Tenn. Employee’s Back Problems Meet ‘Direct and Natural Consequence’ Rule

Gallatin, TN (WorkersCompensation.com) -- If a worker experiences pain that could be related to a workplace injury, what happens if the compensable injury happened a long time ago?

In Hudgins v. Global Personnel Solutions Inc., No. E2023-00792-SC-R3-WC (Tenn. 03/05/24), Tennessee's top court held that it depends if the later malady was a "direct and natural consequence" of the original.

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The employee sustained an injury to her right hand and right knee after tripping over a pallet at work. The employer accepted the injuries as compensable and provided medical benefits, including a partial knee replacement.

Later, the employer contested the compensability of the employee's spinal conditions that developed after the initial injury, but a trial court and the Appeals Board found that her conditions were compensable and identified the date of maximum medical improvement. The employer appealed to the Tennessee Supreme Court.

In Tennessee, the "direct and natural consequence" rule is a judicially created doctrine holding that a subsequent injury, whether in the form of an aggravation of the original injury or a new and distinct injury, is compensable if it is the direct and natural result of a compensable injury.

A 2013 law in Tennessee, known as the "Reform Act," redefined a compensable "injury" to require that employees prove by a preponderance of the evidence that the injury arose ''primarily out of and in the course and scope of employment."

In the employee's case, the court found that this provision didn't affect her claim.

"Tennessee's direct and natural consequence rule requires a finding by a preponderance of the evidence that the employment contributed more than fifty percent to such consequential injuries for them to be compensable," the court wrote.

According to the court, the employee met this standard through her:

+ Medical records.
+ Deposition testimony of her authorized treating physicians.
+ Own live testimony.

This evidence, in the court's view, sufficiently established that the employee's back and hip injuries were directly related to the knee injury based on the "evolution of the whole symptom complex as it evolved over time."

The court concluded that the employee showed that her employment contributed more than 50 percent in causing her subsequent back injury, thus making her later-developing spinal injury compensable.

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