FILED
Aug 06, 2026
12:15 PM(CT)
TENNESSEE COURT OF
WORKERS' COMPENSATION
CLAIMS
TENNESSEE BUREAU OF WORKERS’ COMPENSATION
IN THE COURT OF WORKERS’ COMPENSATION CLAIMS
AT NASHVILLE
Aaron Rudisill, Docket No. 2016-06-0683
Employee,
v.
Boze Logging, Inc., State File No. 86190-2015
Employer,
and
Clarendon Nat’l Ins. Co., Judge Kenneth M. Switzer
Carrier.
COMPENSATION ORDER GRANTING MEDICAL BENEFITS
In this post-judgment claim, Aaron Rudisill seeks an order that Boze Logging
authorize stem-cell treatment under an open-medical benefits provision of a
settlement agreement. Medical proof showed that the authorized treating physician
referred Mr. Rudisill to a neurology specialist, which referral Boze Logging
repeatedly disregarded. The Court held a compensation hearing on August 4, 2026,
and now finds that Mr. Rudisill has shown by a preponderance of the evidence that
the doctor made a valid referral, which Boze Logging must honor.
Facts
Mr. Rudisill injured his back and spine at work on September 29, 2014, and
later underwent fusion surgery. The parties settled the claim with open medical
benefits.
In late 2023, Mr. Rudisill began experiencing decreased stability and
increased pain in his low back and buttocks, along with numbness and stabbing pain
in his left foot. At a February 2024 authorized visit with a nurse practitioner, he was referred to a “neurological surgeon.”
1
Rather than offering a panel of neurosurgeons, Boze Logging sent Mr.
Rudisill to an orthopedist, the current panel-selected physician, Dr. Roy Terry.
Mr. Rudisill reported low-back and leg pain at the first visit with Dr. Terry in
April 2024, as well as bowel and urinary incontinence and progressive weakness in
both legs. Dr. Terry documented “significant right lower extremity weakness” and
ordered diagnostic testing. An MRI revealed “myelomalacia . . . at the T12 level
within the thoracic cord from prior injury.”
Over the next several months, Dr. Terry repeatedly referred Mr. Rudisill for
specialized treatment. In July, Dr. Terry assessed progressive focal motor weakness,
right-calf atrophy, and other chronic pain. He wrote, “We will refer the patient to
Dr. [Barton] Huddleston at Vanderbilt neurology about possible myelomalacia with
possible treatment plans with stem cells.” (Emphasis added). In August, and after
reviewing the EMG results, Dr. Terry wrote, “we will re-send the referral for the
patient to see Dr. Huddleston with Vanderbilt neurology about possible
myelomalacia with possible treatment plans with stem cells.” (Emphasis added). In
October, he again noted the referral to Dr. Huddleston and wrote, “REFERRAL TO
DR. HUDDLESTON WAS MADE AT LAST VISIT.” (Emphasis in original).
Mr. Rudisill did not see Dr. Huddleston or receive a panel of specialists.
Notes from his next visit with Dr. Terry in January 2025 explained, “We attempted
to refer the patient to physician Dr. Huddleston for possible myelomalacia with
possible treatment plans with stem cells, but he does not do this procedure.” Dr.
Terry continued:
We are working on finding a provider who performs this procedure. In
reality I am not really looking for the procedure of stem-cell itself. I
am looking for someone who would be able to [say] what kind of
regeneration capacity might be able to be done for someone who [has]
myelomalacia[.]
Mr. Rudisill received written information from Kellum Stem Cell Institute in
March, and he later discussed the documentation at a visit with Dr. Terry in May.
As the plan, Dr. Terry wrote; “Recommendation for treatment with stem cell
treatment and physical therapy. This gentleman did go to two separate sites for
evaluation for stem cell and feels that the Kellum stem cell facility is optimal.”
Afterward, Boze Logging requested utilization review, asking, “[I]s the
requested Stem Cell treatment . . . medically necessary?” The reviewing physician
2
did not certify the suggested treatment on May 29, 2025, and Mr. Rudisill and Dr.
Terry did not appeal.
In September, Dr. Terry repeated his “recommendation for treatment with
stem-cell treatment and physical therapy.” However, at that time, the utilization
review noncertification remained in effect under Tennessee Compilation Rules and
Regulations 0800-02-06-.06(9)(a) (2022).
