GISELE JONES, Employee, v. WAL-MART STORES, INC., and AIG/CMI, Employer-Insurer/Appellants.
WORKERS= COMPENSATION COURT OF APPEALS
SEPTEMBER 9, 2002
MEDICAL TREATMENT & EXPENSE - REASONABLE & NECESSARY. Substantial evidence supports the compensation judge=s finding that the proposed surgical release of the right long finger, the proposed MRI, and proposed psychological treatment were reasonable and necessary medical treatment.
Determined by Rykken, J., Johnson, C.J., Stofferahn, J.
Compensation Judge: Peggy A. Brenden.
MIRIAM P. RYKKEN, Judge
The employer and insurer appeal the compensation judge=s finding that the employee=s claimed medical expenses were reasonable and necessary, and causally related to the employee=s work injury. We affirm.
On April 8, 1997, Gisele Jones, the employee, sustained an overuse-type work injury to her right hand and right elbow while working as a department manager for Wal-Mart Stores, Inc., the employer, which was insured for workers= compensation liability by Insurance Company of the State of Pennsylvania, the insurer. The employee treated with Dr. Peter Russell at the Institute for Athletic Medicine, and was referred to Dr. Mark Urban, an orthopedic surgeon. The employee was treated with splints, cortisone injections, and casting, and underwent physical therapy. The employer and insurer accepted liability for this injury and paid various workers= compensation benefits. The employee was eventually able to return to work without restrictions.
On February 25, 2000, the employee was working an overnight shift, remodeling her department, which involved moving display shelves and wall displays. At the end of the shift, the employee experienced excruciating pain in her neck, right shoulder, elbow, and wrist, as well as burning and tingling in her right elbow with numbness into two fingers of her right hand. The employer and insurer accepted primary liability for this injury as well. The employee treated with Dr. Clare McCarthy, an orthopedic upper extremity specialist, and underwent physical therapy and cortisone injections. On October 16, 2000, Dr. McCarthy performed a right ulnar transposition surgery and a right carpal tunnel release surgery. After the surgery, the employee continued to have some pain and numbness. The employee was again referred to the Institute of Athletic Medicine, where a strengthening exercise resulted in a Atrigger finger@ condition of the employee=s right long finger. Dr. McCarthy indicated that a surgical release could relieve this condition, and prescribed an A1 pulley release. Dr. McCarthy also recommended an MRI of the right shoulder to determine whether the employee had a rotator cuff tear or lesion on the right shoulder. In addition, Dr. McCarthy referred the employee to Dr. Ronald Wutchiett for a psychological consultation for difficulty in coping with her injury and her resulting loss of function and inability to engage in some of her usual daily activities. Dr. Wutchiett recommended an initial trial of six sessions of individual psychotherapy.
At deposition, Dr. McCarthy testified that she had diagnosed the employee with ulnar neuropathy at the cubital tunnel, carpal tunnel syndrome, right shoulder impingement or bursitis, CMC arthritis, long finger stenosing tenosynovitis and clinical depression. Dr. McCarthy opined that the employee=s work activities with the employer were a substantial contributing cause of these conditions.
On July 23, 2001, the employee filed a medical request for authorization of the right trigger finger release surgery, an MRI of her right shoulder, and work conditioning and hardening programs. The employee later amended her claim to request authorization for six sessions with Dr. Wutchiett, a psychologist, for depression she claimed was causally related to her work injury. The employer and insurer objected, denying that the requested treatment was reasonable and necessary, and also denying that the treatment was causally related to the employee=s admitted work injuries.
A hearing was held on December 6, 2001. At the hearing, the parties stipulated that the employee sustained an admitted work injury on April 8, 1997, and:
On February 25, 2000, the employee sustained an admitted work injury at Wal Mart. The area injured was the right shoulder, aggravation of the right elbow and right wrist and a trigger finger condition in the right long finger.
The hearing record was held open for submission of an independent medical examination report. On December 11, 2001, the employee underwent an examination with Dr. William Call at the request of the employer and insurer. Dr. Call concluded that the employee had not sustained any work-related injury on February 25, 2000, and that the employee=s symptoms were subjective and within her control. Dr. Call diagnosed the employee=s April 8, 1997, injury as Asubjective discomfort about the right elbow with no objective evidence of pathology,@ and concluded that this injury resolved as of September 3, 1998, with no further need for medical treatment or work restrictions thereafter. Dr. Call concluded that the employee sustained no injury on February 25, 2000, but instead experienced a continuation of her previous subjective symptoms without objective pathology. Dr. Call found no objective reasons for permanent or temporary restrictions related to this second injury, and opined that the medical care and treatment the employee received after her second injury was not reasonable or necessary to cure and relieve her of the effects of any injury. He concluded as follows:
With respect to 4-8-97, the patient attributed subjective symptoms to her medical epicondylar area associated with lifting boxes. This would be consistent although there is no objective evidence of any pathology. With respect to 2-25-00, she indicated global discomfort associated with lifting boxes. Again, as noted above, these symptoms are totally within her own control and she can attribute them to whatever she wishes. If she attributes them to lifting boxes, I have no reason to dispute that. Nevertheless, there is no objective evidence of any injury associated with this activity either on 4-8-97 or 2-25-00.
