross-examination, the speculative nature of the proof was revisited, and Dr. Moore testified unequivocally that Employee’s injury could have occurred while rising from a squatting to a standing position, regardless of where Employee was at the time. Dr. Moore also stated that Employee’s body weight and mechanics could have caused his knee to dislocate as he was standing up, “tight space or not.”

The trial court, despite the employee stating on numerous occasions that the proof was no different now than when the claim was denied at the expedited hearing level, found the claim compensable, and held that medical proof of causation was unnecessary because the condition was such an obvious injury. The trial court also found, in the alternative, that Dr. Moore’s testimony met the medical causation standard.

The Workers Compensation Appeals Board (WCAB) was presented with those issues among others on appeal, but found they could resolve all issues by dealing with the medical proof alone. In a well-reasoned opinion, the WCAB held that while “could have,” “possible,” “in theory,” and other such medical testimony may have been sufficient at one time to carry the day for an injured worker, it is not sufficient today. An injured worker is entitled to benefits “only if it has been shown by a preponderance of the evidence that the employment contributed more than fifty percent (50%) in causing the injury, considering all causes.” Tenn. Code Ann. § 50-6-102(13)(B) (2014). Dr. Moore’s testimony falls short of meeting this standard. It is uncontroverted that Employee had prior knee problems, had prior surgeries on his knees, and had an underlying condition that pre-disposed him to kneecap dislocation. The record is devoid of evidence establishing that the employment contributed more than fifty percent in causing the injury considering all causes. To the contrary, Dr. Moore, the only medical expert to testify, agreed that Employee’s knee dislocated “tight space or not.”

Furthermore, the claim that the injury was obvious was also debunked. The WCAB held that although the injury itself – the displaced kneecap – may arguably be characterized as obvious, its relationship to Employee’s work activities is not. Again, it is uncontroverted that Employee had pre-existing knee problems that required multiple surgeries. It is also uncontroverted that he suffered from an underlying condition which pre-disposed him to kneecap dislocation. And Dr. Moore, referring to the area where Employee was tying the wire behind the baler, stated that Employee’s knee dislocated “tight space or not.” Whether standing up from a squatting position would be sufficient to dislocate a kneecap is not “the most obvious, simple and routine” case even assuming this pre-reform principle survives the adoption of sections 50-6102(13)(B) and 50-6-102(13)(C).

The claim was remanded for a dismissal, and then employee appealed directly to the Supreme Court, who in another well-reasoned decision, mirrored the holdings of the WCAB, and confirmed that medical proof is necessary in all but the most obvious cases, and that if the medical proof does not support the theory that the work event contributed more than 50% in causing the injury in question, it will not be found compensable. This is a great decision for employers, and demonstrates that at the appellate level, the Courts are applying the appropriate standards and creating precedent that demonstrates how claims should be decided. Should you need any further information on this case, please feel free to contact the lead attorney, Duane Willis with Morgan & Akins, at the link presented above.