KIMBERLY ASPLING, Employee/Appellant, v. SIMMONS AIRLINES and AMERICAN INT=L GROUP/SPECIALTY RISK SERVS., Employer-Insurer.
WORKERS= COMPENSATION COURT OF APPEALS
SEPTEMBER 12, 2002
CAUSATION - TEMPORARY AGGRAVATION. Substantial evidence, including expert opinion, supported the compensation judge=s decision that the employee=s work injury was merely temporary.
Determined by Johnson, C.J., Wilson, J., Pederson, J.
Compensation judge: Carol A. Eckersen.
THOMAS L. JOHNSON, Judge
The compensation judge found the employee=s May 21, 2001, personal injury was temporary and she had recovered by September 21, 2001. Accordingly, the compensation judge granted the employer and insurer=s petition to discontinue benefits. The employee appeals. We affirm.
Kimberly Aspling, the employee, began working for Simmons Airlines, the employer, on July 10, 2000, as a station agent at the Duluth Airport. On May 21, 2001, the employee sustained a personal injury while loading cargo into an airplane. The employer and its insurer admitted liability for the employee=s personal injury and paid benefits to and on behalf of the employee.
On May 23, 2001, the employee saw Dr. Shawn P. McMahon, complaining of pain in the lumbar/thoracic region of her spine extending into the neck area, resulting from her work injury. On examination, Dr. McMahon found a diminished spinal range of motion with tenderness and mild spasm of the paraspinal muscles. The doctor diagnosed thoracolumbar strain with associated cervical neck pain, muscular in nature, and he prescribed physical therapy and released the employee to work, subject to restrictions. The employee returned to see Dr. McMahon on May 31, 2001, with continued complaints of spinal pain and intermittent right arm pain. The diagnosis remained persistent cervical thoracolumbar strain with a question of mild radiculopathy in the C5-6 dermatome on the left. Dr. McMahon ordered the physical therapy continued.
Dr. McMahon ordered an MRI scan of the cervical spine, which was performed on July 2, 2001. Dr. Passe interpreted the scan as normal except for a mild reversal of the normal cervical curvature with no significant degenerative disk disease. On July 2, 2001, the employee returned to see Dr. McMahon, reporting worsening symptoms including numbness in her arms and legs. Dr. McMahon noted the employee moved about the examination room very easily. Palpation of the employee=s neck did not elicit any significant spasm, and muscle strength testing of the extremities was normal, as was flexion and extension. The doctor reviewed the MRI scan and concluded the etiology of the employee=s symptoms was very difficult to determine. He then recommended a neurological consultation.
On July 6, 2001, the employee was examined by Dr. Richard Strand at the request of the employer and insurer. The doctor obtained a history from the employee, reviewed her medical records, and conducted a physical examination. Dr. Strand found no muscle spasm or tenderness in the cervical or lumbar spine, full range of spinal motion, and a normal neurological examination. The doctor diagnosed subjective complaints of pain without objective findings, reporting that he found no signs of any significant injury and that he recommended no further treatment. The doctor also opined that the employee had reached maximum medical improvement and had sustained no permanent partial disability. Finally, Dr. Strand concluded the employee could return to work without restrictions.
On July 26, 2001, the employee was seen by Dr. David McKee on referral from Dr. McMahon. At that time, the employee reported a dramatic spread of her symptoms, including neck and back pain, shooting pains into all four extremities, weakness, and migratory sensory loss and parasthesias. The doctor performed an EMG of the left arm and leg, which were normal, and his neurological examination was within normal limits. Noting that the employee had a very dramatic history, Dr. McKee nevertheless found nothing objectively wrong with her on physical examination and concluded she was neurologically healthy. Dr. McKee recommended the employee increase her activity level and ordered an x-ray, which showed mild thoracic scoliosis.
The employee returned to see Dr. McMahon on August 8, 2001, with continued complaints of back pain, primarily in the thoracic and lumbar regions, with symptoms of dysesthesia in the left arm and left leg. The doctor noted the employee moved about the examination room without difficulty and found a normal range of cervical motion, although the employee complained of pain with flexion and extension. Side bending was diminished bilaterally, but no spasm or muscular tenderness was noted. Dr. McMahon concluded that he was unable to find any physical evidence to support the employee=s subjective complaints, and he decided to refer the employee to Dr. Jed Downs, an occupational medical specialist, for further evaluation.