(Er. Exh. 6.)
In Findings and Order served and filed January 10, 2002, the compensation judge found that the employee had sustained a work injury on February 25, 2000, in the nature of Aulnar neuropathy at the cubital tunnel, right carpal tunnel syndrome, right shoulder impingement or bursitis, right CMC arthritis and right long finger stenosing tenosynovitis.@ (Finding 1.) The compensation judge found that the proposed surgical release of the right long finger, the proposed MRI, and proposed psychological treatment were reasonable and necessary, but that the work hardening/conditioning programs were not currently reasonable and necessary. The employer and insurer appeal.
STANDARD OF REVIEW
On appeal, the Workers= Compensation Court of Appeals must determine whether Athe findings of fact and order [are] clearly erroneous and unsupported by substantial evidence in view of the entire record as submitted.@ Minn. Stat. ' 176.421, subd. 1. Substantial evidence supports the findings if, in the context of the entire record, Athey are supported by evidence that a reasonable mind might accept as adequate.@ Hengemuhle v. Long Prairie Jaycees, 358 N.W.2d 54, 59, 37 W.C.D. 235, 239 (Minn. 1984). Where evidence conflicts or more than one inference may reasonably be drawn from the evidence, the findings are to be affirmed. Id. at 60, 37 W.C.D. at 240. Similarly, A[f]actfindings are clearly erroneous only if the reviewing court on the entire evidence is left with a definite and firm conviction that a mistake has been committed.@ Northern States Power Co. v. Lyon Food Prods., Inc., 304 Minn. 196, 201, 229 N.W.2d 521, 524 (1975). Findings of fact should not be disturbed, even though the reviewing court might disagree with them, Aunless they are clearly erroneous in the sense that they are manifestly contrary to the weight of the evidence or not reasonably supported by the evidence as a whole.@ Id.
Minn. Stat. ' 176.135 requires the employer to furnish such medical treatment as may reasonably be required to cure and relieve the employee from the effects of the injury. An employee has the burden of proving that his or her claimed medical expenses were reasonable, necessary, and causally related to his or her work injury. See, e.g., Adkins v. University Health Care Ctr., 405 N.W.2d 233, 39 W.C.D. 898 (Minn. 1987). The reasonableness and necessity of medical treatment under Minn. Stat. ' 176.135 is a question of fact for the compensation judge. See Hopp v. Grist Mill, 499 N.W.2d 812, 48 W.C.D. 450 (Minn. 1993). In addition, questions of medical causation fall within the province of the compensation judge. Felton v. Anton Chevrolet, 513 N.W.2d 457, 50 W.C.D. 181 (Minn. 1994).
The compensation judge specifically rejected Dr. Call=s opinion that the employee=s symptoms were subjective and under her control, and emphasized that the employee=s testimony and treatment history indicated that the employee=s symptoms and resulting limitations were not under her control. Also, the compensation judge stated that Athe lack of objective findings is not a bar to recovery when the weight of the evidence proves the conditions at issue and care proposed are reasonable and necessary,@ citing Hatle v. Streater, 49 W.C.D. 377 (W.C.C.A. 1993), summarily aff=d (Minn. Dec. 2, 1993). The employer and insurer argue that the compensation judge improperly relied upon Hatle to exclude Dr. Call=s opinion from consideration, and therefore that the matter should be reversed and remanded. Dr. Call concluded that there was no injury on February 25, 2000, to which the employee=s work duties with the employer were a substantial contributing factor.
At the hearing, however, the employer and insurer stipulated that the employee had sustained an admitted work injury at Wal-Mart on February 25, 2000, and that the area injured was the right shoulder, aggravation of the right elbow and right wrist and a trigger finger condition in the right long finger. The employer and insurer now argue that the conditions found by the compensation judge, Aulnar neuropathy at the cubital tunnel, right carpal tunnel syndrome, right shoulder impingement or bursitis, right CMC arthritis and right long finger stenosing tenosynovitis@ require supporting objective findings and that the compensation judge erred by rejecting Dr. Call=s opinion. We disagree. The compensation judge did not erroneously rely upon the Hatle case to reject Dr. Call=s opinion. The compensation judge did not disregard Dr. Call=s opinion, as argued by the employer and insurer. Instead, the compensation judge made a choice between adequately founded expert medical opinions, the opinions of Dr. McCarthy and Dr. Call. It is the compensation judge's responsibility, as trier of fact, to resolve conflicts in expert testimony. Nord v. City of Cook, 360 N.W.2d 337, 342, 37 W.C.D. 364, 372 (Minn. 1985). As Dr. McCarthy=s opinions were adequately founded, the compensation judge did not err by relying upon those opinions in reaching her conclusion. Substantial evidence, including the employee=s testimony and Dr. McCarthy=s opinions, supports the compensation judge=s finding that the proposed surgical release of the right long finger, the proposed MRI, and proposed psychological treatment were reasonable and necessary medical treatment, and we affirm.