JAMES CARLSON, Employee, v. CITY OF MINNEAPOLIS, SELF-INSURED, Employer/Appellant.
WORKERS= COMPENSATION COURT OF APPEALS
JANUARY 8, 2003
CAUSATION - SUBSTANTIAL EVIDENCE. Substantial evidence, including the adequately founded opinion of the employee=s treating physician, supports the compensation judge=s finding that the employee=s November 13, 1997 personal injury caused or accelerated an onset of low back symptoms.
Determined by Johnson, C.J., Wilson, J. and Stofferahn, J.
Compensation Judge: John A. Ellefson
THOMAS L. JOHNSON, Judge
The self-insured employer appeals the compensation judge=s finding that the employee=s November 13, 1997 personal injury caused or accelerated an onset of symptoms in the employee=s low back. We affirm.
James Carlson, the employee, was involved in a non-work-related car accident in December 1993. The employee was then a police officer for the City of Minneapolis, the employer. A CT scan showed a free fragment herniated disc at L5-S1. In December 1994, the employee saw Dr. Phudhiphorn Thienprasit for a neurosurgical consultation. On examination, the doctor noted positive straight leg raising with left-sided leg pain radiating into the foot. Dr. Thienprasit later performed an L5-S1 hemilaminectomy on the left. On January 19, 1995, Dr. Thienprasit prescribed a conditioning program with home exercise, and believed the employee would be able to return to full-time duty by March 1995. Effective March 6, 1995, Dr. Gary B. Johnson released the employee to return to his job as a police officer, without restrictions. Thereafter, the employee had no further medical treatment for his low back until November 1997.
On November 13, 1997, the employee, while working for the employer as a police officer, was involved in an automobile accident. A car driven by the employee was struck by an oncoming car. The employee estimated his speed was 10 miles an hour and the other driver=s speed was 30 miles an hour. The self-insured employer admitted liability for a personal injury on that date.
On November 18, 1997, the employee saw Dr. Philip Oversten at the Allina Occupational Health Clinic complaining of neck pain radiating into the shoulders and headaches. The doctor diagnosed a cervical sprain/strain and prescribed physical therapy. On November 19, the employee saw a physical therapist at Abbott Northwestern Hospital and again complained of pain in the neck and upper back with constant headaches. Physical therapy was commenced. On November 25, 1997, the employee told Dr. Oversten he continued to have aching discomfort in the base of his neck bilaterally into the shoulder blades. Dr. Oversten diagnosed a neck and mid-back sprain/ strain. On December 10, 1997, the employee saw Dr. Daniel Feely at Golden Valley Family Physicians complaining of a sore neck following the car accident. The employee stated his neck had improved but was still somewhat stiff and sore. He denied any other joint problems. Dr. Feely also diagnosed a cervical strain.
The employee next saw Dr. Oversten on February 17, 1998, and stated his upper back and neck pain had resolved but noted a gradual onset of low back pain over the past month. The employee gave Dr. Oversten a history of his 1993 injury followed by a laminectomy and stated he recovered with no restrictions. The doctor diagnosed mechanical low back pain which he found consistent with the 1993 injury. The doctor prescribed further physical therapy. On February 20, 1998, the physical therapist at Abbott Northwestern Hospital saw the employee and recorded a history of the November 13, 1997 motor vehicle accident followed by significant upper back and neck problems. The employee stated approximately one month ago his low back Awent out@ with subsequent bilateral low back stiffness with pain into his right knee and thigh. Physical therapy was again instituted. The employee returned to see Dr. Oversten on May 5, 1998, with continued complaints of low back pain radiating into the right buttock. The doctor again diagnosed mechanical low back pain and stated it was unknown whether this was related to the November 13, 1997 injury. However, based on the employee=s recovery from his 1993 injury, the doctor found no direct relationship between the employee=s low back pain and that injury. The doctor did note, however, the employee had significant degenerative disc disease at L5-S1.
On February 22, 2001, the employee saw Dr. John G. Stark with complaints of back pain. The employee gave the doctor a history of a previous laminectomy in 1994 from which he recovered until his November 13, 1997 car accident. The employee believed his low back symptoms were caused or aggravated by the 1997 injury. Dr. Stark diagnosed a probable annular tear or degeneration following a disc herniation aggravated by a motor vehicle accident. By report dated May 10, 2001, the doctor opined the employee=s November 13, 1997 injury was a substantial contributing cause of his need for medical treatment thereafter, and opined the employee was in need of a single level L5-S1 lumbar fusion. Dr. Stark further opined the employee=s pre-existing lumbar injury was aggravated in the motor vehicle accident of November 13, 1997, as substantiated by the employee=s new onset of back and leg symptoms related in the medical records. In a report dated October 11, 2001, Dr. Stark stated, AThe patient had a motor vehicle accident on that date [November 13, 1997] and was made suddenly and permanently worse. It is true that he had some preoperative complaint, but this was in the distant past and he was feeling well and normal until the November 1997 accident.@ (Pet. Ex. A.) The doctor concluded that while the employee had pre-existing changes in his back, he suffered a permanent aggravation as a result of the 1997 injury.