At the final visit in February 2026, Dr. Terry wrote:
The patient does have the possibility of improvement only with some
type of treatment with stem cells that may help to improve his condition
in his spinal cord but certainly are not guaranteed to do so. I do not find
evidence of any of the normal methods of moderate medicine able to
find significant benefit for him. . . . It is my opinion within a reasonable
degree of medical certainty that this gentleman [is] unlikely to improve
with any kind of regular medical treatment. If it is possible I believe it
would be reasonable to consider an attempt at treatment with more
forward types of treatment which may be able to be of benefit. This
treatment may include stem cell type treatment.
Boze Logging then deposed Dr. Terry in June, at which time Dr. Terry agreed
that he “recommended that he seek further recommendation on stem cell care or
stem cell treatment.” Dr. Terry further agreed that stem cell treatment is not his
“primary area of practice.” The following relevant exchange occurred:
Q: Now, during your treatment of Mr. Rudisill, you noted you
needed someone else to opine as to some stem cells and the
regeneration capacity for someone who has myelomalacia, as you were
uncertain to the updates in that area?
A:` Yeah, myelomalacia. Yeah. It’s a spinal cord degeneration.
And yes, I did request that some information be sent and that I’d have
someone call me about what the capacities were that they felt they could
accomplish with him.
Boze Logging also introduced a C-32 based on a records review by Dr. Jeffrey
Hazlewood, who stated that stem-cell treatment is not reasonable or necessary.
At trial, Mr. Rudisill testified to his worsening instability and weakness. He
sought an appointment with a specialist and potentially stem-cell treatment.
3
Findings of Fact and Conclusions of Law
Mr. Rudisill bears the burden of proof and must show by a preponderance of
the evidence that he is entitled to the requested benefits. Tenn. Code Ann. § 50-6-239(c)(6) (2025).
The Workers’ Compensation Law requires an employer to furnish “medical
treatment “ordered by the attending physician . . . made reasonably necessary by
accident[.]” Id. § 50-6-204(a)(1)(A). Subdivision 50-6-204(a)(3)(ii) continues that
when necessary, a treating physician chosen from a panel “shall make referrals to a
specialist physician[.] . . . The employer shall be deemed to have accepted the
referral, unless the employer, within three (3) business days, provides the employee
a panel of three (3) or more independent reputable [specialist] physicians[.]”
Regulations echo this subdivision. Tennessee Compilation Rules and
Regulations 0800-02-01-.06(8) (2018) states that when “the authorized treating
physician, selected by the employee from an initial panel, refers the employee for
specialized care, the employer shall be deemed to have accepted the referral, unless
the employer, within three (3) business days, provides a panel of three (3) or more
independent reputable physicians[.]”
Under section 50-6-204(a)(3)(H), once the panel-selected physician makes a
referral to a specialist, it is presumed to be medically necessary. Beech v. G4S
Secure Solutions (USA), Inc., 2020 TN Wrk. Comp. App. Bd. LEXIS 71, at *9-10
(Dec. 16, 2020). Further, the Appeals Board emphasized that employers must either
timely honor a direct referral or offer a panel of specialists within three business days when a panel physician makes a referral. See Rhodes v. Amazon.com, 2019 TN Wrk.
Comp. App. Bd. LEXIS 24, at *14 (June 11, 2019) (“[t]he statutory scheme . . .
contemplates direct referrals to specialists and provides employers the option of
accepting the referrals or, instead, providing a panel of specialists[.]”).
The facts and law in Beech are similar to this case. In Beech, an authorized
physician referred the employee to a psychiatrist or a neuropsychologist, but the
employer did not timely offer a panel of specialists from either field. Instead, it sent the authorized doctor a letter asking if the employee needs the referral primarily as a result of the alleged injury. The doctor wrote no. After an expedited hearing, the
trial court held that the employer must offer a specialist panel based on the referral. The Board affirmed, reasoning:
4
The issue is not whether Employee has come forward with sufficient
evidence to convince the trial court that the referral was medically
necessary or that his alleged psychological injury is causally related to
the work incident. That was not Employee’s burden to prove at that
stage of the case. Instead, the relevant issue is whether Employee came
forward with sufficient proof from which the trial court could conclude
a panel-selected treating physician made a referral to a specialist.
