A Tennessee workers compensation judge has ordered a transportation company to pay nearly $750,000 in medical bills and provide ongoing care for a truck driver who lost his arm to a “flesh-eating” infection that began with a minor scratch suffered on the job.
In an expedited hearing order issued Tuesday, a judge with the Tennessee Court of Workers’ Compensation Claims found that the driver is likely to prove at trial that a small laceration to his left arm — sustained while adjusting a refrigerated trailer bulkhead — was the primary cause of his necrotizing fasciitis, subsequent amputation, and need for continued treatment, which includes psychiatric care, according to 2025 TN WC 86.
The court ordered Marten Transport Ltd. to pay past medical expenses and to authorize ongoing treatment with orthopedic provider, whom the worker had originally selected from a panel before the insurer denied the claim. The court also directed Marten to offer a panel of psychiatrists for management of his work-related mental injury.
The driver testified he scratched his arm on a bulkhead safety belt while delivering freight, initially treating the two-inch wound himself with a paper towel, antibiotic cream and a bandage before continuing his route. Over the next day, he developed blackening of the skin, severe nausea, vomiting, confusion and loss of bowel control. Co-workers eventually took him to a hospital, from which he was airlifted to Vanderbilt Medical Center and diagnosed with group A streptococcus and necrotizing fasciitis. Surgeons amputated his left arm and performed multiple procedures on his right arm.
The company denied the workers compensation claim, arguing that the worker’s extensive preexisting conditions — including vascular disease, lung cancer and heavy smoking — were the primary drivers of his catastrophic infection, and that inconsistencies in his account undermined his credibility.
Both sides relied on records reviews. The worker’s chosen doctor opined that the work-related laceration provided the entry point for the strep infection and that the cut primarily caused the amputation and related treatment. Marten’s physician questioned whether the cut occurred as described and testified that the worker’s immunocompromised status was the primary cause of the infection’s progression; in his view, a healthy person with the same laceration “would have been just fine.”
The judge sided with the worker’s doctor on causation and emphasized Tennessee’s settled rule that an employer takes the employee as it finds him. Even if a preexisting condition makes the consequences of an otherwise compensable injury worse than expected, that heightened reaction does not defeat compensability, the court said, citing prior Tennessee Supreme Court precedent on aggravation of preexisting conditions.
The court also rejected Marten’s reliance on minor discrepancies in the worker’s descriptions of the accident, pointing to his exhaustion, serious illness, surgeries and subsequent heart and cancer treatments. An injured worker is not to be “penalized simply for being a poor historian,” the judge wrote, quoting earlier case law.
On income benefits, the court held that the worker is entitled to temporary total disability from the day after he entered the hospital until his release. However, because neither party offered wage records and the worker could only estimate his net earnings at $1,500 to $2,000 per week, the court reserved calculation of the compensation rate and the precise amount owed.
The judge also declined, at this interlocutory stage, to award attorney fees for alleged unreasonable denial, finding the high threshold for such relief was not met. A status hearing is set for Jan. 23, 2026, and Marten must comply with the medical and TTD directives within seven business days absent an interlocutory appeal.