Appeals court hears dispute over whether truck crash "aggravation" met Tennessee's 50% causation rule

An appellate panel on Tuesday heard arguments in Joe Carroll Edwards v. Peaply's LLC over whether a Aug. 14, 2020, truck crash aggravated preexisting knee osteoarthritis enough to make knee replacements compensable under Tennessee workers' compensation law.

Larry Hicks, counsel for the employee, told the court the case turns on the statutory causation standard and the weight to give medical opinions: "the statute is clear, relative to that, that there if the aggravation is more than 50% related to the accident ... then it is compensable." Hicks said the trial court found the claimant credible and that the medical record shows the wreck ‘‘hastened the need for surgery.’’

The case centers on whether the workers' compensation appeals board applied the correct standard of review and whether treating and independent medical exam (IME) opinions were entitled to a statutory presumption of causation. Defense counsel disputed the factual and causal findings. Steven Wharton, appearing for PeopleEase and Van Liner Insurance Company, summarized the defense medical view: "the motor vehicle accident was not greater than 50% because of miss Edwards' primary diagnosis or resulted any change of anatomical function in either knee." Wharton noted that treating and IME physicians differ on whether the accident produced an anatomic change or merely exacerbated underlying end-stage osteoarthritis.

At issue is the interaction of two legal questions raised repeatedly during argument: (1) the appropriate appellate standard of review for the appeals board's decision (the parties urged de novo review of statutory questions rather than an abuse-of-discretion standard), and (2) how Tennessee Code provisions on causation and treatment—cited in argument as 56-10-212 and related provisions—apply where a claimant had asymptomatic end-stage osteoarthritis before an accident that later produced disabling symptoms.

Counsel described conflicting expert testimony in the record. Hicks emphasized testimony from panel physicians who described a fracture and ligament disruption to the left proximal tibia and said the post-crash symptoms and imaging supported surgery; he also cited testimony that the employee became symptomatic only after the wreck. Defense counsel relied on testimony from Dr. Jason Hutchinson and an IME by Claiborne Christian, who told the court the accident did not produce an anatomic change that, in their view, made the surgery more than 50% caused by the crash. Another testifying orthopedist, identified in the record as Dr. Schroeder, concluded the accident aggravated the knees and contributed to the need for at least the left knee replacement.

Hicks asked the panel to reinstate the trial court's order awarding medical benefits, arguing the appeals board relied on a treating physician's factual and legal misunderstandings when it reversed. Wharton and other defense counsel urged the court to scrutinize whether the statutory presumption attached to any treating-physician opinion and to accept the appeals board's factfinding where supported by some medical testimony. The court asked several clarifying questions about how physicians should state causation in practice and how an "acceleration" or "hastening" of a need for treatment fits the statutory text.

No decision was announced from the bench. The panel told counsel it would take the case under advisement and issue a written ruling.

Votes at a glance: none (oral argument only; no panel decision announced).