Beech, 2020 TN Wrk. Comp. App. Bd. LEXIS 71 at *9 (Emphasis added).
Here, the standard is higher—Mr. Rudisill must show by “a preponderance of
the evidence” that a panel-selected physician made a specialist referral. He met that burden.
Boze Logging repeatedly ignored referrals in this case. The nurse practitioner
initially referred Mr. Rudisill for treatment with a “neurological surgeon.” Boze
Logging did not offer a panel of neurosurgeons. Instead, it offered a panel of
orthopedists, and Mr. Rudisill chose Dr. Terry. Afterward, Dr. Terry unambiguously
made three direct referrals to Dr. Huddleston. Boze Logging once again did not set
an appointment with Dr. Huddleston or offer a panel of specialists for several
months.
At the most recent visit in February 2026, Dr. Terry “recommended” stemcell treatment after trying other courses of treatment with little success. His notes are lengthy and detailed, and he is clearly concerned about finding relief for Mr.
Rudisill’s myelomalacia.
Dr. Terry repeated this “recommendation” at his deposition very recently.
However, the doctor clarified that he wanted a professional within another area of
specialization to give an opinion “about what the capacities were that they felt they could accomplish with him.” The Court interprets the doctor’s words to find that he
actually made a referral to a specialist capable of treating Mr. Rudisill’s
myelomalacia.
By ignoring the referrals and instead focusing on the reasonable necessity of
stem-cell treatment, Boze Logging acted as though a specialist in the treatment of
myelomalacia has recommended stem-cell treatment. But to date, no referral
physician has done this, because Boze Logging has not provided a panel of
specialists.
5
Therefore, the evidence preponderates in Mr. Rudisill’s favor for specialized
medical treatment of myelomalacia. Boze Logging must offer a panel of specialists.
Mr. Rudisill remains entitled to future reasonable, necessary, and work-related
medical benefits under the settlement order.
The Court additionally refers Boze Logging to the Compliance Program under
section 50-6-118(a)(8) and (11) for imposition of penalties for its failure to timely provide medical treatment made reasonably necessary by the accident and
recommended by the authorized treating physician, and for its wrongful failure to
satisfy terms of an approved settlement, specifically the open medical benefits
provision.
The $150.00 filing fee is taxed to Boze Logging, to be paid to the Court Clerk
under Tennessee Compilation Rules and Regulations 0800-02-21-.06 (2026) within
five business days, and for which execution might issue if necessary. Unless
appealed, this order becomes final 30 days after issuance.
IT IS ORDERED.
ENTERED August 6, 2026.
JUDGE KENNETH M. SWITZER
Court of Workers’ Compensation Claims
APPENDIX
Exhibits:
1) C-32 Dr. Terry
2) Dr. Terry’s deposition transcript
3) Medical records
4) C-32 Dr. Hazlewood
6
CERTIFICATE OF SERVICE
I certify that a copy of this Order was sent as indicated on August 6, 2026.
Regular
Name Email Sent to
Aaron Rudisill,
employee X X
David Goudie, [email protected]
employer’s X
attorney
Penny Shrum
Clerk, Court of Workers’ Compensation Claims
7
Right to Appeal:
If you disagree with the Court’s Order, you may appeal to the Workers’ Compensation
Appeals Board. To do so, you must:
1. Complete the enclosed form entitled “Notice of Appeal” and file it with the Clerk of the
Court of Workers’ Compensation Claims before the expiration of the deadline.
¾ If the order being appealed is “expedited” (also called “interlocutory”), or if the
order does not dispose of the case in its entirety, the notice of appeal must be filed
within seven (7) business days of the date the order was filed.
¾ If the order being appealed is a “Compensation Order,” or if it resolves all issues
in the case, the notice of appeal must be filed within thirty (30) calendar days of
the date the Compensation Order was filed.
When filing the Notice of Appeal, you must serve a copy on the opposing party (or attorney,
if represented).
2. You must pay, via check, money order, or credit card, a $75.00 filing fee within ten calendar
days after filing the Notice of Appeal. Payments can be made in-person at any Bureau office
or by U.S. mail, hand-delivery, or other delivery service. In the alternative, you may file an
Affidavit of Indigency (form available on the Bureau’s website or any Bureau office)
seeking a waiver of the filing fee. You must file the fully-completed Affidavit of Indigency
within ten calendar days of filing the Notice of Appeal. Failure to timely pay the filing
fee or file the Affidavit of Indigency will result in dismissal of your appeal.
