State News : Tennessee

January 2026

Tennessee Supreme Court Clarifies Compensability Standard for Aggravation of Pre-Existing Conditions

On December 22, 2025, the Tennessee Supreme Court issued the Edwards v. Peoplease, LLC. decision which provided much-needed clarification on the proof needed to establish a compensable aggravation of a pre-existing condition. 

In Edwards, the employee was a truck driver who was involved in a motor vehicle accident when one of her tires blew out. She received authorized medical treatment with Dr. Jason Hutchison, who diagnosed her with end-stage tricompartmental arthritis in both knees. Bilateral knee replacement surgeries were recommended. Dr. Hutchison opined that the knee arthritis was pre-existing, but that the accident “may have caused a significant exacerbation of the arthrosis.” However, Dr. Hutchison further opined that the exacerbation of knee symptoms was not compensable under the Tennessee Workers’ Compensation Law. Employer denied responsibility for the knee replacement surgeries under workers’ compensation.

The employee sought a second opinion with Dr. Timothy Sweo. Dr. Sweo agreed that knee replacement surgeries were appropriate, but Dr. Sweo opined that the need for both knee replacements was most likely greater than 51% caused by the work accident.

The trial court convened an expedited hearing and ruled that Ms. Edwards was likely to prevail on the merits. The trial court found that Dr. Hutchison had misapprehended the law by concluding that the exacerbation of a pre-existing condition is not compensable under the Tennessee Workers' Compensation Law. The trial court agreed with Dr. Sweo’s opinion that the need for knee replacement surgery was primarily caused by the work accident and ordered the Employer to pay for medical benefits, including the knee replacement surgeries.

On the first appeal to the Workers’ Compensation Appeals Board, the Appeals Board affirmed the trial court’s order that the employer should provide medical treatment for any symptoms related to the accident but reversed the trial court’s order for knee replacement surgeries. The Appeals Board remanded the case back to the trial court.

On remand, both parties retained additional medical experts. The employer hired Dr. Christian Claiborne, who opined that “an aggravation is synonymous with an anatomic change” and that Ms. Edwards had not suffered a permanent anatomic change from the accident. Like Dr. Hutchison, Dr. Claiborne testified that the pre-existing arthritis, not the truck accident, necessitated knee surgery. 

The employee hired Dr. Lawrence Schrader, who opined that Ms. Edwards had sustained an aggravation to her knee arthritis that was more likely than not due to the truck accident. Dr. Schrader testified that Ms. Edwards was asymptomatic prior to the accident and became permanently symptomatic after the accident aggravated her pre-existing arthritis.

The trial court convened another hearing and determined that the opinions of Dr. Sweo and Dr. Schrader were supported by the evidence and again ordered the Employer to pay for bilateral knee replacement surgeries. As part of the trial court’s order, it again stated that Dr. Hutchison had misstated Tennessee law by opining that exacerbations of pre-existing conditions were not compensable. The trial court also stated that Dr. Christian was incorrect when he stated that an aggravation injury required an anatomic change.

On the second appeal to the Appeals Board, two of the three judges determined that Ms. Edwards’ knee surgeries were not compensable. While the majority found that the preponderance of the evidence supported the trial court’s finding that Ms. Edwards had sustained a compensable aggravation of her pre-existing knee arthritis, the evidence did not support a finding that the need for bilateral knee replacements was more than 50% caused by the truck accident. The majority attributed greater weight to the opinions of Dr. Hutchison and Dr. Christian than to the opinions of Dr. Sweo and Dr. Schrader. The dissenting judge disagreed with the majority’s conclusion, reasoning that there was sufficient evidence that the truck accident caused new or increased symptoms that led to functional limitations and the need for knee replacement surgery was hastened by the truck accident.

Employee appealed the Appeals Board’s decision to the Tennessee Supreme Court. The Supreme Court reversed the Appeals Board, finding that the post-reform workers’ compensation statute indicated a change from prior case which required a permanent worsening of a condition before an aggravation was compensable. The Supreme Court clarified that under current law, a compensable aggravation does not require proof of a permanent anatomic change or worsening of the condition.  Instead, a compensable aggravation requires: (1) proof establishing that the work accident contributed more than 50% in causing the aggravation, and (2) proof establishing that the aggravation contributed more than 50% in causing disablement or the need for medical treatment. The Supreme Court held that Ms. Edwards’ proof satisfied both elements and therefore determined that the employer was responsible for the knee surgery.

The Edwards decision represented an important clarification (and some would argue, a drastic change) in the analysis of compensability of aggravation injuries. No longer should we be focused on whether the accident caused an anatomic change to the pre-existing condition, since the Supreme Court determined that such a finding was not necessary. Instead, we should be more focused on the more general questions of whether the work accident was the primary cause of the aggravation, and whether the aggravation was the primary cause of the medical treatment at issue.

For any questions, please contact:
Fredrick R. Baker, Member
Wimberly Lawson Wright Daves & Jones, PLLC
1420 Neal Street, Suite 201
P.O. Box 655
Cookeville, TN 38503-0655
Phone: 931-372-9123
Fax: 931-372-9181
fbaker@wimberlylawson.com
www.wimberlylawson.com

August 2025

Tennessee Workers' Compensation Legislative Changes

Tennessee found less changes in its workers’ compensation legislation in 2025 than it did last year, but there are still several worth noting, including: Bureau’s Administration changes (SB1309/HB0128); an Advisory Council extension (SB0050/HB0228); PTSD Extensions (SB0289/HB0310); addition of cancers to firefighter related legislation (SB0288/HB0482); and Administrative Dissolution changes (SB0306/HB0459-Pub. Ch. 113) (SB0669/HB1226).

