The employer blamed his health history – here's why that strategy backfired
A minor scratch from trailer components cost one trucking company over $700,000.
On March 5, 2026, Tennessee's Workers' Compensation Appeals Board ruled that Marten Transport, Limited must cover the medical bills of a truck driver who lost his arm after a scratch sustained on the job became catastrophically infected. The decision, which runs to the heart of how employers handle workers' compensation claims involving employees with preexisting health conditions, is a sharp reminder that trying to shift the blame onto an employee's medical history is a strategy with serious limits.
The facts of the case are hard to forget. Terry Gandy, a truck driver who picked up loads from a Shelbyville distribution center and delivered them to Walmart locations across Tennessee and Kentucky, alleged he scratched his wrist on trailer components during a delivery run in April 2023. It seemed minor. He said he applied some Neosporin, possibly wiped it clean, and kept working.
Days later, the skin around the wound had turned black. By April 22, Gandy could barely walk or speak clearly when he pulled back into the Shelbyville yard. His manager, thinking he was drunk, took him to the emergency room. Doctors stabilized him but determined he needed more specialized care, and transferred him by medical flight to Vanderbilt University Medical Center. It was there that physicians identified the true extent of what was happening.
At Vanderbilt, doctors found that Gandy had contracted a Group A streptococcal infection that had developed into necrotizing fasciitis – the condition commonly known as flesh-eating bacteria. Gandy's left arm was amputated the next morning. His right arm required multiple surgeries. By the time he was discharged on May 21, 2023, his medical bills had topped $700,000.
Marten Transport denied the claim. The company argued the scratch may not have happened at work at all, noting that Gandy had spent the prior weekend building a curio cabinet at home using a hammer, nails, and a saw. It also pointed to Gandy's significant health problems – advanced vascular disease, a subsequent lung cancer diagnosis, a long history of smoking – and argued that these conditions, not the scratch, were the real reason a minor wound became a catastrophic injury.
The employer's infectious disease expert backed that position, conceding that a cut did provide the entry point for the bacteria, but maintaining that Gandy's compromised immune system and his failure to seek care quickly enough were what drove the infection to such devastating extremes.
Gandy's medical expert disagreed. He testified that Group A strep simply cannot invade tissue without a wound to enter through, that the laceration was the direct cause of the infection, and that the amputation was primarily a result of what happened on that delivery route. Even after being made aware of Gandy's full medical history – including the cancer – the expert did not change his opinion.
The Appeals Board found that the law was squarely on Gandy's side. Under a well-established workers' compensation principle, an employer takes a worker as they are. That means that if a job-related injury triggers a chain of medical consequences – even a chain that is longer or more severe because of who that particular employee is – the employer is still on the hook. The court found no legal basis for Marten Transport's argument that Gandy's poor health should reduce or eliminate his entitlement to benefits.
The board also upheld an order requiring the company to fund psychiatric treatment. A psychiatrist who evaluated Gandy found that his preexisting depression and anxiety had worsened following the amputation, and Marten Transport offered no medical evidence to push back on that finding.
The one area where the employer succeeded was on the question of temporary wage replacement benefits. Because neither side had filed a wage statement and there was no medical evidence in the record addressing how long Gandy was actually unable to work, the board found there was not enough information to calculate what he was owed. That issue was sent back to the trial court for further proceedings.
For HR professionals – especially those in industries where employees work physically demanding jobs or operate equipment – the case carries a pointed message. When a workplace injury sets events in motion, the employer generally cannot escape responsibility for where those events lead, even if a healthier employee might have fared better. Contesting a claim by focusing on an employee's underlying conditions rather than the incident itself is a gamble that, as Marten Transport discovered, does not always pay off.