3. You are responsible for ensuring a complete record is presented on appeal. If no court
reporter was present at the hearing, you may request from the Court Clerk the audio
recording of the hearing for a $25.00 fee. If you choose to submit a transcript as part of your
appeal, which the Appeals Board has emphasized is important for a meaningful review of
the case, a licensed court reporter must prepare the transcript, and you must file it with the
Court Clerk. The Court Clerk will prepare the record for submission to the Appeals Board,
and you will receive notice once it has been submitted. For deadlines related to the filing of
transcripts, statements of the evidence, and briefs on appeal, see the applicable rules on the
Bureau’s website at https://www.tn.gov/wcappealsboard. (Click the “Read Rules” button.)
4. After the Workers’ Compensation Judge approves the record and the Court Clerk transmits
it to the Appeals Board, a docketing notice will be sent to the parties.
If neither party timely files an appeal with the Appeals Board, the Court Order
becomes enforceable. See Tenn. Code Ann. § 50-6-239(d)(3) (expedited/interlocutory
orders) and Tenn. Code Ann. § 50-6-239(c)(7) (compensation orders).
For self-represented litigants: Help from an Ombudsman is available at 800-332-2667.
NOTICE OF APPEAL
Tennessee Bureau of Workers’ Compensation
www.tn.gov/workforce/injuries-at-work/
[email protected] -800-332-2667
Docket No.: ________________________
State File No.: ______________________
Date of Injury: _____________________
Employee
v.
Employer
Notice is given that ____________________________________________________________________
[List name(s) of all appealing party(ies). Use separate sheet if necessary.]
appeals the following order(s) of the Tennessee Court of Workers’ Compensation Claims to the Workers’ Compensation Appeals Board;ĐŚĞĐŬŽŶĞŽƌŵŽƌĞĂƉƉůŝĐĂďůĞďŽdžĞƐĂŶĚŝŶĐůƵĚĞƚŚĞĚĂƚĞĨŝůĞͲ ƐƚĂŵƉĞĚŽŶƚŚĞĨŝƌƐƚƉĂŐĞŽĨƚŚĞŽƌĚĞƌ;ƐͿďĞŝŶŐĂƉƉĞĂůĞĚͿ͗
ප Expedited Hearing Order filed on _______________ ප Motion Order filed on ___________________ ප Compensation Order filed on__________________ ප Other Order filed on_____________________ issued by Judge _________________________________________________________________________.
Statement of the Issues on Appeal
Provide a short and plain statement of the issues on appeal or basis for relief on appeal: ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________
Parties
Appellant(s) (Requesting Party): _________________________________________ ܆Employer ܆Employee Address: ________________________________________________________ Phone: ___________________ Email: __________________________________________________________
Attorney’s Name: ______________________________________________ BPR#: _______________________ Attorney’s Email: ______________________________________________ Phone: _______________________ Attorney’s Address: _________________________________________________________________________
* Attach an additional sheet for each additional Appellant *
LB-1099 rev. 01/20 Page 1 of 2 RDA 11082 Employee Name: _______________________________________ Docket No.: _____________________ Date of Inj.: _______________
Appellee(s) (Opposing Party): ___________________________________________ ܆Employer ܆Employee Appellee’s Address: ______________________________________________ Phone: ____________________ Email: _________________________________________________________
Attorney’s Name: _____________________________________________ BPR#: ________________________ Attorney’s Email: _____________________________________________ Phone: _______________________ Attorney’s Address: _________________________________________________________________________
* Attach an additional sheet for each additional Appellee *
CERTIFICATE OF SERVICE
I, _____________________________________________________________, certify that I have forwarded a true and exact copy of this Notice of Appeal by First Class mail, postage prepaid, or in any manner as described in Tennessee Compilation Rules & Regulations, Chapter 0800-02-21, to all parties and/or their attorneys in this case on this the __________ day of ___________________________________, 20 ____.
[Signature of appellant or attorney for appellant]
LB-1099 rev. 01/20 Page 2 of 2 RDA 11082