The first of these bills, SB1309, makes a variety of changes, including, but not limited to (1) removing the end date of June 30, 2025 for the Vocational Recovery Fund; (2) increasing the minimum age requirement to serve as a workers’ compensation judge to 35 years, and the minimum number of years of experience to seven; (3) increasing the number of terms that a workers’ compensation judge may be appointed after the expiration of their initial term to three additional terms (there is an additional note on service of a less-than-full term); and (4) extension of the sunset of attorney’s fee award to June 30, 2030. There also exists in this bill the addition of fees related to burial, cremation, or other lawful means of disposition of human remains when looking at attorney’s fees.

Senate Bill 0050 extends the advisory council on workers’ compensation to June 30, 2031, amending T.C.A. Title 4, Chapter 29, and Title 50, Chapter 6.

The next change is seen in alterations to the James “Dustin” Samples Act. The changes now create a presumption that the diagnosis of a law enforcement officer or emergency medical responder with post-traumatic stress disorder as the result of responding to certain incidents was incurred in the line of duty for purposes of workers’ compensation coverage. This amends T.C.A. Title 7, Chapter 51, and Title 50, Chapter 6.

Further changes regarding first responders were reflected in Senate Bill 0288 which effected the addition of prostate cancer, breast cancer, and pancreatic cancer to the list of cancers for which a presumption exists that the ailment arose out of employment. This exists for full-time firefighters and must be combatted by contrary evidence shown by competent medical evidence. This alters T.C.A. §7-51-201.

The final noteworthy legislative changes in Tennessee for workers’ compensation are reflected in SB0306-Public Chapter 113. This piece of legislation allows the State to dissolve a business if that business knowingly files false information with the state, and/or if that business has ties to foreign adversaries. This is determined by the United States Secretary of Commerce. Lastly, Senate Bill 0669 deletes all references to the World Health Organization and instead requires a pandemic to be declared by the federal Centers for Disease Control and Prevention. It also requires a subsequent declaration of a state of emergency by the governor to issue executive orders and directives related to pandemics.

While not as monumental as years prior, the legislative changes seen in 2025 are nonetheless necessary to learn, and keep in mind, as attorneys and employers continue to manage the daily challenges of Tennessee Workers’ Compensation Law.

For any questions, please contact:
Fredrick R. Baker, Member
Brendan Walsh, Associate
Wimberly Lawson Wright Daves & Jones, PLLC
1420 Neal Street, Suite 201
P.O. Box 655
Cookeville, TN 38503-0655
Phone: 931-372-9123
Fax: 931-372-9181
fbaker@wimberlylawson.com
bwalsh@wimberlylawson.com
www.wimberlylawson.com

June 2024

Tennessee Workers’ Compensation Legislative Changes

The 2024 year brings the following legislative updates to Tennessee Workers’ Compensation Law: Public Chapter 532; Public Chapter 666; Public Chapter 0813; Public Chapter 492; Public Chapter 498; and Public Chapter 499. These legislative changes range from clarifications to filing First Reports of Injury, to extensions of the Bureau of Workers’ Compensation’s authority to enforce laws.

The first of several updates in recent Tennessee Workers’ Compensation Law finds its place in the Public Chapter 532. This Bill was signed by Governor Lee on March 7, 2024, and becomes effective on July 1, 2024. This Bill amends current Tennessee laws to make a consistent, uniform period of 14 days for electronic filing for the First Report of Injury to the Bureau of Workers’ Compensation (BWC), as well as removing the Notice of Controversy form requirement – a filing is now made electronically via Electronic Data Interchange (EDI). This Bill further provides clarification that uninsured employers penalties apply to construction and non-construction entities. Finally, this Bill extends the sunset of PC 189 (2021) until July 1, 2029 – allowing the Bureau of Workers’ Compensation to continue to enforce workers’ compensation insurance coverage laws.

Another legislative change is Public Chapter 666. This Bill enacts the Tennessee Self-Insurers’ Guaranty Association Act, creating the Tennessee Self-Insurers’ Guaranty Association – a nonprofit, unincorporated legal entity. The purpose of this Act is to provide for a streamlined and more efficient process for the payment of self-insured workers’ compensation claims. It will also serve as an avenue for the assessment of costs of the protection among those self-insured. This Bill was signed by Governor Lee on April 9, 2024, and became effective upon signing.

The legislative updates continue with Public Chapter 0813. This Bill requires the Comptroller of the Treasury (COT) to conduct a study of all insurers – including insurance pools – that provide policies of workers’ compensation coverage to local government entities. This will include a review of solvency and a comparative rate study. The Bill additionally requires the COT to report the findings to the Speaker of the Senate and the House of Representatives by January 1. 2025. This was signed by Governor Lee on April 29, 2024, and became effective immediately.

The final legislative updates for 2024 lie in Public Chapter 492, Public Chapter 498, and Public Chapter 499. These, respectively, (1) extend the Bureau of Workers’ Compensation to June 30, 2029; (2) extend the Medical Advisory Committee to June 30, 2029; and (3) extend the Medical Payment Committee to June 30, 2029.

Each of the preceding bills have been signed by Governor Bill Lee, and are either effective July 1^st, or were effective upon their signing.

For any questions, please contact:

Fredrick R. Baker, Member
Brendan Walsh, Associate
Wimberly Lawson Wright Daves & Jones, PLLC
1420 Neal Street, Suite 201
P.O. Box 655
Cookeville, TN 38503-0655
Phone: 931-372-9123
Fax:  931-372-9181
fbaker@wimberlylawson.com
bwalsh@wimberlylawson.com
www.wimberlylawson.com