Tiffany Lewis Denyer v. Peninsula Hospital

This workers' compensation appeal has been referred to the Special Workers' Compensation Appeals Panel of the Supreme Court in accordance with Tenn. Code Ann._ 5-6-225 (e)(3) for hearing and reporting to the Supreme Court of findings of fact and conclusions of law. The employer contends the trial court's award of 5 percent permanent partial disability to the arm was excessive. We disagree and affirm. Tenn. Code Ann. _ 5-6-225(e) (1999) Appeal as of Right; Judgment of the Circuit Court Affirmed and Remanded H. DAVID CATE, SP. J., in which WILLIAM M. BARKER, J., and ROGER E. THAYER, SP. J., joined. R. Kim Burnette and John A. Willis, Knoxville, Tennessee, attorneys for appellant, Peninsula Hospital. Garry Ferraris, Knoxville, Tennessee, attorney for appellee, Tiffany Lewis Denyer. MEMORANDUM OPINION I. Factual Background The employee, Tiffany Lewis Denyer, has a bachelor of science degree in nursing from St. Louis University. She was twenty-eight (28) years old at the time of trial. On February 2, 1997, she became employed as a psychiatric nurse with the employer, Peninsula Hospital. She has continued to work for the employer except for two periods of leave. The leave periods consisted of a three month period in the summer of 1998, when she worked at a summer camp for disabled youth, and for about six months in 2, when she worked as an occupational health nurse for Blount Memorial Hospital. After each leave she returned to work for the employer on a "PRN" or as needed basis, which provided that she would submit the hours she wanted to work and the employer would schedule her for work, if available. She continued to work in that capacity. When she returned to work for the employer after her second leave, she began to experience pain, cramping, numbness, tingling, decreased grip strength and fine motor skills in her right arm, which is her dominant arm. She also received a sprain from a restraint, which she reported to the employer. The employer provided her with a panel of three doctors, from which she chose Dr. C. Sanford Carlson, who she saw on May 9, 2. He treated her without success with steroid injections, splinting, anti-inflammatories and heat. On October 27, 2, Dr. Carlson performed right carpal tunnel surgery, releasing the median nerve which was plastered to the underside of the transverse carpal ligament. The employee returned to work on December 4, 2, and began to experience pain and swelling. She returned to Dr. Carlson on December 6, 2, and was taken off from work for a week and was assigned writing restrictions. Dr. Carlson concluded she reached maximum medical improvement on April 25, 21, and assigned her a permanent impairment of 5 percent to the right upper extremity based on the AMA Guidelines. Even though she continued to experience pain and cramping, Dr. Carlson placed her on no restrictions after the next two or three months, because carpal tunnel is a self-limited condition when released. He said his "usual admonition would be to do the best you can to get by, rest the hand, stretch the hand, modify technique." Dr. Carlson saw her the last time on August 13, 22, when he recommended she continue to work and decrease her writing requirements for the next four to five weeks. At this time he suggested she obtain a second opinion from another doctor. She went to Dr. E. B. Burns on February 21, and March 11, 23. Dr. Burns was in agreement with Dr. Carlson's treatment and recommended that she should tolerate the symptoms or change jobs. She has continued to work for the employer, although she continues to have problems writing on the patients' charts, and performing such nursing duties as drawing blood. She has requested and been assigned to the medicine room because it required less writing. The medicine room is a position which is not sought after by other nurses. She has purchased a typewriter, which she can use at times, to reduce the writing requirements. Since the hospital is a psychiatric locked facility she has had to learn to open the doors with her left arm and hand and to open the medicine bottles with a different technique. The employee describes her current symptoms relating to her arm, wrist, and hand, as follows: -2-