On July 10, 2001, the employee was examined by Dr. Paul T. Wicklund at the request of the self-insured employer. As part of his examination, Dr. Wicklund reviewed the contemporaneous medical records and concluded there was no indication in any of the immediate medical records of any irritation or aggravation to the employee=s low back following his 1997 injury. Accordingly, Dr. Wicklund concluded the 1997 injury did not cause the employee=s need for low back treatment after 1997. Rather, Dr. Wicklund opined the employee was predisposed to low back problems because of a congenital condition, the prior L5-S1 surgery and a degenerative disc problem. The doctor concluded the employee did not sustain a lumbar spine injury in the 1997 car accident. Had the employee injured his low back in 1997, Dr. Wicklund stated he would have expected the employee to have low back symptoms within two to three weeks of the date of the injury.
The employee filed a claim petition seeking payment of temporary total disability benefits as a result of his injury on November 13, 1997. The case was heard by a compensation judge at the Office of Administrative Hearings on November 1, 2001. In a Findings and Order served and filed November 14, 2001, the compensation judge found the employee=s November 13, 1997 injury caused or accelerated the onset of symptoms for the employee=s low back condition and awarded benefits. The self-insured employer appealed. By decision dated June 3, 2002, the Workers= Compensation Court of Appeals vacated the compensation judge=s Findings and Order and remanded the case to the compensation judge for further findings. In a second Findings and Order filed August 15, 2002, the compensation judge again found the November 13, 1997 personal injury caused or accelerated the onset of symptoms for the employee=s low back condition and again awarded benefits. The self-insured employer appeals.
The self-insured employer contends the compensation judge=s finding that the employee=s November 13, 1997 injury caused or accelerated an onset of low back symptoms is unsupported by substantial evidence. The appellant argues that the medical records document no ongoing complaints of low back pain by the employee until February 17, 2001. Based, in part, on the contemporaneous medical records, Dr. Wicklund opined the personal injury did not cause the employee=s need for low back treatment. The appellant contends that only the opinions of Dr. Wicklund are supported by the evidence and the compensation judge=s decision should be reversed. We disagree.
It is the compensation judge=s responsibility as the trier of fact to resolve conflicts in expert testimony. A trier of fact=s choice between experts whose testimony conflicts is generally upheld unless the facts assumed by the expert in rendering his opinion are not supported by the evidence. See Nord v. City of Cook, 360 N.W.2d 337, 37 W.C.D. 364 (Minn. 1985). Dr. Stark opined the employee=s work-related car accident of November 13, 1997 was a substantial contributing cause of the employee=s subsequent need for low back treatment and a lumbar fusion. The appellant asserts, however, that Dr. Stark=s opinions are based on erroneous assumptions, incorrect information and an inadequate knowledge of the employee=s medical history. The appellant, therefore, contends Dr. Stark=s opinions lack foundation and the compensation judge erroneously relied upon them. Accordingly, the employer seeks a reversal of the compensation judge=s award of benefits.
In his letter report of May 10, 2001, Dr. Stark maintained his conclusion was Aclearly substantiated by the patient=s new onset of back and leg symptoms, which are related in the historical record to the injury of that date. This is strongly suggested by contemporaneous records.@ (Pet. Ex. A.) The appellant points out the first recorded complaint by the employee of low back pain was not until February 17, 1998, approximately three months after the accident. The employee testified he provided Dr. Stark with copies of his Apre-existing medical records.@ (T. at 61.) However, the appellants observe, neither the employee nor Dr. Stark specifically identified which records he reviewed. Thus, Dr. Stark=s opinions are, the appellant contends, based upon a faulty history and erroneous assumptions. We are not persuaded.
Dr. Stark began treating the employee on February 22, 2001, at which time he received a history of the employee=s prior laminectomy by Dr. Thienprasit. Further, the employee prepared a lengthy questionnaire which described in some detail his prior medical history and treatment. The doctor then performed a complete orthopedic examination The employee testified he provided his medical records to Dr. Stark. In addition, Dr. Stark reviewed Dr. Wicklund=s July 10, 2001 examination report which summarized the employee=s prior medical history. As a general rule, this level of medical expertise and practical experience establishes competency to provide an expert medical opinion. See Reinhardt v. Colton, 337 N.W.2d 88 (Minn. 1983).
In addition, the employee testified to an immediate onset of low back pain and leg pain following the November 1997 car accident. (T. 48, 81, 93.) The employee testified he initially thought the pain would go away but it began to worsen in December 1997 and he ultimately decided to seek treatment. (T. 113-14.) By the beginning of 1998, the employee testified the low back and leg pain began to affect his job performance and daily activities. In an unappealed finding, the compensation judge found the employee=s testimony was credible.
The employee=s testimony of an immediate onset of back and leg symptoms following the 1997 injury is consistent with and provides adequate support for Dr. Stark=s conclusion that the injury was a contributing cause of the employee=s subsequent need for low back medical care. The doctor examined and treated the employee and was familiar with his medical history. Given the evidence in this case, we must conclude Dr. Stark=s opinions were adequately founded and the compensation judge could reasonably rely upon them. See Grunst v. Immanuel-St. Joseph=s Hosp., 424 N.W.2d 66, 40 W.C.D. 1130 (Minn. 1988). The decision of the compensation judge is, therefore, affirmed.
 The doctor erroneously referred to a work-related injury in 1994.