Comp court applies more weight to treating physician over medical examiners

Giving more weight to an injured city worker’s treating physician as opposed to several medical examiners, a workers compensation court in Tennessee on Monday ordered an employer to cover spinal surgery, provide disability benefits, and pay past temporary total disability benefits of $36,238 and $7,248 in attorney fees.

Michael Brown suffered a work injury in 2023, when a bucket from a boom truck struck him on the head as it was lowered to the ground. In the emergency room, he reported neck, back and right-shoulder pain but no weakness or numbness. Multiple CT scans did not reveal any acute abnormalities, according to Brown, Michael v. City of Pulaski Electric Systems, filed in the Tennessee Court of Workers’ Compensation Claims.

Following conservative treatment and continuing complaints of pain, Pulaski authorized him to see a board-certified orthopedic spine specialist, who recommended fusion surgery. The city then denied treatment after two independent medical examiners found inconsistencies in scans. One also noted that Mr. Brown smoked, which leads to “unsuccessful fusions.”

The spine specialist discharged Mr. Brown after the surgery was denied. A second physician hired by Pulaski after two visits “could not verify any of Mr. Brown’s pain complaints or see an abnormality he could attribute to the work injury.” He placed Mr. Brown at maximum medical improvement and referred him to pain management and medication management. A third physician saw Mr. Brown, who eventually placed him on maximum medical improvement with a 4% impairment and said he did not anticipate any further treatment.

Months later, Mr. Brown returned with continuing complaints about pain and numbness. He was eventually seen by the first spine specialist again, who recommended surgery and refuted some of the assertions by the other doctors.

Mr. Brown filed an appeal, which resulted in a ruling in his favor. The court explained “that no doctor has presented any other non-surgical options to relieve Mr. Brown’s complaints.”

“He has undergone multiple courses of conservative treatment with no significant improvement. Likewise, no doctor has said that Mr. Brown was not credible or that his symptoms were not real. The fact that (the spine specialist) is offering a possible solution must weigh in favor of surgery,” the ruling states.

On the issue of weighing medical evidence, the court wrote the spine surgeon “is more qualified to address the reasonableness and necessity of a cervical fusion than the other physicians” and that he spent more time with Mr. Brown. In contrast, the other physicians saw him no more than twice and some never at all, only reviewing records.