By Jane Salem, staff attorney, Nashville
Yesterday, the Appeals Board released its first opinion from the cases on oral argument last week.
In Ibarra v. Amazon Fulfillment Services, the Board resolved three issues.
The first was notice. The Workers’ Compensation Law requires written notice of a work-related injury unless an employer has actual notice.
Amazon argued that Grecia Ibarra only reported “soreness” to her supervisor rather than an actual injury. However, Ibarra testified without contradiction that she “reported constantly to my assistant manager,” and she described the frequency of those reports as “every day from September to the next year.” She then sought treatment at Amazon’s on-site clinic, where she was treated for nine days before a nurse referred her to a physician. Afterward Amazon provided a panel.
Presiding Judge Tim Conner’s opinion observed, “Employer does not explain why it would provide Employee a panel of physicians pursuant to Tennessee’s workers’ compensation law if there had never been any report of a work-related injury.”
The trial court concluded that Amazon had actual notice, and the Board agreed.
The second issue was whether Ibarra satisfied the statute’s requirement that she suffered a work injury due to a “specific incident, or set of incidents . . . identifiable by time and place of occurrence.”
The Board noted that Ibarra wasn’t alleging a single traumatic event that led to a back injury, but rather that “repetitive lifting of heavy totes at work, beginning in September 2018,” caused her injury.
The Board has previously held that an injured worker can meet her burden at an expedited hearing “by presenting evidence from which the trial court can determine he or she is likely to prove a compensable set of incidents over an identifiable period of time.” (Emphasis added.)
Judge Conner wrote that Ibarra’s unrefuted testimony – that her low-back pain began while lifting heavy totes at work in September 2018, she reported her back pain to an assistant manager on multiple occasions, and she received treatment from an on-site nurse and a panel-selected physician – supported the conclusion that she’s likely to prevail at trial in proving “a set of incidents sufficiently identifiable by time and place of occurrence.”
As for the third issue, medical causation, Amazon argued that because the panel-selected physician didn’t give an opinion on the work-relatedness of the injury but instead referred Ibarra to an orthopedic specialist, it wasn’t obligated to honor that referral.
The Board disagreed, reasoning in part that “there is no indication in the medical records that [the doctor] referred Employee to an orthopedic specialist solely for the purpose of obtaining a causation opinion.”
Instead, the treating doctor reviewed Ibarra’s symptoms; noted her complaints of pain when lifting heavy items at work; ordered and reviewed x-rays, which revealed abnormalities; and referred her to a specialist “for further evaluation.” A referral by an authorized treating physician is presumed medically necessary under the statute.
Judge Conner wrote, “[U]nder the circumstances presented in this case, it was Employer’s burden to prove [the doctor’s] referral was not medically necessary. We conclude Employer did not meet that burden. It offered no proof to contradict Employee’s lay testimony, and it offered no expert proof to indicate [the doctor’s] referral to an orthopedic specialist was not medically necessary for evaluation and treatment of Employee’s alleged back injury.”
The Board affirmed and remanded the case to the trial court.
As the opinions from last week’s arguments are released, we’ll be notifying you about them in future blog posts.