The Tennessee Workers’ Compensation Appeals Board on Tuesday clarified employers’ obligations to provide second surgical opinions and the circumstances under which litigation may be assessed attorney’s fees.
As documented in 2025 TN WC App. 57, a psychiatric nurse practitioner was stabbed multiple times by a patient in her employer’s parking lot, suffering injuries to her abdomen, torso, arms, head and face and was later diagnosed with post-traumatic stress disorder. After a series of reconstructive surgeries, her treating physician recommended additional abdominal-wall reconstructive surgery, prompting a dispute over the worker’s request for a second opinion.
The appeals board, in affirming a trial court’s determination in part, held that once an authorized treating physician recommends surgery, an employee is automatically entitled to a second opinion under Tennessee law. The board rejected the employer’s claim that the treating physician must explicitly order the second opinion for it to be authorized by the insurer.
Instead, the board found that the statute places the decision squarely with the employee: “the employee’s right to a second opinion examination is triggered when an authorized physician recommends surgery” and that the “only prerequisite to an employee’s entitlement to a second opinion examination pursuant to (state law) is a surgical recommendation from an authorized treating physician.”
The board emphasized that the legislature intended to give injured workers an additional safeguard, given the invasiveness of surgery.
The board reversed the trial court’s denial of attorney’s fees, finding that the employer’s refusal to authorize the second opinion constituted a failure to furnish medical benefits required by law.