When the employee saw Dr. Downs on August 20, 2001, she gave a history of significant pain in the area of the thoracolumbar junction with numbness and shooting pains into her arms and legs. On examination, a standing flexion test and stork test on the right were positive. The doctor noted a right-sided dysfunction at C4 and dysesthesias with upper limb tension testing in a median nerve bias, and he recommended further physical therapy for immobilization and stabilization and ordered an MRI. An MRI of the lumbosacral spine was performed on August 28, 2001. Dr. Eckmann, the radiologist, reported the scan was negative with a normal-appearing thoracolumbar junction. The employee then received physical therapy at the Polinsky Rehabilitation Center, commencing on August 20, 2001.
The employee returned to see Dr. McMahon on September 5, 2001, reporting some slight improvement with the physical therapy. She stated she preferred not to return to work until her back was totally improved. On examination, the doctor noted that the employee moved about the examination room easily, palpation elicited no muscular spasm, and the employee=s range of motion was essentially normal. On September 11, 2001, the employee returned to see Dr. Downs. The doctor reviewed the MRI scan, which he interpreted as normal. His diagnosis was mechanical back pain with some associated spasm and irritability, and he recommended lumbar facet blocks. On September 26, 2001, Dr. Downs diagnosed thoracic TL junction mechanical back pain and continued work restrictions, which precluded loading cargo onto airplanes. The doctor recommended that the employee be off work. On October 3, 2001, Dr. McMahon examined the employee and found no spasm on palpation or other abnormalities, and he recommended the employee continue with her care with Dr. Downs.
On November 5, 2001, Dr. Downs recommended continued pilates exercises and work restrictions. On December 6 and December 24, 2001, Dr. Downs=s diagnosis of thoracolumbar sprain was unchanged, and he continued his light-duty work restrictions. By report dated November 8, 2001, Dr. Downs diagnosed an ongoing thoracic and lumbosacral sprain, which he attributed to the employee=s personal injury.
By report dated November 8, 2001, Dr. Downs diagnosed the employee with an ongoing thoracic and lumbosacral sprain. He concluded the most critical level was T12-L1, which demonstrated ligamentous instability with spasm. The doctor also stated the employee demonstrated mechanical restrictions of the pelvis and lumbar and upper thoracic spine. Dr. Downs opined that these conditions were substantially caused by the employee=s personal injury of May 21, 2001, and opined that the employee had a total of a 6% permanent partial disability as a result of her injury. The doctor felt the employee could work subject to a 20-pound lifting restriction, which was incompatible with her work duties with the employer.
On February 11, 2002, Dr. Strand reviewed the employee=s medical records generated subsequent to his initial evaluation of July 6, 2001. Following his review, the doctor concluded that the MRI scans were completely normal, and he opined that the October 2001 functional capacity evaluation was inconsistent. Dr. Strand concluded the additional medical records supported his opinion that his original examination in July 2001 was completely normal.
Following her personal injury, the employee returned to work with the employer, subject to restrictions. The employee was then off work from July 7 through September 1, 2001, and was paid temporary total disability benefits. She returned to work on September 22, 2001, and continued to work for the employer until she was terminated on October 21, 2001.
The employer and insurer filed a petition to discontinue workers= compensation benefits on December 12, 2001, and the case was heard by a compensation judge at the Office of Administrative Hearings on February 22, 2002. In a findings and order filed April 12, 2002, the compensation judge found the employee had a temporary injury on May 21, 2001, from which she had fully recovered by September 21, 2001. Accordingly, the compensation judge granted the petition to discontinue benefits. The employee appeals.
The compensation judge found the effects of the employee=s personal injury had ended by September 21, 2001. In reaching this conclusion, the judge specifically adopted the opinion of Dr. Strand that the employee could work without restrictions as of the date of his examination, on July 6, 2001. On appeal, the employee contends the opinions of Dr. Strand lack adequate foundation. Accordingly, the employee argues that the compensation judge improperly relied upon those opinions and asks this court to reverse the judge=s decision.
The competence of a witness to render expert medical testimony depends upon both the degree of the witness=s scientific knowledge and the extent of the witness=s practical experience with the matter at issue. Reinhardt v. Colton, 337 N.W.2d 88 (Minn. 1983). Dr. Strand examined the employee on July 6, 2001. As part of his evaluation, the doctor obtained a history from the employee, reviewed her medical records, and conducted a physical examination. As a general rule, this level of knowledge establishes a doctor=s competence to render an expert opinion. See Grunst v. Immanuel-St. Joseph Hosp., 424 N.W.2d 66, 40 W.C.D. 1130 (Minn.1988). Because we find no lack of foundation for the opinions of Dr. Strand, the compensation judge could properly rely upon them. The decision of the compensation judge is, therefore, affirmed.
 It is unclear why the compensation judge found the employee had recovered from her temporary injury by September 21, 2001, rather than July 6, 2001. The employee was, however, paid temporary total disability benefits during this period, so it is not important to the result here which date is used.