In Tennessee one worker suffered an injury to his leg that ultimately affected his entire body and his way of life. His case went to court when his employer disagreed with his level of impairment.

Guy Ratledge worked for Ryan McClain as a construction worker. Langley Enterprises LLC in Tennessee hired McClain as a subcontractor in the fall of 2011, so they were the “employer” when Ratledge fell from the roof of a house they were working on and injured his leg, suffering a compound fracture to his tibia and fibula in his lower left leg. His orthopedic surgeon was Dr. Peter Nowotarski. The doctor did one surgery to set the fracture and stabilize the bones but then did a second surgery to set the fracture with internal metal plates. After Ratledge had been healing and using crutches for several months healing he was allowed to put his full weight on the ankle for the first time. The metal plates cracked. His doctor did a third surgery and had to shorten his fibula. Ratledge slowly healed but was advised not to work at heights, instead being designated as a “ground laborer”. He was found to have reached maximum medical improvement in December of 2012 but still felt lower back pain and depression. Dr. Nowotarski never made an impairment rating so Ratledge went to Dr. Dale Ingram who said that since his left leg was slightly shorter than his right and atrophied, he was 20 percent impaired. He said Ratledge should not work on ladders or scaffolding and advised against walking up the stairs or on slippery surfaces, even squatting or kneeling.

Ratledge sought workers’ compensation benefits in 2013. Ratledge said he had not worked since he had been injured and he did not really have any other kind of work skills or experience than labor, he found it hard to do everyday activities since he was in so much pain with both his leg and his back.

Langley’s medical examiner Dr. Kennedy found that he was now 30 percent impaired and labeled his injury as full-body according to the AMA guidelines. He said since the leg injury was now affecting his back and potentially body as a whole if he fell as a result of his leg injury, his injury could be classified as “body as a whole”. Given Ratledge’s limited education and now his debilitating injury, opportunities for jobs were slim, said another vocational consultant Dr. Colvin. He estimated that Ratledge’s vocational disability was at 90 percent.

The initial trial court awarded Ratledge 400 weeks of benefits at a weekly compensation rate for vocational disability of 90 percent body as a whole. Langley appealed saying that labeling the injury body as a whole allowed him to collect excessive benefits. The Tennessee Supreme Court said the trial court was correct in assignment him full body medical impairment and Ratledge met three of the four criteria to make him eligible for excessive permanent partial disability benefits. He did not have a high school degree, he did not really have transferable job skills for another occupation, and did not have any reasonable employment opportunities given his location and medical situation.